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  • 1
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    Serum β〈sub〉2〈/sub〉-Microglobulin Predicts Mortality in Peritoneal Dialysis Patients: A Prospective Cohort Study
    S. Karger AG ; 2015
    In:  American Journal of Nephrology Vol. 42, No. 2 ( 2015), p. 91-98
    Details
    In: American Journal of Nephrology, S. Karger AG, Vol. 42, No. 2 ( 2015), p. 91-98
    Abstract: 〈 b 〉 〈 i 〉 Background/Aims: 〈 /i 〉 〈 /b 〉 β 〈 sub 〉 2 〈 /sub 〉 -Microglobulin (β 〈 sub 〉 2 〈 /sub 〉 -M) is a surrogate marker of middle-molecule uremic toxins and is associated with mortality in chronic hemodialysis patients. However, the impact of serum β 〈 sub 〉 2 〈 /sub 〉 -M levels on mortality in peritoneal dialysis (PD) patients is uncertain. The purpose of this study was to examine the association of serum β 〈 sub 〉 2 〈 /sub 〉 -M levels with all-cause mortality in PD patients. 〈 b 〉 〈 i 〉 Methods: 〈 /i 〉 〈 /b 〉 A total of 771 PD patients were selected from the Clinical Research Center registry for end-stage renal disease cohort in Korea. Patients were categorized into 3 groups by tertiles of serum β 〈 sub 〉 2 〈 /sub 〉 -M levels. The primary outcome was all-cause mortality. 〈 b 〉 〈 i 〉 Results: 〈 /i 〉 〈 /b 〉 The median value of serum β 〈 sub 〉 2 〈 /sub 〉 -M was 23.6 mg/l (interquartile range 14.8-33.4 mg/l), and the median follow-up period was 39 months. The Kaplan-Meier analysis showed that the all-cause mortality rate was significantly different according to tertiles of serum β 〈 sub 〉 2 〈 /sub 〉 -M in PD patients (p = 0.03, log-rank). Multivariate Cox proportional analysis showed that the hazards ratio for all-cause mortality was 1.02 (95% CI 1.01-1.04, p = 0.006) per 1 mg/l increase in β 〈 sub 〉 2 〈 /sub 〉 -M after adjustment for multiple confounding factors that relate to malnutrition and inflammation marker. However, serum β 〈 sub 〉 2 〈 /sub 〉 -M was not associated with all-cause mortality after adjustment for residual renal clearance. 〈 b 〉 〈 i 〉 Conclusions: 〈 /i 〉 〈 /b 〉 These results are supportive of the potential role of the serum β 〈 sub 〉 2 〈 /sub 〉 -M level as a predictor of mortality in PD patients.
    Type of Medium: Online Resource
    ISSN: 0250-8095 , 1421-9670
    URL: Article
    DOI: 10.1159/000439060
    Language: English
    Publisher: S. Karger AG
    Publication Date: 2015
    detail.hit.zdb_id: 1468523-1
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  • 2
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    Urinary Soluble HLA Class I Antigen in Patients with Minimal Change Disease: A Predictor of Steroid Response
    S. Karger AG ; 1998
    In:  Nephron Vol. 79, No. 1 ( 1998), p. 44-49
    Details
    In: Nephron, S. Karger AG, Vol. 79, No. 1 ( 1998), p. 44-49
    Abstract: In primary minimal change disease (MCD) and focal segmental glomerulosclerosis (FSGS), increased lymphocyte reactivity to renal antigens has been defined. Soluble HLA class I antigen (sHLA-I) is actively secreted by T and B lymphocytes when they are stimulated by mitogens, antigens and lymphokines. To determine if serum and urine sHLA-I levels could predict steroid response in patients with MCD and differentiate those from FSGS, we have investigated 45 healthy controls, biopsy-proven 17 patients with MCD (edema and 24-hour urine protein 〉 3.5 g/day), 8 patients with FSGS (24-hour urine protein 〉 1 g/day) and 10 patients with membranous nephropathy (MGN) (24-hour urine protein 〉 1 g/day). Before and after prednisone therapy (1 mg/kg/day or 2 mg/kg/EOD for 8 weeks), the levels of serum and urinary sHLA-I were measured by ELISA (sHLA-STAT; Sangstat Co., Calif., USA). After 8 weeks of treatment, 10 patients with MCD were responders (MCD-CR) while the other 7 patients with MCD were nonresponders (MCD-NR). Three of 7 patients with MCD-NR were re-biopsied and finally diagnosed as FSGS. They were included in the data of patients with FSGS. In