A 64-year-old man with ethanol intoxication, ingested a bottle of Herbiace (100 ml, 32 w/v% of bialaphos, CAS #35597-43-4, Meiji Seika Kaisha, Tokyo, Japan). He had severe metabolic acidosis and was treated with infusions of sodium bicarbonate and furosemide, plus gastric lavage and enema. The metabolic acidosis improved 15 hours after treatment but nystagmus, apnea and convulsions were progressive. Although his sensorium was clear, spontaneous respirations were not observed for 64 hours. The electroencephalographic findings of atypical triphasic waves and slow waves suggest a unique response to bialaphos poisoning. His clinical course indicates that the management of apnea is critically important to recovery from bialaphos poisoning.
A 57-year-old man presented to a local clinic with gradually progressive wheezing and was referred to our hospital. Chest computed tomography revealed atelectasis in the lingular segment of the left lung and a polypoid lesion in the left main bronchus. Endoscopic resection of the endobronchial tumour was performed with a high-frequency electrosurgical snare under general anaesthesia. Based on histological examination of the resected specimen, an endobronchial cartilaginous hamartoma was diagnosed. This approach may be an alternative for resection of selected benign endobronchial tumours. After 2 years of follow up, the patient remains free of disease. While endobronchial hamartoma is relatively rare, this diagnosis should be considered in a patient with respiratory complaints, such as gradual progression of wheezing and persistent cough.
We report a case of small cell lung cancer with metastasis without any lesion in the lungs. The patient was 55-year-old man who visited to the hospital with dizziness. He underwent general examinations and enhanced-magnetic resonance imaging (MRI) of the head revealed that a lesion with ring enhancement sign in the cerebellum. Despite the fact that no lesions were detected in his lungs in chest computed tomography (CT), mediastinal lymph node enlargement and elevated levels of ProGRP in serum indicated an unknown primary small cell lung cancer and its brain metastasis. A biopsy of No. 3 lymph node performed by mediastinoscopy revealed small-cell lung cancer (SCLC). The patient was treated with chemotherapy after the diagnosis, and although the treatment was effective temporarily, the patient died 18 months after the diagnosis.
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