Clinical characteristics and risk factors of renal function deterioration in children with renal dysplasia complicated with chronic kidney disease / 现代泌尿外科杂志

【Objective】 To explore the clinical characteristics and risk factors of renal function deterioration in children with renal dysplasia and chronic kidney disease (CKD), so as to provide a basis for the diagnosis, treatment, and management. 【Methods】 The clinical data of children with renal dysplasia complicated with CKD treated in the Children’s Hospital of Chongqing Medical University during 2012 and 2022 were retrospectively analyzed, including the gender, age of diagnosis, growth index, concomitant malformation and complications. According to the diagnostic criteria and staging standard of KDIGO2020 guidelines, patients with disease deteriorated to CKD stage 4-5 were enrolled into the regression group. Factors affecting the deterioration of renal function were determined with Cox regression analysis. 【Results】 A total of 122 children were involved, including 66 (54.1%) with CKD stag 4-5. There were more boys than girls. Bilateral and unilateral renal dysplasia occurred in 88 (72.13%) and 34 (27.87%) cases, respectively, and 64 (52.46%) cases were complicated with other urinary diseases. There were significant differences in weight, height and body mass index (BMI) among patients with CKD stage 1-5 (P<0.01). The age of onset of CKD <10 years, BMI lower than the 3rd percentile of the same sex and age, bilateral renal dysplasia, and one or more complications of congenital renal and urinary tract abnormalities (CAKUT) were the risk factors of deterioration of renal function (P<0.05). 【Conclusion】 Renal dysplasia complicated with CKD are more common in boys, with high incidence of bilateral renal dysplasia. Bilateral renal dysplasia, age of onset of CKD <10 years, BMI lower than 3% and complications are important influencing factors of renal dysplasia in children with CKD.

Spinal Subdural Hematoma Following Cranial Subdural Hematoma : A Case Report with a Literature Review

Coexistence of cranial and spinal subdural hematomas is rare and only a few cases have been reported in the literature. Herein, we report a case of cranial and spinal subdural hematomas after previous head trauma. As the pathogenesis of simultaneous intracranial and spinal subdural hematoma yet remains unclear, we developed an alternative theory to those proposed in the literature for their coexistence, the migration of blood through the subdural space.

Two patients with acute myocardial infarction presenting with simultaneous acute ischemic stroke / 대한내과학회지

Myocardial infarction (MI) and stroke often share the same risk factors and pathogenic mechanism. Sometimes they can occur in the same patient proximately, occurring days or weeks apart. However, the simultaneous occurrence of MI and stroke is rare and presents a diagnostic and therapeutic challenge. Specifically, an acute stroke can alter typical features of MI. Thus, recognition of the coexistence of these two events requires a high threshold of suspicion. The authors describe two patients who presented with simultaneous stroke and MI development. The two events developed on the same day in both patients. The second patient did not have chest pain, whereas chest symptoms could not be assessed in the first patient secondary to altered mental status. After the diagnoses were made using clinical and laboratory findings, urgent percutaneous coronary intervention was performed in both patients.

The Studies on the Concomitant Diseases and Combined Medication in Patients with Onychomycosis / 대한의진균학회지

OBJECTIVE: We performed this survey to provide the information about how many patients with onychomycosis have concomitant diseases and combined medication and to gauge about the drug interaction risk of antifungal agent. METHOD: The findings presented in this report are based on total 569 onychomycosis patients, with KOH positive, who visited 6 university hospitals from February 2007 to March 2007. RESULT: The patients with onychomycosis had concomitant diseases (43.1%) and used combination medication (36.4%). The majority of the patient have concomitant diseases, such as hypertension (12.2%), diabetic melitus (9.5%) and hyperlipidemia (4.1%), more frequent in elderly patients. Main factor to choose antifungal agent for the cure of onychomycosis is the efficacy of the medication (55%), as well as, the safety and drug interaction risk of antifungal agent, more important in case of the patient taking a variety of concomitant drugs. CONCLUSION: It is concluded that physicians should be aware of the potential interaction of the medications in order to prevent or reduce the burden of adverse events. It is required to have more cautious choice of oral antifungal agent in those patients who are taking combined medications in patients with onycomycosis.

Changes of several sero-enzyme activities in patients with chronic cor pulmonale / 中国医师进修杂志

Objective To explore the changes of several sero-enzyme activity including lactate dehydrogenase (LDH),aspartate aminotransferase(AST),alanine aminotransferase (ALT),creeatine phosphatase kinase (CPK) and its isoenzyme (CK-MB),?-hdroxybutyrate dehydrogenase (HBDH) in patients with chronic cor disease and its clinical significance. Methods The sera LDH,AST,ALT,CPK,CPK-MB and HBDH from 15 healthy controls and 61 patients with chronic cor disease were examined before and after treatment.CPK-MB/CPK and HBDH/LDH were calculated and simultaneously the blood gas analysis was performed. Results In experimental group all the sera enzymes contents before treatment were significantly higher than those after treatment (P