1.Pregnancy Outcomes of Different Methods for Multifetal Pregnancy Reduction: A Comparative Study.
Jung Ryeol LEE ; Seung Yup KU ; Byung Chul JEE ; Chang Suk SUH ; Ki Chul KIM ; Seok Hyun KIM
Journal of Korean Medical Science 2008;23(1):111-116
The purpose of this study was to evaluate the outcomes of various methods of multifetal pregnancy reduction (MFPR) and to determine which method produces better outcomes. One hundred and forty-eight patients with multiple pregnancies resulting from assisted reproduction programs and underwent MFPR were included. According to the use of potassium chloride (KCl), patients were divided into 'KCl', and 'non- KCl' groups, and based on gestational age at the time of procedures, patients were divided into 'Early' (before 8 weeks of gestation) and 'Late' (at 8 weeks or later) groups. Firstly, to clarify the effect of each component of MFPR procedure, data were analyzed between 'KCl' and 'non-KCl' groups, and between 'Early' and 'Late' groups with adjustments. Secondly, comparison between 'Early, non-KCl' and 'Late, KCl' groups was performed to evaluate the combinative effect of both components. Non-KCl groups showed a significantly higher take-home-baby rate, and lower risk of extreme prematurity and preterm premature rupture of membranes (PPROM) than KCl groups. Early groups showed a lower immediate loss rate than Late groups. As compared with 'Late, KCl' group, 'Early, non-KCl' group was superior in terms of immediate loss, pregnancy loss, take-home-baby, and PPROM rates. Our data suggest that the 'Early, non-KCl' method may be a better option for MFPR.
Adult
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Female
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Humans
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Potassium Chloride/therapeutic use
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Pregnancy
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*Pregnancy Outcome
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Pregnancy Reduction, Multifetal/*methods
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Retrospective Studies
2.Clinical analysis of 17 cases of Gitelman syndrome.
Ling QU ; Ting-Ting ZHANG ; Yi-Ming MU
Journal of Southern Medical University 2012;32(3):432-434
OBJECTIVETo analyze the clinical and laboratory characteristics of Gitelman syndrome.
METHODSSeventeen patients with Gitelman syndrome (male/female: 11/6) were analyzed for their clinical symptoms, laboratory test results, imaging findings, treatments and outcomes.
RESULTSFifteen of the 17 patients presented with varying degrees of lower limb weakness, and 8 experienced flaccid paralysis. The laboratory tests showed hypokalemia (17/17), hypomagnesemia (17/17) and hypocalcemia (17/17). Blood renin activity (17/17), angiotensin II (14/17) and aldosterone levels (7/17) were significantly higher in the patients than in normal subjects. The symptoms were relieved by potassium alone or in combination with indomethacin, spironolactone and other potassium magnesium asparaginate, but the serum potassium and magnesium failed to recover the normal levels after the treatments.
CONCLUSIONThe primary clinical manifestations of Gitelman syndrome are lower extremity weakness with hypokalemia and hypomagnesemia. Combined drug therapies including potassium, magnesium, aldosterone antagonists and other drugs are recommended. The prognosis of the patients is favorable.
Adolescent ; Adult ; Child ; Female ; Gitelman Syndrome ; diagnosis ; drug therapy ; Humans ; Indomethacin ; therapeutic use ; Male ; Middle Aged ; Potassium Chloride ; therapeutic use ; Potassium Magnesium Aspartate ; therapeutic use ; Retrospective Studies ; Spironolactone ; therapeutic use ; Young Adult
3.Comparable prognosis in different neonatal histidine-tryptophan-ketoglutarate dosage management.
Li-Ting BAI ; Yuan-Yuan TONG ; Jin-Ping LIU ; Zheng-Yi FENG ; Ju ZHAO ; Sheng-Wen GUO ; Yu JIN ; Pei-Yao ZHANG ; Yi-Xuan LI
Chinese Medical Journal 2021;134(24):2968-2975
BACKGROUND:
Histidine-tryptophan-ketoglutarate (HTK) is a solution commonly used for organ transplantation. However, there is no certified fixed regimen for on-pump heart surgery in neonates. We aimed to retrospectively evaluate the outcomes related to different HTK dosages and to analyze the safety of high-dosage perfusion.
METHODS:
A total of 146 neonates who underwent on-pump heart surgery with single-shot HTK perfusion were divided into two groups according to HTK dosages: a standard-dose (SD) group (n = 63, 40 mL/kg < HTK ≤ 60 mL/kg) and a high-dose (HD) group (n = 83, HTK >60 mL/kg). Propensity score matching (PSM) was performed to control confounding bias.
