A Case of Yellow Nail Syndrome: Misdiagnosis as Congestive Heart Failure / 결핵및호흡기질환

Yellow nail syndrome (YNS) is a rare disorder of unknown cause associated with yellow nails, lymphedema and respiratory manifestations. It was first described by Samman and White in 1964, and to date, approximately 150 cases have been reported. The diagnosis of YNS is essentially a clinical one and based on the presence of characteristic findings. We report a case of YNS of a 62-year-old female who presented with a 4-month history of dyspnea and recurrent pleural effusion. The patient had a 5-year history of leg swelling and dyspnea. She had been managed with medications for congestive heart failure (CHF) for two years and she was referred to our hospital for further evaluation and management.

Delayed Recovery of Sedation by Continuous Midazolam Infusion in an ESRD Patient on Peritoneal Dialysis: A Case Report / 대한신장학회지

Midazolam, a benzodiazepine derivatives, is widely used in intensive care unit for sedation of patients who require mechanical ventilation. Although midazolam has a short acting time, it might cause a prolonged sedation, especially in patients with renal failure. We report the case of a 76-year-old man who received peritoneal dialysis and showed prolonged sedation after stopping continuous infusion of midazolam. The patient who has received maintenance hemodialysis for five months admitted in intensive care unit to manage pneumonia and severe congestive heart failure. In ICU, hemodialysis was transferred to peritoneal dialysis due to severe cardiac dysfunction. He was treated with mechanical ventilation under sedation with midazolam. However, even though stopping midazolam, deep sedation by midazolam was not restored. The patient completely recovered from sedation after 280 hours.