S-31 Gastric ulcer induced by gastric mucormycosis

( Myeong Su Chu ),( Hyeon Jeong Yun ),( Seok Hwan Kim ),( Seung Woo Lee ) 대한내과학회 2016 대한내과학회 추계학술대회 Vol.2016 No.1

Mucormycosis is an opportunistic fungal infection that is associated with high mortality in immunocompromised individuals. While rhinocerebral and pulmonary forms are most common, primary gastrointestinal presentation such as hematemesis is very uncommon. We report a rare case of invasive gastric mucormycosis in a 56-year-old diabetic gentleman with a history of chronic alcoholism presenting with complaints of vomiting and hematemesis. At presentation, he was hemodynamically unstable. Upon esophagogastroduodenoscopy exploration, there were multiple ulcerofungating mucosal lesion at gastric body and fundus[Fig 1][Fig 2]. Histopathology revealed aseptate, broad, obtuse angled fungal hyphae, and invasive mucormycosis was confirmed by special stains Periodic acid-Schiff (PAS)[Fig 3]. Antifungal agent medication was performed. At follow up esophagogastroduodenoscopy, the multiple ulcerofungating gastric mucosal lesion were healed[Fig 4]. This case demonstrates an unusual first hematemesis manifestation of gastric mucormycosis. In an immunocompromised patient who is suspected to have gastric ulcer or gastrointestinal bleeding, mucormycosis infection should be considered early in the course of treatment. Early diagnosis and appropriate approach are needed to improve outcomes of such patients.

Solitary schwannoma of the ascending colon

Chu, Myeong Su,Kang, Hyun Mo,Sun, Hyeong Ju,Kim, Dong Min,Kwak, Hyong Jong Yeungnam University College of Medicine 2016 Yeungnam University Journal of Medicine Vol.33 No.1

Schwannomas are uncommon neoplasms arising from Schwann cells of the neural sheath. Gastrointestinal schwannomas are rare, accounting for 1% of all malignant gastrointestinal tumors. Colonoscopic biopsy with immunohistochemical (IHC) staining is useful for confirming this tumor. We report on a patient with schwannoma arising from the ascending colon, which was detected by colonoscopy and endoscopic submucosal dissection was attempted. A 41-year-old man presented with abdominal discomfort. The patient was diagnosed with a subepithelial tumor on colonoscopy. He underwent endoscopic submucosal dissection. Histopathology and IHC staining confirmed that the colonic lesion was a benign schwannoma. However, the resection margin was positive. Therefore, laparoscopic ileocolectomy was performed.

Poster Session : PS 1396 ; Nephrology : Renal Hemangioma

( Myeong Su Chu ),( Hyeong Ju Sun ),( Dong Min Kim ) 대한내과학회 2014 대한내과학회 추계학술대회 Vol.2014 No.1

Background: Renal hemangioma is an uncommon benign tumor. Because of pre-operative distinction between renal hemangioma and renal cell carcinoma are extremely diffi-cult, most patients are treated with nephrectomy. Here we report a 59-year-old female who was mistaken for renal cell carcinoma. Case report: A 59-year-old woman was admitted to our clinic due to painless gross hematuria that had persisted for days. Physical examination was unremarkable. All routine blood tests were normal and no obvious anemia could be found. Urine analysis detected numerous RBC. Urine cytology was negative for malignancy. Enhanced CT scan showed ill defined high attenuation, enhancing parapelvic mass in Lt. kidney, mid portion. (fig.1). Because the tumor`s nature suspected renal malignancy surgical exploration with left nephroureterectomy was performed. Grossly, the tumor showed a hemorrhagic and sponge-like cut surface (fig.2). Microscopic findings revealed hemangioma. Conclusions: In patients with gross hematuria and CT scan findings of ill defined high attenuation, enhancing parapelvic mass lesion locating at the pelvicalyceal junction or inner medulla of kidneys, cavernous hemangioma should be included in the differential diagnosis.

