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OBJECTIVE: To investigate the influence of patients' genetic and clinical parameters on tacrolimus dosage and concentration after lung transplantation. METHODS: A total of 50 patients who had received lung transplantation in our hospital from April 2017 to August 2018 were enrolled in this study. Information was collected 1 year after transplantation. Tacrolimus concentration was determined by chemiluminescent microparticle immunoassay (CMIA) and CYP3A5 genotype was detected by Sanger sequencing. Body weight adjusted dosage (D) and dosage adjusted concentration (C/D) were calculated. Influence of CYP3A5 genotype on D and C/D were analyzed. Multiple linear regression was performed to determine influential factors on tacrolimus dosage 1 year after lung transplantation. RESULTS: While maintaining tacrolimus concentration within therapeutic range, dosage requirement for CYP3A5*1/*1 and *1/*3 patients was higher than that of *3/*3 patients and C/D value was lower than that of *3/*3 patients (P<0.05). Multivariable linear regression results showed that CYP3A5 genotype, hemoglobin and age had significant influence on tacrolimus D, among which hemoglobin and age showed negative correlation (P<0.05). Prediction equation for tacrolimus D was obtained by multivariable linear regression. The correlation coefficient between predicted dose and actual dose was 0.824 (95% CI: 0.705-0.893). CONCLUSION: Tacrolimus dosage after lung transplantation is influenced by CYP3A5 genotype, hemoglobin and age. Using these factors for tacrolimus dosage prediction could possibly be instructive for individualized use of tacrolimus.
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Objective To collect the laboratory parameters and clinical parameters of blood culture positive samples,and analyze the composition and laboratory characteristics of real pathogens by combining with clinical follow-up and anti-infectious treatment outcomes.Methods We conducted a prospective study to isolate the 483 strains of pathogens from 4313 cases of blood samples for clinical examination between March 2013 and March 2015.The results of laboratory and clinical infections were collected for each positive culture and were followed up for clinical follow-up to understand the responsible doctors' experience-based judgment and targeted clinical treatment of antibiotics.After comprehensive analysis we determined the real pathogens and contaminants.Results Of the 483 positive cultures,331 were finally determined as pathogenic ones,accounting for 68.5% of the number of positive isolates; 97 were contaminated bacteria (20.1%); and 55 strains with uncertain pathogenic nature (11.4%).Escherichia coli accounted for the highest proportion (41.2%)of pathogenic bacteria.Coagulase-negative staphylococci took up the highest proportion (75.3%)of the contaminated bacteria.As many as 253 strains (52.4%)were detected from the aerobic or anaerobic bottles.The detection rate of Escherichia coli in anaerobic bottles (23.9%)was higher than that in aerobic bottles (13.8%)(P <0.05).Of 97 strains of positive isolates,only one bottle was reported positive for 90 strains,accounting for (92.8%),and more than two bottles of 7 positive strains,accounting for (7.2%)(P <0.05).34 positive in 24 h (35.1%),77 positive in 48 h (79.4%),the positivebacteria ratio within 48 h (79.4%)was higher than that of bacteria contamination ratio within 24 h (χ2 =38.935, P =0.000),with a significant difference.Conclusion Establishment of contaminated bacteria in blood culture cannot rely solely on laboratory or clinical parameters.It should be combined with the experience of clinicians to determine the clinical response to comprehensive judgments.For the laboratory to determine the presence of contamination,the number of positive bottles and the amount of sun are still two factors of important value.Paying attention to inspection of anaerobic bottles is more conducive to the detection of Escherichia coli.
