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1.
Article in English | WPRIM | ID: wpr-900438

ABSTRACT

Background/Aims@#Integrated relaxation pressure (IRP) is an important metric for functional evaluation of the lower esophageal sphincter. However, the effectiveness of IRP for evaluation of upper esophageal sphincter (UES) function has not yet been clarified. @*Methods@#High-resolution manometry (HRM) was performed in 180 patients with dysphagia. For comparison, 26 asymptomatic subjects were also recruited. IRP of the UES was defined as means of 0.2, 0.25, or 0.3 seconds (sIRPs) of maximal deglutitive relaxation in a 0.4-second window (a new equation for IRP calculation was developed using MATLAB). Also, the relaxation time interval of the UES, and mesopharyngeal and hypopharyngeal contractility (as a contractile integral) were evaluated using HRM. @*Results@#In normal subjects, mean values of 0.2, 0.25, and 0.3 sIRPs differed significantly from each other (P < 0.05). They were not associated with the relaxation time interval of the UES. In contrast, in patients with dysphagia, mean values of 0.2, 0.25, and 0.3 sIRPs were strongly related to relaxation time intervals of the UES (P < 0.05), and mean values of 0.2, 0.25, and 0.3 sIRPs in patients with aspiration were significantly higher than those of patients without aspiration (P < 0.01). However, in multivariate regression analyses, the main risk factor for aspiration was only a shorter relaxation time interval. @*Conclusions@#IRP values were significantly higher in patients with dysphagia and aspiration. However, its usefulness as a predictive factor for aspiration was less than the relaxation time interval of the UES.

2.
Article in English | WPRIM | ID: wpr-899943

ABSTRACT

Background@#Because persistent fever often occurs in adrenal insufficiency, it might be confused with infectious diseases. This study aimed to identify clinical characteristics and risk factors of patients with adrenal insufficiency and fever. @*Methods@#All adult patients (n = 150) admitted to a tertiary care hospital in South Korea and diagnosed with adrenal insufficiency between 1 March 2018, and 30 June 2019, were recruited. Patients were excluded if they had: 1) proven structural problems in the adrenal or pituitary gland; 2) a history of chemotherapy within 6 months prior to the diagnosis of adrenal insufficiency; and 3) other medical conditions that may cause fever. @*Results@#Among the included patients, 45 (30.0%) had fever at the time of the diagnosis of adrenal insufficiency. The mean C-reactive protein level was higher (11.25 ± 8.54 vs. 4.36 ± 7.13 mg/dL) in patients with fever than in those without fever. A higher proportion of patients with fever changed antibiotics (33.3% vs. 1.0%). On multivariate logistic regression analysis, female sex (odds ratio [OR], 0.32) lowered the risk of adrenal insufficiency with fever, while a history of surgery within 6 months (OR, 4.35), general weakness (OR, 7.21), and cough (OR, 17.29) were significantly associated with that. @*Conclusion@#The possibility of adrenal insufficiency should be considered in patients with fever of unknown origin, especially those with risk factors.

3.
Article in English | WPRIM | ID: wpr-892734

ABSTRACT

Background/Aims@#Integrated relaxation pressure (IRP) is an important metric for functional evaluation of the lower esophageal sphincter. However, the effectiveness of IRP for evaluation of upper esophageal sphincter (UES) function has not yet been clarified. @*Methods@#High-resolution manometry (HRM) was performed in 180 patients with dysphagia. For comparison, 26 asymptomatic subjects were also recruited. IRP of the UES was defined as means of 0.2, 0.25, or 0.3 seconds (sIRPs) of maximal deglutitive relaxation in a 0.4-second window (a new equation for IRP calculation was developed using MATLAB). Also, the relaxation time interval of the UES, and mesopharyngeal and hypopharyngeal contractility (as a contractile integral) were evaluated using HRM. @*Results@#In normal subjects, mean values of 0.2, 0.25, and 0.3 sIRPs differed significantly from each other (P < 0.05). They were not associated with the relaxation time interval of the UES. In contrast, in patients with dysphagia, mean values of 0.2, 0.25, and 0.3 sIRPs were strongly related to relaxation time intervals of the UES (P < 0.05), and mean values of 0.2, 0.25, and 0.3 sIRPs in patients with aspiration were significantly higher than those of patients without aspiration (P < 0.01). However, in multivariate regression analyses, the main risk factor for aspiration was only a shorter relaxation time interval. @*Conclusions@#IRP values were significantly higher in patients with dysphagia and aspiration. However, its usefulness as a predictive factor for aspiration was less than the relaxation time interval of the UES.

