Blunt trauma of the chest and abdomen frequently result in cardiac injury. We experienced a 47 year-old male patient of myocardial contusion with aortic insufficiency after blunt chest trauma. On the secondd day after admission, the patient developed sudden hypoxemia and wide pulse pressure. A pulmonary arterial catheter was inserted and initial cardiac output and pulmonary capillary wedge pressure was 3.56 L/min/m(2) and 32 mmHg, respectively. There was akinesia of the anterior septum, anterior wall, inferior wall and inferior septum with aortic regurgitation(I/IV), and the ejection fraction was 25% on echocardiogram. Myocardial contusion with valvular injury was suspected. Dobutamine infusion was started and after five days the pulmonary capillary wedge pressure was decreased to 14 mmHg. The ejection fraction was increased to 69% in spite of decreasing dobutamine but aortic regurgitation(II/VI) remained. Therefore echocardiogram and pulmonary artery catheterization will be helpful to diagnose suspected cardiac contusion and for better outcome.
Abdomen ; Anoxia ; Blood Pressure ; Cardiac Output ; Catheterization, Swan-Ganz ; Catheters ; Contusions ; Dobutamine ; Heart ; Humans ; Male ; Middle Aged ; Pulmonary Wedge Pressure ; Thorax*

Drug-induced acute interstitial nephritis is characterized by renal interstitial inflammatory cell infiltration and commonly presents as acute renal failure. This is caused mainly by methicillin, non-steroidal antiinflammatory drugs, sulfonamide diuretics such as thiazide, but cases induced by furosemide are rare. We report a patient with acute interstitial nephritis causing reversible acute renal failure and dermatitis while she was taking furosemide. A 37-year old woman was referred to our hospital because of generalized skin rash and non-oliguric acute renal failure. She had peripheral eosinophilia (1,577/mm3) and serum creatinine level of 6.8mg/dL. Skin biopsy showed leukoclastic vasculitis and percutaneous renal biopsy showed severe interstitial infiltration of lymph ocyte and mild interstitial fibrosis with focal tubular atrophy. After withdrawal of furosemide, renal function and skin lesions were completely recovered.
Acute Kidney Injury ; Adult ; Atrophy ; Biopsy ; Creatinine ; Dermatitis ; Diuretics ; Eosinophilia ; Exanthema ; Female ; Fibrosis ; Furosemide* ; Humans ; Methicillin ; Nephritis, Interstitial* ; Skin ; Vasculitis

Complex diseases such as stroke and cancer have two or more genetic loci and are affected by environmental factors that contribute to the diseases. Due to the complex characteristics of these diseases, identifying candidate genes requires a system-level analysis of the following: gene ontology, pathway, and interactions. A database and user interface, termed StrokeBase, was developed; StrokeBase provides queries that search for pathways, candidate genes, candidate SNPs, and gene networks. The database was developed by using in silico data mining of HGNC, ENSEMBL, STRING, RefSeq, UCSC, GO, HPRD, KEGG, GAD, and OMIM. Forty candidate genes that are associated with cerebrovascular disease were selected by human experts and public databases. The networked cerebrovascular disease gene maps also were developed; these maps describe genegene interactions and biological pathways. We identified 1127 genes, related indirectly to cerebrovascular disease but directly to the etiology of cerebrovascular disease. We found that a protein-protein interaction (PPI) network that was associated with cerebrovascular disease follows the power-law degree distribution that is evident in other biological networks. Not only was in silico data mining utilized, but also 250K Affymetrix SNP chips were utilized in the 320 control/disease association study to generate associated markers that were pertinent to the cerebrovascular disease as a genome- wide search. The associated genes and the genes that were retrieved from the in silico data mining system were compared and analyzed. We developed a well-curated cerebrovascular disease-associated gene network and provided bioinformatic resources to cerebrovascular disease researchers. This cerebrovascular disease network can be used as a frame of systematic genomic research, applicable to other complex diseases. Therefore, the ongoing database efficiently supports medical and genetic research in order to overcome cerebrovascular disease.
Computer Simulation ; Data Mining ; Databases, Genetic ; Gene Regulatory Networks ; Genes, rel ; Genetic Loci ; Genetic Research ; Humans ; Polymorphism, Single Nucleotide ; Stroke

