In preparation for the surge of coronavirus disease 2019 (COVID-19), it is crucial to allocate medical resources efficiently for distinguishing people who remain asymptomatic until the end of the disease. Between January 27, 2020, and April 21, 2020, 517 COVID-19 cases from 13 healthcare facilities in Gyeonggi province, Korea, were identified out of which the epidemiologic and clinical information of 66 asymptomatic patients at the time of diagnosis were analyzed retrospectively. An exposure-diagnosis interval within 7 days and abnormal aspartate aminotransferase levels were identified as characteristic symptom development in asymptomatic COVID-19 patients. If asymptomatic patients without these characteristics at the time of diagnosis could be differentiated early, more medical resources could be secured for mild or moderate cases in this COVID-19 surge.

Occupational exposure to trichloroethylene (TCE) can occasionally induce severe cutaneous disorders, including hypersensitivity syndrome and Stevens-Johnson syndrome. The clinical manifestation of TCE hypersensitivity syndrome is quite similar to that of drug-induced hypersensitivity syndrome and includes skin lesions, hepatitis, fever, and lymphadenopathy. Almost all cases of TCE hypersensitivity syndrome developed within 2–8 weeks after the first exposure to TCE in an occupational setting. This typical course and clinical feature of hypersensitivity syndrome together with occupational history of TCE contact may lead to prompt diagnosis and treatment of this potentially fatal disease. This report describes a 32-year-old man who has been intermittently engaged in cleaning work using TCE for about 3 years, and then developed TCE hypersensitivity syndrome. To the best of our knowledge, this is the first case of TCE hypersensitivity syndrome with a long duration of symptom onset due to intermittent exposure to TCE. Thus, physicians should take thorough occupational history when seeing a patient with hypersensitivity syndrome has neither history of drug intake nor regular exposure to TCE.
Adult ; Diagnosis ; Fever ; Hepatitis ; Humans ; Hypersensitivity* ; Lymphatic Diseases ; Occupational Exposure ; Skin ; Stevens-Johnson Syndrome ; Trichloroethylene*

BACKGROUND: We developed a patient-centered, smartphone-based, diabetes care system (PSDCS). This study aims to test the feasibility of glycosylated hemoglobin (HbA1c) reduction with the PSDCS. METHODS: This study was a single-arm pilot study. The participants with type 2 diabetes mellitus were instructed to use the PSDCS, which integrates a Bluetooth-connected glucometer, digital food diary, and wearable physical activity monitoring device. The primary end point was the change in HbA1c from baseline after a 12-week intervention. RESULTS: Twenty-nine patients aged 53.9±9.1 years completed the study. HbA1c and fasting plasma glucose levels decreased significantly from baseline (7.7%±0.7% to 7.1%±0.6%, P<0.0001; 140.9±39.1 to 120.1±31.0 mg/dL, P=0.0088, respectively). The frequency of glucose monitoring correlated with the magnitude of HbA1c reduction (r=-0.57, P=0.0013). The components of the diabetes self-care activities, including diet, exercise, and glucose monitoring, were significantly improved, particularly in the upper tertile of HbA1c reduction. There were no severe adverse events during the intervention. CONCLUSION: A 12-week application of the PSDCS to patients with inadequately controlled type 2 diabetes resulted in a significant HbA1c reduction with tolerable safety profiles; these findings require confirmation in a future randomized controlled trial.
Blood Glucose ; Delivery of Health Care ; Diabetes Mellitus ; Diabetes Mellitus, Type 2 ; Diet ; Diet Records ; Fasting ; Glucose ; Hemoglobin A, Glycosylated ; Humans ; Motor Activity ; Pilot Projects* ; Self Care ; Smartphone

Hypercoagulability disorders are commonly encountered in clinical situations in patients with a variety of cancers. However, several hypercoagulability disorders presenting as first symptoms or signs in cancer patients have rarely been reported. We herein described a case of a woman with adenocarcinoma of the lung presenting with deep vein thrombosis, nonbacterial thrombotic endocarditis, recurrent cerebral embolic infarction, and heart failure.
Adenocarcinoma ; Carcinoma, Non-Small-Cell Lung ; Endocarditis ; Endocarditis, Non-Infective ; Female ; Heart Failure ; Humans ; Infarction ; Lung ; Lung Neoplasms* ; Thrombophilia* ; Venous Thrombosis

Hypercoagulability disorders are commonly encountered in clinical situations in patients with a variety of cancers. However, several hypercoagulability disorders presenting as first symptoms or signs in cancer patients have rarely been reported. We herein described a case of a woman with adenocarcinoma of the lung presenting with deep vein thrombosis, nonbacterial thrombotic endocarditis, recurrent cerebral embolic infarction, and heart failure.
Adenocarcinoma ; Carcinoma, Non-Small-Cell Lung ; Endocarditis ; Endocarditis, Non-Infective ; Female ; Heart Failure ; Humans ; Infarction ; Lung ; Lung Neoplasms* ; Thrombophilia* ; Venous Thrombosis

