OBJECTIVE: To investigate the expression level and prognostic value of miR-21, miR-18a, miR-146a, and Let-7b derived from serum exosomes in patients with multiple myeloma (MM). METHODS: Serum exosomes were extracted from 57 MM patients and 20 healthy persons using ExoQuick exosome precipitation solution kit, and the relative expression level of miR-21, miR-18a, miR-146a, and Let-7b derived from serum exosomes was measured by RT-qPCR. Correlations of the expression levels of all miRNAs mentioned above with routine laboratory parameters were analyzed by Spearman correlation analysis. The relationship between the expression level of miR-21, miR-18a, miR-146a, and Let-7b derived from serum exosomes and overall survival of patients with MM was analyzed using the Kaplan-Meier survival curve. RESULTS: The expression levels of miR-21, miR-18a, and Let-7b derived from serum exosomes in patients with MM were significantly lower than those in the normal control group (P<0.001), while the expression level of miR-146a between the two groups was not significantly different (P>0.05). The expression level of miR-21 was strongly negatively correlated with serum β₂-microglobulin concentration (r=-0.830), and weakly negatively correlated with serum creatinine, corrected serum calcium, and cystatin C (r=-0.488, -0.282, -0.627). The expression levels of Let-7b and miR-18a were also weakly negatively correlated with the corrected serum calcium, β₂-microglobulin, and cystatin C concentration (r=-0.305, -0.362, -0.461; -0.317, -0.542, -0.434). However, there was no significant correlation between the expression level of miR-146a and routine laboratory parameters in MM patients. The overall survival rate of MM patients with low expression level of miR-21, miR-18a, and Let-7b significantly decreased compared with high expression level group (P<0.05), however, the expression level of miR-146a was not related to the overall survival rate. CONCLUSION Aberrant low expression levels of miR-21, miR-18a, and Let-7b derived from serum exosomes exist in patients with MM, which are associated with a worse overall survival rate.
Calcium/metabolism* ; Creatinine/metabolism* ; Cystatin C/metabolism* ; Exosomes/metabolism* ; Humans ; MicroRNAs/metabolism* ; Multiple Myeloma/metabolism*

Urea clearance index (KT/Vurea) and creatinine clearance weekly (Ccr) are main indexes to evaluate dialysis adequacy. In order to discuss whether they are suitable to evaluate peritoneal dialysis adequacy, we applied trans-peritoneum transport kinetic model and explored the transport characteristics of fluid and various solutes. We found that: (1) There was no specific relationship among the removal of solutes with different molecular weights; (2) There was significant difference between urea removal and fluid and sodium removal. Our results suggest that urea and creatinine removal do not represent other solutes and fluid removal. KT/Vurea and Ccr may thus not suit to be used alone to evaluate peritoneal dialysis adequacy.
Biomarkers ; metabolism ; Blood Urea Nitrogen ; Creatinine ; metabolism ; Humans ; Peritoneal Dialysis, Continuous Ambulatory ; Urea ; metabolism

Against the large number of assessment indices to the adequacy peritoneal dialysis and incompatibility of some indices, an intelligent assessment approach to the peritoneal dialysis adequacy based on MART2 (modified from ART2) network is proposed. After non-dimension and weighting preconditioning, the assessment indices were put to MART2 and sorted into many clusters. The center-of-gravity of each cluster was identified as adequacy or inadequacy according to the assessment criteria of dialysis adequacy, and the adequacy of each cluster could be determined by the adequacy of corresponding center-of-gravity when the network threshold was high. Finally, the peritoneal dialysis adequacy of each patient could be judged according to the adequacy of cluster to which the patients' indices belong. Experimental results demounstrate its effectiveness.
Creatinine ; metabolism ; Guideline Adherence ; Humans ; Kidney Failure, Chronic ; metabolism ; therapy ; Peritoneal Dialysis ; instrumentation ; standards ; Quality Assurance, Health Care ; Urea ; metabolism

