Acute kidney injury (AKI) secondary to near-drowning is rarely described and poorly understood. Only few cases of severe isolated AKI resulting from near-drowning exist in the literature. We report a case of near-drowning who developed to isolated AKI due to acute tubular necrosis (ATN) requiring dialysis. A 21-yr-old man who recovered from near-drowning in freshwater 3 days earlier was admitted to our hospital with anuria and elevated level of serum creatinine. He needed five sessions of hemodialysis and then renal function recovered spontaneously. Renal biopsy confirmed ATN. We review the existing literature on near-drowning-induced AKI and discuss the possible pathogenesis.

There has been no study to investigate whether cystatin C could predict cardiovascular events in incident dialysis patients. We aimed to delineate the role of serum cystatin C and cystatin C-based estimated glomerular filtration rate (eGFRcysC) for prediction of cardiovascular events.

Behçet's disease is a relapsing inflammatory disorder characterized by vasculitis of unknown cause and has been reported rarely in association with malignant diseases. In most cases the autoimmune nature of Behçet's disease and the long-term immunosuppressive therapy for disease control have been proposed to be responsible for malignant transformation. Although a few cases of various solid tumor and myelodys-plastic syndrome have been reported in association with Behçet's disease, acute leukemia has seldom been associated with Behçet's disease in Korea. We report a case of 38-year-old man with acute myeloblastic leukemia association with a Behçet's disease who had not received long-term treatment.

BACKGROUND/AIMS:Dieulafoy lesions are an important cause of upper gastrointestinal bleeding. The purpose of this study was to assess the efficacy of endoscopic treatment for these lesions and to identify the possible predictive factors for rebleeding associated with clinical and endoscopic characteristics.METHODS:Records from 44 patients admitted with Dieulafoy bleeding between January 2006 and December 2007 were reviewed. We retrospectively analyzed the clinical and endoscopic findings and then correlated the rebleeding risk factors with Dieulafoy lesions.RESULTS:Primary hemostasis was achieved by endoscopic treatment in 39 patients (88.6%). There were no significant differences between the rebleeding and non-rebleeding groups with respect to age, gender, initial hemoglobin levels, presence of shock, concurrent disease, location of bleeding, or initial hemostatic treatment methods. However, the use of non-steroidal anti-inflammatory drugs or anticoagulants (p=0.02) and active stages in the Forrest classification (p<0.01) were risk factors for rebleeding after endoscopic therapy.CONCLUSIONS:Endoscopic therapy is effective and safe for treating Dieulafoy lesions, and it has both short- and long-term benefits. Early identification of risk factors such as the use of non-steroidal anti-inflammatory drugs or anticoagulants and the Forrest classification of bleeding predict the outcome of Dieulafoy lesions.

We present the case of a 34-year-old man with acute biphenotype leukemia that co-expressed B-lymphoid and myeloid antigen after the diagnosis of pulmonary alveolar proteinosis (PAP). The diagnosis of PAP was established by Periodic Acid-Schiff reaction staining on the Video Associated Thoracoscope guided lung biopsy and biphenotype leukemia was revealed by immunohistochemical stains of the blasts harvested from the bone marrow biopsy. Supposedly, PAP follows a hematologic malignancy, yet this case shows the reverse sequence.

Acquired hemophilia is a rare but potentially life-threatening hemorrhagic disorder caused by the development of autoantibodies against coagulation factor VIII. Concentrates of human factor VIII, desmopressin, activated prothrombin complex concentrates, recombinant activated factor VII can all be used to control episodes of acute bleeding. The recent availability of bypassing agents like recombinant activated factor VII has been shown to be clinically safe and effective as treatment for acute bleeding. In this case report, a 67 year-old male patient with Rh negative blood type developed gross hematuria and bleeding after transurethral resection due to prostatic hypertrophy. After vesicocutaneous fistular reduction operation, post-operative bleeding was presented. The acute bleeding was controlled successfully by the combined treatment with recombinant activated factor VII (Novo sevenⓇ) and prednisone.

Primary malignant lymphoma of the urinary bladder is a rare disease, and it accounts for only 0.2% of all the cases of extranodal lymphoma.The prognosis of primary bladder lymphoma has been favorable, with many patients being alive and well several years after treatment.We report here on a case of primary diffuse large B cell lymphoma of the urinary bladder in a 75-year-old man patient who presented with a one-month history of persistent dysuria.The abdominal CT revealed a mass at the posterior wall of the urinary bladder.The tissue obtained by transurethral cystoscopy showed an atypical lymphoid proliferation, which was consistent with diffuse large B cell lymphoma.The patient received systemic chemotherapy of rituximab and CHOP (cyclophosphamide, doxorubicin, vincristine and prednisolone) and he achieved a significant partial remission.(