RESULTS:
The SD group had a higher weight (3.7 ± 0.4 vs. 3.4 ± 0.4 kg, P < 0.0001), a lower proportion of complete transposition of the great artery (69.8% vs. 85.5%, P = 0.022), a lower cardiopulmonary bypass (CPB) time (123.5 [108.0, 136.0] vs. 132.5 [114.8, 152.5] min, P = 0.034), and a lower aortic x-clamp time (82.9 ± 27.1 vs. 95.5 ± 26.0 min, P = 0.005). After PSM, 44 patients were assigned to each group; baseline characteristics and CPB parameters between the two groups were comparable. There were no significant differences in peri-CPB blood product consumption after PSM (P > 0.05). The incidences of post-operative complications were not significantly different between the two groups. There were no significant differences in ventilation time, intensive care unit stay, and post-operative hospital stay (P > 0.05). Follow-up echocardiography outcomes at 1 month, 3 to 6 months, and 1 year showed that left ventricular ejection fraction and end-diastolic dimension were comparable between the two groups.
CONCLUSIONS
In neonatal on-pump cardiac surgery patients, single-shot HD (>60 mL/kg) HTK perfusion had a comparable heart protection effect and short-term post-operative prognosis as standard dosage perfusion of 40 to 60 mL/kg. Thus, this study provides supporting evidence of the safety of HD HTK perfusion.
Glucose/therapeutic use*
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Histidine
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Humans
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Infant, Newborn
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Mannitol
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Organ Preservation Solutions
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Potassium Chloride/therapeutic use*
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Prognosis
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Retrospective Studies
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Stroke Volume
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Tryptophan
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Ventricular Function, Left
4.Medical and Dietary Therapy for Kidney Stone Prevention.
Korean Journal of Urology 2014;55(12):775-779
The prevalence of kidney stone disease is increasing, and newer research is finding that stones are associated with several serious morbidities. These facts suggest that emphasis needs to be placed not only on stone treatment but also stone prevention. However, there is a relative dearth of information on dietary and medical therapies to treat and avoid nephrolithiasis. In addition, studies have shown that there are many misconceptions among both the general community and physicians about how stones should be managed. This article is meant to serve as a review of the current literature on dietary and drug therapies for stone prevention.
Allopurinol/therapeutic use
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Calcium Oxalate/analysis
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Cystine/analysis
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*Diet
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Humans
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Kidney Calculi/chemistry/*prevention & control
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Potassium Citrate/therapeutic use
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Sodium Chloride Symporter Inhibitors/therapeutic use
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Uric Acid/analysis
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Urological Agents/*therapeutic use
5.Thyrotoxic Periodic Paralysis Associated with Transient Thyrotoxicosis Due to Painless Thyroiditis.
Sang Bo OH ; Jinhee AHN ; Min Young OH ; Bo Gwang CHOI ; Ji Hyun KANG ; Yun Kyung JEON ; Sang Soo KIM ; Bo Hyun KIM ; Yong Ki KIM ; In Joo KIM
Journal of Korean Medical Science 2012;27(7):822-826
Thyrotoxic periodic paralysis (TPP) is a rare manifestation of hyperthyroidism characterized by muscle weakness and hypokalemia. All ethnicities can be affected, but TPP typically presents in men of Asian descent. The most common cause of TPP in thyrotoxicosis is Graves' disease. However, TPP can occur with any form of thyrotoxicosis. Up to our knowledge, very few cases ever reported the relationship between TPP and painless thyroiditis. We herein report a 25-yr-old Korean man who suffered from flaccid paralysis of the lower extremities and numbness of hands. The patient was subsequently diagnosed as having TPP associated with transient thyrotoxicosis due to painless thyroiditis. The paralytic attack did not recur after improving the thyroid function. Therefore, it is necessary that early diagnosis of TPP due to transient thyrotoxicosis is made to administer definite treatment and prevent recurrent paralysis.
Administration, Oral
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Adult
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Anti-Arrhythmia Agents/therapeutic use
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Humans
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Hypokalemic Periodic Paralysis/*diagnosis/drug therapy/etiology
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Male
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Organotechnetium Compounds/chemistry/diagnostic use
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Potassium Chloride/therapeutic use
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Propranolol/therapeutic use
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Radiopharmaceuticals/diagnostic use
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Thyroiditis/*complications/radiography/ultrasonography
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Thyrotoxicosis/*diagnosis/etiology
6.Impact of loop diuretics on blood sodium in patients hospitalized for heart failure.
