Sarcoidosis can affect two or more members of the same family, and the reported occurrence of such familial sarcoidosis is variable from 0.5 to 14%. Recently we have experienced familial sarcoidosis affected mother and daughter, for the first time in Korea. Mother was diagnosed as Stage II sarcoidosis 4 years ago by transbronchial lung biopsy and cervical lymph node biopsy with compatible BAL finding in our hospital. This time, the daughter was admitted with bilateral hilar enlargement and anterior uveitis. Even though she had positive tuberculin skin test and atypical BAL finding(lymphocyte: 61%, CD4/CD8: 1.22). Transbronchial lung biopsy and mediastinal lymph node biopsy revealed noncaseating epithelioid granulorna without AFB. Slit lamp examination of the eyes showed severe anterior uveitis. Systemic steroid therapy was started due to progressive uveitis with antituberculous medication.
Biopsy ; Humans ; Korea* ; Lung ; Lymph Nodes ; Mothers ; Nuclear Family ; Sarcoidosis* ; Skin Tests ; Tuberculin ; Uveitis ; Uveitis, Anterior

No abstract available.
Biopsy, Fine-Needle* ; Small Cell Lung Carcinoma*

The gastric adenoma, which is also called as borderline epithelial lesion, dysplasia, atypical epithelial lesion, is occasionally encoutered during gastroscopy, but the natural history of a gastric adenoma has not been clarified in view of the pre-melignant potential. In Korea, there has been few report for its gastroscopic feature, gastroscopic diagnostic accuracy, or loag-term clinical follow-up yet. (continue...)
Adenoma* ; Follow-Up Studies* ; Gastroscopy ; Korea ; Natural History

The association of gastric tubular adenoma and adenocarcinoma is already well known. Then, are those two pathologic lesions merely incidentally coexisting or does the one evolve to the other? That is a longstanding controversy. Nowadays, as is the case with the colonic tubular adenoma, the hypothesis that gastric tubular adenoma may be a precancerous lesion is generally accepted. However the direct evidences are rare. We report a clear case proving the potential of direct malignant transformation of gastric tubular adenorna through the 9-year close endoscopic follow-up. The developed cancer is well differentiated, surrounded with background tubular adenoma and limited to the submucosal layer.
Adenocarcinoma ; Adenoma* ; Colon ; Follow-Up Studies*

Endoscopic variceal ligation (EVL) is effective for the management of bleeding esophageal varices, and its use is widespread now. EVL necessitates the use of overtubes. Two primary techniques have been used for overtube placement; one is with endoscope, and the other is with bougie dilator. Overtube placement with endoseope is not without risk. There are reportd of esophageal or pharyngeal laceration or perforation. Overtube placement with bougie dilator circumvents this risk, but it is rather cumbersome to use. The authors devised a safe and easy method for overtube placement, and applied it to a number of patients to test its safety and convenience. First, overtube-dilator assembly was prepared as follows. A Rigiflex achalasia dilator (balloon 30mm OD, 10cm length; Microvasive Co) was lubricated and inserted into the overtube. A tenth of the balloon tip was protruded out of the overtube, then the balloon was insufflated with air at 10-15 psi. Second, standard endoscopy was performed, followed by placement of guide wire in the stomach. Overtube-dilator assembly was lubricated and introduced over the wire as a rail. Once the overtube was properly positioned, the balloon was deflated, and the balloon and wire were removed as a whole, which completed overtube placement. For 65 patients with esophageal variceal bleeding, 82 procedures of EVL were performed using the new technique. Overtube-dilator assembly was easy to prepare and handle. This technique added little time to the procedure and minimizes patients discomfort. No patient suffered major complications such as bleeding, laceration or perforation. This novel method for overtube placement was safe and convenient for use in EVL. It can also be applied to other procedures using overtube such as endoscopic foreign body removal.
Endoscopes ; Endoscopy ; Esophageal Achalasia ; Esophageal and Gastric Varices ; Foreign Bodies ; Hemorrhage ; Humans ; Lacerations ; Ligation* ; Stomach

Melanosis coli is the brownish black discoloration of the colon due to accumulation of pigment containing macrophages in lamina propria. The nature and source of this pigment is controversial but many studies have suggested that the pigment is related to lipofuscin. Melanosis coli has been reported to be closely associated with prolonged administration of anthraquinone purgatives. But this condition is sometimes associated with colonic polyp colon cancer, rediation therapy or non-anthraquinone purgatives administration. Moreover the fact that melanosis coli could be found in subjects who never used purgatives suggested that, even though chronic consumption of anthraquinone purgatives seems to play a major role, other factors may be involved in the pathogenesis of melanosis coli. We presented a case of melanosis Coli in a 47-year-old female with history of rectal instillation of petroleum for control of hemorrhoids.
Administration, Rectal* ; Cathartics ; Colon ; Colonic Neoplasms ; Colonic Polyps ; Female ; Hemorrhoids ; Humans ; Lipofuscin ; Macrophages ; Melanosis* ; Middle Aged ; Mucous Membrane ; Petroleum*

