ABSTRACT
We report a case of pulmonary adenocarcinoma complicated by the syndrome of inappropriate secretion of antidiuretic hormone (SIADH) following adjuvant chemotherapy. A 51-year-old woman with stage IIIA adenocarcinoma received left lower lobe lobectomy in July, 2006. And then combination chemotherapy with paclitaxel and cisplatin was given to the patient. In five days after completion of second cycle of the chemotherapy, she visited emergency room because of general weakness and seizure. Her brain MRI was shown to be no evidence of brain metastasis. Serum sodium, urine and plasma osmolarities were 117mEq/L, 589 and 244mOsm/kg, respectively. She was improved with fluid restriction. Although occurrence of SIADH following chemotherapy is rare, physician should give an attention the potential for development of SIADH in the course of chemotherapyin non-small cell lung cancer patient.
Subject(s)
Female , Humans , Middle Aged , Adenocarcinoma , Brain , Carcinoma, Non-Small-Cell Lung , Chemotherapy, Adjuvant , Cisplatin , Drug Therapy , Drug Therapy, Combination , Emergency Service, Hospital , Inappropriate ADH Syndrome , Magnetic Resonance Imaging , Neoplasm Metastasis , Osmolar Concentration , Paclitaxel , Plasma , Seizures , SodiumABSTRACT
BACKGROUND: To evaluate the clinical characteristics of lung cancer patients in Korea, where there is a higher number of smokers than in Western countries. METHODS: A retrospective study was performed on 1655 lung cancer patients, who were diagnosed at a university hospital between September 1996 and August 2005. Age, gender, cell types and clinical stage were analysed. Of 941 patients, who responded to a questionnaire at the time of diagnosis, the smoking habits, occupational history, family history of lung cancer in the first-degree relatives, coexisting diseases (diabetes mellitus and cardiovascular disease), body weight loss, ECOG performance status and presenting symptoms, were examined prospectively. In addition, coexisting diseases including chronic obstructive pulmonary disease, idiopathic pulmonary fibrosis and active pulmonary tuberculosis were evaluated. RESULTS: Of the 1655 patients, the male to females ratio was 3.6. Squamous cell carcinoma was the most common cancer whereas adenocarcinoma was more common in lifetime nonsmokers or women. 19.9% of the patients were non smokers and 80.1% ever smokers. Since 2000, there was an increase in the incidence of adenocarcinoma with a corresponding decrease in the incidence of squamous cell carcinoma. 6.2% of patients were asymptomatic. A coincident diagnosis of chronic obstructive pulmonary disease, cardiovascular disease, diabetes mellitus, active pulmonary tuberculosis, and idiopathic pulmonary fibrosis was made in: 44.1%, 22.2%, 10.7%, 3.9%, and 1.6% of patients, respectively. A positive family history of lung cancer in the first-degree relatives was identified in 4.4% of patients. An occupational history relevant to lung cancer was identified in 12.2% of patients. CONCLUSION: There is a high proportion of cigarette smokers in Korean lung cancer patients. The most common cell type was squamous cell carcinoma. However, a more detailed, prospective study of the clinical characteristics will be needed to better characterize lung cancer in Korea.
Subject(s)
Female , Humans , Male , Adenocarcinoma , Body Weight , Carcinoma, Squamous Cell , Cardiovascular Diseases , Diabetes Mellitus , Diagnosis , Idiopathic Pulmonary Fibrosis , Incidence , Korea , Lung Neoplasms , Lung , Prospective Studies , Pulmonary Disease, Chronic Obstructive , Surveys and Questionnaires , Retrospective Studies , Smoke , Smoking , Tertiary Care Centers , Tobacco Products , Tuberculosis, PulmonaryABSTRACT
Here we report a case of posterior left ventricular (LV) free wall rupture following postinfarct ventricular septal rupture (VSR). A 58-year-old man was transferred to the hospital under the impression of acute myocardial infarction. Posterior VSR was seen on echocardiographic examination. The intraaortic balloon pump catheter was introduced percutaneously and the emergent operation was proposed. Sudden circulatory collapse was developed shortly after the anesthetic induction and the patient's chest was hurriedly opened while on cardiopulmonary resuscitation. The acute cardiac tamponade was seen and the blood was seen pumping from the longitudinal tear at the mid-level of LV posterior wall, measuring 2 cm in length. The cardiopulmonary bypass was set and LV reconstruction was done. The postoperative recovery was delayed due to the brain injury presumably caused by preoperative cardiac arrest.
Subject(s)
Humans , Middle Aged , Brain Injuries , Cardiac Tamponade , Cardiopulmonary Bypass , Cardiopulmonary Resuscitation , Catheters , Echocardiography , Heart Arrest , Heart Septal Defects , Heart Ventricles , Myocardial Infarction , Rupture , Shock , Thorax , Ventricular Septal RuptureABSTRACT
Acute respiratory distress syndrome (ARDS) caused by adenovirus is a rare event in healthy adults, especially in non- military settings. Although treatment with intravenous ribavirin has been reported, supportive care, including mechanical ventilation, is known to be the main stay in the treatment of ARDS caused by adenovirus, with high-dose steroid treatment having rarely been reported. We report our experience with a 41-year-old, otherwise healthy, woman with ARDS, treated with high-dose steroid and mechanical ventilatory support.
Subject(s)
Adult , Female , Humans , Acute Disease , Adenoviridae Infections/complications , Radiography, Thoracic , Respiration, Artificial , Respiratory Distress Syndrome/pathology , Steroids/therapeutic use , Tomography, X-Ray ComputedABSTRACT
Recently, Minimally invasive direct coronary artery bypass(MIDCAB) procedure eliminating cardiopulmonary bypass becomes one of the rapidly developing strategies in cardiac surgery. Here, we report a case of minimally invasive axillocoronary bypass as coronary reoperative procedure in which the previous LAD graft was occluded and the left internal mammary flow was deemed inadequate. The methodology is described with review of the relevant literature.
Subject(s)
Cardiopulmonary Bypass , Coronary Artery Bypass , Coronary Vessels , Reoperation , Minimally Invasive Surgical Procedures , Thoracic Surgery , TransplantsABSTRACT
The surgical treatment of postinfarct aneurysm on the posterobasal aspect of left ventricle is seldom reported compared to apical aneurysm although the actual incidence is higher than expected, partly because of the complexity of the operation and unpredictable postoperative results. Here, we present a case of postinfarct posterobasal left ventricular aneurysm in which endoventricular circular patch plasty technique was applied successfully. The methodology is described with review of the relevant literature.