Heterotopic pregnancy describes the rare coexistence of intrauterine and extrauterine gestations. The commonly accepted incidence is 1:30,000 but the actual number is significantly higher. This condition remains difficult to diagnose and potentially dangerous to both mot- her and fetus. The incidence has risen after wider use of ovulation induction and the adve- nt of techniques of assisted reproduction. We report a case of simultaneous intrauterine pregnancy and tubal pregnancy.
Female ; Fetus ; Incidence ; Ovulation Induction ; Pregnancy ; Pregnancy, Heterotopic* ; Pregnancy, Tubal ; Reproduction

Four cases of sudden unexpected death during hospitalization are described where autopsy examination showed lobar pneumonia. As widely accepted, sudden death is defined as a natural unexpected death within 1 hour of symptoms and it is well known that pneumonia can be a cause of sudden death. Although pneumonia is a common finding in autopsy, it is not usual that pneumonia is a direct cause of death, especially in medicolegal autopsy cases. In the present study about 4 cases, pneumonia was primary illness and direct cause of death. 4 victims were all male(39~74 years) and found dead on the bed or corridor couch during their admission. The authors describe the autopsy findings, clinical features and courses, and predisposing factors, with literature review.
Autopsy* ; Causality ; Cause of Death ; Death, Sudden ; Hospitalization ; Humans ; Pneumonia*

Swallowing caustic materials may produce full-thickness burn and loss of esophageal function. Caustics, both acid and alkalis, can corrode and destroy living tissue. Full-thickness burn of esophiageal epithelium causes severe stricture which frequently requires surgical repair. Recently, non-operative dilatation of luminal stenosis has been utilized. Esophageal endoscopic endoprosthesis has been used widely in malignant esophageal stricture but not in benign stricture. In recurrent benign esophageal stricture following repetitive balloon dilatation, we experienced a case of an 18-year-old woman with severe stricture which was successfully managed by esophageal endoprosthesia So we report this case with the review of the literature.
Adolescent ; Alkalies ; Burns ; Caustics ; Constriction, Pathologic ; Deglutition ; Dilatation ; Epithelium ; Esophageal Stenosis* ; Female ; Humans ; Lye* ; Phenobarbital

Swallowing caustic materials may produce full-thickness burn and loss of esophageal function. Caustics, both acid and alkalis, can corrode and destroy living tissue. Full-thickness burn of esophiageal epithelium causes severe stricture which frequently requires surgical repair. Recently, non-operative dilatation of luminal stenosis has been utilized. Esophageal endoscopic endoprosthesis has been used widely in malignant esophageal stricture but not in benign stricture. In recurrent benign esophageal stricture following repetitive balloon dilatation, we experienced a case of an 18-year-old woman with severe stricture which was successfully managed by esophageal endoprosthesia So we report this case with the review of the literature.
Adolescent ; Alkalies ; Burns ; Caustics ; Constriction, Pathologic ; Deglutition ; Dilatation ; Epithelium ; Esophageal Stenosis* ; Female ; Humans ; Lye* ; Phenobarbital

Choledochocele is a kind of choledochal cyst and represents a prolapse or herniation of the intramural segment of the distal common bile duct into the duodenal lumen. It is rare congenital anomaly and, easlily overlooked due to non-specific clinical symptoms, signs, and non-characteristic radiologic features. The cause of choledochocele remains uncertain and it was suggested that thete are two distinct types in the pathogenesis of it, i.e., congenital and acquired. Recently, many cases of choledochocele were reported, which diagnosed by ERCP and safely treated with endoscopic unroofing and EST followed by continued observation as well as interval ERCP and/or endoscopic ultrasonography. We present here four cases of symptomaatic choledochoceles that had been managcd by end- oscopic therapy and continucd observation.
Biliary Tract* ; Cholangiopancreatography, Endoscopic Retrograde ; Choledochal Cyst* ; Common Bile Duct ; Endosonography ; Pancreas* ; Prolapse

Non-parasitic true cyst of spleen is one of the rare disease entities. It is thought that they usually develop as a result of abnormality in the development of the spleen and spontaneous or traumatic hemorrhage of the spleen with subsequent organization and liquefaction. It is often presented with asymptomatic abdominal mass, or symptom of compressive effect on a neighboring organ. After corrective differential diagnosis using USG or CT, it can be treated with splenectomy, totally or partially, according to its size and location. We report a case of true splenic cyst in 22-year old female patient who was treated with splenectomy.
Diagnosis, Differential ; Female ; Hemorrhage ; Humans ; Rare Diseases ; Spleen ; Splenectomy ; Young Adult

