A Case of Cervical Adenocarcinoma with Pulmonary Metastasis Resembling Miliary Tuberculosis / 대한암학회지

Cervical cancer is the most common gynecologic cancer, accounting for 22.2% of all cancers in Korean women and is almost of squamous cell type. The reported incidence of adenocarcinoma of the uterine cervix varies from 4 to 20% of all cervical malignancies, and have shown an increase in the percentage of adenocarcinoma. Adenocarcinoma may have a slightly poorer prognosis than squamous cell carcinoma for each stage of disease. Pulmonary metastases are observed in 2~9% of patients and correlates with stage of disease. We report a case of cervical adenocarcinoma with pulmonary metastases simulating miliary tuberculosis. These metastases was confirmed by open lung biopsy.

Prevalence of TEM- and SHV-type Beta-lactamase gene in Escherichia coli and Klebsiella pneumoniae in Korea / 감염

BACKGROUND: Resistance to beta-lactams in E. coli is mostly via acquisition of plasmid-mediated beta-lactamase gene. Among the plasmid-mediated beta-lactamases, TEM-1 beta-lactamase is by far the most prevalent among ampicillin-resistant E. coli. The prevalence of TEM-1 or TEM-2 ranged from 61% to 98% across the surveys. Klebsiella species generally have class A chromosomal beta-lactamases, which differ greatly from the class C types. Most K. pneumoniae isolates have chromosomally mediated SHV-1 beta-lactamase in most surveys. There has been only one report of prevalence and types of beta-lactamases in E. coli and K. pneumoniae in Korea. We performed this study to determine the prevalence and types of beta-lactamases in E. coli and K. pneumoniae isolated in Korea. METHODS: Ampicillin resistance was determined by disk diffusion test (E. coli) and agar dilution method (K. pneumoniae). Fifty five isolates of E. coli and 92 isolates of K. pneumoniae which were derived from patients in 2 university hospitals in Korea during 1996 were tested by TEM- and SHV-specific PCR. RESULTS: The ampicillin resistance rate in E. coli and K. pneumoniae was 82% and 94.6%, respectively. TEM-type beta-lactamase gene was found in 53% of E. coli isolates. 93.5% of K. pneumoniae isolates was found to have SHV-type beta- lactamase gene. CONCLUSION: In Korea TEM-type beta-lactamase gene was most prevalent in E. coli, but its prevalence rate was relatively low compared with those in other country. For K. pneumoniae, the isolates with SHV type beta-lactamase gene were predominant.

A Case of Late Presentation of Congenital Cystic Adenomatoid Malformation of the Lung / 결핵

Congenital cystic adenomatoid malformation of the Lung(CCAM) is characterized by anomalous fetal development of terminal respiratory structures, resulting in an adenomatoid proliferation of bronchiolar elements and cystic formation. CCAM was first described and differentiated from other cystic lung disease in the English literature by Ch'in and Tang in 1949. CCAM is a rare, potentially lethal form of congenital pulmonary cystic disease and the salient features of lesion are an irregular network of terminal respiratory bronchiole-like structures and macrocysts variably lined by pseudostratified ciliated columnar epithelium and simple cuboidal epithelium. Adult presentation of CCAM of the lung is so tare that only 9 cases have been reported in the literature of date. The pathogenesis of CCAM remains disputed and reseachers have variously proposed that the lesion represents a developmental anomaly, hamartoma, or a form of pulmonary dysplasia. Van Dijk and Wagenvoort divided CCAM into three subtypes: cystic, intermediated, and solid. These correspond to types I, II, and III of Stocker. In adults, the evaluation of cystic or multicystic lung disease requires consideration of a differential diagnosis including the acquired lesions of lung abscess, cavitary neoplasm or inflammatory mass, bullous disease, bronchiectasis, and postinflammatory pneumatocele. Congenital lesions such as sequestration, bronchopulmonary-foregut anomalies, and bronchogenic cyst are also encounted. The definitive treatment for CCAM is complete removal of the involved lobe. Partial lobectomy leads to multiple complications, including severe post-operative infection. We report a case of CCAM in a 14-year-old female presentated with a pneumothorax and large bullae, who was treated by surgical remove of the involved lobe.