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Objective@#Cyber addiction, which is more vulnerable in adolescents, is defined as the excessive use of computers and the Internet that causes serious psychological, social, and physical problems. In this study, we investigated the resting-state functional connectivity (rsFC) in adolescents with cyber addiction. @*Methods@#We collected and analyzed resting-state functional neuroimaging data of 20 patients with cyber addiction, aged 13−18 years, and 27 healthy controls. Based on previous studies, the seed regions included the dorsolateral prefrontal cortex, medial orbitofrontal cortex, lateral orbitofrontal cortex, dorsal anterior cingulate cortex, insula, hippocampus, amygdala, nucleus accumbens, and the ventral tegmental area. Seed-to-voxel analyses were performed to investigate the differences between patients and healthy controls. A correlation analysis between rsFC and cyber addiction severity was also performed. @*Results@#Patients with cyber addiction showed the following characteristics: increased positive rsFC between the left insular−right middle temporal gyrus; increased positive rsFC between the right hippocampus−right precentral gyrus;increased positive rsFC between the right amygdala−right precentral gyrus and right parietal operculum cortex; increased negative rsFC between the left nucleus accumbens−right cerebellum crus II and right cerebellum VI. @*Conclusion@#Adolescents with cyber addiction show altered functional connectivity during the resting state. The findings of this study may help us better understand the neuropathology of cyber addiction in adolescents.
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Bile pigment, bilirubin, and biliverdin concentrations may change as a results of biliary tract cancer (BTC) altering the mechanisms of radical oxidation and heme breakdown. We explored whether changes in bile pigment components could help distinguish BTC from benign biliary illness by evaluating alterations in patients with BTC. We collected bile fluid from 15 patients with a common bile duct stone (CBD group) and 63 individuals with BTC (BTC group). We examined the bile fluid’s bilirubin, biliverdin reductase (BVR), heme oxygenase (HO-1), and bacterial taxonomic abundance. Serum bilirubin levels had no impact on the amounts of bile HO-1, BVR, or bilirubin. In comparison to the control group, the BTC group had considerably higher amounts of HO-1, BVR, and bilirubin in the bile. The areas under the curve for the receiver operating characteristic curve analyses of the BVR and HO-1 were 0.832 (p<0.001) and 0.891 (p<0.001), respectively. Firmicutes was the most prevalent phylum in both CBD and BTC, according to a taxonomic abundance analysis, however the Firmicutes/Bacteroidetes ratio was substantially greater in the BTC group than in the CBD group. The findings of this study showed that, regardless of the existence of obstructive jaundice, biliary carcinogenesis impacts heme degradation and bile pigmentation, and that the bile pigment components HO-1, BVR, and bilirubin in bile fluid have a diagnostic significance in BTC. In tissue biopsies for the diagnosis of BTC, particularly for distinguishing BTC from benign biliary strictures, bile pigment components can be used as additional biomarkers.
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Purpose@#In this pilot study, using next-generation sequencing and integrated messenger RNA (mRNA) sequencing, we investigated circulating microRNA (miRNA) expression profiling from bile-derived exosomes to identify dysregulated miRNA signatures and oncogenic pathways and determine their effects on targeted mRNAs in cholangiocarcinoma (CCA).Moreover, we explored the possibility that genetic analysis using bile-derived exosomes may replace gene analysis using tissue. @*Methods@#Bile was collected from a patient with perihilar CCA before curative resection. As a control, bile was collected from a patient with a common bile duct stone. Exosomes were isolated from the bile, and we performed next-generation miRNA sequencing using isolated exosomes. To evaluate miRNA-mRNA interactions, mRNA sequencing was performed using bile fluid in both patients. @*Results@#We identified 22 differentially expressed miRNAs. More than 65% of the predicted mRNA targets of those miRNAs were actually differentially expressed between control and CCA bile samples. In functional pathway analysis, targets of 22 miRNAs were primarily enriched in mitogen-activated protein kinase, platelet derived growth factor, vascular endothelial growth factor, epidermal growth factor receptor, and p53 signaling. In particular, in the functional assessment of miRNAmRNA interactions, RAS pathways, including downstream pathways (PI3K-AKT-mTOR and RAS-RAF-MEK-ERK), were determined to be enriched. @*Conclusion@#Circulating miRNAs in bile-derived exosomes provide new information for the development of miRNA analysis in CCA. These miRNAs may represent the oncogenic characteristics of CCA tissue, enabling them to be used instead of tissue samples for the diagnosis of CCA. Further research investigating circulating miRNAs in bile exosomes may lead to more rational, targeted approaches to treatment.
