Idiopathic sudden sensorineural hearing loss in dialysis patients

Although sudden sensorineural hearing loss (SSNHL) affects chronic kidney disease (CKD) patients more frequently than non-CKD patients, few reports have described SSNHL in dialysis patients. We aimed to review the characteristics of SSNHL in chronic dialysis patients and evaluate treatment responses to steroid therapy. We retrospectively reviewed the records of dialysis patients diagnosed with idiopathic SSNHL at Asan Medical Center between January 2000 and December 2014. Pure tone and speech audiometry analyzes were performed before and 2?weeks and 2?months after treatment onset to evaluate outcomes. Twenty-two patients (11 men, 11 women; mean age: 49.9?±?11.7?years) were included; 16 (72%) and 6 (28%) had undergone hemodialysis and peritoneal dialysis, respectively, for a median of 49.2?±?41.4 (1–144) months. End-stage renal disease was most frequently caused by diabetic nephropathy (11 cases), chronic glomerulonephritis (1 case) and unknown factors (7 cases). Common accompanying symptoms included tinnitus (68.2%), ear fullness (45.5%) and vertigo (27.3%). The mean pure tone audiometry threshold at the initial presentation was 82.6?±?22.4?dB. At 2?months post-steroid treatment, 4 (18.2%), 4 (18.2%) and 6 (27.3%) patients exhibited a complete, partial, or slight recovery, respectively; 8 patients (36.3%) showed no improvement. Although we could not identify the specific cause of SSNHL in this population, our relatively large case series elucidates the precise clinical features of SSNHL in this population and demonstrates the outcomes of steroid treatment.     

Recent Evidence of Hantavirus Circulation in the American Tropic

Hantaan virus was discovered in Korea during the 1970s while other similar viruses were later reported in Asia and Europe. There was no information about hantavirus human infection in the Americas until 1993 when an outbreak was described in the United States. This event promoted new studies to find hantaviruses in the Americas. At first, many studies were conducted in Brazil, Argentina, Chile, Uruguay and Paraguay, while other Latin American countries began to report the presence of these agents towards the end of the 20th century. More than 30 hantaviruses have been reported in the Western Hemisphere with more frequent cases registered in the southern cone (Argentina, Chile, Uruguay, Paraguay, Bolivia and Brazil). However there was an important outbreak in 2000 in Panama and some rare events have been described in Peru, Venezuela and French Guiana. Since hantaviruses have only recently emerged as a potential threat in the tropical zones of the Americas, this review compiles recent hantavirus reports in Central America, the Caribbean islands and the northern region of South America. These studies have generated the discovery of new hantaviruses and could help to anticipate the presentation of possible future outbreaks in the region.     

Hepatocellular carcinoma: a practical review for the surgical pathologist

Hepatocellular carcinoma causes significant human morbidity and mortality worldwide. In Western Europe and North America, the rising prevalence of nonalcoholic steatohepatitis is a major contributor to chronic liver disease and, ultimately, hepatocellular carcinoma. In some cases, a definitive diagnosis of hepatocellular carcinoma can be rendered in the absence of histologic confirmation; needle core biopsies may be taken for small and/or indeterminate liver lesions. Pathologists continue to provide important clinical care through the diagnosis, staging, and molecular understanding of this malignancy. This article summaries the epidemiology, imaging, histopathology, and targeted immunohistochemical profile of hepatocellular carcinoma in adults with a focus on practical knowledge for daily use.     

Prostate volume as an independent predictor of prostate cancer in men with PSA of 10–50?ng ml?1

Prostate volume (PV) has been shown to be associated with prostate cancer (PCa) detection rates in men with a prostate-specific antigen (PSA) in the ‘grey zone'' (2.0–10.0 ng ml⁻¹). However, the PSA ‘grey zone'' in Asian men should be higher because the incidence of PCa in Asian men is relatively low. Therefore, we evaluated the association between PV and PCa detection rates in men with PSAs measuring 10–50 ng ml⁻¹. Men who underwent a 13-core prostatic biopsy with PV documentation participated in the study. A multivariate stepwise regression was used to evaluate whether the PV at time of prostate biopsy could predict the risk of PCa. The rates of PCa among men in different PSA ranges, stratified by PV medians (<60 and ≥60 ml), were calculated. There were 261 men included in the final analysis. PV was the strongest predictor of PCa risk (odds ratio, 0.02; P<0.001) compared to other variables. The PCa rates in men with PVs measuring <60 and ≥60 ml in the 10–19.9 ng ml⁻¹ PSA group were 40.6% and 15.1%, respectively, while the rates for men with PSAs measuring 20–50 ng ml⁻¹ were 65.1% and 26.8%. PV is an independent predictor of PCa in men with PSA measuring 10–50 ng ml⁻¹. In clinical practice, particularly for those countries with lower incidences of PCa, PV should be considered when counselling patients with PSAs measuring 10–50 ng ml⁻¹ regarding their PCa risks.     

High-intensity focused ultrasound as a treatment option in renal cell carcinoma

Due to the widespread use of modern imaging modalities, small renal masses are discovered incidentally at increasing rates. Advances in minimally invasive technologies have changed the treatment options for renal cell carcinoma. High-intensity focused ultrasound aims to completely ablate renal tumors in a noninvasive manner. Experimental studies have demonstrated principle feasibility and safety of the technology. However, clinical studies on renal cell carcinoma are very limited and no substantial oncologic results are available to date. Major technical improvements are mandatory to enable high-intensity focused ultrasound as an effective treatment option for patients with small renal masses.     

经皮肾镜治疗肾复杂性结石并发症的不同诱因早期护理干预的效果分析

目的 探讨经皮肾镜治疗肾复杂性结石患者针对并发症的不同诱因早期护理干预效果.方法 将我院2009年3月至2012年3月收治的100例采用经皮肾镜治疗复杂性结石的患者随机分为两组,对照组给予常规护理,实验组给予早期针对性护理干预,观察比较两组患者的护理效果.结果 实验组能减少并发症的发生,患者并发症能够更快治愈.患者的焦虑程度降低,对我院护理工作的满意度更高,与对照组比较有显著差异,P＜ 0.05.结论 经皮肾镜治疗肾复杂性结石手术患者针对并发症的不同诱因实施早期护理干预,具有较好的效果.