We report a case of primary mucosa-associated lymphoid tissue (MALT) lymphoma in the esophagus that manifested as a large submucosal tumor (SMT). Primary esophageal lymphoma is very rare, occurring in less than 1% of all patients with gastrointestinal lymphoma. Only a few cases of MALT lymphoma in the esophagus have been reported in the English literature. A 53-year-old man was referred to Dongguk University Ilsan Hospital (Goyang, Korea) in July 2012 for further evaluation and treatment of an esophageal SMT. Endoscopy showed a cylindrically elongated submucosal mass with normal overlying mucosa in the mid esophagus, 25-30 cm from the incisor teeth. He underwent surgery to confirm the diagnosis. Pathologic findings showed diffuse small atypical lymphoid cells which were stained with Bcl-2, CD20, but not with CD3, CD5, CD23, Bcl-6, or cyclin D1. These cells showed a positive monoclonal band for immunoglobulin heavy chain gene rearrangement. Based on the pathological, immunohistochemical, and molecular biological features, the esophageal mass was diagnosed as extranodal marginal zone B-cell lymphoma of the MALT type.
Antigens, CD20/metabolism ; Bone Marrow/pathology ; Esophageal Neoplasms/*diagnosis/pathology/surgery ; Gastroscopy ; Humans ; Immunohistochemistry ; Lymphoma, B-Cell, Marginal Zone/*diagnosis/pathology/surgery ; Male ; Middle Aged ; Mucous Membrane/pathology ; Proto-Oncogene Proteins c-bcl-2/metabolism ; Tomography, X-Ray Computed

No abstract available.
Adult ; Colon, Transverse/radiography ; Colonoscopy ; Fibrosis/pathology ; Gastrointestinal Hemorrhage ; Humans ; Intestinal Mucosa/pathology/*surgery ; Male ; Pneumatosis Cystoides Intestinalis/*diagnosis/surgery ; Tomography, X-Ray Computed

Norcardia is an aerobic, gram-positive, AFB positive filamentous organism which is frequently branching. Nocardial infection is usually opportunistic and is found in immunosuppressed patients during transplantation or anti-cancer chemotherapy. With the increasing number of AIDS, nocardial infection have been increasingly recognized as a serious human infection. Among patients on peritoneal dialysis, Nocardia is a rare cause of peritonitis : only one case has been reported in Korea. It is extremely important to make an early and correct diagnosis and treatment with susceptible antibiotics. We report here a case of nocardial peritonitis associated with Continuous Ambulatory Peritoneal Dialysis(CAPD) which was resistant to trimethoprim/sulfamethoxazole and has treated successfully with imipenem and amikacin.
Amikacin ; Anti-Bacterial Agents ; Diagnosis ; Drug Therapy ; Humans ; Imipenem ; Korea ; Nocardia ; Peritoneal Dialysis ; Peritoneal Dialysis, Continuous Ambulatory* ; Peritonitis*

The purpose of this study was to identify nursing diagnoses and nursing interventions that are found in the home health care patients, and to establish a basis for a standardized Nursing Intervention List that would help nurses doing home health care nursing. For this study, the records of 150 home health care clients who were discharged, from the Home Health Care Center at Yonsei Medical Center, between January to July, 2001 were analyzed. Of the 43 nursing diagnoses recorded for these clients are 43, the most frequent diagnoses were in the area of Exchanging. There were 2,814 nursing interventions which is a mean of 4.73 nursing interventions per diagnosis. We confirmed that most of the interventions were related to 'education' and 'advice'. We present a Home Health Care Nursing Intervention List that was developed based on the results of this study. It has the five 5 criteria of the ICNP classification, Observing, Management, Performance, Caring, and Informing.
Classification ; Delivery of Health Care ; Diagnosis ; Home Health Nursing* ; Humans ; Nursing ; Nursing Diagnosis

Substantial ACL ruptures are not common in adolescence or childhood. During this period, ACL tibia avulsion fractures are more common than substantial ACL ruptures are. However, recent advancements in MRI and increases in adolescent sports activity have led to increased diagnosis of substantial ACL ruptures. Many physeal-sparing ACL reconstruction methods have been reported. However, some physeal-sparing ACL reconstructions are associated with poor outcomes because of laxity in the reconstructed ligament and discordance in the isometric point. We report a 14-year-old male patient with a chronic substantial ACL rupture and a longitudinal medial meniscus tear who was treated with ACL reconstruction and all-inside meniscal repair, which spares the femoral physis and reduces tibia physeal injury with an Achilles allograft.
Adolescent ; Anterior Cruciate Ligament Reconstruction ; Humans ; Ligaments ; Male ; Menisci, Tibial ; Rupture ; Sports ; Tibia ; Transplantation, Homologous

