A prospective study of vitamin B6, B12, folate, and homocysteine levels was carried out in 7 kidney transplant(KT) recipients. The first sample for the basal level was drawn on the morning of the KT day before the start of cyclosporine injection. Thereafter, serial blood samples were taken every day until the serum creatinine level decreased below 1.5 mg/dl and then every 2 or 3days until discharge. The serum creatinine level decreased to below 1.5 mg/dl within 3days except for cases 4 and 6. The homocysteine levels decreased markedly in synchronisation with serum creatinine levels increased during the first 7days and then declined together with serum creatinine levels but went up again after a few days. The levels of B6, and vitamin B12 do not continue to decrease after the levels of serum creatinine have decreased to 1.5mg/dl, while homocysteine levels go up progressively. In conclusion, contrary to our expectation, the level of homocysteine rebounds a few days after KT following a transient decline. A deficiency of folic acid, vitamin B6 and vitamin B12 does not seem to cause hyperhomocysteinemia in KT recipients. It is necessary to pay attention to hyperhomocysteinemia in KT recipients, especially when the recipients have an atherosclerosis-related complication.
Creatinine ; Cyclosporine ; Folic Acid ; Homocysteine* ; Hyperhomocysteinemia ; Kidney ; Kidney Transplantation* ; Plasma* ; Prospective Studies ; Vitamin B 12 ; Vitamin B 6

No abstract available.
Ultrasonography*

Postpartum hemorrhage is a common cause of maternal mortality; its main cause is placenta accreta. Therapeutic hypothermia is a generally accepted means of improving clinical signs in postcardiopulmonary resuscitation patients. A 41-year-old pregnant woman underwent a cesarean section under general anesthesia at 37 weeks of gestation. After the cesarean section, the patient experienced massive postpartum bleeding, which led to cardiac arrest. Once spontaneous circulation returned, the patient underwent an emergency hysterectomy and was placed under therapeutic hypothermia management. The patient recovered without neurological complications.
Adult ; Anesthesia, General ; Cesarean Section ; Emergencies ; Female ; Heart Arrest* ; Hemorrhage ; Humans ; Hypothermia ; Hypothermia, Induced* ; Hysterectomy* ; Maternal Mortality ; Placenta Accreta ; Postpartum Hemorrhage* ; Postpartum Period* ; Pregnancy ; Pregnant Women ; Resuscitation

Pigmented neurofibroma, a variant of neurofibroma, has rarely been observed in patients with or without neurofibromatosis. Pigmented neurofibroma is characterized histologically by the coexistence of scattered melanin-laden cells and benign spindle cells with neural differentiation. We report a case of pigmented neurofibroma in a 22-year-old female patient.
Female ; Humans ; Neurofibroma* ; Neurofibromatoses ; Young Adult

Leiomyosarcoma of the rectum is a extremely rare disease without well documented report on its management and prognosis. The most complicated problem lies on the correct diagnosis. Many pathologic and histologic criteria have been proposed to make it clear. The treatment of rectal leiomyosarcoma is controversial. Some authors recommand wide local excison for low-grade tumors as much as 2 cm in diameter. However, radical abdominoperineal resection is the procedure of choice. Leiomyosarcoma of the rectum is resistant to radiotherapy, and no single effective chemotherapeutic drug has been found yet, although adriamycin is effective in one third of all cases. The local recurrence rate was much higher in patients receiving wide local excision and the overall 5-year or 10-year survival rate is similar. We report a case of rectal leiomyosarcoma and review the literature.
Diagnosis ; Doxorubicin ; Humans ; Leiomyosarcoma* ; Prognosis ; Radiotherapy ; Rare Diseases ; Rectum* ; Recurrence ; Survival Rate

No abstract available.
Olivopontocerebellar Atrophies*

The patient was a 52-year-old female with swelling in both lower legs and peripheral blood eosinophilia. Biopsy specimen revealed the heavy infiltration of eosinophils with sparse small lymphocytes showing mild atypia. The diagnosis was Kimura disease. The symptoms including eosinophilia were relieved by steroid treatment. At 17 months from initial biopsy, the patient developed swelling of the buttock. At 25 months, fever and dyspnea with multiple lung nodules developed. Wedge resection revealed multiple aggregates of CD3(+), CD56(+), Epstein-Barr virus(+) large atypical lymphocytes with necrosis. The patient was finally diagnosed with extranodal NK/T cell lymphoma (NKTL). Epstein-Barr virus in situ hybridization retrospectively performed on the previous biopsies demonstrated Epstein-Barr virus infection in small CD3(+) lymphocytes. The patient expired after 26 months despite chemotherapy. Blood eosinophilia correlated well with disease activity during the clinical course. This case shows not only unusual histologic features, which hampered the correct diagnosis, but also a unique clinical manifestation of NKTL.
Angiolymphoid Hyperplasia with Eosinophilia ; Biopsy ; Buttocks ; Dyspnea ; Eosinophilia ; Eosinophils ; Epstein-Barr Virus Infections ; Female ; Fever ; Herpesvirus 4, Human ; Humans ; In Situ Hybridization ; Leg ; Lung ; Lymphocytes ; Lymphoma ; Middle Aged ; Morphinans ; Muscle, Skeletal ; Necrosis ; Retrospective Studies