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Purpose@#In this pilot study, using next-generation sequencing and integrated messenger RNA (mRNA) sequencing, we investigated circulating microRNA (miRNA) expression profiling from bile-derived exosomes to identify dysregulated miRNA signatures and oncogenic pathways and determine their effects on targeted mRNAs in cholangiocarcinoma (CCA).Moreover, we explored the possibility that genetic analysis using bile-derived exosomes may replace gene analysis using tissue. @*Methods@#Bile was collected from a patient with perihilar CCA before curative resection. As a control, bile was collected from a patient with a common bile duct stone. Exosomes were isolated from the bile, and we performed next-generation miRNA sequencing using isolated exosomes. To evaluate miRNA-mRNA interactions, mRNA sequencing was performed using bile fluid in both patients. @*Results@#We identified 22 differentially expressed miRNAs. More than 65% of the predicted mRNA targets of those miRNAs were actually differentially expressed between control and CCA bile samples. In functional pathway analysis, targets of 22 miRNAs were primarily enriched in mitogen-activated protein kinase, platelet derived growth factor, vascular endothelial growth factor, epidermal growth factor receptor, and p53 signaling. In particular, in the functional assessment of miRNAmRNA interactions, RAS pathways, including downstream pathways (PI3K-AKT-mTOR and RAS-RAF-MEK-ERK), were determined to be enriched. @*Conclusion@#Circulating miRNAs in bile-derived exosomes provide new information for the development of miRNA analysis in CCA. These miRNAs may represent the oncogenic characteristics of CCA tissue, enabling them to be used instead of tissue samples for the diagnosis of CCA. Further research investigating circulating miRNAs in bile exosomes may lead to more rational, targeted approaches to treatment.
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Purpose@#To assess patient radiation doses during diagnostic and therapeutic neurointerventional procedures from multiple centers and propose dose reference level (RL). @*Materials and Methods@#Consecutive neurointerventional procedures, performed in 22 hospitals from December 2020 to June 2021, were retrospectively studied. We collected data from a sample of 429 diagnostic and 731 therapeutic procedures. Parameters including dose-area product (DAP), cumulative air kerma (CAK), fluoroscopic time (FT), and total number of image frames (NI) were obtained. RL were calculated as the 3rd quartiles of the distribution. @*Results@#Analysis of 1160 procedures from 22 hospitals confirmed the large variability in patient dose for similar procedures. RLs in terms of DAP, CAK, FT, and NI were 101.6 Gy·cm2, 711.3 mGy, 13.3 minutes, and 637 frames for cerebral angiography, 199.9 Gy·cm2, 3,458.7 mGy, 57.3 minutes, and 1,000 frames for aneurysm coiling, 225.1 Gy·cm2, 1,590 mGy, 44.7 minutes, and 800 frames for stroke thrombolysis, 412.3 Gy·cm2, 4,447.8 mGy, 99.3 minutes, and 1,621.3 frames for arteriovenous malformation (AVM) embolization, respectively. For all procedures, the results were comparable to most of those already published. Statistical analysis showed male and presence of procedural complications were significant factors in aneurysmal coiling. Male, number of passages, and procedural combined technique were significant factors in stroke thrombolysis. In AVM embolization, a significantly higher radiation dose was found in the definitive endovascular cure group. @*Conclusion@#Various RLs introduced in this study promote the optimization of patient doses in diagnostic and therapeutic interventional neuroradiology procedures. Proposed 3rd quartile DAP (Gy·cm2) values were 101.6 for diagnostic cerebral angiography, 199.9 for aneurysm coiling, 225.1 for stroke thrombolysis, and 412.3 for AVM embolization. Continual evolution of practices and technologies requires regular updates of RLs.
