Primary Adenoid Cystic carcinoma Arising in the Bronchus / 결핵

BACKGROUND: Primary adenoid cystic carcinoma arising in the bronchus is an uncommon disease that is histologically and ultrastructurally identical to the salivary gland tumor of the same name and regarded as a slow growing low-grade malignancy. We examined its clinkcal characteristics. METHODS: We collected 13 Korean cases of primary adenoid cystic carcinoma arising in the bronchus including 5 cases of our own and 8 cases from the literature. RESULT: The patients ages ranged from 20 to 74. Men numbered 9 and women 4. The presenting symptoms were cough, dyspnea, and hemoptysis. The fiberoptic bronchoscopic findings were primarily hypervascular polypoid mass with a smooth surface that obstructed airway totally or near totall. There were three inoperable cases including two cases with distant metastasis to bone or cervica lymph node and one case with mediastinal invasion. The remaining 10 patients underwent surgical resection. Among them, two patients received postoperative radiotherapy. The median survival was 21 months in the 8 surgical and evaluable cases. One paient lived 13 years without recurrence. The prognosis was relatively favorable in operable cases. CONCLUSION: It was not common for primary adenoid cystic carcinoma arising in the bronchus to have distant metastasis or invasion to the mediastinum on presentation. The prognosis was relatively favorable in operable cases. It would be important to perform flexible bronchoscopy for early diagnosis and to do surgical treatment if possible

A Case of Eyeball Metastasis of Lung Adenocarcinoma Confirmed by Enucleation / 결핵

Metastatic tumors to the eyes are probably the most common type of intraocular malignancies. The most common metastatic tumor is the breast cancer overall and lung cancer in men. An eyeball metastasis from lung cancer has a poor prognosis. Differentiating an eyeball metastasis from the primary malignant melanoma is important. Eyeball metastasis of a lung adenocarcinoma confirmed by pathology has not report in Korea. Here we reoprt a case of a metastatic lung adenocarcinoma to the eyeball confirmed by enucleation and a transbronchial lung biopsy with a review of the relevant literature.

The risk factors in patients with candiduria associated with candidemia / 대한내과학회지

BACKGROUND: The early diagnosis of candidemia is critical for the management. The candidemia is known to be associated with 10% of candiduria. But the risk factors in patients with candiduria who are associated with candidemia are not known. We analyzed the risk factors in patients with candiduria who are associated with candidemia. METHODS: We retrospectively reviewed 164 patients with candiduria in Yonsei Medical Center from January 1998 to December 1998. Candiduria patients were divided into two groups. Candiduria patients without candidemia (Group I, 147 patients) and candiduria patients with candidemia (Group II, 17 patients). RESULTS: 1) The mean age of the patients were 57.5 years in group I and 62.5 years in group II. There were no significant differences in the sex ratio between the two groups. 2) Central venous catheter insertion (53%, 100% in group I, II), hypotension (14%, 59% in group I, II), other associated infections (64%, 100% in group I, II), intensive care (41, 76% in group I, II) and fever (46%, 82% in group I, II) were the very significant risk factors in patients with candiduria who were associated with candidemia. 3) Urinary tract procedure (11%, 88% in group I, II), urinary catheter insertion (63%, 94% in group I, II), thrombocytopenia (17%, 41% in group I, II) and DM (8%, 24% in group I, II) were the significant risk factors of candidemia. 4) Candida colony count (cfu/mL) of urine culture was not a significant risk factor. 5) Mortality rate (27%, 59% in group I, II) was significantly high in patients with candidemia. CONCLUSION: Central venous catheter insertion, hypotension, other associated infections, intensive care and fever were the very significant risk factors of candidemia in patients with candiduria.

The risk factors in patients with candiduria associated with candidemia / 대한내과학회지

BACKGROUND: The early diagnosis of candidemia is critical for the management. The candidemia is known to be associated with 10% of candiduria. But the risk factors in patients with candiduria who are associated with candidemia are not known. We analyzed the risk factors in patients with candiduria who are associated with candidemia. METHODS: We retrospectively reviewed 164 patients with candiduria in Yonsei Medical Center from January 1998 to December 1998. Candiduria patients were divided into two groups. Candiduria patients without candidemia (Group I, 147 patients) and candiduria patients with candidemia (Group II, 17 patients). RESULTS: 1) The mean age of the patients were 57.5 years in group I and 62.5 years in group II. There were no significant differences in the sex ratio between the two groups. 2) Central venous catheter insertion (53%, 100% in group I, II), hypotension (14%, 59% in group I, II), other associated infections (64%, 100% in group I, II), intensive care (41, 76% in group I, II) and fever (46%, 82% in group I, II) were the very significant risk factors in patients with candiduria who were associated with candidemia. 3) Urinary tract procedure (11%, 88% in group I, II), urinary catheter insertion (63%, 94% in group I, II), thrombocytopenia (17%, 41% in group I, II) and DM (8%, 24% in group I, II) were the significant risk factors of candidemia. 4) Candida colony count (cfu/mL) of urine culture was not a significant risk factor. 5) Mortality rate (27%, 59% in group I, II) was significantly high in patients with candidemia. CONCLUSION: Central venous catheter insertion, hypotension, other associated infections, intensive care and fever were the very significant risk factors of candidemia in patients with candiduria.

A Case of acute respiratory distress syndrome induced by all-trans-retinoic acid / 결핵

Acute respiratory distress syndrome (ARDS) has been reported to be associated with a variety of medical and surgical conditions, including All-trans-retinoic acid (ATTA). ATRA is very efficaceous drug to acute promyelocytic leukemia (APL). This drug can induce complete remission at APL without fatal risk of disseminated intravascular coagulation. But ATRA treatment, sometimes, produces the symptoms of fever, weight gain and acute respiratory distress, renal function impairment. The causes of these symptoms are not fully proved, but supposed as the result of leukostasis and capillary leak syndrome from excessive leukocyte differentiation and cytokines release. Recently, we experienced a 24-year-old woman who complained gum bleeding for 6 days. At bone marrow biopsy, she was diagnosed as APL. 2 days after ATRA treatment, she was suffered from the symptoms of dyspnea and general ache. At laboratory examination, total leukocyte count was 50,400/mm3 PaO2 was 42.5 mmHg and chest PA revealed the findings compatible with ARDS. Treatment with low dose ara-C, corticosteroid and general supportive cares were tried. Within 3 days after treatment, the patient recovered from ADRD by evidence of arterial blood gas study and chest radiographs. She has acquired complete remission of APL with maintenance of ATRA. And so, we present this case with a review of related literatures.