A Case of Giant Carcinosarcoma of the Parotid Gland / 대한이비인후과학회지

Carcinosarcoma, or true malignant mixed tumor of the salivary gland, is a very rare malignant tumor comprised of both carcinomatous and sarcomatous elements and accounts for only 0.04-0.16% of all salivary gland tumors. Carcinosarcoma usually occurs in the parotid gland. Other locations including submandibular gland, minor salivary gland, uterus, bladder or lung have been reported. We report a rare case of carcinosarcoma of the parotid gland in an 85-year-old female. The tumor was large, about 19x17 cm in size, and was successfully excised.

A Case of Jacobson's Nerve Schwannoma Extending into the External Auditory Canal / 대한이비인후과학회지

Schwannomas are slow-growing, benign neurogenic tumors arising from schwann cells. Their localization in the external auditory canal and the middle ear has rarely been reported. The authors experienced a very rare case of Jacobson's nerve schwannoma that extended into the external auditory canal in a 55-year-old woman. The tumor eroded the wall of the cochlear promontory and exposed the membranous labyrinth. The jugular foramen and the wall of the ear canal were preserved without destruction. This report represents the first documented case of a Jacobson's nerve schwannoma, which involved the external auditory canal.

Peripheral nitric oxide activity in patients with liver cirrhosis / 대한내과학회지

BACKGROUND: Nitric Oxide (NO) induced by NO synthase is known to be associated with hyperdynamic circulation and collateralization by vascular remodeling in patients with cirrhosis. METHODS: To assess the significance of peripheral NO activity in patients with cirrhosis, we measured the production of NO metabolites, nitrate and nitrite, using the nitrate/nitrite colorimetric assay with Griess reagents in the peripheral venous blood of 95 cirrhotic patients with or without clinical portal hypertension (PHT), and in the peripheral venous blood of 32 control patients without liver disease. RESULTS: The peripheral NO activities in cirrhotic patients with clinical PHT, cirrhotic patients without clinical PHT, and non-liver disease control patients were 86.1+/-40.6 micro mol/L, 83.5+/-47.2 micro mol/L and 52.3+/-38.4 micro mol/L, respectively. NO activity was significantly higher in cirrhotic patients than in non-liver disease control patients (p<0.05), while there was no significant difference of NO activity between the cirrhotic patients with or without clinical PHT. Peripheral NO activities in cirrhotic patients with Child-Pugh classification A, B, and C were 84.9+/-45.5 micro mol/L, 81.9+/-53.2 micro mol/L and 86.4+/-39.8 micro mol/L, respectively; these results were not significantly different. A significant correlation of NO activity with the biochemical profiles of the serum albumin level, bilirubin level and prothrombin time were not defined. CONCLUSIONS: Peripheral NO activity was increased in cirrhotic patients, but it did not reflect the degree of clinical portal hypertension and the function of the hepatic reserve in this study. For a precise analysis of the association of NO and hyperdynamic circulation with collateralization in cirrhosis, intrahepatic or portal NO activity might be considered rather than peripheral NO activity.

A Case of Severe Skin Eruption Caused by Lamivudine in a Patient with Chronic Hepatitis B / 대한소화기학회지

Lamivudine is widely used for the treatment of chronic hepatitis B infection because of it's remarkable antiviral efficacy and safety. We report a case of severe skin eruption caused by lamivudine. A 47-year-old female was admitted because of jaundice and itching sensation. She was diagnosed as chronic hepatitis B infection a few years ago but did not receive any specific treatment. Laboratory data showed acute deterioration of chronic hepatitis B infection. We prescribed lamivudine as a rescue therapy. Her general condition improved and lab data showed improvement in liver function test thereafter. However, she complained of severe skin eruption and itching sensation a few days after the discharge. We stopped lamivudine because the symptoms did not improve despite the use of anti-histamine. Skin biopsy showed interface dermatitis. After stopping lamivudine, her symptoms improved. However, the skin eruption developed again after lamivudine was restarted. Adefovir was used instead, and the patient did not experience any further skin problems since then.

Chronic Necrotizing Bronchopulmonary Aspergillosis With Elements of Bronchocentric Granulomatosis

Chronic necrotizing pulmonary aspergillosis (CNPA) is an unusual form of pulmonary aspergillosis arising in the setting of mildly immune compromised state or altered local defense system. CNPA rarely shows histological findings mimicking bronchocentric granulomatosis (BCG), which is characterized by peribronchiolar granulomatous destruction. We describe a case representing CNPA with elements of BCG. A-64 year-old woman was admitted because of atypical pneumonia with multi-focal variable sized consolidations and cavitary lesions on high-resolution computed tomography (HRCT). The open lung biopsy specimen showed large areas of necrotizing pneumonia with some scattered aspergillus hyphae within the lung parenchyma. Some terminal bronchioles were found to be destroyed and were replaced by peribronchiolar granulomatous inflammation. There was no evidence of angioinvasion by aspergillus or aspergillous emboli. Despite vigorous antifungal agent and steroid treatment, she died of acute airway obstruction by bronchial casts on the thirty-fourth hospital day.

