Coronary artery calcification is associated with cardiovascular risk factors and metabolic syndrome, and several studies have already reported that coronary artery calcification score are closely related to the amount of atherosclerotic plaques. This study was conducted on 109 patients who underwent coronary calcium CT who visited the comprehensive health examination center in Daegu city during the period from December 2020 to February 2021. we would like to investigate the relationship between coronary artery calcification score and blood factors. As a result of the study, the abnormal group increased the risk of calcification by 1.113 times compared to the normal group in the waist circumference factor. In the fasting glucose factor, the abnormal group increased the risk of calcification by 1.036 times compared to the normal group, and in the triglyceride factor, the abnormal group was normal. As the risk of calcification increased 1.008 times compared to the group, the waist circumference factor, fasting glucose factor, and triglyceride factor were found to be factors affecting coronary artery calcification score. The risk of developing calcification is primarily associated with waist circumference, anemia and triglycerides, and health care and health checks are expected to help reduce the incidence of cardiovascular disease and reduce medical costs.
Background: Sleep-related breathing disorders are commonly found in patients with chronic renal failure and particularly, sleep apnea may have an influence on the long-term mortality rates in these patients. Maintenance hemodialysis is the mainstay of medical measures for correcting the metabolic derangements of chronic renal failure but it is uncertain whether it may alleviate sleep disorders including sleep apnea. Methods: Forty seven patients on maintenance hemodialysis were surveyed with the sleep questionnaire about their clinical symptoms related to sleep disorders. Among them, 15 patients underwent the polysomnography and their blood levels of urea nitrogen, creatinine, electrolytes and the arterial blood gases in the nights before and following hemodialysis were measured. Results: Forty(85.1%) of the 47 patients complained of the symptoms associated with sleep-wake cycle disturbances, 55.3% experienced snoring and 27.7% reported witnessed apneas. The duration of REM sleep increased significantly in the nights after hemodialysis compared to the nights without hemodialysis(p<0.05) and the percentage of total sleep time comprising NREM sleep decreased significantly in the nights following hemodialysis compared to the nights before hemodialysis(p<0.05). The percentage of total sleep time consisting of the stage 1 and 2 NREM sleep showed the trend for a decrease in the nights after hemodialysis(p=0.051), while the percentage of total sleep time comprising the stage 3 and 4 NREM sleep did not change between nights. The obstructive sleep apnea was more predominant type than the central one in both nights and there were no differences in the apnea index and the apnea-hypopnea index between the nights. The decrease in the blood level of urea nitrogen, creatinine, potassium and phosphorus was observed after hemodialysis(p<0.05), but the differences of parameters measured during polysomnography between the nights did not correlate with the changes of biochemical factors obtained on the two nights. Arterial blood gas analysis showed that pH was significantly greater in the nights after hemodialysis than in the nights before hemodialysis(p<0.05), but there were no correlations between the parameters examined during polysomnography and the parameters of arterial blood gas analysis(p<0.05). Conclusion: These results suggest that chronic renal failure is an important systemic disorder which is strongly associated with sleep disorders. Maintenance hemodialysis, although it is a widely accepted measure to treat chronic renal failure, did not significantly modulate the sleep architecture and the severity of sleep apnea. Thus, taking the patients with chronic renal failure into account, it is advisable to try not only to find a substantial way for correcting metabolic derangements but also to consider the institution of more effective treatments for sleep disorders.