healthy controls, serum sHLA-I was detected (415 ± 256 ng/ml), but urinary sHLA-I was not. At entry, there were no differences in age, sex, serum Cr and 24-hour urine protein among the patients with MCD-CR, MCD-NR and FSGS, but serum albumin was significantly elevated in patients with FSGS and MGN (p 〈 0.05). Serum sHLA-I levels were notably elevated in MCD-CR (1,040 ± 1,066 ng/ml), in MCD-NR (668 ± 315 ng/ml) and in FSGS (713 ± 790 ng/ml), but not in patients with MGN (444 ± 86 ng/ml) when compared with controls (p 〈 0.05). On the other hand, urinary sHLA-I levels in MCD-NR (541 ± 239 ng/mg Cr) and in FSGS (457 ± 239 ng/mg Cr) were significantly higher than those in MGN (125 ± 28 ng/mg Cr) and in MCD-CR (100 ± 42 ng/mg Cr, p 〈 0.05) and these substantial differences were maintained for 8 weeks. In all patients, serum and urinary sHLA-I levels were not reduced during 8 weeks of steroid therapy. We conclude that elevated serum and urinary sHLA-I levels reflect increased cellular immune response and disease activity in patients with MCD and FSGS. In patients with MCD, urinary sHLA-I may be an easily measurable indicator of predicting steroid response, while MCD-NR with high urinary sHLA-I levels might be re-evaluated for the possibility of FSGS.
    Type of Medium: Online Resource
    ISSN: 1660-8151 , 2235-3186
    URL: Article
    DOI: 10.1159/000044990
    Language: English
    Publisher: S. Karger AG
    Publication Date: 1998
    detail.hit.zdb_id: 2810853-X
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  • 3
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    Persistent Left Superior Vena cava Detected by Hemodialysis Catheterization
    S. Karger AG ; 1999
    In:  Nephron Vol. 83, No. 1 ( 1999), p. 87-88
    Details
    In: Nephron, S. Karger AG, Vol. 83, No. 1 ( 1999), p. 87-88
    Type of Medium: Online Resource
    ISSN: 1660-8151 , 2235-3186
    URL: Article
    DOI: 10.1159/000045478
    Language: English
    Publisher: S. Karger AG
    Publication Date: 1999
    detail.hit.zdb_id: 2810853-X
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  • 4
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    The Derived Neutrophil-to-Lymphocyte Ratio Is an Independent Prognostic Factor in Transplantation Ineligible Patients with Multiple Myeloma
    S. Karger AG ; 2018
    In:  Acta Haematologica Vol. 140, No. 3 ( 2018), p. 146-156
    Details
    In: Acta Haematologica, S. Karger AG, Vol. 140, No. 3 ( 2018), p. 146-156
    Abstract: 〈 b 〉 〈 i 〉 Background: 〈 /i 〉 〈 /b 〉 The neutrophil-to-lymphocyte ratio (NLR) is an independent prognostic marker in solid and hematological cancers. While the derived NLR (dNLR) was shown to be non-inferior to the NLR in large cohorts of patients with different cancer types, it has not been validated as a prognostic marker for multiple myeloma (MM) to date. 〈 b 〉 〈 i 〉 Methods: 〈 /i 〉 〈 /b 〉 Between May 22, 2011 and May 29, 2014, 176 patients with MM from 38 centers who were ineligible for autologous stem cell transplantation were analyzed. The dNLR was calculated using complete blood count differential data. The optimal dNLR cut-off value according to receiver operating characteristic analysis of overall survival (OS) was 1.51. All patients were treated with melphalan and prednisone combined with bortezomib. 〈 b 〉 〈 i 〉 Results: 〈 /i 〉 〈 /b 〉 The complete response rate was lower in the high dNLR group compared to the low dNLR group (7 vs. 26.1%, respectively; 〈 i 〉 p 〈 /i 〉  = 0.0148); the corresponding 2-year OS rates were 72.2 and 84.7%, respectively ( 〈 i 〉 p 〈 /i 〉  = 0.0354). A high dNLR was an independent poor prognostic factor for OS (hazard ratio 2.217, 95% CI 1.015–4.842; 〈 i 〉 p 〈 /i 〉  = 0.0458). 〈 b 〉 〈 i 〉 Conclusion: 〈 /i 〉 〈 /b 〉 The dNLR is a readily available and cheaply obtained parameter in clinical studies, and shows considerable potential as a new prognostic marker for transplantation-ineligible patients with MM.
