PURPOSE: To report a case of visual field defect and optic atrophy in a patient with periventricular leukomalacia. CASE SUMMARY: A 22-year-old woman was referred to our hospital for further glaucoma evaluation. She was diagnosed with normal tension glaucoma by her local ophthalmologist. Best corrected visual acuity and intraocular pressure were 1.0 and 16 mm Hg in both eyes, respectively. Fundus examination showed a cup disc ratio of 0.36 in the right eye and 0.34 in the left eye. However, the optic disc had temporal pallor. Red-free photograph and optical coherence tomography showed supratemporal retinal nerve fiber layer atrophy. Visual field examinations revealed inferior visual field defect in both eyes. The patient was born at 34 weeks of gestation with a birth weight of 1600 g. Brain magnetic resonance imaging (MRI) showed periventricular leukomalacia. CONCLUSIONS: The author presents a case of periventricular leukomalacia with inferior visual field defect and optic atrophy in a patient who was previously diagnosed with glaucoma. If non-specific clinical features that differ from typical glaucomatous clinical features are observed in a patient with a history of prematurity, a brain MRI can aid the diagnosis.
Atrophy ; Birth Weight ; Brain ; Eye ; Female ; Glaucoma ; Humans ; Infant, Newborn ; Intraocular Pressure ; Leukomalacia, Periventricular ; Low Tension Glaucoma ; Magnetic Resonance Imaging ; Nerve Fibers ; Optic Atrophy ; Pallor ; Pregnancy ; Retinaldehyde ; Tomography, Optical Coherence ; Visual Acuity ; Visual Fields

No abstract available.
Splenectomy*

OBJECTIVE: Despite the increasing number of female participation in employment, blue-collar women have been exposed to higher health risk. This study is to describe the prevalence of chronic diseases, health behaviors, and medical service utilization of female blue-collar workers. METHODS: Data were derived from the 2001 Korea National Health and Nutrition Survey (KNHANES). The sample was made up of 37,108 male and female participants aged 20 or over selected nation-wide by probability sampling from Korea. This study applied the logistic regression for nominal variables such as disease prevalence and health behaviors and with the regression for continuos variables such as the length and costs of medical services. RESULTS: In general, women's prevalence of chronic illness and uncured rate were significantly higher than male, and especially female blue-collar workers had the highest prevalence, uncured rate, unhealthy status, and perceived stress. However, the medical care cost was the lowest in female blue-collar workers. CONCLUSIONS: The findings suggest that female blue-collar workers were more likely to experience health problems, and that despite the highest health risk, health service is not effectively utilized, and health policy maker should take consider of special status of female blue collar workers who are in health inequality.
Aged ; Chronic Disease ; Employment ; Female ; Health Behavior ; Health Care Costs ; Health Policy ; Health Services ; Humans ; Korea ; Logistic Models ; Male ; Nutrition Surveys ; Prevalence ; Socioeconomic Factors ; Women's Health

Bougie or balloon dilation is a good short-term treatment for caustic esophageal strictures, although recurrence after dilation occurs in approximately 30% of these cases. Therefore, long-term treatment options are required in some cases, and endoscopic incisional therapy has been used for patients with an anastomotic stricture in the gastrointestinal tract. A 58-year-old woman presented with severe swallowing difficulty because of a caustic esophageal stricture, which was caused by accidental exposure to anhydrous acetic acid at infancy. She had undergone several previous bougie and balloon dilations but the stricture did not improve. We performed sequential treatment comprising incision with an insulated-tip knife, balloon dilation, and an oral steroid, which resulted in the patient’s symptoms markedly improving. Thus, we report this case of an intractable caustic esophageal stricture, which was successfully treated using combined endoscopic sequential treatment.
Acetic Acid ; Caustics ; Constriction, Pathologic ; Deglutition ; Deglutition Disorders ; Dilatation ; Esophageal Stenosis* ; Female ; Gastrointestinal Tract ; Humans ; Middle Aged ; Recurrence