4.
Article in English | WPRIM | ID: wpr-892239

ABSTRACT

Background@#Because persistent fever often occurs in adrenal insufficiency, it might be confused with infectious diseases. This study aimed to identify clinical characteristics and risk factors of patients with adrenal insufficiency and fever. @*Methods@#All adult patients (n = 150) admitted to a tertiary care hospital in South Korea and diagnosed with adrenal insufficiency between 1 March 2018, and 30 June 2019, were recruited. Patients were excluded if they had: 1) proven structural problems in the adrenal or pituitary gland; 2) a history of chemotherapy within 6 months prior to the diagnosis of adrenal insufficiency; and 3) other medical conditions that may cause fever. @*Results@#Among the included patients, 45 (30.0%) had fever at the time of the diagnosis of adrenal insufficiency. The mean C-reactive protein level was higher (11.25 ± 8.54 vs. 4.36 ± 7.13 mg/dL) in patients with fever than in those without fever. A higher proportion of patients with fever changed antibiotics (33.3% vs. 1.0%). On multivariate logistic regression analysis, female sex (odds ratio [OR], 0.32) lowered the risk of adrenal insufficiency with fever, while a history of surgery within 6 months (OR, 4.35), general weakness (OR, 7.21), and cough (OR, 17.29) were significantly associated with that. @*Conclusion@#The possibility of adrenal insufficiency should be considered in patients with fever of unknown origin, especially those with risk factors.

5.
Article in English | WPRIM | ID: wpr-874524

ABSTRACT

We investigated the cardiovascular complications and mortality rates of patients with diabetes in South Korea. The rates of hospitalization due to cardiovascular complications and mortality were analyzed using the Korean National Health Insurance Service-National Sample Cohort. From 2006 to 2015, the rates of hospitalization due to major cardiovascular complications decreased, while those due to heart failure (from 72 to 146 and 124 to 161 per 10,000 men and women, respectively) and peripheral artery disease (from 39 to 55 and 19 to 35 per 10,000 men and women, respectively) increased. In the period 2007 to 2015, the mortality rates for cancer, cerebrovascular disease, diabetes, heart disease, and hypertensive disease all decreased. However, the mortality rate for pneumonia increased. We observed a continuous reduction in cardiovascular complications and mortality in adults with diabetes. However, with the increase in some diabetes complications, more efforts are needed to prevent diabetes complications.

6.
Article in Korean | WPRIM | ID: wpr-913267

ABSTRACT

Baek-ok injection (glutathione) has been widely used antioxidant therapy to whiten and has antiaging effects in Korea. Glutathione is an enzyme which synthesizes leukotriene, then it can induce asthma attack theoretically; however, there have been few case reports concerning this therapy. In this report, we described a 41-year-old woman who developed glutathione-induced life-threatening asthma attack. She has asthma history controlled by an intermittent salbutamol inhaler. She developed general weakness and dyspnea right after glutathione injection, and injection was discontinued. Dyspnea was progressively aggravated, and she lost consciousness with shock. Cardiopulmonary resuscitation was started, and she arrived at the Emergency Department with wheezing, hypoxia, severe respiratory acidosis, and nonmeasurable blood pressure. Intubation and mechanical ventilation were started with intramuscular epinephrine/intravenous methylprednisolone injection and repeated salbutamol/ipratropium/budesonide inhalation. After 5 hours, extubation and spontaneous breathing were successful without wheezing. Next day, pulmonary function test showed moderate an obstructive airway disease pattern, and she was discharged with inhaled fluticasone/salmeterol, oral methylprednisolone, and montelukast. We can exclude anaphylaxis, because serum tryptase obtained at the Emergency Department was 0.0 mg/dL and the absence of skin lesions and angioedema at arrival. Baek-ok injection (glutathione) should be carefully performed in asthma patients.

