Thymic carcinoid tumor is a rare mediastinal tumor, which was firstly described by Rosai and Higa in 1972. A carcinoid tumor of the thymus has recently been regarded as a distinct tumor from thymoma, and is probably Kultschizky cell origin. The pathologic diagnosis of thymic carcinoid is made from findings from light microscopy, immunohistochemical studies and electron microscopy. About 50% of thymic carcinoids were seen with endocrinopathies. Recurrences and extrathoracic metastasis are characteristics of thymic carcinoids. Surgical removal of the intial and tumor recurred are considered to be the most effective treatment today. However, the role of the adjuvant radiotherapy and the chemotherapy is still uncertain. Herein we report a case of thymic carcinoid tumor, which was confirmed by operation and pathologic study.
Carcinoid Tumor* ; Diagnosis ; Drug Therapy ; Mediastinal Neoplasms ; Microscopy ; Microscopy, Electron ; Neoplasm Metastasis ; Radiotherapy, Adjuvant ; Recurrence ; Thymoma ; Thymus Gland ; Thymus Neoplasms

Leiomyosarcoma (LMS) within the scrotum is a rare malignant genitourinary tumor in adults. Due to its rarity, a consensus on a clear approach to diagnosis and treatment guidelines has not yet been reached. We present a case of a paratesticular LMS in a 64-yearold man with a painless swelling of the right scrotum. Scrotal ultrasound and pelvic MRI were performed and revealed an extratesticular mass with a heterogeneous appearance.The patient underwent a right radical orchiectomy, and the mass was confirmed to be LMS, originating from the right spermatic cord. Preoperative diagnosis of LMS is challenging since it has overlapping clinical and imaging features with other sarcomas. MRI is a valuable imaging modality for the definitive characterization of the tumor. To provide timely and appropriate treatment, the correlation of the patient’s clinical information and imaging findings is necessary.

Foreign bodies of the upper gastrointestinal tract are usually discovered in children, persons with esophageal disease, prisoners with a purpose of secondary gain, and mentally disturbed or disabled individuals. In adults, accidentally or intentionally ingested foreign bodies such as dentures, coins, corks, toothbrush, needles, and nails are reported. To our knowledge, there has been one case of gastric bezoar caused by glue ingestion that was removed by surgical operation in Korea. However, there has been no case report of esophageal foreign body caused by glue ingestion neither in Korea nor elsewhere. We report a case of a man with a history of chronic glue inhalation, who ingested glue with suicidal intent, that was solidified from the upper esophagus to the stomach. It was successfully removed by therapeutic endoscopy.
Adhesives* ; Adult ; Bezoars ; Child ; Dentures ; Eating* ; Endoscopy ; Esophageal Diseases ; Esophagus ; Foreign Bodies* ; Humans ; Inhalation ; Intention ; Korea ; Needles ; Numismatics ; Prisoners ; Prisons ; Stomach ; Upper Gastrointestinal Tract

A pathologic splenic rupture is rare, occurring primarily in a spleen affected by infective, hematological, and neoplastic disease. To the best of our knowledge, no prior reports of a pathologic splenic rupture due to scrub typhus exist. Intrasplenic pseudoaneurysms and focal infarctions are visible on an initial CT scan. Moreover, the spontaneous splenic rupture occurred a week later. We report a case of nontraumatic-splenic rupture in a patient with scrub typhus.
Aneurysm, False ; Humans ; Infarction ; Rupture ; Scrub Typhus ; Spleen ; Splenic Rupture ; Typhus, Endemic Flea-Borne

PURPOSE: Maxillary bone grafts and implantations have increased over recent years despite a lack of maxillary bone quality and quantity. The number of patients referred for oroantral fistula (OAF) due to implant or bone graft failure has increased, and in patients with an oroantral fistula, the pedicled buccal fat pad is viewed as a robust, reliable option. This study was conducted to document the usefulness of buccal fat pad grafts for oroantral fistula closure. MATERIALS AND METHODS: We retrospectively studied 25 patients with OAF treated with a buccal fat pad graft from 2015 to 2018. Sex, age, OAF location, cause, duration, presence of systemic disease, smoking, previous dental surgery, and side effects were investigated. RESULTS: A total of 25 patients were studied. Mean patient age was 54.8 years, and the male to female ratio was 19:6. Causes of oroantral fistula were cyst enucleation, tumor resection, implant removal, bone graft failure, and extraction. Excellent results were obtained in 23 (92%) of the 25 patients. In the other two patients that both smoked, a small fistula was observed during follow-up. No recurrence of oroantral fistula was observed after 2 months to 1 year of follow-up. CONCLUSIONS The incidence of oroantral fistula is increasing due to implant and bone graft failures. Oroantral fistula closure using a pedicled buccal fat pad was found to have a high success rate.