Multiple endocrine neoplasia type 1 (MEN1) syndrome is a relatively rare disease, characterized by the occurrence of multiple endocrine tumors in the parathyroid and pituitary glands as well as the pancreas. Here, we report a case of MEN1 with neuroendocrine tumors (NETs) in the stomach, duodenum, and pancreas. A 53-year-old man visited our hospital to manage gastric NET. Five years prior to his visit, he had undergone surgery for incidental meningioma. His brother had pancreatic nodules and a history of surgery for adrenal adenoma. His brother's daughter also had pancreatic nodules, but had not undergone surgery. The lesion was treated by endoscopic submucosal dissection and diagnosed as a grade 1 NET. Another small NET was detected in the second duodenal portion, resected by endoscopic submucosal dissection, which was also diagnosed as a grade 1 NET. During evaluation, three nodules were detected in the pancreas, and no evidence of pituitary, parathyroid tumors, or metastasis was observed. After surgery, the pancreatic lesions were diagnosed as NETs, with the same immunohistochemical patterns as those of the stomach and duodenum. Genetic testing was performed, and a heterozygous mutation was detected in the MEN1 gene, which is located on 11q13.
Adenoma ; Duodenum* ; Endoscopy ; Genetic Testing ; Germ-Line Mutation ; Humans ; INDEL Mutation ; Meningioma ; Middle Aged ; Multiple Endocrine Neoplasia Type 1* ; Neoplasm Metastasis ; Neuroendocrine Tumors* ; Nuclear Family ; Pancreas* ; Pituitary Gland ; Rare Diseases ; Siblings ; Stomach*

PURPOSE: A sensitive assay to detect minimal residual disease (MRD) in neuroblastoma (NBL) is necessary for accurate assessment of disease status and optimal treatment. Reverse transcriptase-polymerase chain reaction (RT-PCR) for tyrosine hydroxylase (TH) mRNA was developed to detect minimal residual NBL cells. METHODS: Thirteen patients with stage I to IV NBL and one healthy donor were included in this study. Samples for bone marrow (BM) and peripheral blood (PB) were obtained at diagnosis, during treatment, and during follow-up after completion of treatment, and were examined for TH mRNA with RT-PCR. RESULTS: TH mRNA was detected in NBL cell line and cells obtained from BM with cytologic tumor invasion, but was not detected in normal PB mononuclear cells (MNC). Occult NBL cells were detected at a level of 1 for 105~6 normal PB MNC by this method. TH mRNA was detected in 13 of 28 BM or PB samples. TH mRNA came to be not detected after administration of chemotherapeutic agent. TH mRNA was detected in 1 PB sample harvested for transplantation and was detected in 2 of 5 PB samples obtained from patients who were transplanted with autologous PB stem cells in partial response (PR) state. TH mRNA was not detected in patient transplanted in complete response (CR) state. In recent examinations, TH mRNA was detected in 1 of 7 CRs and in 2 of 6 PRs. CONCLUSION: RT-PCR for TH mRNA was a sensitive method to detect minimal residual NBL cells. This method can be used to evaluate initial disease status, response to treatment, time to collect stem cells for transplantation, suitability of cellected stem/progenitor cells and to detect relapse early. But the clinical significances of TH mRNA detected by this method require further investigation.
Bone Marrow ; Cell Line ; Diagnosis ; Follow-Up Studies ; Humans ; Neoplasm, Residual ; Neuroblastoma* ; Recurrence ; RNA, Messenger* ; Stem Cells ; Time-to-Treatment ; Tissue Donors ; Transplantation ; Tyrosine 3-Monooxygenase* ; Tyrosine*

While esophagogastric varices are common manifestations of portal hypertension, variceal bleeding from the jejunum is a rare complication of liver cirrhosis. In addition, ectopic variceal bleeding occurs in the duodenum and at sites of previous bowel surgery in most cases, including of stomas. We report a case of obscure overt gastrointestinal bleeding from jejunal varices in a 55-year-old woman who had not previously undergone abdominal surgery, who had liver cirrhosis induced by the hepatitis C virus. Emergency endoscopy revealed the presence of esophageal varices without stigmata of recent bleeding, and no bleeding focus was found at colonoscopy. She continued to produce recurrent melena with hematochezia and received up to 21 units of packed red blood cells. CT angiography revealed the presence of jejunal varices, but no active bleeding was found. Capsule endoscopy revealed fresh blood in the jejunum. The patient submitted to embolization of the jejunal varices via the portal vein, after which she had a stable hemoglobin level and no recurrence of the melena. This is a case of variceal bleeding from the jejunum in a liver cirrhosis patient without a prior history of abdominal surgery.
Angiography ; Capsule Endoscopy ; Embolization, Therapeutic ; Esophageal and Gastric Varices/complications/diagnosis ; Female ; *Gastrointestinal Hemorrhage ; Humans ; Hypertension, Portal ; Jejunal Diseases/*diagnosis/therapy ; Liver Cirrhosis/*diagnosis ; Melena/complications ; Middle Aged ; Tomography, X-Ray Computed