PURPOSE: The purpose of this study was to investigate the association of generalized aggressive periodontitis with IL-6 promoter gene single nucleotide polymorphisms(SNP). MATERIAL AND METHODS: The study population consisted of 52 generalized aggressive periodontitis patients(GAP) and 30 periodontally healthy control subjects, who were systemically healthy non-smokers. Genomic DNA was obtained from buccal swab. The IL-6 promotor SNP at the positions of -597, -572, and -174 were genotyped by amplifying the polymorphic region using polymerase chain reaction(PCR), restriction enzyme digestion and gel electrophoresis. RESULT: The genotype distributions for G/G, G/A and A/A genotypes of IL-6 -597 were 30.8%, 40.4%, and 28.8% in the GAP group and 53.3%, 40%, and 6.7% in the control group and were statistically different between 2 groups(p<0.05). Allele 2 frequency of IL-6 -597 were significantly higher in the GAP group than the control group(p<0.01). At the position of IL-6 -572, the distribution for C/C, C/G and G/G genotypes were 23.1%, 55.8% and 21.2% in the GAP group and 20%, 33.3%, and 46.7% in the control group. In female subjects, the genotype distribution were significantly different between 2 groups (p<0.01). In male subjects, allele 2 frequency of IL-6-572 was significantly lower in the GAP group than the control group(p<0.05). The genotype distribution of IL-6 -174 in the GAP group were 96.2%, 3.8% for G/G, G/C genotypes whereas only the G/G genotype was detected in the control group. CONCLUSION: In conclusion, significant associations were found in IL-6 gene promoter(-597, -572) polymorphisms and generalized aggressive periodontitis. Further cohort study will be necessary in larger population.
Aggressive Periodontitis ; Alleles ; Cohort Studies ; Digestion ; DNA ; Female ; Genotype ; Humans ; Interleukin-6 ; Male

No abstract available.
Glomerulonephritis, Membranous* ; Small Cell Lung Carcinoma*

Although spontaneous bacterial peritonitis is a frequent complication in the childhood nephrotic syndrome, it is very rare in adults with nephrotic syndrome. It frequently develops when the patients are either in relapse or receiving steroid therapy at the time peritonitis is diagnosed. We report an unusual case of a spontaneous bacterial peritonitis as the presenting feature in a 15-year-old male patient with nephrotic syndrome. He presented with diffuse abdominal pain and distension for 15 days. Abdominal paracentesis revealed the diagnostic laboratory findings of peritonitis, and the bacterial culture of the ascites showed a mixed growth of Escherichia coli and Pseudomonas aeruzinosa. His serum albu- min level was 1.6gldL and the amount of 24 hours proteinuria was 21.0g/day. Although he was treated with adequate antibiotics for 3 weeks, the peritonitis was more aggravated. We decided to insert a catheter into the peritoneal cavity for continuous drainage of the intractable ascites. Two weeks after drainage, the peritonitis improved as the peritonitis subsided, the proteinuria disappeared completely without a steroid therapy. Six months after spontaneous remission, the proteinuria have recurred, and the kidney biopsy then showed focal segmental glomerulorsclerosis.
Abdominal Pain ; Adolescent ; Adult ; Anti-Bacterial Agents ; Ascites ; Biopsy ; Catheters ; Drainage ; Escherichia coli ; Humans ; Kidney ; Male ; Nephrotic Syndrome* ; Paracentesis ; Peritoneal Cavity ; Peritonitis* ; Proteinuria ; Pseudomonas ; Recurrence ; Remission, Spontaneous

Iodinated contrast-induced acute renal failure is estimated to occur in 0.15 to 2% of all patients undergoing contrast imaging studies. Incidence is higher in patients with renal insufficiency, diabetes mellitus, dehydration, multiple myeloma, congestive heart failure, advanced age. We here report successful vascular interventional procedure by using gadopentetate dimeglumine(Gd-DTPA) as a contrast agent in a patient with chronic renal insufficiency and right superficial femoral artery stenosis. The patient had a history of iodinated contrast-induced acute renal failure. Gd-DTPA(0.17mmoVkg) diluted 1: 1 with 0.9% norrnal saline was used as contrast agent for the interventional procedure. Percutaneous transluminal angioplasty was successfully performed and there was no evidence of contrast material- induced acute renal failure after the procedure. Gd- DTPA is an alternative contrast agent for patients with chronic renal insufficiency.
Acute Kidney Injury ; Angioplasty* ; Constriction, Pathologic ; Dehydration ; Diabetes Mellitus ; Femoral Artery ; Gadolinium DTPA* ; Heart Failure ; Humans ; Incidence ; Multiple Myeloma ; Pentetic Acid ; Renal Insufficiency ; Renal Insufficiency, Chronic*

