Clinical characteristics of acute kidney injury in patients with glyphosate surfactant herbicide poisoning

In this study, we investigated the clinical characteristics of acute kidney injury (AKI) in patients with glyphosate surfactant herbicide (GSH) poisoning. Methods: This study was performed between 2008 and 2021 and included 184 patients categorized into the AKI (n = 82) and nonAKI (n = 102) groups. The incidence, clinical characteristics, and severity of AKI were compared between the groups based on the Risk of renal dysfunction, Injury to the kidney, Failure or Loss of kidney function, and End-stage kidney disease (RIFLE) classification. Results: The incidence of AKI was 44.5%, of which 25.0%, 6.5%, and 13.0% of patients were classified into the Risk, Injury, and Failure categories, respectively. Patients in the AKI group were older (63.3 ± 16.2 years vs. 57.4 ± 17.5 years, p = 0.02) than those in the non-AKI group. The length of hospitalization was longer (10.7 ± 12.1 days vs. 6.5 ± 8.1 days, p = 0.004) and hypotensive episodes occurred more frequently in the AKI group (45.1% vs. 8.8%, p < 0.001). Electrocardiographic (ECG) abnormalities on admission were more frequently observed in the AKI group than in the non-AKI group (80.5% vs. 47.1%, p < 0.001). Patients in the AKI group had poorer renal function (estimated glomerular filtration rate at the time of admission, 62.2 ± 22.9 mL/min/1.73 m2 vs. 88.9 ± 26.1 mL/min/1.73 m2 , p < 0.001) on admission. The mortality rate was higher in the AKI group than in the non-AKI group (18.3% vs. 1.0%, p < 0.001). Multiple logistic regression analysis showed that hypotension and ECG abnormalities upon admission were significant predictors of AKI in patients with GSH poisoning. Conclusion: The presence of hypotension on admission may be a useful predictor of AKI in patients with GSH intoxication.

Peritoneal Dialysis-associated Peritonitis Caused by Chryseobacterium indologenes / 대한내과학회지

Chryseobacterium indologenes (C. indologenes) is a nonmotile, gram-negative bacillus that is widely distributed in nature. Generally considered nonpathogenic, C. indologenes rarely infects humans and is not normally present in the human microflora. C. indologenes infections have been observed in cases of peritoneal dialysis (PD)-associated peritonitis, although the incidence of these infections is low. Although C. indologenes is generally susceptible to trimethoprim-sulfamethoxazole, levofloxacin, ciprofloxacin, piperacillin-tazobactam, and cefepime, no guidelines have been established for the treatment of PD-associated peritonitis. Here we report the first case of PD-associated peritonitis in Korea with C. indologenes identified as the sole etiologic agent. The patient recovered after intraperitoneal antibiotic treatment without the need for Tenckhoff catheter removal.

Predictors of Clinical Outcome in Patients with Angiographically Intermediate Lesions with Minimum Lumen Area Less than 4 mm² Using Intravascular Ultrasound in Non-Proximal Epicardial Coronary Artery / 전남의대학술지

We investigated predictors of major adverse cardiac events (MACE) with two years after medical treatment for lesions with angiographically intermediate lesions with intravascular ultrasound (IVUS) minimum lumen area (MLA) <4 mm² in non-proximal epicardial coronary artery. We retrospectively enrolled 104 patients (57 males, 62±10 years) with angiographically intermediate lesions (diameter stenosis 30–70%) with IVUS MLA <4 mm² in the non-proximal epicardial coronary artery with a reference lumen diameter between 2.25 and 3.0 mm. We evaluated the incidences of major adverse cardiovascular events (MACE including death, myocardial infarction, target lesion and target vessel revascularizations, and cerebrovascular accident) two years after medical therapy. During the two-year follow-up, 15 MACEs (14.4%) (including 1 death, 2 myocardial infarctions, 10 target vessel revascularizations, and 2 cerebrovascular accidents) occurred. Diabetes mellitus was more prevalent (46.7% vs. 18.0%, p=0.013) and statins were used less frequently in patients with MACE compared with those without MACE (40.0% vs. 71.9%, p=0.015). Independent predictors of MACEs with two years included diabetes mellitus (odds ratio [OR]=3.41; 95% CI=1.43–8.39, p=0.020) and non-statin therapy (OR=3.11; 95% CI=1.14–6.50, p=0.027). Long-term event rates are relatively low with only medical therapy without any intervention, so the cut-off of IVUS MLA 4 mm² might be too large to be applied for defining significant stenosis. The predictors of long-term MACE were diabetes mellitus and statin therapy in patients with angiographically intermediate lesions in non-proximal epicardial coronary artery.

