A Case of Amylase Producing Small Cell Lung Cancer / 결핵

The majority of lung cancers associated with hyperamylasemia are adenocarcinomas. Here we report an unusual case of a 54-year-old male patient who complained of dyspnea, anterior chest wall discomfort and facial edema for one month, presenting with a huge mediastinal mass and hyperamylasemia complicated by pericardial effusion Histological evaluation of mediastinal mass revealed small cell carcinoma and pericardium showed nonspecific inflammation with fibrosis. The serum amylase had an electrophoretic mobility similar to that of salivary gland enzyme. There were no evidence of a salivary or pancreatic causes of hyperamylasemia. After chemotherapy, parenchymal lung lesions improved and hyperamylasemia disappeared. For the mannagement of peracardial effusion a pericardial window was forms(i. We concluded that the striking increase in serum amylase was due to the ectopic production of this enzyme by the tumor.

Distribution of phospholipase C isozymes in normal human lung tissue and their immunohistochemical localization

Phospholipase C(PLC) plays a central role in signal transduction and it is important in cellular growth, differentiation and transformation. There are currently ten known mammalian isozymes of PLC identified and cloned. However, there are no report of PLC distribution in human lung tissue or their significances in pulmonary diseases. Presence of various PLC isozymes in normal human lung tissue was studied from surgical specimens. PLC isozymes in tissue extracts of the lung were partially purified by successive chromatographic steps on heparin-sepharose CL-6B conventional and TSKgel heparin-5PW HPLC columns and their activities were assayed. PLC activity peaks identified in the chromatography were immunoblotted with specific antibodies against ten known mammalian PLC isozymes(PLC-beta 1-4, -gamma 1-2, and -delta 1-4). In addition, immunohistochemical staining of the lung tissue was performed to determine subcellular and histological localization of PLC isozymes. The results indicate that normal human lungs contain beta 1, beta 3, gamma 1, and delta 1, isozymes of PLC. The order of amount present in the lung tissue was PLC-delta 1 > gamma 1 >beta 1 >> beta 3, in descending order. On immunohistochemistry, PLC-gamma 1 was most widely distributed and was present in bronchiolar epithelium, in type I and type II pneumocytes as well as in fibroblasts of the interstitial tissue. PLC-delta 1 was present in the cytoplasm of the bronchiolar epithelium whereas PLC-beta 1 was localized to the apical membranous portion of the same epithelium. PLC-beta 3 was seen in the nucleus of the respiratory and alveolar lining epithelium as well as in the nucleus of lung fibroblasts.

A Case of Bronchial Granular Cell Tumor / 결핵

Granular cell tumor (GCT) of tracheobronchial tree is a rare neoplasm comprising approximately 6-10% of all GCT and about 1.6% of all benign tumors of the tracheobronchial tree. Since the first observation of GCT in the bronchus by Kramer in the late 1930s, less than 100 cases have been reported in tracheobronchial tree, and probably no such case have been published in Korea yet. Here we report an experience concerning 53 year-old women with an active pulmonary tuberculosis, who also was diagnosed to have a bronchial GCT on bronchoscopy and immunohistochemistry of the specimens.

Unusual Roentgenographic Presentation of Lung Cancer in aPregnant Woman with Acute Respiratory Failure / 결핵

Diagnostic procedures in pregnant wowen is limited and is usually delayed, especially so if she is on mechanical ventilation. A 28-year-old pregnant woman with severe dyspnea was referred to our hopital under the impression of miliary tuberculosis. The respiratory failure was so severe that patient had to be managed with mechanical ventilator under clinical imression of overwhelming pneumonia or pulmonary tuberculosis. But the patient's conditions deteriorated. Bronchoscopy and blind transbronchial lung biopsy performed to determine the nature of the etiology, and to our surprise, revealed squamous cell carcinoma of the lung.

Computed Tomography of Catamenial Hemoptysis / 결핵

A 41-year-old female was admitted to our hospital for self-audible wheezing sound and dyspnea. On past history, she has been suffered from chest discomfort, and treated recurrently by other hospitals. But, there was no symptomatic improvement. A stridor and mixed wheezing sound was auscultated on whole lung field. PFT revealed fixed type or variable intra- & extra-thoracic air way obstructive pattern. By bronchoscopy & bronchogram, we found web-like structure on the distal trachea. A bronchoplasty was performed and the post-operative PFT showed slight improvement & she had no more complaints.

