1.KMJ Teaching Tips 1: Reflecting on My Lesson.
Keimyung Medical Journal 2016;35(1):85-87
No abstract available.
2.Thyroid Tuberculosis Diagnosis by Core Needle Biopsy Associated with Lymph Node Enlargement.
Kyoung Sun PARK ; Kwang Min KIM ; Nam Yeol CHO ; Shin Hee LEE ; Yu Ah CHOI ; Mi Seon LEE
Keimyung Medical Journal 2016;35(1):79-84
Tuberculosis of thyroid gland is rare. We experienced a case of tuberculosis of the thyroid gland with contralateral lymph node enlargement in a 45-year-old female patient. She had no clinical respiratory symptom and no weight change. Thyroid sonography demonstrated 5.4 × 3.8 mm sized round low echogenic mass on lower pole of left thyroid gland and right cervical lymph node enlargement. Core needle biopsy of thyroid showed epithelioid chronic granuloma in the caseous necrosis. She was administrered anti-tuberculosis therapy for 24 weeks. After medication, thyroid sonographic finding improved and thyroid mass and right cervical lymph node enlargement disappeared.
Biopsy, Large-Core Needle*
;
Diagnosis*
;
Female
;
Granuloma
;
Humans
;
Lymph Nodes*
;
Middle Aged
;
Necrosis
;
Thyroid Gland*
;
Tuberculosis*
;
Ultrasonography
3.Intractable in Stent Thrombosis in Malignant Superior Vena Cava Syndrome.
Sang Ho LEE ; Chang Woo SHIM ; Ho Seok CHI ; Hye In LEE ; Do Il CHOI ; Heung Tae KIM ; Hyun Beom KIM ; In Joon LEE ; Sun Young KIM
Keimyung Medical Journal 2016;35(1):73-78
Endovascular treatment (EVT) including angioplasty and stenting is an effective treatment for superior vena cava (SVC) syndrome. Recurrence of SVC syndrome is mainly caused by tumor progression and occurs in around 20% after EVT, but sometimes venous thrombosis within stent accounts for recurrence of SVC syndrome. Anticoagulation after EVT is still a controversial issue. In our case, a 73-year-old man with SVC syndrome caused by mediastinal metastasis from non-small cell lung cancer underwent endovascular stent followed by anticoagulation with low molecular weight heparin (LMWH), but symptomatic progression due to in-stent thrombosis necessitated the second procedure after two weeks. A total of 4 sessions of endovascular stent and anticoagulation with LMWH, warfarin and rivaroxaban did not induce durable resolution of in-stent thrombosis. Our case suggests refractory in-stent thrombosis could develop despite of anticoagulation after endovascular stent for SVC syndrome.
Aged
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Angioplasty
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Carcinoma, Non-Small-Cell Lung
;
Heparin, Low-Molecular-Weight
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Humans
;
Neoplasm Metastasis
;
Recurrence
;
Rivaroxaban
;
Stents*
;
Superior Vena Cava Syndrome*
;
Thrombosis*
;
Vena Cava, Superior*
;
Venous Thrombosis
;
Warfarin
4.Double Lumen Endobronchial Tube Malposition Due to Enlargement of Paratracheal Lymph Node.
Ji Yoon JUNG ; Soo Young SHIM ; Sang Jin PARK ; Ki Bum PARK
Keimyung Medical Journal 2016;35(1):68-72
Double lumen endobronchial tube (DLT) is used for lung separation in the surgical patients undergoing thoracic and mediastinal surgery. The use of DLT can lead to potential problems such as tube malposition and airway trauma. DLT can be placed in the inappropriate position due to abnormal and distorted anatomy of trachea or bronchus. We report a case of right main bronchial insertion of left-sided DLT by enlargement of paratracheal lymph node not detected in preoperative evaluations for 10 days.
Bronchi
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Humans
;
Lung
;
Lymph Nodes*
;
Trachea
5.Primary Bacteremia in Diabetes Patient Caused by Non-O1/non-O139 Vibrio cholerae.
