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  • 1
    Online Resource
    Online Resource
    S. Karger AG ; 2005
    In:  Respiration Vol. 72, No. 6 ( 2005), p. 651-653
    In: Respiration, S. Karger AG, Vol. 72, No. 6 ( 2005), p. 651-653
    Abstract: We report a case of pulmonary infiltrates with eosinophilia (PIE) induced by nimesulide in an asthmatic patient on regular inhaled corticosteroid treatment. A high level of eosinophils in induced sputum was detected. No evidence of bacterial or fungal infection was observed. The patient responded rapidly to corticosteroid treatment. Rechallenge with nimesulide induced blood and sputum eosinophilia, confirming our diagnosis. Nimesulide, though it is a relatively safe drug to use in aspirin-sensitive asthmatics, may (like other nonsteroidal anti-inflammatory drugs) cause PIE in asthmatic patients and thus should be used cautiously.
    Type of Medium: Online Resource
    ISSN: 0025-7931 , 1423-0356
    Language: English
    Publisher: S. Karger AG
    Publication Date: 2005
    detail.hit.zdb_id: 1464419-8
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  • 2
    Online Resource
    Online Resource
    S. Karger AG ; 2021
    In:  Nephron Vol. 145, No. 5 ( 2021), p. 513-517
    In: Nephron, S. Karger AG, Vol. 145, No. 5 ( 2021), p. 513-517
    Abstract: 〈 b 〉 〈 i 〉 Context: 〈 /i 〉 〈 /b 〉 The outbreak of coronavirus disease 2019 (CO­VID-19) has rapidly evolved into a global pandemic. Kidney dysfunction is common among patients with COVID-19, and patients who develop acute kidney injury (AKI) have inferior outcomes. There is a growing body of evidence that AKI occurs in a substantial number of patients with COVID-19 and that developing AKI is associated with significantly worse outcomes for COVID-19 patients. The risk for death was amplified when AKI resulted in kidney replacement therapy (KRT). 〈 b 〉 〈 i 〉 Subject of Review: 〈 /i 〉 〈 /b 〉 The Study of the Treatment and Outcomes in Critically Ill Patients with COVID-19 (STOP-COVID) conducted a multicenter retrospective observational study enrolling 3,099 critically ill adults with COVID-19 admitted to intensive care units (ICUs) (J Am Soc Nephrol 2021;32:161–176). A total of 637 of 3,099 patients (20.6%) developed AKI treated with KRT (AKI-KRT) within 14 days of ICU admission, 350 of whom (54.9%) died within 28 days of ICU admission. Predictors of COVID-19 patients’ progress to AKI-KRT were higher BMI, higher stages of CKD, lower ratio of the partial pressure of arterial oxygen over the fraction of inspired oxygen (PaO2:FiO2 ratio) on ICU admission, and greater number of vasopressors received on ICU admission. 〈 b 〉 〈 i 〉 Second Opinion: 〈 /i 〉 〈 /b 〉 Recently, some investigations revealed that the independent predictors of COVID-19 with AKI include older age, Black race, diabetes, hypertension, cardiovascular disease, mechanical ventilation, higher interleukin-6 level, and use of vasopressor medications. It seems that the underlying comorbidities with preexisting vascular endothelial damage and/or the more serious critically ill CO­VID-19 patients can contribute to the development of AKI and even AKI-KRT.
    Type of Medium: Online Resource
    ISSN: 1660-8151 , 2235-3186
    Language: English
    Publisher: S. Karger AG
    Publication Date: 2021
    detail.hit.zdb_id: 2810853-X
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  • 3
    In: Nephron Clinical Practice, S. Karger AG, Vol. 114, No. 2 ( 2009-11-7), p. c158-c164
    Abstract: 〈 i 〉 Background/Aims: 〈 /i 〉 Subarachnoid hemorrhage (SAH) and intracerebral hemorrhage (ICH) are two subtypes of hemorrhagic stroke that may cause severe complications in patients with autosomal-dominant polycystic kidney disease (ADPKD). The differences in clinical features between SAH and ICH associated with ADPKD are not known. 〈 i 〉 Methods: 〈 /i 〉 Among 647 ADPKD patients hospitalized between 1997 and 2007 in our hospital, 11 with ICH (1.7%) and 6 with SAH (0.9%) were identified. 〈 i 〉 Results: 〈 /i 〉 Patients with SAH were significantly younger than patients with ICH (39 ± 6 vs. 57 ± 15 years, p = 0.013). The systolic blood pressure on admission was significantly higher in patients with ICH (194 ± 26 vs. 145 ± 18 mm Hg, p = 0.001). Two patients (18.2%) with ICH died after a first episode, 6 had a second episode, and 2 had a third episode. Two patients (33.3%) with SAH died after a first episode but the survivors had no recurrence during follow-up. The 30-day survival curves comparing patients with ICH and SAH were not significantly different. Patients with a Glasgow Coma Score less than 9 on arrival had a significantly worse outcome. 〈 i 〉 Conclusion: 〈 /i 〉 Clinical features differed between ICH and SAH associated with ADPKD. Nevertheless, blood pressure control and early recognition of hemorrhagic stroke are important in ADPKD patients.