Purpose: The aim of this study was to investigate the current prevalence of protein-energy malnutrition (PEM) and the nutritional status of hospitalized pediatric patients. Methods: We evaluated the nutritional status of the 200 patients from February to July 1994 and the 233 patients from February to July 1999 admitted to Pediatric Department of Chosun University Hospital. Nutritional status was assessed by anthropometric and laboratory data. The nutritional status was classified according to based on the Waterlow criteria and using the laboratory data obtained between 3 days to 5 days after admission. Results: 1) The prevalence of acute PEM (weight for height) was as follows: severe, 0.5%; moderate, 7%; mild, 18%; and none, 74.5% in 1994 and severe, 2.24%; moderate, 3.59%; mild, 19.73%; and none, 74.4% in 1999. 2) The prevalence of chronic PEM (height for age) was as follows: severe, 5%; moderate, 5.5%; mild, 25.5%; and none, 64% in 1994 and severe, 2.24%; moderate, 4.04%; mild, 22.87%; and none, 70.85% in 1999. There was not a statistically significant difference between 1994 and 1999. 3) The prevalence of PEM according to age group, all age group had in general higher prevalence of mild PEM. 4) Values for hemoglobin and albumin were below than total lymphocyte values in PEM. Conclusion: The prevalence of acute or chronic PEM was common in hospitalized children. Therefore, the assessment of nutritional status may an important role to establish effective nutritional support and to improve their subsequent hospital course in hospitalized pediatric patient.
Song, Wung Joo;Lee, Sunho;Jeon, Young Mi;Kim, Sook Za;Jang, Mea Young
Journal of The Korean Society of Inherited Metabolic disease
/
v.18
no.2
/
pp.35-42
/
2018
Purpose: To follow up Korean patients with metabolic and endocrine disorders ascertained by Korea Genetics Research Center, and assess the long-term effectiveness of extended newborn screening program in Korea. Methods: From January 2000 to December 2017, tandem mass spectrometry and fluoroimmunoassay were employed in extended newborn screening (NBS). The NBS program obtained dried blood spots from 283,626 babies, 48 hours after birth, and screened for galactosemia, congenital hypothyroidism (CH), congenital adrenal hyperplasia (CAH), and 50 preventable inborn errors of amino acid, fatty acid, and organic acid metabolism. Results: 28 cases of amino acid disorders, 75 cases of organic acid disorders, 27 cases of fatty acid disorders, 51 cases of urea cycle disorders, 127 cases of CH, 14 cases of CAH, and 15 cases of galactosemia were ascertained through NBS and subsequent confirmatory laboratory tests. Patients with amino acid metabolic disorders, galactosemia, CH, or CAH were more likely to have a better long-term outcome if detected early. Early management of MSUD led to much better outcome in over 90%. Despite early intervention, 32% of other organic acidemia cases still resulted in developmental delay and neurological problems. Fatty acid disorders showed varied results; those with EMA and MCAD had a good outcome, but those with VLCAD had serious neurological problems and considerably higher mortality. 75% with UCD experienced serious neurological complications and higher mortality. Conclusion: The nation-wide NBS program must be accompanied by comprehensive long-term management and physician and family education of inborn errors of metabolism for a better outcome.
Background: Proper construction of vascular access and adequate maintenance are essential for the prognosis of the hemodialysis patients. Though arteriovenous fistula using autogenous vessel is the first of choice, the incidence of arteriovenous fistula using artificial graft is gradually increasing. The aim of this study was to analyse the patency rates between autogenous and artificial fistula, among artificial graft types, according to the accompanied disease. Material and Method: A retrospective study was conducted on 186 patients who underwent 292 arteriovenous fistula operations for hemodialysis at Korea University Guro Hospital between 1996 and 2000. Mean age of the patients was 54.37 $\pm$ 12.79years, and the male: female ratio 99:87. Result: Among 292 operations, there were 156 autogenous fistula and 116 graft fistula. The other 20 operations were thrombectomy, takedown of graft, revision, and balloon dilatation. Patency rates of autogenous fistula were 92.78 $\pm$ 2.35% at 1 year and 39.03$\pm$9.08% at 5 years, and those of graft fistula were 96.09 $\pm$ 2.22% at 1 year and 16.45 $\pm$ 10.15% at 5 scars. However, there was no statistical significance between the two operations. The patients who had hypertension, diabetes or both had no statistical significance in the patency rate compared to that of patients without underlying disease. In addition, the type of graft used did not affect the patency rate. Second operation was needed in 62 patients and third operation in 31 patients, but their patency rate again had no statistical significance compared to that of the first operation. Conclusion: The patency of the artificial graft fistula was comparable to the autogenous fistula, but the patency according to types of graft need to be studied further. Furthermore, the underlying diseases did not affect the fistula patency.