Yu GUAN ; Xuesi WU ; Min XU ; Jiahui WU
Chinese Journal of Cardiology 2014;42(7):582-587
OBJECTIVETo observe the level of blood sodium in patients hospitalized for heart failure with water-sodium retention treated with loop diuretics and risk factors of low blood sodium.
METHODSWe selected 1 378 acute decompensated heart failure patients who visited Anzhen Hospital, and they are treated with loop diuretics, 259 patients with weight loses more than 1 kg in one week was enrolled in the final analysis, and divided into 3 groups: Group A (weight reduction between 1-3 kg), Group B (weight reduction between 3-5 kg) and Group C (weight reduction over 5 kg). Blood sodium, creatinine and uric acid were compared among groups and risk factors of low blood sodium were analyzed.
RESULTSBlood sodium was similar before and post loop diuretics treatment in Group A, and reduced in group B ((138.28 ± 3.73) mmol/L vs. (139.34 ± 3.66) mmol/L, P < 0.05) and in Group C((137.60 ± 4.07) mmol/L vs. (139.44 ± 4.12) mmol/L, P < 0.05). Forty-six (17.8%) patients developed hyponatremia post loop diuretics treatment. Duration of loop diuretics use was the independent risk infector for hyponatremia (OR = 1.191, 95%CI 1.010-1.385).
CONCLUSIONSLoop diuretics use is safe for treating hospitalized patients for heart failure with water-sodium retention and the risk of developing hyponatremia is low. Duration of loop diuretics use is the independent risk factor of hyponatremia.
Acute Disease ; Creatinine ; Heart Failure ; complications ; drug therapy ; Humans ; Hyponatremia ; Risk Factors ; Sodium ; blood ; Sodium Potassium Chloride Symporter Inhibitors ; adverse effects ; therapeutic use ; Sodium, Dietary
7.High Dose Vitamin D3 Attenuates the Hypocalciuric Effect of Thiazide in Hypercalciuric Rats.
Hye Ryoun JANG ; Jay Wook LEE ; Sejoong KIM ; Nam Ju HEO ; Jeong Hwan LEE ; Hyo Sang KIM ; Ji Yong JUNG ; Yun Kyu OH ; Ki Young NA ; Jin Suk HAN ; Kwon Wook JOO
Journal of Korean Medical Science 2010;25(9):1305-1312
Thiazide is known to decrease urinary calcium excretion. We hypothesized that thiazide shows different hypocalciuric effects depending on the stimuli causing hypercalciuria. The hypocalciuric effect of hydrochlorothiazide (HCTZ) and the expression of transient receptor potential vanilloid 5 (TRPV5), calbindin-D(28K), and several sodium transporters were assessed in hypercalciuric rats induced by high calcium diet and vitamin D3. Urine calcium excretion and the expression of transporters were measured from 4 groups of Sprague-Dawley rats; control, HCTZ, high calcium-vitamin D, and high calcium-vitamin D with HCTZ groups. HCTZ decreased urinary calcium excretion by 51.4% in the HCTZ group and only 15% in the high calcium-vitamin D with HCTZ group. TRPV5 protein abundance was not changed by HCTZ in the high calcium-vitamin D with HCTZ group compared to the high calcium-vitamin D group. Protein abundance of NHE3, SGLT1, and NKCC2 decreased in the hypercalciuric rats, and only SGLT1 protein abundance was increased by HCTZ in the hypercalciuric rats. The hypocalciuric effect of HCTZ is attenuated in high calcium and vitamin D-induced hypercalciuric rats. This attenuation seems to have resulted from the lack of HCTZ's effect on protein abundance of TRPV5 in severe hypercalciuric condition induced by high calcium and vitamin D.
Animals
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Calcium/therapeutic use/urine
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Calcium Channels/genetics/metabolism
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Cholecalciferol/*toxicity
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Hydrochlorothiazide/*therapeutic use
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Hypercalciuria/chemically induced/*drug therapy
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Rats
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Rats, Sprague-Dawley
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Sodium Chloride Symporter Inhibitors/*therapeutic use
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Sodium-Glucose Transporter 1/genetics/metabolism
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Sodium-Hydrogen Antiporter/genetics/metabolism
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Sodium-Potassium-Chloride Symporters/genetics/metabolism
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TRPV Cation Channels/genetics/metabolism