Mycoplasma pneumoniae (M. pneumoniae) primarily causes respiratory tract infections in persons aged 5-20 years. Tracheobronchitis and bronchopneumonia are the most commonly recognized clinical symptoms associated with M. pneumoniae infection. Complications of this infection are unusual; in particular, cardiac involvement is very rare and is generally accompanied by pneumonia. Nonrespiratory illness can therefore involve direct invasion by M. pneumoniae or autoimmune mechanisms, as suggested by the frequency of cross reaction between human antigens and M. pneumoniae. Herein, we report a case of severe acute myopericarditis with pneumonia caused by M. pneumoniae in a healthy young child who presented with fever, lethargy, oliguria and dyspnea. She survived with aggressive therapy including clarithromycin, intravenous immunoglobulin, inotropics, and diuretics. The patient was discharged on the 19th day after admission and followed up 1 month thereafter at the outpatient clinic without sequelae.
Aged ; Ambulatory Care Facilities ; Azithromycin ; Bronchopneumonia ; Child ; Clarithromycin ; Cross Reactions ; Diuretics ; Dyspnea ; Fever ; Humans ; Immunoglobulins ; Lethargy ; Mycoplasma ; Mycoplasma pneumoniae ; Myocarditis ; Oliguria ; Pericarditis ; Pneumonia ; Pneumonia, Mycoplasma ; Respiratory Tract Infections

Cis-AB and B(A) alleles encode an ABO enzyme with dual A and B glycosyltransferase activity. Although globally rare, the cis-AB phenotype is found relatively often in Korean, Japanese, and Chinese populations. Cases of the B(A) allele have been reported mostly in the Chinese population. Forward typing performed in a Cambodian woman with an ABO discrepancy demonstrated a strong reaction with anti-A and anti-B reagents, while there was no reaction with lectin anti-A 1. The anti-A 1 antibody was detected in reverse typing. Through ABO gene sequence analyses of exons 6 and 7, one of the alleles was identified as ABO*B.01. In contrast, the other allele harboring a c.803G＞C substitution was either ABO*cisAB.05 or ABO*BA.06 allele. The ABO*cisAB.05 and ABO*BA.06 alleles remain indistinguishable despite routine serological testing and ABO genotyping. To the best of the author’s knowledge, this is the first case report of these variants discovered in a Cambodian individual residing in Korea.

BACKGROUND: Pretransfusion tests are essential for safe transfusions, but occasionally, part or all can be omitted when a transfusion is needed urgently in an emergency. The purpose of this study was to share the authors' experience of various pretransfusion test protocols in a tertiary referral hospital in Korea. METHODS: From July 2016 to June 2017, all transfusion cases at Samsung Medical Center were analyzed retrospectively. For each pretransfusion test protocol, the parameters regarding issue, return and disposal rate of blood products, occurrence of hemolytic transfusion adverse effect, and prescription frequency of each respective department and ordering site were analyzed. RESULTS: A total of 90,539 units of red blood cells, 24,814 units of fresh frozen plasmas, 24,758 units of single donor platelets, and 23,303 units of platelet concentrates were issued during the study period. Among them, 3.6%, 1.8%, 0.3%, and 0.4% of red blood cells, fresh frozen plasmas, single donor platelets, and platelet concentrates were issued according to the emergency transfusion protocols. When various pretransfusion test protocols were applied to issue blood products, there was no case in which an adverse hemolytic transfusion reaction was suspected. When compared with usual pretransfusion test protocol, all emergency transfusion protocols showed significantly higher return and wastage rates in red blood cells and fresh frozen plasmas. Platelets also had a higher return and wastage rate, but the difference was not significant. CONCLUSION: These results suggests that there is no different risk of adverse hemolytic transfusion reaction regardless the pre-transfusion protocols, but management about of the increased rate of return and wastage of blood products in emergency transfusions should be considered.
Blood Platelets ; Emergencies ; Erythrocytes ; Humans ; Korea ; Plasma ; Prescriptions ; Retrospective Studies ; Tertiary Care Centers* ; Tissue Donors ; Transfusion Reaction