Hormone replacement therapy (HRT) is an effective regimen that has been found to prevent these diseases in postmenopausal women. However, HRT is accompanied by an increased risk of unfavorable outcomes. This study was conducted to evaluate the effects of Eisenia Bicyclis extract on lipids in ovariectomized rats. Fifty 7-week-old female Sprague-Dawley rats were randomly assigned to four groups: sham-operated rats (SHAM), ovariectomized rats (OVX-CON), and ovariectomized rats that were treated with Eisenia bicyclis extracts. The extract-treated diets were fed to the rats for 6 weeks after operation. Antioxidant effects were measured by DPPH free radical scavenging activity. Antioxidant activity of the ethanol extract increased in a dose-dependent manner and was about 55.9% in a concentration of 100 ${\mu}g/ml$. We measured the total cholesterol content, triglyceride content, HDL-cholesterol content, LDL-cholesterol content, atherosclerotic index, cardiac risk factor in serum, and anti-platelet aggregation and blood rheology. The total cholesterol and triglyceride concentration in serum increased for the OVX-control group, but supplementation with the E. bicyclis extract caused these factors to decrease. Notably, the serum LDL-cholesterol concentration in the OVX-EB200 group was significantly lower than the OVX-CON group. In addition, the blood passage times in rats that received the E. bicyclis extract were more rapid than the times in the untreated group (OVX-CON). Microscopic evaluation revealed that whole blood passed more smoothly through the microchannels in rats in the E. bicyclis extract supplement groups. Our results clarified the effects of E. bicyclis extract on serum lipid content in ovariectomized rats, and consequently we expect positive effects from providing E. bicyclis extract to postmenopausal women with cardiovascular disease.
Objectives : The purpose of this study is to investigate the minor stress in daily life related to undergoing hemodialysis and the relationship between minor stresses, coping skills, and subjective quality of life among the patients with end stage renal disease. Methods : Seventy seven patients on hemodialysis were enrolled in this study. Minor stress was assessed with daily stress inventory-Korean version(K-DSI), ways of coping checklist identified the use of the following coping strategies:problem-focused, seek social support, emotion-focused coping and wishful thinking. Socio-demographic data were obtained and World Health Organization-Quality of Life Scale(brief form) was also administered to subjects. Results : Participants mean age was $55.92{\pm}13.71$ years. The mean of the event, impact and impact/event (I/E) ratio scores of K-DSI were $29.06{\pm}21.57$, $88.69{\pm}75.88$ and $2.92{\pm}1.11$, respectively. These scores were much higher than normative data of K-DSI. Among the 5 categories of this inventory, the scores of cognitive stressors were highest. 5 categories of the inventory showed positive relationship with way of coping subscales, which showed coefficient of correlation between 0.259(p<.01) and 0.495(p<.001). However, no significant correlation was found between minor stress subscales and quality of life. Hemodialysis patients in our study used more emotional-focused coping methods, which was considered as passive way of cope than problem-orientated coping methods. Conclusion : The main findings of this study indicated that patients on hemodialysis showed higher level of perceived minor stress than normal population. The patients treated with hemodialysis tend to use passive way of coping primarily. For assessing the stress in patients on hemodialysis, clinician has to consider both level of perceived minor stress and the ways of coping the patients primarily use.
