BACKGROUND: Recently, the prevalence of diabetes mellitus in elderly people is increasing in Korea because of an increase in longevity. With advancing age, also a greater proportion of end-stage renal disease (ESRD) patients with complex medical co-morbidity contributes to the higher mortality seen in patients receiving dialysis. Diabetic nephropathy has become the most important cause of ESRD worldwide. More intensive therapeutic manipulation is needed to prevent the progression of diabetic nephropathy, but there are few studies about this subject in type 2 diabetes. The aim of this study is to predict renal outcomes of elderly people with type 2 diabetes and investigate risk factors related with the deterioration of renal function and the development of ESRD. METHODS: Study subjects were 67 elderly patients (over 65 years old) with type 2 diabetes. We retrospectively analyzed risk factors for the end points of doubling of serum creatinine or the development of ESRD (dialysis or transplantation). RESULTS: 17 patients (26.4%) reached the end points during the follow-up period. 16 patients of 43 patients with decreased renal function reached the end points and only one of 24 patients with preserved renal function reached the end points. A univariate analysis revealed significant correlations between renal outcomes and duration of diabetes, anemia, hypoalbuminemia, BUN, baseline serum creatinine, GFR, serum calcium, phosphorus, uric acid levels and the degree of proteinuria. In our multivariate analysis, proteinuria and baseline serum creatinine level were significantly independent risk factors. The risk of doubling of serum creatinine or development of ESRD among patients with baseline urinary protein excretion rate >or=1g/24h was six times higher compared with the risk among those with urinary protein excretion rate <1g/24h. CONCLUSION: Proteinuria and the degree of baseline kidney dysfunction are significant risk factors that contribute to the deterioration of renal function and the development of ESRD in elderly patients with type 2 diabetes. Proteinuria is the most powerful independent predictor of renal outcomes.
Aged* ; Anemia ; Calcium ; Creatinine ; Diabetes Mellitus ; Diabetic Nephropathies* ; Dialysis ; Follow-Up Studies ; Humans ; Hypoalbuminemia ; Kidney ; Kidney Failure, Chronic ; Korea ; Longevity ; Mortality ; Multivariate Analysis ; Phosphorus ; Prevalence ; Proteinuria ; Retrospective Studies* ; Risk Factors ; Uric Acid

This study was conducted to determine the serum cardiac troponin I (cTnI) concentrations in clinically normal (uninfected) Korean Jindo dogs and those infected with Dirofilaria (D.) immitis. Forty Korean Jindo dogs (22 females, 18 males) were obtained from two kennels in the Boryeong area of Chungnam Province and the Daejeon area, Korea. Significantly higher cTnI concentrations were observed in D. immitis-infected dogs than clinically normal dogs. cTnI testing in addition to thoracic radiography, echocardiography, and electrocardiography shows promise as an additional method for diagnosis of heartworm infection.
Animals ; Chungcheongnam-do ; Diagnosis ; Dirofilaria immitis* ; Dirofilaria* ; Dogs* ; Echocardiography ; Electrocardiography ; Female ; Humans ; Korea ; Radiography, Thoracic ; Troponin I* ; Troponin*

A feeding gastrostomy tube is used to provide chronic nutritional support for patients who have a swallowing disability. Serious complications associated with feeding gastrostomy are rare. However, dislocation of the gastrostomy tube into the duodenum can lead to serious complications. There have been 7 reports in which the gastrostomy tube used for enteral feeding was associated with acute pancreatitis. But there have been no reports of pancreatitis associated with feeding gastrostomy in Korea. Further, all the reported cases were associated with both pancreatitis and cholangitis secondary to the compression of the major papilla by the percutaneous endoscopic gastrostomy tube. To the best our knowledge, this is the first report of acute pancreatitis, without cholangitis, that was induced by the compression of migrating surgical gastrostomy tube. Herein, we report on a case of a 68-year-old Korean male diagnosed with acute pancreatitis, and this was induced by the migration of a surgical gastrostomy tube.
Aged ; Cholangitis ; Deglutition ; Dislocations ; Duodenum ; Enteral Nutrition ; Gastrostomy ; Humans ; Korea ; Male ; Nutritional Support ; Pancreatitis

