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*

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

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

No abstract available.
Korea* ; Lymphoma*

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

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

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*

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

PURPOSE: IMVP-16 (Ifosfamide/Methotrexate/VP-16) regimen consists of drugs that are not commonly used as the first-line therapy of non-Hodgkin's lymphoma. This study was performed to determine the efficacy of this relatively non-cross resistant regimen, with the addition of prednisone, in patients with primary refractory or relapsed non-Hodgkin's lymphoma. MATERIALS AND METHODS: Patients with primary refractory or relpased intermediate to high grade non-Hodgkin's lymphoma were treated with ifosfamide (1000 mg/m2 iv, D1-5 with mesna), methotrexate (30 mg/m2 iv, D 3 & 10), VP-16 (100 mg/m2 iv, D 1-3), and prednisone (120 mg devided by 3 doses, D1-5). The treatment was repeated every 3 weeks. RESULTS: Between Jan. 1988 and Aug. 1993, thirty eight patients were included. In 33 evaluable patients (4 loss-to follow up and 1 ineligibility) the median age was 49 years. The common histologic types were diffuse large cell type (52%) and immunoblastic type (18%). The proportion of patients with relapsed and refractory NHL was 39% and 61%, respectively. The rate of complete remission was 21% (7/33) and overall response rate was 48% (16/33). The median-response duration was 8 months (1.5~45+). Hematologic toxicities were tolerable. Non-hematologic side effects were also tolerable including stomatitis, peripheral neuropathy, and toxic hepatitis. Three treatment-related deaths were associated with sepsis, ARDS (adult respiratory distress syndrome) and acute gastrointestinal bleeding. CONCLUSION: Based on these results, IMVP-16/Pd combination chemotherapy seems to have a moderate efficacy for the relapsed or refractory non-Hodgkin's lymphoma with tolerable toxicities.
Drug Therapy, Combination* ; Drug-Induced Liver Injury ; Etoposide ; Follow-Up Studies ; Hemorrhage ; Humans ; Ifosfamide ; Lymphoma, Non-Hodgkin* ; Methotrexate ; Peripheral Nervous System Diseases ; Prednisone ; Sepsis ; Stomatitis

BACKGROUND: Acute myelogenous leukemia (AML) is frequently encountered in elderly patients whereas intensive chemotherapy yield lower rate of complete remission (CR) and survival than young patients. This study was aimed to review the clinical features and treatment outcomes of elderly patients (>or=60) with AML. METHODS: We respectively reviewed the clinical features, laboratory findings and outcomes of treatment from the medical records of 115 patients with the elderly AML (>or=60), admitted in Seoul National University Hospital, between Jan.1995 and Dec.2004. RESULTS: Their median age was 66 (60~86) years with male predominance (M:F=68:47). Complete response rate in patients with conventional chemotherapy was 66.7% (42 of 63 patients; 95% CI 50.2~78.4). Median overall survival (OS) was 5.2 months with clinical benefit in the conventional chemotherapy group, compared to supportive or palliative group (11.5 vs 0.9months; p<0.0001). In between two age groups, the sixties (n=69) showed higher CR rate (69.0 vs 61.9%; p=0.9) and longer median overall survival (7.0 vs 4.4months; p=0.8) than patients group of the seventies (n=38) but without statistical significance. CONCLUSIONS: Conventional induction chemotherapy improved survival rate than palliative or supportive treatment.
Aged* ; Drug Therapy ; Humans ; Induction Chemotherapy ; Leukemia, Myeloid, Acute* ; Male ; Medical Records ; Prognosis ; Retrospective Studies* ; Seoul ; Survival Rate