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Objective@#: Given the high risk of rebleeding and recurrence of blood blister-like aneurysms (BBAs), we treated ruptured BBAs of the internal carotid artery (ICA) with stent-assisted coil embolization (SAC). This study aimed to evaluate the efficacy and safety of SACs. @*Methods@#: We retrospectively reviewed clinical and radiological data from eight patients with ruptured BBAs of the supraclinoid ICA. The modified Rankin Scale (mRS) was used to assess clinical outcomes, while radiological outcomes were evaluated on angiographs. For a pooled analysis, data from literature reporting the outcomes of ruptured BBAs treated with SAC were collected and analyzed in conjunction with our data. @*Results@#: In our cohort, the mean Raymond classification score was 1.57±0.53 immediately after initial endovascular treatment. There were no perioperative complications or rebleeding events during the follow-up period. The mean mRS score at patient discharge was 1.00±0.81 and improved to 0.28±0.48 by the last follow-up day. The recurrence rate was 25% with an asymptomatic presentation and successful treatment with multiple stent insertion. Pooled analysis of 76 cases of SAC revealed a complete occlusion rate immediately after treatment of 54.8%, rebleeding rate 7.94%, and recurrence rate 24.2%. Good clinical outcomes with mRS score 0–2 were observed in 89.9% by the last clinical follow-up. Total mortality rate was 7.7%. @*Conclusion@#: This treatment appears to not only minimize the hemodynamic burden on the fragile dome specific to this type of aneurysm, but also provides an opportunity for safe and effective treatment in recurrent cases.
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Background@#Aquaporin 1 (AQP1) is a transmembrane channel protein that allows rapid transposition of water and gases, in recent discoveries of AQP1 function involve cell proliferation, differentiation, wound healing, inflammation and infection in different cell types, suggesting that AQP1 plays key roles in diverse biologic process. Until now, less is known about the function of AQP1 on ultraviolet radiation induced photoaged skin. @*Objective@#In this study we set out to examine whether AQP1 expression may be influenced by repeated irradiation of ultraviolet B (UVB) in cultured dermal fibroblasts. @*Methods@#To elucidate the function of AQP1 in skin photoaging, human dermal fibroblasts (HS68) were irradiated by a series of 4 sub-cytotoxic doses of UVB which are known as UV-induced cell premature senescence model. Reverse transcription polymerase chain reaction and Western blotting were conducted to detect AQP1 expression from different groups. Then, cells were transfected with AQP1-targeting small interfering RNA. The activities of signaling proteins upon UVB irradiation were investigated to determine which pathways are involved in AQP1 expression. @*Results@#AQP1 expression was increased by 100 mJ/cm2 of UVB irradiation, but decreased by 200 mJ/cm2. Depletion of the AQP1 increased the apoptotic sensitivity of cells to UVB, as judged by upregulation of the p53, p21, poly (adenosine diphosphate [ADP]-ribose) polymerase and Bax together with the increased Bax/Bcl2 ratio. UVB induced downregulation of AQP1 was significantly attenuated by pretreatment with the MEK/ERK inhibitor (PD98059). @*Conclusion@#We concluded that AQP1 expression was down-regulated by repeated exposure of UVB via MEK/ERK activation pathways. The AQP1 reduction by UVB lead to changes of physiological functions in dermal fibroblasts, which might be associated with the occurrence and development of UVB induced photoaging.
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BACKGROUND: In the life cycle, bone mineral density (BMD) is the most optimal condition in the 20s. In Korea, vitamin D deficiency status is very serious in Korean women due to recent lack of activity, weight polarization, and inadequate nutritional intake. The purpose of this study was to compare serum vitamin D and BMD according to obesity status in Korean young adult women. METHODS: A total of 143 female college students participated in the research. Body fat and lean body status were analyzed using a body composition analyzer. Nutrient intakes of the subjects were assessed by 3-days food record method. The BMDs was measured by dual energy X-ray absorptiometry. The subjects were divided into normal weight group and obesity group on their body mass index. RESULTS: Obesity group showed significantly higher weight, body fat (%), and body fat (kg) than normal weight group and T-scores of lumbar-2 spines were significantly lower. Obesity group showed high triglyceride and low-density lipoprotein cholesterol levels and vitamin D levels were significantly lower. Physical fitness and activity status showed that sit and reach and sit up were significantly lower in obesity group. The intake of carbohydrates was higher in the obesity group than in the normal weight group, and the intake of vitamin C and vitamin D was significantly lower. Factors affecting serum vitamin D were analyzed as body fat (%), lumbar-2 T-score, triglyceride, and carbohydrate intake. CONCLUSIONS: Obese women need more effort to manage their serum vitamin D status and balanced nutrition to prevent bone loss.