ABSTRACT
Objective To collect the laboratory parameters and clinical parameters of blood culture positive samples,and analyze the composition and laboratory characteristics of real pathogens by combining with clinical follow-up and anti-infectious treatment outcomes.Methods We conducted a prospective study to isolate the 483 strains of pathogens from 4313 cases of blood samples for clinical examination between March 2013 and March 2015.The results of laboratory and clinical infections were collected for each positive culture and were followed up for clinical follow-up to understand the responsible doctors' experience-based judgment and targeted clinical treatment of antibiotics.After comprehensive analysis we determined the real pathogens and contaminants.Results Of the 483 positive cultures,331 were finally determined as pathogenic ones,accounting for 68.5% of the number of positive isolates; 97 were contaminated bacteria (20.1%); and 55 strains with uncertain pathogenic nature (11.4%).Escherichia coli accounted for the highest proportion (41.2%)of pathogenic bacteria.Coagulase-negative staphylococci took up the highest proportion (75.3%)of the contaminated bacteria.As many as 253 strains (52.4%)were detected from the aerobic or anaerobic bottles.The detection rate of Escherichia coli in anaerobic bottles (23.9%)was higher than that in aerobic bottles (13.8%)(P <0.05).Of 97 strains of positive isolates,only one bottle was reported positive for 90 strains,accounting for (92.8%),and more than two bottles of 7 positive strains,accounting for (7.2%)(P <0.05).34 positive in 24 h (35.1%),77 positive in 48 h (79.4%),the positivebacteria ratio within 48 h (79.4%)was higher than that of bacteria contamination ratio within 24 h (χ2 =38.935, P =0.000),with a significant difference.Conclusion Establishment of contaminated bacteria in blood culture cannot rely solely on laboratory or clinical parameters.It should be combined with the experience of clinicians to determine the clinical response to comprehensive judgments.For the laboratory to determine the presence of contamination,the number of positive bottles and the amount of sun are still two factors of important value.Paying attention to inspection of anaerobic bottles is more conducive to the detection of Escherichia coli.
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BACKGROUND: DuaLight(TM) is a recently developed phototherapeutic device that is used for targeted phototherapy. However, the efficacy of DuaLight(TM) therapy for vitiligo has not been evaluated nor has it been reported on in the Korean medical literature. OBJECTIVE: This study was conducted to evaluate the efficacy of DuaLight(TM) therapy for treating localized vitiligo and we wanted to determine the clinical parameters that could affect the therapeutic outcome. METHODS: Eighty-three lesions from thirty-eight patients were treated by using DuaLight(TM) once or twice a week. The repigmentation grade of each treated lesion was evaluated on a 5-point scale from 0 (no repigmentation), 1 (1~24%), 2 (25~49%), 3 (50~74%), to 4 (75~100%). Results: Thirty-four lesions of the 83 lesions (40.9%) improved to 50% repigmentation after DuaLight(TM) therapy. The clinical parameters that affected the therapeutic outcome were the lesions' anatomical location and the clinical subtype of vitiligo. Yet a history of previous treatment and the skin type did not affect the therapeutic result. Perilesional hyperpigmentation (47.4%) was the most common side effect, but the other adverse effects were limited and transient. CONCLUSION: DuaLight(TM) therapy is an effective, safe therapeutic modality for localized vitiligo. However, similar to other non-surgical therapeutic modalities, the therapeutic outcome is mainly dependent on the anatomical location.
Subject(s)
Humans , Hyperpigmentation , Phototherapy , Skin , VitiligoABSTRACT
BACKGROUND: DuaLight(TM) is a recently developed phototherapeutic device that is used for targeted phototherapy. However, the efficacy of DuaLight(TM) therapy for vitiligo has not been evaluated nor has it been reported on in the Korean medical literature. OBJECTIVE: This study was conducted to evaluate the efficacy of DuaLight(TM) therapy for treating localized vitiligo and we wanted to determine the clinical parameters that could affect the therapeutic outcome. METHODS: Eighty-three lesions from thirty-eight patients were treated by using DuaLight(TM) once or twice a week. The repigmentation grade of each treated lesion was evaluated on a 5-point scale from 0 (no repigmentation), 1 (1~24%), 2 (25~49%), 3 (50~74%), to 4 (75~100%). Results: Thirty-four lesions of the 83 lesions (40.9%) improved to 50% repigmentation after DuaLight(TM) therapy. The clinical parameters that affected the therapeutic outcome were the lesions' anatomical location and the clinical subtype of vitiligo. Yet a history of previous treatment and the skin type did not affect the therapeutic result. Perilesional hyperpigmentation (47.4%) was the most common side effect, but the other adverse effects were limited and transient. CONCLUSION: DuaLight(TM) therapy is an effective, safe therapeutic modality for localized vitiligo. However, similar to other non-surgical therapeutic modalities, the therapeutic outcome is mainly dependent on the anatomical location.