BACKGROUND: To evaluate the effects of alendronate in preventing bone loss at the spine and hip in Korean cases of primary osteoporosis, we treated 138 patients with 10 mg of alendronate daily. Of the 138 patients treated, 50 were treated for one complete year, and at their final visit, measurements were taken to assess the completed outcome of the reatment, and the results from this small group were compared with those of the rest. The way this has been written causes ambiguity concerning exactly who was being studied. Check that my rewrite of this section conveys correctly the group that was studied, and how. METHODS: The serum levels of calcium(Ca) and phosphorous(P), total alkaline phosphatase(ALP), the urine calcium creatinine ratio(Uca/cr) and urine deoxypyridinoline(DPD) were measured before, during, and after the 1 year treatment period. The bone mineral densities(BMDs) at the spine and hip were also measured before and after the treatment period. New clinical fractures and side effects, were evaluated during the treatment period. RESULTS: The total serum ALP and urine DPD were decreased significantly, after the treatment period, by 38.3 and 40.5% respectively. The bone mineral density at the spine and hip were significantly increased after 1 year, by 6.7 and 2.0%, respectively. Of the 50 subjects who had completed a full year of treatment, only 4(8%) had developed new clinical fractures. Of the 138 patients who had been treated, 8(5.8%) discontinued the medication due to side effects. Of these, 7 had gastrointestinal symptoms, and 1 had skin eruption. CONCLUSION: Alendronate significantly decreased the total serum ALP and urine DPD and significantly increased spine and hip bone mineral density. Alendronate 10mg was effective in preventing bone loss in Korean cases of primary osteoporosis.
Alendronate* ; Bone Density ; Calcium ; Creatinine ; Hip ; Humans ; Metabolism* ; Osteoporosis* ; Skin ; Spine

Measurement of the serum CA 125 level as a tumor marker in patients with epithelial ovarian cancer has been widely used to monitor disease status and predict survival of patient. While a number of benign gynecologic as well as benign or malignant non-gynecologic conditions are associated with elevations of serum CA 125 levels, the established normal range describes a healthy population of women. Because the metabolism and clearance of CA 125 is not well understood and mild or moderate degrees of renal impairment frequently occurs in ovarian cancer patients during treatment or course of disease, it is valuable to investigate the effect of impaired renal function on serum level of CA 125. Eighty-nine women on hemodialysis who had no other definite cause to elevate serum CA 125 level were selected at random. The age of the patients ranged from 19 to 83 and renal disease was secondary in most cases to diabetes mellitus, hypertension or glomeru-lonephritis. The creatinine clearance was less than 10cc/min for all patients. (continue)
Creatinine ; Diabetes Mellitus ; Female ; Humans ; Hypertension ; Metabolism ; Ovarian Neoplasms ; Reference Values ; Renal Dialysis

Enflurane is metabolized in the liver by the hepatic microsomal enzyme system, cytochrome P-450 (P450IIE1) and induces enzyme system during enflurane exposure. Enhanced biotransformation might occur after enflrane itself and pathologic conditions, such as fasting, diabetes, chemical diabetes. Increased inorganic fluoride, one of the enflurane metabolites could impair renal function. The possibility of increased enflurane defluorination in the diabetic patient, group 1 (control, n= 6), group 2 (blood sugar level below 200mg%, n=6) and group 3 (blood sugar level above 200 mg%, n=5), was investigated by measuring the serum and urine F in the preoperative period and 1 MAC-hr, 2 MAC-hr, immediate postoperative and 24th postoprative hour. In the preoperative, iaunediate postoperative and 24th postoperative hour, the changes of renal function were measured by the BUN and creatinine. The results were as follows: 1) In the diabetic groups, serum fluoride ion increased significantly after enflumane anesthesia at a11 time intervals. Between control and group 3, there were significant difference of aerum inorganic fiuoride after enflurane anesthesia. 2) Urine fluoride levels increased significantly after enflurane anesthesia in all groups 3) There were no changes in renal function after enflurane anestheaia. Our study indicated that enflurane dose not harm diabetic patients.
Anesthesia ; Biotransformation ; Creatinine ; Cytochrome P-450 Enzyme System ; Enflurane* ; Fasting ; Fluorides ; Humans* ; Liver ; Metabolism* ; Preoperative Period