Albendazole binds to parasite's tubulin inhibiting its glucose absorption. Its common adverse effects are nausea, vomiting, constipation, thirst, dizziness, headache, hair loss and pruritus. Although mainly metabolized in the liver, abnormal liver function tests were a rare adverse effect during clinical trials and we found no literature about albendazole-induced hepatitis requiring admission. This patient had a previous history of albendazole ingestion in 2002 resulting in increase of liver function tests. And in 2005, the episode repeated. We evaluated the patient for viral hepatitis, alcoholic liver disease, and autoimmune hepatitis, but no other cause of hepatic injury could be found. Liver biopsy showed periportal steatosis and periportal necrosis. The initial abnormal liver function test improved only with supportive care. These findings and the Roussel Uclaf Causality Assessment Method of the Council for International Organizations of Medical Sciences (RUCAM/CIOMS) score of 9 are compatible with drug-induced hepatitis so we report the case of this patient with a review of the literature.
Albendazole/*adverse effects ; Antiprotozoal Agents/*adverse effects ; Eosinophils/metabolism ; Glucose/metabolism ; Hepatitis, Toxic/*diagnosis ; Humans ; Liver/drug effects ; Liver Function Tests ; Male ; Middle Aged ; Necrosis

Brunnera's gland hyperplasia is a benign tumor of the duodenum and it is rarely associated with clinical symptoms. We report on a 64-yr-old man with Brunnera's gland hyperplasia who had undergone a duodenocephalo-pancreatectomy. The reason is that he presented upper gastrointestinal obstructive symptoms and the esophagogastroduodenoscopic finding revealed the lesion to be an infiltrating type mass on the second portion of the duodenum with luminal narrowing. An abdominal computed tomography showed a 2.5 cm-sized mass in the duodenal second portion with a suspicious pancreatic invasion and 7 mm-sized lymph node around the duodenum. Duodenocephalopancreatectomy was successfully performed. Histological examination revealed a Brunnera's gland hyperplasia. The final diagnosis was the coexistence of Brunnera's gland hyperplasia and pancreatic heterotopia with a pancreatic head invasion. The literature on Brunnera's gland hyperplasia is reviewed.
Brunner Glands/*pathology/radiography ; *Choristoma ; Diagnosis, Differential ; Duodenal Neoplasms/*pathology/radiography/surgery ; Duodenum/pathology/radiography ; Endoscopy, Gastrointestinal ; Humans ; Hyperplasia ; Male ; Middle Aged ; Pancreatic Diseases/*pathology/radiography ; Pancreaticoduodenectomy ; Severity of Illness Index ; Tomography, X-Ray Computed

Cronkhite-Canada syndrome (CCS) is a rare nonfamilial polyposis syndrome characterized by epithelial disturbances both in the gastrointestinal tract and in the epidermis. The pathologic finding of the polyp is usually a hamartomatous polyp of the juvenile type; however, the possibility of serrated adenoma associated malignant neoplasm was reported in some Japanese cases. Up till now in South Korea, 13 CCS cases have been reported, but there was no case accompanied by the colon cancer. We report the first case of CCS associated with malignant colon polyp and serrated adenoma in Korea. A 72-year-old male patient who complained of diarrhea and weight loss was presented with both hands and feet nail dystrophy, hyperpigmentation, and alopecia. Endoscopic examination showed numerous hamartomatous polyps from the stomach to the colon. The pathologic results confirmed colon cancer and serrated adenoma. Helicobacter pylori eradication and prednisolone was used. Thus, the authors report this case along with a literature review.
Adenoma ; Alopecia ; Asian Continental Ancestry Group ; Colon ; Colonic Neoplasms ; Diarrhea ; Epidermis ; Foot ; Gastrointestinal Tract ; Hand ; Helicobacter pylori ; Humans ; Hyperpigmentation ; Intestinal Polyposis ; Korea ; Male ; Nails ; Polyps ; Prednisolone ; Republic of Korea ; Stomach ; Weight Loss