Sex-Related Outcomes of Successful Drug-Coated Balloon Treatment in De Novo Coronary Artery Disease

Purpose@#Although drug-coated balloon (DCB) treatment is known to be effective for de novo lesions, the influence of sex on angiographic and clinical outcomes remains unknown. This study aimed to investigate the angiographic and clinical impact of DCB treatment in patients with de novo coronary lesions according to sex. @*Materials and Methods@#A total of 227 patients successfully treated with DCB were retrospectively enrolled and divided into two groups according to sex. The primary endpoint was late lumen loss (LLL) at 6-month angiography, and the secondary endpoint was target vessel failure (TVF), which included cardiac death, target vessel myocardial infarction, target lesion revascularization, and target vessel thrombosis. @*Results@#The study enrolled 60 women (26.4%) and 167 men (73.6%). Compared to men, women had a smaller vessel size, larger DCB to reference vessel ratio, and more dissections after DCB treatment (55.0% vs. 37.1%, p=0.016). Women also had a significantly higher LLL compared to men (0.12±0.26 mm vs. 0.02±0.22 mm, p=0.012) at the 6-month follow-up angiography. During a median follow-up of 3.4 years (range 12.7–28.9 months), TVF was similar (women 6.7% vs. men 7.8%, p=0.944). In multivariable analysis, women were independently associated with a higher LLL. @*Conclusion@#LLL was higher in women, but there was no difference in TVF between women and men. Based on multivariable analysis, the women sex was an independent predictor of higher LLL (Impact of Drug-coated Balloon Treatment in de Novo Coronary Lesion; NCT04619277).

Sex-Related Outcomes of Successful Drug-Coated Balloon Treatment in De Novo Coronary Artery Disease

Purpose@#Although drug-coated balloon (DCB) treatment is known to be effective for de novo lesions, the influence of sex on angiographic and clinical outcomes remains unknown. This study aimed to investigate the angiographic and clinical impact of DCB treatment in patients with de novo coronary lesions according to sex. @*Materials and Methods@#A total of 227 patients successfully treated with DCB were retrospectively enrolled and divided into two groups according to sex. The primary endpoint was late lumen loss (LLL) at 6-month angiography, and the secondary endpoint was target vessel failure (TVF), which included cardiac death, target vessel myocardial infarction, target lesion revascularization, and target vessel thrombosis. @*Results@#The study enrolled 60 women (26.4%) and 167 men (73.6%). Compared to men, women had a smaller vessel size, larger DCB to reference vessel ratio, and more dissections after DCB treatment (55.0% vs. 37.1%, p=0.016). Women also had a significantly higher LLL compared to men (0.12±0.26 mm vs. 0.02±0.22 mm, p=0.012) at the 6-month follow-up angiography. During a median follow-up of 3.4 years (range 12.7–28.9 months), TVF was similar (women 6.7% vs. men 7.8%, p=0.944). In multivariable analysis, women were independently associated with a higher LLL. @*Conclusion@#LLL was higher in women, but there was no difference in TVF between women and men. Based on multivariable analysis, the women sex was an independent predictor of higher LLL (Impact of Drug-coated Balloon Treatment in de Novo Coronary Lesion; NCT04619277).

Impact of Dissection after Drug-Coated Balloon Treatment of De Novo Coronary Lesions:Angiographic and Clinical Outcomes