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Femenino , Humanos , Adulto Joven , Absorciometría de Fotón , Tejido Adiposo , Ácido Ascórbico , Composición Corporal , Índice de Masa Corporal , Peso Corporal , Densidad Ósea , Carbohidratos , Colesterol , Corea (Geográfico) , Estadios del Ciclo de Vida , Lipoproteínas , Métodos , Estado Nutricional , Obesidad , Aptitud Física , Columna Vertebral , Triglicéridos , Deficiencia de Vitamina D , Vitamina D , VitaminasRESUMEN
No abstract available.
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Colágeno , Fibroblastos , Expresión Génica , Proteínas Quinasas p38 Activadas por MitógenosRESUMEN
OBJECTIVES@#The combined effects of obesity and appendicular skeletal muscle (ASM) on atherosclerosis, especially in middle-aged populations, remain poorly understood. This cross-sectional study investigated the effects of ASM on carotid intima-media thickness (IMT) according to body mass index (BMI) in middle-aged Korean adults.@*METHODS@#Herein, 595 men and 1,274 women aged 30–64 years completed questionnaires and underwent health examinations as part of the Cardiovascular and Metabolic Disease Etiology Research Center cohort. ASM was measured via bioelectrical impedance analysis and adjusted for weight (ASM/Wt). IMT was assessed using B-mode ultrasonography; highest quartile of IMT was defined as gender-specific top quartile of the IMT values. Higher BMIs was defined as a BMI over 25.0 kg/m2.@*RESULTS@#Compared to the highest ASM/Wt quartile, the lowest ASM/Wt quartile was significantly associated with highest quartile of IMT in men with lower BMIs (adjusted odds ratio [aOR], 2.78; 95% confidence interval [CI], 1.09 to 7.13), but not in those with higher BMIs (aOR, 0.59; 95% CI, 0.24 to 1.91). In women, there was no significant association of low skeletal muscle mass with highest quartile of IMT, regardless of BMI.@*CONCLUSION@#Low appendicular skeletal muscle mass is associated with carotid arterial wall thickening in men with lower BMIs, but not in men with higher BMIs. Our findings suggest that the risk of atherosclerosis may be low in middle-aged Korean men with appropriate body weight and skeletal muscle mass maintenance.
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OBJECTIVES: The combined effects of obesity and appendicular skeletal muscle (ASM) on atherosclerosis, especially in middle-aged populations, remain poorly understood. This cross-sectional study investigated the effects of ASM on carotid intima-media thickness (IMT) according to body mass index (BMI) in middle-aged Korean adults. METHODS: Herein, 595 men and 1,274 women aged 30–64 years completed questionnaires and underwent health examinations as part of the Cardiovascular and Metabolic Disease Etiology Research Center cohort. ASM was measured via bioelectrical impedance analysis and adjusted for weight (ASM/Wt). IMT was assessed using B-mode ultrasonography; highest quartile of IMT was defined as gender-specific top quartile of the IMT values. Higher BMIs was defined as a BMI over 25.0 kg/m2. RESULTS: Compared to the highest ASM/Wt quartile, the lowest ASM/Wt quartile was significantly associated with highest quartile of IMT in men with lower BMIs (adjusted odds ratio [aOR], 2.78; 95% confidence interval [CI], 1.09 to 7.13), but not in those with higher BMIs (aOR, 0.59; 95% CI, 0.24 to 1.91). In women, there was no significant association of low skeletal muscle mass with highest quartile of IMT, regardless of BMI. CONCLUSION: Low appendicular skeletal muscle mass is associated with carotid arterial wall thickening in men with lower BMIs, but not in men with higher BMIs. Our findings suggest that the risk of atherosclerosis may be low in middle-aged Korean men with appropriate body weight and skeletal muscle mass maintenance.