    Type of Medium: Online Resource
    ISSN: 0001-5792 , 1421-9662
    URL: Article
    DOI: 10.1159/000490488
    Language: English
    Publisher: S. Karger AG
    Publication Date: 2018
    detail.hit.zdb_id: 1481888-7
    detail.hit.zdb_id: 80008-9
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  • 5
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    Electro-Acupuncture Reverses Nerve Growth Factor Abundance in Experimental Polycystic Ovaries in the Rat
    S. Karger AG ; 2004
    In:  Gynecologic and Obstetric Investigation Vol. 57, No. 2 ( 2004), p. 80-85
    Details
    In: Gynecologic and Obstetric Investigation, S. Karger AG, Vol. 57, No. 2 ( 2004), p. 80-85
    Abstract: Polycystic ovary syndrome (PCOS) remains one of the most common causes of anovulation in women of reproductive age. There is some evidence that nerve growth factor (NGF) is involved in the pathogenesis of PCOS. Therefore, seeking the pathogenesis of PCOS is important for controlling fertility. In traditional Oriental Medicine, acupuncture has been used for the function of ovaries. The present study was designed to determine whether electro-acupuncture (EA) could affect experimentally induced polycystic ovary (PCO) in the rat. The two acupoints Sp-6 and E-128 were stimulated to test for efficacy in the protein expression of NGF. Polycystic ovaries were induced by a single injection of estradiol valerate (4 mg i.m.). During the experimental period of 8 weeks, some of the rats were treated with EA twice weekly; this group was compared with a vehicle-treated control group and an estradiol-injected group not subjected to EA. At day 60, the protein expression of NGF was examined by immunohistochemistry in the ovaries, the adrenal glands and some parts of the brain. The estradiol treatment induced a clear PCO appearance, and was associated with a robust increase in NGF expression in the ovaries, the adrenal glands and the brain. EA treatment partly reversed the NGF abundance, particularly in the ovaries, but not in the brain. Our data show that EA affects the NGF involvement in ovarian dysfunction.
    Type of Medium: Online Resource
    ISSN: 0378-7346 , 1423-002X
    URL: Article
    DOI: 10.1159/000075382
    RVK:
    XA 45603
    Language: English
    Publisher: S. Karger AG
    Publication Date: 2004
    detail.hit.zdb_id: 1482695-1
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  • 6
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    Successful Treatment of Massive Lower Gastrointestinal Bleeding Caused by Mixed Infection of Cytomegalovirus and Mucormycosis in a Renal Transplant Recipient
    S. Karger AG ; 2001
    In:  American Journal of Nephrology Vol. 21, No. 3 ( 2001), p. 232-236
    Details
    In: American Journal of Nephrology, S. Karger AG, Vol. 21, No. 3 ( 2001), p. 232-236
    Abstract: We describe a case of lower gastrointestinal bleeding due to mixed infection of cytomegalovirus (CMV) and mucormycosis in a renal transplant recipient. A 33-year-old male received renal transplantation and his clinical course was uneventful. On the 18th postoperative day, acute rejection was developed and this was treated with high-dose methylprednisolone and OKT3. During antirejection treatment, sudden onset massive hematochezia was developed. Emergency colonofibroscopy revealed multiple colonic ulcers and pathologic findings were consistent with mucormycosis and CMV infection. The patient was successfully treated with amphotericin B (1.0–1.5 mg/kg) and ganciclovir (62.5–125 mg/day) for 5 weeks. To our knowledge, this is the first report showing coexistence of mucormycosis and CMV in the colon ulcer base. This finding suggests that CMV infection may trigger fungal infection in the pathogenesis of colonic ulcer.
