ABSTRACT
PURPOSE: This study compared the oncologic results of docetaxel chemotherapy (DOC) in castration-resistant prostate cancer (CRPC) according to continuous addition of androgen deprivation therapy (ADT) during chemotherapy. MATERIALS AND METHODS: We retrospectively reviewed the medical records of 106 patients who received DOC in 6 medical institutes. Among them, 72 patients had a complete medical record: 28 patients with ADT (DOC+continuous ADT group) and 44 without ADT (DOC only group). We compared the progression-free survival of these groups after DOC. RESULTS: Docetaxel was administered an average of 28 months after primary ADT as the first treatment. A median number of 6 cycles of DOC was administered in both groups. In the DOC+continuous ADT group, orchiectomy was performed in 18 patients and luteinizing hormone-releasing hormone agonist was injected in 10 patients. During DOC treatment, prostate-specific antigen (PSA) progression-free survival was statistically different (6.0±4.75 months in DOC+continuous ADT group vs. 4.8±3.2 months in DOC only group, p=0.024), whereas radiologic progression-free survival was not statistically different (5.0±3.12 months in DOC+continuous ADT group vs. 5.0±2.79 months in DOC only group, p=0.387). CONCLUSIONS: In our cohort, continuous addition of ADT showed a significant benefit in PSA progression-free survival during DOC in CRPC patients. Further prospective studies are needed to confirm these observations.
Subject(s)
Humans , Academies and Institutes , Cohort Studies , Disease-Free Survival , Drug Therapy , Gonadotropin-Releasing Hormone , Medical Records , Orchiectomy , Prospective Studies , Prostate , Prostate-Specific Antigen , Prostatic Neoplasms , Retrospective StudiesABSTRACT
Infection stones are more likely to form after urinary diversion as the result of urinary stasis. To prevent urinary stasis due to encrusted pyelitis in a transplanted kidney, we describe an alternative a surgical treatment: ileo-pelvic anastomosis. In our patient with a transplanted kidney, the ileal conduit had previously been anastomosed end-to-side owing to renal tuberculosis with an atrophied bladder; the transplanted ureter was anastomosed to the ileum in the left lower abdomen with an ileal conduit on the opposite side. Routine check-up revealed hydronephrosis with infected pyelitis and ureteritis in the transplanted kidney. We performed ileo-pelvic end-to-end anastomosis to prevent urinary stasis by lengthening the ileal conduit and performed augmentation cystoplasty to support the atrophied bladder following tuberculosis. We suggest that this approach may be useful in similar cases.
Subject(s)
Humans , Abdomen , Hydronephrosis , Ileum , Kidney , Kidney Transplantation , Pyelitis , Transplants , Tuberculosis , Tuberculosis, Renal , Ureter , Urinary Bladder , Urinary DiversionABSTRACT
Renal graft recipients with hepatitis B virus(HBV) infection are at increased risk of fatal outcome, when 1they have serological evidence of active viral replication, such as HBV-DNA and/or HBeAg. Some patients have been treated successfully with interferon. But the major drawback of this therapy is acute rejection. Lamivudine is a potent inhibitor of hepatitis B virus replication. The aim of this study was to determine the efficacy and safety of lamivudine therapy in HBsAg positive renal recipients with active viral replication. Of the 20 HBsAg positive renal transplants, 12 patients with positive HBV-DNA, determined by hybridization method, were given lamivudine. The doses of lamivudine ranged from 37.5 to 150mg/day according to the graft function of patients. Alanine aminotransferase(ALT), aspartate aminotransferase (AST), HBsAg, HBeAg, anti-HBe, HBV-DNA and creatinine were regularly monitored. Lamivudine was well tolerated without significant side effect. Viral replication was effectively suppressed, as evidenced by negative conversion of serum HBV-DNA in 11 of 12 patients and reduction in HBV-DNA titer in 1 patient. In 3 patients who stopped lamivudine due to economic reason, HBV-DNA promptly increased to high titer, but decreased to undetectable level after retrial of medication. In 2 patients with initial negative conversion of HBV-DNA and under continued medication, HBV-DNA reappeared at 7 and 16 months respectively after initiation of lamivudine, with deterioration of hepatic function in 1 patient. These patients with lamivudine-resistant mutant continued medication with persistent low titer of HBV-DNA and without further aggravation of hepatic dysfunction. Lamivudine seems to inhibit HBV replication effectively in HBV-infected renal recipients and seems to be helpful in delaying the progression of liver disease. However, the optimal duration of treatment and long term efficacy and safety remain to be determined.
Subject(s)
Humans , Alanine , Aspartate Aminotransferases , Creatinine , Fatal Outcome , Hepatitis B e Antigens , Hepatitis B Surface Antigens , Hepatitis B virus , Hepatitis B , Hepatitis B, Chronic , Hepatitis , Interferons , Kidney Transplantation , Lamivudine , Liver Diseases , TransplantsABSTRACT
Systemic lupus erythematosus, an autoimmune disease with multisystem involvement, has been reported to be associated with a number of gastrointestinal complications and symptoms such as nausea, vomiting, and abdominal pain. However, acute pancreatitis only rarely has been reported as a complication of SLE. We report a case of SLE presenting drug unrelated acute pancreatitis as a initial manifestation.
Subject(s)
Abdominal Pain , Autoimmune Diseases , Lupus Erythematosus, Systemic , Nausea , Pancreatitis , VomitingABSTRACT
A 63-year-old woman presented to the hospital with gross hematuria and acute renal failure. Kidney function deteriorated rapidly and progressively. A renal biopsy revealed segmental or circumferential crescents associated with linear deposits of immunoglobulin G, typical of anti-glomerular basement membrane disease. Both c-ANCA and anti-GBM antibody were detected in serum. She was treated with hemodialysis, plasmapheresis, high dose steroid and cyclophosphamide. However, she died 7 weeks after treatment because of pneumonia, without recovery of renal function. Serologic positivity of both ANCA and anti-GBM antibody are becoming more frequently recognized in rapidly progressive glomerulonephritis. The influence of c-ANCA on the clinical course of anti-GBM glomerulonephritis remains to be determined.