We encountered a family in which two of four members, the husband and his wife, had summer-type hypersensitivity pneumonitis at the same time, about two months after they moved to the residence. A ...45-year-old man had cough, fever and exertional dyspnea. Chest computed tomography showed diffuse centriloblar ground-glass attenuation in both lung fields. His 43-year-old wife had chest small nodular shadows and similar symptoms to his husband. Serum anti-Tricosporon cutaneum (T. asahi: serotype II and T. mucoides: serotype I) antibodies of both patients were at the positive level. They were given diagnosis as summer-type hypersensitivity pneumonitis by radiological, serological and histological examinations. The symptoms in both cases were improved immediately after administration of systemic corticosteroid. Summer-type hypersensitivity pneumonitis was assumed to be caused for about two months duration of expousure to antigen.
A 4-month old girl was diagnosed as having stage IV neuroblastoma of the right adrenal gland. Preoperative chemotherapy was given, followed by local surgical excision. Postoperatively, irradiation of ...the tumor bed and adjuvant chemotherapy was given for 11 months. Nine years after cessation of chemotherapy, the patient developed left hip-joint pain. Biopsy of the ischium showed chondroblastic osteosarcoma. Limb salvage surgery was performed after preoperative chemotherapy. Postoperatively, adjuvant chemotherapy was given for 14 months. Twenty-two months after treatment for the secondary osteosarcoma, the patient has been remained in disease-free condition without any evidence of relapse. A second osteosarcoma occurring outside the radiation field after treatment for neuroblastoma is quite rare. This unusual case emphasized the need for close monitoring for development of second malignant neoplasms in survivors of neuroblastoma even in the absence of a known predisposing factor, such as radiation therapy.
Celotno besedilo
Dostopno za:
DOBA, IJS, IZUM, KILJ, NUK, PILJ, PNG, SAZU, UILJ, UKNU, UL, UM, UPUK
Among 20 patients (11 males and 9 males) with cerebrovascular disease, knee extensor muscle strength of unaffected side was evaluated in peak torque of the maximum isometric contraction, rate of ...muscle strength development, and muscular fatigue. The mean peak torque of the patients was 7.8±2.1 kg·m in males and 5.6±1.9 kg·m in females, and that of healthy controls was 12.1±2.3 kg·m in males and 7.2±2.1 kg·m in females. Irrespective of the sexes, the mean peak torque of the patients was significantly lower than that of healthy controls. The mean muscle strength incidence of the patients was 23.3±13.3 kg/sec in males and 17.7±9.5 kg/sec in females, and that of healthy controls was 35.7±11.8 kg/sec in males and 25.9±13.5 kg/sec in females, exhibiting a significant difference between the patients and controls. The rate of muscle strength development for the initial 2 sec to peak torque was lower in the patients than in controls, showing no significant difference. The decreasing rate of peak torque after 30 repetitive muscle contractions was significantly higher in the patients compared with controls. These results purport that muscular quickness and endurance should especially be heightened in muscle strengthening exercise for hemiplegic patients.
A 71-year-old man was admitted due to persistent pyrexia of over 2 weeks duration, dry cough, and chest computed tomographic (CT) findings of interstitial pneumonia. On admission, his body ...temperature was 38.0 degrees C, and there was mild livedo reticularis observed on the trunk and skin of the extremities. Fine crackles were detected in the lower lung fields. Laboratory examinations showed high levels of an inflammatory reaction and a positive rheumatoid factor, but the findings were negative for any other autoantibodies, including the antineutrophil cytoplasmic antibody. His bronchoalveolar lavage fluid revealed an increase in CD4+ lymphocytes. A biopsy specimen of the abdominal skin showed necrotizing vasculitis of the muscular arteries. Lung biopsy specimens showed necrotizing and granulomatous vasculitis of the pulmonary arteries in the usual interstitial pneumonia pattern, with numerous lymphoid follicles. Therefore, a diagnosis of polyarteritis nodosa was clinically and pathologically established. This case of interstitial pneumonia associated with polyarteritis nodosa was difficult to discriminate from microscopic polyarteritis.
We herein describe the first case, to our knowledge, of surgical biopsy-proven usual interstitial pneumonia (UIP) as the pulmonary manifestation in primary biliary cirrhosis (PBC). A 56-year-old male ...was admitted to our hospital because of the identification of bilateral reticular infiltrate on a chest roentgenogram. He was histologically confirmed to have PBC without definite signs of Sjögren's syndrome at age 47. His chest CT scan showed bibasilar reticular opacities without a honeycomb appearance, while a bronchoalveolar lavage fluid analysis revealed no lymphocytosis. A surgical lung biopsy specimen revealed evidence of a UIP pattern. The patient's condition has remained stable for a follow-up period of two years without treatment. Our case indicates that the UIP pattern is an additional form of diffuse interstitial pneumonia/fibrosis that may develop in association with sporadic PBC.
PDF