An Infective Endocarditis with Abscess Formation not Accompanied with Heart Failure

Heart failure is the most common cause of death of infective endocarditis. The contributing factors of heart failure include valve destruction, myocarditis, coronary artery emboli with myocardial infarction and abscess. Recently, we experienced a thiry nine year-old man who was hospitalized at Inha University Hospital because of fever, chill and dyspnea (NYHA functional class I-II). The grade IV/Vi systolic murmur was heard at the right upper sternal border and the apex and the grade III/VI diastolic murmur was heard at Erb's area. No crackles were heard. Blook cultures grew Streptococcus viridans. Chest X-ray showed mild cardiomegaly without pulmonary congestion sign. Echocardiogram showed aortic valve vegetations, abscess and grade II/IV aortic regurgitation. Aortic valve replacement and abscess removal were performed. Findings included henegg sized abscess which reduced 70% of cross sectional area of left ventricular outflow tract and located between posterior wall of left ventricle and right and left coronary rings.

A Case of Syndrome X

Typically, patients afflicted with syndrome X complained of stress induced angina pectoris, and their electrocardiograms show corresponding ST-segment depressions during exercise. However, angiography is unable to demonstrate significant coronary artery luminal narrowing and significant coronary artery spasm to provocation test. And left ventricular performance at rest remains remarkably unimpaired. Syndrome X is characterized by reduction of coronary vascular reserve but without depression of left ventricular performance or negative effect on survival. The reduction of coronary vascular response is supposed to be resulted from reduced coronary vasodilator reponse due to abnormal contraction of coronary prearteriolar vessels. This case is a 43-year-old female who has had exertional chest pain since 5 months ago. The chest pain was relieved by rest and subligual nitroglycerin administration. The exercise electrocardiography showed significant ST segment depressions on lead II, III aVF and V4-V6 at stage 1, when she experienced chest pain. On 24 hour ambulatory electrocardiogram, significant ST segment depression was recorded at the time when the patient had chest pain. But coronary arteriography demonstrated normal coronary artery and no significant coronary artery spasm to provocation test with ergonovine maleate. On exercise thallium-201 scintigraphy, perfusion decrease was suspected on anterolateral wall of left ventricle. The patient was diagnosed as a syndrome X and was managed with isosorbide and nifedipine and her exercise tolerance increased significantly on follow up exercise test performed 1 month later. But she has complained of a few of attack of chest pain until now.

Two Cases of Triple Gastric Cancer / 대한소화기내시경학회지

Multiple gastric caner, now considered to be a sort of multiple primary cancer by Moertel's classification, is a special type of cancer in which two or more tumor lesions arise independently from the stomach. Although its incidence is rare and it has never been reported in Korea yet, the report of multiple gastric cancer is increasing with lengthened life survival and improved diagnostic method. We recently experienced two cases of triple gastric cancer, the one in 53-years-old male who had well differentiated adenocarcinoma(EGC IIb+c) on antrum, poorly differentiated adenocarcinoma on cardia and moderately differentiated adenocarcinoma on mid-body, and the other in 65-years-old female who had two poorly differentiated adenocarcinoma on cardia and anterior wall of low body and moderately differentiated adenocarcinoma (EGCIIc) on posterior wall of low body. Triple gastric cancer is rare, so we reported 2 cases of triple gastric cancer.

A Case of Early Gastric Cancer in Childhood / 대한소화기내시경학회지

The incidence of gastric cancer is high in old age group and low in young age group, extremely rare in child age. So the diagnosis of gastric cancer in young age is often delayed, and this, with other factors such as poorly differentiated histopathologic tendency and rapid growing nature, makes the prognosis poorer than in other age guoup. Therefore it should always be remembered that the young who has gastric symptom may have malignancy in his stomach in spite of the age. We report a case of early gastric cancer in a 16-years old male with the review of the literature.