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Eosinophilia in Patients with End Stage Renal Disease Undergoing Hemodialysis 接受血液透析的终末期肾病患者嗜酸性粒细胞增多
Pub Date : 2021-12-30 DOI: 10.15746/sms.21.016
Kyoungha Kim, T. Chang, S. Yoon, Min-Young Lee, N. Lee, J. Won, Myungsook Chang
Objective: Eosinophilia in patients on hemodialysis has already been reported. It has been associated with allergy to dialyzers and exaggerated activation of complement during hemodialysis. Its etiology, however, remains unknown. In addition, there are not enough studies on eosinophilia in patients on hemodialysis in Korea. Therefore, we performed this retrospective study to find out the prevalence and possible etiologic factors of blood eosinophilia in patients undergoing hemodialysis.Methods: Between January 2013 to December 2015, the patients hospitalized for hemodialysis at Soonchunhyang University Hospital and National Health Insurance Service Medical Center (Ilsan Hospital) were included in this study. Eosinophilia was defined when absolute eosinophil count was greater than 500/μL, respectively. We retrospectively reviewed the medical records of patients about parasite infection, other malignancies, and history of kidney transplantation.Results: Of the 2,155 patients hospitalized for hemodialysis at two centers, 1,057 patients (49%) were found to have eosinophilia. We investigated 1,199 patients’ information (Soonchunhyang University Hospital) by the medical records. Two hundred two patients (16.8%) had no identifiable and/or possible causes. Only two patients complained of symptoms such as itching. Steroids were administered to control symptoms, and both patients had normal eosinophil levels, and steroids were discontinued. Other patients did not complain of specific symptoms associated with eosinophilia and did not take medication such as steroids. Eosinophilia was improved in 49% of patients without special treatments.Conclusion: We found that the eosinophil counts in patients with end stage renal disease on hemodialysis were frequently elevated. However, in most cases, eosinophilia was not clinically relevant.
目的:血液透析患者嗜酸性粒细胞增多已有报道。它与透析时对透析剂过敏和补体的过度激活有关。然而,其病因尚不清楚。此外,国内对血液透析患者嗜酸性粒细胞的研究也不足。因此,我们进行了这项回顾性研究,以了解血液透析患者血液嗜酸性粒细胞增多的患病率和可能的病因。方法:选取2013年1月至2015年12月在顺天香大学附属医院和国民健康保险服务中心(一山医院)住院的血液透析患者为研究对象。嗜酸性粒细胞绝对计数大于500/μL时为嗜酸性粒细胞增多。我们回顾性地回顾了患者关于寄生虫感染、其他恶性肿瘤和肾移植史的医疗记录。结果:在两个中心住院进行血液透析的2155例患者中,发现1057例(49%)患者有嗜酸性粒细胞增多症。对顺天香大学附属医院1199例患者的病历资料进行了调查。222名患者(16.8%)没有可识别和/或可能的病因。只有两名患者抱怨有瘙痒等症状。给予类固醇以控制症状,两名患者的嗜酸性粒细胞水平正常,类固醇停用。其他患者没有与嗜酸性粒细胞增多症相关的特殊症状,也没有服用类固醇等药物。未经特殊治疗的患者中有49%的嗜酸性粒细胞得到改善。结论:我们发现终末期肾病血液透析患者的嗜酸性粒细胞计数经常升高。然而,在大多数情况下,嗜酸性粒细胞增多与临床无关。
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引用次数: 0
Association of Body Mass Index and Waist Circumference with Prostate-Specific Antigen 体质指数和腰围与前列腺特异性抗原的关系
Pub Date : 2021-12-30 DOI: 10.15746/sms.21.017
Jin Lee, Hwang-Sik Shin, Y. Cho, Jeung Eun Oh
Objective: Prostate-specific antigen (PSA) is widely used as a screening tool of prostate cancer, although there has been a controversy about efficacy. In Korea, rapid growth of obesity prevalence in adult men is a one of the biggest health problems. The objective of this study was to evaluate the potential association between body mass index (BMI), waist circumference (WC) and PSA.Methods: We calculated BMI and WC of a total of 25,603 males who visited the Soonchunhyang University Cheonan Hospital Health Promotion Center from January 2016 to December 2020. This was categorized as follows: BMI < 23 kg/m2 (normal), 23 kg/m2 ≤ BMI < 25 kg/m2 (overweight), BMI ≥ 25 kg/m2 (obesity) and WC < 90 cm (normal), WC ≥ 90 cm (abdominal obesity). We analyzed the association between BMI, WC and PSA.Results: The mean PSA value was 1.08 ng/mL, 1.03 ng/mL, and 0.97 ng/mL at normal, overweight, and obesity group, respectively. The mean PSA value was 1.04 ng/mL and 0.96 ng/mL at normal and abdominal obesity group. Thus, the mean PSA value decreased with an increase in BMI and WC category (P < 0.001). The correlation coefficient between BMI, WC and PSA was -0.055, -0.044 and they were statistically significant (P < 0.001).Conclusion: We observed a significant negative correlation between BMI, WC and PSA value. Therefore, PSA value should be considered in relation to BMI and WC.
