A case of primary small cell neuroendocrine carcinoma of the liver / 대한내과학회지

Extrapulmonary small cell carcinoma is a highly malignant and poorly differentiated neuroendocrine tumor. The overall incidence in the United States is approximately 0.1~0.4%. Moreover, small cell carcinoma of the liver is extremely rare and few cases have been reported in the literature. We experienced a 65-year-old woman with a 15 cm hepatic mass, which was localized in the left lobe of a noncirrhotic liver. The mass was confirmed as small cell carcinoma by immunohistochemical staining of a biopsy specimen. Other possible primary sites were excluded by radiologic and endoscopic evaluations. The patient was treated with combination chemotherapy. She was in partial response on the last follow-up visit.

A case of Castleman's disease patient treated successfully with cyclic high-dose steroid therapy / 대한내과학회지

Castleman's disease is rare, and its cause is unknown. Although various treatments have been attempted, no standard treatment has been established for it. A 51-year-old male on hemodialysis with end-stage renal disease was admitted to our hospital with fever and myalgia. He was diagnosed with multicentric Castleman's disease (MCD) of the hyaline vascular type. Considering his underlying disease and general condition, cyclic high-dose steroid therapy (prednisolone 1 mg/kg/day for 5 days) was administered every 4 weeks, eight times in total. After this, no symptomatic manifestations of MCD or signs on computed tomography were observed. We report an immunocompromised patient diagnosed with MCD of the hyaline vascular type, who was successfully treated with cyclic high-dose steroid therapy.

A Case of Merkel Cell Carcinoma Differentially Diagnosed by Thyroid Transcription Factor-1 / 대한피부과학회지

Merkel cell carcinoma is a rare aggressive primary neuroendocrine skin tumor. It is more prevalent in elderly patients and commonly occurs as a solitary lesion on the head and neck. This case reports an 84-year old female with an asymptomatic 1x1.5 cm sized erythematous nodule on the right side of the nose that had rapidly enlarged over a one-month period. Histopathologically, it is difficult to differentiate Merkel cell carcinoma from metastatic small cell lung cancer. Thyroid transcription factor-1 (TTF-1) staining was very useful to differentiate Merkel cell carcinoma from metastatic small cell lung cancer. This case was positive for cytokeratin 20, but negative for TTF-1. We report a case that was diagnosed as Merkel cell carcinoma by TTF-1 staining.

Two Cases of Central Venous Catheter Removal Distress Syndrome / 대한신장학회잡지

Much attention has been paid to the insertion of central venous catheter(CVC) but their removal is a subject discussed rarely. After removal of a central venous catheter, rare but potentially life-threatening, transient cardiopulmonary collapse or neurological dysfunction had developed. The failure to appreciate these complications may be a significant factor in their high mortality. Early recognition and treatment may be made possible by a high index of suspicion. In this report, the clinical courses of two patients with central venous catheter removal distress syndrome are reviewed. Also guidelines for safe removal of CVC are formulated. An awareness of potential CVC removal complications is most important for their prevention and timely treatment. CVCs should be removed with the same degree of meticulous attention to detail that accompanies their insertion. Medical personnel should be reminded that removal of the catheter is an integral component of CVC management.

Progress of Experimental Trichophyton Verrucosum Infection in Guinea Pig / 영남의대학술지

T. verrucosum Infection has been reported for the first time in 1986 in Korea and has been increasing progressively. To evaluate the progress of clinical and histopathological change of dermatophytosis caused by T. verrucosum, inoculation study, using T. verrucosum isolated from infected human (human strain) and from infected cattle (cattle strain), was done in 24 male albino Hartley guinea pig. Their clinical and histopathological changes were evaluated. In addition, comparison for the growth rate between human strain and cattle strain on Sabouraud's glucose agar was made. The results were as follows: 1. Growth rate on Sabouraud's glucose agar: Cattle strain showed significantly more rapid growth rate than human strain on Sabouraud's glucose rate at 25℃ and 37℃. And cattle strain showed more rapid growth rate at 37℃ than 25℃. But human strain showed no significant difference of growth rate at both temperature. 2. Clinical findings: Initial erythema, scale and crust were developed about 8th after inoculation. All three findings reached maximum severity about 12th to 16th day and disappeared about 30th to 34th day after inoculation. There was no significant difference in progress of erythema, scale and crust between cattle strain and human strain. 3. Histopathological findings: Although mild acanthosis was noticed on the 3rd day after inoculation, the other findings including parakeratosis, intraepidermal abscess, spongiosis and vascular change, cellular infiltration were found on 9th day after inoculation. They reached maximum severity on the 12th day and lasted to the 25th day after inoculation. After that, all three findings were decreased gradually between 29th day and 33th day. On the PAS staining, hyphae and spores were found on the 6th day and disappeared on the 21th day after inoculation. 4. In trichophyton skin test, all of the 24 guinea pigs became positive within average 9.83±1.17 days These findings suggested that dermatophytosis caused by T.verrucosum induced rapid cell mediated immunity and contributed to rapid resolution of the lesion.

A Case of Kerion Celsi due to Microsporum canis in An Aged Woman / 대한피부과학회지

Kerion celsi is severe inflammatory type of tinea capitis. It occurs almost exclusively in pre-pubertal children. We report a case of Kerion celsi occuring in a 79-year-old woman. Culture of infected hair on Sabouraud glucose agar showed Microsporum canis Farnily history and fungus study suggested the importance of indirect route in Microsporum canis infection.