Acute infection increases disease activity in patients with systemic lupus erythematosus(SLE) and causes life threatening complication such as acute renal failure or ischemic bowel disease. We here report a case of acute renal failure and ischemic bowel disease complicated by acute pyelonephritis in a patient with SLE. A 19-year-old woman was admitted for high fever and right flank pain. Urine examination revealed acute pyelonephritis. Thrombocytopenia, proteinuria, positive antinuclear antibody and anti-dsDNA, false positive VDRL confirmed SLE. The pyelonephritis improved with antibiotic treatment, but oliguria and abdominal pain and ascites newly developed. Kidney biopsy and abdominal computed tomography revealed lupus nephritis type IV and ischemic bowel disease, respectively. After methylprednisolone and cyclophosphamide treatment, the patient improved.
Abdominal Pain ; Acute Kidney Injury* ; Antibodies, Antinuclear ; Ascites ; Biopsy ; Cyclophosphamide ; Female ; Fever ; Flank Pain ; Humans ; Kidney ; Lupus Erythematosus, Systemic* ; Lupus Nephritis ; Methylprednisolone ; Oliguria ; Proteinuria ; Pyelonephritis* ; Thrombocytopenia ; Young Adult

Acute multifocal bacterial nephritis is a severe form of acute renal infection in which heavy leucocytic infiltrates occurs throughout kidney. Therefore, in contrast to uncomplicated acute pyelonephritis, it frequently causes acute renal failure. We here report an unusual case of acute multifocal bacterial nephritis which caused acute real failure and massive proteinuria. A 44-year old man was referred to our hospital because of high fever and both flank pain and non-oliguric acute renal failure. He had pyuria and massive proteinuria(5.87g/day), and serum creatinine level of 3.6mg/dL. We initially suspected hemorrhagic fever with renal syndrome. But immunofluorescent antibody for Hantavirus was negative and E. coli was isolated at urine. Computed tomography showed multifocal areas of wedge-shaped low densities in both kidneys. Kidney biopsy revealed tubulointerstitial infiltration of leucocyte without glomerular change. After treatment of antibiotics, proteinuria completely disappeared and serum creatinine level decreased to 1.0mg/dL.
Acute Kidney Injury ; Adult ; Anti-Bacterial Agents ; Biopsy ; Creatinine ; Fever ; Flank Pain ; Hantavirus ; Hemorrhagic Fever with Renal Syndrome ; Humans ; Kidney ; Nephritis* ; Proteinuria ; Pyelonephritis ; Pyuria

BACKGROUND: Preeclampsia, pregnancy induced hypertension, is considered to be associated with increased vascular permeability leading to albumin loss from the intravascular space. Although hypoalbuminemia is common in pregnant women with preeclampsia, the impact of hypoalbuminemia on maternal and fetal morbidity in preeclampsia is not well known yet. METHODS: This study included 392 pregnant women with preeclampsia. The patients were divided into hypoalbuminemia group (serum albumin <3.0 g/dL) and normal group (serum albumin >or=3.0 g/dL) based on the lowest serum albumin level. And we compared clinical factors representing maternal and fetal morbidity between the two groups. The mean age of the patients was 30+/-5 years and mean pregnant duration was 35.5+/-3.4 weeks. RESULTS: Of the total 392 patents, 280 patients (71.4%) had hypoalbuminemia. Compared to normal group (n=112), hypoalbuminemia group (n=280) had higher incidence of twin pregnancy (7.5% vs. 1.8%, p=0.030), acute renal failure (12.5% vs. 3.6%, p=0.008), hepatic dysfunction (33.5% vs. 12.2%, p<0.001), thrombocytopenia (37.8% vs. 19.6%, p=0.001), severe proteinuria (>3.5 g/day) (34.4% vs. 10.8%, p=0.002), respectively. But there was no difference in maternal age, pulmonary edema, abruptio placenta, postpartum hemorrhage between the two groups. Concerning fetal morbidity, the incidence of intrauterine growth retardation in hypoalbuminemia group was higher than that in normal group (25.0% vs. 12.5%, p=0.011) and birth weight in hypoalbuminemia group was smaller than that in normal group (2.5+/-0.8 vs. 2.8+/-0.8 kg, p=0.002). CONCLUSION: This data suggest that hypoalbuminemia frequently occurs in pregnant women with preeclampsia and it is closely associated with maternal and fetal morbidity.
Acute Kidney Injury ; Birth Weight ; Capillary Permeability ; Female ; Fetal Growth Retardation ; Humans ; Hypertension ; Hypertension, Pregnancy-Induced ; Hypoalbuminemia ; Incidence ; Maternal Age ; Placenta ; Postpartum Hemorrhage ; Pre-Eclampsia* ; Pregnancy ; Pregnancy, Twin ; Pregnant Women ; Proteinuria ; Pulmonary Edema ; Serum Albumin* ; Thrombocytopenia