Sarcomatoid carcinomas of the lung are rare malignant biphasic tumors composed of carcinomatous and sarcomatous components. We report a case of endobronchial sarcomatoid carcinoma in a 56-year-old man with a history of smoking, in whom the tumor was an endobronchial mass arising from the superior segmental bronchus of the left lower lobe and protruding against the main bronchus without parenchymal invasion. The patient underwent left pneumonectomy but four months later died of mesenteric sarcomatous metastasis.
Bronchi ; Humans ; Lung Neoplasms ; Lung* ; Middle Aged ; Neoplasm Metastasis ; Pneumonectomy ; Smoke ; Smoking

Leopard syndrome, a feature of a syndrome, is a acronym of Lentiginosis, Electrocardiographic conduction abnormalities, Ocular hypertelorism, Pulmonic stenosis, Abnormal genitalia, Retardation of growth, and Deafness. It is one of the autosomal dominant neurocutaneous traits accompanied by neurologic abnormality. We have experienced a case of Leopoard syndrome associated with 46,XX pure gonadal dysgenesis, which was diagnosed by laparoscopic biopsy, karyotyping, and dermatologic consultation. So we report this case with a brief review of literatures. In our knowledge, this very rare case is presented for the first time in Korea.
Biopsy ; Deafness ; Electrocardiography ; Genitalia ; Gonadal Dysgenesis* ; Gonads* ; Hypertelorism ; Karyotyping ; Korea ; Lentigo ; LEOPARD Syndrome* ; Panthera* ; Pulmonary Valve Stenosis

The incidence of endobronchial tumor in the pediatric period is very rare and the symptoms are very close to those of respiratory tract infection. Diagnosis can be delayed because of low clinical suspicion and the many ways in which these tumors can present. We report the first case, in Korea, of a pulmonary carcinoid tumor that presented with recurrent pneumonia at the same location in adolescence. Treatment is surgical and geared towards complete resection while sparing healthy lung parenchyma. Long-term and careful follow up is recommended to detect local and distant metastasis.
Adolescent* ; Carcinoid Tumor* ; Diagnosis ; Follow-Up Studies ; Humans ; Incidence ; Korea ; Lung ; Neoplasm Metastasis ; Pneumonia* ; Respiratory Tract Infections

This study was performed to elucidate the mechanism of improved oxygenation after surfactant replacement therapy in respiratory distress syndrome (RDS) of the newborn infants. In 26 newborns with RDS, end tidal-CO2 tension (PetCO2), arterial blood gas analysis and pulmonary function tests were measured at baseline, 30 min, 2 hr and 6 hr after surfactant administration. The changes in dead space/tidal volume ratio (VD/VT ratio=(PaCO2-PetCO2)/PaCO2), oxygenation index and arterial-alveolar partial pressure difference for oxygen ((A-a)DO2) were elucidated and correlated with pulmonary mechanics. Oxygenation index and (A-a)DO2 improved, and VD/VT ratio decreased progressively after surfactant administration, becoming significantly different from the baseline at 30 min and thereafter with administration of surfactant. Pulmonary mechanics did not change significantly during the observation period. VD/VT ratio showed close correlation with OI and (A-a)DO2, but not with pulmonary mechanics. These results suggest that decreased physiologic dead space resulting from the recruitment of atelectatic alveoli rather than improvement in pulmonary mechanics is primarily responsible for the improved oxygenation after surfactant therapy in the RDS of newborn.
Airway Resistance ; Human ; Infant, Newborn ; Lung/physiopathology* ; Lung Compliance ; Pulmonary Gas Exchange ; Pulmonary Surfactants/therapeutic use* ; Respiratory Dead Space* ; Respiratory Distress Syndrome/physiopathology ; Respiratory Distress Syndrome/drug therapy* ; Tidal Volume*