Purpose@#Dissection after plain balloon angioplasty is required to achieve adequate luminal area; however, it is associated with a high risk of vascular events. This study aimed to examine the relationship between non-flow limiting coronary dissections and subsequent lumen loss and long-term clinical outcomes following successful drug-coated balloon (DCB) treatment of de novo coronary lesions. @*Materials and Methods@#A total of 227 patients with good distal flow (Thrombolysis in Myocardial Infarction flow grade 3) following DCB treatment were retrospectively enrolled and stratified according to the presence or absence of a non-flow limiting dissection. The primary endpoint was late lumen loss (LLL) at 6-month angiography, and the secondary endpoint was target vessel failure (TVF, a composite of cardiac death, target vessel myocardial infarction, target vessel revascularization, and target vessel thrombosis). @*Results@#The cohort consisted of 95 patients with and 132 patients without a dissection. There were no between-group differences in LLL (90.8%) returning for angiography at 6 months (0.05±0.19 mm in non-dissection and 0.05±0.30 mm in dissection group, p= 0.886) or in TVF (6.8% in non-dissection and 8.4% in dissection group, p=0.799) at a median follow-up of 3.4 years. In a multivariate analysis, the presence of dissection and its severity were not associated with LLL or TVF. Almost dissections (93.9%) were completely healed, and there was no newly developed dissection at 6-month angiography. @*Conclusion@#The presence of a dissection following successful DCB treatment of a de novo coronary lesion may not be associated with an increased risk of LLL or TVF (Impact of Drug-coated Balloon Treatment in de Novo Coronary Lesion; NCT04619277).

Scoring Methods of Polysomnography for Diagnosis of Sleep Apnea in Adolescents / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Respiratory scoring guidelines for children and adults have been used for evaluating adolescents both in the 2007 and 2012 American Academy of Sleep Medicine (AASM) scoring manuals. We compared the scoring methods of polysomnography used in these scoring manuals, where pediatric and adult scoring rules were adopted for the diagnosis of sleep apnea in adolescents. SUBJECTS AND METHOD: 106 Korean subjects aged between 13 and 18 years were enrolled. All subjects underwent overnight polysomnography in a sleep laboratory. Data were scored according to both pediatric and adult guidelines in the 2007 and 2012 AASM scoring manuals. RESULTS: Both pediatric and adult apnea hypopnea index (AHI) using the 2012 method were significantly higher than those using the 2007 method. The difference in AHI compared between pediatric and adult scores with the 2012 AASM scoring system was markedly decreased from that with the 2007 method. There was a significant discordance in sleep apnea diagnosis between pediatric and adult scoring rules in the 2012 method. CONCLUSION: Both pediatric and adult rules were used for the diagnosis of adolescent sleep apnea in the 2012 method. However, there was significant discordance in the diagnosis between pediatric and adult scoring guidelines in the 2012 AASM manual, probably due to different cut-off values of AHI for the diagnosis of sleep apnea in pediatric (≥1) and adult (≥5) patients. Further studies are needed to determine a more reasonable cut-off value for the diagnosis of sleep apnea in adolescents.

The Potential Utility of Iodinated Contrast Media (ICM) Skin Testing in Patients with ICM Hypersensitivity

Both immediate and delayed hypersensitivity reactions to iodinated contrast media (ICM) are relatively common. However, there are few data to determine the clinical utility of immunologic evaluation of ICM. To evaluate the utility of ICM skin testing in patients with ICM hypersensitivity, 23 patients (17 immediate and 6 delayed reactions) were enrolled from 3 university hospitals in Korea. With 6 commonly used ICM including iopromide, iohexol, ioversol, iomeprol, iopamidol and iodixanol, skin prick (SPT), intradermal (IDT) and patch tests were performed. Of 10 patients with anaphylaxis, 3 (30.0%) and 6 (60.0%) were positive respectively on SPTs and IDTs with the culprit ICM. Three of 6 patients with urticaria showed positive IDTs. In total, 11 (64.7%) had positive on either SPT or IDT. Three of 6 patients with delayed rashes had positive response to patch test and/or delayed IDT. Among 5 patients (3 anaphylaxis, 1 urticaria and 1 delayed rash) taken subsequent radiological examinations, 3 patients administered safe alternatives according to the results of skin testing had no adverse reaction. However, anaphylaxis developed in the other 2 patients administered the culprit ICM again. With 64.7% (11/17) and 50% (3/6) of the sensitivities of corresponding allergic skin tests with culprit ICM for immediate and delayed hypersensitivity reactions, the present study suggests that skin tests is useful for the diagnosis of ICM hypersensitivity and for selecting safe ICM and preventing a recurrence of anaphylaxis caused by the same ICM.