STUDY DESIGN: A retrospective study. OBJECTIVE: To analyze the outcome of the surgical treatment for lumbar spinal stenosis with fracture in multiple osteoporotic vertebral body compression fractures. SUMMARY OF LITERATURE REVIEW: An osteoporotic vertebral compression fracture, without neurological symptom, has mainly been treated with conservative care. Sometimes, vertebroplasty or kyphoplasty has been used as a surgical treatment. In the case of a single thoracolumbar fracture with neurological symptoms, not improved by conservative care, decompression, fusion and instrumentation through an anterior or a posterior approach has been attempted. MATERIALS AND METHODS: 10 patients, who had received surgical treatment for symptomatic lumbar spinal stenosis with fracture out of those with multiple osteoporotic vertebral body compression fractures, and over the age of 60, were assessed. The surgical treatment was performed on the patient with all of the following five criteria; (1) severe back pain caused by fractures, (2) neurological symptoms of lumbar spinal stenosis, (3) radiological evidences of stenosis by lumbar fracture, (4) no response to conservative treatment for over 3 months, and (5) adequate physical ability for daily living without a severe medical condition. The surgical procedure included: decompressive laminectomy, posterior instrumentation using pedicle screw fixation, and fusion in situ. The pedicle screws were located 2-3 above and below the most cephalad and caudad fractured vertebral bodies. RESULTS: Clinically, favorable results were obtained in 8 of the 10 patients. In the roentgenographic assessment, the operated states were well maintained, without the metallic failure or instability. Halos around the pedicle screws were seen in 4 patients, but there was no significant evidence of loosening. There were no serious medical and systemic complications in the peri- and postoperative periods. Additional vertebral body fractures and pain were seen in 5 patients, but they had been well managed, conservatively. CONCLUSION: Favorable clinical results could be expected for the surgical treatment of lumbar spinal stenosis, with fracture, in the patients with multiple osteoporotic vertebral fractures, as long as the surgical treatment was indicated exactly and carefully.
Back Pain ; Constriction, Pathologic ; Decompression ; Fractures, Compression* ; Humans ; Kyphoplasty ; Laminectomy ; Postoperative Period ; Retrospective Studies ; Spinal Stenosis* ; Vertebroplasty

Hemolytic uremic syndrome (HUS) is characterized clinically by classic triad of microangiopathic hemolytic anemia, thrombocytopenia and acute renal failure. The illness is uncommon and various agents have been associated with HUS, such as infectious, genetic, environmental and phamacological factor. We experienced a case of hemolytic uremic syndrome in a eighty-year old man with a evidence for recent Epstein-barr virus infection. He developed hemolytic anemia, thrombocytopenia, hypertension and azotemia. His renal dysfunction was recovered by hemodialysis, plasmapheresis, warfarin and dypiridamole. We present this case with a review of the literature.
Acute Kidney Injury ; Anemia, Hemolytic ; Azotemia ; Disseminated Intravascular Coagulation ; Hemolytic-Uremic Syndrome* ; Herpesvirus 4, Human ; Hypertension ; Plasmapheresis ; Renal Dialysis ; Thrombocytopenia ; Warfarin

BACKGROUND/AIMS: Proton pump inhibitor (PPI) is generally prescribed to prevent post endoscopic submucosal dissection (ESD) bleeding. However, there was no consensus about the effectiveness of intravenous (IV) or oral PPI. We conducted this investigation to evaluate whether oral PPI can be also safely and effectively used to prevent post-ESD bleeding by measurement of intragastric pH. MATERIALS AND METHODS: Patients were assigned in the fixed order to IV pantoprazole by 40 mg every 12 hours and oral lansoprazole fast disintegrating tablet (LFDT) by 30 mg every 8 hours. We checked intragastric pH and hemoglobin (Hb) levels at pre and post-ESD procedure. RESULTS: A total of 10 patients (LFDT group: 6 patients, IV pantoprazole group: 4 patients) were included. There was no difference of baseline Hb level between two groups (LFDT, 14.38+/-0.46 mg/dL; IV pantoprazole, 13.85+/-0.83 mg/dL; P=0.18). After 24 hours, change of Hb level was not different between LFDT (0.95+/-0.30 mg/dL) and IV pantoprazole group (0.98+/-0.45 mg/dL; P=0.96). Baseline intragastric pH was 3.72+/-0.19 with LFDT and 4.31+/-0.41 with IV pantoprazole group (P=0.18). After 24 hours, there was no significant difference of the extent of pH increase between LFDT (2.38+/-0.28) and IV pantoprazole group (2.17+/-0.21; P=0.60). CONCLUSIONS: There was no difference in both the increase of post-24 hour intragastric pH and decrease of post-24 hour Hb between LFDT and IV pantoprazole group. Oral PPI regimen may be able to replace IV PPI therapy for the prevention of post-ESD bleeding and LFDT might be superior to IV PPIs in the aspect of cost-effectiveness.
Consensus ; Hemorrhage* ; Humans ; Hydrogen-Ion Concentration ; Lansoprazole* ; Proton Pump Inhibitors ; Proton Pumps

