We experienced 3 cases of Candida esophagitis in infancy which were diagnosed by esophageal endoscopy. First case, 10 month-old boy with combined immune deficiency had suffered from oral thrush and poor feeding for more than 4 months. Esophageal endoscopy revealed multiple whitish creamy patches on the friable erythematous and necrotic mucosa of the esophagus. He was firstly treated with amphotericin-B but in vain. Then he was treated with fluconazole (5 mg/kg/day) and in a few days oral thrush nearly disappeared and endoscopy after 2 weeks revealed complete healing of the esophagitis. Second case, 6 month-old boy with some cellular immue defect also suffered from oral thrush, poor feeding and intermittent fever. He was treated with fluconazole and oral thrush was imporved. He was discharged without follow up endoscopy. Third case, 4 month-old girl with liver cirrhosis due to infantile cholestasis had Candida sepsis. Esophagitis was found incidentally during the endoscopic examination of esophageal varix. First 2 cases showed multiple small filling defects and decreased motility on esophagography. Candida antigen was not detected in the sera of all 3 cases of candidiasis. We conclude that Candidia esophagitis should be suspected when an infant has been suffering from long-term treatmet-resistant oral thrush and poor feeding and that esophageal endoscopy can be easily performed in infants also and useful in diagnosing esophagitis and assessing the outcome of treatment.
Candida* ; Candidiasis ; Candidiasis, Oral ; Cholestasis ; Endoscopy ; Esophageal and Gastric Varices ; Esophagitis* ; Esophagus ; Female ; Fever ; Fluconazole ; Humans ; Infant ; Liver Cirrhosis ; Male ; Mucous Membrane ; Sepsis

BACKGROUND/AIMS: The colonic transit time in patients with liver cirrhosis has not been studied extensively in South Korea. Thus, the authors investigated the differences of colonic transit time between cirrhotic patients and normal controls with attention to factors that affect this change. METHODS: Fifteen cirrhotic patients and 15 controls were included in this study. To exclude any organic diseases, colonoscopy was preceded. The colonic transit time was measured by taking plain abdominal films on the 4th and 7th days after ingestion of radiographic non-absorbable colon markers for 3 days. RESULTS: The colonic transit time was 10.7 +/- 2.6 hours and 24.0 +/- 4.1 hours for cirrhotic patients and controls, respectively, indicating that the transit time in cirrhotic patients is much faster (p<0.05). The transit time for each segment of the colon was also measured. For the ascending colon, average transit time of the cirrhotic patients and controls were 5.60 +/- 1.93 and 6.88 +/- 1.77 hours respectively. For the descending colon, those were 2.80 +/- 1.04 and 10.80 +/- 2.59 hours (p<0.05), while those in the rectosigimoid portion were 2.32 +/- 0.81 and 4.96 +/- 1.19 hours, respectively. These results indicated that a significant difference is present in the descending colon. Additionally, the transit time is correlated with age and albumin level (B=0.760, p<0.05 and B=7.498, p<0.01, respectively). CONCLUSIONS: The colonic transit time of cirrhotic patients is faster than that of control, especially in the descending colon.
Colon/*physiopathology ; Female ; *Gastrointestinal Transit ; Humans ; Liver Cirrhosis/*physiopathology ; Male ; Middle Aged

BACKGROUND: Subarachnoid hemorrhage is a fatal disease relatively common in the East Asian population. It can lead to cardiac arrest in several pathologic processes. We attempted to elucidate the characteristics of out-of-hospital cardiac arrest caused by non-traumatic subarachnoid hemorrhage. METHODS: We conducted a retrospective, observational study in which patients who had visited Samsung medical center emergency room for out-of-hospital cardiac arrest from January, 1999 to December 2008 were enrolled. A total of 218 OHCA patients who had achieved ROSC were investigated by review of medical charts. Excluding those who had worn trauma, we analyzed 22 patients who had been diagnosed for SAH by brain non-contrast CT scan. RESULTS: Median age of aneurysmal SAH-induced OHCA patients was 61 (IQR 54-67) years. Fourteen patients (64%) were female and 15 patients (68%) were witnessed. Besides, 7 patients (32%) had complained of headache before collapse. We also found 11 patients (50%) had been diagnosed with hypertension previously. All of them showed unshockable rhythm (asystole 60%, PEA 40%) initially. Their median duration of ACLS was 10 minutes. Majority of patients died within 24 hours and survivors showed poor neurologic outcome. CONCLUSIONS: Subarachnoid hemorrhage is a relatively uncommon cause of cardiac arrest, and the outcome of OHCA induced by SAH is very poor. However, emergency physicians have to consider the possibility of SAH when trying to determine the cause of arrest, especially when treating patients who have the characteristics described above.
Aneurysm ; Asian Continental Ancestry Group ; Brain ; Emergencies ; Female ; Headache ; Heart Arrest ; Humans ; Hypertension ; Out-of-Hospital Cardiac Arrest ; Pathologic Processes ; Peas ; Retrospective Studies ; Subarachnoid Hemorrhage ; Survivors ; Wit and Humor as Topic