A Case of Acute Renal Failure after Application of Mercury to the Skin / 대한신장학회잡지

Mercury is one of the heavy metals that cause intoxications. Mercury can cause muscular tremor, psychic irritability, renal toxicity and so on. Mercury intoxications usually occur chrough chronic respiratory ingestion. We describe a case in that a woman had applicated inorganic mercury to her whole body and developed mercury intoxications which can be characterized by the whole body skin rash, fever, acute renal failure and the hepatotoxicity appeared. We managed the patient with diuretics, antibiotics and continuous veno-venous hemodiafiltration. On the 6th hospital day, serum creatinine was normalized. Since then, the skin rash and hepatotoxicity were gradually alleviated.

A case of stomach metastasis from breast cancer / 대한내과학회지

Metastatic cancer from breast cancer is not uncommon and it often involves multiple organs. Gastric metastasis from breast cancer is much rarer than lung, bone and lymph node metastasis. Most of the symptoms are nonspecific, so it is not easy to differentiate primary gastric cancer from gastric metastasis from the breast. In particular, gastric and breast cancers are the two most common cancers among Korean women, so efforts should be made to distinguish primary gastric cancer from gastric metastasis because treatment and prognosis are very different between two. A few cases have been reported in Korea concerning gastric metastasis from breast cancer. We report here a case of gastric metastasis from infiltrating duct carcinoma of the breast.

Two Cases of Patchy Renal Vasoconstriction without Antecedent Anaerobic Exercise / 대한신장학회잡지

Patchy renal vasoconstriction is one of the reversible renal vasoconstrictions, which usually occur in healthy young men following strenuous anaerobic exercise. Analgesics, viral infection, dehydration were known to be the causes of patchy renal vasoconstriction. We experienced two cases of patchy renal vasoconstriction without antecedent anaerobic exercise. The first case is a 54-year-old woman admitted to a hospital with severe loin pain. On admission, serum creatinine was elevated to 2.2 mg/dL. Patchy areas of delayed contrast enhancement in both kidneys were observed on immediate post-contrast CT and 14 hours delayed image. This severe loin pain was initiated without anaerobic exercise. On the 4th day, her loin pain was relieved and on the 12th day of her illness, serum creatinine was normalized with supportive care. The second case is an 18- year-old man presented with pain in the both flanks. Five days earlier, operation had been performed for treatment of gynecomastia. There had been no preceding anaerobic exercise before the flank pain occurred. On admission to the hospital, laboratory studies revealed a serum creatinine 2.3 mg/dL. Computed tomography showed multiple patchy areas of enhancement in the renal parenchyma. On 12 hours delayed image, there were delayed contrast enhancement. On the sixth day, serum creatinine decreased to 1.4 mg/dl and the loin pain was subsided. Patchy renal vasoconstriction can occur without exercise, and we suggest that patchy renal vasoconstriction should be suspected in the patients suffering from acute renal failure with severe loin pain even without strenuous exercise.

Combination Chemotherapy of Oxaliplatin, 5-Fluorouracil and Low Dose Leucovorin in Patients with Advanced Colorectal Cancer / Journal of the Korean Cancer Association, 대한암학회지

PURPOSE: The aim of this study was to evaluate the efficacy and tolerability of the oxaliplatin, 5-fluorouracil (5-FU) and low dose leucovorin (LV) combination in patients with advanced colorectal cancer. MATERIALS AND METHODS: Patients with unresectable or recurrent colorectal carcinomas were prospectively accrued. Up to one prior chemotherapy regimen was allowed. Patients received oxaliplatin, 85 mg/m2, administered as a 2-hour infusion on day 1, followed by LV, 20 mg/m2, as a bolus and 5-FU, 1, 500 mg/m2, via continuous infusion for 24 hours on days 1 and 2. Treatment was repeated every 2 weeks until disease progression or adverse effects prohibited further therapy. RESULTS: Between August 1999 and May 2004, 31 patients were enrolled in this study. Of the patients enrolled, 24 and 31 were evaluable for tumor response and survival analysis, respectively. The patients' characteristics included a median age of 59, with 6 (19%) having had prior chemotherapy. No patient achieved a complete response, but nine (38%) attained a partial response. Seven (29%) patients maintained a stable disease and 8 (33%) experienced increasing disease. The median duration of the response was 6 months. After a median follow-up of 9.6 months, the median time to progression was 3.8 months, with a median survival of 10.7 months. The hematological toxicities were mild to moderate, with no treatment-related mortality or infection. The major non-hematological toxicity was gastrointestinal toxicity. CONCLUSIONS: The combination chemotherapy of oxaliplatin, low dose LV and continuous infusion of 5-FU is safe and has a cost-benefit, but is a moderately effective regimen in advanced colorectal cancer. A randomized trial comparing low and high dosages of leucovorin in the FOLFOX regimen is warranted.