Association of Proteinuria with Metabolic Syndrome in Korean Adults / 가정의학회지

BACKGROUND: Proteinuria is a predictor of chronic kidney disease and a common risk factor for cardiovascular disease. Previous studies have reported that a urinary albumin-creatinine ratio and a glomerular filtration rate was related to the metabolic syndrome. However, there have been few studies on association between the metabolic syndrome and proteinuria by the urine dip-stick test. We examined the association between the metabolic syndrome and the proteinuria by the urine dip-stick test. METHODS: The subject of this study included 20,075 adults aged more than 18 years old who visited the Health Promotion Center of the Seoul National University Hospital from April 2001 to March 2007. The metabolic syndrome was defined according to the criteria of the American Heart Association and National Heart, Lung and Blood Institute, and proteinuria was defined as a dipstick test above the '1+' level. The crude and multivariated-adjusted odds ratios of proteinuria were calculated by using logistic regression models with each component of the metabolic syndrome. RESULTS: Proteinuria was noticed in 5.7% of the subjects with metabolic syndrome, and 2.7% without metabolic syndrome. The multivariate-adjusted odds ratios of proteinuria in participants with elevated blood pressure level, elevated plasma glucose level and high triglyceride level were 2.23 (95% confidence interval [CI], 1.95 to 2.55), 2.33 (95% CI, 2.06 to 2.62), 1.64 (95% CI, 1.45 to 1.84). The multivariate-adjusted odds ratio of proteinuria in participants with the metabolic syndrome compared with participants without the metabolic syndrome was 2.30 (95% CI, 1.91 to 2.76), respectively. CONCLUSION: These findings suggest that proteinuria by the urine dip-stick test might be an important predictor in the metabolic syndrome.

Comparison of the Quality of Bowel Preparation for Double Contrast Barium Enema According to Remind Calls: A Double-Blind Clinical Trial / 가정의학회지

BACKGROUND: Adequate bowel preparation is essential for accurate double-contrast barium enema (DCBE) examination. Several protocols have been performed including controlled diet, split dosage of cathartic, fasting dinner 1 day before the exam. The aim of this study was to compare the effect of remind calls on the quality of bowel preparation. METHODS: We conducted a clinical trial for 248 subjects who did DCBE at the health promotion center of a single hospital. One hundred and seven patients received instructions and remind calls one day before starting bowel preparation, and the others received only instructions. Two specialized radiologists rated the quality of bowel preparation on a scale of excellent/good/fair/poor. In addition, we collected data for age, sex, education, income, and the reason for the exam with a detailed questionnaire. RESULTS: The basal characteristics of subjects between 'remind call' and 'no remind call' groups were similar except age (57.0 +/- 9.8 years, 54.4 +/- 8.1 years, respectively P = 0.021). The proportion of 'excellent' was higher in the 'remind call' group (35.5%) than in the 'no remind call' group (23.4%) with statistical significance (P = 0.037). The adjusted odds ratio was 2.015 for 'remind calls' (P = 0.017), and 0.958 for age (P = 0.011). CONCLUSION: Remind calls and age were associated with the quality of bowel preparation. Remind calls increased the proportion of 'excellent' quality of bowel preparation, which can help accurate assessment.

Binocular Luminance Summantion in Estoropic and Exotropic Kittens

Nomal kittens showed a gradual increase from 17.6% to 25.5% of BLS with aging from the fifth week to the ninth. Young kittens showed significantly less BLS than adult ones(p<0.1). There was no significant difference in BLS between exotropic and nomal kittens or alternating and non-alternating strabismic ones. However, there was a significant difference in BLS between esotropic and nomal ones(p<0.1). These results suggested that the BLS can be used as an index for the extent of total field from both eyes.

A Case of Endodermal Sinus Tumor of the Orbit

A 3-year-old girl with rapidly progressive proptosis had an unusual malignant germ cell tumor of the orbit identified as an endodermal sinus tumor. The endodermal sinus tumor is a malignant germ cell neoplasm that usually arises in gonads, but on rare ocassion ocurrs in extragonadal locations. Histologic examination revealed pseudo papillary pattern that on occasion created peculiar organoid structure similar to the glomeruli(Shiller-Dubal bodies). The patient was treated with exenteration of left orbit and three drug chemotherapy. The present case is of particular interest because of the rarity of extragonadal endodermal sinus tumor.