Impact of Arterial Stiffness on Regional Myocardial Function Assessed by Speckle Tracking Echocardiography in Patients with Hypertension

BACKGROUND: Arterial stiffening may affect regional myocardial function in hypertensive patients with normal ejection fraction (EF). METHODS: Brachial-ankle pulse wave velocity (PWV) was measured in 70 patients, of mean age 48 +/- 14 years, with untreated hypertension and EF > 55%. Using two-dimensional-speckle tracking echocardiography, we measured longitudinal and circumferential strain (epsilon) and strain rate (SR). Basal and apical rotations were measured using short axis views. RESULTS: The mean systolic and diastolic blood pressure in these patients was 152 +/- 15 mmHg and 92 +/- 11 mmHg, respectively. The mean value of PWV was 1578 +/- 274 cm/s. PWV significantly correlated with age (r = 0.682, p 1700 cm/s compared to those with PWV < or = 1400 cm/s or those with PWV 1400-1700 cm/s. CONCLUSION: In hypertensive patients with normal ejection fraction, arterial stiffening contributes to impaired systolic and diastolic function of the regional myocardium. Compensatory increases in ventricular twist were diminished in patients with advanced stage of vascular stiffening.

Hypoadiponectinemia in Patients With Paroxysmal Atrial Fibrillation

BACKGROUND AND OBJECTIVES: Adiponectin is an adipose tissue-derived hormone that has beneficial effects on cardiac function and has been reported to be associated with lipid metabolism, glucose metabolism, and insulin resistance. Serum levels of adiponectin are reduced in obese individuals compared with non-obese individuals. Obesity is associated with an increased incidence of atrial fibrillation (AF); however, the role of adiponectin in AF is unclear. The aim of this study is to evaluate the relationship between the plasma adiponectin level and AF. SUBJECTS AND METHODS: Sixty-one consecutive patients were prospectively enrolled for this study. Subjects were divided into two groups: patients with AF (n=30) and controls (n=31). Laboratory evaluation, including levels of plasma adiponectin, was performed and echocardiographic parameters were measured. RESULTS: The baseline characteristics were not different between the two groups. The plasma adiponectin level of patients in the AF group was significantly lower than in the control group (14.9+/-7.2 vs. 19.+/-8.9 microg/mL, p<0.05). In addition, when we divided the AF patients into paroxysmal and chronic AF, the plasma adiponectin level was significantly lower in patients with paroxysmal AF, compared with the control group. In multiple binary logistic regression analysis to evaluate the independent predictors for AF, adiponectin and left atrial diameter were strong independent predictors of AF. CONCLUSION: In this study a lower plasma adiponectin concentration was significantly associated with that of paroxysmal AF. Hypoadiponectinemia can potentially be an important risk factor for AF.

Correlation of Right Atrial Appendage Velocity with Left Atrial Appendage Velocity and Brain Natriuretic Peptide

BACKGROUND: Left atrial appendage (LAA) anatomy and function have been well characterized both in healthy and diseased people, whereas relatively little attention has been focused on the right atrial appendage (RAA). We sought to evaluate RAA flow velocity and to compare these parameters with LAA indices and with a study of biomarkers, such as brain natriuretic peptide, among patients with sinus rhythm (SR) and atrial fibrillation (AF). METHODS: In a series of 79 consecutive patients referred for transesophageal echocardiography, 43 patients (23 with AF and 20 controls) were evaluated. RESULTS: AF was associated with a decrease in flow velocity for both LAA and RAA [LAA velocity-SR vs. AF: 61 +/- 22 vs. 29 +/- 18 m/sec (p < 0.01), RAA velocity-SR vs. AF: 46 +/- 20 vs. 19 +/- 8 m/sec (p < 0.01)]. Based on simple linear regression analysis, LAA velocity and RAA velocity were positively correlated, and RAA velocity was inversely correlated with brain natriuretic peptide (BNP). CONCLUSION: AF was associated with decreased RAA and LAA flow velocities. RAA velocity was found to be positively correlated with LAA velocity and negatively correlated with BNP. The plasma BNP concentration may serve as a determinant of LAA and RAA functions.

