Concurrent occurrence of adenocarcinoma and neuroendocrine type small cell carcinoma in the ampulla of Vater / 대한내과학회지

Small cell carcinoma in the ampulla of Vater is rare, and the concurrent occurrence of adenocarcinoma and small cell carcinoma is extremely rare. We report the case of a double primary tumor, adenocarcinoma and small cell carcinoma, in the ampulla of Vater.

The Reliability and the Validity of Health Related QOL Measurement Method in Hemodialysis Patients / 대한신장학회지

PURPOSE: It is necessary to confirm of the reliability and the validity of health-related quality of life (HRQOL) methods, because there could be some difference according to the underlying diseases, languages and cultures. METHODS: To assess the reliability, we did the test-retest by using the WHO-QOL (Korean version) and the SF-36 (Korean version) in the maintain hemodialysis (HD) patients (N=57). And then, we measured the Cronbach coefficient in the domains of both HRQOL methods. To assess the validity, we compared the result of both HRQOL methods in HD group with control group (N=60). We analyzed the inter-relationship of the domains which keep identical meanings in both methods. RESULT: 1. The test-retest showed high correlation between two tests, except the two domains of SF- 36 which are the role limitation-physical activity (RP) domain and the role limitation-emotion (RE) domain. The Cronbach coefficients are range of 0.749-0.862 in the WHO-QOL, and 0.666-0.944 in the SF-36 (p<0.05). 2. We found that HRQOL of HD group was lower than that of control group except in the RP domain and the RE domain of SF-36. And there was the highest correlation between the domains which keep identical meaning of both HRQOL methods. CONCLUSION: The Korean WHO-QOL and SF-36 are reliable and valid to measure the QOL of ESRD patients except in the RP domain and the RE domain of SF-36. We expect these methods will be used easily in the evaluation of the HRQOL in HD patients.

The Association of KLOTHO Gene Polymorphism with Serum Osteoprotegerin Levels in Maintenance Hemodialysis Patients / 대한신장학회지

PURPOSE: Klotho mutant mice showed abnormal calcium and vitamin D metabolism, hyperphosphatemia and vascular calcification. We observed the frequencies of klotho gene polymorphism and investigated their relation with some clinical parameters including serum osteoprotegerin (OPG) levels in maintenance hemodialysis (HD) patients. METHODS: Total 88 patients (mean age 58+/-13 years, male:female=47:41) on maintenance HD were enrolled. The genotypings for G-395A in promoter and C1818T in exon 4 of klotho gene were performed with real-time polymerase chain reaction. We measured blood pressure, body mass index (BMI), and serum calcium, phosphorus, parathyroid hormone (PTH), alkaline phosphatase, hs-CRP, lipid profiles and OPG. RESULTS: In G-395A in promoter, the distribution of genotypes was GG 66% (n=58), GA 23% (n=20) and AA 11% (n=10), respectively and the allele frequencies were 0.773 for G allele and 0.227 for A allele. In C1818T in exon 4, the distribution of genotypes was CC 63% (n=55), CT 30% (n=26), and TT 7% (n=7), and the frequencies were 0.773 for C allele and 0.227 for T allele. G-395A shows correlations with BMI and HDL-cholesterol (p<0.005). G-395A and C1818T in klotho gene show no statistical correlation with other clinical parameters of vascular calcification including OPG. CONCLUSION: Klotho G-395A and C1818T polymorphisms are not correlated with OPG in maintenance HD patients. Further research needs for the other klotho polymorphisms on chronic kidney disease and end-stage renal disease.