A case of 39-year-old diabetic patient with a calcitonin and somatostatin secreting pancreatic islet tumor is presented. He had suffered from chronic diarrhea and dyspepsia for 10 years and was diagnosed with diabetes 2 years ago. Abdominal CT revealed a huge abdominal mass which was considered as a neuroendocrine tumor after US-guided needle biopsy. A distal pancreatectomy and splenectomy were performed. Histologically, tumor cells, amanged in solid sheets, showed small nuclei without significant atypia and granular eosinophilic cytoplasm. Tumor cells showed strong immunoreacitivity for calcitonin and somatostatin. The serum clacitonin was markedly elevated (268.7 pmol/L, normal range; 0.9-7.6 pmol/L). After resection of the tumor, diarrhea and dyspepsia diappeared, and oral glucose tolerance test showed normal glucose tolerance with normalization of calcitonin.
Adult ; Biopsy, Needle ; Calcitonin* ; Cytoplasm ; Diabetes Mellitus* ; Diarrhea ; Dyspepsia ; Eosinophils ; Glucose ; Glucose Tolerance Test ; Humans ; Islets of Langerhans* ; Neuroendocrine Tumors ; Pancreatectomy ; Reference Values ; Somatostatin* ; Splenectomy ; Tomography, X-Ray Computed

PURPOSE: The object of the present study were to clarify the effect of dialysis treatment and residual renal function on olfactory function of patients with chronic renal failure and to assess the correlations between the Cross Cultural Smell Identification Test (CC-SIT) scores and various clinical variables. METHODS: Ninety subjects were studied and divided four groups; age- and sex-matched healthy controls (Control, n=20), patients with varying degree of renal insufficiency but not on dialysis (Pre- dialysis, n=20), patients on CAPD (PD, n=22), and patients on hemodialysis (HD, n=28). We performed olfactory function test using the CC-SIT kit and compared the CC-SIT scores of each of the groups. RESULTS: The CC-SIT scores of each of the groups were; Control : 8.6+/-1.5, Pre-dialysis : 7.2+/-2.0, PD : 8.1+/-1.2, HD : 8.5+/-1.4. In Pre-dialysis group, the CC-SIT scores were significantly lower than Control group (p=0.01). But, no significant difference was observed in the CC-SIT scores between HD and PD group and control group (p>0.05). Creatinine clearance was positively correlated with the CC-SIT scores in control and Pre-dialysis group (r=0.58, p= 0.0001). Total Kt/V was positively correlated with the CC-SIT scores only in HD group (r=0.39, p= 0.03). But, no correlation was found between Kt/ Vurea, URR or residual renal function and the CC- SIT scores in HD and PD group (p>0.05). Age was negatively correlated with the CC-SIT scores only in Control group (r=-0.76, p=0.0001). CONCLUSION: Our results indicate that smell disturbance in patients with chronic renal faliure can be recovered by adequate dialysis treatment.
Creatinine ; Dialysis* ; Humans ; Kidney Failure, Chronic* ; Peritoneal Dialysis, Continuous Ambulatory ; Renal Dialysis ; Renal Insufficiency ; Smell