PURPOSE: This study was carried out to elucidate the effects of nitric oxide synthase(NOS) inhibitor, NG-monomethyl-L-arginine(L-NMMA) and nitric oxide precursor, L-arginine(L-Arg) on cerebral hemodynamics and energy metabolism during reoxygenation-reperfusion(RR) after hypoxia-ischemia(HI) in newborn piglets. METHODS: Twenty-eight newborn piglets were divided into 4 groups; Sham normal control(NC), experimental control(EC), L-NMMA(HI & RR with L-NMMA), and L-Arg(HI & RR with L-Arg) groups. HI was induced by occlusion of bilateral common carotid arteries and simultaneously breathing with 8 percent oxygen for 30 mins, and followed RR by release of carotid occlusion and normoxic ventilation for one hour. All groups were monitored with cerebral hemodynamics and cytochrome aa3 (Cyt aa3) using near infrared spectroscopy(NIRS). Na+, K(+)-ATPase activity, lipid peroxidation products, and tissue high energy phosphate levels were determined biochemically in the cerebral cortex. RESULTS: In experimental groups, mean arterial blood pressure, PaO2, and pH decreased, and base excess and blood lactate level increased after HI compared to NC group(P<0.05). These variables subsequently returned to baseline after RR except pH. There were no differences among the experimental groups. In NIRS, oxidized hemoglobin(HbO2) decreased and hemoglobin(Hb) increased during HI(P<0.05) but returned to base line immediately after RR; 40 min after RR, the HbO2 had decreased significantly compared to NC group(P<0.05). Changes of Cyt aa3 decreased significantly compared to NC after HI and recovered at the end of the experiment. Significantly reduced cerebral cortical cell membrane Na+, K(+)-ATPase activity and increased lipid peroxidation products(P<0.05) were not improved with L-NMMA or L-Arg. CONCLUSION: These findings suggest that NO is not involved in the mechanism of HI and RR brain damage during the early acute phase of RR.
Anoxia ; Arginine* ; Arterial Pressure ; Brain ; Carotid Artery, Common ; Cell Membrane ; Cerebral Cortex ; Electron Transport Complex IV ; Energy Metabolism* ; Hemodynamics* ; Humans ; Hydrogen-Ion Concentration ; Hypoxia-Ischemia, Brain* ; Infant, Newborn* ; Ischemia ; Lactic Acid ; Lipid Peroxidation ; Nitric Oxide ; omega-N-Methylarginine* ; Oxygen ; Perfusion ; Respiration ; Ventilation

Lymphangioleiomyomatosis(LAM) is rare and essentially limited to women in the reproductive ages. A 39-year-old female was admitted due to progressive exerUional dyspnea and intermittent productive cough. Chest PA showed marked hyperinflation of the lung associated with a diffuse reticulo-nodular pattern. High resolution CT scan of the thorax demonstrated that diffusely scattered thin-walled cysts were distributed throughout the bilateral lung fields. Abdominal CT scan showed variable sized multiple angiomyolipoma of both kidney. By open lung biopsy, she was diagnosed as pulmonary LAM associated with Tuberous sclerosis and renal Angiomyolipoma. We present the case and discuss the connection between pulmonary LAM and Tuberous sclerosis.
Adult ; Angiomyolipoma* ; Biopsy ; Cough ; Dyspnea ; Female ; Humans ; Kidney ; Lung ; Sclerosis* ; Thorax ; Tomography, X-Ray Computed ; Tuberous Sclerosis

The Mycobacterium avium complex (MAC) comprises slow-growing mycobacteria that is ubiquitous in the environment and capable of infecting diverse species with consequences ranging from asymptomatic infection to clinically significant and even fatal disease. Especially, basal pleural disease is infrequently found in immunocompetent person. We report a very rare case of M. avium pleuritis with massive pleural effusion without any predisposing conditions. A previously healthy 36-year-old man was admitted to our hospital because of generalized malaise, low-grade fever, and right pleuritic chest pain of 5 days' duration. Chest X-ray showed mottled infiltration in the right upper lung zone with minimal right pleural effusion which was exudate with lymphocyte-dominance. The pleural effusion progressively increased without responding to anti-tuberculosis treatment. Afterwards M. avium was identified from the pleural effusion using PCR-Restriction Fragment Length Polymorphism Assay(PCR-RFLP). The treatment regimen was changed to rifampine, ethambutol, clarithromycin and streptomycin afterwhich the patient recovered.
Adult ; Asymptomatic Infections ; Chest Pain ; Clarithromycin ; Ethambutol ; Exudates and Transudates ; Fever ; Humans ; Lung ; Lung Diseases* ; Mycobacterium avium Complex ; Mycobacterium avium* ; Mycobacterium* ; Pleural Diseases ; Pleural Effusion* ; Pleurisy ; Rifampin ; Streptomycin ; Thorax