PURPOSE: To demonstrate the proton MR spectroscopic characteristics of non-neoplastic focal basal ganglialesions with high signal intensity on long TR MR images in patients with neurofibromatosis type 1(NF-1), and tocompare them with those of normal-appearing basal ganglia in patients without focal lesions. MATERIALS AND METHODS: Single-voxel proton MR spectroscopy was performed in six patients with NF-1 from two families(three with andthree without non-neoplastic focal brain lesions). All six individual spectra were obtained from basal gangliawith voxel sizes of about 1 x 1 x 1 cm, three from focal pallidal lesions in patients with focal lesions and threefrom normal-appearing basal ganglia in patients without focal lesions. Spectra were acquired using a 1.5T clinicalMR imager and stimulated echo acquisition mode sequence, with the following parameters: 30 ms of echo time, 13.7ms of mixing time, and 2560 ms of repetition time. Zero and first-order phase correction was performed. RESULTS:N-acetyl aspartate(NAA)/creatine(Cr) ratios were similar between focal basal ganglia lesions and normal-appearingbasal ganglia, though the former showed slightly lower choline(Cho)/Cr ratios and slightly higher NAA/Cho ratiosthan the latter. Relatively enhanced resonances around 3.75 ppm, assigned as glutamate/glutamine, were observed inthe spectra of three focal lesions. Lipid resonances around slightly different positions were observed in all sixpatients, regardless of the presence or absence of focal lesions. CONCLUSION: Slightly decreased Cho levels andrelatively enhanced glutamate/glutamine resonances are thought to characterize the focal basal ganglia lesions ofNF-1. Different mobile lipids appear to be present in the basal ganglia of NF-1 patients, regardless of thepresence of focal lesions.
Basal Ganglia* ; Brain ; Ganglia ; Humans ; Magnetic Resonance Spectroscopy* ; Neurofibromatoses* ; Neurofibromatosis 1* ; Protons*

Surgery is the primary treatment for adenocarcinoma arising from Barrett's esophagus. However, in order to avoid the high risk of complications of surgical resection, many physicians try various endoscopic treatments in cases of early adenocarcinoma and high-grade dysplasia of Barrett's esophagus. Endoscopic submucosal dissection (ESD) is a recently highlighted technique because of its high rate of en bloc resection, but there is controversy about ESD because of the uncertain long-term effect. There is a high risk of local recurrence after endoscopic treatments especially in a long-segment Barrett's esophagus, but there are no reports about this in Korea. This case we report on shows that the early adenocarcinoma arising from a long-segment Barrett's esophagus was curatively removed by ESD, but recurred high-grade dysplasia was detected on the remnant Barrett's esophagus after one year. We report here on a case of recurred esophageal malignancy after successful endoscopic resection of adenocarcinoma from a Barrett's esophagus.
Adenocarcinoma ; Barrett Esophagus ; Korea ; Recurrence

PURPOSE: There are limited population-based data regarding herpes zoster in children. Thus we conducted a multi-institutional epidemiological analysis of herpes zoster in children and comparative analysis according to their immune status. MATERIALS AND METHODS: The study included 126 children under the age of 18 years who were hospitalized for herpes zoster at 8 hospitals in South Korea, between July 2009 and June 2015. The subjects were divided into 2 groups according to their immune status, and medical records were reviewed. RESULTS: There were 61 cases (48.4%) in the immunocompetent group and 65 cases (51.6%) in the immunocompromised group. Median age was older in immunocompromised group (11.4 vs. 8.6) (p<0.001). The mean duration of hospitalization was longer in immunocompromised group (11.0 vs. 6.6) (p<0.001). Patients were treated with oral or intravenous antiviral agents. A total of 12 in immunocompetent group were cured only by oral acyclovir. No treatment failure was found in both groups. Six immunocompromised patients had postherpetic neuralgia and 1 case was in immunocompetent group. In immunocompetent children, herpes zoster was likely caused by early varicella infection. There was no increase in progression of severity in both groups due to appropriate treatment. CONCLUSION: Early initiation of therapy is necessary for those in immunocompromised conditions. And inactivated herpes zoster vaccination may be considered in immunocompromised adolescents in the future.
Acyclovir ; Adolescent ; Antiviral Agents ; Chickenpox ; Child ; Child, Hospitalized ; Herpes Zoster ; Hospitalization ; Humans ; Immunocompromised Host ; Korea ; Medical Records ; Neuralgia, Postherpetic ; Treatment Failure ; Vaccination