BACKGROUND AND OBJECTIVES: Angiotension II, the active component in the renin angiotensin system, modulates blood pressure via vasoconstriction and sodium retention. In normal subjects, the active level of the RAS is reflected by the plasma renin activity (PRA). Importantly, when blood pressure is elevated, the level of RAS is reactively suppressed, and that of PRA approaches zero. Therefore, this study was conducted to find the characteristics of hypertensive patients according to the level of circulating renin. SUBJECTS AND METHODS: The subjects were 275 essential hypertensive patients, with a mean age of 53.2+/-11.9 years, 9.5% of which had diabetes. Patients were classified into 3 groups: low, normal and high renin (high PRA>4.5 ng/mL/h, normal PRA: 0.75-4.5 ng/mL/h and low PRA<0.75 ng/mL/h). The relationship between the PRA and other parameters, such as plasma aldosterone, SBP, DBP, heart rate, lipid profile, body mass index (BMI) and left ventricular mass index (LVMI), were compared. The mean SBP, DBP, heart rate, lipid profile, BMI and LVMI values were compared between the 3 groups. The distribution of the PRA value was compared by sex, age, diabetes, dyslipidemia and obesity. RESULTS: The percentages of the study population with low renin essential hypertension (LREH), normal renin essential hypertension (NREH) and high renin essential hypertension (HREH) were 47, 46 and 8%, respectively. A greater proportion of female patients showed LREH (58.6 vs. 36.1% of male), as did elderly (>55 year-old) compared to younger patients (58.7 vs. 36.2%, both p<0.001). However, there were no significant differences in the hemodynamics (SBP, DBP and heart rate), LVMI and cardiovascular risk factors (obesity, dyslipidemia and diabetes) between the 3 groups. CONCLUSION: Women and elderly people are more likely to have LREH compare to men and younger people, who are more likely to have HREH.
Aged ; Aldosterone ; Blood Pressure ; Body Mass Index ; Dyslipidemias ; Epidemiology ; Female ; Heart ; Heart Rate ; Hemodynamics ; Humans ; Hypertension ; Male ; Obesity ; Plasma* ; Renin* ; Renin-Angiotensin System ; Risk Factors ; Sodium ; Vasoconstriction

PURPOSE: This study analyzed the tumor response, overall survival, progression free survival and related prognostic factors in patients with muscle invasive bladder cancer subjected to bladder preserving treatment. MATERIALS AND METHODS: Between August 1995 and June 2004, 37 patients with muscle invasive (transitional cell carcinoma, clinically stage T2-4) bladder cancer were enrolled for the treatment protocol of bladder preservation. There were 33 males and 4 females, and the median age was 67 years (range 38~86 years). Transurethral resection of the bladder (TURB) was performed in 17 patients who underwent complete resection. The median radiation dose administered was 64.8 Gy (range 55.8~67 Gy). The survival rate was calculated by the Kaplan-Meier method. RESULTS: An evaluation of the response rate was determined by abdomen-pelvic CT and cystoscopy at three months after radiotherapy. A complete response was seen in 17 patients (46%). The survival rate at three years was 54.7%, with 54 months of median survival (range 3~91 months). During the study, 17 patients died and 13 patients had died from bladder cancer. The progression free survival rate at three years was 37.2%. There were 24 patients (64.9%) who had disease recurrence: 16 patients (43.2%) had local recurrence, 6 patients (16.2%) had a distant recurrence, and 2 patients (5.4%) had both a local and distant recurrence. The survival rate (p=0.0009) and progression free survival rates (p=0.001) were statistically significant when compared to the response rate after radiotherapy. CONCLUSION: The availability of complete TURB and appropriate chemoradiotherapy were important predictors for bladder preservation and survival.
Chemoradiotherapy ; Clinical Protocols ; Cystoscopy ; Disease-Free Survival ; Female ; Humans ; Male ; Radiotherapy ; Recurrence ; Survival Rate ; Urinary Bladder Neoplasms* ; Urinary Bladder*

Break of a stent delivery catheter and subsequent stent loss (SL) has been a rare event in the drug-eluting stent (DES) era. We here report a case of successful retrieval of a stent after a break if the delivery catheter and SL from a balloon catheter at a culprit lesion. We finally resolved this situation using a simple balloon technique for both the broken stent catheter inside of the guide catheter and the unexpanded stent in the culprit lesion. Thus balloons are an important weapon in our armamentarium in the cardiac catheterization laboratory for urgent retrieval of a lost stent. Their apt use definitely allowed our patient to avoid undergoing emergency cardiovascular thoracic surgery.
Angioplasty ; Cardiac Catheterization ; Cardiac Catheters ; Catheters ; Dimaprit ; Drug-Eluting Stents ; Emergencies ; Humans ; Stents ; Thoracic Surgery