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A Case of Seminal Fluid-induced Anaphylaxis.

Ju Young JEONG ; Sun JIN ; Jung Wha PARK ; Hye Jin JUNG ; Jong Myung LEE ; Su Jeong KIM

Keimyung Medical Journal.2014;33(2):173-179.

A 27-year-old female developed a series of symptoms consistent with anaphylactic shock following intercourse and visited emergency department. After administration of epinephrine, corticosteroid and antihistamine, her symptoms improved. Previously, she had often developed urticaria after intercourse. However it was not so severe. Skin prick test using her husband's diluted seminal plasma showed positive result. She was diagnosed as seminal plasma allergy and advised to use condom until she wants to conceive. We report a case regarding human seminal plasma allergy presented as anaphylactic shock and conduct literature review of Korean cases.
Adult ; Anaphylaxis* ; Condoms ; Emergency Service, Hospital ; Epinephrine ; Female ; Humans ; Hypersensitivity ; Semen ; Skin ; Urticaria

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Peritonitis Due to Leuconostoc Species in a Patient Receiving Continuous Ambulatory Peritoneal Dialysis.

Sang Hwan BYUN ; Jang Ho PARK ; Kyung Min NAM ; Yung Sun CHO ; Hyun Ju KIM ; Bo Jeung SEO

Keimyung Medical Journal.2014;33(2):169-172.

Leuconostoc species are gram-positive cocci and they are rarely pathogenic in human. Leuconostoc infections are commonly associated with immunocompromised status and indwelling medical devices include intravenous catheter, tracheostomy, endotracheal intubation and percutaneous endoscopic gastrostomy. Clinical isolates of Leuconostoc were frequently misidentified, usually as viridans streptococci, but they possess inherent resistance to vancomycin despite sensitivity to most other antibiotics. We present a case of Leuconostoc peritonitis in patients receiving continuous ambulatory peritoneal dialysis (CAPD). A 48-year-old man with hypertensive nephropathy has been treated with peritoneal dialysis, developed peritonitis due to Leuconostoc species. The peritonitis was poorly responded to empirical antibiotics. He was successfully treated with intraperitoneal administration of ampicillin. The dialysis catheter was left in place, and continued to function. To our knowledge, this is the first case of Leuconostoc peritonitis reported in Korea.
Ampicillin ; Anti-Bacterial Agents ; Catheters ; Dialysis ; Gastrostomy ; Gram-Positive Cocci ; Humans ; Intubation, Intratracheal ; Korea ; Leuconostoc* ; Middle Aged ; Peritoneal Dialysis ; Peritoneal Dialysis, Continuous Ambulatory* ; Peritonitis* ; Tracheostomy ; Vancomycin ; Viridans Streptococci

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A Case of Portal Vein and Splenic Vein Occlusion after Endoscopic Variceal Occlusion Therapy in Gastric Variceal Bleeding.

Eun Jeong KANG ; Soo Young PARK ; Yu Rim LEE ; Chang Yeon KIM ; Sun Young AHN ; Jung Gil PARK ; Hyun Seok LEE ; Won Young TAK ; Young Oh KWEON

Keimyung Medical Journal.2014;33(2):164-168.

Acute gastric variceal bleeding is one of the most serious complications in portal hypertension, and is associated with high mortality and morbidity. Endoscopic variceal obturation (EVO) using Histoacryl(R) (n-butyl-2-cyanoacrylate) has been accepted as an effective hemostatic procedure in acute gastric variceal bleeding. However, EVO is not a widely performed because of technical difficulties and complications such as mucosal ulceration, perforation, and systemic embolism. Herein, we report a patient who developed hepatic failure caused by portal vein occlusion by Histoacryl(R) injection for management of gastric variceal bleeding.
Embolism ; Esophageal and Gastric Varices* ; Humans ; Hypertension, Portal ; Liver Failure ; Mortality ; Portal Vein* ; Splenic Vein* ; Ulcer

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A Case of Rathke Cleft Cyst Apoplexy.

Ealmaan KIM

Keimyung Medical Journal.2014;33(2):159-163.