    Type of Medium: Online Resource
    ISSN: 1660-2110
    Language: English
    Publisher: S. Karger AG
    Publication Date: 2009
    detail.hit.zdb_id: 2098336-0
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  • 4
    In: Medical Principles and Practice, S. Karger AG, Vol. 18, No. 6 ( 2009), p. 486-489
    Abstract: 〈 i 〉 Objective: 〈 /i 〉 To report an unusual case of synchronous renal cell carcinoma and CNS lymphoma in a patient with autosomal dominant polycystic kidney disease (ADPKD). 〈 i 〉 Case Presentation and Intervention: 〈 /i 〉 A 58-year-old woman presented with progressive right hemiparesis of 2 months’ duration. A brain CT scan revealed multiple enhanced lesions in the basal ganglia and the right occipital lobe. CNS lymphoma was confirmed by a stereotactic biopsy. Polycystic kidneys and a right renal mass were found incidentally. It was decided to treat the patient with cranial radiotherapy and chemotherapy first. The patient achieved complete remission of CNS lymphoma after 3 months, but the renal mass remained unchanged. A needle biopsy of the renal mass revealed renal cell carcinoma and unilateral nephrectomy was performed successfully. The patient remained in complete remission at 6-year follow-up. 〈 i 〉 Conclusion: 〈 /i 〉 The patient was treated successfully with a combination of chemotherapy, radiotherapy, and unilateral nephrectomy. This report highlights the need for clinicians to remain alert to the possibility of double malignancies while caring for ADPKD patients, especially when multiple unexplained manifestations exist.
    Type of Medium: Online Resource
    ISSN: 1011-7571 , 1423-0151
    Language: English
    Publisher: S. Karger AG
    Publication Date: 2009
    detail.hit.zdb_id: 1482963-0
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  • 5
    In: Nephron, S. Karger AG, Vol. 147, No. 8 ( 2023), p. 510-520
    Abstract: 〈 b 〉 〈 i 〉 Purpose: 〈 /i 〉 〈 /b 〉 Chronic kidney disease of uncertain etiology (CKDu) is an environmental nephropathy in which the etiological factors are yet uncertain. Leptospirosis, a spirochetal infection that is common among agricultural communities, has been identified as a potential etiology for CKDu beyond environmental nephropathy. Although CKDu is a chronic kidney disease, in endemic regions, an increasing number of cases are reported with features suggestive of acute interstitial nephritis without any known reason (AINu), with or without background CKD. The study hypothesizes that exposure to pathogenic leptospires is one of the causative factors for the occurrence of AINu. 〈 b 〉 〈 i 〉 Method: 〈 /i 〉 〈 /b 〉 This study was carried out using 59 clinically diagnosed AINu patients, 72 healthy controls from CKDu endemic region (endemic controls [ECs]), and 71 healthy controls from CKDu non-endemic region (non-endemic controls [NECs] ). 〈 b 〉 〈 i 〉 Results: 〈 /i 〉 〈 /b 〉 The seroprevalence of 18.6, 6.9, and 7.0% was observed in the AIN (or AINu), EC, and NEC groups, respectively, from the rapid IgM test. Among 19 serovars tested, the highest seroprevalence was observed at 72.9, 38.9, and 21.1% in the AIN (AINu), EC, and NEC groups, respectively, by microscopic agglutination test (MAT), particularly for serovar 〈 i 〉 Leptospira santarosai 〈 /i 〉 serovar Shermani. This emphasizes the presence of infection in AINu patients, and this also suggests that 〈 i 〉 Leptospira 〈 /i 〉 exposure might play an important role in AINu. 〈 b 〉 〈 i 〉 Conclusion: 〈 /i 〉 〈 /b 〉 These data suggest that exposure to 〈 i 〉 Leptospira 〈 /i 〉 infection could be one of the possible causative factors for the occurrence of AINu, which may lead to CKDu in Sri Lanka.
