A 58-year-old man developed proteinuria and renal dysfunction following pneumonia caused by methicillin-resistant Staphylococcus aureus (MRSA). Vancomycinwas administered, and prednisolone pulse therapy and plasmapheresis were performed. Subsequently, serum creatinine was decreased. Eight months later, creatinine and CRPwere again elevated, and MRSA was detected. Vancomycinwas again administered and plasmapheresis was performed. However, renal function was not improved and continuous hemodialysis was initiated. This case indicates that complete eradication of MRSA is necessary to treat MRSA-associated glomerulonephritis, and if this is not attained, a permanent loss of renal function occurs. (Internal Medicine 40: 424-427, 2001)

We report a case of obvious pseudoaldosteronism which occurred after the additional administration of cilostazol against arteriosclerosis obliterans (ASO)

A 56-year-old female with chronic renal failure caused by chronic glomerulonephritis underwent continuous ambulatory peritoneal dialysis(CAPD)in December 2005. Approximately 3 months later, a large right hydrothorax suddenly developed. The concentration of glucose in the intrapleural fluid was markedly higher than that in serum, suggesting pleuroperitoneal communication. Technetium-99m-labeled macroaggregated albumin scan clearly demonstrated communication between the peritoneal and pleural cavities. Despite the condition, the patient wanted to continue with CAPD and thus video-assisted thoracoscopic surgery was performed. Using dialysis solution containing indigo carmine infused through a CAPD catheter, we found two blebs on the diaphragm that gradually became enlarged and stained blue. Dialysis solution flowed through one of these blebs. Following cyst removal, the diaphragm defect was directly closed with a surgical stapler. The postoperative course was very favorable and the patient could restart CAPD the day following surgery, and was discharged from our hospital on day 7 postoperatively. Two years and 10 months since the surgery, there has not been any recurrence of hydrothorax.

No abstract

No abstract