目的:前列腺特异性抗原(PSA)作为前列腺癌的筛查工具被广泛使用,但其疗效一直存在争议。在韩国,成年男性肥胖率的快速增长是最大的健康问题之一。本研究的目的是评估体重指数(BMI)、腰围(WC)和PSA之间的潜在关联。方法:对2016年1月至2020年12月在顺天乡大学天安医院健康促进中心就诊的25603名男性进行BMI和WC计算。BMI < 23 kg/m2(正常)、23 kg/m2≤BMI < 25 kg/m2(超重)、BMI≥25 kg/m2(肥胖)、WC < 90 cm(正常)、WC≥90 cm(腹部肥胖)。我们分析了BMI、WC和PSA之间的关系。结果:正常组、超重组、肥胖组平均PSA值分别为1.08、1.03、0.97 ng/mL。正常组和腹型肥胖组的PSA平均值分别为1.04 ng/mL和0.96 ng/mL。因此,平均PSA值随着BMI和WC类别的增加而降低(P < 0.001)。BMI、WC与PSA的相关系数分别为-0.055、-0.044,差异均有统计学意义(P < 0.001)。结论:BMI、WC与PSA值呈显著负相关。因此,应考虑PSA值与BMI和WC的关系。
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引用次数: 0
The Optical Coherence Tomographic Findings Which Predict Outcome of Calcified Coronary Lesions after Percutaneous Coronary Intervention: A Serial Follow-up Study 经皮冠状动脉介入治疗后预测冠状动脉钙化病变预后的光学相干断层扫描结果:一项系列随访研究
Pub Date : 2021-06-30 DOI: 10.15746/sms.21.002
Jihong Jang, Si-Hyuk Kang, Young-Seok Cho, E. Shin, J. Suh
Objective: Imaging modalities such as intravascular ultrasonography or computed tomography or angiography have shown limitations in assessing coronary calcification. In this study, we investigated whether quantitative indices of optical coherence tomography (OCT) in calcified lesions are correlated with the late outcome of a coronary stent.Methods: We consecutively enrolled patients who had more than grade 2 coronary calcification on fluoroscopy. OCT was performed at baseline, immediately after stenting, and at 9 months after stenting. We analyzed qualitative and quantitative characteristics of plaque, calcification, and stent-related indices.Results: All images of 3-time points were available in a total of 10 patients. Calcified lesions were frequently associated with thin cap fibroatheroma (100%), plaque erosion (20%), or rupture (20%) before the procedure. Thrombus was found in 100% of cases in the OCT immediately after stenting. Maximal calcium area before stenting was strongly correlated with late luminal loss assessed by 9-month follow-up OCT (r= 0.766, P= 0.01).Conclusion: Preprocedural OCT assessment on calcified coronary lesion may predict high-risk procedure and late stent outcome. Further studies are warranted to confirm these findings.
目的:血管内超声、计算机断层扫描或血管造影等成像方式在评估冠状动脉钙化方面存在局限性。在这项研究中,我们研究了钙化病变的光学相干断层扫描(OCT)的定量指标是否与冠状动脉支架的晚期预后相关。方法:我们连续招募了在x线透视下冠脉钙化超过2级的患者。OCT分别在基线、支架植入术后和支架植入术后9个月进行。我们分析了斑块、钙化和支架相关指标的定性和定量特征。结果:10例患者3个时间点的影像全部获得。术前钙化病变常伴有薄帽纤维粥样瘤(100%)、斑块侵蚀(20%)或破裂(20%)。支架置入术后立即进行OCT检查发现血栓率100%。通过随访9个月的OCT评估,支架植入前最大钙面积与后期管腔损失密切相关(r= 0.766, P= 0.01)。结论:术前对钙化冠状动脉病变的OCT评估可预测高危手术和晚期支架预后。需要进一步的研究来证实这些发现。
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引用次数: 0
A Case of Digital Intraosseous Epidermoid Inclusion Cyst of the Distal Phalanx 指骨远端指骨内表皮样包涵囊肿1例
Pub Date : 2021-06-30 DOI: 10.15746/sms.21.010
S. Hwang
Intraosseous epidermoid inclusion cyst is a very rare cystic lesion of the bone, that has been reported primarily in middle-aged men. A congenital etiology has been proposed, although post-traumatic or iatrogenic events remain the most prevalent hypotheses. A 61-year-old woman visited Soonchunhyang University Gumi Hospital complaining of painful swelling of her right middle finger. Radiologic findings of the lesion showed a well-defined, lytic, expansile lesion originating at the tip of the distal phalanx. Preoperative imaging suggested benign cartilage tumors such as enchondroma or acute osteomyelitis. Intralesional curettage, culture, and biopsy were performed. Histopathological analysis demonstrated stratified squamous epithelium with keratinized cellular debris, consistent with a diagnosis of digital intraosseous epidermoid inclusion cyst. We present a case of an epidermoid inclusion cyst originating at the tip of the distal phalanx of the right middle finger.