7.
Yonsei Medical Journal ; : 951-957, 2020.
Article | WPRIM | ID: wpr-833385

ABSTRACT

Purpose@#To compare the clinical characteristics and renal outcomes between patients who initially had lupus nephritis (LN) at the onset of systemic lupus erythematosus (SLE) (initial-onset LN) and those who developed LN within 5 years after SLE onset (early-onset LN). @*Materials and Methods@#SLE patients with biopsy-proven LN were retrospectively reviewed. The clinical parameters and renal outcomes were compared between initial-onset and early-onset LN groups. We used Cox regression analysis to estimate risk of worse renal outcomes according to the onset time of LN. @*Results@#Of all 136 LN patients, 92 (67.6%) and 44 (32.4%) patients were classified into the initial-onset and early-onset LN groups, respectively. The initial-onset LN group had higher prevalences of class IV LN (54.3% vs. 34.1%, ,p=0.027), impaired renal function (34.8% vs. 11.4%, p=0.004), microscopic hematuria (73.9% vs. 54.5%, p=0.024), and higher urine protein/creatinine ratio [4626.1 (2180.0–6788.3) mg/g vs. 2410.0 (1265.0–5168.5) mg/g,p=0.006] at LN diagnosis. Renal relapse (46.3% vs. 25.7%, p=0.039) and progression to chronic kidney disease (CKD) or end-stage renal disease (ESRD) were more common (24.4% vs. 8.3%, p=0.042) in the initial-onset LN group. In Cox regression analysis, the initial-onset LN group had higher risks of renal relapse [adjusted hazard ratio (HR) 3.56, 95% confidence interval (CI) 1.51–8.35,p=0.004] and progression to CKD or ESRD (adjusted HR 4.57, 95% CI 1.03–20.17,p=0.045), compared with the early-onset LN group. @*Conclusion@#Patients with LN at SLE onset may have more severe renal presentations and experience worse renal outcomes than those who develop LN within 5 years.

8.
Article | WPRIM | ID: wpr-831881

ABSTRACT

The prevalence of chronic kidney disease (CKD) is increasing worldwide. Although hyperuricemia has been associated with CKD in many studies, it remains controversial whether this is the cause or the result of decreased renal function. Recent observational studies of healthy populations and patients with CKD have reported that uric acid (UA) has an independent role in the development or progression of CKD. Experimental studies have shown several potential mechanisms by which hyperuricemia may cause or promote CKD. However, other reports have indicated an association between hypouricemia and CKD. This opposing effect is hypothesized to occur because UA is a major antioxidant in human plasma and is associated with oxidative stress. In this article, we discuss the potential association between UA imbalance and CKD and how they can be treated.

9.
Article | WPRIM | ID: wpr-831596

ABSTRACT

Background@#Serum uric acid (SUA) is recognized as a risk factor for chronic kidney disease (CKD) and mortality. However, there is controversy as to whether a high or low level of SUA is related to the risk of CKD progression or death, and whether it differs between males and females. @*Methods@#We included 143,762 adults who underwent voluntary health screening between 1995 and 2009 in Korea. For each sex, we divided participants into sex-specific quintiles according to SUA levels and compared end-stage renal disease (ESRD) incidence and mortality between the groups with low and high SUA levels and those with middle SUA levels. Sex-specific Cox proportional hazard analyses were performed for ESRD and all-cause mortality. @*Results@#Among the 143,762 participants, 0.2% (n = 272) developed ESRD. The hazard ratio (HR) of ESRD was higher in the highest (adjusted HR, 2.13; 95% confidence interval [CI], 1.18–3.84) and lowest (adjusted HR, 1.90; 95% CI, 1.02–3.51) SUA quintiles than in the middle SUA quintile in males and the highest SUA quintile in females (adjusted HR, 2.31; 95% CI, 1.10–4.84). Four-point three percent (n = 6,215) of participants died during a mean follow-up period of 157 months. The hazard ratio (HR) of all-cause mortality was higher in the highest SUA quintile than in the middle SUA quintile in males (adjusted HR, 1.15; 95% CI, 1.03–1.28) and females (adjusted HR, 1.17; 95% CI, 1.01–1.35). @*Conclusion@#Elevated levels of SUA are associated with increased risk for ESRD and all-cause mortality in both sexes. Low levels of SUA might be related to ESRD and death only in males, showing U-shaped associations. Our findings suggest sex-specific associations between SUA levels and ESRD development and mortality.