Impact of Right Ventricular Apical Pacing and Its Frequency on Left Atrial Function

BACKGROUND: Right ventricular apical (RVA) pacing induces left ventricular (LV) dyssynchrony, increases the risk of persistent atrial fibrillation in the long term. The aim was to investigate the effects of RVA pacing on left atrial (LA) function, which are unknown. METHODS: Echocardiographic evaluation including LV dyssynchrony based on conventional Doppler, tissue Doppler imaging and speckle tracking strain echocardiography was done before and after (12 months) single-chamber ventricular pacemaker implantation in 40 patients with sick sinus syndrome. Patients were divided to 2 groups, according to the RVA pacing frequency (group I had higher pacing rate of more than 50% and group II, less than 50%). RESULTS: There was no significant difference in LV ejection fraction, however, mean global LV strain, myocardial performance index, and parameters of LV dyssynchrony had shown significant changes after 12 months of RVA pacing. There were also significant increase in the LA volume index and the reduction of peak systolic LA strain and strain rate (SR), peak early and late diastolic SR after RVA pacing. Moreover, there was significant deterioration of LV dyssynchrony and both LA and LV longitudinal function in even group II. LA functional deterioration and LA volume was significantly correlated with the frequency of RVA pacing. CONCLUSION: LV dyssynchrony, induced by RVA pacing, significantly impaired active LA contraction and passive stretching, and these findings were shown in the patients with even less than 50% of RVA pacing. Impairment of LA strain/SR was significantly correlated with the frequency of RVA pacing.

Correlation of Right Atrial Appendage Velocity with Left Atrial Appendage Velocity and Brain Natriuretic Peptide

BACKGROUND: Left atrial appendage (LAA) anatomy and function have been well characterized both in healthy and diseased people, whereas relatively little attention has been focused on the right atrial appendage (RAA). We sought to evaluate RAA flow velocity and to compare these parameters with LAA indices and with a study of biomarkers, such as brain natriuretic peptide, among patients with sinus rhythm (SR) and atrial fibrillation (AF). METHODS: In a series of 79 consecutive patients referred for transesophageal echocardiography, 43 patients (23 with AF and 20 controls) were evaluated. RESULTS: AF was associated with a decrease in flow velocity for both LAA and RAA [LAA velocity-SR vs. AF: 61 +/- 22 vs. 29 +/- 18 m/sec (p < 0.01), RAA velocity-SR vs. AF: 46 +/- 20 vs. 19 +/- 8 m/sec (p < 0.01)]. Based on simple linear regression analysis, LAA velocity and RAA velocity were positively correlated, and RAA velocity was inversely correlated with brain natriuretic peptide (BNP). CONCLUSION: AF was associated with decreased RAA and LAA flow velocities. RAA velocity was found to be positively correlated with LAA velocity and negatively correlated with BNP. The plasma BNP concentration may serve as a determinant of LAA and RAA functions.

Impact of Right Ventricular Apical Pacing and Its Frequency on Left Atrial Function

BACKGROUND: Right ventricular apical (RVA) pacing induces left ventricular (LV) dyssynchrony, increases the risk of persistent atrial fibrillation in the long term. The aim was to investigate the effects of RVA pacing on left atrial (LA) function, which are unknown. METHODS: Echocardiographic evaluation including LV dyssynchrony based on conventional Doppler, tissue Doppler imaging and speckle tracking strain echocardiography was done before and after (12 months) single-chamber ventricular pacemaker implantation in 40 patients with sick sinus syndrome. Patients were divided to 2 groups, according to the RVA pacing frequency (group I had higher pacing rate of more than 50% and group II, less than 50%). RESULTS: There was no significant difference in LV ejection fraction, however, mean global LV strain, myocardial performance index, and parameters of LV dyssynchrony had shown significant changes after 12 months of RVA pacing. There were also significant increase in the LA volume index and the reduction of peak systolic LA strain and strain rate (SR), peak early and late diastolic SR after RVA pacing. Moreover, there was significant deterioration of LV dyssynchrony and both LA and LV longitudinal function in even group II. LA functional deterioration and LA volume was significantly correlated with the frequency of RVA pacing. CONCLUSION: LV dyssynchrony, induced by RVA pacing, significantly impaired active LA contraction and passive stretching, and these findings were shown in the patients with even less than 50% of RVA pacing. Impairment of LA strain/SR was significantly correlated with the frequency of RVA pacing.

