, Jihyun Lee, Yeji Han, Seog Ki Min, Min-Sun Cho, Yeon-Ah Sung A substantial proportion of adrenal incidentalomas demonstrates subtle hormonal hypersecretion; however, adenomas that cosecrete aldosterone and cortisol are rare. We here report a case of an adrenal mass that was incidentally detected on a computed tomography scan in a 57-year-old man. The patient had a 10-year history of diabetes mellitus and a 5-year history of hypertension. Evaluation revealed hyperaldosteronemia with an elevated plasma aldosterone-to-renin ratio, hypokalemia, unsuppressed cortisol after dexamethasone administration, and elevated urinary free cortisol concentration. The appearance of the right adrenalectomy specimen indicated adrenal adenoma. Postoperatively, the blood glucose and blood pressure control improved and the urinary cortisol and aldosterone-to-renin ratio normalized. A complete endocrine evaluation in patients with incidentally discovered adrenal masses should be performed, even if the patient has a long-standing history of hypertension and diabetes, to avoid any postoperative adrenal crises.
, Tae Hun Kim, Kwon Yoo, Ye Ji Han, Jeong Eun Choi, Ji Yoon Kim, Min-Sun Cho Primary biliary cirrhosis (PBC) is a chronic cholestatic liver disease that may progress to end stage liver cirrhosis. Benefits of ursodeoxycholic acid (UDCA) treatment has been investigated through large clinical studies. However, most of the studies were done in western countries and recent increase in prevalence of this relatively uncommon chronic liver disease draws attention in Korea. As early UDCA treatment effectively prevent the grave consequences of PBC progression, early diagnosis and lifelong management with UDCA is important. This study was designed to investigate the clinical features of PBC and response rates of UDCA treatments in Ewha Womans University Medical Center.
Clinical data of PBC patients diagnosed between 2001 and 2014 at Ewha Womans University Medical Center were analyzed retrospectively.
A total of 35 patients with mean follow-up duration of 42 months were enrolled. At the diagnosis, 72.7% of the patients were asymptomatic, 5.7% had decompensated liver cirrhosis. The mean serum alkaline phosphate (ALP) level was 2.65 times upper limit of normal. UDCA was prescribed in 91.4% of the patients (n=32), among which 77.4% exhibited biochemical responses defined as serum ALP less than 2 upper limit of normal at 6 months (Mayo criteria).
Most PBC patients were asymptomatic at the time of diagnosis and the average biochemical responses rate to UDCA treatment were ranged from 60.0% to 78.9% according to various response criteria. To elucidate the clinical features and courses of Korean PBC patients in detail, larger scale investigations and longer clinical follow up studies are warranted.
, Hee Jung Choi, Hyo Moon Son, Yoon-Ii Choi, Min-Sun Cho Actinomycosis causes a chronic suppurative, granulomatous disease which is characterized by extensive abscess formation, and sulfur granule formation. Actinomycosis may present different clinical forms: cervicofacial, thoracic, abdominal and cerebral actinomycosis. The diagnosis can only be made after surgery. In general, patients with abdominal actinomycosis have undergone abdominal surgery. We report four cases of primary appendiceal actinomycosis presenting as acute appendicitis without history of abdomen surgery.
, Hye-Kyung Jung, Min-Sun Cho, Min-Jin Lee, Myung-Eun Song, Da-Yeon Oh, Ha Eung Song Sunitinib an inhibitor of the vascular endothelial growth factor receptor, is highly effective against renal cell carcinoma and is now widely used in patients with metastatic disease. Gastroesophageal reflux disease (GERD) is rarely reported as a side effect of sunitinib. We report two cases of GERD with upper gastrointestinal bleeding related to sunitinib administration. Both cases responded well to conservative management. Microscopic findings in both cases showed cellular atypia such as hyperchromasia, increases in nuclear size, and multinucleation. The cellular atypia of the squamous mucosa appears to be associated with reparative processes.
Citations
, Hanna Kang, Dong Eun Song, Min-Sun Cho DNA methylation of promoter-associated CpG islands is an epigenetic modification of DNA associanted with gene silencing. p73 is a member of the p 53 family which is a tumor suppressor gene producing apoptosis and cell cycel arrest. We investigated the methylation pattern of p73 on the cases diagnosed at Ewha university hospital between 1993-2002.
Sixteen cases of NK/T cell lymphomas and 7 cases of normal controls, which were 2 cases of peripheral blood mononuclear cells and 5 cases of nasal mucosal tissue were studied. Methylation-speific PCR for p73 were done.
All cases of NK/T cell lymphomas except one(93.8%) showed hypermethylation of p73. Six cases among 7 normal control cases(14.2%) revealed unmethylated p73.
This results suggested that inactivation of p73 could be associated with tumorigenesis of NK cells.
, So-Youn Woo Epstein-Barr virus(EBV) is associated with development of various types of lymphoma, especially NK/T cell lymphoma. Recently, its subtypes and LMP-1, major oncoprotein of EBV, have been studied. We investigated the frequency of EBV, its subtypes, and LMP-1 status on the cases diagnosed at Ewha university hospital between 1993 and 2002.
Sixteen cases of NK/T cell lymphomas were studied. In situ hybridization for EBER-1 mRNA and PCR for EBV subtypes and 30 base pair deletion of LMP-1 were done.
All cases showed EBV positivity by EBER in situ hybridization. All cases contained Type A viruses and 10 cases(62.5%) revealed LMP-1 30bp deletion.
EBV act as a causative role in the development of NK/T cell lymphoma. The exact role of LMP-1 30bp deletion variant in the lymphomatogenesis should be studied with larger number of cases.
, Woon Sup Han Subacute necrotizing lymphadenitis is a self-limiting disorder that typically affects cervical lymph nodes of young women. Although autoimmune reaction and a viral etiology have been suggested, the definite cause has been uncertain. We evaluated the association of M. tuberculosis and non-tuberculous mycobacterium with this disorder.
From 1994 to 2002, Clinicopathological findings of 38 cases were reviewed. Multiplex nested PCR was done using DNA extracted from paraffin-embedded tissue. Sequencing analysis was done to the cases showing positive band.
3 cases among 38(7.89%) showed amplified non-tuberculous mycobacterium DNA. Two cases are M. gordonae and one is M. fortuitum by sequencing analysis. All cases revealed no positive band for M. tuberculosis. Negative control cases showed no bands for both mycobacteriums.
Although 7.89% of cases showed amplified non-tuberculous mycobacterium DNA, more study is needed to confirm the association of non-tuberculous mycobacterium with subacute necrotizing lymphadenitis.
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