Solitary schwannoma of the ascending colon

( Myeong Su Chu ),( Hyun Mo Kang ),( Hyeong Ju Sun ),( Dong Min Kim ),( Hyong Jong Kwak ) 영남대학교 의과대학 2016 Yeungnam University Journal of Medicine Vol.33 No.1

Schwannomas are uncommon neoplasms arising from Schwann cells of the neural sheath. Gastrointestinal schwannomas are rare, accounting for 1% of all malignant gastrointestinal tumors. Colonoscopic biopsy with immunohistochemical (IHC) staining is useful for confirming this tumor. We report on a patient with schwannoma arising from the ascending colon, which was detected by colonoscopy and endoscopic submucosal dissection was attempted. A 41-year-old man presented with abdominal discomfort. The patient was diagnosed with a subepithelial tumor on colonoscopy. He underwent endoscopic submucosal dissection. Histopathology and IHC staining confirmed that the colonic lesion was a benign schwannoma. However, the resection margin was positive. Therefore, laparoscopic ileocolectomy was performed.

The Application of the Fatty Liver Inhibition of Progression (FLIP) Algorithm and Steatosis, Activity, and Fibrosis (SAF) Score in Korean Patients with Nonalcoholic Fatty Liver Disease

( Myeong Su Chu ),( Hyeon Jeong Yun ),( Myeong Jun Song ),( Seung Won Jung ),( Young Seok Kim ),( Si Hyun Bae ),( Jong Young Choi ),( Sang Wook Choi ),( Seung Kew Yoon ) 대한간학회 2016 춘·추계 학술대회 (KASL) Vol.2016 No.1

Aims: Biopsy is still the gold standard for the diagnosis of nonalcoholic steatohepatitis (NASH) but the definition may vary in evaluation of biopsies for clinical trials. Recently, a scoring system (steatosis, activity, fibrosis[SAF]) allowing the use of an algorithm (fatty liver inhibition of progression [FLIP]) reported for the classification of liver injury in morbid obesity. We evaluated the application of SAF score and FLIP algorithm in Korean patients with nonalcoholic fatty liver disease (NAFLD). Methods: We analyzed the 126 patients with biopsy-proven NAFLD in 5 centers in Korea from Aug, 2008 to April, 2016. Results: In total study populations, 56 patients (44.4 %) were diagnosed to NASH, 70 (55.6%) as NAFLD including 60 patients of a gray zone (NAS 3-4) according to NAS scoring system. Based FLIP algorithms, 72 patients (57.1 %) were categorized as NASH, 54 (42.9 %) as NAFLD. 21 patients (35%) in gray zone (NAS 3-4) and 5 patients (NAS ≥5) were categorized as NASH and steatosis, respectively. The activity score (ballooning+ lobular inflammation) enabled discriminating NASH. All patients with NASH had A ≥3, whereas 3 patients (5.2%) with A2 had NASH. Especially, the presence of ballooning in activity score was the significant factor to discriminate NASH and steatosis. This activity score was also closely correlated with both alanine aminotransferase (ALT) and aspartate aminotransferase (AST) and Fragmented cytokeratin-18, respectively (P=0.000, 0.023, 0.006 respectively). Fibrosis grade by SAF score was significantly correlated with NAFLD fibrosis score and fibroscan (P=0.026, 0.000, respectively). Conclusions: The FLIP algorithm and SAF score system in the NAFLD may provide the favorable tools in Korean patients. Among the SAF score, the ballooning of hepatocyte may be an important factor to discriminate NASH and NAFLD, although it is one of the major limitations of liver biopsy.

관광경영학 전공심화과정과 학점은행 제를 연계한 학사 학위과정 개설에 관한 연구

성명희 ( Myeong-hee Seong ),추수경 ( Su-kyung Chu ),이혁진 ( Hyuk-jin Lee ),정혜진 ( Hye-jin Chung ),구경원 ( Kyung-won Koo ) 한국고등직업교육학회 2003 한국고등직업교육학회논문집 Vol.4 No.2

For the realization of an open education society, various forms of learning and qualifications obtained on and off campus are approved as credits. The present study aims to suggest the directions of an establishment and management of a B.A. degree program in junior college through combining Credit Bank System Courses with Advanced Major Courses in Tourism Management. A questionnaire was administered to 250 employees of the tourism industry field who graduated from junior college. The questionnaire was designed to address 21 research questions: 7 questions on the information about the participants, 4 questions on the necessity of continuing education, 10 questions on the advanced major courses. The finding indicated that over 90% of employees that graduated from junior college wished to continue studying; the main reason that they could not continue studying was their lack of time; discussion-based teaching which reflected their job fields was mostly preferred; the most required course in the tourism-related field was the English language. In conclusion, the teaching technique and curriculum of the courses should reflect the tourism field. A ‘2+1+1 Flexible · Selective Practical Model’ might be suggested according to the students' preference.