The patient was a 52-year-old female with swelling in both lower legs and peripheral blood eosinophilia. Biopsy specimen revealed the heavy infiltration of eosinophils with sparse small lymphocytes showing mild atypia. The diagnosis was Kimura disease. The symptoms including eosinophilia were relieved by steroid treatment. At 17 months from initial biopsy, the patient developed swelling of the buttock. At 25 months, fever and dyspnea with multiple lung nodules developed. Wedge resection revealed multiple aggregates of CD3(+), CD56(+), Epstein-Barr virus(+) large atypical lymphocytes with necrosis. The patient was finally diagnosed with extranodal NK/T cell lymphoma (NKTL). Epstein-Barr virus in situ hybridization retrospectively performed on the previous biopsies demonstrated Epstein-Barr virus infection in small CD3(+) lymphocytes. The patient expired after 26 months despite chemotherapy. Blood eosinophilia correlated well with disease activity during the clinical course. This case shows not only unusual histologic features, which hampered the correct diagnosis, but also a unique clinical manifestation of NKTL.
Angiolymphoid Hyperplasia with Eosinophilia ; Biopsy ; Buttocks ; Dyspnea ; Eosinophilia ; Eosinophils ; Epstein-Barr Virus Infections ; Female ; Fever ; Herpesvirus 4, Human ; Humans ; In Situ Hybridization ; Leg ; Lung ; Lymphocytes ; Lymphoma ; Middle Aged ; Morphinans ; Muscle, Skeletal ; Necrosis ; Retrospective Studies

Allopurinol is a xanthine oxidase inhibitor widely used to control plasma uric acid levels. Serious and life threatening adverse effects such as the allopurinol hypersensitivity syndrome(AHS) are rare. We describe a 32-year-old female patient who was treated with allopurinol and developed fever, rash, and renal and liver dysfunction.
Adult ; Allopurinol* ; Exanthema ; Female ; Fever ; Humans ; Hypersensitivity* ; Liver Diseases ; Plasma ; Uric Acid ; Xanthine Oxidase

The Epstein-Barr virus(EBV) is known to play a causal role in oncogenesis and to be associated with endemic Burkitt's lymphomas, B cell lymphomas in immunocompromised patients, and nasopharyngeal carcinomas. More recently, EBV has also associated with Hodgkin's disease, B cell lymphomas in non-immunocompromised patients, and T-cell lymphomas. Twenty eight cases of a non-Hodgkin's lymphoma of gastrointestinal tract were investigated to determine both the immunophenotype by using immunohistochemical staining and the incidence of the EBV nuclear antigen by using the polymerase chain reaction. Twenty-four of the 28 cases(85.7%) were B-cell type, and 4 of the 28 cases(14.3%) are of T-cell type. The EBV nuclear antigen was detected in three of the 28 cases(10.7%), including two cases of B-cell lymphoma of the stomach and one case of T-cell lymphoma of the small bowel. The EBV nuclear antigen was more frequently found in malignant lymphomas arising in the intestine(1/4) than in stomach(2/16). EBV positivity (25%) in T-cell NHLs was rather higher than EBV positivity (8.3%) in B-cell NHLs. Further expanded evaluations on the role of EBV in the tumorigenesis of a gastrointestinal malignant lymphomas are necessary because the cases of gastrointestinal lymphomas examined were very limited.
B-Lymphocytes ; Burkitt Lymphoma ; Carcinogenesis ; Gastrointestinal Tract* ; Herpesvirus 4, Human* ; Hodgkin Disease ; Humans ; Immunocompromised Host ; Incidence* ; Lymphoma ; Lymphoma, B-Cell ; Lymphoma, Non-Hodgkin* ; Lymphoma, T-Cell ; Polymerase Chain Reaction ; Stomach ; T-Lymphocytes