骨内表皮样包涵囊肿是一种非常罕见的骨囊性病变,主要发生于中年男性。虽然创伤后或医源性事件仍然是最普遍的假设,但已提出先天性病因。顺天乡大学龟尾医院的A某(61岁)表示,右手中指肿痛。病灶的放射学表现为一清晰、溶解性、扩张性病灶,起源于远节指骨尖端。术前影像学提示为良性软骨肿瘤,如软骨瘤或急性骨髓炎。进行病灶内刮除、培养和活检。组织病理学分析显示层状鳞状上皮伴角化细胞碎片,符合指骨内表皮样包涵性囊肿的诊断。我们报告一例起源于右中指远端指骨尖端的表皮样包涵囊肿。
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引用次数: 0
Annular Pancreas with Meckel’s Diverticulum and Ladd’s Band in Neonate 新生儿环状胰腺伴梅克尔憩室和拉德带
Pub Date : 2021-06-30 DOI: 10.15746/sms.21.009
H. Kim
Annular pancreas is a rare congenital malformation consisting of pancreatic tissue surrounding the descending portion of the duodenum and induces intestinal obstruction. This is caused by incomplete rotation of the ventral pancreatic bud. In children, the annular pancreas is also associated with trisomy 21 and other congenital diseases such as Meckel’s diverticulum, intestinal, or cardiac malformations. Here we presented a rare case of the annular pancreas with Meckel’s diverticulum identified by the abdominal exploration of an 8-day-old girl who suffered from projectile bilious vomiting. A plain abdominal radiograph showed a ‘double-bubble sign’ with air in the stomach and duodenum, and the upper gastrointestinal series showed a dilated proximal duodenum, with partial obstruction of the descending duodenum. The exploration revealed an annular pancreas, Meckel’s diverticulum, and Ladd’s band without large bowel malrotation. Subsequently, she ate well and was discharged on the 27th hospital day.
环状胰腺是一种罕见的先天性畸形,由围绕在十二指肠下降部分的胰腺组织组成,并引起肠梗阻。这是由腹侧胰腺芽旋转不完全引起的。在儿童中,环状胰腺也与21三体和其他先天性疾病(如梅克尔憩室、肠道或心脏畸形)有关。在此,我们报告一例罕见的环状胰腺伴梅克尔憩室的病例,该病例由一位8天大的女孩腹部探查发现,她患有抛射性胆汁性呕吐。腹部平片示双泡征,胃和十二指肠内有空气,上消化道示十二指肠近端扩张,部分下行十二指肠梗阻。检查显示环状胰腺、梅克尔憩室和拉德带,未见大肠旋转不良。随后,患者进食良好,于住院第27日出院。
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引用次数: 0
Preputial Stones as a Rare Complication of Buried Penis: A Case Report 隐伏性阴茎罕见并发症包皮结石1例
Pub Date : 2021-06-30 DOI: 10.15746/sms.21.006
Si Hyun Kim, D. Kim
Preputial calculi are a very rare manifestation of urolithiasis that occur most often in uncircumcised elderly males with poor hygiene and low socioeconomic status. Here, we present a case of preputial calculi in a 13-year-old boy with a buried penis. No penile shaft was observed and hard materials palpated around the penile foreskin. Imaging examinations showed several stones around the penis and surgical correction was indicated. The stones were removed and a circumferential incision along the coronal edge allowed for degloving with rotated skin flaps. Surgical removal of the stones and reconstruction was performed to promote hygiene and prevent future infection.
