Background/Aims: Although numerous noninvasive steatosis indices have been developed to assess hepatic steatosis, whether they can be applied to young adults in the evaluation of metabolic dysfunction-associated steatotic liver disease (MASLD) remains uncertain. Methods: Data from patients under 35 years of age who visited the Liver Health Clinic at the Armed Forces Goyang Hospital between July 2022 and January 2024 were retrospectively collected. Steatosis was diagnosed on the basis of a controlled attenuation parameter score ≥250dB/m. MASLD was defined as the presence of steatosis in patients with at least one cardiometabolic risk factor. Results: Among the 1,382 study participants, 901 were diagnosed with MASLD. All eight indices for diagnosing steatosis differed significantly between the MASLD and non-MASLD groups (p<0.001). Regarding the predictive performance, the hepatic steatosis index (HSI), fatty liver index (FLI), Framingham steatosis index, Dallas steatosis index, Zhejiang University index, lipid accumulation product, visceral adiposity index, and triglyceride glucose-body mass index exhibited an area under the curve of 0.898, 0.907, 0.899, 0.893, 0.915, 0.869, 0.791, and 0.898, respectively. The cutoff values for the FLI and HSI were re-examined, indicating a need for alternative cutoff values for the HSI, with a rule-in value of 42 and a rule-out value of 36 in this population. Conclusions This study presents novel findings regarding the predictive performance of established steatosis markers in young adults. Alternative cutoff values for the HSI in this population have been proposed and warrant further validation.

Background/Aims: Although numerous noninvasive steatosis indices have been developed to assess hepatic steatosis, whether they can be applied to young adults in the evaluation of metabolic dysfunction-associated steatotic liver disease (MASLD) remains uncertain. Methods: Data from patients under 35 years of age who visited the Liver Health Clinic at the Armed Forces Goyang Hospital between July 2022 and January 2024 were retrospectively collected. Steatosis was diagnosed on the basis of a controlled attenuation parameter score ≥250dB/m. MASLD was defined as the presence of steatosis in patients with at least one cardiometabolic risk factor. Results: Among the 1,382 study participants, 901 were diagnosed with MASLD. All eight indices for diagnosing steatosis differed significantly between the MASLD and non-MASLD groups (p<0.001). Regarding the predictive performance, the hepatic steatosis index (HSI), fatty liver index (FLI), Framingham steatosis index, Dallas steatosis index, Zhejiang University index, lipid accumulation product, visceral adiposity index, and triglyceride glucose-body mass index exhibited an area under the curve of 0.898, 0.907, 0.899, 0.893, 0.915, 0.869, 0.791, and 0.898, respectively. The cutoff values for the FLI and HSI were re-examined, indicating a need for alternative cutoff values for the HSI, with a rule-in value of 42 and a rule-out value of 36 in this population. Conclusions This study presents novel findings regarding the predictive performance of established steatosis markers in young adults. Alternative cutoff values for the HSI in this population have been proposed and warrant further validation.

Background/Aims: Although numerous noninvasive steatosis indices have been developed to assess hepatic steatosis, whether they can be applied to young adults in the evaluation of metabolic dysfunction-associated steatotic liver disease (MASLD) remains uncertain. Methods: Data from patients under 35 years of age who visited the Liver Health Clinic at the Armed Forces Goyang Hospital between July 2022 and January 2024 were retrospectively collected. Steatosis was diagnosed on the basis of a controlled attenuation parameter score ≥250dB/m. MASLD was defined as the presence of steatosis in patients with at least one cardiometabolic risk factor. Results: Among the 1,382 study participants, 901 were diagnosed with MASLD. All eight indices for diagnosing steatosis differed significantly between the MASLD and non-MASLD groups (p<0.001). Regarding the predictive performance, the hepatic steatosis index (HSI), fatty liver index (FLI), Framingham steatosis index, Dallas steatosis index, Zhejiang University index, lipid accumulation product, visceral adiposity index, and triglyceride glucose-body mass index exhibited an area under the curve of 0.898, 0.907, 0.899, 0.893, 0.915, 0.869, 0.791, and 0.898, respectively. The cutoff values for the FLI and HSI were re-examined, indicating a need for alternative cutoff values for the HSI, with a rule-in value of 42 and a rule-out value of 36 in this population. Conclusions This study presents novel findings regarding the predictive performance of established steatosis markers in young adults. Alternative cutoff values for the HSI in this population have been proposed and warrant further validation.

