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Prognostic impact of chromogranin A in patients with acute heart failure

  • Kim, Hong Nyun;Yang, Dong Heon;Park, Bo Eun;Park, Yoon Jung;Kim, Hyeon Jeong;Jang, Se Yong;Bae, Myung Hwan;Lee, Jang Hoon;Park, Hun Sik;Cho, Yongkeun;Chae, Shung Chull
    • Journal of Yeungnam Medical Science
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    • v.38 no.4
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    • pp.337-343
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    • 2021
  • Background: Chromogranin A (CgA) levels have been reported to predict mortality in patients with heart failure. However, information on the prognostic value and clinical availability of CgA is limited. We compared the prognostic value of CgA to that of previously proven natriuretic peptide biomarkers in patients with acute heart failure. Methods: We retrospectively evaluated 272 patients (mean age, 68.5±15.6 years; 62.9% male) who underwent CgA test in the acute stage of heart failure hospitalization between June 2017 and June 2018. The median follow-up period was 348 days. Prognosis was assessed using the composite events of 1-year death and heart failure hospitalization. Results: In-hospital mortality rate during index admission was 7.0% (n=19). During the 1-year follow-up, a composite event rate was observed in 12.1% (n=33) of the patients. The areas under the receiver-operating characteristic curves for predicting 1-year adverse events were 0.737 and 0.697 for N-terminal pro-B-type natriuretic peptide (NT-proBNP) and CgA, respectively. During follow-up, patients with high CgA levels (>158 pmol/L) had worse outcomes than those with low CgA levels (≤158 pmol/L) (85.2% vs. 58.6%, p<0.001). When stratifying the patients into four subgroups based on CgA and NT-proBNP levels, patients with high NT-proBNP and high CgA had the worst outcome. CgA had an incremental prognostic value when added to the combination of NT-proBNP and clinically relevant risk factors. Conclusion: The prognostic power of CgA was comparable to that of NT-proBNP in patients with acute heart failure. The combination of CgA and NT-proBNP can improve prognosis prediction in these patients.

Ureteral Injury Caused By Blunt Trauma: A Case Report (둔상에 의한 요관 손상 1례)

  • Kwon, Oh Sang;Mun, Yun Su;Woo, Seung Hwo;Han, Hyun Young;Hwang, Jung Joo;Lee, Jang Young;Lee, Min Koo
    • Journal of Trauma and Injury
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    • v.25 no.4
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    • pp.291-295
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    • 2012
  • Ureteral trauma is rare, accounting for less than 1% of all urologic traumas. However, a missed ureteral injury can result in significant morbidity and mortality. The purpose of this case presentation is to suggest another method for early detection of ureteral injury in blunt traumatic patient. A 47-years-old man was injured in pedestrian traffic accident. He undergone 3-phase abdominal CT initially and had had a short-term follow-up simple. We suspected ureteral injury. Our final diagnosis of a ureteral injury was based on follow-up and antegrade pyeloureterography, he underwent emergency surgery. We detected the ureteral injury early and took a definitive action within 24 hours. In blunt trauma, if abnormal fluid collection in the perirenal retroperitoneal space is detect, the presence of a ureteral injury should be suspected, so a short-term simple X-ray or abdominal CT, within a few hours after initial abdominal CT, may be useful.

Scalp metastasis from an adenocarcinoma of the lung mimicking a cystic mass: case report and literature review

  • Kim, Han Koo;Kang, Seung Hyun;Kim, Woo Seob;Kang, Shin Hyuk;Kim, Woo Ju;Kim, Hyeon Seok;Bae, Tae Hui
    • Archives of Craniofacial Surgery
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    • v.23 no.5
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    • pp.237-240
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    • 2022
  • A 67-year-old man visited our plastic surgery clinic complaining of a palpable protruding mass (2.0×2.5 cm) in the right occipital region. To establish an appropriate treatment plan for the cystic mass, brain magnetic resonance imaging was performed. A 2.2 cm nodular lesion with peripheral enhancement in the right occipital region of the scalp was confirmed. In addition, two rim-enhancing nodular lesions up to 9 mm with marked perilesional edema in the right frontal lobe were confirmed. The findings suggested metastasis from cancer. After further evaluations, a mass in the right lower lung field was identified as adenocarcinoma of the lung. Histological examination characterized the excised lesion as a cutaneous metastasis from lung adenocarcinoma. This case report shows that a cystic mass, which commonly occurs in the scalp, may indicate lung cancer. In particular, if a cystic mass of the scalp is identified in a person at high risk for lung cancer, appropriate evaluation and urgent treatment should be performed.

