BACKGROUND: Hepatitis B virus (HBV) infection leads to hepatic and extrahepatic manifestations including chronic kidney disease (CKD). However, the association between HBV and CKD is not clear. This study investigated the association between chronic HBV infection and CKD in a nationwide multicenter study. METHODS: A total of 265,086 subjects who underwent health-check examinations in 33 hospitals from January 2015 to December 2015 were enrolled. HBV surface antigen (HBsAg) positive cases (n = 10,048), and age- and gender-matched HBsAg negative controls (n = 40,192) were identified. CKD was defined as a glomerular filtration rate (GFR) < 60 mL/min/1.73 m² or proteinuria as at least grade 2+ of urine protein. RESULTS: HBsAg positive cases showed a significantly higher prevalence of GFR < 60 mL/min/1.73 m² (3.3%), and proteinuria (18.9%) than that of the controls (2.6%, P < 0.001, and 14.1%, P < 0.001, respectively). In the multivariate analysis, HBsAg positivity was an independent factor associated with GFR < 60 mL/min/1.73 m² along with age, blood levels of albumin, bilirubin, anemia, and hemoglobin A1c (HbA1c). Likewise, HBsAg positivity was an independent factor for proteinuria along with age, male, blood levels of bilirubin, protein, albumin, and HbA1c. A subgroup analysis showed that HBsAg positive men but not women had a significantly increased risk for GFR < 60 mL/min/1.73 m². CONCLUSION: Chronic HBV infection was significantly associated with a GFR < 60 mL/min/1.73 m² and proteinuria (≥ 2+). Therefore, clinical concern about CKD in chronic HBV infected patients, especially in male, is warranted.
Anemia ; Antigens, Surface ; Bilirubin ; Case-Control Studies* ; Female ; Glomerular Filtration Rate ; Hepatitis B Surface Antigens ; Hepatitis B virus ; Hepatitis B, Chronic* ; Hepatitis, Chronic* ; Humans ; Male ; Multivariate Analysis ; Prevalence ; Proteinuria ; Renal Insufficiency, Chronic*

Acute myocardial infarctions involving multiple coronary arteries simultaneously are infrequent and causative risk factors of the occlusions are unclear. However, severe complications arise, such as congestive heart failure or death. We report a case of two simultaneously occluded coronary arteries. A 39-year-old Korean man with simultaneous total occlusion of the left anterior descending artery and the right coronary artery presented with chest discomfort and cardiogenic shock. Immediate percutaneous coronary intervention was performed and a transvenous temporary pacemaker and intra-aortic balloon counterpulsation catheter were inserted. Through continuous effort he was discharged 8 days post intervention without any complaints.
Adult ; Arteries* ; Catheters ; Coronary Occlusion ; Coronary Vessels* ; Counterpulsation ; Heart Failure ; Humans ; Myocardial Infarction* ; Percutaneous Coronary Intervention ; Risk Factors ; Shock, Cardiogenic ; Thorax

Plasma pH can be altered during pregnancy and at labor. Membrane excitability of smooth muscle including uterine muscle is suppressed by the activation of K+ channels. Because contractility of uterine muscle is regulated by extracellular pH and humoral factors, K+ conductance could be connected to factors regulating uterine contractility during pregnancy. Here, we showed that TASK-2 inhibitors such as quinidine, lidocaine, and extracellular acidosis produced contraction in uterine circular muscle of mouse. Furthermore, contractility was significantly increased in pregnant uterine circular muscle than that of non-pregnant muscle. These patterns were not changed even in the presence of tetraetylammonium (TEA) and 4-aminopyridine (4-AP). Finally, TASK-2 inhibitors induced strong myometrial contraction even in the presence of L-methionine, a known inhibitor of stretchactivated channels in myometrium. When compared to non-pregnant myometrium, pregnant myometrium showed increased immunohistochemical expression of TASK-2. Therefore, TASK-2, seems to play a key role during regulation of myometrial contractility in the pregnancy and provides new insight into preventing preterm delivery.
4-Aminopyridine ; Acidosis ; Animals ; Contracts ; Female ; Hydrogen-Ion Concentration ; Lidocaine ; Membranes ; Methionine ; Mice ; Muscle, Smooth ; Muscles ; Myometrium ; Plasma ; Pregnancy ; Quinidine ; Relaxation ; Uterine Contraction ; Uterus