Background/Aims: Although numerous noninvasive steatosis indices have been developed to assess hepatic steatosis, whether they can be applied to young adults in the evaluation of metabolic dysfunction-associated steatotic liver disease (MASLD) remains uncertain. Methods: Data from patients under 35 years of age who visited the Liver Health Clinic at the Armed Forces Goyang Hospital between July 2022 and January 2024 were retrospectively collected. Steatosis was diagnosed on the basis of a controlled attenuation parameter score ≥250dB/m. MASLD was defined as the presence of steatosis in patients with at least one cardiometabolic risk factor. Results: Among the 1,382 study participants, 901 were diagnosed with MASLD. All eight indices for diagnosing steatosis differed significantly between the MASLD and non-MASLD groups (p<0.001). Regarding the predictive performance, the hepatic steatosis index (HSI), fatty liver index (FLI), Framingham steatosis index, Dallas steatosis index, Zhejiang University index, lipid accumulation product, visceral adiposity index, and triglyceride glucose-body mass index exhibited an area under the curve of 0.898, 0.907, 0.899, 0.893, 0.915, 0.869, 0.791, and 0.898, respectively. The cutoff values for the FLI and HSI were re-examined, indicating a need for alternative cutoff values for the HSI, with a rule-in value of 42 and a rule-out value of 36 in this population. Conclusions This study presents novel findings regarding the predictive performance of established steatosis markers in young adults. Alternative cutoff values for the HSI in this population have been proposed and warrant further validation.

BACKGROUND AND OBJECTIVES: The localization of parathyroid glands is a challenging problem to surgeons in parathyroidectomy. The purpose of this study was to introduce the intraoperative methylene blue infusion as a localization modality of parathyroid glands and to determine the usefulness of intraoperative methylene blue infusion for localization of parathyroid glands in secondary hyperparathyroidism. MATERIALS AND METHOD: Seven prospective cases of secondary hyperparathyroidism surgically treated from Sep. 2004 to Mar. 2006 were included in this study. In parathyroidectomy, intraoperative methylene blue infusion for localization of parathyroid glands was performed. RESULTS: In six cases of initial operation, four parathyroid glands were well stained and in a case of reoperation, three parathyroid glands were stained. After the surgery, all patients were well controlled in symptoms and calcium levels in blood serum, and 6 patients reached normal iPTH levels in serum. CONCLUSION: Intraoperative methylene blue infusion is an effective localization tool in parathyroidectomy for secondary hyperparathyroidism.
Calcium ; Humans ; Hyperparathyroidism, Secondary* ; Methylene Blue* ; Parathyroid Glands ; Parathyroidectomy* ; Reoperation ; Serum

BACKGROUND: The present study was aimed to know the cause of impaired bactericidal activity, especially the metabolism of oxygen free radicals in neutrophils from patients with end-stage renal disease (ESRD). METHODS: We measured the amount of superox ide anion, the activity of three antioxidant enzymes, myeloperoxidase, copper ion level, zinc ion level and the amount of malondialdehyde in neutrophils from patients with ESRD before and after hemodialysis. Reverse transcription-polymerase chain reaction (RT-PCR) for superoxide dismutase (SOD) was also done. RESULTS: The malondialdehyde level, the amount of superoxide anion, catalase, and myeloperoxidase levels in the neutrophils from the patients with ESRD were higher than those from healthy controls. SOD activity, hydrogen peroxide level and zinc level were lower in ESRD patients. On the RT-PCR, the relative index, which is defined the ratio of the band densities for SOD to glyceraldehyde 3-phosphate dehydrogenase, was decreased in neutrophils from patients with ESRD. Glutathione peroxidase activity in the neutrophils from ESRD patients did not show any significant change. CONCLUSION: These results indicate that there are some alterations in metabolism of oxygen free radicals including lower levels of hydrogen peroxide which exerting a direct germicidal ability, due to decreased gene expression and mineral levels. And these alterations might be one of the major mechanisms of impaired microbicidal activity in patients with ESRD.
Catalase ; Copper ; Free Radicals ; Gene Expression ; Glutathione Peroxidase ; Glyceraldehyde 3-Phosphate ; Humans ; Hydrogen Peroxide ; Kidney Failure, Chronic* ; Malondialdehyde ; Metabolism* ; Neutrophils* ; Oxidoreductases ; Oxygen ; Peroxidase ; Reactive Oxygen Species* ; Renal Dialysis ; Superoxide Dismutase ; Superoxides ; Zinc

OBJECTS: To assess risk factors related to the occurrence of rebleeding in patients with aneurysmal subarachnoid hemorrhage (SAH) who had been planned to the early surgery, this study was conducted retrospectively. MATERIAL AND METHODS: During the period from January, 1993 to December, 1995, 258 patients with aneurysmal SAH who admitted within 3 days of their SAH and had been planned to early surgery were selected as study population. Ten variables including age, sex, hypertension history, rebleeding before admission, systolic blood pressure on admission, intracerebral or intraventricular hematoma, clinical grade, computed tomographic (CT) grade, admission time after SAH, hemostatic parameter were analyzed by the univariate and multivariate logistic regression method using the Statistical Analysis System (SAS). RESULTS: Of the 258 patients, 25 (9.69%) patients had rebleeding. Admission within 2 hours after SAH (p=0.001), clinical grade IV-V (p=0.015), rebleeding before admission (p=0.000), and intracerebral or intraventricular hematoma (p=0.04) appeared to be associated with a higher risk of rebleeding on the univariate analysis. Particularly, the patients who admitted to hospital within 2 hours after SAH and who are clinical grade IV or V appeared to be more likely to have early rebleeding. Rebleeding before admission was revealed as a independent factor associated with rebleeding on the multivariate logistic regression analysis. CONCLUSION: The short course use of antifibrinolytics, 3-dimensional CT angiography and endovascular surgery should be considered for the patients with aneurysmal SAH who have rebleeding history before admission, intracerebral or intraventricular hematoma, who admit to hospital within 2 hours after SAH, and who are clinical IV or V to minimize rebleeding in the interval between SAH attack and early surgery.
Aneurysm* ; Angiography ; Antifibrinolytic Agents ; Blood Pressure ; Hematoma ; Humans ; Hypertension ; Intracranial Aneurysm ; Logistic Models ; Retrospective Studies ; Risk Factors ; Subarachnoid Hemorrhage*