A Sociomedical Research on Oriental Hospital Out and Inpatients of Cerebrovascular Accident / 한국역학회지

This study is comprehend the reality and characteristics of C.V.A. patients and to be helpful to its prevention and cure by resarching C.V.A. outpatient or inpatients who visited some of the oriental hospitals during three months from April 1 to June 30 1996 which are located in Taegu and Kungbuk Province, and concluded as follow: 1. The general characteristics of the subjects were: (1) 52.3% of the subjects were male. (2) In terms of age, 34.7% of them were in the sixties. (3) In terms of job, 28.5% of them were housewives(the highest percentage). (4) 77.6% of them had their spouses. (5) 67.2% of them were middle class. (6) In terms of educational background, 24.6% of them were literate of korean alphabets, and 23.4% were elemantary school gradurates. (7) 51.6% of them were outpatients. 2. 73.3% of the subjects experienced C.V.A. for the first time, and 23.1% were at recurrence, and 3.6% were chronic. 3. In terms of C.V.A. types, 49.8% of the subjects had cerebral hemorrhage, and 41.9% had cerebral infarction, and 8.3% had the others. In cerebral hemorrage, the percentage in "male, forties, job of sales service, unmarried, middle class, high educational background" were higher than the others respectively. And in cerebral infarction, the percentages in female, over seventies, official job, married, upper class were higher than the others respectively. 4. In terms of reasons of C.V.A. 49.5% of them were high blood pressure, and 24.2% were high stress, and 18.8% were overwork, and 4.0% were fatness, and 2.5% were heredity. In high blood pressure, the percentages in "high age, teacher, unmarried, lower class, low educa-tional background" were higher than the others respectively. 5. In terms of family members' C.V.A. , 56.7% of the subjects answered negatively, and 43.3% positively. In terms of the diseases which they had now except for C.V.A., 33.6% of them had hypertention, and 16.2% had diabetes, and 9.4% had neuralgia, and 4.0% had heart disease, and 16.6% had the otehrs, and 20.2% had no other disease. In heart disease, the percentages in "male, teachers, middlelower class, middle school graduates, inpatients" were higher than the others respectively. In neuralgia, the percentages in "fifties and sixties, housewives, spouse alive, upper class, literate of Korean alphabet" were higher than the others respectively. In terms of the diseases which they had now except for C.V.A., 33.6% of them had hypertension, and 16.2% had diabetes, and 9.4% had neuralgia, and 4.0% had heart diseases, the percentages in "fifties and sixties, housewives, spouse alive, upper class, literate of Korean alphabets" were higher than the others respectively. 6. In terms of the diseases which they had before C.V.A., 22.4% of them had hypertension, and 18.8% had diabetes, and 8.1% had heart diseases, and 11.2% had neuralgia and arthritis, and 7.8% had cancer, and 21.7% had the others. 7. In terms of exercise behaviors before C.V.A., 41.2% of them did nothing, and 58.8% did sometimes. 8. In terms of fatness level by self judgement, 36.1% of them thought "proper", and 41.1% thought themselves "fat(the highst percentage), and housewives(45.5%) thought themselves "fat". 9. In terms of favorite food, 50.2% of them liked meat, and 33.2% liked vegetables, and 13.0% liked fish. 10. In terms of fancy things of C.V.A. patients, 57.0% of them were non-smokers, and 53.1% were non-drinkers, and 55.2% disliked coffee. In smoking level, 16.6% of them smoked less than five pieces a day. In drinking, 18.0% of them drank half a glass of soju. In coffee, 25.3% of them drank a cup of coffee a day. 11. The level of satisfaction with C.V.A. patient-healing methods ; In medical therapy, 43.3% of C.V.A. patients thought it "usual", and 44.1% thought it "satisfactory" and 7.9% thought it "unsatis-factory". In acupunture and moxibustion 39.7% of the C.V.A. patients thought it "usual", and 53.0% thought it satisfactory" and 3.3% thought it "unsatisfactory". The level of satisfaction With Physiotherapy was average 61.7% and 4.0% was "unsatisfactory". From above statement, by considering those characteristics we should develop programs and materials to be health to the prevention and cure of C.V.A. and we should help hospitals and medical personnel families concerned to make use of them.