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Adulto , Femenino , Humanos , Masculino , Aterosclerosis , Composición Corporal , Índice de Masa Corporal , Peso Corporal , Grosor Intima-Media Carotídeo , Estudios de Cohortes , Estudios Transversales , Impedancia Eléctrica , Enfermedades Metabólicas , Músculo Esquelético , Músculos , Obesidad , Oportunidad Relativa , Sarcopenia , UltrasonografíaRESUMEN
OBJECTIVES: The combined effects of obesity and appendicular skeletal muscle (ASM) on atherosclerosis, especially in middle-aged populations, remain poorly understood. This cross-sectional study investigated the effects of ASM on carotid intima-media thickness (IMT) according to body mass index (BMI) in middle-aged Korean adults.METHODS: Herein, 595 men and 1,274 women aged 30–64 years completed questionnaires and underwent health examinations as part of the Cardiovascular and Metabolic Disease Etiology Research Center cohort. ASM was measured via bioelectrical impedance analysis and adjusted for weight (ASM/Wt). IMT was assessed using B-mode ultrasonography; highest quartile of IMT was defined as gender-specific top quartile of the IMT values. Higher BMIs was defined as a BMI over 25.0 kg/m2.RESULTS: Compared to the highest ASM/Wt quartile, the lowest ASM/Wt quartile was significantly associated with highest quartile of IMT in men with lower BMIs (adjusted odds ratio [aOR], 2.78; 95% confidence interval [CI], 1.09 to 7.13), but not in those with higher BMIs (aOR, 0.59; 95% CI, 0.24 to 1.91). In women, there was no significant association of low skeletal muscle mass with highest quartile of IMT, regardless of BMI.CONCLUSION: Low appendicular skeletal muscle mass is associated with carotid arterial wall thickening in men with lower BMIs, but not in men with higher BMIs. Our findings suggest that the risk of atherosclerosis may be low in middle-aged Korean men with appropriate body weight and skeletal muscle mass maintenance.
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Adulto , Femenino , Humanos , Masculino , Aterosclerosis , Composición Corporal , Índice de Masa Corporal , Peso Corporal , Grosor Intima-Media Carotídeo , Estudios de Cohortes , Estudios Transversales , Impedancia Eléctrica , Enfermedades Metabólicas , Músculo Esquelético , Músculos , Obesidad , Oportunidad Relativa , Sarcopenia , UltrasonografíaRESUMEN
PURPOSE: The purpose of this study was to investigate the accuracy and reliability of the semi-automated ultrasonographic volume measurement tool, virtual organ computer-aided analysis (VOCAL), for measuring the volume of parathyroid glands. METHODS: Volume measurements for 40 parathyroid glands were performed in patients with secondary hyperparathyroidism caused by chronic renal failure. The volume of the parathyroid glands was measured twice by experienced radiologists by two-dimensional (2D) and three-dimensional (3D) methods using conventional sonograms and the VOCAL with 30°angle increments before parathyroidectomy. The specimen volume was also measured postoperatively. Intraclass correlation coefficients (ICCs) and the absolute percentage error were used for estimating the reproducibility and accuracy of the two different methods. RESULTS: The ICC value between two measurements of the 2D method and the 3D method was 0.956 and 0.999, respectively. The mean absolute percentage error of the 2D method and the 3D VOCAL technique was 29.56% and 5.78%, respectively. For accuracy and reliability, the plots of the 3D method showed a more compact distribution than those of the 2D method on the Bland-Altman graph. CONCLUSION: The rotational VOCAL method for measuring the parathyroid gland is more accurate and reliable than the conventional 2D measurement. This VOCAL method could be used as a more reliable follow-up imaging modality in a patient with hyperparathyroidism.
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Humanos , Estudios de Seguimiento , Hiperparatiroidismo , Hiperparatiroidismo Secundario , Imagenología Tridimensional , Fallo Renal Crónico , Métodos , Tamaño de los Órganos , Glándulas Paratiroides , Paratiroidectomía , UltrasonografíaRESUMEN
No abstract available.