BACKGROUND AND OBJECTIVES: Transforming growth factor-beta1 (TGF-beta1) is a multifunctional regulator of cellular differentiation, motility and growth. Loss of sensitivity to the growth inhibitory effects by TGF-beta1 plays important roles in neoplastic progression. So expression of TGF-beta1 has been described in several tumors, but little is known about the role of TGF-beta1 in neoplastic progression of human larynx. The aim of this study was to investigate the role of TGF-beta1 in the neoplastic progression of human larynx. MATERIALS AND METHODS: We evaluated the expression of TGF-beta1 using immunohistochemical study in 6 cases of normal laryngeal mucosa, 6 cases of laryngeal dysplasia, 20 cases of laryngeal carcinoma. RESULTS: The results were as follows: 1) Normal laryngeal mucosa has no expression of TGF-beta1. 2) The expression of TGF-beta was 16.7% in laryngeal dysplasia, 50.0% in laryngeal carcinoma. CONCLUSION: The TGF-beta1 expression rate was correlated to the progression of laryngeal lesions when compared to normal laryngeal mucosa, laryngeal dysplasia and laryngeal carcinoma.
Humans ; Laryngeal Mucosa* ; Larynx ; Transforming Growth Factor beta ; Transforming Growth Factor beta1

BACKGROUND AND OBJECTIVES: Tumor angiogenesis is an essential process required for growth and metastasis of cancer. Basic fibroblast growth factor (bFGF) is one of angiogenetic factors, and platelet endothelial cell adhesion molecule (CD-31) is the commonly used marker to identify the vessel. It is unclear that the degree of angiogenesis and expression of bFGF are related to the growth and metastasis in laryngeal squamous cell carcinoma. We examined the expression of bFGF and degree of angiogenesis in laryngeal squamous cell carcinoma and compared them to normal larynx. Relationship between bFGF and angiogenesis to growth and nodal metastasis in laryngeal squamous cell carcinoma was also evaluated. MATERIAL AND METHODS: Immunohistochemical study for bFGF and CD-31 were performed to detect the angiogenetic factor and degree of angiogenesis in 24 squamous cell carcinoma of larynx and 6 normal laryngeal tissue. Relationship of bFGF expression and degree of angiogenesis in laryngeal squamous cell carcinoma were compared to that in normal larynx. We evaluated relationship of expression of bFGF and degree of angiogenesis to primary stage and nodal stage in laryngeal squamous cell carcinoma. RESULTS: These expression of bFGF and degree of angiogenesis in laryngeal squamous cell carcinoma were significantly higher than in the normal control (p<0.05). The degree of angiogensis were significantly correlated with bFGF expression (p<0.05): the bFGF expression and degree of angiogenesis were not correlated to the nodal stage, but to the primary stage in laryngeal squamous cell carcinoma (p<0.05). CONCLUSION: These results indicate that bFGF and angiogenesis may play an important role in the growth of larygeal squamous cell carcinoma.
Blood Platelets ; Carcinoma, Squamous Cell* ; Endothelial Cells ; Fibroblast Growth Factor 2 ; Larynx ; Neoplasm Metastasis

The nephrotic syndrome in association with extrarenal malignancy is not an uncommon event. The membranous nephropathy is most frequently associated with various carcinomas of the lung, breast, stomach and colon. Though the exact causal relationship has not been determined completely, deposition of the immune complexes composed of antitumor antibody and tumor antigens in the subepithelium is most favorably accepted. We experienced a patient with previously diagnosed membranous nephropathy and subsequently demonstrated early gastric cancer during patient follow-up. After surgical resection proteinuria improved significantly. All physicians are strongly recommended to examine thoroughly and search carefully for possibility of concomitant occult malignancy when an aged patient, especially over 40 years old, is diagnosed as a nephrotic syndrome.
Adult ; Antigen-Antibody Complex ; Antigens, Neoplasm ; Breast ; Colon ; Follow-Up Studies ; Glomerulonephritis, Membranous* ; Humans ; Lung ; Nephrotic Syndrome ; Proteinuria ; Stomach ; Stomach Neoplasms*