PURPOSE: Several studies have suggested that hyperlipidemia might be a causative factor contributing to the progression of initial glomerular injury through the development of glomerulosclerosis. We examined the potential beneficial effect of atorvastatin - which blocks the rate limiting step of cholesterol synthesis by inhibiting HMG-CoA reductase - in PAN- induced nephrosis. MATERIALS AND METHODS: Glomerulosclerosis was induced in Sprague-Dawley male rats by repeated administration of PAN. Sprague-Dawley male rats were divided into 3 groups:group I(control), group II(PAN 20 mg/kg, subcutaneous injection), group III(PAN 20 mg/kg subcutaneous injection and atorvastatin 50 mg/kg/day per oral). On the 11th week, upon sacrifice of the experimental animals, blood sampling, 24-hr urine collection and nephrectomy were performed. RESULTS: Group III had significantly lower BUN and higher serum albumin(30.9+/-17.2 vs. 17.3+/-2.5 mg/dL; 2.3+/-0.1 vs. 2.5+/-0.2 g/dL, P<0.05) compared with group II. In the lipid profiles, group III was associated with a reduction in total cholesterol and LDL(291+/-173 vs. 167+/-72 mg/dL; 57+/-53 vs. 27+/-12 mg/dL, P>0.05) compared with group II. Atorvastatin administration lowered the glomerular sclerosing index significantly(26.2% vs. 13.3%, P<0.05). CONCLUSION: Puromycin-induced glomerulosclerosis could be ameliorated by the reduction of hyperlipidemia with atorvastatin. This suggests that hyperlipidemia contributes to the pathogenesis of glomerulosclerosis.
Animals ; Cholesterol ; Humans ; Hyperlipidemias ; Injections, Subcutaneous ; Male ; Nephrectomy ; Nephrosis* ; Oxidoreductases ; Puromycin* ; Rats* ; Rats, Sprague-Dawley ; Urine Specimen Collection

Perioperative cerebral infarction is uncommon and its mechanism is often uncertain. This is a report of an unusual case of acute cerebral infarction following general anesthesia. The patient was a 83-year-old female admitted for total hip replacement arthroplasty (THRA). There were no previous cerebro- and cardio-vascular symptoms and history. During introduced general anesthesia with sevoflurane, there was a persistent low systolic BP of 80-100 mmHg (preoperative BP was 140/85 mmHg). On emerging from anesthesia, confusion and dense right hemiparesis were observed. Emergency CT brain scan showed early cerebral infarction in the middle cerebral artery (MCA) territory. Even though prompt supportive neurosurgical intensive care was initiated, the patient died at postoperative 4 days.
Aged, 80 and over ; Anesthesia ; Anesthesia, General ; Arthroplasty* ; Arthroplasty, Replacement, Hip* ; Brain ; Cerebral Infarction* ; Emergencies ; Female ; Humans ; Critical Care ; Middle Cerebral Artery ; Paresis

We report here on a case of a patient who developed paraplegia after thoracic epidural block that was done for the management of postherpetic neuralgia, and the patient was later diagnosed with spine metastasis from prostate cancer. This patient developed paraplegia of both lower extremities 2 weeks after the epidural block. We took X-ray and performed MRI of the thoracic spine for the differential diagnosis of paraplegia associated with herpes zoster, complications of epidural block or other diseases. The diagnosis of the paraplegia was spinal cord compression at T8, and this was caused by metastatic tumor that originated from prostate cancer. When we encounter paraplegia after epidural block, we should also consider other diseases as well as the complications of epidural block like direct neural damage, abscess and hematoma. Especially when there is the possibility of cancer, early detection, an accurate diagnosis and timely treatment can provide the best chance to ameliorate further medical consequences and optimize the quality of life.
Abscess ; Diagnosis ; Diagnosis, Differential ; Hematoma ; Herpes Zoster ; Humans ; Lower Extremity ; Magnetic Resonance Imaging ; Neoplasm Metastasis* ; Neuralgia, Postherpetic ; Paraplegia ; Prostate ; Prostatic Neoplasms ; Quality of Life ; Spinal Cord Compression ; Spine

Waldenstrom macroglobulinemia, which is characterized by elevation of serum monoclonal IgM paraprotein, has recently been responsible for the treatment of purine analogues. Fludarabine, one of purine analogues, has been associated with autoimmune hemolytic anemia in patient with chronic lymphocytic leukemia. However, autoimmune hemolytic anemia after fludarabine treatment for Waldenstrom macroglobulinemia has not been reported. We experienced a case of autoimmune hemolytic anemia after fludarabine treatment for Waldenstrom macroglobulinemia. In this case, hemolytic anemia with positive direct Coombs' test occurred at 20 months after the first administration of fludarabine, relapsed at 5 days after re-administration. This anemia responded to steroid therapy. Autoimmune hemolytic anemia associated with fludarabine therapy can be severe and fatal, especially if a patient is re-treated with this drug after a previous episode of hemolytic anemia.
Anemia ; Anemia, Hemolytic ; Anemia, Hemolytic, Autoimmune* ; Coombs Test ; Humans ; Immunoglobulin M ; Leukemia, Lymphocytic, Chronic, B-Cell ; Waldenstrom Macroglobulinemia*