Initiation of peritoneal dialysis in a patient with chronic renal failure associated with tetralogy of Fallot: a case report.

BACKGROUND: Tetralogy of Fallot is the most common cyanotic congenital heart disease. Patients with the condition have a high risk of developing chronic kidney disease. Treatment of kidney disease in patients with complex hemodynamics presents unique challenges. However, there are very few reports on the treatment of end-stage renal failure in patients with tetralogy of Fallot. CASE PRESENTATION: We present a rare case of peritoneal dialysis in a 47-year-old man with tetralogy of Fallot who had not undergone intracardiac repair. Peritoneal dialysis successfully removed fluids and solutes without adversely affecting the patient's hemodynamics. Our patient was managed with peritoneal dialysis for 5 years before he succumbed to sepsis secondary to digestive tract perforation. CONCLUSIONS: In this paper, we discuss the importance of monitoring acid-base balance, changes in cyanosis, and hyperviscosity syndrome during peritoneal dialysis in patients with tetralogy of Fallot. Lower leg edema and B-type natriuretic peptide level were useful monitoring parameters in this case. This case illustrates that with attention to the patient's unique requirements, peritoneal dialysis can provide successful renal replacement therapy without compromising hemodynamics in patients with tetralogy of Fallot.

Long-term clinical course of immunotactoid glomerulopathy complicated with diffuse large B-cell lymphoma.

We report a case of immunotactoid glomerulopathy (ITG) complicated with diffuse large B-cell lymphoma (DLBCL). A 68-year-old woman presented with leg edema and was diagnosed with nephrotic syndrome (NS). Renal biopsy revealed ITG. We treated the patient with prednisolone (20 mg/day) and she achieved complete remission of NS. Steroids were gradually reduced. After 1 year, the patient presented with a breast mass determined on biopsy to be DLBCL. She underwent six cycles of R-CHOP (rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisolone) therapy. Follow-up revealed complete remission of both DLBCL and ITG. NS recurred after 5 years and she was simultaneously diagnosed with recurrence of DLBCL in bone marrow. She underwent four cycles of R-EPOCH (rituximab, etoposide, prednisolone, vincristine, cyclophosphamide, doxorubicin) therapy and entered remission for DLBCL. NS improved, but the treatment did not lead to remission. After 2 additional years, NS and DLBCL recurred again. She was administered rituximab and NS improved, although proteinuria tended to increase thereafter. One year later, we started prednisolone (10 mg/day), and proteinuria tended to decrease. She is currently undergoing outpatient follow-up. This case suggests that ITG with MGUS should be treated with the possibility of developing malignant hematological disease during the course.

An approach to control of band gap energy and photoluminescence upon band gap excitation in Pr(3+)-doped perovskites La(1/3)MO3 (M=Nb, Ta):Pr3+.

We synthesized polycrystalline pristine and Pr(3+)-doped perovskites La(1/3)MO(3) (M = Nb, Ta):Pr(3+) and investigated their crystal structure, optical absorption, and luminescence properties. The optical band gap of La(1/3)NbO(3) (3.2 eV) is smaller than that of La(1/3)TaO(3) (3.9 eV), which is primarily due to the difference in electronegativity between Nb and Ta. In La(1/3)NbO(3):Pr(3+), the red emission assigned to the f-f transition of Pr(3+) from the excited (1)D(2) level to the ground (3)H(4) state upon band gap photoexcitation (near-UV) was observed, whereas the f-f transition of Pr(3+) with blue-green emission from the excited (3)P(0) level to the ground (3)H(4) state was quenched. On the other hand, in La(1/3)TaO(3):Pr(3+), the blue-green emission upon band gap photoexcitation was observed. Their differences in emission behavior are attributed to the energy level of the ground and excited states of 4f(2) for Pr(3+), relative to the energy levels of the conduction and valence bands, and the trapped electron state, which mediates the relaxation of electron from the conduction band to the excited state of Pr(3+). La(1/3)NbO(3):Pr(3+) is a candidate red phosphor utilizing near-UV LED chips (e.g., λ = 375 nm) as an excitation source.