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Guillain-Barre syndrome (GBS) is an immune-mediated acute polyradiculoneuropathy and commonly occurs after a preceding infection or immunization sequalae. Following the severe acute respiratory syndrome-coronavirus-2 virus pandemic with co-introduction of massive vaccinations, several GBS cases associated with coronavirus disease 2019 (COVID-19) infection per se or after vaccination for COVID-19 were reported internationally. Herein, we report two cases of Korean GBS presenting with tetraplegia after two different COVID-19 vaccinations (42-year old man by AstraZeneca and 48-year woman by Pfizer vaccines) within four weeks after vaccination. The patients were diagnosed with clinical examination, serial electromyography, and compatible laboratory results and improved after comprehensive rehabilitative treatment and intravenous immunoglobulin therapy. Furthermore, we performed an electrodiagnostic follow-up study of each case to examine their unique characteristics.
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BACKGROUND/AIMS: This report discusses the frequency and clinical characteristics of bladder cancer diagnosed with multi-detector computed tomography (MDCT) in outpatients visiting a nephrology and urology clinic with asymptomatic isolated hematuria. METHODS: MDCT was performed on outpatients who presented to the nephrology and urology clinic at the Holy Family Hospital of the Catholic University of Korea with asymptomatic isolated hematuria from January 2005 to December 2007. RESULTS: Of the 1,819 patients who underwent MDCT, the results were normal in 54.1%, showed a simple renal cyst in 25.7%, a renal calculus in 4.7%, and a malignant tumor of the urinary tract in 1.7%. Twenty-five patients (1.3%) were diagnosed with bladder cancer, including 20 (80%) men and 5 (20%) women. The average age of the patients with bladder cancer was 74.5+/-7.3 years. The 25 patients diagnosed with bladder cancer had a higher rate of gross hematuria, older age, and male gender (p<0.05) compared to the other patients. In addition, their hemoglobin and albumin levels were significantly lower (p<0.05). For all patients, the frequency of bladder cancer in those with asymptomatic microscopic hematuria, excluding those with gross hematuria, was extremely low (0.3%, 6 patients). CONCLUSIONS: MDCT may constitute an adequate diagnostic test for patients with asymptomatic hematuria. Older male patients with gross hematuria require a thorough urologic evaluation.
Subject(s)
Female , Humans , Male , Diagnostic Tests, Routine , Hematuria , Hemoglobins , Kidney Calculi , Korea , Nephrology , Outpatients , Urinary Bladder , Urinary Bladder Neoplasms , Urinary Tract , UrologyABSTRACT
Tsukamurella pulmonis is an aerobic actinomycete. We report a catheter-related bacteremia of T. pulmonis. A 39 yr-old male with ALL was hospitalized to receive bone marrow transplantation (BMT). Although the patient developed a high fever at the 7th hospital day (HD), it subsided with vancomycin treatment, and he received BMT at 9th HD. Fever resurged at 16th HD despite sustained treatment with vancomycin, meropenem, and amphotericin B, but subsided with removal of Hickman catheter (HC) at 19th HD. Three sets of blood cultures comprising one from the HC and two from venipunctures were taken at 7th, 16th, and 19th HD, and the distal tip of the HC was also cultured. The aerobic vials of all 3 HC-withdrawn blood cultures and one peripheral blood culture taken at 19HD and the HC tip culture grew long, straight, thin gram-positive rods that were positive on modified Kinyoun stain. This organism showed tiny, rough, grey colonies after 3-day incubation and grew to large flat colonies when incubation was extended. It was catalase-positive, urease-positive, and alkaline-slant/alkaline-deep on triple sugar iron agar, and hydrolyzed hypoxanthine. The sequence of 1,296 base pairs of 16S rRNA of this organism showed a 100.0% homology with the published sequence of T. pulmonis DSM 44142T. To our knowledge, this is the first report of T. pulmonis bacteremia in Korea.