    Type of Medium: Online Resource
    ISSN: 0250-8095 , 1421-9670
    URL: Article
    DOI: 10.1159/000046253
    Language: English
    Publisher: S. Karger AG
    Publication Date: 2001
    detail.hit.zdb_id: 1468523-1
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  • 7
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    Effect of Prolonged Subcutaneous Implantation of Peritoneal Catheter on Peritonitis Rate during CAPD: A Prospective Randomized Study
    S. Karger AG ; 1998
    In:  Blood Purification Vol. 16, No. 3 ( 1998), p. 171-178
    Details
    In: Blood Purification, S. Karger AG, Vol. 16, No. 3 ( 1998), p. 171-178
    Abstract: We conducted a prospective randomized controlled study to confirm our earlier observation that prolonged subcutaneous implantation of peritoneal catheter reduced peritonitis rate when compared to retrospective data from patients with catheters placed by conventional access technique. A total of 60 patients were randomized into two groups: 30 patients had catheters left implanted subcutaneously for 6 weeks (I) and the other 30 patients had catheters inserted by conventional technique and had 6 weeks of break-in period (C). Subgroups of 15 patients each with new and conventional techniques used Y-connector (IY, CY) and remaining patients used standard spikes (IS, CS).Mean age was 47.7 years (range 16–71); 61.0% were male and 44.1% diabetics. Peritonitis, exit site infection, simultaneous peritonitis and exit site infection, and complication related to 〈 i 〉 Staphylococcus 〈 /i 〉 or 〈 i 〉 Pseudomonas 〈 /i 〉 infections were observed for up to 2 years in each patient after initiation of bag exchange or until termination of CAPD by transfer to hemodialysis or by death.Total duration of observation was 493.2 patient-months for new access technique and 409.6 patient-months for conventional technique. Patients in IY group had the lowest incidence of peritonitis (1/14.9 patient-months) and exit site infection (1/16.8 patient-months) among four subgroups. Peritonitis rate in IY was significantly lower compared to CY or CS. The total peritonitis-free period in those patients who did not experience peritonitis during the observation period was also significantly longer in IY (120 patient-months) than in CY (26 patient-months), IS (10.6 patient-months), or CS (10.4 patient-months). Simultaneous peritonitis and exit site infection was observed in none of IY group but 3 episodes in CY, 4 episodes in IS, and 3 episodes in CS. The rates of complications related to 〈 i 〉 Staphylococcus aureus 〈 /i 〉 and 〈 i 〉 Pseudomonas 〈 /i 〉 infections were also significantly lower in IY than in CY, IS, or CS. Technique survival did not differ between the two groups.The present results confirm our previous observation that the new access technique reduces the incidence of peritonitis probably by reducing infection via periluminal route. The Y-connector system further reduces peritonitis rate by reducing infection via intraluminal route.
    Type of Medium: Online Resource
    ISSN: 0253-5068 , 1421-9735
    URL: Article
    DOI: 10.1159/000014331
    Language: English
    Publisher: S. Karger AG
    Publication Date: 1998
    detail.hit.zdb_id: 1482025-0
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  • 8
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    Clinicopathologic Report of Uveal Melanoma with Persistent Exudative Retinal Detachment after Gamma Knife Radiosurgery
    S. Karger AG ; 2010
    In:  Ophthalmologica Vol. 224, No. 1 ( 2010), p. 16-21
    Details
    In: Ophthalmologica, S. Karger AG, Vol. 224, No. 1 ( 2010), p. 16-21
    Abstract: 〈 i 〉 Aims: 〈 /i 〉 Our purpose was to report the clinical and pathological findings from uveal melanoma patients with persistent exudative retinal detachment (RD) after Gamma Knife radiosurgery (GKR). 〈 i 〉 Methods: 〈 /i 〉 A retrospective review was performed. 〈 i 〉 Results: 〈 /i 〉 GKR was performed on 19 uveal melanoma patients from 2004 to 2006, and 5 of them developed persistent exudative RD. The mean initial largest basal tumor diameter in these 5 patients was 14.4 ± 1.9 mm, and the mean tumor height was 9.2 ± 1.0 mm. Marginal doses of 40–50 Gy radiation were administered. RD developed or had become aggravated an average of 3 (1–10) months after GKR. Two patients underwent enucleation, while the remaining 3 underwent tumor removal by endoresection with retinal reattachment surgery by vitrectomy and silicone oil tamponade. These procedures were undertaken an average of 6.3 (1.5–14) months after radiation and 3.3 (0.5–5) months after the onset or aggravation of RD. Histologically 4 tumors showed 50–100% necrosis without any mitotic activity. Thus local tumor control after GKR appeared sufficient regardless of RD. 〈 i 〉 Conclusion: 〈 /i 〉 Aggravation or development of exudative RD after GKR does not necessarily entail treatment failure. Therefore, retinal reattachment surgery in persistent exudative RD may be an option to preserve the eye.