Chang In NOH ; Ji Yeon LEE ; Hyun Ah KIM ; Seong Yeol RYU
Keimyung Medical Journal 2016;35(1):63-67
Vibrio cholerae (V. cholerae) serotype O1 or O139 is the etiological agents of cholera. These bacteria are responsible for gastrointestinal infections or more rarely bacteremia in patients with an underlying disease, leading to life-threatening complications. A 73-year-old man presented to the hospital with fever and vomiting. Blood cultures grew non-O1/non-O139 V. cholerae. In this case, clinical improvement and microbiological eradication were achieved due to early appropriate antibiotic therapy. These results suggest that early antibiotic therapy allowed a good outcome in diabetic patient infected with V. cholerae . To our knowledge, this is the first case of primary bacteremia caused by non-O1/non-O139 Vibrio cholera in Korea.
Aged
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Bacteremia*
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Bacteria
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Cholera
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Fever
;
Humans
;
Korea
;
Serogroup
;
Vibrio cholerae*
;
Vibrio*
;
Vomiting
6.Primary Hepatic Tuberculosis Mimicking Hepatocelluar Carcinoma in Patient with Chronic Viral Hepatitis B and C.
Sei Myong CHOI ; Kyung In SHIN ; Byoung Kuk JANG ; Jae Seok HWANG ; Woo Jin CHUNG ; Koo Jeong KANG ; Yu Na KANG
Keimyung Medical Journal 2016;35(1):58-62
Hepatic tuberculosis (TB) is usually associated with pulmonary or miliary TB, but primary hepatic TB is rare less than 1% of all cases of TB. Because hepatic TB lacks typical clinical manifestations as well as typical imaging findings, it is difficult to differentiate TB from the malignancies such as hepatic metastasis, intrahepatic cholangiocarcinoma and hepatocellular carcinoma. A 76-year-old woman was presented with single liver mass detected on routine examination. She was clinically diagnosed with hepatocellular carcinoma and underwent surgical excision of the lesion. However, histologic examination revealed caseous necrotizing granuloma and the PCR test for Myco-bacterium tuberculosis was positive. The final diagnosis was primary hepatic TB. Here we report the case with primary hepatic TB who was initially misdiagnosed with hepatocellular carcinoma and underwent surgical excision.
Aged
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Carcinoma, Hepatocellular
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Cholangiocarcinoma
;
Diagnosis
;
Female
;
Granuloma
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Hepatitis B*
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Hepatitis*
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Humans
;
Liver
;
Neoplasm Metastasis
;
Polymerase Chain Reaction
;
Tuberculosis
;
Tuberculosis, Hepatic*
7.Inflammatory Pseudotumor of the Liver Mimicking an Infiltrative Malignancy.
Ji Hwan CHUNG ; Won Hyeong PARK ; Ji Won LEE ; Jae Yun YANG ; Seong Yeong AHN ; Sang Hee LEE ; Hui Seo KIM ; Seung Moon HAN
Keimyung Medical Journal 2016;35(1):50-57
Inflammatory pseudotumor (IPT) is a relatively rare and benign disease characterized by chronic inflammatory cell infiltration with fibrosis. It is difficult to diagnose IPT because of the absence of specific symptoms or unique radiological findings. IPT can be mistaken for a malignant tumor, such as cholangiocarcinoma or hepatocellular carcinoma, due to their similar clinical and radiological findings. Unfortunately, hepatic resection is often performed due to misdiagnosis. Presented here is a case of a woman aged over 60 years who presented with general weakness lasting more than one month and unexplained body weight loss.
Body Weight
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Carcinoma, Hepatocellular
;
Cholangiocarcinoma
;
Diagnostic Errors
;
Female
;
Fibrosis
;
Granuloma, Plasma Cell*
;
Humans
;
Liver*
8.Autoimmune Hepatitis-systemic Lupus Erythematosus Overlap Syndrome Diagnosed after Tapering Immunosuppressive Therapy.
