ABSTRACT
A new staging system for multiple myeloma (MM) has utilized serum concentrations of beta 2-microglobulin (S beta2 M) and albumin as important prognostic factors for survival. Since S beta2 M is an indicator of glomerular filtration rate, we compared the prognostic values of S beta2 M and 24-hr urinary creatinine clearance (Ccr) in patients with MM. We retrospectively reviewed the records of 170 MM patients from January 1996 to November 2003 whose 24-hr urinary Ccr was available at the time of diagnosis. We found that pretreatment S beta2 M was inversely related to Ccr (Spearman's correlation coefficient=-0.787). In univariate analysis, the hazard ratio (HR) of death was 1.043 (p<0.001) for S beta2 M and 0.985 (p<0.001) for Ccr. Multivariate analysis showed that S beta2 M (HR 1.030, p=0.010) and Ccr (HR 0.993, p=0.059) were significant prognostic factors in patients' survival. In conclusion, 24-hr urinary Ccr may be utilized for staging of patients with MM.
Subject(s)
beta 2-Microglobulin/blood , Survival Analysis , Retrospective Studies , Prognosis , Neoplasm Staging/methods , Multivariate Analysis , Multiple Myeloma/drug therapy , Creatinine/urineABSTRACT
ESRD patients have higher cardiovascular mortality risk than the general population. Increased QT dispersion has been shown to be a risk factor for cardiac arrhythmia in chronic hemodialysis patients with diabetes or arterial disease. It is known that QT dispersion is significantly prolonged in postdialysis than in predialysis. It is associated with a decrease in serum potassium. During hemodialysis, serum potassium is decreased and QT dispersion increases. Therefore ventricular arrhythmia frequently occurs in the latter half of dialysis. We report 2 cases of ventricular arrhythmia caused by potassium removal during dialysis in chronic hemodialysis patients.
Subject(s)
Humans , Arrhythmias, Cardiac , Dialysis , Hypokalemia , Kidney Failure, Chronic , Mortality , Potassium , Renal Dialysis , Risk FactorsABSTRACT
Histamine H2-receptor antagonists are commonly used in many clinical conditions, and their hepatotoxicity has been reported occasionally.However, cholestatic hepatitis induced by nizatidine is very rare. Here, we report a young female patient with severe cholestatic hepatitis associated with nizatidine use. She had taken nizatidine to manage asymptomatic reflux laryngitis by an otonasolaryngology doctorfor about 20 days. After about 15 days of nizatidine administration, jaundice developed and continued for more than2 months withmaximal serum total bilirubin reaching 17.5 mg/dL, in spite of the discontinuation of medication. Liver specimen obtained by needle biopsy revealed severe centrilobular cholestatic hepatitis. Her liver function improved slowly and serum total bilirubin decreased down to 1.7 mg/dL after months later from the development of jaundice. As far as our knowledge, this is the second case of nizatidine- induced cholestatic hepatitis reported in the literature.
Subject(s)
Female , Humans , Bilirubin , Biopsy, Needle , Cholestasis , Hepatitis , Histamine , Jaundice , Laryngitis , Liver , NizatidineABSTRACT
Autoimmune chronic pancreatitis is a disease characterized by diffuse swelling of the pancreas, irregular narrowing of the main pancreatic duct and elevated levels of serum IgG, and lymphoplasmacytic infiltration is observed on histologic examination. Steroid therapy can dramatically reverse the clinical symptoms and the histologic and radiologic findings. It is known that recurrence is very rare after successful steroid treatment. Furthermore, there have not yet been any reports about a case that relapsed during maintenance therapy with low dose steroid. We experienced a rare case of autoimmune chronic pancreatitis that relapsed despite maintenance therapy with low-dose steroid, and the patient again responded to high-dose steroid.
Subject(s)
Humans , Male , Middle Aged , Administration, Oral , Autoimmune Diseases/drug therapy , Cholangiopancreatography, Endoscopic Retrograde , Chronic Disease , Dose-Response Relationship, Drug , Follow-Up Studies , Glucocorticoids/administration & dosage , Pancreatitis/drug therapy , Prednisolone/administration & dosage , Recurrence , Tomography, X-Ray ComputedABSTRACT
Congenital cystic adenomatoid malformation (CCAM) is a rare congenital disorder of pulmonary development that usually presenting as a respiratory distress in the neonatal period. Presentation in adulthood is rare and only 40 cases of CCAM in adulthood have been reported in literatures. A 49-year-old woman presented with hemoptysis. Postero anterior chest radiograph showed an air-fluid level in right upper lobe. A computed tomographic (CT) scan of the chest showed multilocular thick-walled cystic lesions in right upper lobe. A CT angiography showed cystic lesions with normal bronchial artery supply in right upper lobe, which were consistent with CCAM. A complete surgical resection of the right upper lobe was performed confirming a type 2 CCAM according to the expanded Stocker's classification.
Subject(s)
Female , Humans , Middle Aged , Angiography , Bronchial Arteries , Classification , Congenital, Hereditary, and Neonatal Diseases and Abnormalities , Cystic Adenomatoid Malformation of Lung, Congenital , Hemoptysis , Lung , Radiography, Thoracic , ThoraxABSTRACT
We report a rare case of idiopathic chylothorax and chyluria. A 31 year-old woman was referred to our hospital with a right-sided pleural effusion. Cream-colored pleural fluid and urine were confirmed as chylothorax and chyluria, respectively, by a lipoprotein electrophoresis. Even though she had previously underwent surgery for pelvic fibrosarcoma and experienced its recurrence, there has been no change of mass size and no evidence of thoracic duct or urinary tract obstruction as of the moment. Hence, idiopathic chylothorax and chyluira was diagnosed. Because she responded poorly to conservative treatment, thoracic duct ligation and pleurodesis were performend ; wherease chyluria was resolved spontaneously.
Subject(s)
Adult , Female , Humans , Chylothorax , Electrophoresis , Fibrosarcoma , Ligation , Lipoproteins , Pleural Effusion , Pleurodesis , Recurrence , Thoracic Duct , Urinary TractABSTRACT
Emphysematous cystitis is a rare disease that is associated with diabetes mellitus, neurogenic bladder, chronic genitourinary infection, and malignancy. Fever, chill, abdominal pain, and urinary difficulties were the most frequent presenting symptoms associated with emphysematous cystitis. We report a case of incidentally detected asymptomatic emphysematous cystitis in a 67 years old female patient with diabetic nephropathy. We review characteristic features of all 19 cases that has been reported in korean medical journals till now. Risk factors for this condition appear to be female sex, old age, and diabetes mellitus.