A case of multiple hemangioendothelioma of the cauda equina nerve roots and conus medullaris is described. This case is the first report of intradural multiple hemangioendothelioma in Korea. A 74-year-old woman presented with a 4-month history of progressive bilateral leg weakness and lancinating leg pain especially at night. Magnetic resonance image revealed multiple enhancing nodular masses in the cauda equina nerve roots and pial surface of the conus medullaris. We performed total removal of conus medullaris mass and partial removal of two nerve rootlets masses. Two lesions were histologically examined and found to be hemangioendotheliomas
Aged ; Cauda Equina* ; Conus Snail ; Female ; Hemangioendothelioma* ; Humans ; Korea ; Leg ; Spinal Cord*

Amidarone is one of the most commonly prescribed anti-arrythmic agents for almost all arrythmias, whether atrial or ventricular in origin. There are several side effects associated with amiodarone therapy. These include corneal deposits, abnormal liver function tests, hyper and hypothyroidism, bluish discolorations of the skin, bone marrow suppression, coagulopathies, peripheral neuropathies, and pulmonary toxicity. Amiodarone-induced pulmonary toxicity(APT), which was first described in 1980, is potentially serious side effects that are believed to develop in 5% of patients. Doctors often assume that APT occurs only when high amiodarone doses are used for a long time, but in practice a low maintenance dose of amiodarone may also be toxic. In this report, a case of amiodarone-induced pulmonary toxicity after a long course of a low dose therapy for refractory supraventricular arrythmia is described.
Amiodarone ; Arrhythmias, Cardiac ; Bone Marrow ; Humans ; Hypothyroidism ; Liver Function Tests ; Peripheral Nervous System Diseases ; Skin

Exercise-induced ischemic ST responses were analyzed in 36 patients who presented with chest pain and had exercise test and the results were compared with their coronary angiographic findings. Among 36 exercise test positives, the incidences of one-, two- and three vessel disease, and left main disease were 25%(9 cases), 30%(11 cases), 25%(9 cases) and 9%(3 cases), respectively. The incidence of multivessel disease(i.e., two-to three vessel disease or left main disease) in patients with ST depression > or =2.0mm was 72% and that in those with ST depression of 1.0-1.9mm was 45%. In patients with downsloping ST depression, the incidence of multivessel disease was significantly higher than that of one vessel disease(86% vs 14%, p<0.001). But both incidences of one vessel disease and multivessel disease were similar in patients with flat and slowly upsloping ST depression. More than two thirds of patients with ischemic ST depression appearing in the first 6 minutes of exercise or those lasting past 7 minutes in recovery were associated with multivessel disease. It is concluded that attention to depth, type, appearance time and duration of ST depression during exercise test is particularly helpful in detecting patients with advanced coronary disease.
Chest Pain ; Coronary Artery Disease* ; Coronary Disease ; Coronary Vessels* ; Depression ; Electrocardiography* ; Exercise Test ; Humans ; Incidence

Bleeding that recur or continues after hospital admission for an acutely bleeding peptic ulcer is the single most important factor adversely affecting prognosis. The endoscopic findings of stigmata of recent hemorrhage such as active bleeding, a visible vessel or fresh blood clots in peptic ulcer indicate relatively high rebleeding risk. 30 patients with stigmata of recent hemorrhage in bleeding peptic ulcers were treated by endoscopic alcohol injection therapy during the 3-year period from August 1989 to July 1992. 30 cases included 24 gastric ulcers, 4 duodenal ulcers, and 2 stomal ulcers. 8 of these were actively bleeding at the time of endoscopy and non-bleeding visible vessels were identified in 15 patients and fresh blood clots were present in 7. 12 of total 30 cases had rebleeding or continuous bleeding. 3 of 8 with active bleeding, 5 of 15 with non-bleeding bisible vessels, and 4 of 7 with fresh blood clots had rebleeding. Emergency operations were done in 4 cases. There was no complication such as perforation and mortality. We think that this modality of endoscopic hemostasis is safe and simple, but further randomized controlled trials will be needed to evaluate the efficacy of hemostasis by endoscopic alcohol injection therapy.
Christianity ; Duodenal Ulcer ; Emergencies ; Endoscopy ; Hemorrhage* ; Hemostasis ; Hemostasis, Endoscopic ; Humans ; Mortality ; Peptic Ulcer* ; Prognosis ; Stomach Ulcer ; Ulcer