ABSTRACT
A 71-year-old man who had no prior history of chemotherapy or radiation therapy was diagnosed with nodular sclerosis Hodgkin's disease (HD) and IgA-kappa multiple myeloma (MM) simultaneously. The patient achieved a complete response of HD and a minor response of MM after 6 cycles of COPP/ABV chemotherapy. Thereafter, he had received oral mephalan and prednisolone without disease progression for 12 months. At 27-month follow-up, he succumbed to overwhelming pneumonia and septic shock with progressive disease of MM. We present this case as a first report of simultaneous occurrence of HD and MM in South Korea.
Subject(s)
Aged , Humans , Disease Progression , Drug Therapy , Follow-Up Studies , Hodgkin Disease , Korea , Multiple Myeloma , Pneumonia , Prednisolone , Sclerosis , Shock, SepticABSTRACT
Torsades de pointes (TdP) is a rare complication of a complete atrioventricular block with QT prolongation. Additional risk factors, such as hypokalemia, may increase the risk of TdP during atrioventricular (AV) block. We experienced a case of TdP, caused by a complete heart block and hypokalemia, which was successfully treated by implanting a permanent pacemaker and correction of the electrolyte imbalance.
Subject(s)
Atrioventricular Block , Heart Block , Hypokalemia , Risk Factors , Torsades de PointesABSTRACT
Thymolipoma is rare benign tumor of the thymic gland and mostly occurs at anterior mediastinum. Thymolipoma comprises 2~9% of thymic tumor and less than 1% of mediastinal mass. Therefore, thymolipoma should be differentiated from anterior mediastinal tumor such as thymoma, germ cell tumor and lymphoma. These tumors resemble cardiomegaly, pleural effusion, basal atelectasis, pericardial tumor and cyst, pleural tumor, lung cancer and pulmonary sequestration, and differentiated from above mentioned diseases. Though most cases are asymptomatic, there can be dyspnea with compression of adjacent organ by mass effect, and myasthenia gravis. We experienced a thymolipoma simulating cardiomegaly and report the case with the review of literatures.
Subject(s)
Bronchopulmonary Sequestration , Cardiomegaly , Dyspnea , Lung Neoplasms , Lymphoma , Mediastinum , Myasthenia Gravis , Neoplasms, Germ Cell and Embryonal , Pleural Effusion , Pulmonary Atelectasis , Thymoma , Thymus NeoplasmsABSTRACT
BACKGROUND AND OBJECTIVES: We evaluated the efficacy of embolic protection using the PercuSurge GuardWire (PSG) system during primary percutaneous coronary intervention (PCI) on lesions with angiographic features suggesting large thrombus burden of the infarct-related artery (IRA). SUBJECTS AND METHODS: Between June 2002 and May 2003, we enrolled 30 patients who underwent primary PCI with angiographic features suggesting large IRA thrombus burden (abrupt end occlusive pattern, persistent dye stasis, reference diameter >4 mm, floating thrombus, accumulated thrombus >5 mm). Fourteen patients received primary PCI with the PSG system (PSG group) and 16 received primary PCI without the PSG system (control group). We compared angiographic results (TIMI flow, myocardial blush grade) and > or =50% resolution of ST segment elevation at 2 hours after reperfusion. RESULTS: Baseline clinical and angiographic characteristics were not significantly different between the two groups. Primary PCI with the PSG system was performed successfully in all patients. Post PCI TIMI grade 3 flow and myocardial blush grade 3 were achieved significantly more often in the PSG group (100% vs. 69%, p=0.022; 57% vs. 6%, p=0.004, respectively). Resolution of ST-segment elevation > or =50% was observed significantly more often in the PSG group (79% vs. 31%, p=0.01). CONCLUSION: Primary PCI with the PercuSurge GuardWire system might improve coronary blood flow and micro-vascular circulation in patients with angiographic features suggesting large thrombus burden.