Rathke cleft cysts (RCCs) are benign epithelial lesions of the sellar and suprasellar region. Most RCCs remain clinically silent throughout an individual's life. Symptomatic patients with RCCs manifest headaches, endocrinopathies, and visual disturbances secondary to parasellar extension. Rarely, RCCs can present in a manner similar to pituitary tumor apoplexy. One such case is reported herein. This 53-year-old man presented with acute headache, vomiting, and partial hypopituitarism. Surgical drainage of the cyst contents via a transnasal route confirmed the diagnosis of RCC and pituitary infarction.
Central Nervous System Cysts ; Diagnosis ; Drainage ; Headache ; Humans ; Hypopituitarism ; Infarction ; Middle Aged ; Pituitary Apoplexy ; Pituitary Neoplasms ; Stroke* ; Vomiting

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Effect of Isotretionin for Refractory Solid-pseudopapillary Tumor of the Pancreas which Previously did not Respond to Anticancer Drugs and Radiation Therapy.

Yoon Jung KIM ; Young Joon AHN ; Hee Jung LEE ; Hye Ra JUNG ; Ok Bae KIM ; Kyoung Sook WON ; Ji Yoon KIM ; Heung Sik KIM

Keimyung Medical Journal.2014;33(2):152-158.

Solid pseudopapillary neoplasm (SPN) of the pancreas is an exocrine tumor with low malignant nature. Although it's treatment of choice is complete surgical resection, the patients who are not eligible for surgical therapy need other kinds of therapy and there are little reports. Vitamin A and its derivatives in some tumors are known to be prohibiting the tumors' growth by reducing the manifestation of transcription factors. We present one case of SPN of the pancreas, which was not eligible for resection and was not responding to chemotherapy and radiation therapy, but, responded with the administration of Isotretionin (Roaccutan(R)). Therefore, for inoperable SPN of the pancreas, we consider Isotretionin therapy can be used as treatment and, in the future, new studies with more of Isotretionin treatment implemented cases should be conducted to identify their anticancer mechanism.
Drug Therapy ; Humans ; Pancreas* ; Transcription Factors ; Vitamin A

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A Case of Gastric Variceal Bleeding Controlled by Percutaneous Tranhepatic Glue Embolization.

Chang Jae HUR ; Wang Yong CHOI ; Eu Gene HAN ; Byoung Kuk JANG ; Jae Seok HWANG ; Woo Jin CHUNG

Keimyung Medical Journal.2014;33(2):146-151.

Gastric variceal bleeding has relatively low incidence rate compared to esophageal variceal bleeding. However, gastric variceal bleeding tends to lead to a massive bleeding and rebleeding which in turn leads to high mortality rate. In cases where endoscopic approach is limited, Ballon-occluded retrograde transvenous obliteration (BRTO) could be considered as a next modality of seizing acute bleeding. Venous catheterization should be preceded to perform venous embolization, however, in cases of hypovolemic shock status, alternative approaches are required. We are reporting a case of 60-year old female with hypovolemic status due to a massive hematemesis, who went through a percutaneous transhepatic glue embolization to control gastric variceal bleeding.
Adhesives* ; Catheterization ; Catheters ; Esophageal and Gastric Varices* ; Female ; Hematemesis ; Hemorrhage ; Humans ; Hypovolemia ; Incidence ; Mortality ; Shock

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Anaphylactic Shock Following Intravenous Injection of Cisatracurium and Sufentanil During Anesthesia Induction.

Hyun Jee KIM ; Jin Hong BAE ; Kyung Hwa KWAK

Keimyung Medical Journal.2014;33(2):140-145.

Anaphylaxis under general anesthesia is rare but can present as cardiovascular collapse, airway obstruction, and/or skin manifestation. A high level of suspicion is required for the recognition and prompt management and anaphylaxis can be diagnosed through clinical findings. The most common causes of anaphylaxis during general anesthesia are neuromuscular blocking agents, antibiotics, and latex. We present a case of anaphylactic shock following intravenous injection of cisatracurium and sufentanil. The patient was under anesthesia induction and within minutes after injection of these drugs, generalized erythema, bronchospasm, and severe hypotension developed. The Patient was managed with epinephrine, proper hydration, hydrocortisone, and pheniramine and the surgery was decided to be postponed. Subsequent surgery should be performed after conducting skin tests which can help identify the causal agents and determine alternative drugs. Anesthesiologists should be aware that not only expeditious diagnosis and management of anaphylaxis but also further evaluation in order to determine the safe method of subsequent anesthesia.
Airway Obstruction ; Anaphylaxis* ; Anesthesia* ; Anesthesia, General ; Anti-Bacterial Agents ; Bronchial Spasm ; Diagnosis ; Epinephrine ; Erythema ; Humans ; Hydrocortisone ; Hypotension ; Injections, Intravenous* ; Latex ; Neuromuscular Blocking Agents ; Pheniramine ; Shock ; Skin Manifestations ; Skin Tests ; Sufentanil*

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Rectal Prolapse Complicated withC lostridium difficile-associated Pseudomembranous Colitis in a Child.