BACKGROUND/AIMS: Polyethyleneglycol (PEG) is safe but its large volume and bad taste reduces patients' compliance. Sodium phosphate (NaP) is a hyperosmotic agent and its small volume can increase patients' compliance but electrolyte imbalance is a problem. Therefore, we conducted a study to determine whether patients' compliance can be enhanced and electrolyte imbalance reduced by combining these two agents. METHODS: Forty-one admitted patients receiving colonoscopy at Korea University Hospital from June 28, 2004 to August 14, 2004 were randomly divided into two groups for colon cleansing with either PEG 4 L (n=21) or PEG 2 L plus NaP 45 mL (n=20). Patients were assessed for patient tolerance, quality of preparation, and changes of biochemical parameters. RESULTS: Overall discomfort was statistically lower in the combination group, PEG 2 L plus NaP 45 mL (p=0.035). Although patients in the combination group reported less fullness (p=0.076) and nausea (p=0.087), the findings were not statistically significant. The quality of the preparation was comparable between the two groups (p=0.872). The phosphorus level in the combination group showed a statistically significant increase (0.58+/-0.46) after colon cleansing (p=0.020) but was not clinically significant. CONCLUSIONS: The combination of NaP 45 mL and PEG 2 L showed less overall discomfort with comparable quality of preparation and without serious electrolyte abnormality compared to 4 L of PEG. Therefore, the combination of NaP 45 mL and PEG 2 L could be used as an alternative colonoscopic colon cleansing agent when patients have trouble taking 4 L of PEG alone.
Colon* ; Colonoscopy* ; Compliance ; Detergents ; Humans ; Korea ; Nausea ; Phosphorus ; Prospective Studies* ; Sodium*

BACKGROUND/AIMS: Recently, treatment using an endoscopic device is actively being developed. Techniques for incision and bleeding control have been developed, but endoscopic suturing remains to be perfected. Using an endoscopic suturing technique, a variety of diseases could be managed noninvasively. We have attempted to use a new endoscopic suturing device which enables a continuous suture using a flexible upper endoscope. METHODS: A suturing device was designed where a semicircular needle could sew through tissue by rotation making a continuous suture possible. RESULTS: We successfully sutured the stomach tissue of a dog using an optimized suturing device model. CONCLUSIONS: The initial model was found to have some problems. However, we hope to develop a continuous suturing device for flexible upper endoscope procedures in Korea.
Animals ; Dogs ; Endoscopes ; Endoscopes, Gastrointestinal* ; Endoscopy ; Hemorrhage ; Hope ; Korea ; Needles ; Stomach ; Sutures*

Crohn's disease is a chronic inflammatory bowel disease which affects mainly children and young adults, and its cause remains unknown so far. Infliximab, a monoclonal antibody to the pivotal cytokine tumor necrosis factor-alpha, has been approved as a drug for both induction and maintenance therapy for moderately to severely active, or fistula-complicated Crohn's disease. The authors report a 12-year-old male patient diagnosed as Crohn's disease complicated with a perianal fistula, which was refractory to the conventional therapy. After the 0, 2, and 6 week scheduled intravenous infusion of infliximab, the patient reached to clinical remission in both subjective symptoms and objective manifestations. For children or young adults who develop Crohn's disease in a refractory course, infliximab may serve as a drug which leads to a clinical improvement or even to an extent of remission.
Antibodies, Monoclonal/*administration & dosage ; Child ; Crohn Disease/*drug therapy ; Drug Administration Schedule ; English Abstract ; Gastrointestinal Agents/*administration & dosage ; Humans ; Infusions, Intravenous ; Male

The Cronkhite-Canada Syndrome (CCS) is a monfamilial disorder of adults characterized by diffuse gastro-intestinal polyposis, ectodermal changes consisting of alopecia, dystrophy of nails and cutaneous hyper-pigmentation. The pathogenesis and the causes of CCS remain unknwon but the symptoms such as diarrhea and malnutrition are generally progressive, and the prognosis is knwon to be poor. Though the definitive treatment is not well known, it has been reported that the conservative management is the most important treatment, and that the clinical sourse can be reversible. One case was experienced involving Cronkhite-Canada Syndromen in a patient who was managed by conservative treatment and an other who was treated by corticosteroid. These two cases are reported herein with a review of corresponding literature.
Adult ; Alopecia ; Canada* ; Diarrhea ; Ectoderm ; Humans ; Intestinal Polyposis ; Malnutrition ; Prognosis

Postganglionic cholinergic dysautonomia is a rare disease characterized by impaired secretion of tears and saliva, generalized absence of sweating, lack of cardiac response to carotid massage and atony of the gastrointestinal tract and urinary bladder. Autonomic function tests show the preservation of sympathetic adrenergic functions in contrast to the generalized involvement of postganglionic parasympathetic and sympathetic cholinergic nerves. Recently, we experienced a patient with gut dysmotility in selective postganglionic cholinergic dysautonomia. She is now being treated with bethanechol and milk of magnesia and has experienced minimal symptom improvement.
Bethanechol ; Gastrointestinal Tract ; Humans ; Magnesium Oxide ; Massage ; Milk ; Primary Dysautonomias* ; Rare Diseases ; Saliva ; Sweat ; Sweating ; Tears ; Urinary Bladder