This study was conducted to evaluate the effect of Sigma Anti-bonding Molecule Calcium Carbonate (SAC) as therapy for ovariectomy-induced osteoporosis in rats. Three weeks after surgery, fifteen ovariectomized Sprague-Dawley rats were divided randomly into 3 groups: sham-operated group (sham), ovariectomized group (OVX) and SAC-treatment group (OVX+SAC). The OVX+SAC group was given drinking water containing 0.0012% SAC for 12 weeks. Bone breaking force and mineralization as well as blood parameters related to the bone metabolism were analyzed. In OVX animals, blood concentration of 17beta-estradiol decreased significantly, while osteocalcin and type I collagen C-terminal telopeptides (CTx) increased. Breaking force, bone mineral density (BMD), calcium and phosphorus in femurs, as well as uterine and vaginal weights, decreased significantly following OVX. However, SAC treatment (0.0012% in drinking water) not only remarkably restored the decreased 17beta-estradiol and increased osteocalcin and CTx concentrations, but also recovered decreased femoral breaking force, BMD, calcium and phosphorus, although it did not reversed reproductive organ weights. It is suggested that SAC effectively improve bone density by preventing bone turnover mediated osteocalcin, CTx and minerals, and that it could be a potential candidate for therapy or prevention of postmenopausal osteoporosis.
Animals ; Bone Density ; Calcium ; Calcium Carbonate ; Collagen Type I ; Drinking ; Drinking Water ; Female ; Femur ; Humans ; Minerals ; Organ Size ; Osteocalcin ; Osteoporosis ; Osteoporosis, Postmenopausal ; Phosphorus ; Rats ; Rats, Sprague-Dawley ; Weights and Measures

This study was conducted to provide basic data on physiological and hematological characteristics, and organ weights of beagle dogs. A total of 237 beagle dogs were used to determine differences in physiological and hematological parameters, and organ weights depending on sex and age. The respiratory rate of both sexes tended to increase as they grew older and the female heart rate was slightly higher than that of males. Male and female body weights increased rapidly to 33 weeks old followed by a gradual increase to 41-weeks-old. The relative weight of the brain was negatively correlated with body weight, whereas the weight of reproductive organs was positively correlated with body weight. The platelet count of female dogs was slightly higher than that of males. The red blood cell, hemoglobin, and hematocrit of both sexes increased non-significantly with age. In the leukocyte differential count, the neutrophils, and eosinophils of both sexes tended to increase as they grew older, whereas basophils, lymphocytes, and monocytes decreased. In the serum biochemical profiles, alkaline phosphatase was slightly higher in males than females, while the total cholesterol of female dogs at 9-months-old was higher than that of males at the same age. Other biochemical components, including alanine aminotransferase, blood urea nitrogen, creatinine, triglyceride, and total protein increased non-significantly with age in both sexes. To conclude, we observe no significant physiological or hematological differences with sex or age, although decreasing and increasing trends were detected with some parameters. These data provide valuable reference indices of the normal physiological and hematological characteristics of beagle dogs, which should prove useful in toxicological and pharmacological studies.
Alanine Transaminase ; Alkaline Phosphatase ; Animals ; Basophils ; Biochemistry ; Blood Urea Nitrogen ; Body Weight ; Brain ; Cholesterol ; Creatinine ; Dogs ; Eosinophils ; Erythrocytes ; Female ; Heart Rate ; Hematocrit ; Hematology ; Hemoglobins ; Humans ; Leukocytes ; Lymphocytes ; Male ; Monocytes ; Neutrophils ; Organ Size ; Platelet Count ; Respiratory Rate ; Urology

PURPOSE: Natural orifice transluminal endoscopic surgery (NOTES) is a new operation technique that utilizes natural orifices of the patient's body with the intention to puncture hollow viscera in order to insert an endoscope into a peritoneal cavity for incisionless surgery. The aim of this study was to evaluate the safety and feasibility of endoscopic cecectomy through the rectum in one dog and the vagina in another dog. METHODS: This study was performed in two beagle dogs for rectal and vaginal approaches. A five-milimeter trocar was inserted into the abdominal cavity by the Hasson method and intra-abdominal pressure was maintained at 5 mmHg with CO2. After pneumoperitoneum was accomplished, the rectum or vagina was incised with a needle knife and a one-channel gastric endoscope was inserted into the abdominal cavity. Counter-traction was performed using a laparoscopic grasper introduced via the 5 mm trocar in the umbilicus. The cecum was dissected from the base by using a needle knife with the aid of laparoscopic counter-traction. The resected cecum was retrieved through the anus or vagina without pouch bag. The incised rectum was closed by using 90-degree endoclips whereas the incised vagina was not repaired. RESULTS: Cecectomies were successfully performed with both transrectal and transvaginal routes. Both cases had no complication and recovered from surgery uneventfully. CONCLUSION: Endoscopic cecectomy with hybrid NOTES are feasible and safe. With the improvement of surgical experiences and further instrumental development, NOTES can be one option for human intestinal surgery.
Abdominal Cavity ; Anal Canal ; Animals ; Cecum ; Chimera ; Dogs ; Endoscopes ; Humans ; Intention ; Models, Animal ; Natural Orifice Endoscopic Surgery ; Needles ; Peritoneal Cavity ; Pneumoperitoneum ; Punctures ; Rectum ; Surgical Instruments ; Umbilicus ; Vagina ; Viscera