    Type of Medium: Online Resource
    ISSN: 1660-8151 , 2235-3186
    Language: English
    Publisher: S. Karger AG
    Publication Date: 2023
    detail.hit.zdb_id: 2810853-X
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  • 6
    In: Respiration, S. Karger AG, Vol. 77, No. 4 ( 2009), p. 398-406
    Abstract: 〈 i 〉 Background: 〈 /i 〉 Acute respiratory distress syndrome (ARDS) is a common diagnosis in intensive care units (ICUs) and is frequently correlated with acute kidney injury (AKI). 〈 i 〉 Objectives: 〈 /i 〉 To investigate the outcomes of critically ill patients with ARDS and to shed light on the association between prognosis and risk of renal failure, injury to kidney, failure of kidney function, loss of kidney function and end-stage renal failure (RIFLE) classification. 〈 i 〉 Methods: 〈 /i 〉 This retrospective study investigated the medical records of 60 critically ill patients with ARDS who underwent open lung biopsy (OLB) in 2 medical intensive care units of a tertiary care hospital from December 1999 to May 2005. 〈 i 〉 Results: 〈 /i 〉 The overall mortality rate was 55% (33/60). The increase in mortality was progressive and significant (χ 〈 sup 〉 2 〈 /sup 〉 for trend, p 〈 0.001) with increasing severity of the RIFLE classification. The Glasgow coma scale, alveolar-arterial O 〈 sub 〉 2 〈 /sub 〉 tension difference and maximum RIFLE (RIFLE 〈 sub 〉 max 〈 /sub 〉 ) score for days 1 and 3 in the ICU and on the day of OLB were independent predictors of hospital mortality by forward conditional logistic regression. Hosmer-Lemeshow goodness-of-fit test results demonstrate that RIFLE 〈 sub 〉 max 〈 /sub 〉 has a good fit. The area under the receiver operating characteristic curve (AUROC) and RIFLE 〈 sub 〉 max 〈 /sub 〉 score indicate good discriminative power (AUROC 0.750 ± 0.063, p = 0.001). Cumulative survival rates at the 6-month follow-up following hospital discharge differed significantly (p 〈 0.05) for non-AKI versus RIFLE 〈 sub 〉 max 〈 /sub 〉 -risk, RIFLE 〈 sub 〉 max 〈 /sub 〉 -injury and RIFLE 〈 sub 〉 max 〈 /sub 〉 -failure patients. 〈 i 〉 Conclusion: 〈 /i 〉 In patients with ARDS undergoing OLB, the use of the RIFLE score improves prediction of outcome.
    Type of Medium: Online Resource
    ISSN: 0025-7931 , 1423-0356
    Language: English
    Publisher: S. Karger AG
    Publication Date: 2009
    detail.hit.zdb_id: 1464419-8
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  • 7
    In: Cerebrovascular Diseases, S. Karger AG, Vol. 37, No. 5 ( 2014), p. 342-349
    Abstract: 〈 b 〉 〈 i 〉 Background: 〈 /i 〉 〈 /b 〉 Arteriovenous malformation (AVM) is one of the cerebrovascular diseases that bear a high risk of hemorrhage. The treatment modalities include microsurgical resection, endovascular embolization, stereotactic radiosurgery, or combinations that vary widely. Several large series have been reported, while data from Asian populations were few. The aim of this study was to examine the efficacy of linear accelerator stereotactic radiosurgery (LINAC SRS) for the treatment of intracranial AVMs, to evaluate the hemorrhage rate and to analyze associated factors. 〈 b 〉 〈 i 〉 Methods: 〈 /i 〉 〈 /b 〉 One hundred and sixteen patients with AVM were treated with LINAC SRS in a single institute between September 1994 and May 2005 and were retrospectively evaluated. The demographics of patients, clinical characteristics of AVM, the treatment modalities, and the parameters of the LINAC SRS were analyzed. Delayed toxicity and hemorrhage rate after treatment were also evaluated. The AVM obliteration and bleed rates were calculated using the Kaplan-Meier method and Cox regression analyses. 〈 b 〉 〈 i 〉 Results: 〈 /i 〉 〈 /b 〉 The efficacy rate with total obliteration after treatment was 81.9% (95 of 116 patients). The median interval to achieve total obliteration was 49 months. Microsurgical resection combined with SRS for residual AVMs achieved better obliteration rates compared to SRS alone (statistically significant, p = 0.001), while no significant difference was found between the embolization group and the group with no prior treatment (p = 0.895). The Spetzler-Martin grade of AVM is a relative factor of obliteration, higher grades resulting in a worse outcome (p = 0.009). Obliteration was significantly influenced by AVM volume in univariate analysis (p = 0.034), and volume 〈 5 cm 〈 sup 〉 3 〈 /sup 〉 contributed to improved obliteration (p = 0.01). There was no statistically significant difference in the hemorrhagic rate and the complication rate between ruptured and unruptured AVMs, while the unruptured group had a higher obliteration rate (p = 0.024). The annual hemorrhage rate after LINAC SRS treatment was 1.9%. The bleeding rate was 3.3% in the first year after radiosurgery, 2.1% in the second year, 1.9% between the second and fifth year, and 1.5% between the fifth and tenth year. Patients with hemorrhagic events before radiosurgery appeared to have a higher rebleeding risk during the latency period. Twenty-three patients (19.8%) had late adverse effects with regard to posttreatment radiological follow-up, but only 1 (0.8%) had newly developed neurological deficits. 〈 b 〉 〈 i 〉 Conclusion: 〈 /i 〉 〈 /b 〉 LINAC SRS achieved a high obliteration rate and reduced the risk of hemorrhage effectively in ruptured and unruptured intracranial AVMs. Prior microsurgical resection provided better outcome, while embolization showed no benefit. Adverse effects after treatment are acceptable and require long-term follow-up.
