No abstract available.
Korea* ; Lymphoma*

BACKGROUND: Renin-ngiotensin system (RAS) blockers have been used to delay the progression of various renal diseases, but these medications cause hyperkalemia and the elevation of serum creatinine which impede the continuation of the medications. So far, there have been no data on the changes of serum creatinine or serum potassium after withdrawal of the RAS blockers. METHODS: We reviewed medical records of 60 patients who stopped the RAS blockers due to the elevation of serum creatinine or hyperkalemia between March 1995 and May 2005. They were assigned to either the elevated creatinine group or the hyperkalemia group according to the cause of the withdrawal. RESULTS: In the elevated creatinine group (n=37), the serum creatinine and GFR values at the point of withdrawal were 4.0+/-1.8 mg/dL and 18.2+/-10.4 mL/min/1.73m2, respectively. After discontinuation of the medications, a decrease in serum creatinine and an increase in GFR were noted at one month. After one month, however, serum creatinine increased continuously up to 6 months. Serum potassium levels decreased significantly after the drug withdrawal until the end of the study period. In the hyperkalemia group (n=23), the serum creatinine and serum potassium values at the point of withdrawal were 3.0+/-1.0 mg/dL and 6.4+/-0.4 mEq/L, respectively. A significant decrease in serum potassium was also noted after the withdrawal and this decrease lasted up to 6 months. But the transient decrease of serum creatinine, observed in the creatinine group, was not seen in this group. CONCLUSION: It was found that there was a beneficial effect on serum creatinine and GFR immediately after the withdrawal of RAS blockers only when they were stopped due to elevation of the serum creatinine concentration. The serum potassium levels were consistently decreased after the withdrawal of RAS blockers in both elevated creatinine and hyperkalemia groups.
Angiotensin II* ; Angiotensin Receptor Antagonists ; Angiotensins* ; Creatinine* ; Humans ; Hyperkalemia ; Medical Records ; Potassium* ; Renal Insufficiency, Chronic*

PURPOSE: To evaluate the parameters affecting vaulting and correlation between preoperative crystalline lens rise and vaulting after implantable collamer lense (ICL) implantation. METHODS: A total of 53 eyes of 34 patients who underwent ICL implantation were examined retrospectively. White-to-white (WTW) and anterior chamber depth (ACD) were obtained from scanning topography (ORB scan) before surgery. Preoperative crystalline lens rise (CLR) and vaulting at 6 months after ICL implantation were measured using anterior segment optic coherence tomography (AS-OCT). Multiple regression analysis was performed to evaluate the factors affecting central vaulting. RESULTS: The mean preoperative crystalline lens rise was -120 +/- 219 microm, and mean central vaulting 6 months after surgery was 544 +/- 175 microm. Preoperative SE, WTW, ACD, and CLR were significantly correlated with vaulting at 6 months after surgery. With the use of meaningful variables, multiple regression analysis showed that CLR, WTW, ACD and SE, in that order of influence, had significant effects on vaulting and the multiple regression equation was obtained as follows: Vaulting (microm) = (160.913 x ACD (mm)) + (170.134 x WTW (mm)) + (-0.338 x CLR (microm)) + (-23.783 x SE (D)) - 2250.184. CONCLUSIONS: CLR had a stronger influence on vaulting after ICL implantation than the previously proven parameters: WTW, ACD, and SE. In addition to WTW, ACD and SE, CLR should also be considered a new criterion for estimating vaulting after ICL implantation.
Anterior Chamber ; Crystallins ; Eye ; Humans ; Lens, Crystalline ; Lenses, Intraocular ; Retrospective Studies

BACKGROUND AND OBJECTIVE: In patients with aspirin-sensitive asthma, anti-inflammatory treatment is a common problem in clinical practice. Nimesulide has been chosen due to weak inhibitory action on cyclooxygenase in ASA-sensitive asthma patients. In this study, we evaluated the safety of nimesulide in patients with ASA-sensitive asthma. METHODS: We performed lysine-aspirin bronchoprovocation test to confirm ASA-sensitive asthma, and nimesulide oral provocation test (up to 200 mg) to screen nimesulide sensitivity in 17 cases of bronchial asthma patients. RESULTS: Fifteen (88.2%) of 17 subjects showed positive responses to lysine-aspirin bronchoprovocation test. Six (35.3%) patients reacted to nimesulide oral provocation test. Of the six patients who reacted to nimesulide, three experienced bronchospasm, two urticaria, and one anaphylaxis. All positive reactions occurred within the 200 mg dose. One of 6 subjects showed a positive response to nimesulide oral provocation test without ASA-sensitivity. CONCLUSION: The prevalence of nimesulide sensitivity among aspirin-sensitive asthma was 33.3%, which was higher than in the previous reports. Screening oral provocation test is essential before prescribing relative COX-2 inhibitors for ASA-sensitive asthmatic patients. A case of nimesulide-sensitive asthma without ASA-sensitivity was also noted.
Anaphylaxis ; Asthma* ; Bronchial Spasm ; Cyclooxygenase 2 Inhibitors ; Humans ; Mass Screening ; Prevalence* ; Prostaglandin-Endoperoxide Synthases ; Urticaria