BACKGROUND/AIMS: Proton pump inhibitor (PPI) is generally prescribed to prevent post endoscopic submucosal dissection (ESD) bleeding. However, there was no consensus about the effectiveness of intravenous (IV) or oral PPI. We conducted this investigation to evaluate whether oral PPI can be also safely and effectively used to prevent post-ESD bleeding by measurement of intragastric pH. MATERIALS AND METHODS: Patients were assigned in the fixed order to IV pantoprazole by 40 mg every 12 hours and oral lansoprazole fast disintegrating tablet (LFDT) by 30 mg every 8 hours. We checked intragastric pH and hemoglobin (Hb) levels at pre and post-ESD procedure. RESULTS: A total of 10 patients (LFDT group: 6 patients, IV pantoprazole group: 4 patients) were included. There was no difference of baseline Hb level between two groups (LFDT, 14.38+/-0.46 mg/dL; IV pantoprazole, 13.85+/-0.83 mg/dL; P=0.18). After 24 hours, change of Hb level was not different between LFDT (0.95+/-0.30 mg/dL) and IV pantoprazole group (0.98+/-0.45 mg/dL; P=0.96). Baseline intragastric pH was 3.72+/-0.19 with LFDT and 4.31+/-0.41 with IV pantoprazole group (P=0.18). After 24 hours, there was no significant difference of the extent of pH increase between LFDT (2.38+/-0.28) and IV pantoprazole group (2.17+/-0.21; P=0.60). CONCLUSIONS: There was no difference in both the increase of post-24 hour intragastric pH and decrease of post-24 hour Hb between LFDT and IV pantoprazole group. Oral PPI regimen may be able to replace IV PPI therapy for the prevention of post-ESD bleeding and LFDT might be superior to IV PPIs in the aspect of cost-effectiveness.
Consensus ; Hemorrhage* ; Humans ; Hydrogen-Ion Concentration ; Lansoprazole* ; Proton Pump Inhibitors ; Proton Pumps

OBJECTIVES: The purpose of this study was to evaluation the effect of administration of postpartumtonic agent(MMQ) on postpartum anemia during puerperal period, obesity control and uterine involution. SUBJECTS AND METHODS: From June 2002 to November 2002, twenty women who underwent spontaneous vaginal delivery at department of obstetrics and gynecology, college of medicine, Pochon CHA University ghopital were included in this study. All women were randomly assigned to receive postpartum tonic agent(MMQ, Albiomed Co.Ltd) or placebo two times a day after each meal for four weeks. They were assessed obesity test(BMI), hematologic examination(CBC, reticulocyte count), liver function test(AST/ALT) and ultrasound test at first day and 28th days after delivery. RESULTS: There was no statistically significant difference between the two group in demographic characteristics. No statistically significant difference were found in this study between the two group in hemoglobin, hematocrit, BMI and the size of uterus. There was no adverse effect to the tested drug. CONCLUSION: There was no significant difference in efficacy and safety between MMQ and placebo in the effect of postpartum anemia, obesity control and reduction of recovery perod. The following limitations have to be considered; Iron supplement, variable diet, seaweed ingestion, consumption of herb and small sample ize. Therefore, a extensive prospective study with control of these variables should be required.
Administration, Oral* ; Anemia* ; Diet ; Eating ; Female ; Gynecology ; Hematocrit ; Humans ; Iron ; Liver ; Meals ; Obesity* ; Obstetrics ; Postpartum Period* ; Reticulocytes ; Seaweed ; Ultrasonography ; Uterus