PURPOSE: To evaluate the incidence and clinical features of age-related macular degeneration (AMD) in Korea. METHODS: Web-based (www.armd-nova.or.kr) registration was conducted for AMD patients aged 50 or more who were newly diagnosed by retinal specialists in Korea from August 20, 2005 to August 20, 2006. Patient data including ophthalmologic examination, fundus photography, fluorescein angiogram and/or indocyanin green angiogram (ICG), past medical history, behavioral habit, combined systemic diseases were up-loaded. RESULTS: Among finally enrolled 1,141 newly diagnosed AMD patients, 690 patients (60.5%) were male and 451 patients (39.5%) were female. The average age of AMD patients was 69.7+/-8.0. Early AMD was observed in 190 patients and 951 patients had late AMD. Classic choroidal neovascular membrane (CNVM) was observed in 18.6% of exudative AMD patients and 63.4 % had occult CNVM. Subfoveal CNVM was observed in 80.4% of the patients with CNVM. Among the 580 exudative AMD eyes that performed indocyanin green angiography (ICG), 184 eyes (31.7%) had polypoidal choroidal vasculopathy (PCV) and 36 eyes (6.2%) showed retinal angiomatous proliferation (RAP). Age, male gender, smoking, diabetes and hypertension significantly increased the risk of the AMD among Koreans. CONCLUSIONS: Because of the low rate of participation by retinal specialists, definite incidence of AMD was not obtainable. However, the estimated 1-year AMD incidence in the Pusan area of Korea is at least 0.4%. In contrast to Western people, 31.7% of exudative AMD cases were revealed to be PCV and 6.2% were revealed to be RAP. This discrepancy between ethnic groups should be considered in the diagnosis and treatment modality selection of Korean AMD patients.
Aged ; Angiography ; Choroid ; Ethnic Groups ; Eye ; Female ; Fluorescein ; Humans ; Hypertension ; Incidence ; Korea ; Macular Degeneration ; Male ; Membranes ; Photography ; Retinaldehyde ; Smoke ; Smoking ; Specialization

BACKGROUND AND OBJECTIVES: The thrombolysis in myocardial infarction (TIMI) myocardial perfusion grade (TMPG) is associated with the long term clinical outcomes. This study compared the TMPG with the myocardial viability as determined by 18F-fluorodeoxyglucose positron emission tomography (FDG-PET), and with improvement of the left ventricular (LV) function on echocardiography. SUBJECTS AND METHODS: We enrolled 44 consecutive patients (37 men: age 56+/-11 years) who underwent primary percutaneous coronary intervention (PCI) for ST segment elevation myocardial infarction (STEMI). We assessed the coronary flow reserve (CFR), the diastolic deceleration time (DDT), the coronary wedge pressure (Pcw) and the coronary wedge pressure/mean aortic pressure (Pcw/Pa). All the patients underwent FDG-PET scans on the 7th day after primary PCI. The patients were divided into 3 groups according to the TMPG (TMPG 0/1: n=18, TMPG 2: n=14, TMPG 3: n=12). RESULTS: There was a significant correlation between the TMPG and the CFR, DDT, Pcw and Pcw/Pa (r=0.367, p=0.017; r=0.587, p<0.001; r=-0.513, p<0.001; r=-0.614, p<0.001, respectively). There was a significant correlation between the TMPG and the % of FDG uptake (r=0.587, p<0.001) and the patients with TMPG 3 had the most favorable % of FDG uptake (TMPG 0/1 vs TMPG 2 vs TMPG 3; 42.0+/-12.3% vs 53.9+/-11.2% vs 59.3+/-13.3%, p=0.001). On echocardiography, the patients with TMPG 3 revealed an improvement of the LV ejection fraction (53.4+/-9.9% vs 60.0+/-7.0%, p=0.004) and the patients with TMPG 2 and TMPG 3 revealed improvement of their regional wall motion abnormality (RWMA) index (1.44+/-0.26 vs 1.24+/-0.18, p=0.022; 1.35+/-0.26 vs 1.15+/-0.18, p=0.018, respectively). CONCLUSION: The angiographically determined TMPG might be clinically useful for the assessment of myocardial viability and it might be a useful predictor for improvement of the LV function in patients suffering with STEMI.
Angioplasty ; Arterial Pressure ; DDT ; Deceleration ; Echocardiography ; Humans ; Male ; Myocardial Infarction* ; Percutaneous Coronary Intervention* ; Perfusion* ; Positron-Emission Tomography ; Pulmonary Wedge Pressure ; Ventricular Function, Left