    Type of Medium: Online Resource
    ISSN: 1015-9770 , 1421-9786
    Language: English
    Publisher: S. Karger AG
    Publication Date: 2014
    detail.hit.zdb_id: 1482069-9
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  • 8
    In: Cellular Physiology and Biochemistry, S. Karger AG, Vol. 44, No. 2 ( 2017), p. 728-740
    Abstract: Background/Aims: ATG4B is a cysteine protease required for autophagy, which is a cellular catabolic pathway involved in energy balance. ATG4B expression is elevated during tumor growth in certain types of cancer, suggesting that ATG4B is an attractive target for cancer therapy. However, little is known about the mechanisms through which ATG4B deprivation suppresses the growth of cancer cells. Methods: Cancer cells were transfected with either siRNA against ATG4B or an expression vector encoding wild-type ATG4BWT or encoding catalytic mutant ATG4BC74A to determine cell cycle progression by propidium iodide staining or by BrdU incorporation assay using flow cytometry. The GFP-MAP1LC3-II puncta and protein levels in the cells were determined by immunofluorescence and immunoblotting, respectively. Results: Knockdown of ATG4B blocked cell proliferation, particularly at the G1-S phase transition, in various cancer cells. Moreover, knockdown of ATG4B or overexpression of the ATG4BC74A catalytic mutant reduced both autophagic flux and ATP levels and increased AMP-activated protein kinase (AMPK) phosphorylation in the cancer cells. Nevertheless, knockdown of ATG4B had only a minor effect on AMPK activation and G1 phase arrest in liver kinase B1 (LKB1)-deficient or AMPK-inhibited cancer cells. Conclusion: These results imply that targeting ATG4B might inhibit autophagy and trigger the LKB1-AMPK energy-sensing pathway, resulting in tumor growth suppression.
    Type of Medium: Online Resource
    ISSN: 1015-8987 , 1421-9778
    Language: English
    Publisher: S. Karger AG
    Publication Date: 2017
    detail.hit.zdb_id: 1482056-0
    SSG: 12
    SSG: 15,3
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  • 9
    In: Cellular Physiology and Biochemistry, S. Karger AG, Vol. 36, No. 3 ( 2015), p. 1250-1258
    Abstract: Background: Low concentrations of carbon monoxide (CO) have anti-inflammatory effects and can reduce bone erosion in a murine collagen-induced arthritis model. The objective of this study was to assess the effects of CO on receptor activator of NF-γB ligand (RANKL), one of the key stimulators of osteoclastogenesis. Methods: The in vivo effects of CO on RANKL expression were assessed in a collagen antibody-induced arthritis model in mice. Cell proliferation and apoptosis were assessed in the RAW246.7 cell line stimulated with RANKL and exposed to either air or CO. The number of tartrate resistant acid phosphatase (TRAP)-positive RAW246.7 cells was also examined after treatment with RANKL and the peroxisome proliferator-activated receptor gamma (PPARγ) agonist, Troglitazone. Results: CO reduced RANKL expression in the synovium of arthritic mice. Although CO slightly increased RAW246.7 cell proliferation, no differences in activated caspase 3 levels were detected. In addition, Troglitazone ameliorated the inhibitory effects of CO on RANKL-induced TRAP expression by RAW246.7 cells. Conclusions: CO suppresses osteoclast differentiation by inhibiting the RANKL-induced activation of PPAR-γ. Given the role of the PPAR-γ/cFos (AP-1) pathway in regulating the transcription factor, NFATc1, the master regulator of osteoclastogenesis, further studies are warranted to explore CO in treating inflammatory bone disorders.
    Type of Medium: Online Resource
    ISSN: 1015-8987 , 1421-9778
    Language: English
    Publisher: S. Karger AG
    Publication Date: 2015
    detail.hit.zdb_id: 1482056-0
    SSG: 12
    SSG: 15,3
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  • 10
    Online Resource
    Online Resource
    S. Karger AG ; 1993
    In:  American Journal of Nephrology Vol. 13, No. 6 ( 1993), p. 442-447
    In: American Journal of Nephrology, S. Karger AG, Vol. 13, No. 6 ( 1993), p. 442-447
    Type of Medium: Online Resource
    ISSN: 1421-9670 , 0250-8095
    Language: English
    Publisher: S. Karger AG
    Publication Date: 1993
    detail.hit.zdb_id: 1468523-1
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