Eikenella corrodens is a slow growing, facultatively anaerobic gram-negative rod that is part of the normal flora of the oral cavity and upper respiratory tracts. In most patients with E. corrodens infections, host defenses are compromised due to surgery, or chronic debilitating illness such as malignancies, or immunosuppressive therapy. This organism causes abscesses and infections that are at times fatal. We experienced a case of E. corrodens isolated from liver abscess in an immunocompetent patient. A 50-year-old man who is a dentist, was hospitalized because of fever and myalgia of 10 days' duration. Abdominal ultrasonography showed non-septated, 3.8x4.6 cm sized abscess in the segment 6/7 of the liver. E. corrodens was isolated from aspiration of liver abscess. This organism was presumably acquired from his patient's oral cavity during dental procedure. We hope that increased awareness to E. corrodens will raise the index of suspicion, and contribute to optimal management of these infections, minimizing the significant morbidity associated with this organism.
Abscess ; Bites, Human* ; Dentists ; Eikenella corrodens* ; Eikenella* ; Fever ; Hope ; Humans ; Humans* ; Liver Abscess* ; Liver* ; Middle Aged ; Mouth ; Myalgia ; Respiratory System ; Ultrasonography

Eikenella corrodens is a slow growing, facultatively anaerobic gram-negative rod that is part of the normal flora of the oral cavity and upper respiratory tracts. In most patients with E. corrodens infections, host defenses are compromised due to surgery, or chronic debilitating illness such as malignancies, or immunosuppressive therapy. This organism causes abscesses and infections that are at times fatal. We experienced a case of E. corrodens isolated from liver abscess in an immunocompetent patient. A 50-year-old man who is a dentist, was hospitalized because of fever and myalgia of 10 days' duration. Abdominal ultrasonography showed non-septated, 3.8x4.6 cm sized abscess in the segment 6/7 of the liver. E. corrodens was isolated from aspiration of liver abscess. This organism was presumably acquired from his patient's oral cavity during dental procedure. We hope that increased awareness to E. corrodens will raise the index of suspicion, and contribute to optimal management of these infections, minimizing the significant morbidity associated with this organism.
Abscess ; Bites, Human* ; Dentists ; Eikenella corrodens* ; Eikenella* ; Fever ; Hope ; Humans ; Humans* ; Liver Abscess* ; Liver* ; Middle Aged ; Mouth ; Myalgia ; Respiratory System ; Ultrasonography

The Mycobacterium avium complex (MAC) comprises slow-growing mycobacteria that is ubiquitous in the environment and capable of infecting diverse species with consequences ranging from asymptomatic infection to clinically significant and even fatal disease. Especially, basal pleural disease is infrequently found in immunocompetent person. We report a very rare case of M. avium pleuritis with massive pleural effusion without any predisposing conditions. A previously healthy 36-year-old man was admitted to our hospital because of generalized malaise, low-grade fever, and right pleuritic chest pain of 5 days' duration. Chest X-ray showed mottled infiltration in the right upper lung zone with minimal right pleural effusion which was exudate with lymphocyte-dominance. The pleural effusion progressively increased without responding to anti-tuberculosis treatment. Afterwards M. avium was identified from the pleural effusion using PCR-Restriction Fragment Length Polymorphism Assay(PCR-RFLP). The treatment regimen was changed to rifampine, ethambutol, clarithromycin and streptomycin afterwhich the patient recovered.
Adult ; Asymptomatic Infections ; Chest Pain ; Clarithromycin ; Ethambutol ; Exudates and Transudates ; Fever ; Humans ; Lung ; Lung Diseases* ; Mycobacterium avium Complex ; Mycobacterium avium* ; Mycobacterium* ; Pleural Diseases ; Pleural Effusion* ; Pleurisy ; Rifampin ; Streptomycin ; Thorax