Journal of Yeungnam Medical Science

Case report

Interleukin-6-producing paraganglioma as a rare cause of systemic inflammatory response syndrome: a case report: Yin Young Lee, Seung Min Chung; J Yeungnam Med Sci. 2023;40(4):435-441. Published online March 7, 2023; DOI: https://doi.org/10.12701/jyms.2022.00766

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Abstract PDF: Pheochromocytomas and paragangliomas (PPGLs) may secrete hormones or bioactive neuropeptides such as interleukin-6 (IL-6), which can mask the clinical manifestations of catecholamine hypersecretion. We report the case of a patient with delayed diagnosis of paraganglioma due to the development of IL-6-mediated systemic inflammatory response syndrome (SIRS). A 58-year-old woman presented with dyspnea and flank pain accompanied by SIRS and acute cardiac, kidney, and liver injuries. A left paravertebral mass was incidentally observed on abdominal computed tomography (CT). Biochemical tests revealed increased 24-hour urinary metanephrine (2.12 mg/day), plasma norepinephrine (1,588 pg/mL), plasma normetanephrine (2.27 nmol/L), and IL-6 (16.5 pg/mL) levels. 18F-fluorodeoxyglucose (FDG) positron emission tomography/CT showed increased uptake of FDG in the left paravertebral mass without metastases. The patient was finally diagnosed with functional paraganglioma crisis. The precipitating factor was unclear, but phendimetrazine tartrate, a norepinephrine-dopamine release drug that the patient regularly took, might have stimulated the paraganglioma. The patient’s body temperature and blood pressure were well controlled after alpha-blocker administration, and the retroperitoneal mass was surgically resected successfully. After surgery, the patient’s inflammatory, cardiac, renal, and hepatic biomarkers and catecholamine levels improved. In conclusion, our report emphasizes the importance of IL-6-producing PPGLs in the differential diagnosis of SIRS.

Original article

Impact of calcineurin inhibitors on rat glioma cells viability: Jeong Hun Seong, Woo Yeong Park, Jin Hyuk Paek, Sung Bae Park, Seungyeup Han, Kyo-Cheol Mun, Kyubok Jin; Yeungnam Univ J Med. 2019;36(2):105-108. Published online January 21, 2019; DOI: https://doi.org/10.12701/yujm.2019.00108

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Background
Although kidney transplantation outcomes have improved dramatically after using calcineurin inhibitors (CNIs), CNI toxicity continues to be reported and the mechanism remains uncertain. Here, we investigated the neurotoxicity of CNIs by focusing on the viability of glioma cells.
Methods
Glioma cells were treated with several concentrations of CNIs for 24 hours at 37 ℃ and their cell viability was evaluated using 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide assay.
Results
Exposure to 0, 0.25, 0.5, 2.5, 5.0, and 10.0 mM concentrations respectively showed 100%, 64.3%, 61.3%, 68.1%, 62.4%, and 68.6% cell viability for cyclosporine and 100%, 38.6%, 40.8%, 43.7%, 37.8%, and 43.0% for tacrolimus. The direct toxic effect of tacrolimus on glioma cell viability was stronger than that of cyclosporine at the same concentration.
Conclusion
CNIs can cause neurological side effects by directly exerting cytotoxic effects on brain cells. Therefore, we should carefully monitor the neurologic symptoms and level of CNIs in kidney transplant patients.

Citations

Citations to this article as recorded by

Tacrolimus-Induced Neurotoxicity After Transplant: A Literature Review
Paige Verona, Jocelyn Edwards, Kassidy Hubert, Federica Avorio, Vincenzina Lo Re, Roberta Di Stefano, Anna Carollo, Heather Johnson, Alessio Provenzani
Drug Safety.2024; 47(5): 419. CrossRef

Case Reports

A Case of Nonfunctioning Paraganglioma of the Posterior Mediastinum.: Young Chul Mun, Sung Keun Yu, Hye Jung Park, Kyeong Cheol Shin, Choong Ki Lee, Jin Hong Chung, Kwan Ho Lee, Mee Jin Kim, Jung Cheul Lee; Yeungnam Univ J Med. 2000;17(2):155-160. Published online December 31, 2000; DOI: https://doi.org/10.12701/yujm.2000.17.2.155

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Abstract PDF: Paraganglioma is a tumor from the extra adrenal paraganglion system and is rarely observed in the mediastinum. The authors experienced a case of nonfunctioning paraganglioma of the posterior mediastinum. The patient was 34-years-old male in whom abnormal mass lesion was nites in chest radiograph with hemoptysis. His blood pressure and serologic examination were within normal range upon admission to our hospital. Chest CT revealed a tumor in the left lower lobe. Diagnostic thoracoscopy was performed and diagnosed a posterior mediastinal mass. Surgical resection was them performed. Posterior mediastinal mass was removed successfully and histological examination of the surgical specimen diagnosed paraganglioma. He received radiotherapy after surgery and was followed up. Related literature are reviewed.

A Case of Desmoplastic Infantile Ganglioglioma.: Kwang Chul Song, Seong Ho Kim, Jang Ho Bae, Oh Ryong Kim, Byung Yon Choi, Soo Ho Cho, Dong Seok Kim; Yeungnam Univ J Med. 1997;14(2):451-458. Published online December 31, 1997; DOI: https://doi.org/10.12701/yujm.1997.14.2.451

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Abstract PDF: The desmoplastic infantile ganglioglioma is very rare cerebral tumor. It has been known to be characterized by its voluminious size, intense desmoplasia and the frequent presence of astrocytic and ganglioglionic differentiation. Also, It is usually presented in infantile period and predilected in the frontal and parietal lobes. We treated a huge desmoplastic infantile ganglioglioma(8?7?6cm) on the right frontotemporo-parietal area with only gross total resection. It includes solid mass & several cysts and shows the areas of the proliferation of spindle cells exhibiting storiform pattern in dense desmoplastic stroma and the areas composed of spindle shaped glial component.

Original Article

Nucleolar organizer regions in glioma.: Hae Joo Nam, Dong Suk Kim, Won Hee Choi, Tae Sook Lee; Yeungnam Univ J Med. 1991;8(2):63-69. Published online December 31, 1991; DOI: https://doi.org/10.12701/yujm.1991.8.2.63

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Abstract PDF: Nucleolar organizer regions (NOR) are loops of ribosomal DNA (rDNA) which are transcribed by RNA polymerase I. They produce ultimately ribosome and protein. Thus they are believed to reflect nuclear activity. We applied silver colloid staining technique to human glioma to examine relationship between the mean number of Ag-NOR and histopathological grading. The mean number of Ag-NOR (±S. E of the mean) were 1.17±0.07 in normal brain, 1.53±0.25 in astrocytoma, 2.37±0.71 in malignant astrocytoma. And 2.88±0.41 in glioblastoma multiforme. And there was a statistically significant difference among these. The results show that Ag-NOR technique is a rather simple and rapid method and will become a helpful tool for estimation of the proliferative potential of glioma.

Case Report

A BRW Stereotaxic Biopsy of Brain Stem Glioma.: Seung Chan Beak, Byung Yon Choi, Choong Bae Moon, Yong Chul Chi, Soo Ho Cho; Yeungnam Univ J Med. 1986;3(1):343-349. Published online December 31, 1986; DOI: https://doi.org/10.12701/yujm.1986.3.1.343

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Abstract PDF: Histopathological diagnosis of brain stem glioma should be performed for the purpose of the determination of its management and clinical course, but its surgical biopsy has been followed by high mortality and morbidity. We performed the tissue sampling for histological examination with BRW stereotaxic system under local anesthesia successfully.

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