RESUMEN
This patient was a 28-year-old man who had been treated with steroids for recurrent asthmatic attacks since around the age of 20. At one time the steroid therapy was discontinued and other treatments, including bronchodilator therapy and desensitization therapy, were substituted. At age 28, he first consulted our hospital due to the recurrence of attacks. We found peripheral eosinophlia and a cytologic examination revealed Curschmann spirals in his sputum. Migratory infiltrate recurred, and steroids and antibiotics were prescribed each time. A confirmed diagnosis of allergic bronchopulmonary aspergillosis was made at age 35. The patient was treated with continuous oral steroids for recurrent infiltrates. After the start of inhale steroid therapy at age 44, the frequency of attacks decreased and tapering of the oral steroids became possible. It is notable that lung tissue destruction progressed by recurrent pneumonia and emphysema extended into all portions of the lung. Furthermore, this case history is of value since it yields a series of images taken over a period of 27 years.
Asunto(s)
Antiinflamatorios/administración & dosificación , Aspergilosis Broncopulmonar Alérgica/diagnóstico por imagen , Aspergilosis Broncopulmonar Alérgica/tratamiento farmacológico , Prednisolona/administración & dosificación , Adulto , Humanos , Masculino , Radiografía Torácica , Tiempo , Tomografía Computarizada por Rayos XRESUMEN
BACKGROUND: Previous studies have reported a synergistic effect between irinotecan and cisplatin. We have conducted a phase I trial combining these agents to find the optimal dose of irinotecan in combination with a fixed dose of cisplatin. METHODS: Patients with advanced solid tumors, aged < or =75 years, performance status < or =2, and adequate organ function were enrolled in this study. They were treated at 4-week intervals with irinotecan plus 20 mg/m(2) cisplatin on days 1, 8, and 15. The starting dose of irinotecan of 40 mg/m(2) was escalated in 10 mg/m(2) increments until a maximum dose of 90 mg/m(2) was reached. RESULTS: The recommended dose for phase II studies is 90 mg/m(2) of irinotecan and 20 mg/m(2) of cisplatin on days 1, 8, and 15. Overall response to the chemotherapy was 35% (95% confidential interval, 19.2-54.6%). CONCLUSION: This combination seems to be active against lung cancer with acceptable toxicity. A phase II study is now ongoing.
Asunto(s)
Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico , Camptotecina/análogos & derivados , Neoplasias/tratamiento farmacológico , Adulto , Anciano , Protocolos de Quimioterapia Combinada Antineoplásica/efectos adversos , Camptotecina/administración & dosificación , Camptotecina/efectos adversos , Cisplatino/administración & dosificación , Cisplatino/efectos adversos , Esquema de Medicación , Femenino , Humanos , Infusiones Intravenosas , Irinotecán , Neoplasias Pulmonares/tratamiento farmacológico , Masculino , Persona de Mediana Edad , Resultado del TratamientoRESUMEN
A 49-year-old man with diabetes mellitus and alcoholic liver cirrhosis presented with dyspnoea and fever. A chest computed tomography scan revealed three areas of loculated pleural effusion. Initially, the patient was thought to have an intrapleural empyema and was treated with intravenous antibiotics and closed drainage. However, as he did not improve, he was then treated with open drainage. During open drainage, the patient was diagnosed to have an extrapleural empyema and improved following open drainage treatment.