包皮结石是一种非常罕见的尿石症表现,最常见于未行包皮环切术、卫生条件差和社会经济地位低的老年男性。在这里,我们报告一例包皮结石,在一个13岁的男孩与埋藏的阴茎。未见阴茎轴,阴茎包皮周围有硬物质。影像学检查显示阴茎周围有几颗结石,需要手术矫正。取下结石,沿冠状边缘做环状切口,旋转皮瓣取下手套。手术取出结石并进行重建,以促进卫生和预防未来感染。
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引用次数: 0
Association between Heart Rate Variability and Metabolic Syndrome 心率变异性与代谢综合征之间的关系
Pub Date : 2021-06-30 DOI: 10.15746/sms.21.001
Yong‐Jin Cho, Dongying Song
Objective: Several studies suggested that heart rate variability (HRV) is a risk factor for metabolic syndrome. The objective of this study was to evaluate the association between HRV and metabolic syndrome among Korean adults.Methods: We included 6,945 people who visited the Soonchunhyang University Cheonan Hospital Health Examination Center and tested HRV, from March 2016 to November 2019. Among them, 6,827 subjects were included. We excluded those who had a history of hypertension, diabetes, stroke, or other disease and excluded them from the omission of questionnaires. We examined HRV with machine WISE-8000 (MooYoo Instruments, Seongnam, Korea) and divided three groups of HRV results. The diagnosis of metabolic syndrome was made using criteria modified National Cholesterol Education Program Adult Treatment Panel III. Logistic regression analysis was used to calculate odds ratios between HRV results and metabolic syndrome.Results: The odds ratio for metabolic syndrome in low HRV result was 2.87 (95% confidence interval [CI], 1.87–3.34) compared with high HRV result. After adjustment for age, smoking, alcohol consumption, and physical activity, the odds ratio for metabolic syndrome in low HRV result was also 3.37 (95% CI, 2.44–4.65) compared with high HRV result.Conclusion: Low HRV result using WISE-8000 (MooYoo Instruments) showed an increased risk for metabolic syndrome. HRV was associated with an increased risk of metabolic syndrome in Korean adults.
目的:几项研究表明心率变异性(HRV)是代谢综合征的危险因素。本研究的目的是评估韩国成人HRV与代谢综合征之间的关系。方法:我们纳入了2016年3月至2019年11月期间到顺天乡大学天安医院健康检查中心进行HRV检测的6945人。其中纳入6827名受试者。我们排除了那些有高血压、糖尿病、中风或其他疾病史的人,并将他们排除在问卷遗漏之外。我们使用WISE-8000机器(韩国城南的MooYoo仪器公司)检测HRV,并将HRV结果分为三组。代谢综合征的诊断采用国家胆固醇教育计划成人治疗小组III修订的标准。采用Logistic回归分析计算HRV结果与代谢综合征的比值比。结果:与高HRV组相比,低HRV组代谢综合征的比值比为2.87(95%可信区间[CI], 1.87 ~ 3.34)。在调整了年龄、吸烟、饮酒和体力活动因素后,与高HRV结果相比,低HRV结果中代谢综合征的优势比也为3.37 (95% CI, 2.44-4.65)。结论:使用WISE-8000 (MooYoo Instruments)的低HRV结果表明代谢综合征的风险增加。HRV与韩国成年人代谢综合征风险增加有关。
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引用次数: 0
Ventricular Tachycardia in Neonates: A Report of Two Cases and Review of the Literature 新生儿室性心动过速2例报告并文献复习
Pub Date : 2021-06-30 DOI: 10.15746/sms.21.003
Yoo-ra Jung, Sun Hyang Lee, G. Park, Sung Shin Kim
In the case of hemodynamically stable broad complex tachycardia, it is essential to evaluate the causes and to diagnose correctly in the selection of appropriate management and drugs. We report two neonates diagnosed with idiopathic ventricular tachycardia, which is extraordinarily rare. One presented with idiopathic fascicular ventricular tachycardia (right bundle branch block pattern with a superior axis), and the other presented with right ventricular outflow tract ventricular tachycardia (left bundle branch block pattern with an inferior axis). These two forms are representative of benign ventricular tachycardia. No features of cardiovascular shock were observed. While the recommended initial drug treatments are different, the conditions were well controlled by propranolol without the development of any adverse events. There was no recurrence of arrhythmia for several months in the outpatient clinic.