Seo, Han-Kyung;Kim, Min-Woo;Lim, Seok-Tae;Sohn, Myung-Hee
The Korean Journal of Nuclear Medicine
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v.38
no.4
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pp.300-305
/
2004
Purpose: We underwent this study to evaluate the factors which influence labeling efficiency when modified in vivo erythrocyte labeling technique was used. Materials and methods: Thirty healthy volunteers (M:F=19:11, age:$25{\pm}2$ yrs) were enrolled in this study. Totally, two hundred ten samples were obtained from them. The 1 mg of stannous pyrophosphate was injected intravenously at the beginning of labeling. After suitable tinning time (5 min, 20 min, 35 min) passed by, blood (5 mL, 3 mL or 1 mL) was withdrawn into 10 mL syringe previously containing Tc-99m (740 MBq) and anticoagulant (heparin, ACD or CPDA) through 19-gauged scalp needle. The generator ingrowth time of Tc-99m was within 24 hrs in each case. The blood samples were placed on rotating invertor during incubation (10 min, 25 min, 40 min) but some of them were not. Immediately after the conclusion of incubation, the labeled blood specimens to analyze were centrifuged. and then %Unbound Tc-99m was calculated. Statical analysis was used paired T-test and one way ANOVA with SPSS 10.0. Results: The binding efficiency at 1 mL of blood volume was $73{\pm}32%,\;91{\pm}10%$ at 3 mL and $96{\pm}7%$ at 5 mL (p<0.01). The binding efficiency at 5 min of tinning time was $45{\pm}23%,\;98{\pm}6%$, at 20 min and $97{\pm}8%$ at 35 min (p<0.001). The binding efficiency at 10 min of incubation time was $96{\pm}7%,\;95{\pm}12%$ at 25 min and $98{\pm}3%$ at 40 min (p>0.05). The binding efficiency in case of using rotating invertor was $96{\pm}7%$ and the binding efficiency in case of not using it was $87{\pm}18%$ (p>0.05). There was no significant difference between them. In binding efficiency according to kinds of anticoagulants, ACD was $98{\pm}4%$, CPDA was $97{\pm}6%$ and heparin was $89{\pm}20%$ (p<0.001). Conclusion: When modified in vivo erythrocyte labeling technique is used with Tc-99m, the methods to obtain the highest labeling efficiency are as follow. The withdrawing blood volume should be over 3 mL, tinning time should be kept between 20 min and 35 min, and incubation time should be kept between 10 min and 40 min. ACD or CPDA have to be used as a anticoagulant except heparin and the blood samples should be placed on rotating invertor during incubation.
Background: Left ventricular diastolic filling is an important determinant for maintenance of cardiac output during hemodialysis. Few investigators have studied the influence of hemodialysis on diastolic function. To evaluate the change of left ventricular systolic and diastolic function. we performed M-mode and Doppler echocardiographic studies before and after hemodialysis. Methods: The study population consisted of 30 patients(15 patients were male, mean age $45{\pm}10$ years) with CRF on maintenance hemodialysis. They have normal left ventricular systolic function(Fractional shortening>30%) and no evidence of valvular heart disease or regional wall motion abnormalities. The ejection fraction (EF) was measured using M-mode echocardiography and Doppler indices such as peak E velocity, peak A velocity, isovolumetric relaxation time(IVRT), deceleration time(DT). and left ventricular ejection time(LVET) obtained from Doppler echocardiography. The index of myocardial performance (IMP) was calculated from each of the Doppler velocity indices. Results: The weight reduction after hemodialysis was $2.1{\pm}1.0kg$(p<0.0001), After hemodialysis, there was some decrease in blood pressure(p<0.05), but no significant change in heart rate, EF and fractional shortening, mean VCF, peak A velocity, and DT. And significant reduction in peak E velocity, E/A ratio(p<0.0001. p<0.001), and significant increase in IVRT and IMP(p<0.05, p<0.0001) were noted. Conclusion: In conclusion, preload reduction is the main mechanism that accounts for changes in Doppler diastolic indices after hemodialysis. And an increased IMP suggests that diastolic function may be aggravated after hemodialysis, and that implies impaired left ventricular filling and disturbed left ventricular compliance.
Arteriovenous fistula Is the most widely used mean of vascular access for long-term hemodialysis in patients with end-stage renal disease. Lymphangioma associated with arteriovenous fistula is very rare, seemed to be developed from Iymphatic fluid accumulation. Lymphangioma is benign neoplasm, arises de hobo or secondary to surge y or irradiation, and affects almost any part of the body served by the Lwphasic system. Treatment of choise for Iymphangioma Is surgical excision. We repo$\ulcorner$t a case of procedure using Gore-Tex graft between left brachial artery and cephalic vein for vascular access of hemodialysis in 59 year old female, with successful surgical removal.
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