, Hee-June Kim
, Sung Hun Kim, Suk-Joong Lee Citations
, Min A Park, Myung Jae Park, So Young Park, Seung Hyeun Lee Uremic pleuritis is a fibrinous pleuritis of unknown pathogenesis in patients with chronic kidney disease. Although it responds to regular dialysis or repeated thoracentesis, cases that are refractory to those therapies have been reported. We report a case of uremic pleuritis which showed marked improvement following corticosteroid therapy. The effusion was exudate, and negative in cytology and microbiology. Pleural biopsy revealed chronic inflammation with fibrosis. The pleural effusion did not respond to chest tube drainage and continuance of hemodialysis. With a diagnosis of refractory uremic pleuritis, we started methylprednisolone. The pleural effusion responded to the treatment and resolved without complication.
Citations
, Jeong Hee Hahm Periorbital hemanogiomas are commonly associated with ocular complications such as amblyopia or strabismus. So early treatment and regular ophthalmologic study are recommended.
We report a case of upper eyelid strawberry hemangioma in a 5-month-old infant. Thehemangioma was treated with intralesional corticosteroid injection, and so a marked involutionof the tumor resulted. There were no local or gystemic complications. So this therapeutic methodis considered to be sueful in the management of strawberry haemangioma.
Pancreatitis is the most common and serious complication of ERCP. On the basis of several reports, corticosteroid, octreotide, or calcium channel blocker might be effective in this regard. The aim of this study was to determine whether the phamacologic agents(steroid, variable amount of octreotide, and verapamil) prevent post-ERCP pancreatitis.
A total of 80 patients were randomized. All patients received intravenously gabexate mesilate(Foy®) before endoscopy. Group 1 has been dose of octreotide (0.2mg blous and 6mg intravenous infusion) in group 3, and verapamil in group 4. Clinical outcomes and risk factors were analysed in each groups. We checked cytokines (IL-1, TNF-α) in group 3 and 4 compared with control and alcohol induced pacreatitis.
The overall frequency of hyperamylasemia and pancreatitis were 35% (28/80) and 13.7% (11/80), respectively. There was no difference among 4 groups with the incidence and severity of pancreatitis. The groups were similar with regard to demographic characteristics, type of procedure performed(diagnostic or therapeutic), the presence of diverticulum, visualization of pancreatic duct. There was no risk factors of ERCP-pancreatitis in all groups. In the cytokine data, TNF-α was markedly decreased on right after ERCP in patients with hyperamyasemia and pancreatitis.
Prophylactic administered corticosteroid, octredtid, or verpamil would not be helpful for prevention in post-ERCP pancreatitis. Also IL-1 and TNF-α may not be useful markers in prediction of ERCP-pancretitis. But TNF-α would be useful marker as mild form ERCP-pancreatitis and alcoholic pancreatitis.
, Gi Beom Hwang, Hye Jean Lee The purpose of this study is investigating variables affecting the numbers of clinical laboratory tests.
Data about the number of clinical laboratory tests, hospital characteristics, and the number of patients between January 1999 and December 1999 was collected. Data resources were Statistical Yearbook, Standardization Audit by Korean Hospital Association and Internal Data Set of each hospital. Hospital characteristics were hospital ownership, tertiary care hospital, duration since opening, licensed hospital beds, the rates of medical inpatient and outpatient. Multiple regression analysis was applied to find factors affecting the number of clinical laboratory tests. Models for WBC, RBC, Hb, Hct, PLT, LDC, PT, PTT, AST, ALT, and GLU were statistically adequate.
As the results, hospital ownership, duration since opening, licensed hospital beds, the rate of medical outpatient were statistically significant. Private hospitals showed higher numbers than public hospitals, hospitals within 5 years since opening showed higher numbers than others. The licensed hospital beds was positively correlated with the numbers of the tests, whereas the rates of medical outpatient was negatively correlated.
In conclusion, hospital characteristics affect the numbers of clinical laboratory tests. It could be a clue why the costs of medical services were different among medical facilities.
, Kyung Eun Lee Pancreatitis is the most common and serious complication of diagnostic and therapeutic ERCP. On the basis of several reports, corticostroid or octreotide might be effective in this regard. The aim of this study was to determine whether the pharmacologic agents(stroid and octreotide) prevent post-ERCP pancreatitis.
Patients received an intravenous infusion of hydrcortisone(100mg) and octreotide (0.2mg bolus) in treated group Tmmediately before endoscopy. A total of 140 patients(73men and 67 women, with an average age of 61.5 yr) who were scheduled to undergo diagnostic or therapeutic ERCP. Nine patients were excluded from the final evaluation for incomplete records. The remaining 131 patients, 61 in the treated group and 70 in the control group, were analyzed.
The overall frequency of hyperamylasmia and pancreatitis were 33.6%(44/131) and 7.6%(10/131), respectively. The all pancreatitis were mild. There was no difference between the groups with the incidence and severity of pancreatitis. The procedure-induced pancreatitis occured in 5 of 61(8.2%) patients treated with hydrocortisone and octreotide and 5 of 70(7.2%) patients in the control group(p=ns). the groups were similar with regard to desmographic characteristics, type of procedure performed(diagnostic or therapeutic), the presence of diverticulum, visualization of pancreatic duct. The only risk factor of ERCP-pancreatitis is the visualization of pancreatic duct in both groups.
Prophylactic administered corticosteroid and octreotide did not prevent of post-ERCP pancreatitis. Pancreatic injury may be only related to maneuver of pancreatic duct.
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