PURPOSE: The object of this study is to evaluate bone metabolism in healthy adolescents according to the progression of puberty. METHODS: Forty boys(13.9+/-1.7 years) and 42 girls(12.1+/-1.6 years) were classified by Tanner stage (TS) and bone age. Serum levels of osteocalcin(OC) and bone specific alkaline phosphatase(BALP) were measured as bone formation markers. Serum level of C-terminal telopeptide of type I collagen (ICTP) and urinary N-terminal telopeptide of type I collagen(NTx) concentrations adjusted by creatinine concentrations were measured as bone resorption markers. Serum or urine levels of bone turnover markers in each pubertal development group and bone age group were analysed. RESULTS: In boys, BALP and OC levels increased to peak levels significantly(P<0.05), and decreased significantly(P<0.05) from the peak levels to the levels at TS 5. ICTP and NTx levels seemed to increase to peak levels and to decrease from the peak levels to the levels at TS 5. But there were no significant differences except decreasing NTx levels. All showed peak levels between 13 and 15 years of bone age. In comparison with each TS group, BALP and OC levels were significantly different(P<0.05) between each TS group, but ICTP and NTx were not. In girls, the levels of all bone markers seemed to increase to peak levels without significance, and then decrease significantly(P< 0.05). All showed peak levels between 11 and 13 years of bone age. All except ICTP level were significantly different between each TS group(P<0.05). CONCLUSION: The bone metabolism seems to increase as progression of puberty, and to decrease during late puberty. Bone formation markers levels change more actively, rather than bone resorption markers levels during puberty. And the increment of bone formation in early puberty is more significant in boys rather than in girls.
Adolescent ; Bone Resorption ; Collagen Type I ; Creatinine ; Female ; Humans ; Metabolism* ; Osteogenesis ; Puberty*

Among many causes of calcium containing urinary stones, the hypercalciuria associated with normocalcemia is the most common one. Absorptive hypercalciuria and renal hypercalciuria constitute two major forms of idiopathic hypercalciuria. According to Coe et al., a renal leak of calcium and secondary hyperparathyroidism are present in renal hypercalciuria but not in absorptive hypercalciuria. It has been suggested that fasting urinary cAMP may provide a measure of parathyroid function. So determination of fasting urinary calcium and cAMP may be useful in the differentiation of the two major forms of idiopathic hypercalciuria. We performed the study to evaluate the significance of urinary calcium and cAMP in the determinating the types of hypercalciuria. Calcium metabolism studies and urinary cAMP determination were done in 28 in-patients with urinary stones under usual diet and fasting state. The results were as followings: 1. Among 28 patients, 15 patients had renal hypercalciuria, 6 had absorptive hypercalciuria and 7 had normocalciuria. 2. On usual diet, 24-hour urine cAMP level was 3.815+/-0.560 nmol/mg creatinine in renal hypercalciuria, 3.508+/-1.253 nmol/mg creatinine in absorptive hypercalciuria and 3.202+/-0.980 nmol/mg creatinine in normocalciuric patients. 3. On fasting state, 2-hour urine cAMP level was 4.611+/-2.591 nmol/mg creatinine in renal hypercalciuria, 4.304+/-3.173 nmol/mg creatinine in absorptive hypercalciuria and 2.400+/-1.080 nmol/mg creatinine in normocalciuric patients. 4. urinary cAMP on usual diet and fasting condition did not differ significantly among 15 renal and 6 absorptive hypercalciuric patients. (t-value; 0.82 and 0.22, respectively, p>0.1)
Calcium ; Creatinine ; Diet ; Fasting ; Humans ; Hypercalciuria ; Hyperparathyroidism, Secondary ; Metabolism ; Urinary Calculi*

Malnutrition is commonly seen in children with chronic liver diseases, and there are interactions between them. Chronic liver diseases can cause malnutrition and this can affect the prognosis of children with chronic liver diseases. Due to the complexity of nutritional assessment in children with chronic liver diseases, there are still no unified standards for the diagnosis of malnutrition. Early identification of malnutrition and related intervention helps to improve the prognosis of children with chronic liver diseases. This article reviews the features of nutrition in children with chronic liver diseases and related nutritional assessment methods.
Blood Proteins ; analysis ; Child ; Chronic Disease ; Creatinine ; urine ; Humans ; Liver Diseases ; metabolism ; Nutrition Assessment ; Skinfold Thickness

Aged ; Creatinine ; blood ; Crystallization ; Embolism, Cholesterol ; blood ; diagnosis ; drug therapy ; Humans ; Kidney ; metabolism ; pathology ; Male