A Case of a Right Atrial and Inferior Vena Caval Thrombus Resembling a Right Atrial Myxoma

A right atrial and inferior vena caval thrombus in a structurally normal heart is a very rare condition. We report a case of such a thrombus in a 66-year-old woman. She was admitted to our hospital with recent onset dyspnea. Based on echocardiography, we suspected that she had myxoma. We performed an excision of a mass, which was found, by pathologic examination, to be an organized mural thrombus.

Gender Differences of P Wave Signal Averaged Electrocardiograms: Based on the Risk of Atrial Fibrillation

BACKGROUND AND OBJECTIVES: Certain types of arrhythmias have gender differences. Women have a higher incidence of drug-induced QT prolongation than in men. However, there are no reports regarding gender-related differences of the P wave signal averaged electrocardiogram (PWSAE), based on the risk of atrial fibrillation (AF). PWSAE has been recognized as a diagnostic tool for identifying the risk of paroxysmal atrial fibrillation (PAF). We therefore investigated the influence of gender in the parameters of PWSAE and in the risk of AF. SUBJECTS AND METHODS: We recorded 100 PWSAEs in apparently healthy Korean subjects (53 men and 47 women), aged 20 to 79 years. RESULTS: The mean age of the male subjects was 38.2 years and the mean age of the female subjects was 43.2 years (p=0.19). The body surface area (BSA) were larger in men (1.83 m2 vs. 1.53 m2, p<0.05). In men, the filtered P wave duration (fPD) was longer than in women (136.8 msec vs. 125.2 msec, p<0.05). The root mean square voltage in the terminal 20 ms of the filtered P wave (RMS20) was 5.9 micron V in women and 4.5 micron V in men (p<0.05). CONCLUSION: Men have a longer fPD and lower RMS20 than women. The BSA showed a positive correlation with fPD and a negative correlation with RMS20. This study suggests that BSA is an important factor for fPD and RMS20. In addition, as men have a larger BSA as compared with women, we suspect that men have a higher risk of AF as compared with women.

Correlation of ST Segment Elevation in Lead V1 and the Conal Branch of Right Coronary Artery in Patients with Acute Anterior Wall Myocardial Infarction

BACKGROUND AND OBJECTIVES: Dual blood supply to the anterior interventricular septum (IVS), derived from the septal branches of the left anterior descending artery (LAD) and the conal branch of the right coronary artery (RCA), may prevent ST segment elevation in lead V1 during an anterior acute myocardial infarction (AMI), and predict a favorable in-hospital clinical course. SUBJECTS AND METHODS: The admission 12-lead electrocardiogram (ECG), and the coronary angiograms performed within 10 days of hospital admission, were evaluated in 67 patients with anterior wall AMI, as defined by a ST segment elevation > or =2mm in at least 2 of the V1 to 4 leads. The patients were divided into two groups according to the magnitude of the ST segment elevation in V1 lead: group 1 (ST or =1.5 mm, n=45). The conal branch types were classified into small (a diameter 0.5 mm), reaching the IVS. RESULTS: A large conal branch was found in 11 patients of each group 50 and 24%, respectively (p=0.04). There was no significant relation between the sites of the LAD lesion, whether proximal or distal to the first septal branch, and the presence of ST segment elevation in lead V1. The serum cardiac enzymes, Killip class and the incidence of in-hospital congestive heart failure, were not significantly different. CONCLUSION: The absence of ST segment elevation in lead V1 during an anterior AMI suggested that the IVS is protected by a large conal branch, in addition to the septal branch of the LAD, but this did not influence the in-hospital clinical course.