Cytomegalovirus (CMV) infection has been described in immunosuppressed individuals such as patients with AIDS, those receiving chemotherapy, and post-transplantation. CMV can cause severe disease either via reactivation of latent virus or via primary infection. In immunocompetent patients, CMV infection is usually transient and does not exhibit many symptoms. The colon is the site most frequently affected by severe CMV disease in immunocompetent patients. Clinically, CMV colitis commonly presents with diarrhea, fever, and abdominal pain. Although some patients recover spontaneously, others suffer from severe complications, such as bowel perforation, severe gastrointestinal bleeding and, rarely, stricture, and surgery is the choice of treatment in these patients. We report a case of stricture of the proximal transverse colon, presenting as a complication of CMV colitis, in an immunocompetent man with acute respiratory distress syndrome. We performed laparoscopic segmental resection of the proximal transverse colon.
Abdominal Pain ; Colitis ; Colon ; Colon, Transverse ; Constriction, Pathologic ; Cytomegalovirus ; Diarrhea ; Fever ; Hemorrhage ; Humans ; Immunocompetence ; Laparoscopy ; Respiratory Distress Syndrome, Adult ; Viruses

Urothelial carcinomas (UCs) can occur in the upper urinary tract or lower urinary tract. Upper urinary tract urothelial carcinoma (UUT-UC) is relatively a rare disease and accounts for only about 5% of UC cases. Sporadic cases of late-onset metastasis, associated with UC of the bladder, have occasionally been reported. In contrast, no late-onset distant metastatic UUT-UC without local recurrence has, to the best of our knowledge, been reported in the English literature. We report an extremely rare case of distant metastatic UC, mimicking lung adenocarcinoma that originated from UUT-UC 12 years previously.
Adenocarcinoma ; Lung ; Lung Neoplasms ; Neoplasm Metastasis ; Rare Diseases ; Recurrence ; Urinary Bladder ; Urinary Tract ; Urothelium

Epithelial growth factor receptor (EGFR) tyrosine kinase inhibitors (TKIs) have been widely used for non-small-cell lung cancer patients. Its untoward cutaneous effects are largely well known and developed in many patients treated with EGFR TKIs. However trichomegaly of eyelash is rarely reported. Although trichomegaly is not a drug-limiting side effect, it could be troublesome of continuing the treatment because of cosmetic issue or eyeball irritation by long eyelashes. Therefore clinicians are needed to pay attention to this uncommon effect. We herein describe erlotinib induced trichomegaly of eyelashes in a woman with adenocarcinoma of the lung.
Adenocarcinoma ; Cosmetics ; Eyelashes ; Female ; Humans ; Lung ; Lung Neoplasms ; Physiological Effects of Drugs ; Protein-Tyrosine Kinases ; Quinazolines ; Receptor, Epidermal Growth Factor ; Erlotinib Hydrochloride

In immunocompetent individuals, pulmonary cryptococcosis is a rarely diagnosed fungal infection. It's common radiological findings are multiple pulmonary nodules. We report a case of pulmonary cryptococcosis in a 67-year-old woman who presented with solitary pulmonary nodule (SPN) on chest computed tomography (CT). She complained of intermittent blood tinged sputum for 10 days. She was a non-smoker and had no clinical evidence of immonosuppression. Pathological examination of the lung tissue core via percutaneous fine needle biopsy revealed chronic granulomatous inflammation compatible with cryptococcosis on the special stain. She received 6 months of antifungal therapy with fluconazole and the SPN was disappeared on the CT after antifungal therapy. We also reviewed that the features of pulmonary cryptococcosis presenting SPN in immnocompetent patients reported in the Korean literatures.
Aged ; Biopsy, Fine-Needle ; Cryptococcosis ; Female ; Fluconazole ; Humans ; Immunocompetence ; Inflammation ; Lung ; Multiple Pulmonary Nodules ; Solitary Pulmonary Nodule ; Sputum ; Thorax ; Tolnaftate

BACKGROUND/AIMS: To determine whether female smokers are more or less susceptible to the detrimental pulmonary-function effects of smoking when compared to male smokers among patients with lung cancer. METHODS: Pack-years and pulmonary function indices were compared between 1,594 men and women with lung cancer ifferences in individual susceptibility to smoking were estimated using a susceptibility index formula. RESULTS: Of the patients, 959 (92.8%) men and 74 (7.2%) women were current smokers. Common histological types of lung cancer were squamous cell carcinoma, adenocarcinoma, and small cell carcinoma, among others. Women had a lower number of pack-years, forced expiratory volume in 1 second (FEV1, liters), forced vital capacity (FVC, liters), and total lung capacity (TLC, liters) compared to those of men (25.0 +/- 19.2 vs. 42.9 +/- 21.7 for pack-years; 1.4 +/- 0.5 vs. 2.0 +/- 0.6 for FEV1; 3.0 +/- 0.7 vs. 2.0 +/- 0.6 for FVC; 4.5 +/- 0.8 vs. 5.7 +/- 1.0 for TLC; all p < 0.001). The susceptibility index for women was significantly higher compared to that of men (1.1 +/- 4.1 vs. 0.7 +/- 1.1; p = 0.001). A significant inverse association was shown between the susceptibility index and TLC and FVC (r = -0.200 for TLC, -0.273 for FVC; all p < 0.001). CONCLUSIONS: The results suggest that the detrimental effects of smoking on pulmonary function are greater in women, as compared to those in men, among patients with lung cancer.
Adult ; Aged ; Aged, 80 and over ; Chi-Square Distribution ; Cohort Studies ; Female ; *Gender Identity ; Humans ; Korea/epidemiology ; Lung Neoplasms/complications/*epidemiology/pathology ; Lung Volume Measurements ; Male ; Middle Aged ; Respiratory Function Tests ; Risk Assessment ; Sex Factors ; Smoking/*adverse effects/epidemiology