Foreign bodies of the upper gastrointestinal tract are found in all age groups, and the foreign bodies can be ingested incidentally or intentionally. They are usually common in children, but they have also been discovered in adults with esophageal disease, artificial teeth, mental retardation, in patients seeking secondary gains and in alcoholics. The types of foreign bodies vary for different social and cultural conditions, and can include coins, corks, toys, fish bones, toothbrushes, needles, nails and pens. Foreign bodies of the upper gastrointestinal tract are usually passed into the intestinal tract spontaneously, but sometimes intervention is required. We report a case of an 80-year-old man with a past medical history of depressive disorder that had ingested adhesives. The adhesives present in the esophagus were removed by the use of therapeutic endoscopy. However, the adhesives in the stomach were too large to remove by the use of an endoscopic procedure, and gastrotomy was performed.
Adhesives ; Adult ; Aged, 80 and over ; Alcoholics ; Child ; Cyanoacrylates ; Depressive Disorder ; Eating ; Endoscopy ; Esophageal Diseases ; Esophagus ; Foreign Bodies ; Humans ; Intellectual Disability ; Intention ; Nails ; Needles ; Numismatics ; Play and Playthings ; Stomach ; Tooth, Artificial ; Upper Gastrointestinal Tract

Tuberculosis is one of the main infectious health problems in Korea, and a combination of antibiotics is required to treat this illness. The combination therapy with rifampicin, isoniazid, ethambutol and pyrazinamide has many adverse reactions and there have been several case reports about pseudomembranous colitis (PMC) after anti- tuberculosis treatment. Rifampicin is regarded as a main cause of anti-tuberculosis induced PMC because of its bacteriocidal effect, and interruption of the offending drug, such as rifampicin, is usually necessary to treat the PMC. However, in patents with uncompensated tuberculosis, the discontinuance of anti-tuberculosis medication accentuates the disease severity, and continuance of the anti-tuberculosis medication is necessary to overcome the tuberculosis. We report here on a case in which the anti- tuberculosis agents induced PMC in 32 year old female who was diagnosed with active pulmonary tuberculosis. She was treated with maintenance of the anti-tuberculosis medication and also the addition of both oral metronidazole and probiotics.
Anti-Bacterial Agents ; Enterocolitis, Pseudomembranous ; Ethambutol ; Female ; Humans ; Isoniazid ; Korea ; Metronidazole ; Probiotics ; Pyrazinamide ; Rifampin ; Tuberculosis ; Tuberculosis, Pulmonary

In Korea, the number of Hepatitis A virus (HAV) infections has suddenly increased and has become the most common cause of acute viral hepatitis during recent years. A 36-year-old female was diagnosed with acute fulminant hepatitis caused by HAV. Her clinical symptoms and AST/ALT recovered after supportive treatment; however, a re-elevation of AST/ALT was observed. Weperformed another viral marker study, autoimmune marker study and liver biopsy to rule out another hepatic insult. As a result, anti- HEV IgM, an anti-nuclear antibody and anti-smooth muscle antibody were positive and liver histology showed chronic hepatitis. In conclusion, we report a case of hepatitis A and E coinfection in an autoimmune hepatitis patient.
Adult ; Biomarkers ; Biopsy ; Coinfection ; Female ; Hepatitis ; Hepatitis A ; Hepatitis A virus ; Hepatitis E ; Hepatitis, Autoimmune ; Hepatitis, Chronic ; Humans ; Immunoglobulin M ; Korea ; Liver ; Muscles