Doppler Indexes of Pulmonary Venous Flow Predict Death after Acute Myocardial Infarction

BACKGROUND: Restrictive left ventricular (LV) filling patterns after acute myocardial infarction (AMI) predict poor prognosis. Doppler indexes of LV inflow, especially peak velocity ratio of early versus late diastolic flow (E/A) and deceleration time, can predict heart failure or death. Doppler indexes of pulmonary venous flow are also used to diagnose restrictive LV filling, but their prognostic values after AMI are not known. METHODS: Doppler echocardiographic examination were performed in patients with AMI (n=122) between 7 to 10 days after attack, and followed for 30 months. Death group included 9 deaths (7.4%) during follow-up. 18 age-matched patients (control group) were selected from 70 patients without death, heart failure or readmission. Doppler echocardiographic indexes of peak systolic velocity (SV), peak diastolic velocity (DV), and peak reverse flow velocity associated with atrial contraction (AR) of pulmonary venous flow were measured by transthoracic echocardiography. RESULTS: Death group had lower SV (46.1+/-6.3 vs 57.0+/-14.7 cm/sec; p=0.059) and SV/DV ratio (1.26+/-0.50 vs 1.58+/-0.37; p=0.076). Death group had significantly more patients with SV/DV ratio less than 1.3 (67% vs 17%; p=0.026). AR was significantly different between death and control groups (29.7+/-7.8 vs 24.7+/-6.8 cm/sec; p=0.023). Death group had significantly more patients with AR greater than 25 (78% vs 33%; p=0.046). CONCLUSION: SV/DV ratio and AR of pulmonary venous flow predicted death after AMI.

The Inhibitory Effect of Amiloride on the Growth of Human Gastric Carcinoma Cells in Vitro / 대한암학회지

PURPOSE: In the present study the effects of amiloride on the growth of human gastric adenocarcinoma cell line, AGS cells were examined with or without the addition of 5-fluorouracil (5-FU) in vitro. MATERIALS AND METHODS: The growth of AGS cells was examined by counting number of cells on two and four days post-treatment with 50 micrometer, 100 micrometer, 200 micrometer, 400 micrometer, 800 micrometer, amiloride, and 0.1 microgram/ml, 0.3 microgram/ml 5-FU, after plating AGS cells into 6 well plates at a density of 10 x 10(4) cells/well. The reversibility of the effects of amiloride was examined on two to eight days post-treatment with 400 micrometer amiloride after seeding 2 x 10(4) cells/dish. Cell cycle analysis was performed after four day-treatment with 400 micrometer amiloride. RESULTS: Amiloride (50~800 micrometer) significantly inhibited the growth of AGS in a dose-dependent fashion (p<0.05). The inhibitory effect of amiloride on growth of AGS was reversible since removal of amiloride after 24 hours treatment led to resumption of rapid growth up to control levels. Amiloride combined with 5-FU markedly inhibited the growth of AGS in a dose-dependent fashion compared to that of amiloride or 5-FU alone (p<0.05). The fraction of S phase, G0-G1 phase and G2-M phase was 19.3%, 55.7%, 18.8%, in the amioride group (400 micrometer) and 43.9%, 37.4%, 25.1% in the control group, respectively, showing significantly higher G1 fraction in amiloride group compared to control. CONCLUSION: This is the first paper which reported that amiloride inhibited in vitro growth of human gastric adenocarcinoma cells and that its effect of growth inhibition may be synergistic with 5-FU. Amiloride given with or without 5-FU may be useful agent in the treatment of gastric carcinomas. The inhibitory effects of amiloride on the growth of AGS may be mediated in part by blocking G1-S transition of cell cycle.

A Clinical Study of Foreign Body Aspiration in Children in Suwon-Kyungki Province / 소아알레르기및호흡기학회지