Peritoneal Dialysis-associated Peritonitis Caused by Chryseobacterium indologenes / 대한내과학회지

Chryseobacterium indologenes (C. indologenes) is a nonmotile, gram-negative bacillus that is widely distributed in nature. Generally considered nonpathogenic, C. indologenes rarely infects humans and is not normally present in the human microflora. C. indologenes infections have been observed in cases of peritoneal dialysis (PD)-associated peritonitis, although the incidence of these infections is low. Although C. indologenes is generally susceptible to trimethoprim-sulfamethoxazole, levofloxacin, ciprofloxacin, piperacillin-tazobactam, and cefepime, no guidelines have been established for the treatment of PD-associated peritonitis. Here we report the first case of PD-associated peritonitis in Korea with C. indologenes identified as the sole etiologic agent. The patient recovered after intraperitoneal antibiotic treatment without the need for Tenckhoff catheter removal.

A Case of Methanol Poisoning Treated with Continuous Renal Replacement Therapy: The Serial Measurements of Serum Methanol Concentrations in Methanol Poisoning

Methanol poisoning is a medical emergency that requires rapid elimination of the toxin and its metabolites for recovery. The danger of methanol results from the accumulation of its toxic metabolite formic acid. This accumulation may result in the development of metabolic acidosis, visual impairment, and damage to the basal ganglia. Extracorporeal treatment is recommended in severe cases of methanol poisoning with coma, seizure, new vision deficits, metabolic acidosis, high serum anion gap, elevated methanol concentrations or impaired kidney function. Although the serum methanol concentration is helpful in determining the use of extracorporeal treatment, methanol assays are not standard laboratory tests in Korea. Herein, we report a case of methanol poisoning in which the patient's clinical improvement was confirmed using serum and urine methanol levels.

Acute interstitial nephritis induced by Solanum nigrum

Acute interstitial nephritis (AIN) is an important cause of reversible acute kidney injury and pathologically characterized by inflammatory infiltrate in the renal interstitium. Solanum nigrum (S. nigrum) is a medicinal plant member of the Solanaceae family. Although S. nigrum has been traditionally used to treat various ailments such as pain, inflammation, and fever, it has also been reported to have a toxic effect, resulting in anticholinergic symptoms. However, there have been no reports of AIN caused by S. nigrum. Here, we report the first case of biopsy-confirmed AIN after ingestion of S. nigrum. The patient was successfully treated using corticosteroid therapy.

Case of Follicular Bronchiolitis in Rheumatoid Arthritis

Follicular bronchiolitis is an uncommon bronchiolar disorder that is characterized by the presence of hyperplastic lymphoid follicles with reactive germinal centers. The condition is associated with connective tissue diseases such as rheumatoid arthritis, Sjögren’s syndrome, and immunodeficiency disorders. A 56-year-old man with rheumatoid arthritis was admitted to hospital with a progressively enlarging pulmonary nodule in the left upper lobe. A follow-up contrast tomography scan showed that the nodule had increased in size from 4.2 mm to 6.3 mm over a 3 month period. An open lung biopsy was performed to establish a definite pathologic diagnosis of the pulmonary nodule, which was suspected to be a lung malignancy. The nodule was diagnosed as follicular bronchiolitis based on the histopathology findings. We describe a patient with follicular bronchiolitis that was confirmed by an open lung biopsy, and is believed to have had rheumatoid involvement.