The Association of Strabismus and Congenital Cataract

We operated on 37 congenital cataract patients(bilateral 23, unilateral 14) from April, 1984 to April, 1986. The age of the patients at the time of their operation ranged from 2 months to 15 years old. The average age was 4.1 years old. The follow-up period ranged from 5 months to 6.3 years, the average being 2.2 years. We compared the incidence of strabismus according to unilaterality, the method of operation, the age at which the operation took place, and the correction of vision. All strabismic cases were exotropic. The strabismus occurred in 34% of all patients at the first examination and 65% at the final examination during follow-up period. The occurrence rates of the strabismus during the follow-up period were 22% in the bilateral cases, and 50% in the unilateral ones. This difference was statistically significant(p<0.05). According to the operation method, the strabismus occurred in 25% of I and A cases, but only 16% of lensectomy ones. This was also statistically signiIicant(p<0.05). The occurrence of strabismus had a statistically significant difference of 8% in operations before 3 years of age and 32% after 3 years. The occurrnce of stabismus was increased in cases of old age, after cataract, poor postoperative visual correction, and unilatral cases.

Binocular luminance summation (BLS) in esotropic and exotropic kittens

Normal kittens showed a gradual increase from 17.6% to 25.5% of BLS with aging from the fifth week to the ninth. Young kittens showed significantly less BLS than do adult ones (p < 0.1), There was significant difference of BLS between exotropic and normal kittens or alternating and non-alternating strabismic ones. However, there was a significant diftrence between esotropic and normal ones (p < 0.1). These results suggested that the BLS can be used as a index for the extent of total field from both eyes.

Neonatal Retinal Hemorrhages and Influence of Perinatal Factors

Retinal hemorrhages in the newborn infant were first described shortly after the invention of the ophthalmoscope(Jaeger. 1961). Frequency of the retinal hemorrhages in the newborn infant has been reported to be between 2.6 and 50%. We postulate that the retinal hemorrhages are caused by maternal factors and fetal factors. Maternal factors include delivery type, maternal age, duration of pregnancy, parity, duration of labor, and maternal blood pressure. Fetal factors include color of the amnionic fluid, body weight, and sex. We examined the fundus of 161 newborn infants and investigated the above factors that influenced the retinal hemorrhages. The results were as follows: 1. The overall incidence of the retinal hemorrhages were 35.4%. 2. According to the delivery types, retinal hemorrhages were found in 57.9% after vacuum extraction, in 41.7% after induction delivery, in 33.8% after spontaneous delivery, and in 13.5% after Cesarean section. 3. As the duration of pregnancy increased in complicated delivery, retinal hemorrhages also tendted to increase. 4. The incidence of hemorrhages were greater in the hypertensive mother and abnormal color of amnionic fluid in spontaneous delivery. 5. The incidence of retinal hemorrhages were greater in the high body weight, multipara, and normal duration of labor. 6. Retinal hemorrhages were not related the maternal age and fetal sex. 7. Retinal hemorrhages were absorbed within four weeks.

Fluorescent low density lipoprotein and acetylated low density lipoprotein labeling of cultured bovine trabecular endothelial cells

A preliminary study was performed to investigate the staining characteristics of trabecula. endothelial cells with low density lipoprotein (LDL) and acetylated low density lipoprotein (Ac-LDL) labeled with a fluorescent probe, 1, 1`- dioctadecyl-3,3,3`, 3`- tetramethyl-indocarbocyanine perchlorate (Dil). Trabecular endothelial cells revealed a strong fluorescence with Dil-LDL, which was contradictory to the previous results obtained from other types of endothelial cells. These cells also showed a moderate fluorescence with Dil-Ac-LDL. Scleral fibroblasts and keratocytes showed a moderate to strong fluorescence with Dil-LDL and a weak fluorescence with Dil-Ac-LDL. Corneal endothelial cells revealed a very weak background fluorescence with Dil-LDL and a moderate fluorescence with Dil-Ar-LDL. Therefore, these four kinds of cells could not be definitely differentiated depending only on the staining characteristics with Dil-LDL and Dil-Ac-LDt.