BACKGROUND/AIMS: Primary thyroid disease is prevalent in chronic renal disease, especially in patients requiring chronic dialysis. However, the relationship between kidney function and the prevalence of primary thyroid disease has not been studied in Korea, a nation where the dietary iodine intake is excessive. METHODS: Retrospective data from 2201 consecutive adult patients who visited a health promotion center over the last 5 years were analyzed; specifically, 54 patients with chronic kidney disease not requiring hemodialysis and 64 adults treated with hemodialysis. The glomerular filtration rate (GFR) was estimated using the abbreviated Modification of Diet in Renal Disease equation. Multivariable logistic regression was used to evaluate the independent association between the prevalence of primary hypothyroidism and estimated GFR. RESULTS: The prevalence of overt hypothyroidism increased from 0.5% at an estimated GFR > 90 mL/min/1.73 m2 to 6.3% in end-stage renal disease requiring chronic dialysis (p < 0.001 for trend). Compared with participants with an estimated GFR > 60 mL/min/1.73 m2, those with an estimated GFR < 60 mL/min per 1.73 m2 had an increased odds of overt hypothyroidism after adjusting for age, gender, fasting blood glucose (FBS), and the total cholesterol (TC) and triglyceride (TG) concentrations. CONCLUSIONS: These findings suggest that overt primary hypothyroidism is relatively common (6.3%) among persons with chronic kidney disease requiring chronic dialysis, and it is independently associated with a progressively lower estimated GFR.
Adult ; Blood Glucose ; Cholesterol ; Dialysis ; Diet ; Fasting ; Glomerular Filtration Rate ; Health Promotion ; Humans ; Hypothyroidism ; Iodine ; Kidney ; Kidney Failure, Chronic ; Korea ; Logistic Models ; Prevalence ; Renal Dialysis ; Renal Insufficiency, Chronic ; Retrospective Studies ; Thyroid Diseases

The role of acetylcholine as an excitatory neurotransmitter is well established, and cholinergic neurons appear to play an important role in the mammalian retinae. Though it has been reported that certain conventional and displaced amacrine cells are consistently labeled with anti-choline acetyltransferase antiserum in the mammalian retinae, little has been studied on the synaptic circuitry of cholinergic neurons to clarify mechanism of its action in the visual processing of the mammalian retinae. This study was conducted to localize cholinergic neurons and to define their synaptic circuitry in the rat retina by immunocytochemical method using anti-choline acetyltransferase antiserum. The results were as follows: 1. Cholinergic neurons of the rat retina were conventional amacrine cells located in the inner nuclear layer and displaced amacrine cells in the ganglion cell layer. 2. Cholinergic amacrine cells were branched in the middle of the sublamina a of the inner plexiform layer, and cholinergic displaced amacrine cells branched in the sublamina b, forming one prominent band, respectively. 3. Presynaptic processes to cholinergic amacrine cell processes were axon terminals of invaginating and flat cone bipolar cells, and unlabelled amacrine cell processes in the inner plexiform layer. Postsynaptic dyads at the ribbon synapses of axon terminals of cone bipolar cells were cholinergic amacrine cell process and dendrite of ganglion cell, cholinergic amacrine cell process and unlabelled amacrine cell process and cholinergic amacrine cell process and cholinergic amacrine cell process. In addition, cholinergic amacrine cell process formed postsynaptic monoad at the ribbon synapse. 4. Cholinergic amacrine cell processes made output conventional chemical synapses onto the dendrites of ganglion cells, unlabelled amacrine cell processes and cholinergic amacrine cell processes in the inner plexiform layer. These results demonstrate that (1) cholinergic neurons are conventional amacrine cells and displaced amacrine cells of which somata are located in the inner nuclear layer and ganglion cell layer, respectively, (2) cholinergic conventional amacrine cells are involved in OFF pathway, and cholinergic displaced amacrine cells play an important role in ON pathway in visual processing of lightness, and (3) acetylcholine released from cholinergic neurons by light excites directly ON and OFF ganglion cells or indirectly ON and OFF ganglion cells via non-cholinergic amacrine cells.
Acetylcholine ; Amacrine Cells ; Animals ; Choline O-Acetyltransferase ; Cholinergic Neurons* ; Dendrites ; Ganglion Cysts ; Neurotransmitter Agents ; Presynaptic Terminals ; Rats* ; Retina* ; Synapses

Here, we report an unusual case of anaplastic large-cell lymphoma presenting as ascites. A 62-year-old man with alcoholic liver cirrhosis was admitted for ascites. The ascites was an exudate, and atypical cells with nuclear irregularity suggesting the presence of a lymphoma were found on cytological examination of the ascites. However, no primary lesion was found after an exhaustive physical, laboratory, endoscopic, and radiologic examination, and the atypical cells were negative for human herpes virus-8 DNA. Therefore, no definitive diagnosis was made. He was followed regularly without chemotherapy. After 30 months, iliopsoas and erector spinae muscle lesions developed. An ultrasonography-guided gun biopsy of the iliopsoas muscle lesion was performed that revealed anaplastic pleomorphic tumor cells. An immunohistochemical study showed that the tumor cells were positive for LCA and CD30 and negative for CK and ALK. The patient was diagnosed with a primary systemic anaplastic large-cell lymphoma. He could not undergo chemotherapy due to acute renal failure and died after 10 days
Acute Kidney Injury ; Ascites ; Biopsy ; DNA ; Exudates and Transudates ; Humans ; Liver Cirrhosis, Alcoholic ; Lymphoma ; Lymphoma, Large-Cell, Anaplastic ; Middle Aged ; Muscles