OBJECTIVE: The purpose of the present study was to determine whether a relationship exists between the clinical symptoms (dysmenorrhea and infertility) and prostaglandin (PG) concentrations in follicular and peritoneal fluid in the women with endometriosis during the late follicular phase of the menstrual cycle. METHODS: Thirty patients with pelvic endometriosis diagnosed by pelvic surgery were enrolled. Eight patients were suffering from severe dysmenorrhea and 11 had history of primary or secondary infertility among them. Endometriosis patients were grouped by the presence of each symptom and compared with 33 control patients without endometriosis. Peritoneal fluid was collected in the beginning of peritoneal opening and dominant follicular fluid was aspirated by syringe needle at the time of operation. Then PGE2 and PGF2a concentration were measured at each tube. RESULTS: Follicular fluid PGF2a levels were increased in 30 endometriosis patients (P=0.003), and the levels were significantly higher in 11 patients with infertility compared with the control (P=0.001). Peritoneal fluid PGF2a levels were significantly higher in 8 patients with severe dysmenorrhea compared with the others or the control (P=0.028). Follicular or peritoneal fluid PGE2 levels were not different between any group and the control. There was no significant correlation between size of endometrioma and each PG levels. CONCLUSION: Severe dysmenorrhea in endometriosis patients would be related with the high level of peritoneal fluid PGF2a concentration, and infertility in endometriosis would be related with the high level of follicular fluid PGF2a concentration.
Ascitic Fluid* ; Dinoprostone* ; Dysmenorrhea ; Endometriosis* ; Female ; Follicular Fluid ; Follicular Phase ; Humans ; Infertility ; Menstrual Cycle ; Needles ; Prostaglandins ; Syringes

PURPOSE: Natural orifice transluminal endoscopic surgery (NOTES) is a new surgical option using endoscopic advancement to the peritoneal cavity through the stomach, colon, vagina, or urinary bladder without an abdominal wall scar (incision). The aim of this study was to assess the feasibility of transgastric gastroscopic intra-abdominal exploration with gastric incision and closure before the NOTES would be done. METHODS: Under general anesthesia of a female dog, one-channel gastroscope was advanced to the stomach and the lumen was irrigated with anti-bacterial solution. The anterior wall of the antrum was incised by about 1 cm with a needle knife; then, the gastroscope was advanced into the peritoneal cavity. An exploration of the entire intra-abdominal cavity was performed. RESULTS: We were able to evaluate the stomach, the greater omentum, the diaphragm, the peritoneum, the urinary bladder, the bowel, the spleen, the liver, the gallbladder, the uterine horn, the uterine body, and the vagina, but could not evaluate the ovary, the kidney, and the pancreas. The observation of the abdominal cavity was followed by the gastric wall closure with a 135o endoclip. The dog was recovered after confirmation of secure closure of the incision site. CONCLUSIONS: Transgastric incision, closure, and abdominal exploration are feasible without an abdominal wall scar, and the NOTES can be one option for future abdominal operations in humans and needs to be further investigated.
Abdominal Cavity ; Abdominal Wall ; Anesthesia, General ; Animals ; Cicatrix ; Colon ; Diaphragm ; Dogs* ; Female* ; Gallbladder ; Gastroscopes ; Horns ; Humans ; Kidney ; Liver ; Natural Orifice Endoscopic Surgery ; Needles ; Omentum ; Ovary ; Pancreas ; Peritoneal Cavity ; Peritoneum ; Spleen ; Stomach ; Urinary Bladder ; Vagina