Lymph Node Metastasis after Spontaneous Regression of Non-Small Cell Lung Cancer

  • Jeong, Jae Hwa;Choi, Pil Jo;Yi, Jung Hoon;Jeong, Sang Seok;Lee, Ki Nam
    • Journal of Chest Surgery
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    • v.52 no.2
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    • pp.119-123
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    • 2019
  • Spontaneous regression of lung cancer is a very rare and poorly understood phenomenon. A 64-year-old man presented to Dong-A University Hospital with a shrunken nodule in the right lower lobe. Although the nodule showed a high likelihood of malignancy on needle aspiration biopsy, the patient refused surgery. The nodule spontaneously regressed completely in the next 17 months. However, the subcarinal lymph node was found to be enlarged 16 months after complete regression was observed. We pathologically confirmed metastasis of squamous cell carcinoma and performed neoadjuvant chemotherapy, surgery, and adjuvant chemoradiation. Regardless of tumor size reduction, it is preferable to perform surgery aggressively in cases of operable lung cancer.

Hemophagocytic lymphohistiocytosis diagnosed by brain biopsy

  • Ju, Hee Young;Hong, Che Ry;Kim, Sung Jin;Lee, Ji Won;Kim, Hyery;Kang, Hyoung Jin;Park, Kyung Duk;Shin, Hee Young;Chae, Jong-Hee;Phi, Ji Hoon;Cheon, Jung-Eun;Park, Sung-Hye;Ahn, Hyo Seop
    • Clinical and Experimental Pediatrics
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    • v.58 no.9
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    • pp.358-361
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    • 2015
  • Hemophagocytic lymphohistiocytosis (HLH) is characterized by fever, splenomegaly, jaundice, and pathologic findings of hemophagocytosis in bone marrow or other tissues such as the lymph nodes and liver. Pleocytosis, or the presence of elevated protein levels in cerebrospinal fluid, could be helpful in diagnosing HLH. However, the pathologic diagnosis of the brain is not included in the diagnostic criteria for this condition. In the present report, we describe the case of a patient diagnosed with HLH, in whom the brain pathology, but not the bone marrow pathology, showed hemophagocytosis. As the diagnosis of HLH is difficult in many cases, a high level of suspicion is required. Moreover, the pathologic diagnosis of organs other than the bone marrow, liver, and lymph nodes may be a useful alternative.

Sialolithiasis Mimicking Metastatic Thyroid Cancer (갑상선암 전이병소로 오인된 타석증 증례)

  • Jeong, Hwan-Jeong;Bom, Hee-Seung;Song, Ho-Cheon;Min, Jung-Jun;Kim, Seung-Min;Kim, Ji-Yeul
    • The Korean Journal of Nuclear Medicine
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    • v.34 no.1
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    • pp.94-98
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    • 2000
  • We report a false positive case of I-131 scan due to a sialolithiasis in right submandibular gland. I-131 images showed not only remnant thyroid tissues and functional metastases in the anterior neck but also a hot uptake near right submandibular gland. We confirmed the sialolithiasis by radiologic studies. Sialolithiasis should be regarded as a false positive cause when I-131 scan shows a hot spot near salivary bed.

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Spontaneous Vertebral Reduction during the Procedure of Kyphoplasty in a Patient with Kummell's Disease

  • Hur, Won-Seok;Choi, Sang-Sik;Lee, Mi-Kyoung;Lee, Dong-Kyu;Lee, Jae-Jin;Kim, Kyong-Jong
    • The Korean Journal of Pain
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    • v.24 no.4
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    • pp.231-234
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    • 2011
  • Kummell's disease is a spinal disorder characterized by delayed post-traumatic collapse of a vertebral body with avascular necrosis. Although definitive treatment for Kummell's disease has not been established, it has been reported that percutaneous vertebroplasty or kyphoplasty has shown good results. However, these procedures are not recommended for severely collapsed vertebral bodies because of the risk of cement leakage or technical difficulties. Authors report a rare case of spontaneous reduction in vertebral height by the insertion of a working cannula into the vertebral body in Kummell's disease.

Metastasis of Rhabdomyosarcoma to the Male Breast: a Case Report with Magnetic Resonance Imaging Findings

  • Kim, Myeongjong;Kang, Bong Joo;Park, Ga Eun;Kim, Sung Hun;Lee, Jeongmin;Lee, Ahwon
    • Investigative Magnetic Resonance Imaging
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    • v.23 no.1
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    • pp.75-80
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    • 2019
  • Metastasis of rhabdomysarcoma to the breast is a very rare manifestation in adult males. Herein, we report a case of metastasis from embryonal rhabdomyosarcoma in the left hypothenar muscle that presented as a breast mass in a 38-year-old man, who four months later expired because of multiple bone metastases related to pancytopenia. We describe the various imaging findings, including mammograms, ultrasonography, computerized tomography (CT), positron emission tomography-computed tomography (PET-CT), and magnetic resonance imaging (MRI) of this rare disease. The various imaging findings of this lesion could be helpful for future diagnosis of male breast lesions.