10.
Article in English | WPRIM | ID: wpr-919031

ABSTRACT

BACKGROUND/AIMS@#Patients with chronic kidney disease (CKD) have been found to show markedly increased rates of end-stage renal disease, major adverse cardiovascular and cerebrovascular events (MACCEs), and mortality. Therefore, new biomarkers are required for the early detection of such clinical outcomes in patients with CKD. We aimed to determine whether the level of circulating renalase was associated with CKD progression, MACCEs, and all-cause mortality, using data from a prospective randomized controlled study, Kremezin STudy Against Renal disease progression in Korea (K-STAR; NCT 00860431).@*METHODS@#A retrospective analysis of the K-STAR data was performed including 383 patients with CKD (mean age, 56.4 years; male/female, 252/131). We measured circulating renalase levels and examined the effects of these levels on clinical outcomes.@*RESULTS@#The mean level of serum renalase was 75.8 ± 34.8 μg/mL. In the multivariable analysis, lower hemoglobin levels, higher serum creatinine levels, and diabetes mellitus were significantly associated with a higher renalase levels. Over the course of a mean follow-up period of 56 months, 25 deaths and 61 MACCEs occurred. Among 322 patients in whom these outcomes were assessed, 137 adverse renal outcomes occurred after a mean follow-up period of 27.8 months. Each 10-μg/mL increase in serum renalase was associated with significantly greater hazards of all-cause mortality and adverse renal outcomes (hazard ratio [HR] = 1.112, p = 0.049; HR = 1.052, p = 0.045). However, serum renalase level was not associated with the rate of MACCEs in patients with CKD.@*CONCLUSIONS@#Our results indicated that circulating renalase might be a predictor of mortality and adverse renal outcomes in patients with CKD.

11.
Experimental Neurobiology ; : 612-627, 2019.
Article in English | WPRIM | ID: wpr-763785

ABSTRACT

Aldose reductase (AR) protein, a member of the NADPH-dependent aldo-keto reductase family, reduces a wide range of aldehydes and enhances cell survival by inhibition of oxidative stress. Oxidative stress is known as one of the major pathological factor in ischemia. Since the precise function of AR protein in ischemic injury is fully unclear, we examined the function of AR protein in hippocampal neuronal (HT-22) cells and in an animal model of ischemia in this study. Cell permeable Tat-AR protein was produced by fusion of protein transduction domain in Tat for delivery into the cells. Tat-AR protein transduced into HT-22 cells and significantly inhibited cell death and regulated the mitogen-activate protein kinases (MAPKs), Bcl-2, Bax, and Caspase-3 under oxidative stress condition. In an ischemic animal model, Tat-AR protein transduced into the brain tissues through the blood-brain barrier (BBB) and drastically decreased neuronal cell death in hippocampal CA1 region. These results indicate that transduced Tat-AR protein has protective effects against oxidative stress-induced neuronal cell death in vitro and in vivo, suggesting that Tat-AR protein could be used as potential therapeutic agent in ischemic injury.


Subject(s)
Aldehyde Reductase , Aldehydes , Blood-Brain Barrier , Brain , CA1 Region, Hippocampal , Caspase 3 , Cell Death , Cell Survival , Humans , In Vitro Techniques , Ischemia , Models, Animal , Neurons , Oxidative Stress , Oxidoreductases , Protein Kinases
12.
Article in English | WPRIM | ID: wpr-763679