Subject(s)
Adult , Humans , Male , Actinomycetales/classification , Actinomycetales Infections/diagnosis , Bacteremia/diagnosis , Bone Marrow Transplantation , Catheter-Related Infections/microbiology , Leukemia, Myeloid, Acute/therapy , Phylogeny , RNA, Ribosomal, 16S/geneticsABSTRACT
PURPOSE: Determination of accurate body fluid is essential for treating hypertension in end stage renal disease patients undergoing dialysis. However, the determination of dry body weight based on clinical assessment has low sensitivity and specificity. This study was done in order to examine the usefulness of bioimpedance analysis in determining the volume of CAPD patients. METHODS: Twenty-four hours ambulatory blood pressure and plasma concentrations of atrial natriuretic peptide (ANP) were measured and peritoneal equilibration test (PET) were obtained from 32 stable CAPD patients. Patients were divided into three groups; patients with normal blood pressure (group A, 11 people), and patients who have hypertension but controlled (under 130/80mmHg) with anti-hypertension medication (group B, 9 people), patients who have high blood pressure (over 130/80 mmHg) with 2 more anti-hypertension medication (group C, 12 people). We measured normalized extracellular fluid (nECF), extracelluar fluid/intracellular fluid ratio (ECF/ICF) and extracellular fluid/total body water (ECF/ TBW) of each group by using bioimpedance analysis (BIA) and compared the results of each group. We also compared the values of nECF, ECF/ICF, ECF/TBW indices from patients with those from normal renal function people. RESULT: Thirteen men and nineteen women participated in this test. Their mean age was 53+/-12 years and mean duration of CAPD was 49+/-38 months. Among three groups, plasma ANP level in group C (53.1+/-13.6 pg/mL) was significantly higher than the level in group A (10.3+/-7.2 pg/mL) and B (13.7+/-8.1 pg/mL) (p<0.05). The values of nECF, ECF/ICF, ECF/TBW that measured by BIA in group C was significant higher than the values in group A and B, but the values in group A and B were not significant different. The values of nECF, ECF/ICF, ECF/TBW from patients with normal kidney function were not different from those of group A and B, but the values were significantly lower than the values in group C (p<0.05). Plasma ANP level was correlated with nECF, ECF/ICF, ECF/TBW (p<0.05) value. Plasma ANP and nECF, ECF/ICF, ECF/TBW was not influenced different PET result. CONCLUSION: BIA is considered as a useful standard to predict the volume status in CAPD patients. In the future, prospective studies are demanded for clinical application.
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Female , Humans , Male , Atrial Natriuretic Factor , Blood Pressure , Blood Volume , Body Fluids , Body Water , Body Weight , Dialysis , Electric Impedance , Extracellular Fluid , Hypertension , Kidney , Kidney Failure, Chronic , Peritoneal Dialysis , Peritoneal Dialysis, Continuous Ambulatory , Plasma , Sensitivity and SpecificityABSTRACT
PURPOSE: In hemodialysis patients with secondary hyperparathyroidism, intravenous administration of calcitriol became widely utilized. In CAPD patients, however, the intravenous administration of calcitriol is not practical. The purpose of the present study was to determine the effect and safety of intraperitoneal (IP) calcitriol pulse therapy in CAPD patients. METHODS: All patients undergoing CAPD between January 2006 and January 2007 and willing to give informed consent were eligible. Inclusion criteria were age greater 18 years, on CAPD for at least 6 months, and secondary hyperparathyroidism (intact PTH >300 pg/mL). Intraperitoneal calcitriol was given by direct infusion into the dialysate (2.0 microgram) twice per week. If hypercalcemia (>10.5 mg/dL) and hyperphosphatemia (>6.5 mg/dL) developed, the patients were excluded from study. RESULTS: Eighteen patients were enrolled into the study. Among them, 16 patients completed the study period. After IP calcitriol for 3 months, there was a significant drop of iPTH level from the pretreatment level of 490+/-234 pg/mL to the level of 318+/-315 pg/mL (p<0.05). There were no definite hypercalcemia during the study period, and only 1 patient was excluded from study due to hyperphosphatemia. CONCLUSION: In CAPD patients, IP calcitriol pulse therapy is effective in treating secondary hyperparathyroidism, and that IP calcitriol pulse therapy is associated with a low incidence of hypercalcemia and hyperphosphatemia.
Subject(s)
Humans , Administration, Intravenous , Calcitriol , Hypercalcemia , Hyperparathyroidism, Secondary , Hyperphosphatemia , Incidence , Informed Consent , Peritoneal Dialysis , Peritoneal Dialysis, Continuous Ambulatory , Renal DialysisABSTRACT
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No abstract available.