对于血流动力学稳定的广泛性复杂心动过速,评估病因,正确诊断,选择合适的治疗方法和药物是至关重要的。我们报告两个新生儿诊断为特发性室性心动过速,这是非常罕见的。一例表现为特发性束状室性心动过速(右束分支阻滞型,上轴),另一例表现为右心室流出道室性心动过速(左束分支阻滞型,下轴)。这两种形式是良性室性心动过速的代表。未观察到心血管休克的特征。虽然推荐的初始药物治疗方法不同,但心得安能很好地控制病情,未发生任何不良事件。门诊几个月无心律失常复发。
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引用次数: 1
Magnetic Resonance Imaging Images of the Local Anesthetic Spreading after Erector Spinae Plane Block at T2 Level 竖脊肌平面阻滞后T2水平局麻扩散的磁共振成像图像
Pub Date : 2021-06-30 DOI: 10.15746/sms.21.012
M. Kim
It has been reported that erector spinae plane block (ESPB), which was performed at the mid-thoracic level, can be effective for the visceral and somatic pain of the thoracic region. The magnetic resonance imaging (MRI) images showed the diffusion of the contrast medium into the transforaminal and epidural spaces after ESPB, and these MRI findings helped to understand the mechanism of the analgesic effect. There have also been reports that ESPB at the upper thoracic level can reduce the pain of the shoulder and upper extremities. However, no MRI images have been reported to support the mechanism of analgesic effect in the cervical region. We report for the first time the MRI images of local anesthetic spread after ESPB at the T2 level.
据报道,在胸椎中段行竖脊平面阻滞术(ESPB),可有效治疗胸椎区内脏和躯体疼痛。磁共振成像(MRI)显示造影剂在ESPB后向椎间孔和硬膜外间隙扩散,这些MRI结果有助于了解镇痛作用的机制。也有报道称,上胸水平的ESPB可以减轻肩部和上肢的疼痛。然而,没有MRI图像报道支持颈部镇痛作用的机制。我们首次报道了ESPB术后T2水平局麻扩散的MRI图像。
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引用次数: 0
The Predictive Factor for Favorable Outcome after Surgical Treatment of Benign Prostate Hyperplasia Performed by Young Urologist - Is Surgical Modality Important in Beginner Urologists? 年轻泌尿科医师行良性前列腺增生手术治疗后预后良好的预测因素——手术方式对初诊泌尿科医师重要吗?
Pub Date : 2020-12-31 DOI: 10.21203/rs.3.rs-136711/v1
Ki Hong Kim, Heejo Yang, Y. Jeon
Background: To identify predictive factors for favorable outcomes after surgical treatments that were performed by beginner urologists in patients with benign prostate hyperplasia (BPH), we retrospectively evaluated outcomes after holmium laser enucleation of the prostate (HoLEP) and transurethral resection of prostate (TURP) that were performed by two young urologists.Methods: Of 80 patients who were treated with HoLEP or TURP, 31 (HoLEP) and 36 (TURP) patients who were followed up for 3 months were enrolled in this study. Preoperative and perioperative variables were evaluated to identify predictive factors for favorable outcome after surgical treatment for BPH.Results: At 3 months postoperative after HoLEP or TURP, the median decrease in IPSS was 13.0. Patients whose IPSS decreased by over 13 points were categorized into a favorable response group after HoLEP or TURP. Univariate and multivariate logistic regression analyses were performed to identify predictors of favorable outcomes at 3 months after HoLEP or TURP, and the preoperative IPSS was identified as an independent predictor for favorable outcomes. Conclusions: When young urologists plan to perform surgical treatment for BPH, they should consider that the severity of symptoms is the most important factor for favorable outcomes. The type of surgical modality for managing BPH is less important. Trial registration : Soonchunhyang university institutional review board approval (No. 2017-07-022)
背景:为了确定由初级泌尿科医师对良性前列腺增生(BPH)患者进行手术治疗后预后良好的预测因素,我们回顾性评估了由两位年轻泌尿科医师进行的钬激光前列腺去核术(HoLEP)和经尿道前列腺切除术(TURP)后的预后。方法:80例接受HoLEP或TURP治疗的患者中,HoLEP 31例,TURP 36例,随访3个月。评估术前和围手术期变量,以确定BPH手术治疗后预后良好的预测因素。结果:HoLEP或TURP术后3个月,IPSS中位数下降13.0。IPSS下降超过13分的患者在HoLEP或TURP后被归类为良好反应组。进行单因素和多因素logistic回归分析,以确定HoLEP或TURP后3个月有利结果的预测因素,术前IPSS被确定为有利结果的独立预测因素。结论:当年轻泌尿科医生计划对BPH进行手术治疗时,他们应该考虑到症状的严重程度是预后良好的最重要因素。治疗前列腺增生的手术方式类型不太重要。试验注册:顺春香大学机构审查委员会批准(2017-07-022)
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引用次数: 1
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Soonchunhyang Medical Science
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