ABSTRACT

BACKGROUND: In order to overcome the limitations of body mass index (BMI) and waist circumference (WC), the z-score of the log-transformed A Body Shape Index (LBSIZ) has recently been introduced. In this study, we analyzed the relationship between the LBSIZ and cardiovascular disease (CVD) in a Korean representative sample. METHODS: Data were collected from the Korea National Health and Nutrition Examination VI to V. The association between CVD and obesity indices was analyzed using a receiver operating characteristic curve. The cut-off value for the LBSIZ was estimated using the Youden index, and the odds ratio (OR) for CVD was determined via multivariate logistic regression analysis. ORs according to the LBSIZ value were analyzed using restricted cubic spline regression plots. RESULTS: A total of 31,227 Korean healthy adults were analyzed. Area under the curve (AUC) of LBSIZ against CVD was 0.686 (95% confidence interval [CI], 0.671 to 0.702), which was significantly higher than the AUC of BMI (0.583; 95% CI, 0.567 to 0.599) or WC (0.646; 95% CI, 0.631 to 0.661) (P<0.001). Similar results were observed for stroke and coronary artery diseases. The cut-off value for the LBSIZ was 0.35 (sensitivity, 64.5%; specificity, 64%; OR, 1.29, 95% CI, 1.12 to 1.49). Under restricted cubic spline regression, LBSIZ demonstrated that OR started to increase past the median value. CONCLUSION: The findings of this study suggest that the LBSIZ might be more strongly associated with CVD risks compared to BMI or WC. These outcomes would be helpful for CVD risk assessment in clinical settings, especially the cut-off value of the LBSIZ suggested in this study.


Subject(s)
Adult , Area Under Curve , Body Composition , Body Mass Index , Cardiovascular Diseases , Coronary Artery Disease , Humans , Korea , Logistic Models , Obesity , Odds Ratio , Risk Assessment , ROC Curve , Sensitivity and Specificity , Stroke , Waist Circumference
13.
Article in English | WPRIM | ID: wpr-763665

ABSTRACT

BACKGROUND: Epidemiological studies have suggested an association between selenium (Se) and diabetes mellitus (DM). However, different studies have reported conflicting results. Therefore, we performed a comprehensive meta-analysis to clarify the impact of Se on DM. METHODS: We searched the PubMed database for studies on the association between Se and DM from inception to June 2018. RESULTS: Twenty articles evaluating 47,930 participants were included in the analysis. The meta-analysis found that high levels of Se were significantly associated with the presence of DM (pooled odds ratios [ORs], 1.88; 95% confidence interval [CI], 1.44 to 2.45). However, significant heterogeneity was found (I2 =82%). Subgroup analyses were performed based on the Se measurement methods used in each study. A significant association was found between high Se levels and the presence of DM in the studies that used blood (OR, 2.17; 95% CI, 1.60 to 2.93; I2 =77%), diet (OR, 1.61; 95% CI, 1.10 to 2.36; I2 =0%), and urine (OR, 1.49; 95% CI, 1.02 to 2.17; I2 =0%) as samples to estimate Se levels, but not in studies on nails (OR, 1.24; 95% CI, 0.52 to 2.98; I2 =91%). Because of significant heterogeneity in the studies with blood, we conducted a sensitivity analysis and tested the publication bias. The results were consistent after adjustment based on the sensitivity analysis as well as the trim and fill analysis for publication bias. CONCLUSION: This meta-analysis demonstrates that high levels of Se are associated with the presence of DM. Further prospective and randomized controlled trials are warranted to elucidate the link better.


Subject(s)
Antioxidants , Diabetes Mellitus , Diet , Epidemiologic Studies , Odds Ratio , Population Characteristics , Prospective Studies , Publication Bias , Selenium , Trace Elements
14.
Article in English | WPRIM | ID: wpr-763662

ABSTRACT

BACKGROUND: The objective of this study was to investigate the prevalence, management, and comorbidities of diabetes among Korean adults aged 30 years and older. METHODS: This study used 2013 to 2016 data from the Korea National Health and Nutrition Examination Survey, a nationally-representative survey of the Korean population. Diabetes was defined as fasting glucose ≥126 mg/dL, current use of antidiabetic medication, a previous history of diabetes, or glycosylated hemoglobin (HbA1c) ≥6.5%. RESULTS: In 2016, 14.4% (approximately 5.02 million) of Korean adults had diabetes. The prevalence of impaired fasting glucose was 25.3% (8.71 million). From 2013 to 2016, the awareness, control, and treatment rates for diabetes were 62.6%, 56.7%, and 25.1%, respectively. People with diabetes had the following comorbidities: obesity (50.4%), abdominal obesity (47.8%), hypertension (55.3%), and hypercholesterolemia (34.9%). The 25.1%, 68.4%, and 44.2% of people with diabetes achieved HbA1c <6.5%, blood pressure <140/85 mm Hg, and low density lipoprotein cholesterol <100 mg/dL. Only 8.4% of people with diabetes had good control of all three targets. CONCLUSION: This study confirms that diabetes is as an important public health problem. Efforts should be made to increase awareness, detection, and comprehensive management of diabetes to reduce diabetes-related morbidity and mortality.