PURPOSE: Foreign bodies in the airway of infant and children require prompt diagnosis and removal. To evaluate the pattern of clinical characteristics and disease course, we reviewed and analyzed a 6-year experience with pediatric airway foreign bodies in children. METHODS: We retrospectively reviewed the medical records of pediatric foreign body aspiration managed by pediatric and otorhinolaryngologic departments of Ajou University Hospital from November 1994 to October 2000. Nineteen cases of aspiration were collected and we analyzed their age, sex, symptoms, duration between onset of symptoms and diagnosis, initial simple radiographic findings, matierials of aspirations, anatomic location of foreign body, length of hospital day, and complications. RESULTS: The mean age was 2.7 years and male-to-female ratio of 1.8 : 1. In 11 cases, choking episode was identified by parents or patients. The correct diagnosis was made within first 24 hours of aspiration in 4 patients; while in 15 cases, the proper diagnosis was done after 24 hours. The most common presenting symptoms were cough (73.6%) and decreased breath sounds (57.9%) and the most common initial finding of simple radiographs was emphysema, presented in 68.4% of patients. Vegetable substances, particularly peanuts were the most common material of identified foreign body. Nine foreign bodies were in the right bronchus, 8 in the left bronchus and 2 in the subglottic area. The mean duration of admissions were 3.75 days in pateints who were diagnosed within 24 hours, however, 8.61 days in those with a delayed diagnosis (P=0.012). CONCLUSION: Taken together, the majority of accidental foreign body aspiration in airway was found under 3-year of age. Pediatricians and parents should be conscious to check for history of foreign body aspiration who have suspicious clinical features of aspiration, for early diagnosis and proper management without complications and long term morbidity.

Clinical study of Outcome and Predisposing Factors for Spontaneous Pneumothorax in the Neonates / 대한주산의학회잡지

No abstract available.

The prevalence of diabetes mellitus in chronic liver disease / 대한내과학회지

The insulin resistance and the altered glucose metabolism in chronic liver disease increase the alteration of glucose intolerance and the prevalence of diabetes mellitus. The prevalence of DM is higher in advanced cirrhosis than in early cirrhosis and higher in C-viral hepatitis or alcoholic liver disease than in B-viral hepatitis. The purpose of this study is to assess the prevalence of DM in chronic liver disease in Korea. METHODS: We reviewed the medical records of 417 patients with chronic liver disease who visit the Yonsei University Sevrance Hospital from January 1994 to March 1998. We examined fasting blood sugar, biochemical study and abdominal ultrasonography. DM was defined on the basis of fasting hyperglycemia (fasting blood sugar exceeding 140 mg/dl) at least two consecutive samples or active treatment with insulin or oral hypoglycemic agents. RESULTS:1) The DM prevalence was 16.8%(70 cases) in total patients and 25.0% (56 cases) in cirrhotic patients. 2) According to sex, there was no statistically significant difference in DM prevalence(16.8% in men and 18.1% in women P=0.78). 3) The DM prevalence was increased with increasing of age(0% in below 30 years, 4.9% in 31-40, 19.6% in 41-50, 22.9% in 51-60, 21.3% in 61-70 and 44.4% in over 71 years, p<0.01). 3) According to severity of liver disease, the DM prevalence was higher in uncompensated cirrhosis than in compensated cirrhosis(2.3% in chronic viral carrier, 8.8% in chronic hepatitis, 17.9% in cirrhosis Child class A, 33.9% in class B, 29.5% in class C). 4) According to cause of liver disease, the DM prevalence was higher in C-viral hepatitis and alcoholics than in B-viral hepatitis(12.1% in B-viral hepatitis, 35.1% in C-viral hepatitis, 40.0% in alcoholics). CONCLUSION: The prevalence of diabetes in the patients with chronic liver disease is much higher than in general population. And the DM prevalence is increased in advanced cirrhosis and C-viral or alcoholic hepatitis. The early diagnosis and treatment of DM in chronic liver disease patients are important.

A Case of Osteosarcoma induced Oncogenic Osteomalacia Detected by MRI / 대한내분비학회지

Oncogenic osteomalacia is a syndrome characterized by phosphaturia, hypophosphatemia, decreased 1,25-dihydroxyvitamin D level and specific signs and symptoms of osteomalacia. It is associated with the presence of neoplasm originated from mesenchyme. Until now, less than 100 cases of oncogenic osteomalacia have been reported. The pathophysiology of oncogenic osteomalacia has not been fully understood, but it has been suggested that a certain substance released by tumor may inhibit not only la-hydroxylase activity and reduce 1,25-dihydroxyvitamin D level in part, but directly inhibit reabsorption of phosphate. And then, reduced phosphaturia, hypophosphatemia and eventually osteomalacia develop. We report a case of osteosarcoma induced oncogenic osteomalacia detected by MRI in 59 year old woman.