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Encéfalo , Infarto Cerebral , Hiperhomocisteinemia , Deficiencia de Vitamina B 12 , Vitamina B 12 , VitaminasRESUMEN
BACKGROUND/AIMS: Sleep duration affects health in various ways. The objective of this study was to investigate the associations of sleep duration with chronic kidney disease (CKD) in a Korean adult population. METHODS: This cross-sectional analysis was conducted for total of 1,360 participants who completed baseline health examinations for the Korean Genome and Epidemiology Study-Kangwha study in 2010 to 2011. Sleep habits were measured by an interviewer-assisted questionnaire. Sleep duration was calculated based on the number of hours per day participants had slept over the past 1 year. CKD was defined as either proteinuria or estimated glomerular filtration rate (eGFR) < 60 mL/min/1.73 m². Multiple logistic regression models were applied to examine associations between sleep duration and CKD. RESULTS: Women with very long sleep duration (≥ 9 hours/day) were at significantly increased odds for having high serum creatinine (odds ratio [OR], 2.936; 95% confidence interval [CI], 1.176 to 7.326), low eGFR (OR, 3.320; 95% CI, 1.372 to 8.034), and CKD (OR, 3.112; 95% CI, 1.315 to 7.363), compared those with a typical sleep duration (7 to < 8 hours/day), after adjusting for sociodemographic status, socioeconomic status, health behaviors, comorbidities, and sleep quality. Among women, for every 1 hour increase in sleep duration per day, there was a 24.6% increase in the presence of CKD (OR, 1.246; 95% CI, 1.019 to 1.523). However, among men, sleep duration was not significantly associated with CKD. CONCLUSIONS: Very long sleep duration was independently associated with a higher prevalence of CKD among Korean women. Gender may influence this association.
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Adulto , Femenino , Humanos , Masculino , Comorbilidad , Creatinina , Estudios Transversales , Epidemiología , Genoma , Tasa de Filtración Glomerular , Conductas Relacionadas con la Salud , Modelos Logísticos , Prevalencia , Proteinuria , Insuficiencia Renal Crónica , Clase SocialRESUMEN
A 6-month-old mature intact female Siamese cat presented with exertional dyspnea. Diagnostic studies revealed pleural effusion, grade 4/6 left basal systolic murmur, deep S-wave in electrocardiograph leads I, II, and III, cardiomegaly with pleural effusion on radiography, pulmonic systolic (~5.8 m/sec) and tricuspid (3.6 m/sec) regurgitant jets, atrial septal defect, and a hypoplastic right outflow tract. Based on these results, the case was diagnosed as pulmonic stenosis with atrial septal defect. To the best of our knowledge, this is the first case report describing pulmonic stenosis with atrial septal defect in a cat in Korea.
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Animales , Gatos , Femenino , Humanos , Lactante , Cardiomegalia , Disnea , Electrocardiografía , Cardiopatías Congénitas , Defectos del Tabique Interatrial , Corea (Geográfico) , Derrame Pleural , Estenosis de la Válvula Pulmonar , Radiografía , Soplos SistólicosRESUMEN
Escherichia coli (E. coli) is a clinically important causative organism that can lead to urinary tract infections. Quinolone antibiotics are among the first-line treatments for urinary tract infections. However, the frequency of resistance to quinolone in E. coli has been increasing. Therefore, new antimicrobial agents that can be used for treatment in lieu of quinolone antibiotics are needed. In this study, thirty-six compounds with higher scores in a virtual screening based on the three-dimensional structure of E. coli DNA gyrase were selected for in vitro antimicrobial activity testing. An in vitro test confirmed the antimicrobial activity of 4-[(1-methyl-6-nitroquinolin-1-ium-4-yl)amino]-N-[4-[(1-methylpyridin-1-ium-4-yl)amino]phenyl]benzamide (ZINC18057104) against E. coli among the 36 compounds. The minimum inhibitory concentration (MIC) of ZINC18057104 against E. coli ATCC® 25922™ was 2 μg/ml, and the MIC₅₀ and MIC₉₀ for the 72 quinolone-resistant E. coli clinical isolates were 4 and 64 μg/ml, respectively. ZINC18057104, which has a quinoline structure which is similar to the quinolone antibiotics, is predicted to exhibit antimicrobial activity in quinolone-resistant E. coli because it has different molecular interactions with the DNA gyrase than that of existing quinolone antibiotics.