BACKGROUND AND OBJECTIVES: The aim of this study was to investigate and compare the incidence and the characteristics of parameters of cervical vestibular-evoked myogenic potentials (cVEMPs) using air-conducted (AC) and bone-conducted (BC) stimulations in normal subjects. SUBJECTS AND METHOD: Twenty-four normal subjects (48 ears) with normal hearing and no previous history of dizziness were included. cVEMP responses were recorded by surface electrodes on sternocleidomastiod muscles in response to AC and BC stimuli sequentially. Variances of parameters, including thresholds, amplitudes and interaural amplitude difference ratios (IADR), were analyzed and compared. RESULTS: cVEMP responses were clearly observed in all 48 ears in both AC and BC cVEMP tests. There was no significant difference in latencies (p1 and n1). However, the thresholds in BC cVEMP testing were significantly lower than those in AC cVEMP testing, when compared to the maximum stimulation level. Interaural amplitude difference ratios showed no significant difference in between the two tests, although amplitudes at maximum stimulation intensity in BC cVEMP testing were significantly larger than those in AC cVEMP testing. CONCLUSION: This study shows that BC cVEMP testing shows lower thresholds compared to AC cVEMP testing in normal subjects, suggesting that the threshold value can be used as a parameter in detecting vestibular dysfunction in the clinic. Further studies in patients with various vestibular disorders are needed.
Dizziness ; Ear ; Electrodes ; Hearing ; Humans ; Incidence ; Muscles ; Vestibular Evoked Myogenic Potentials ; Vibration

This study was carried out to examine the proportion of fatty acids and contents of trans fatty acid in commercial processed foods in Jeon-Buk area. Contents of trans fatty acid in bakery products ranged from 0.2% to 1.0% per 100 g food. Especially garlic bread and pastry contained the highest amount. Popcorns contained trans fatty acid from 0.0% to 13.4%. Among them, instant popcorns for microwave contained the highest amount, while trans fatty acid was hardly detected in popcorns for theater. And trans fatty acid detected in popcorns was mostly in the form of 18 : 1 trans. The content of trans fatty acid in pizza was nearly 0.2%. Amounts of saturated fatty acid and unsaturated fatty acid were similar between each type of pizza and frozen pizza. Fritters such as fried chickens and vegetables contained trans fatty acid less than 0.2% per 100 g food.
Bread ; Chickens ; Fatty Acids ; Garlic ; Microwaves ; Vegetables

BACKGROUND/AIMS: The aims of this study were to evaluate the incidence of reflux esophagitis in patients after a subtotal gastrectomy and to determine risk factors for reflux esophagitis. METHODS: Among 225 patients who underwent a subtotal gastrectomy from June 2003 to December 2004 at Seoul National University Bundang Hospital, 201 patients who received follow-up for more than six months and underwent at least one endoscpoic examination were retrospectively reviewed. We used the Los Angeles (LA) classification system and included a minimal change for reflux esophagitis. RESULTS: There were 173 patients who underwent a Billroth I procedure and 28 patients who underwent a Billroth II procedure. The cumulative incidence of reflux esophagitis was 40.8%. A patient age > or =65 years (p=0.04), a follow-up duration > or =40 months (p=0.03), bile reflux gastritis (p<0.01) and postoperative obesity (p=0.02) were significant risk factors for the development of reflux esophagitis including a minimal change. The number of postoperative endoscopies > or =4 (p=0.012), bile reflux gastritis (p=0.002) and postoperative obesity (p=0.038) were risk factors for a minimal change. A patient age > or =65 years (p=0.04), a follow-up duration > or =40 months (p=0.03) and Helicobacter pylori eradication before surgery (p<0.01) were independent risk factors for LA grade A/B reflux esophagitis. CONCLUSIONS: Bile reflux gastritis is a risk factor for the development of reflux esophagitis after a subtotal gastrectomy. Preoperative helicobacter eradication is also associated with reflux esophagitis, except for a minimal change, but further studies are needed.
Bile Reflux ; Esophagitis, Peptic ; Follow-Up Studies ; Gastrectomy ; Gastritis ; Gastroenterostomy ; Helicobacter ; Helicobacter pylori ; Humans ; Incidence ; Los Angeles ; Obesity ; Retrospective Studies ; Risk Factors

BACKGROUND/AIMS: In recent years, increasing antimicrobial resistance has resulted in falling eradication rates with standard therapies. To overcome the falling eradication rates, rescue therapy have been suggested to be used. However, there is no surveillance of using bismuth-based regimen as first line Helicobacter pylori eradication therapy in Korea. This study aimed to assess the efficacy of bismuth containing PPI-based quadruple therapy as a first line treatment. METHODS: From August 2007 through February 2008, 191 patients with Helicobacter pylori positive peptic ulcer disease (PUD) or chronic gastritis (CG) who received first line therapy for 7 days were retrospectively evaluated. 39, 37, 53, 62 patients received PAC (pantoprazole 40 mg, amoxicillin 1 g, clarithromycin 500 mg bid), L-PAC (pantoprazole 40 mg, amoxicillin 750 mg, clarithromycin 250 mg bid), PACB (PAC plus bismuth 300 mg bid), L-PACB (L-PAC plus bismuth 300 mg bid). RESULTS: There was no significant difference in eradication rates between bismuth containing and non- containing group. However, in PUD, the eradication rate of PACB (95.2%) is somewhat higher than that of PAC (86.2%) without statistical significance. CONCLUSIONS: In PUD, Future study designed with a double-blind controlled large scale might reveal that PPI-based standard quadruple therapy containing a bismuth is superior to the standard triple therapy.
Amoxicillin ; Bismuth ; Clarithromycin ; Gastritis ; Helicobacter ; Helicobacter pylori ; Humans ; Korea ; Peptic Ulcer ; Retrospective Studies