건식중간저장 조건 하에서 냉각속도에 따른 지르코늄 합금 피복관 수소화물 재배열 및 기계적 특성 평가

민수정 ( Su Jeong Min ),김명수 ( Myeong Su Kim ),원주진 ( Chu Chin Won ),김규태 ( Kyu Tae Kim ) 대한금속재료학회(구 대한금속학회) 2013 대한금속·재료학회지 Vol.51 No.7

As-received Zr-Nb cladding tubes and 600 ppm hydrogen-charged tubes were employed to evaluate the effects of cladding cooling rates on the extent of hydride reorientation from circumferential hydrides to radial ones and mechanical property degradations with the use of cooling rates of 2, 4 and 15℃/min from 400℃ to room temperature simulating cladding cooling under interim dry storage conditions. The as-received cladding tubes generated nearly the same ultimate tensile strengths and plastic elongations, regardless of the cooling rates, because of a negligible hydrogen content in the cladding. The 600 ppm-H cladding tubes indicate that the slower cooling rate generated the larger radial hydride fraction and the longer radial hydrides, which resulted in greater mechanical performance degradations. The cooling rate of 2℃/min generates an ultimate tensile strength of 758 MPa and a plastic elongation of 1.0%, whereas the cooling rate of 15℃/min generates an ultimate tensile strength of 825 MPa and a plastic elongation of 15.0%. These remarkable mechanical property degradations of the 600 ppm-H cladding tubes with the slowest cooling rate may be characterized by cleavage fracture surface appearance enhanced by longer radial hydrides and their higher fraction that have been precipitated through a relatively larger nucleation and growth rate.

Poster Session : PS 1468 ; Infectious Diseases : A Case for Infectious Spondylitis Due to MSSA Following Acupuncture

( Hyeong Ju Sun ),( Dong Min Kim ),( Myeong Su Chu ) 대한내과학회 2014 대한내과학회 추계학술대회 Vol.2014 No.1

Introduction: Spinal infection following Acupunture often occurs and can lead to severe complication. Case report: a 52-year-old patient visited hospital due to aggrevated abdominal discomfort from a day before, he had been under Acupunture treatment , 3days ago , for his Lower back pain after Traffic accident On the day of visit, the Laboratory findings were as follows: White blood cell (WBC) count 14.00 K/uL, platelet count 266 K/uL, segmented neutrophil count 80 %, creatinine level 1.0 mg/dL, High sensitive C-reactive protein 5.35 mg/dL. Erythrocyte sedimentation rate 78 mm/hr. After 2 days of his admission, he had fever (38.4) and was sufferd from remaind low back pain. Methicillin Sensitive Staphylococcus Aureus was identified from blood culture, there was no specific findings on Abdominal CT, but He was diagnosed with infectious spondylitis on L-spine MRI so he was treated with IV antibiotics for 30 days and oral intake for additional drug after discharge, his symptoms were improved and his laboratory findings were within normal limits. Conclusion: Iatrogenic spinal infection after Acupucture, may lead to severe complication. And delayed diagnosis may makes treatment difficult.

경도의 우울증이 있는 중년 남자에서 날카로운 돼지 척추뼈에

선형주 ( Hyeong Ju Sun ),이정훈 ( Jeong Hun Lee ),김동민 ( Dong Min Kim ),추명수 ( Myeong Su Chu ),박경선 ( Kyoung Sun Park ),최동진 ( Dong Jin Choi ) 영남대학교 의과대학 2015 Yeungnam University Journal of Medicine Vol.32 No.1

In Korea, cases of direct insertion of foreign bodies into the rectum are rare in the literature. Most cases of rectal insertion of foreign bodies are associated with sexual acts and psychiatric disorder such as schizophrenia. Objects inserted into the anus are usually blunt and shaped like the male genitalia. The removal method can be varied depending on the size and shape of the foreign object, its anatomical location, and the accompanying complications. In cases wherein attempts to remove the object fail or there are rectal perforation and peritonitis complications, immediate laparotomy may be required in order to prevent serious complications such as sepsis. Here, we report on a case of rectal perforation and peritonitis due to insertion of a foreign body in a middle-aged patient, with a literature review. He inserted a sharp pig backbone in his rectum and he only had depression. The patient underwent a Hartmann’s operation as well as psychiatric counseling and treatment. Thus, after removal of foreign bodies, psychiatric counseling and treatment should be carried out in order to prevent similar accidents and to minimize the need for trauma medicine.