100 research outputs found
A comparison of the influence of 2.7% sorbitol-0.54% mannitol and 5% glucose irrigating fluids on plasma serum physiology during hysteroscopic procedures
Cancer in Patients on Chronic Dialysis in Korea
The study of cancer in patients treated with dialysis in Korea has not been reported. The aim of this study was to investigate the incidence and mortality of cancer among patients on dialysis in Korea. The study subjects were 106 cancer patients (2.3%) out of 4,562 end-stage renal disease (ESRD) patients maintained on hemodialysis (HD) or peritoneal dialysis (PD) at Yonsei University Health System from 1996 to 2005. We excluded patients in whom the diagnosis of cancer preceded dialysis or those who received renal allograft or started dialysis after renal allograft. Seventy-three (69%) of our subjects were male and 33 (31%) were female. The mean age at the time of cancer diagnosis was 57.9±11.7 yr. The mean time from the start of dialysis to the diagnosis of cancer was 75.2±63.9 months. The most common cancer site was gastrointestinal tract (GIT) (51%) followed by urinary tract (20%), lung (8%), and thyroid (7%). Sixty nine percent of the total mortality was due to cancer. The mean time from diagnosis to death was 2.9±2.5 yr. In ESRD patients with cancer, there were no significant differences in mortality rates by dialysis modality. In ESRD patients, the most common cancer was GIT cancer followed by urinary tract cancer. Therefore, careful surveillance of these cancers in ESRD patients is highly recommended
Early diagnosis and treatment of breast cancer in Japanese kidney transplant recipients: a single center experience
Relative adrenal insufficiency in post-transplant lymphoproliferative disorder.
Post-transplant lymphoproliferative disorder is treated with rapid decrement of immunosuppressive therapy. This cannot be achieved with ease in patients on long-term glucocorticoid therapy, as chronically suppressed adrenal glands may not be capable of mounting adequate response to stress. A 52-year-old Caucasian male presented with fever, orthostatic hypotension, lymphadenopathy and hyponatraemia. Serum cortisol levels were within normal levels with a sub optimal response to stimulation by ACTH. Hyponatraemia and orthostasis responded poorly to fluid restriction, saline and salt repletion but corrected after increasing the steroid dose. The normal baseline cortisol levels represented a stimulated adrenal gland, however, the ACTH stimulation had inadequate response. This sub optimal stimulation and a good response to increased steroids suggest the presence of relative or occult adrenal insufficiency. Relative adrenal insufficiency must be considered in patients who have received prolonged glucocorticoid therapy and have symptoms such as hypotension and/or hyponatraemia
Case Report - Relative Adrenal Insufficiency in Post-transplant Lymphoproliferative Disorder
Post-transplant lymphoproliferative disorder is treated with rapid
decrement of immunosuppressive therapy. This cannot be achieved with
ease in patients on long-term glucocorticoid therapy, as chronically
suppressed adrenal glands may not be capable of mounting adequate
response to stress. A 52-year-old Caucasian male presented with fever,
orthostatic hypotension, lymphadenopathy and hyponatraemia. Serum
cortisol levels were within normal levels with a sub optimal response
to stimulation by ACTH. Hyponatraemia and orthostasis responded poorly
to fluid restriction, saline and salt repletion but corrected after
increasing the steroid dose. The normal baseline cortisol levels
represented a stimulated adrenal gland, however, the ACTH stimulation
had inadequate response. This sub optimal stimulation and a good
response to increased steroids suggest the presence of relative or
occult adrenal insufficiency. Relative adrenal insufficiency must be
considered in patients who have received prolonged glucococorticoid
therapy and have symptoms such as hypotension and/or hyponatraemia. (J
Postgrad Med 2003;49:69-71
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