Subject(s)
Humans , Hyperpigmentation , Phototherapy , Skin , VitiligoABSTRACT
Objective To evaluate the influence of endoscopic sinus surgery on olfactory disorder caused by chronic sinusitis and nasal polyps by testing the olfactory function of fifty-two patients with chronic sinusitis and nasal polyps before and after endoscopic sinus surgery and then confirming the olfactory rehabilitation of the patients.Methods The olfactory function of the fifty-two patients with chronic sinusitis and nasal polyps was tested through the CCCRC olfactory testing method pre-operation and four weeks,twelve weeks,twenty-four weeks post-operation.The results were analyzed by matched t-test.Results All results of olfactory function after treatment were significantly better than that of pre-operation(P0.05).Conclusion Olfactory function of above patients was significantly improved within the first month post-operation.There was no further improvement in the following five months compared with the first month post-operation.
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OBJECTIVES: Sleep disturbances are very common in hemodialysis (HD) patients with chronic renal failure (CRF). This study aimed to examine the characteristics of sleep disturbances, and to illustrate the relationship of sleep parameters with clinical parameters reflecting metabolic dysfunction in HD patients with CRF. METHODS: The Epworth Sleepiness Scale (ESS) and Sleep Disorders Questionnaire (SDQ) were administered in 26 HD patients with CRF. For fifteen patients with the risk of sleep disorder, nocturnal polysomnographic study (NPSG) and blood sampling were done. RESULTS: Among 15 patients, 14 patients (93%) were diagnosed as sleep disorders, sleep breathing disorder or periodic limb movements in sleep. Uric acid (UA) was positively correlated with sleep efficiency (r=0.571), and negatively correlated with waking after sleep onset, the amount of stage 1 sleep, and respiratory disturbance index (r=-0.515, -0.564, -0.646). Interleukin-6 was positively correlated with obstructive apnea index (r=0.661). CONCLUSION: In our study, the difficulty in maintaining sleep was found in HD patients with CRF. It also showed that increased UA was associated with improved sleep maintenance and decreased breathing disturbance during sleep. This might be related with antioxidant effect of UA in CRF. Further studies on total CRF patients including those without the risk of sleep disorder are necessary.
Subject(s)
Humans , Antioxidants , Apnea , Extremities , Interleukin-6 , Kidney Failure, Chronic , Surveys and Questionnaires , Renal Dialysis , Respiration , Sleep Wake Disorders , Uric AcidABSTRACT
PURPOSE: We performed this study to elucidate whether patient`s satisfaction and improvement of clinical parameters after transurethral resection of prostate(TURP) correlate with the degree of preoperative obstruction. We investigated the role of urodynamic studies as a predictor of outcome after TURP. MATERIALS AND METHODS: Parameters including pre-operative symptom scores(IPSS), uroflow rate, prostate volume and urodynamic studies, were assessed in 27 patients undergoing TURP due to BPH. Bladder outlet obstruction was assessed by pressure-flow study(PFS). Post-operative evaluation was performed with IPSS and uroflowmetry 3 months after surgery. Post-operative patient`s satisfaction was determined by subjective responses to the questionnaires. The subjective responses, clinical and urodynamic parameters were compared and statistically analyzed. RESULTS: Eighteen patients(67%) had preoperative bladder outlet obstruction(BOO; defined as L-PURR> or =3), while 14(52%) demonstrated associated detrusor instability(DI). Significant improvements in IPSS, quality of life, peak flow rate and residual urine were noted in all patients post-operatively(p or =3) and 91%(L-PURR<3). CONCLUSIONS: No differences in the improvements of clinical parameters except voiding symptom scores were noted between obstructive and non-obstructive BPH. However, patient`s satisfaction after surgery was higher for patients in whom preoperative pressure-flow study confirmed obstruction. Also, obstructive parameters such as L-PURR or URA may be useful in predicting postoperative results.