No abstract available.
Adult* ; Cytarabine* ; Cytosine* ; Humans ; Leukemia* ; Mitoxantrone*

No abstract available.
Drug Therapy, Combination* ; Lymphoma, Non-Hodgkin*

BACKGROUND: Acinetobacter bacteremia is an emerging nosocomial infection. We tried to find significant risk factors associated with the prognosis of patients with Acinetobacter bacteremia. METHODS: Retrospective case-control study was designed. The odds ratio estimation and multiple logistic regression for the categorical variables and Mann-Whitney test for the continuous variables were done. RESULTS: From September 1, 1999 to December 31, 2000 there were 25 adult patients with Acinetobacter bacteremia in Ajou University Hospital and 24 patients were confirmed as hospital acquired. The median age and hospital length of stay before bacteremia was 52 years old and 9.5 days respectively. There were 16 male patients. The overall mortality was 45.8 % (11 of 24). Thus there were 11 cases (death) and 13 controls (survival) of mortality. Statistical analysis revealed statistically significant differences between cases and controls in the terms of types of wards, central venous catheter, mechanical ventilation, total parenteral nutrition, and multi-resistant organisms. The multiple logistic regression analysis revealed that the more significant independent factors associated with mortality were mechanical ventilation and multi-resistant organisms. CONCLUSION: Acinetobacter bacteremia is a significant nosocomial infection. Especially mechanical ventilation and multi-resistant organisms were independent risk factors associated with high mortality with Acinetobacter bacteremia.
Acinetobacter* ; Adult ; Bacteremia* ; Case-Control Studies ; Central Venous Catheters ; Cross Infection ; Humans ; Length of Stay ; Logistic Models ; Male ; Middle Aged ; Mortality ; Odds Ratio ; Parenteral Nutrition, Total ; Prognosis* ; Respiration, Artificial ; Retrospective Studies ; Risk Factors*

PURPOSE: The authors evaluated the usefulness of the positron emission tomography (PET) with fluorine-18-tluorodeoxyglucose (8F-FDG) in initial staging, reevaluation after radical therapy and diagnosis of recurrence for non-Hodgkin's lymphoma, compaired to conventional imaging studies. MATERIALS AND METHODS: FDG-PET (ECAT Exact 47, Siemens) and conventional chest X-ray and computerized tomography (CT) were studied in patients with non-Hodgkins lymphoma. RESULTS: There were 17 patients (13 male, 4 female). Age was ranged from 18 to 62 years (median 49). By histological subgroup, diffuse large cell were 8 cases, peripheral T cell were 2 cases, diffuse mixed was 1 case, follicular mixed was 1 case, Burkitt's lymphoma was 1 case, Hodgkin's disease were 3 cases. The aims for PET were the initial staging work-up in 7 cases, the reevaluation of residual disease after radical therapy in 7 cases, the diagnosis of recurrence after complete remission in 3 cases. Between PET image and the conventional image, there were 3 cases with discrepancy, 1 case for initial staging work-up and 2 cases for the reevaluation of residual disease after radical therapy. Among the 3 cases with discrepancy, the 2 cases for the reevaluation of residual disease after radical therapy revealed that PET image reflects the involvement of lymphoma more accurately than the conventional image. CONCLUSION: The visual analysis of FDG-PET would be helpful in determining the residual disease of lymphoma after radical therapy.
Burkitt Lymphoma ; Diagnosis ; Hodgkin Disease ; Humans ; Lymphoma* ; Lymphoma, Non-Hodgkin ; Male ; Positron-Emission Tomography* ; Recurrence ; Thorax

