1.Rhabdomyolysis and Acute Renal Failure Due to Honeybee Stings.
Young Min CHO ; Min Hee RHEW ; Ho Jun CHIN ; Choon Soo LIM ; Cu Rie AHN ; Jin Suk HAN ; Suhng Gwon KIM ; Jung Sang LEE
Korean Journal of Nephrology 1998;17(1):166-169
Honeybee venom consists of melittin, apamin, phospholipase A2, hyaluronidase and other biologically active substances. It can cause potentially lethal reaction after mass envenomation. But, acute renal failure following multiple bee stings is rare and its pathogenesis is not well known. The possible causes of acute renal failure due to multiple bee stings are rhabdomyolysis, hemolysis and direct nephrotoxicity of bee venom. A 60-year-old man was the victim of a bee(Apis mellifera) attack. More than 780 bee stings were found over his face, neck and upper extremities. Gross hematuria, oliguria and generalized edema was developed within a few hours. He has fully recovered after general supportive care including hemodialysis. This case demonstrates that multiple bee stings may cause rhabdomyolysis with consequent acute renal failure.
Acute Kidney Injury*
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Apamin
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Bee Venoms
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Bees
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Bites and Stings*
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Edema
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Hematuria
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Hemolysis
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Humans
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Hyaluronoglucosaminidase
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Melitten
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Middle Aged
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Neck
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Oliguria
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Phospholipases A2
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Renal Dialysis
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Rhabdomyolysis*
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Upper Extremity
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Venoms
2.Predictive Factors of the Long-term Medical Treatment Failure in Benign Prostatic Hyperplasia.
Kyung Seop LEE ; Min Eui KIM ; Se Joong KIM ; Han Kwon KIM ; Hong Sup KIM ; Chun Il KIM ; Tae Gyun KWON ; Hyun Yul RHEW ; Kwangsung PARK ; Dong Soo PARK ; Jong Kwan PARK ; Jae Shin PARK ; Gyung Tak SUNG ; Tae Hee OH ; Sang Min YOON ; Young Goo LEE ; In Rae CHO ; Jin Seon CHO ; Jaeil CHUNG ; Hee Chang JUNG ; Sung Hoo HONG ; Jae Seog HYUN
Korean Journal of Urology 2008;49(9):826-830
PURPOSE: The aim of this study was to identify the clinical baseline factors that affect failure of medical treatment(and especially surgical treatment) for benign prostatic hyperplasia(BPH) in spite of long-term medication. MATERIALS AND METHODS: 802 men who were over 50 years of age with BPH were enrolled for this study. Patients were allocated to a medication group and a surgical treatment group(after having at least a 12 month duration of medication). We compared the differences between the two groups for their initial International Prostate Symptom Score(IPSS), the uroflowmetry, the prostate volume, the postvoid residual urine and the serum prostate specific antigen(PSA). RESULTS: 397 patients had surgical treatment following medication due to BPH progression(acute urinary retention, aggravating LUTS) and 405 patients were given maintenance medical treatment during follow-up. Statistically significant differences were found in the IPSS(23.3+/-6.6 vs. 12.7+/-8.4), the prostate volume(53.5+/-28.1ml vs. 38.3+/-12.6ml), the maximal flow rate(7.8+/-4.7ml/sec vs. 12.7+/-5.4ml/sec), the postvoid residual urine volume(92.7+/-144.4cc vs. 36.5+/-147.1cc), and the PSA(6.1+/-7.6ng/ml vs. 2.8+/- 2.8ng/ml) between the surgical and medication groups. According to the area under the curve(AUC), the IPSS, prostate volume, maximal flow rate, postvoid residual urine volume and PSA are important in descending order. According to the receiver operating characteristic(ROC) curve- based prediction of the surgical intervention, the best cutoff value for the IPSS and prostate volume were 17(area under ROC curve: 0.83) and 40ml (area under ROC curve: 0.68), respectively. Conclusions: The results show that BPH patients with more severe IPSS (>or=17) and a larger prostate volume(>40ml) have a higher risk of surgical intervention, and this suggests that the IPSS and prostate volume may be useful predictors at the initial visit for surgical intervention.
Follow-Up Studies
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Humans
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Male
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Prostate
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Prostatic Hyperplasia
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Treatment Failure
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Urinary Retention