Splanchnic vein thrombosis arising from complications of acute pancreatitis is very rare. It usually occurs as a form of portal, splenic and superior mesenteric vein thrombosis, either in combination or separately. It could develop portal hypertension, bowel ischemia and gastrointestinal variceal bleeding. Treatment of splanchnic vein thrombosis includes anticoagulants, thrombolysis, insertion of shunts, bypass surgery and liver transplantation. In some cases, anticoagulation therapy may be considered to prevent complications. However, the standard protocol for anticoagulation in splanchnic vein thrombosis has not been determined yet. We report a case of 43-year-old man who had portal and splenic vein thrombosis in acute pancreatitis. The patient was successfully treated with oral anticoagulants following low molecular weight heparin therapy.
Adult ; Anticoagulants* ; Esophageal and Gastric Varices ; Heparin, Low-Molecular-Weight ; Humans ; Hypertension, Portal ; Ischemia ; Liver Transplantation ; Mesenteric Veins ; Pancreatitis* ; Splenic Vein* ; Thrombosis* ; Veins ; Venous Thrombosis

Early repolarization is a common electrocardiographic (ECG) feature found in young adults, men and athletes, and has been considered to be a benign feature for the last several decades. But recent studies suggest that early repolarization may be related to idiopathic ventricular fibrillation and sudden cardiac death. We report a young man, 35 years old, who had life threatening ventricular fibrillation and sudden cardiac arrest. He was evaluated for cardiac causes of ventricular fibrillation. There was no explanation other than that his ECG showed an early repolarization pattern so we treated him with implantable cardioverter defibrillator. Thus, we suggest that early repolarization may be related with life threatening ventricular arrhythmia.
Arrhythmias, Cardiac ; Athletes ; Death, Sudden, Cardiac ; Defibrillators ; Electrocardiography ; Humans ; Male ; Ventricular Fibrillation* ; Young Adult

Neisseria cinerea is an oropharyngeal normal flora known as a non-pathogenic gram-negative diplococcus. Encephalo-meningitis related to N. cinerea is very rare. A 15-year-old healthy male visited emergency room for altered mentality with fever, headache, and vomiting. Physical examination showed abdominal tenderness and neck stiffness but there was no skin rash. Cerebrospinal fluid (CSF) examination revealed opening pressure of 210 mmH2O, red blood cell 200/mm3, white blood cell 8,320/mm3, neutrophil 84%, glucose 34 mg/dL, suggesting acute bacterial meningitis. Empirical antibiotics were administered and N. cinerea was identified in CSF culture. The patient showed complete recovery 10 days after administration of ceftriaxone. We report this case as the first N. cinerea meningitis in Korea.
Adolescent ; Anti-Bacterial Agents ; Ceftriaxone ; Cerebrospinal Fluid ; Emergency Service, Hospital ; Erythrocytes ; Exanthema ; Fever ; Glucose ; Headache ; Humans ; Korea ; Leukocytes ; Male ; Meningitis ; Meningitis, Bacterial* ; Neck ; Neisseria cinerea* ; Neutrophils ; Physical Examination ; Vomiting

Cytomegalovirus (CMV) infection in immunocompromised patients is associated with significant morbidity, mortality, and adverse clinical outcome. However, CMV infection in immunocompetent patients has been considered to have subclinical and self-limited course, and does not require treatment. We reports a case of CMV colitis, presented with colon perforation and lower gastrointestinal bleeding in a immunocompetent 31-year-old young male. After conservative treatment, colonoscopy revealed multiple ulcers in transverse colon. CMV colitis was confirmed by microscopic findings and immunohistochemistry. After successful treatment with ganciclovir, the patient improved without invasive procedure.
Adult ; Colitis* ; Colon* ; Colon, Transverse ; Colonoscopy ; Cytomegalovirus* ; Ganciclovir ; Hemorrhage* ; Humans ; Immunocompetence ; Immunocompromised Host ; Immunohistochemistry ; Male ; Mortality ; Ulcer

Gastric metastasis from breast cancer is rare and only six cases have been reported in Korea. Colon metastasis is more rare than gastric metastasis. We report a 63-year-old woman with gastric and colon metastases of invasive lobular carcinoma of breast. She was diagnosed as right breast cancer, received right modified radical mastectomy 10 years ago and has been treated with chemotherapy and hormone therapy. Investigating for melena and a small caliber of stool, we found gastric and colon metastases. The diagnosis of metastatic breast cancer was made through gross pathologic and immunohistochemistry staining. We report a case with gastric and colon metastases from breast cancer and a review of the associated six case reports in Korea.
Breast ; Breast Neoplasms* ; Carcinoma, Lobular ; Colon* ; Diagnosis ; Drug Therapy ; Female ; Humans ; Immunohistochemistry ; Korea ; Mastectomy, Modified Radical ; Melena ; Middle Aged ; Neoplasm Metastasis* ; Stomach*