Hypothyroidism is a clinical state which results from decreased production of thyroid hormone, and its symptoms are various including lack of energy, dryness of skin and hair, dyspnea, bradycardia, hypotension, body weight gain, and constipation. Muscle disorders due to hypothyroidism may include myalgia, muscle weakness, stiffness, delayed tendon reflex, abnormality of electromyography, changes of muscle tissues and increased muscle enzymes. Hypothyroid myopathy manifests as a mild form of myopathy rather than an acute rhabdomyolysis, that is a very rare complication of hypothyroid myopathy and that can cause acute renal failure. We report a case of primary hypothyroidism presented with rhabdomyolysis and acute renal failure. A 50-year-old male referred to our hospital for evaluation and management of generalized edema, muscle weakness, fatigue and myalgia. He had acute rhabdomyolysis and progressed to acute renal failure due to newly developed primary hypothyroidism. After hormone replacement therapy with levothyroxine, the patients renal function and muscular symptom completely recovered.
Acute Kidney Injury* ; Body Weight ; Bradycardia ; Constipation ; Dyspnea ; Edema ; Electromyography ; Fatigue ; Hair ; Hormone Replacement Therapy ; Humans ; Hypotension ; Hypothyroidism* ; Male ; Middle Aged ; Muscle Weakness ; Muscular Diseases ; Myalgia ; Reflex, Stretch ; Rhabdomyolysis* ; Skin ; Thyroid Gland ; Thyroxine

A 42-year-old man without any signs or symptoms of illness underwent esophagogastroduodenoscopy (EGD) for a routine health check up. On esophagogastroduodenoscopy, multiple small and yellowish mucosal plaques were detected in the mid to distal esophagus. These plagues proved to be ectopic sebaceous glands of the esophagus according to the histologic examination. On the immunohistochemical staining with anti-Keratin 14, the basal cells and the heterotopic sebaceous glands were immunoreactive for keratin 14. The histogenesis of this extremely rare lesion is not completely clear. There have been some reports on ectopic esophagus sebaceous glands combined with esophageal cancer or gastric cancer. However, malignant transformation of the ectopic sebaceous gland itself has not yet been reported on. This case was regularly followed up for 12 months, and no interval change or malignant transformation was found both endoscopically and histologically.
Adult ; Endoscopy, Digestive System ; Esophageal Neoplasms ; Esophagus ; Humans ; Keratin-14 ; Sebaceous Glands ; Stomach Neoplasms

Intraductal papillary mucinous neoplasm of the pancreas (IPMN) is a precancerous lesion with a well-described adenocarcinoma sequence. The rate of progression of IPMN appears to be very slow; however, patients with IPMN may be at increased risk for extrapancreatic malignancies. A 55-year-old female was diagnosed with IPMN of the pancreas and a duodenal polyp in 2004. After an approximate 3 year loss to follow-up, she was readmitted for managing abdominal pain and underwent Whipple's operation. Herein, we report a case of a patient with malignant IPMN accompanied by duodenal adenocarcinoma arising from a duodenal polyp.
Abdominal Pain ; Adenocarcinoma ; Duodenal Neoplasms ; Female ; Follow-Up Studies ; Humans ; Middle Aged ; Mucins ; Neoplasms, Multiple Primary ; Pancreas ; Pancreatic Neoplasms ; Polyps

Uremic encephalopathy is a well-known complication in uremia and rarely occurs with involuntary movements which represent basal ganglia lesion. We experienced a cases of recurrent acute uremic encephalopathy associated with reversible bilateral basal ganglia lesion. A 49-year-old man with end stage renal disease due to diabetic nephropathy on continuous ambulatory peritoneal dialysis (CAPD) treatment for the last 2 months was admitted for mental change. His blood sugar was 60 mg/dl, and his mentality was recovered after glucose solution infusion. Five days after admission, he suddenly developed dysarthria and chorea. Brain magnetic resonance imaging (MRI) demonstrated low and high signals on bilateral basal ganglia in T1-weighted and T2-weighted images, respectively. After intensified CAPD treatment, his neurologic manifestations were resolved. One month after discharge, follow-up brain MRI showed decreased size of low attenuation on the basal ganglia. Two months later, he repeatedly developed dysarthria and involuntary movement of extremities. Newly developed bilateral symmetric T1 low and T2 high signal lesion on the basal ganglia was repeatedly observed on brain MRI. At that time, (his) Kt/V was 1.33. So we decided on him to switch from CAPD to hemodialysis, after then his symptoms disappeared.
Basal Ganglia ; Blood Glucose ; Brain ; Chorea ; Diabetic Nephropathies ; Dysarthria ; Dyskinesias ; Extremities ; Follow-Up Studies ; Glucose ; Humans ; Kidney Failure, Chronic ; Magnetic Resonance Imaging ; Middle Aged ; Neurologic Manifestations ; Peritoneal Dialysis, Continuous Ambulatory ; Renal Dialysis ; Uremia