Myoung Sook LEE ; Joon Sung KIM

Keimyung Medical Journal.2014;33(2):136-137.

Among the complications of Clostridium difficile (C. difficile) infection, rectal prolapse has been very rarely reported in children. We report a 29-month-old girl who presented with rectal prolapse complicated with C. difficile-associated pseudomembranous colitis following 3-week course of oral amoxicillin/clavulanic acid for treatment of acute otitis media. The patient complained of fever, abdominal pain and mucoid bloody diarrhea. She also showed a protruded and everted rectal mucosa with discrete white-yellowish exudative plaques. Abdominal CT scan revealed a diffuse wall thickening with mucosal enhancement of the rectosigmoid colon. Both stool culture and toxin assay for C. difficile were positive. Her symptoms were completely improved with oral metronidazole treatment. C. diffile-associated pseudomembranous colitis should be considered as a rare but possible cause of rectal prolapse in children who have recently received antibiotic therapy.
Abdominal Pain ; Child* ; Child, Preschool ; Clostridium difficile ; Colon ; Diarrhea ; Enterocolitis, Pseudomembranous* ; Female ; Fever ; Humans ; Metronidazole ; Mucous Membrane ; Otitis Media ; Rectal Prolapse* ; Tomography, X-Ray Computed

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A Case of Patient with Lung Adenocarcinoma with Double Rare EGFR Mutation of G719C and L861Q.

Jin Tak YUN ; Gi Jun KIM ; Shin Young KIM ; Joon Won JEONG ; Suk Young PARK ; Young Jun YANG ; Ji Chan PARK

Keimyung Medical Journal.2014;33(2):132-133.

The vast majority of epidermal growth factor receptor (EGFR) gene mutations are detected in lung adenocarcinoma. EGFR mutations are the strongest predictor of response to EGFR tyrosine kinase inhibitor (TKI) treatment in patient with advanced non-small cell lung cancer. Of these, exon 19 deletions and exon 21 L858R point mutations account for more than 80% of mutations detected in tumor with EGFR mutations, which called classical EGFR mutations, and double mutations mainly composed of classical and uncommon EGFR mutations are reported to be present in 13% of total EGFR mutations. But there has been no report to date of patient with double mutation of TKI sensitive uncommon EGFR mutations (G719C and L861Q). We experienced a case of patient with lung adenocarcinoma with double mutation of G719C and L861Q, the first case on our literature review, and showing partial response to TKI treatment.
Adenocarcinoma* ; Carcinoma, Non-Small-Cell Lung ; Exons ; Humans ; Lung Neoplasms ; Lung* ; Point Mutation ; Protein-Tyrosine Kinases ; Receptor, Epidermal Growth Factor

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A Case of Polyostotic Fibrous Dysplasia Masquerading as a Mulptile Bone Metastases.

Jaekyung CHEON ; Yumun JEONG ; Ji Young YANG ; Sunpyo LEE ; Misun CHUNG ; Eun Mi SON ; Jae Lyun LEE

Keimyung Medical Journal.2014;33(2):126-131.

Fibrous dysplasia is a benign, bony abnormality that is usually asymptomatic. A 41-year-old male with minimal symptoms presented at this hospital with abnormal findings incidentally seen in his ribs on the chest radiograph. A skeletal survey showed numerous, osteolytic lesions throughout multiple bones. Diagnostic processes for malignancy of undefined primary origin (MUO) were performed in order to identify the underlying primary neoplasm, although abnormal findings were not seen except for multiple bone lesions. A computed tomography guided bone biopsy was performed on his left rib. The final diagnosis was fibrous dysplasia. This case demonstrates that fibrous dysplasia should be considered in the differential diagnosis in young patients with multiple, osteolytic lesions and without a prior history suggesting malignancy.
Adult ; Biopsy ; Bone Neoplasms ; Diagnosis ; Diagnosis, Differential ; Fibrous Dysplasia, Polyostotic* ; Humans ; Male ; Neoplasm Metastasis* ; Radiography, Thoracic ; Ribs

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