Factors Affecting Accurate Quantitation of Proteinuria Using Protein/Creatinine Ratio in Random Urine Specimen / 대한신장학회잡지

It's well known that protein/creatinine ratio(P/C ratio) in random urine samples reflects 24-hour urine protein. However, the factors affecting accurate quantitation of proteinuria using random urine P/C ratio are not fully evaluated. The aim of this study is to evaluate factors affecting accurate quantitaion of proteinuria using random urine P/C ratio. 118 patients admitted in Yonsei university medical center during June 1998 and Dec. 1998 were assessed for the measurement of random urine protein/creatinine ratio from second voided urine. 118 patients(mean age 41.5year, male: female 2.36: 1) had mean creati-nine level 1.83+/-1.78mg/dL, 24-hour pmteinuria 6.06+/-7.64g/day and P/C ratio 4.80+/-4.48, All the patiient.s were divided into A, B, C, I, II, K, IV according to serum creatinine level and 24-hour proteinurim amount. The correlation coefficient(R value) between proteinuria and P/C ratio are shown that in all pa- tients is 0.875, group A(Cr*

Comparison between Oral Pulse and Daily Calcitriol (Calcio(R)) Therapy in Continuous Ambrlatory Peritoneal Dialysis (CAPD) Patients with Secondary Hyperparathyroidism / 대한신장학회잡지

The most widely used method for treatment of secondary hyperparathyroidism(SH) in CAPD patients has been the administration of calcitriol by oral route. In this study, we compared the efficacy and safety of daily low dose calcitriol therapy with those of intermittent high dose pulse therapy. The study group consisted of 38 patients undergoing CAPD with serum intact PTH level of more than 200pg/ mL. Twenty patients were randomly administered daily low dose calcitriol(0.25 microgram/day for 1 month followed by 0.5 microgram daily dose for the next 3 mon-ths) while 18 patients were given intermittent pulse therapy (0.5 microgram-0.5 microgram-0.75 microgram 3 times a week for 1 month, increased to 1.0 microgram-1.25 microgram-1.25 microgram 3 times a week for the next 3 months). Thirty five patients completed the study : 17 on daily oral calcitriol (M: F=0.7:1, mean age=47.3+/-10.6 years, mean duration of CAPD=48.9+/-41.1 months), and 18 on oral pulse calcitriol (M:F=1.6:1, mean age=41.5+/-12.7 years, mean duration of CAPD=49.2+/-41.6 months). The baseline serum levels of calcium, phosphorus, i-PTH, alkaline phosphatase, and total CO2 were not different between daily and pulse group(9.5+/-0.8 vs 9.3+/-0.9mg/dL, 5.8+/-1.3 vs 5.1+/-1.2mg/dL, 443.1+/-162.5 vs 546+/-385.9pg/mL, 91.8+/-47.7 vs 108.9+/-66.5IU/L, 23.7+/-1.9 vs 25.5+/-2.0mEq/L, p>0.05, respectively). The i-PTH level decreased significantly in daily calcitriol group after 1 month (332.8+/-214.8pg/mL, p0.05). The serum calcium increased similarly in both groups after treatment (daily=10.6+/-0.8 vs pulse=l0.1+/-1.0mg/dL, p>0.05). Hypercalcemia(>11.0mg/dL) was rarely observed in all patients (daily=5, pulse=8 episodes). In conclusion, both daily and pulse calcitriol therapy were similarly effective and safe in control of SH.

A Case of Hepatocellular Carcinoma with Duodenal Invasion and Bleeding / 대한소화기내시경학회지

Recent advances in both the diagnosis and treatment of hepatocellular carcinoma have improved the prognosis and changed the clinical significance of the recently increasing distant metastases. Distant metastases found after successful treament of the primary lesions are of great clinical significance for the treatment of hepatocellular carcinoma. The duodenum is a rare site of hematogenous metastases or direct invasion from hepatocellular carcinoma. A 23 year old man was admitted with upper gastrointestinal bleeding. He had been diagnosed with hepatocellular carcinoma and treated by a left lobectomy and chemoembolization. The patient was admittted for 12 months after the treatment of the primary tumor. Endoscopic examination revealed a mass in the duodenal bulb that protruded into the lumen. He died due to massive hematemesis. We report on a rare case of hepatocellular carcinoma with duodenal invasion in a 23-year-old male patient.

Comparison of Epidemiological and Clinical Characteristics of Native Valve Endocarditis between 1979~1984 and 1991~1996 / 감염

BACKGROUND: The changes in the epidemiology of native valve endocarditis have been known in western countries recent years due to the decrease in the inci-dence of rheumatic heart disease, increased longevity of patients with valvular or congenital heart diseases, and the increase in degenerative heart disease due to the in-crease in the average life span of the general popula-tion. In this study, we analyzed and compared the epide-miological and clinical characteristics of patients with na-tive valvular endocarditis fro two different time periods. METHODS: We compared native valve endocarditis patients diagnosed from 1979 - 1984(group I) with those diagnosed from 1991 - 1996(group II). We used modified Duke' s criteria for the diagnosis and statistical analysis was done using SPSS window program. RESULTS: In our study, mean age of the population was higher in group II and significantly larger number of patients were over the age of 50 in group II. Involve-ment of multiple valves with vegetations and peri-valvular abscess were found more frequently in group II. Also, significantly higher percentage of patients from group II underwent surgical treatment. CONCLUSION: The results of this study suggest that the epidemiolocaland clinical characteristics of infective endocarsitis in Korea may change to resemble those in western countries. Further studies regarding this subject are needed.