PILL series. The solitary pulmonary nodule

The solitary pulmonary nodule on chest X-ray (CXR) is a common problem in pulmonary medicine. Its presence raises the question of lung cancer. As five-year survival after resection of a solitary bronchogenic carcinoma can be as high as 80%, prompt evaluation is crucial. This should begin with a cancer risk assessment based on clinical and radiographic factors. The risk and benefits of surgery should next be assessed, and together with the patient's preferences, a management plan can be decided upon. Surgery is recommended for patients at high risk of malignancy with a low surgical risk, while careful observation is adopted for patients at low risk of malignancy coupled with a high surgical risk. Further diagnostic tests may be warranted to aid in this decision process. Although CXR is not useful for lung cancer screening, low-dose computed tomography imaging is increasingly recommended for individuals at high risk for lung cancer.

Adenocarcinoma of the parotid gland with calcification / 대한구강악안면방사선학회지

A 78-year-old woman was referred to Chonbuk National University Dental Hospital complaining of facial palsy and palpable mass on the right parotid gland area. Clinical examination showed non-specific findings of the intraoral region, but showed asymmetrical facial appearance. Panoramic view showed a large amorphous calcified mass on the posterior to the mandibular ramus and thin cortical plate of the posterior ramus. Sialogram showed constriction of the main duct and no further filling of striated, intercalated ducts and parenchymal areas. CT scans demonstrated an irregular, infiltrating mass with slight enhancement in the right parotid gland. The mass showed necrotic areas and calcifications. Bone scan showed marked accumulation of (99m)Tc-MDP on the right posterior maxilla. Microscopic findings demonstrated the minimal morphologic alterations and rare mitotic figures within tumor cells, and diagnosed as adenocarcinoma (NOS, Grade II). This report could be aid in the diagnosis of calcified lesions of the salivary gland.

Polymorphism of CYP2D6*10B of Patients with Schizophrenia in Korean Population / 신경정신의학

OBJECTIVES: This study was done to compare the proportion of the CYP2D6*10 allele between previously reported data of normal Korean subjects and schizophrenic patients. And we investigated the relationship between the CYP2D6*10 allele and the clinical variables such as age of onset, duration of illness and psychopathology. METHODS: Total 82 DSM-IV Korean schizophrenic patients in monotherapy with risperidone participated in this study. The CYP2D6*10 allele which contains C188T mutation in exon 1 was identified by allele specific PCR amplification. We investigated the clinical variables such as age of onset and duration of illness through chart review. The baseline psychopathology with brief psychiatric rating scale (BPRS) before blood collection were done in clinically stable patients. RESULTS: Seventeen (20.7%) out of 82 patients were homozygous for CYP2D6*1, 22 (26.8%) for *10, while the remaining 43 patients (52.4%) were heterozygous for these alleles. These distributions were very similar with previously reported data of Korean normal subjects. There was no significant relationship between the CYP2D6*10 allele and the clinical variables such as age of onset, duration of illness and psychopathology. CONCLUSION: In Korean schizophrenic patients, there was no significant difference in CYP2D6*10 allele compared to normal Korean subjects.