Subject(s)
Adult , Blood Pressure , Cholesterol, LDL , Comorbidity , Diabetes Mellitus , Fasting , Glucose , Glycated Hemoglobin A , Humans , Hypercholesterolemia , Hypertension , Korea , Mortality , Nutrition Surveys , Obesity , Obesity, Abdominal , Prevalence , Public Health , Republic of Korea
15.
Article in English | WPRIM | ID: wpr-785837

ABSTRACT

Despite the correction of secondary renal hyperparathyroidism after successful kidney transplantation, some recipients have persistent hyperparathyroidism due to autonomous hypertrophied parathyroid glands. St. Goar first identified and termed this disease as tertiary hyperparathyroidism. Surgery, either subtotal parathyroidectomy or total parathyroidectomy with autotransplantation, is the main treatment for tertiary hyperparathyroidism. Here, we report a case of a patient with tertiary hyperparathyroidism after two times of kidney transplantation who underwent subtotal parathyroidectomy and also review the relevant literature.


Subject(s)
Autografts , Humans , Hyperparathyroidism , Kidney Transplantation , Parathyroid Glands , Parathyroidectomy , Transplantation, Autologous
16.
Article in English | WPRIM | ID: wpr-713368

ABSTRACT

BACKGROUND: Weight reduction is a lifestyle intervention that has been introduced for prevention and management of chronic kidney disease (CKD). We investigate the additive anti-proteinuric effect of weight reduction on the usage of angiotensin II receptor blockers (ARBs) and its potential mechanisms in hypertensive CKD patients. METHODS: This study is a subanalysis of data from an open-label, randomized, controlled clinical trial. Among the 235 participants, 227 were assigned to subgroups according to changes in body weight. RESULTS: Fifty-eight participants (25.6%) were assigned to group 1 (≥1.5% decrease in body weight after 16 weeks), 32 participants (14.1%) were assigned to group 2 (1.5–0.1% decrease in body weight), and 136 participants (59.9%) were assigned to group 3 (≥ 0.0% increase in body weight). Characteristics at enrollment were not different among the three groups, but mean differences in weight and percent changes in urinary sodium excretion over the period were statistically different (P < 0.001 and P = 0.017). Over the study period, unintentional weight loss independently increased the probability of reduced albuminuria (group 1, relative risk 6.234, 95% confidence interval 1.913–20.315, P = 0.002). Among urinary cytokines, only podocalyxin level decreased significantly in participants who lost weight (P = 0.013). CONCLUSION: We observed that weight loss had an additive effect on the anti-proteinuric effects of ARBs in nondiabetic hypertensive CKD patients, although it was minimal. An additive effect was shown in both obese and non-obese participants, and its possible mechanism is related to reduction of podocyte damage.


Subject(s)
Albuminuria , Angiotensin II , Angiotensin Receptor Antagonists , Angiotensins , Body Weight , Cytokines , Humans , Hypertension , Life Style , Podocytes , Proteinuria , Receptors, Angiotensin , Renal Insufficiency, Chronic , Sodium , Weight Loss
17.
Article in English | WPRIM | ID: wpr-718616