    Type of Medium: Online Resource
    ISSN: 0030-3755 , 1423-0267
    URL: Article
    DOI: 10.1159/000233231
    RVK:
    XA 10000
    Language: English
    Publisher: S. Karger AG
    Publication Date: 2010
    detail.hit.zdb_id: 1483531-9
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  • 9
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    A Pilot Study to Investigate the Efficacy of Fibrin Sealant (Tisseel®) in the Loop Electrosurgical Excision Procedure
    S. Karger AG ; 2015
    In:  Gynecologic and Obstetric Investigation Vol. 80, No. 1 ( 2015), p. 21-25
    Details
    In: Gynecologic and Obstetric Investigation, S. Karger AG, Vol. 80, No. 1 ( 2015), p. 21-25
    Abstract: 〈 b 〉 〈 i 〉 Aims: 〈 /i 〉 〈 /b 〉 The objective of the current study was to evaluate the efficacy and feasibility of fibrin sealant (Tisseel®) in the loop electrosurgical excision procedure (LEEP) for cervical intraepithelial neoplasia (CIN 2 or 3). 〈 b 〉 〈 i 〉 Methods: 〈 /i 〉 〈 /b 〉 We designed a single-blind, prospective, randomized study in 40 consecutive women undergoing LEEP for CIN 2 or 3 at our institute. Two milliliters of fibrin sealant (Tisseel) was applied to the uterine cervix of 20 women immediately after LEEP surgery (treatment group). We evaluated abdominal pain, vaginal bleeding, vaginal discharge and impairment in daily living after 1 week using visual analogue scale questionnaires and compared the results with those of 20 women who did not receive fibrin sealant (control group). 〈 b 〉 〈 i 〉 Results: 〈 /i 〉 〈 /b 〉 Among 40 women who returned for a follow-up 1 week after LEEP, 25 women (62.5%) reported at least one moderate to severe postprocedural symptom. The mean duration of moderate to severe vaginal bleeding and impairment in daily living during postoperative week 1 for the treatment group and the control group was 0.3 ± 0.80 versus 1.7 ± 2.36 days (p = 0.015) and 0.9 ± 1.37 versus 3.00 ± 2.62 days (p = 0.060), respectively. 〈 b 〉 〈 i 〉 Conclusion: 〈 /i 〉 〈 /b 〉 Intraoperative application of fibrin sealant (Tisseel) in LEEP can decrease postoperative vaginal bleeding and impairment in daily living.
    Type of Medium: Online Resource
    ISSN: 0378-7346 , 1423-002X
    URL: Article
    DOI: 10.1159/000369391
    RVK:
    XA 45603
    Language: English
    Publisher: S. Karger AG
    Publication Date: 2015
    detail.hit.zdb_id: 1482695-1
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  • 10
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    Inhibitory Effect of Chrysin (5,7-Dihydroxyflavone) on Experimental Choroidal Neovascularization in Rats
    S. Karger AG ; 2016
    In:  Ophthalmic Research Vol. 56, No. 1 ( 2016), p. 49-55
    Details
    In: Ophthalmic Research, S. Karger AG, Vol. 56, No. 1 ( 2016), p. 49-55
    Abstract: 〈 b 〉 〈 i 〉 Purpose: 〈 /i 〉 〈 /b 〉 The aim of this study was to evaluate the effect of chrysin on laser-induced experimental choroidal neovascularization (CNV) in a rat model. 〈 b 〉 〈 i 〉 Methods: 〈 /i 〉 〈 /b 〉 Male brown Norway rats were anesthetized, and a diode laser was used to break Bruch's membrane. One week later, each rat was intravitreally injected with 5 µl of 15 mg/ml chrysin, and CNV development was determined by fluorescein angiography at 2 weeks. The effect of chrysin on experimental CNV was assessed by fluorescein angiography and histology. 〈 b 〉 〈 i 〉 Results: 〈 /i 〉 〈 /b 〉 Two weeks after laser treatment, the intensity of fluorescein leakage from the photocoagulated lesions decreased significantly compared with the control group (p = 0.044). When the lesions were categorized into low- and high-leakage groups, there was a significant correlation between chrysin treatment and degree of leakage (p = 0.028). Compared with the chrysin-treated group, the relative risk of developing high-leakage lesions in the control group was 3.18. The mean CNV thickness was significantly thinner in chrysin-treated eyes than in control eyes (34.13 ±.0.88 vs. 37.76 ± 0.90 μm, p = 0.005). 〈 b 〉 〈 i 〉 Conclusion: 〈 /i 〉 〈 /b 〉 Chrysin has an inhibitory effect on CNV in an experimental rat model, indicating that chrysin should be further evaluated for its potential as a therapy for CNV in age-related macular degeneration and in other vision-threatening conditions associated with CNV.
    Type of Medium: Online Resource
    ISSN: 0030-3747 , 1423-0259
    URL: Article
    DOI: 10.1159/000444929
    RVK:
    XA 10000
    Language: English
    Publisher: S. Karger AG
    Publication Date: 2016
    detail.hit.zdb_id: 1483177-6
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