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비록 자궁경부암이 갑상선으로의 전이는 매우 드물지만, 자궁경부암의 과거력이 있는 경우, 갑상선부위의 부종이나 촉지되는 결절이 발생하면 반드시 전이성 병변을 의심해봐야 한다. 비록 갑상선으로의 전이는 매우 나쁜 예후를 의미 하지만 고식적 치료로 전신항암요법 및 방사선요법이 환자의 삶의 질 개선에 도움을 줄 수 있다. 드물기는 하지만 갑상선으로의 악성전이 보고가 증가하는 추세로, 이에 대해 어떠한 치료가 가장 효과적일지에 대한 연구가 필요하겠다.

As side effects of chemical antifungal agents has been reported, this study was conducted to confirm the reported antifungal effect of Lespedeza cuneata on Candida albicans (C. albicans), and to investigate the usability of Lespedeza cuneata for the prevention and treatment of oral diseases. Lespedeza cuneata was placed in 80% ethanol at a 5:1 ratio, and was immersed therein for 24 h at a 65°? dry oven. It was concentrated using a rotary vacuum evaporator after filtration. The concentrated Lespedeza cuneata extract was used after being dried using a -80°? freeze dryer. The antifungal effect of Lespedeza cuneata extract on C. albicans was investigated using the paper disc method, which presents the bacterial inhibitory area by 1.5, 2.5, 5, 10, and 20 mg/ml concentrations, as well as the colony-forming units (CFUs) method, which confirms the colony formation on the yeast mold (YM) agar medium. The measurement of the clear paper disc circle using a growth inhibitory section showed bacterial inhibition, with 13 mm at 20 mg/ml, 11 mm at 10 mg/ml, and 10 mm at 5 mg/ml. As the concentration of Lespedeza cuneata extract increased, greater bacterial growth inhibition was observed. The survival rate of C. albicans calculated from the CFUs showed more distinct bacterial growth inhibition as the concentration increased. Based on these results, alleviation of the problems and side effects of the use of the existing antibiotics against oral candidiasis was confirmed, as well as the usability of Lespedeza cuneata for the treatment and prevention of oral diseases.

Enterolith is a rare complication of Billroth II gastrectomy. Most enterolith cases have been reported in association with diverticula, tuberculosis, and Crohn’s disease. We report the case of a huge enterolith that developed in the duodenal stump following common bile duct obstruction and cholangitis, necessitating surgery. The enterolith was clearly visible on the abdominal computed tomography. It was removed through a duodenotomy. The surgery was successful without any significant complications. (Korean J Gastroenterol 2016;67:150-152)

Radiation dermatitis can develop after fluoroscopy-guided interventional procedures. Cases of fluoroscopy-induced radiation dermatitis have been reported since 1996, mostly documented in the fields of radiology, cardiology and dermatology. Since diagnosis and treatment of fluoroscopy-induced radiation dermatitis can be difficult, high grade of suspicion is required. The extent of this reaction is determined by radiation dose, duration of exposure, type of procedure, and host factors and can be aggravated by concomitant use of photosensitizers. Follow-up is important after long and complicated procedures and efforts to minimize radiation exposure time will be necessary to prevent radiation dermatitis. Herein, we report a case of a 58-year-old man with hepatocellular carcinoma presenting with subacute radiation dermatitis after prolonged fluoroscopic exposure during transarterial chemoembolization and chemoport insertion. Physicians should be aware that fluoroscopy is a potential cause of radiation dermatitis. (Korean J Gastroenterol 2016;67:112-115)

With the accumulation of clinical trials demonstrating its efficacy and safety, peroral endoscopic myotomy (POEM) has emerged as a less invasive treatment option for esophageal achalasia compared with laparoscopic Heller myotomy. However, the difficulty in determining the exact extent of myotomy, a critical factor associated with the success and safety of the procedure, remains a limitation. Although the various endoscopic landmarks and ancillary techniques have been applied, none of these has been proven sufficient. As a solution for this limitation, the double-scope POEM technique with a second endoscope to assure the exact length of the submucosal tunnel has been applied since 2014. Before double-scope POEM was introduced, the second endoscope was applied only to confirm the accuracy of the procedure. In the present study, we performed double-scope POEM in the treatment of esophageal achalasia through a novel procedure of simultaneous application of the second endoscope to assist in the conventional POEM procedure.

Acute clinical deterioration in patients with chronic liver disease is called acute on chronic liver failure (ACLF). Principles of management of ACLF consist of early identifying etiology of liver disease, rapid intervention of precipitating event and discreet intensive cares. Despite medical intensive cares, if liver failure progresses, liver transplantation could be the other option. Also, liver transplantation is the only treatment that offers a chance of cure for hepatocellular carcinoma (HCC) and the underlying liver cirrhosis simultaneously. Emergent living donor liver transplantation (LDLT) can be performed for patients with acute liver failure and improves survival rate, especially in circumstances which liver graft is often not available because of deceased donors are not affordable. Here, we describe a chronic hepatitis B patient who developed ACLF accompanying early HCC. Because he did not improved with medical care, he received emergent LDLT. After LDLT, he showed great improvement without critical complications. (Ewha Med J 2016;39(3):76-80) Received July 29, 2015 Accepted May 18, 2016