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Antibacterianos , Antiinfecciosos , Girasa de ADN , ADN , Descubrimiento de Drogas , Escherichia coli , Técnicas In Vitro , Tamizaje Masivo , Pruebas de Sensibilidad Microbiana , Infecciones UrinariasRESUMEN
PURPOSE: The aim of this study was to assess the characteristics of papillary thyroid carcinoma (PTC) in patients aged 65 and older in order to predict postoperative recurrence based on the results of ultrasonographic surveillance. METHODS: Among 1,494 patients (200 male and 1,294 female; mean age, 46.6±11.3 years) who underwent surgery for thyroid cancer at our institution between 2006 and 2015, we retrospectively enrolled 150 PTC patients (29 male and 121 female; mean age, 69.4±4.2 years). To identify the risk factors for recurrence, we analyzed age, gender, multiplicity, size, number, extrathyroidal extension (ETE) of the tumor, lymph node metastasis (LNM), type of surgery, and the dose of radioactive ablation using a Cox regression model to identify hazard ratios (HRs). RESULTS: Among the 115 asymptomatic patients with PTCs detected by screening ultrasonography (n=86), other cross-sectional imaging modalities (computed tomography or positron emission tomography-computed tomography, n=13), or incidentally through a surgical specimen (n=16), 78 patients were confirmed to have papillary thyroid microcarcinomas (PTMCs). The other 35 patients presented with palpable neck masses (n=25), vocal cord palsy (n=9) or blood-tinged sputum (n=1). During the follow-up period (mean, 43.6 months), 17 patients (12.5%) experienced recurrence in the neck. None of the patients died due to PTC-related recurrence or distant metastasis during the follow-up period. Cox regression analysis demonstrated that tumor size (HR, 2.12; P<0.001) and LNM (central LNM: HR, 9.08; P=0.004; lateral LNM: HR, 14.71; P=0.002; both central and lateral LNM: HR, 58.41; P<0.001) significantly increased the recurrence rate. ETE, LNM, and recurrence were significantly less frequent in PTMCs than in non-PTMC (all P<0.001). CONCLUSION: PTCs of small size and absent LNM showed significantly better prognoses in patients 65 years and older.
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Anciano , Femenino , Humanos , Masculino , Electrones , Estudios de Seguimiento , Corea (Geográfico) , Ganglios Linfáticos , Tamizaje Masivo , Cuello , Metástasis de la Neoplasia , Pronóstico , Recurrencia , Estudios Retrospectivos , Factores de Riesgo , Esputo , Glándula Tiroides , Neoplasias de la Tiroides , Ultrasonografía , Parálisis de los Pliegues VocalesRESUMEN
OBJECTIVES: Smoking is known to be associated with nephropathy in patients with diabetes. The distinct effects of smoking before and after diabetes has been diagnosed, however, are not well characterized. We evaluated the association of cigarette smoking before and after a diagnosis of diabetes with the presence of diabetic nephropathy. METHODS: We analyzed data from the 2011-2013 editions of the Korea National Health and Nutrition Examination Survey. A total of 629 male patients diagnosed with diabetes were classified as non-smokers (90 patients), former smokers (225 patients), or continuing smokers (314 patients). A "former smoker" was a patient who smoked only before receiving his diagnosis of diabetes. A "continuing smoker" was a patient who smoked at any time after his diabetes had been diagnosed. Diabetic nephropathy was defined as the presence of albuminuria (spot urine albumin/creatinine ratio ≥30 mg/g) or low estimated glomerular filtration rate (<60 mL/min/1.73 m2). Multiple logistic regression models were used to assess the independent association after adjusting for age, duration of diabetes, hemoglobin A1c, body mass index, systolic blood pressure, medication for hypertension, and medication for dyslipidemia. Female patients were excluded from the study due to the small proportion of females in the survey who smoked. RESULTS: Compared to non-smokers, continuing smokers had significantly higher odds ratio ([OR], 2.17; 95% confidence interval [CI], 1.23 to 3.83) of suffering from diabetic nephropathy. The corresponding OR (95% CI) for former smokers was 1.26 (0.70 to 2.29). CONCLUSIONS: Smoking after diagnosis of diabetes is significantly associated with the presence of diabetic nephropathy in the Korean male population.