Classic polyarteritis nodosa (c-PAN), first described by Kussmaul and Maier in 1866, is a systemic illness characterized by necrotizing inflammation of medium- sized arteries. Rapid progressive renal failure is very rare in c-PAN in contrast to microscopic polyangiitis (MPA). We report a case of c-PAN presented with rapidly progressive renal failure. A 58 year-old male was referred to our hospital for evaluation of asthenia and right visual loss. An increase in serum creatinine level was developed in the 6th day of hospitalization and acute renal failure was aggravated rapidly. Renal biopsy showed the transmural fibrinoid necrosis of small and medium sized arteries with few glomerular crescents. P-ANCA was detected in serum, and all clinical and laboratory findings supported the diagnosis of c-PAN. He was treated with pulse methylprednisolone, followed by oral corticosteroid and cyclophosphamide, and received temporary hemodialysis. After the treatment, he recovered and was discharged but his visual defect was irreversible despite the treatment.
Acute Kidney Injury* ; Antibodies, Antineutrophil Cytoplasmic ; Arteries ; Asthenia ; Biopsy ; Creatinine ; Cyclophosphamide ; Diagnosis ; Hospitalization ; Humans ; Inflammation ; Male ; Methylprednisolone ; Microscopic Polyangiitis ; Middle Aged ; Necrosis ; Polyarteritis Nodosa* ; Renal Dialysis ; Renal Insufficiency

Rhizobium radiobacter, which has been previously discribed as Agrobacterium radiobacter, is a group of phytopathogenic organisms widely distributed in soil. Over the past decade, increasing number of infections due to Rhizobium radiobacter has been reported. Rhizobium radiobacter is now recognized as rare human pathogens affecting mostly immunocompromised hosts and is an opportunistic pathogen often associated with indwelling catheters. We report a case of bacteremia due to Rhizobium radiobacter in an acquired immunodeficiency syndrome (AIDS) patient. The patient was admitted for fever. In the blood culture, Rhizobium radiobacter was isolated. These symptoms and signs were successfully resolved with antibiotics.
Acquired Immunodeficiency Syndrome* ; Agrobacterium tumefaciens* ; Anti-Bacterial Agents ; Bacteremia* ; Catheters, Indwelling ; Fever ; Humans ; Immunocompromised Host ; Rhizobium* ; Soil

Rhizobium radiobacter, which has been previously discribed as Agrobacterium radiobacter, is a group of phytopathogenic organisms widely distributed in soil. Over the past decade, increasing number of infections due to Rhizobium radiobacter has been reported. Rhizobium radiobacter is now recognized as rare human pathogens affecting mostly immunocompromised hosts and is an opportunistic pathogen often associated with indwelling catheters. We report a case of bacteremia due to Rhizobium radiobacter in an acquired immunodeficiency syndrome (AIDS) patient. The patient was admitted for fever. In the blood culture, Rhizobium radiobacter was isolated. These symptoms and signs were successfully resolved with antibiotics.
Acquired Immunodeficiency Syndrome* ; Agrobacterium tumefaciens* ; Anti-Bacterial Agents ; Bacteremia* ; Catheters, Indwelling ; Fever ; Humans ; Immunocompromised Host ; Rhizobium* ; Soil