Bho Hyeon LEE ; Seung Ah PARK ; Joo Kyung KIM ; Dae Young CHEON ; Seong Hun KANG ; Nan Young CHOI ; Ji Won PARK ; Mi Jung KWON ; Young Il SEO ; Sung Eun KIM
Keimyung Medical Journal 2016;35(1):44-49
The differential diagnosis of systemic lupus erythematosus (SLE) and autoimmune hepatitis (AIH) is difficult due to the resemblance of these two disorders. However, the accurate diagnosis is important for prognosis and treatment that are different from each other. We report a case of AIH-SLE overlap syndrome which tapering of prednisone and azathioprine therapy deteriorated the condition of a patient due to flare up of SLE. The patient was a 28-year-old woman diagnosed as AIH. After administrations of prednisone and azathioprine, her condition was improved. During dose reduction, she was admitted to our hospital as fever and dyspnea. She diagnosed as lupus nephritis. After high dose treatment with corticosteroids and azathioprine, she recovered. Once the diagnosis of autoimmune disease such as SLE or AIH has been made, clinicians should also be fully aware of concomitant other autoimmune disease.
Adrenal Cortex Hormones
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Adult
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Autoimmune Diseases
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Azathioprine
;
Diagnosis
;
Diagnosis, Differential
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Dyspnea
;
Female
;
Fever
;
Hepatitis, Autoimmune
;
Humans
;
Lupus Erythematosus, Systemic
;
Lupus Nephritis
;
Prednisone
;
Prognosis
9.Squamous Cell Carcinoma of the Gallbladder Presenting with a Cholecystoduodenal Fistula.
Seung Kook CHO ; Young Bean KO ; Soon Chang PARK ; Sang Jun LEE ; Jae Hyun KIM ; Mee Yon CHO ; Jae Woo KIM ; Kyong Joo LEE
Keimyung Medical Journal 2016;35(1):39-43
Gallbladder cancer (GBC) is the most common primary hepatobiliary carcinoma and the sixth most common gastrointestinal malignancy. Adenocarcinoma accounts for the vast majority of GBCs (80–95%), whereas squamous cell carcinoma constitutes only 0–3.3% of GBCs. A 69-year-old man was suspected to have GBC with a cholecystoduodenal fistula on an abdominal computed tomography scan. He underwent esophagogastroduodenoscopy, which revealed that the duodenum was obstructed by the mass. Duodenal and biliary stents were successfully placed using endoscopic retrograde cholangiopancreatography. Pathology obtained from the duodenum revealed the mass to be a squamous cell carcinoma.
Adenocarcinoma
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Aged
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Carcinoma, Squamous Cell*
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Cholangiopancreatography, Endoscopic Retrograde
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Duodenum
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Endoscopy, Digestive System
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Epithelial Cells*
;
Gallbladder Neoplasms
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Gallbladder*
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Humans
;
Intestinal Fistula*
;
Pathology
;
Stents
10.Iliopsoas Bursitis after Transfemoral Coronary Angiography.
Jeong Chan LEE ; Chan Keol PARK ; Young KIM ; Su Jin YOO ; Seung Cheol SHIM ; Seong Wook KANG ; In Seol YOO
Keimyung Medical Journal 2016;35(1):34-38
A 53-year-old male was admitted to our hospital for evaluation of the second kidney transplant. A Iliopsoas Bursitis was detected on diagnostic abdominopelvic computed tomography. He had undergone a coronary angiography (CAG) due to chest pain 1 month prior to his visit. At that time, he had experienced pain on his right back and flank for some time. We found no other causes or predisposing factors associated with that problem. Thus, we report on a case of iliopsoas bursitis after CAG.
Bursitis*
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Causality
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Chest Pain
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Coronary Angiography*
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Humans
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Kidney
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Kidney Transplantation
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Male
;
Middle Aged