Phosphate binders that contain aluminum are usually prescribed to treat hyperphosphatemia in patients with chronic renal failure, but an accumulation of aluminum can lead to osteomalacia, encephalopathy and anemia. To evaluate the effect of CaCo₃ on serum calcium and phosphorus as a alternative phosphate binder, we studied 13 patients on regular hemodialysis treatment. In basal period, some patients were administered Al(OH)₃ and CaCO₃, others only the former or the latter and others nothing. Al(OH)₃ was stopped in all patients and CaCO₃ was started or increased in all patients. A better control of sCa, sPi and sCa-Pi product was observed during only Ca supplementation, despite Al(OH)₃ discontinuation. Some patients developed a mild hypercalcemia and hypophosphatemia, especially in those who had a normal predialytic sPi. Therfore considering the dialysate Ca concentration according to individual need and the adjustment of amount of CaC₃ to avoid these risks can be recommanded with the dual objective of keeping a positive Ca balance and correcting hyperphosphatemia.

Gastric sarcoidosis is a rare disease accounting for 0.1~0.9% of all sarcoidosis cases. It presents either as a systemic disease or as an isolated finding. Diagnosis is established with biopsy of a lesion. It is important to distinguish between sarcoidosis and a sarcoid-like reaction, which can be caused by Crohn's disease, foreign body reaction, fungal infection, tuberculosis, or malignancy. We report a 60-year-old woman with both gastric and pulmonary sarcoidosis.

Cryptococcal infections occur frequently in patients with cell-mediated immune deficiency, such as acquired immune deficiency syndrome, organ transplants, hematologic malignancy patients and immunocompromised patients who receiving cancer chemotherapy or corticosteroid therapy. In these conditions, cryptococcosis can cause serious infections requiring systemic antifungal therapy such as meningoencephalitis and sepsis. However, pulmonary cryptococcosis in immunocompetent hosts may have self-limited course and improve without treatment. We experienced various pulmonary manifestations of pulmonary cryptococcosis in five immunocompetent patients. We diagnosed three cases of isolated pulmonary cryptococcosis and two cases of disseminated cryptococcosis involving lungs. All cases were treated with intravenous injection of amphotericin B during hostpital care, and maintained with oral fluconazole after discharge. During the follow-up, clinical symptoms and radiologic features were markedly improved.

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• Cryptococcosis with Mediastinal Lymph Node and Lung Involvement in an Immunocompetent Adolescent: A Case Report
  Jiyeon Lee, Chang-Min Cho, Hyun-Hae Cho, Heae Surng Park, Kyung-Hyo Kim
  Pediatric Infection & Vaccine.2021; 28(2): 124.     CrossRef

No abstract available in English.

Acute eosinophilic pneumonia is characterized by acute febrile disease with diffuse interstitial infiltration on chest radiography, eosinophilic infiltration of lung parenchyma on lung biopsy and good response at corticosteroid therapy. There has been several reports that support cigarette smoking recently, even though the pathogenesis is not clear. We encountered a case of acute eosinophilic pneumonia induced by cigarette smoking, who, being a 20-year-old man, presented with acute onset of fever after his first cigarette smoking. His clinical symptoms and the infiltrations on onset x-ray improved after a treatment with corticosteroid.

Dieulafoy's disease is the vascular anomaly characterized by the presence of arteries of persistent large caliber in the submucosa, and in some instances, the mucosa, typically with a small, overlying mucosal defect. Only a few cases of this lesion occuring in the bronchial system have been reported to date. The etiology of Dieulafoy's disease is still unclear, but chronic bronchial injury and/or congenital vascular malformation have been postulated. We encountered a case of bronchial Dieulafoy's disease that developed in a 69-year-old woman who had been treated for pulmonary tuberculosis for 4 months. Her chief complaint was hemoptysis and the bronchoscopic finding showed an intrabronchial protruding lesion produced by the arteries beneath the bronchial mucosa of the anterior segment of right upper lobe. She has been well after the surgical resection of right upper lobe.

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• Clinical characteristics and treatments for bronchial Dieulafoy's disease
  Wenfang Chen, Pingping Chen, Xiuyu Li, Xinglin Gao, Jing Li
  Respiratory Medicine Case Reports.2019; 26: 229.     CrossRef

Primary ciliary dyskinesia is a genetic disorder of abnormal ciliary structure and function that leads to defective mucociliary clearance, resulting in sinopulmonary infection and infertility. Kartagener's syndrome is a subclass of primary ciliary dyskinesia and which is clinically distinguishable by the presence of situs inversus. Electron microscopy of cilia reveals ultrastructural defects in the ciliary axoneme. In the respiratory tract, this inability presumably causes impaired clearance of mucus and inhaled particles and results in the chronic infections of sinuses and bronchial trees that are characterized of the disease. Early diagnosis of the disease may be important for prevention of bronchiectasis and pulmonary insufficiency.

We report one case of primary ciliary dyskinesia associated with Kartagener's syndrome in a 14 year-old young man who was presented as bronchiectasis, chronic and situs inversus, with review of literature.