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Porcelain Heart: Rapid Progression of Cardiac Calcification in a Patient with Hemodialysis
이현욱,윤호중,심병주,이승재,박미연,정진욱,구관민,전희경,이지은,권병진 한국심초음파학회 2012 Journal of Cardiovascular Imaging (J Cardiovasc Im Vol.20 No.4
Cardiac calcification usually occurs in patients with end-stage renal disease. However, rapid progression of cardiac calcification is rarely associated with secondary hyperparathyroidism of end-stage renal disease. We report a patient with end-stage renal disease who showed moderate left ventricular hypertrophy at the first echocardiography, and showed severe myocardial calcification and severe mitral valve stenosis 4 years later. We suspected a rapid progression ‘porcelain heart’ cardiomyopathy secondary to hyperparathyroidism of end-stage renal disease. The patient underwent parathyroidectomy, and considered mitral valve replacement.
Association between Metabolic Syndrome and Microalbuminuria in Korean Adults
이현욱,Hyun-Ju Bak,Jin-Young Shin,송윤미 대한가정의학회 2015 Korean Journal of Family Medicine Vol.36 No.2
Ba ckground: We conducted a population-based cross-sectional study of Korean adults to evaluate theassociation between metabolic syndrome and microalbuminuria as a marker for early-stage chronickidney disease. Me thods: A total of 8,497 adults (3,625 men and 4,872 women) who participated in the Korea NationalHealth and Nutrition Examination Survey between 2011 and 2012 were included. Metabolicsyndrome was defined according to recommendation from a joint interim statement of internationalorganizations published in 2009. Microalbuminuria was defined as a urinary albumin-to-creatinineratio of 30 to 300 mg/g. The association between metabolic syndrome and microalbuminuriawas evaluated using logistic regression analysis with adjustment for covariates while consideringsampling weights and the complex survey design. Re sults: The prevalence of microalbuminuriain subjects with metabolic syndrome was 11% for menand 14.4% for women, whereas the prevalence in subjects without metabolic syndrome was 3.1% formen and 6.7% for women. Metabolic syndrome was significantly associated with an increased risk ofmicroalbuminuriain both women (odds ratio, 2.79; 95% confidence interval, 2.01 to 3.88) and men (oddsratio, 3.00; 95% confidence interval, 2.11 to 4.27). All components of the metabolic syndrome wereassociated with a significantly increased risk of microalbuminuria with the strongest association for highblood pressure. The risk of microalbuminuria increased in a dose-dependent manner (P-value for trend <0.001) with the number of metabolic syndrome components observed for both sexes. Co nclusion: These findings suggest that metabolic syndrome is a risk factor for chronic kidney diseasefrom an early stage.
이현욱,이은희,이창훈,장희경,나서희 대한비뇨의학회 2011 Investigative and Clinical Urology Vol.52 No.2
Purpose: Renal tumors consist of heterogeneous groups that frequently show complex and overlapping morphology, thus making it difficult to make a correct diagnosis. One of the most problematic differential diagnoses is to distinguish chromophobe renal cell carcinoma (RCC) from oncocytoma. These should be distinguished by differences in their behavior and clinical outcome. Our study was performed to identify whether caveolin-1 and MOC-31 are useful immunohistochemical markers for differentiating chromophobe RCC from oncocytoma. Materials and Methods: We selected 23 chromophobe RCCs, 8 oncocytomas, and 25 clear cell RCCs and performed immunohistochemical staining for caveolin-1 and MOC-31. Results: Caveolin-1 was positive in 20 (87%) of 23 chromophobe RCCs, 0 of 8 oncocytomas, and 21 (84%) of 25 clear cell RCCs. MOC-31 was positive in 22 (96%) of 23 chromophobe RCCs, 2 (25%) of 8 oncocytomas, and 14 (56%) of 25 clear cell RCCs. There was a statistically significant difference in the expression of caveolin-1 and MOC-31 between chromophobe RCC and oncocytoma (p<0.001). In addition, clear cell RCC was also significantly different from oncocytoma in the expression of caveolin-1 (p<0.001) and was significantly different from chromophobe RCC in the expression of MOC-31 (p<0.001). Conclusions: Caveolin-1 and MOC-31 can be useful markers in the differential diagnosis of chromophobe RCC, oncocytoma, and clear cell RCC. Purpose: Renal tumors consist of heterogeneous groups that frequently show complex and overlapping morphology, thus making it difficult to make a correct diagnosis. One of the most problematic differential diagnoses is to distinguish chromophobe renal cell carcinoma (RCC) from oncocytoma. These should be distinguished by differences in their behavior and clinical outcome. Our study was performed to identify whether caveolin-1 and MOC-31 are useful immunohistochemical markers for differentiating chromophobe RCC from oncocytoma. Materials and Methods: We selected 23 chromophobe RCCs, 8 oncocytomas, and 25 clear cell RCCs and performed immunohistochemical staining for caveolin-1 and MOC-31. Results: Caveolin-1 was positive in 20 (87%) of 23 chromophobe RCCs, 0 of 8 oncocytomas, and 21 (84%) of 25 clear cell RCCs. MOC-31 was positive in 22 (96%) of 23 chromophobe RCCs, 2 (25%) of 8 oncocytomas, and 14 (56%) of 25 clear cell RCCs. There was a statistically significant difference in the expression of caveolin-1 and MOC-31 between chromophobe RCC and oncocytoma (p<0.001). In addition, clear cell RCC was also significantly different from oncocytoma in the expression of caveolin-1 (p<0.001) and was significantly different from chromophobe RCC in the expression of MOC-31 (p<0.001). Conclusions: Caveolin-1 and MOC-31 can be useful markers in the differential diagnosis of chromophobe RCC, oncocytoma, and clear cell RCC.