Recent clinical trials showed that bortezomib, a novel proteasome inhibitor, had therapeutic activity in multiple myeloma. However, there was no data about the feasibility of bortezomib in Korean patients. We performed a pilot study of bortezomib in patients with relapsed or refractory myeloma (1.3 mg/m2 twice weekly for 2 week in a 3-week cycle). Seven patients were enrolled. The median age of patients was 59 yr. All patients previously received VAD (vincristine, doxorubicin and dexamethasone) and thalidomide chemotherapy. Three patients previously received alkylator-containing chemotherapy and 4 patients, autologous stem cell transplantation. Bortezomib monotherapy resulted in 3 partial remissions (43%), 3 no changes (43%) and 1 progressive disease (14%). One patient who had no response to bortezomib monotherapy experienced partial remission after addition of dexamethasone to bortezomib. The most common serious toxicity was thrombocytopenia (grade 3/4, 10 of 20 cycles (50%)) and grade 3 peripheral neuropathy was developed in 2 of 20 cycles (10%). Drug-related adverse event led to discontinuation of bortezomib in 1 patient. There was no treatment related mortality. Overall, bortezomib seems to be effective and feasible. Conduction of larger clinical studies on Korean patients is necessary to characterize clinical efficacy and safety of bortezomib more precisely.
Aged ; Antineoplastic Agents/administration & dosage/adverse effects/*therapeutic use ; Antineoplastic Combined Chemotherapy Protocols/adverse effects/therapeutic use ; Boronic Acids/administration & dosage/adverse effects/*therapeutic use ; Dexamethasone/administration & dosage/adverse effects ; Disease Progression ; Drug Resistance, Neoplasm ; Female ; Humans ; Korea ; Male ; Middle Aged ; Multiple Myeloma/*drug therapy ; Neoplasm Recurrence, Local ; Pilot Projects ; Pyrazines/administration & dosage/adverse effects/*therapeutic use ; Research Support, Non-U.S. Gov't ; Survival Analysis ; Thrombocytopenia/chemically induced ; Time Factors

BACKGROUND: To compare the mobilizing effects and toxicities of two different doses of cyclophosphamide (CY) plus lenograstim (glycosylated G-CSF), we performed a prospective randomized study by enrolling patients suffering with either high-risk Non-Hodgkin's lymphoma (NHL) or breast cancer undergoing ablative chemotherapy. METHODS: The NHL patients received 4 cycles of CHOP and the breast cancer patients received 2-3 cycles of FAC (FEC) adjuvant chemotherapy. Then, the patients were randomly allocated to receive CY 4 g/m2 (arm A) or 1.5 g/m2 (arm B) in combination with lenograstim. Large volume leukapheresis was carried out and it was continued daily until the target cell dose of 2x10 (6) CD34+ cell/kg was reached. RESULTS: Twenty-seven patients were enrolled in the study. The median number of leukaphereis sessions actually performed was 2.5 sessions in arm A and 3 sessions in arm B. The target cell dose was obtained with the median number of one leukapheresis session in both arms of the study (p=0.09). The collected number of CD34+ cells in the leukapheresis products was higher in arm A than arm B (22.4 vs. 9.9x10 (6) /kg, respectively, p=0.05). Grade III or IV leukopenia was present in 14/15 patients (94%) in arm A and in 1/12 patients (8%) in arm B (p< 0.0001). Grade III or IV thrombocytopenia was present in 8/15 patients (54%) in arm A, but this was not present in any patients of arm B (p=0.0004). Neutropenic fever occurred in 6/15 patients (40%) in arm A, and in 1/12 patients (8%) in arm B (p=0.09). The hematological recovery of the leukocytes and platelets after transplantation was not statistically different between the two doses. CONCLUSION: Low-dose CY plus lenograstim is a safe and effective mobilizing regimen.
Transplantation Conditioning ; Stem Cells/*drug effects ; Recombinant Proteins/administration & dosage/pharmacology ; Prospective Studies ; Myeloablative Agonists/*administration & dosage/pharmacology ; Middle Aged ; Male ; Lymphoma, Non-Hodgkin/*drug therapy ; Leukapheresis ; Humans ; *Hematopoietic Stem Cell Mobilization ; Granulocyte Colony-Stimulating Factor/*administration & dosage/pharmacology ; Female ; Drug Therapy, Combination ; Cyclophosphamide/*administration & dosage/pharmacology ; Chemotherapy, Adjuvant ; Breast Neoplasms/*drug therapy ; Adult