ABSTRACT
Small cell carcinoma of the uterine cervix is rare. It is estimated that 10% of patients with small-cell lung cancer have syndrome of inappropriate secretion of antidiuretic hormone (SIADH) and hyponatremia has been reported to be significantly associated with a poor prognosis. A proportion of small cell carcinoma of the uterine cervix exhibit neuroendocrine characteristics as revealed by immunohistochemistry, However, cases presenting typical symptoms due to SIADH are extremely rare. This report of the SIADH of the uterine cervix is a rare case in the small cell carcinoma of the cervix presenting with tumor-associated paraneoplastic syndrome.
Subject(s)
Female , Humans , Carcinoma, Neuroendocrine , Carcinoma, Small Cell , Cervix Uteri , Hyponatremia , Immunohistochemistry , Inappropriate ADH Syndrome , Lung Neoplasms , Paraneoplastic Syndromes , Prognosis , Rare Diseases , Uterine Cervical NeoplasmsABSTRACT
PURPOSE: Despite the appropriate antibiotic therapy, some patients with pneumonia do not show a significant clinical improvement. One of the important factors associated with the aggravation of pneumonia is the inflammatory response of the patient. The use of intravenous immunoglobulin (IVIG) to regulate inflammation in severe pneumonia may be beneficial. We evaluated the therapeutic effect of IVIG as an add-on therapy in patients whose pneumonia did not respond to the initial antibiotic therapy. METHODS: This study was conducted from January 2006 to March 2009 on 14 patients admitted with pneumonia who showed persistent fever and progressive worsening of radiographic findings in spite of appropriate empirical antibiotic therapy. Immunoglobulin was administrated on the 3rd to 10th admission days (6th days on average). RESULTS: The median age was 67 months (range 16-102 months), and 8 were female. All children received ampicillin+sulbactam+macrolide, or cefotaxime+macrolide. Acute Mycoplasma infection occurred in 64% (9/14) of the patients. The collapse and/or consolidation of the lobe was found in 50% (7/14) of the patients on chest radiograph. After IVIG administration, all patients became afebrile within 24 hrs, and their C-reactive protein and radiographic findings showed a significant improvement in several days. CONCLUSION: Prompt IVIG therapy may be beneficial to patients with pneumonia who did not respond to the initial antibiotic therapy, especially when the use of corticosteroids is contraindicated.
Subject(s)
Child , Female , Humans , Adrenal Cortex Hormones , C-Reactive Protein , Fever , Immunoglobulin A , Immunoglobulins , Immunoglobulins, Intravenous , Inflammation , Mycoplasma Infections , Pneumonia , ThoraxABSTRACT
Spontaneous pneumomediastinum (SPM) is a rare condition in children which is triggered by respiratory infection and inflammation, although it occurs most commonly in asthmatics. It is caused by alveolar rupture and dissection of air into the mediastinum and hilum, and the prognosis is usually benign. We report two cases of SPM and subcutaneous emphysema complicating pneumonia in children with severe H1N1 infection. The patients were admitted to the intensive care unit and treated with oxygen, inhalation of a bronchodilator, intravenous systemic corticosteroid (methyprednisolone, 2 mg/kg/day for 5 days) and antibiotics, together with antiviral therapy. On day 4 after admission, there was no further evidence of SPM. SPM associated with severe H1N1 infection in children resolves with aggressive supportive care, without progression to pneumothorax. We should remain aware of this air leak complication in children with severe respiratory infection.
Subject(s)
Child , Humans , Anti-Bacterial Agents , Emphysema , Inflammation , Influenza, Human , Inhalation , Intensive Care Units , Mediastinal Emphysema , Mediastinum , Oxygen , Pneumonia , Pneumothorax , Prognosis , Rupture , Subcutaneous EmphysemaABSTRACT
Cowden's syndrome is a harmatomatous polyposis syndrome with characteristic mucocutaneous lesions and among the spectra of clinical disorders that has been attributed to germline mutations in the PTEN gene. Although Cowden's syndrome has rarely been reported, immunologic studies have revealed that patients with this syndrome have humoral and/or cellular immune abnormalities. We recently identified a 21-year-old woman with Cowden's syndrome who was diagnosed with candida esophagitis without a history of diabetes, carcinoma, or steroid therapy. We report the immunologic status of this patient and the relationship with candida esophagitis on the basis of a literature review.
Subject(s)
Female , Humans , Young Adult , Candida , Esophagitis , Germ-Line Mutation , Hamartoma Syndrome, MultipleABSTRACT
Fresh-cut foods have been widely used in the school foodservice industry due to their convenience and saving effects of labor and working hours. This study evaluated the effectiveness of using fresh-cut foods in school foodservice with respect to cost efficiency, customer satisfaction, employee satisfaction, and productivity. First, in terms of cost efficiency, the cost of the fresh-cut food per meal price significantly increased by 2.6% via the new production plan. Meanwhile, the costs of labor and food wastes significantly decreased by 3.0% and 0.3%, respectively, after implementing the new plan. Second, customer satisfaction towards foodservice significantly increased, from 2.94 points prior to the new plan to 3.45 points. Third, foodservice productivity such as of the number of meals per full-time equivalent employee increased by 5.7 meals, from 143.0 meals to 148.7 meals after intervention. The productivity index of work hours for producing a meal also increased and was reflected by a work time reduction of 0.77 minutes, specifically from 4.25 minutes to 3.48 minutes. The labor cost per meal also decreased by 29.9 won, from 331.91 won to 301.97 won, but there was no significant difference. Through these results, we identified that using pre-process foods in school foodservice has positive effects on labor saving, customer satisfaction, and employee work satisfaction.