MRI Findings of Cervical Lymphadenopathy: Preliminary Study

PURPOSE: The purpose of this study is to evaluate findings in MRI which maybe useful in differential diagnosis of cervical lymph node enlargement. MATERIALS AND METHODS: We retrospectively analyzed the MRI findings of cervical lymph node enlargement in surgically proven 13 patients. We analyzed the location, size and shape, signal intensity, margin between node and surrounding structures degree and patterns of contrast enhancement RESULTS: No disease specificity in location and size of lymphadenopathy. was demonstrated in MRI. Most lymph nodes shows isointensity or slightly increased signal intensity to adjacent muscle on T1WI and high signal intensity on T2WI. Most of the cases showed contrast enhancement with metastatic lymph nodes showing ring-like and/or patchy enhancement. Tuberculous lymphadenopathy showed homogeneous or rather thick walled ring-like enhancement and one or multiple central nonenhancing portions of eccentrical location in the node. Relatively homogeneous enhancements were noted on reactive lymphold hyperplasia, Lymphoma and Castleman's disease. CONCLUSION: MR imaging was helpful in differentiation of cervical lymph node enlargements. Tuberculous lymphadenopathy showed characteristic findings of rather spherical shaped, thick walled ring enhancement and multiple eccentrically located central nonenhancing portions.

A case report of castleman disease in th neck: CT and MRI finding

Castlernan disease is a rare lymphoproliferative disorder of uncertain cause, which most commonly involves mediastinum and rarely affects retroperitoneal, axillary or cervical lymph nodes. Authors present CT the and MRI findings of a cases of Castleman disease involving cervical lymph nodes. On CT and MR. There were multiple lymph nodes enlargement with homogeneous enhancement along the bilateral internal jugular and spinal accessory lymph node chain.

A case report of castleman disease in th neck: CT and MRI finding

Castlernan disease is a rare lymphoproliferative disorder of uncertain cause, which most commonly involves mediastinum and rarely affects retroperitoneal, axillary or cervical lymph nodes. Authors present CT the and MRI findings of a cases of Castleman disease involving cervical lymph nodes. On CT and MR. There were multiple lymph nodes enlargement with homogeneous enhancement along the bilateral internal jugular and spinal accessory lymph node chain.

Double contrast CT arthrographic findings of shoulder instability

Gleno-humeral joint is a ball and socket joint. It has the greatest range of movement among all the joints of the body. The greatest range of movement is inevitably accompanied by a considerable loss in stability. Thirty-three persons underwent Double contrast CT arthrography of the shoulder for the evaluation of suspected shoulder derangement. We performed 62 shoulder arthrography(33 abnormal shoulders and 29 normal shoulders) and reviewed their findings retrospectively. They had recurrent shoulder dislocation(30 shoulders) or nonspecific shoulder pain(3 shoulders). Injury of the glenoid labrum was seen in 28 shoulders at double contrast CT arthrography. Among 28 cases of the labral injury, detachment was seen in 15 cases, labral tear in 5 cases, and labral erosion in 8 cases. Double contrast CT arthrography also showed Hill-Sachs in 20 shoulders. The numbers of type 1, type 2, and type 3 capsulolabral attachment in 33 shoulder instability cases were 10, 16, and 7, respectivity, while, 16, 12, and, 1 in 29 normal controls. Type 2 and 3 are more common in shoulder instability group than normal control group. Operation was done in 18 shoulders. Comparing with operation findings, the sensitivity of double contrast CT arthrography in the detection of Hill-Sachs defect was 100% with the specificity of 71% and the accuracy of 89%. The sensitivity, and accuracy of double contrast CT arthrography in the detection of labral injury were 94%, 100%, and 95, respectively. Double contrast CT arthrography is a minimally invasive and highly accurate technique for in the evaluation of glenohumeral instability.