OBJECTIVES: The purpose of this study was to compare the safety and efficacy of midazolam sedated Endoscopic retrograde cholangiopancreatography (ERCP) with unsedated ERCP in patients 70 years of ages and older. METHODS: Seventy elderly patients 70 years of age or older who underwent ERCP were divided into two groups: midazolam sedated group (n=43) and unsedated group (n=27). Procedure time, success rate, complications related with ERCP procedure, satisfaction score were analyzed between two groups. RESULTS: Mean procedure time was 20.6 minutes for sedated group and 21.0 minutes for unsedated group (P=0.88). Success rate was 87.5% for sedated group and 100% for unsedated group (P=0.07). Incidence of complications from ERCP procedure showed no significant differences between the sedated and unsedated groups (P=0.10). There was no mortality in both groups related to the sedation or post-ERCP complication. Compared to the unsedated procedure, the sedated ERCP procedure was associated with higher patient satisfaction (P<0.001) and better repeat compliance (P=0.004). CONCLUSION: There was no significant difference in success rate and complications at sedated and unsedated ERCP in patients 70 years of age and older. Unsedated ERCP showed 66.6% satisfaction score compared to sedated ERCP.
Aged ; Cholangiopancreatography, Endoscopic Retrograde* ; Compliance ; Humans ; Incidence ; Midazolam ; Mortality ; Patient Satisfaction

Breast cancer is the second most common cancer in Korean women and its mortality rate has increased steadily. Although breast cancer is heterogeneous tumor, hormone receptor-positive tumors comprise about 75 percent of all breast cancers. Therefore endocrine therapy that works by targeting estrogen receptor is a pivotal treatment for breast cancers. There are selective estrogen receptor modulators, such as tamoxifen and raloxifene, aromatase inhibitors, such as anastrozole, letrozole and exemestane, fulvestrant and luteinizing hormone-releasing hormone agonists used in endocrine therapy. Endocrine therapy is effective in treating early breast cancer as an adjuvant therapy and metastatic breast cancer as a palliative therapy. Also in women who are at high risk for breast cancer, tamoxifen or raloxifene can prevent breast cancer. Studies for neoadjuvant endocrine therapy are emerging. Considering side effects of each drug and overcoming drug resistance are needed to maximize effectiveness of treatment and advance endocrine therapy.
Antineoplastic Agents, Hormonal ; Aromatase Inhibitors ; Breast ; Breast Neoplasms* ; Drug Resistance ; Drug Therapy ; Estrogens ; Female ; Gonadotropin-Releasing Hormone ; Humans ; Mortality ; Palliative Care ; Raloxifene Hydrochloride ; Selective Estrogen Receptor Modulators ; Tamoxifen

Breast cancer is the second most common cancer in Korean women and its incidence has increased. Among the various treatment methods for breast cancer, chemotherapy plays an important role. The use chemotherapy to treat breast cancer began at the mid 20th century and first combination chemotherapy was conducted in mid 1970s. This chemotherapy reduced breast cancer mortality up to 25~30%, anthracycline and taxane based chemotherapeutic regimens are widely used. Chemotherapy could be classified to neoadjuavnt, adjuvant and palliative setting according to its aim and role. In this review, various drug therapeutic options and their backgrounds are considered based on neoadjuvant, adjuvant and metastatic systemic therapies.
Breast Neoplasms* ; Drug Therapy* ; Drug Therapy, Combination ; Female ; Humans ; Incidence ; Mortality

Malignant neoplasm is the most common cause of death in Korea since 1988. In terms of incidence, still gastric cancer is the most common cancer in male, but breast cancer became the second most common female cancer followed by thyroid cancer. The reasons why incidence of breast cancer is increasing, (1) Westernized food patterns; high fat and high calorie diet, (2) late marriage with lower birth rate, (3) shorter period of breast feeding, (4) longer exposure to estrogen; early menarche with late menopause, hormone replacement therapy, (5) low physical activity with high body mass index, (6) environmental stress, and etc. Still incidence of breast cancer in Korea is relatively low comparing to those of American and European populations, but it is very rapidly increasing with annual increase rate of about 6%. So Korean breast cancer specialists should try to study breast cancer in terms of basic and also clinical aspect and also educate laymen for etiology, symptoms and signs, early detection method including breast self-examination and prevention.
Birth Rate ; Body Mass Index ; Breast Feeding ; Breast Neoplasms* ; Breast Self-Examination ; Cause of Death ; Diet ; Estrogens ; Female ; Hormone Replacement Therapy ; Humans ; Incidence ; Korea ; Male ; Marriage ; Menarche ; Menopause ; Motor Activity ; Specialization ; Stomach Neoplasms ; Thyroid Neoplasms

Stress-induced cardiomyopathy, so-called Takotsubo cardiomyopathy, has recently been reported in Japan. Stress-induced cardiomyopathy is characterized by transient left ventricular apical dysfunction and ballooning, with normal coronary angiographic findings. We describe a rare case of stress-induced cardiomyopathy associated with lung adenocarcinoma presenting as hyponatremia.
Acute Coronary Syndrome ; Adenocarcinoma ; Carcinoma, Non-Small-Cell Lung* ; Cardiomyopathies* ; Hyponatremia* ; Inappropriate ADH Syndrome ; Japan ; Lung ; Lung Neoplasms ; Takotsubo Cardiomyopathy