Subject(s)
Humans , Arteries , Myocardial Infarction , Percutaneous Coronary Intervention , Reperfusion , ThrombosisABSTRACT
BACKGROUND: Pleural effusions are generally divided into transudates and exudates. If it is exudative, more diagnostic tests are required in order to determine the cause of the local disease. A malignancy is a common and important cause of exudative pleural effusions. Because the pleural fluid cytology and pleural biopsy specimens do not provide a diagnosis in a high percentage of malignant effusions, several tumor markers have been examined. In order to overcome this limitation, this study hypothesized that C-reactive protein(CRP) and vascular endothelial growth factor(VEGF) measurements would be useful for differentiating trasudates from exudates and determining the differences between a benign and malignant effusion. METHODS: Eighty consecutive patients with a pleural effusion (tuberculous 20, parapneumonic 20, malignant 20, transudative 20) were examined prospectively: 60 of them were classified according to Light's criteria as having an exudative fluid and 20 had a transudative fluid. The standard parameters of a pleural effusion were examined and the serum and pleural effusion VEGF levels were measured using enzyme linked immunosorbent assay(ELISA). CRP in the serum and pleural fluid was determined by a turbidimetric immunoassay. RESULTS: The pleural CRP levels in the exudates were significantly higher than those in the transudates, 4.19+/-4.22 mg/dl and 1.29+/-1.45 mg/dl, respectively. The VEGF levels in the pleural effusions were significantly elevated in the exudates compared to the transudate, 1,011+/-1,055 pg/ml and 389+/-325 pg/ml, respectively. The VEGF ratio in the exudative effusion is significantly higher than a transudative effusions, 3.9+/-4.7 and 1.6+/-0.9, respectively. The pleural CRP levels in the patients with a benign effusion(4.15+/-4.20 mg/dl) were significantly higher than those in the malignant effusion(1.43+/-1.91 mg/dl). The VEGF ratio is significantly higher in malignant effusions(4.9+/-5.5) than in benign effusions(2.8+/-3.6). CONCLUSION: In conclusion, the CRP and VEGF levels in the serum and pleural effusion can distinguish between transudates and exudates. Moreover it can differentiate between benign and malignant pleural effusions.
Subject(s)
Humans , Biopsy , C-Reactive Protein , Diagnosis , Diagnostic Tests, Routine , Exudates and Transudates , Immunoassay , Pleural Effusion , Pleural Effusion, Malignant , Prospective Studies , Biomarkers, Tumor , Vascular Endothelial Growth Factor AABSTRACT
Parathyroid carcinoma is a very rare disease which comprising 0.1~5% of hyperparathyroidism, and it usually presents with marked hypercalcemia. Clinically, it shows hypercalcemia due to the effect of excessive secretion of parathyroid hormone, bone disease, renal involvement and palpable neck mass. It is known that hyperparathyroidism is induced mostly by parathyroid adenoma but it can be seen in parathyroid hyperplasia, hyperparathyroid carcinoma, rarely associated with familial or multiple endocrine neoplasia. Parathyroid carcinoma can be diagnosed with distant metastasis or local invasion. Treatment is complete resection of primary cancerous lesion and local tissue. Since recurrence or distant metastases are frequent, radiological studies should be done when hypercalcemia is recurred. Sometimes, other tumors can causes hypercalcemia. There are several reports of parathyroid cancer associated with multiple endocrine neoplasia, but has never been reported of parathyroid carcinoma associated with meningioma. We experienced a parathyroid carcinoma with meningioma in 68 year old woman and report the case with the review of literatures.
Subject(s)
Aged , Female , Humans , Bone Diseases , Hypercalcemia , Hyperparathyroidism , Hyperplasia , Meningioma , Multiple Endocrine Neoplasia , Neck , Neoplasm Metastasis , Parathyroid Hormone , Parathyroid Neoplasms , Rare Diseases , RecurrenceABSTRACT
Parathyroid carcinoma is a very rare disease which comprising 0.1~5% of hyperparathyroidism, and it usually presents with marked hypercalcemia. Clinically, it shows hypercalcemia due to the effect of excessive secretion of parathyroid hormone, bone disease, renal involvement and palpable neck mass. It is known that hyperparathyroidism is induced mostly by parathyroid adenoma but it can be seen in parathyroid hyperplasia, hyperparathyroid carcinoma, rarely associated with familial or multiple endocrine neoplasia. Parathyroid carcinoma can be diagnosed with distant metastasis or local invasion. Treatment is complete resection of primary cancerous lesion and local tissue. Since recurrence or distant metastases are frequent, radiological studies should be done when hypercalcemia is recurred. Sometimes, other tumors can causes hypercalcemia. There are several reports of parathyroid cancer associated with multiple endocrine neoplasia, but has never been reported of parathyroid carcinoma associated with meningioma. We experienced a parathyroid carcinoma with meningioma in 68 year old woman and report the case with the review of literatures.