ABSTRACT

BACKGROUND: Several epidemiologic studies have suggested that the urine sodium excretion (USE) can be estimated in lieu of performing 24-hour urine collection. However, this method has not been verified in patients with chronic kidney disease (CKD) or in an interventional study. The purpose of this study was to evaluate the usefulness of estimating USE in a prospective low-salt diet education cohort (ESPECIAL). METHODS: A new formula was developed on the basis of morning fasting urine samples from 228 CKD patients in the ESPECIAL cohort. This formula was compared to the previous four formulas in the prediction of 24-hour USE after treatment with olmesartan and low-salt diet education. RESULTS: Most previously reported formulas had low predictability of the measured USE based on the ESPECIAL cohort. Only the Tanaka formula showed a small but significant bias (9.8 mEq/day, P < 0.05) with a low correlation (r = 0.34). In contrast, a new formula showed improved bias (−0.1 mEq/day) and correlation (r = 0.569) at baseline. This formula demonstrated no significant bias (−1.2 mEq/day) with the same correlation (r = 0.571) after 8 weeks of treatment with olmesartan. Intensive low-salt diet education elicited a significant decrease in the measured USE. However, none of the formulas predicted this change in the measured urine sodium after diet adjustment. CONCLUSION: We developed a more reliable formula for estimating the USE in CKD patients. Although estimating USE is applicable in an interventional study, it may be unsuitable for estimating the change of individual sodium intake in a low-salt intervention study.


Subject(s)
Bias , Cohort Studies , Diet , Diet, Sodium-Restricted , Education , Epidemiologic Studies , Fasting , Humans , Methods , Prospective Studies , Renal Insufficiency, Chronic , Sodium , Urine Specimen Collection
18.
Article in English | WPRIM | ID: wpr-717357

ABSTRACT

Early recognition and appropriate management of diabetic peripheral polyneuropathy (DPNP) is important. We evaluated the necessity of simple, non-invasive tests for DPNP detection in clinical practice. We enrolled 136 randomly-chosen patients with type 2 diabetes mellitus and examined them with the 10-g Semmes-Weinstein monofilament examination, the 128-Hz tuning-fork, ankle-reflex, and pinprick tests; the Total Symptom Score and the 15-item self-administered questionnaire of the Michigan Neuropathy Screening Instrument. Among 136 patients, 48 had subjective neuropathic symptoms and 88 did not. The abnormal-response rates varied depending on the methods used according to the presence of subjective neuropathic symptoms (18.8% vs. 5.7%, P < 0.05; 58.3% vs. 28.4%, P < 0.005; 81.3% vs. 54.5%, P < 0.005; 12.5% vs. 5.7%, P=0.195; 41.7% vs. 2.3%, P < 0.001; and 77.1% vs. 9.1%, P < 0.001; respectively). The largest abnormal response was derived by combining all methods. Moreover, these tests should be implemented more extensively in diabetic patients without neuropathic symptoms to detect DPNP early.


Subject(s)
Diabetes Mellitus , Diabetes Mellitus, Type 2 , Diabetic Neuropathies , Diagnosis , Humans , Mass Screening , Michigan , Neurologic Examination , Peripheral Nervous System Diseases , Polyneuropathies , Surveys and Questionnaires
19.
Article in English | WPRIM | ID: wpr-719121

ABSTRACT

BACKGROUND: Epidemiological studies have suggested an association between Hashimoto thyroiditis (HT) and papillary thyroid cancer (PTC) development. Other studies, however, have reported a protective role of HT against PTC progression. Through this updated meta-analysis, we aimed to clarify the effects of HT on the progression of PTC. METHODS: We searched citation databases, including PubMed and Embase, for relevant studies from inception to September 2017. From these studies, we calculated the pooled odds ratios (ORs) of clinicopathologic features and the relative risk (RR) of PTC recurrence with 95% confidence intervals (CIs) using the Mantel-Haenszel method. Additionally, the Higgins I 2 statistic was used to test for heterogeneity. RESULTS: The meta-analysis included 71 published studies with 44,034 participants, among whom 11,132 had HT. We observed negative associations between PTC with comorbid HT and extrathyroidal extension (OR, 0.74; 95% CI, 0.68 to 0.81), lymph node metastasis (OR, 0.82; 95% CI, 0.72 to 0.94), distant metastasis (OR, 0.49; 95% CI, 0.32 to 0.76), and recurrence (RR, 0.50; 95% CI, 0.41 to 0.61). CONCLUSION: In this meta-analysis, PTC patients with HT appeared to exhibit more favorable clinicopathologic characteristics and a better prognosis than those without HT.


Subject(s)
Epidemiologic Studies , Hashimoto Disease , Humans , Lymph Nodes , Methods , Neoplasm Metastasis , Odds Ratio , Population Characteristics , Prognosis , Recurrence , Thyroid Gland , Thyroid Neoplasms
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