Acute Tubulointerstitial Nephritis Induced by Deferasirox following Hematopoietic Stem Cell Transplantation for Severe Aplastic Anemia

Deferasirox is a once-daily, oral iron-chelating agent that is now widely available for the treatment of transfusional hemosiderosis. Deferasirox represents a significant advance in the treatment of iron overload, as the availability of an effective oral therapy has the potential to relieve many patients from the burden of frequent parenteral therapy with the previous reference standard iron chelator, deferoxamine. The well-known drug-related adverse events associated with deferasirox include gastrointestinal disturbances, rash, elevations in liver enzyme levels, and mild increases in serum creatinine levels, but acute renal failure is not common. The authors report a case of acute tubulointerstitial nephritis induced by deferasirox following hematopoietic stem cell transplantation for severe aplastic anemia

A Case of Jarcho-Levin Syndrome with Fusion of Both Kidneys in a Newborn Infant

The Jarcho-Levin syndrome is a rare genetic disorder characterized by a short neck, short trunk, and a constricted thorax, and is due to multiple vertebral and rib defects. The small size of the thorax frequently leads to respiratory insufficiency and death in neonates or infants. This syndrome also combines with various kinds of anomalies, especially renal anomalies. We report an infant with Jarcho-Levin syndrome combined with fusion of both kidneys who was referred from a local obstetric clinic for cyanosis and respiratory difficulty.

A Pilot Study of Comparisons Between 1999 and 2007 Data on Childhood Asthma Caregiver's Quality of Life Questionnaire / 소아알레르기및호흡기학회지

PURPOSE: Childhood asthma is one of the most frequent chronic inflammatory diseases of the respiratory tract and can have profound effects on emotional, and economical aspects not only for childhood asthma patients, but also the patient's caregivers. It was also performed has been done in Korea in 1999 under the supervision of The Korean Academy of Pediatric Allergy and Respiratory Disease (KAPARD). We compared and evaluated the data from the questionnaire between 1999 and 2007 in order to obtain the pilot data for a nation-wide study on the life quality of childhood asthma caregivers. METHODS: We selected childhood asthma patients at the Department of Pediatrics, Hanyang University Seoul Hospital and Guri Hospital. The contents and categories of the questionnaire were identical with the one developed by KAPARD, the questionnaire were filled up twice at first & second visit, divided into emotion and activity domains. All items were rated on a 5 scores from 1 to 5: 1, a lower quality of life; and 5, a satisfactory quality of life. For the validity of the study, the caregivers filled up the first and the second questionnaire at least at 1-week intervals the measurement of forced expiratory volume 1 (FEV1) at each time and also added an item in the second questionnaire which compared the difference between 2 visits, subsequently scoring +5 for the most improved state, -5 for the most aggravated state and 0 for the stationary state. RESULTS: In this study, may higher scores in the second visit suggested successful management of asthma may contribute to the improvement in the caregiver's quality of life. Particularly, items such as "Frustration", "Embarrassment", "Worry about daily works" and "Concern about side effect of medicine" have been improved in the emotion domain, and "sleepless", "Night awakening", and "Disturbance of housework" in the activity domain. Between 1999 and 2007, "Concerning", and "Concern about ordinary works" has been improved in the first visit, and "Disturbance of houseworks", "Worry about daily works" and "Concern about side effects of medicine" in the second visit. CONCLUSION: The results of this study suggest that there may be no significant different items regarding the quality of life between the stable and changed groups, suggesting that our questionnaire can be applicable to clinical practice.

Efficacy and safety of combination chemotherapy with docetaxel and cisplatin as a first-line treatment for advanced gastric cancer / 대한내과학회지

BACKGROUDN: To evaluate the activity and safety of docetaxel and cisplatin for advanced gastric cancer as a first-line chemotherapy treatment. METHODS: Between December 2001 and February 2006, forty-two patients with recurrent or metastatic gastric cancer were enrolled. Docetaxel (75 mg/m2) was administered as a 1-hour intravenous infusion on day 1 and cisplatin (60 mg/m2) was also administered as a 30-minute intravenous infusion on day 1 every three weeks until disease progression or severe toxicity was detected. The response was assessed every 2 cycles. The toxicities were evaluated for every course of chemotherapy according to NCI toxicity criteria. RESULTS: The median age of the patients was 66 (range, 33~77) years. Among the forty-two patients, 38 were male. Twenty-seven patients had an Eastern Cooperative Oncology Group performance score of 0 or 1 and fifteen patients had a score of 2. All patients had adenocarcinoma. Thirty-three of the forty-two patients were assessable for response. Partial responses were observed in 14 patients. The overall response rate was 42.4% (95% C.I., 25.259.6%) and the median response duration was 5.7 (range, 1.4~17.2) months. The median overall survival of all patients was 8.1 (range, 1.2~47.0) months. During a total of 170 cycles, granulocytopenia worse than National Cancer Institute toxicity grade 3 occurred in 7.6% of the patients, thrombocytopenia in 0.6% and anemia in 3.5%, respectively. No deaths resulting from toxicity were observed. Non-hematologic toxicities were minor and were easily controlled. CONCLUSION: Combination chemotherapy with docetaxel and cisplatin has a tolerable efficacy with acceptable toxicities in patients with advanced gastric cancer as a first-line treatment.

Hand-Foot Syndrome with Scleroderma-like Change Induced by the Oral Capecitabine: A Case Report

Hand-foot syndrome (HFS) is a well-known adverse event associated with capecitabine, a prodrug of 5-Fluorouracil (5-FU). HFS manifests as acral erythema, with swelling and dysesthesia of the palms and plantar aspects of the feet, which in the absence of dosage reduction or drug cessation, progresses to moist desquamation and ulceration, resulting in serious infections and loss of function. We report a case of HFS, with scleroderma-like changes, apparently induced by capecitabine. In our case, capecitabine, given in the recommended dosage was observed to lead to hyperpigmentation of the palms and soles, followed by a distinct keratoderma-like thickening unfamiliar to usual cases of HFS. This case may provide important clues for revising the definition of HFS, and allow the formation of effective preventive strategies for this side effect of chemotherapy.

Capecitabine and Oxaliplatin (XELOX) for the Treatment of Patients with Metastatic Gastric Cancer and Severe Liver Dysfunction

Gastric cancer patients with severe liver dysfunction secondary to hepatic metastases have limited treatment options. Most cytotoxic drugs have a narrow therapeutic index. Although both capecitabine and oxaliplatin have been well tolerated as single agents for patients with severe hepatic dysfunction, the combination of these drugs has not been investigated. We report here on a case of successful treatment of a patient suffering with severe liver dysfunction and metastatic gastric cancer; the patient was treated with a combination of capecitabine and oxaliplatin (XELOX). The initial bilirubin level of the patient was 10.9 mg/dL. After two cycles of treatment, his bilirubin level decreased to 2.1 mg/dL. He has experienced an excellent radiological response and he has received six cycles of XELOX chemotherapy. XELOX chemotherapy is feasible and it can be associated with positive outcomes for the patients suffering with metastatic gastric cancer and severe liver dysfunction.