A Case of Squamous Cell Carcinoma in Nasal Cavity Treated with Conversion to Sirolimus in a Patient with Kidney Transplantation / 대한이식학회지

Conversion of immunosuppressants to sirolimus, an inhibitor of mammalian target of rapamycin, is a useful treatment option for prevention of the adverse events of immunosuppressants such as calcineurin inhibitor in renal transplantation recipients. In addition, sirolimus has been improving the quality of life and increasing the survival of patients with renal transplantation by decreasing immunosuppression-related malignancies, particularly skin cancer. However, complete remission of skin squamous cell carcinoma after renal transplantation only by conversion to sirolimus has not been well reported, although its preventive effect on skin cancer is well known. We report on a 72-year-old male with squamous cell carcinoma in his nasal cavity consequent to renal transplantation, which was treated completely with the conversion of cyclosporine to sirolimus without surgical removal or chemotherapy.

Comparison of Heart Rate Variability in Kidney Transplantation and End-Stage Renal Disease Patients on Dialysis / 대한내과학회지

BACKGROUND/AIMS: Heart rate variability (HRV) is a method for evaluation of autonomic nervous system activity by expressing the balance of sympathetic and parasympathetic tones. Some studies of HRV in patients with end-stage renal disease (ESRD) have been performed in Korea. However, few have examined kidney transplantation (KT) patients. Therefore, we investigated autonomic nervous system activity by means of HRV in patients with KT due to ESRD. METHODS: We compared the pattern of cardiac sympathetic and parasympathetic activity by time- and frequency-domain analysis of HRV with 24-h Holter monitoring of 23 KT and 56 dialysis patients. Patients underwent KT between January, 2008 and June, 2011. RESULTS: The mean ages of KT and dialysis patients were 54.2 +/- 12.3 and 53.7 +/- 12.6 years, respectively. The KT group showed increased time- and frequency-domain HRV (including HRV index), very low frequency (VLF), means and standard deviations of all normal R-R intervals for all 5-min segments of the entire recording (SDNNi), low frequency (LF), LF in normalized units (LF norm), and LF to high-frequency power ratio, compared with the dialysis group. CONCLUSIONS: Autonomic tone in patients with KT is higher than that in patients with ESRD on dialysis.

A Case of Sigmoid Colon Tuberculosis Mimicking Colon Cancer

Tuberculosis of the sigmoid colon is a rare disorder. An 80-year-old man visited Bongseng Memorial Hospital for medical examination. A colonoscopy was performed, and a lesion in the sigmoid colon that was suspected to be colon cancer was found. A biopsy was performed, and tuberculous enteritis with chronic granulomatous inflammation was diagnosed. Intestinal tuberculosis is most frequent in the ileocecal area, followed by the ascending colon, transverse colon, duodenum, stomach, and sigmoid colon, in descending order. Hence, we report a case of intestinal tuberculosis in the sigmoid colon, which is rare and almost indistinguishable from colon cancer.

A Case of Polyarteritis Nodosa Mimicking Systemic Lupus Erythematosus / 대한류마티스학회지

Polyarteritis nodosa (PAN) is a rare systemic necrotizing vasculitis involving multiple organ system. Systemic lupus erythematousus (SLE) also presented as a vasculitic symptoms. So, systemic vasculitis and SLE share some clinical features. We report a case of polyarteritis nodosa mimicking SLE. A 45-year-old woman was admitted due to oliguria. She diagnosed SLE because of pericardial effusion, hemolytic anemia, proteinuria, hematuria, and positivity of anti-dsDNA antibody. But she re-diagnosed as PAN through renal angiography and renal biopsy afterwards. She was treated with high dose steroid, cyclophosphamide, and anti-TNF-alpha antibody, but didn't respond those therapies.