Charcoal-induced anthracosis of the terminal ileum / 대한내과학회지

Anthracosis is a very common disease of the bronchus, while anthracosis of the gastrointestinal tract is extremely rare. Only a few cases of anthracosis of the esophagus have been reported and no cases of anthracosis of the terminal ileum are known, except one patient in Korea who was described as having melanosis ilei. A black pigmented lesion was detected in the terminal ileum on colonoscopic examination of a 51-year-old woman. Histological examination revealed a pigmented lesion beneath the mucosal epithelial layer and lymphoid follicular hyperplasia. The lesion consisted of an aggregation of histiocytes containing abundant tiny black pigments. She has taken oral charcoal for 7 years. We diagnosed anthracosis of the terminal ileum caused by oral charcoal and report a case of charcoal-induced anthracosis of the terminal ileum.

Distribution of Mediastinal Lymph Node Enlargement in Non-Small-Cell Lung Cancer / 결핵

BACKGROUND: The aim of this study was to elucidate the mediastinal lymphatic drainage of non- small-cell lung cancer (NSCLC). METHODS: We retrospectively analyzed the frequency of enlarged mediastinal lymph node (LN) in 256 NSCLC patients with N2 or N3 diseases on CT scan, especially with respect to the location of primary tumor. RESULTS: In 57 patients with right upper lobe (RUL) tumors, right lower paratracheal LN (89.5%) was the most commonly enlarged, followed by subcarinal LN (54.4%). In 61 patients with left upper lobe (LUL) tumors, left lower paratracheal (70.5%) and subaortic LNs (52.5%) were commonly enlarged. Subcarinal LN enlargement without ipsilateral superior mediastinal LN enlargement was rarely found in both upper lobe tumors; RUL 8.8%, LUL 6.6%. In patients with right or left lower lobe (RLL or LLL) tumors, the most commonly enlarged LN was subcarinal; 88.2%, 65.7%, respectively. In RLL tumors with both subcarinal and superior mediastinal LN enlargements, the frequency of ipsilateral superior mediastinal LN involvement was similar to that of bilateral superior mediastinal involvement. In LLL tumors with both subcarinal and superior mediastinal LN enlargements, bilateral superior mediastinal involvement was more frequent than ipsilateral superior mediastinal involvement. CONCLUSION: The results of this study suggest that both upper lobe tumors are mainly drained directly to ipsilateral superior mediastinal LNs, and that both lower lobe lesions are drained to superior mediastinal LN via subcarinal LNs.

Doctors' Opinions on Lung Cancer Treatment / 결핵

BACKGROUND: Patients with lung cancer and their relatives often ask the advice of relative or friends who are doctors on the treatment and prognosis of the disease. Therefore a doctor's opinion may play a role in determining the treatment modality and affect therapeutic compliance of patients. The purpose of this study was to find the opinion of general practitioners on lung cancer treatment. METHOD: A mail survey for general practitioners in Taegu City and Northern Kyungsang Province was performed. Each individual was sent a written questionnaire in which he or she was asked for ten questions about management and prognosis of lung cancer. RESULTS: Two hundred and twenty eight doctors filled in the questionnaire. Of the respondents, 68% had the experience of being asked about lung cancer by their friends or relatives. About 52% replied that it was better to tell the patient of his or her disease. And about 22% considered it better to follow the relatives' opinion. On the question about choosing the treatment modality, following the doctors' plan was most appropriate in 86.9%, showing that most respondents favored actively recommending doctors. Nonsurgical treatment was preferable in patients over 80 years old with resectable lung cancer and with an increase in age, significant increase was observed in respondents recommending nonsurgical treatment. Most respondents said that they would actively recommend or advise following the doctor' plan about radiotherapy and chemotherapy. But a large percent of the respondents had a negative view on the effect of radiotherapy and chemotherapy. CONCLUSION: The opinions of general practitioners on the treatment and prognosis of lung cancer was variable. And they did not prefer active treatment for patients with old age or advanced lung cancer.