Background: Online haemodiafiltration (OL-HDF) may improve middle molecular clearance in contrast to conventional haemodialysis (HD). However, OL-HDF requires higher convective flows and cannot sufficiently remove large middle molecules. This study evaluated the efficacy of a medium cutoff (MCO) dialyser in removing large middle molecular uraemic toxins and compared it with that of conventional high-flux (HF) dialysers in HD and predilution OL-HDF. Methods: Six clinically stable HD patients without residual renal function were investigated. Dialyser and treatment efficacies were examined during a single midweek treatment in three consecutive periods: 1) conventional HD using an HF dialyser, 2) OL-HDF using the same HF dialyser, and 3) conventional HD using an MCO dialyser. Treatment efficacy was assessed by calculating the reduction ratio (RR) for β2-microglobulin (β2M), myoglobin, κ and λ free light chains (FLCs), and fibroblast growth factor (FGF)-23 and measuring clearance for FLCs. Results: All three treatments showed comparable RRs for urea, phosphate, creatinine, and uric acid. MCO HD showed greater RRs for myoglobin and λFLC than did HF HD and predilution OL-HDF (myoglobin: 63.1 ± 5.3% vs. 43.5 ± 8.9% and 49.8 ± 7.3%; λFLC: 43.2 ± 5.6% vs. 26.8 ± 4.4% and 33.0 ± 9.2%, respectively; P < 0.001). Conversely, predilution OL-HDF showed the greatest RR for β2M, whereas MCO HD and HF HD showed comparable RRs for β2M (predilution OL-HDF vs.
Non-alcoholic fatty liver disease (NAFLD) is considered a hepatic manifestation of metabolic syndrome and is associated with cardiovascular outcomes. We investigated whether NAFLD was associated with coronary artery calcification (CAC) in participants without a previous history of cardiovascular disease and whether this association differed according to sex and obesity status after adjustment for other atherosclerosis risk factors, alcohol intake, and liver enzyme levels. Among 67,441 participants, data from 8,705 participants who underwent a fatty liver status and CAC assessment during routine health screening were analysed. CAC scores were calculated using computed tomography. NAFLD was diagnosed in patients with evidence of liver steatosis on ultrasonography. Obesity was defined as a body mass index of ≥25 kg/m 2. Multivariate analysis showed a significant association between NAFLD and CAC in non-obese participants (odds ratio, 1.24 [95% confidence interval, 1.01-1.53]), whereas NAFLD and CAC were not associated in obese participants. Interaction analysis showed that the association between NAFLD and CAC was influenced by sex and obesity. Subgroup analysis revealed a significant association between NAFLD and CAC in non-obese male participants (odds ratio, 1.36 [1.07-1.75]), but not in female participants. Our study indicates that non-obese men with NAFLD are prone to CAC. Cardiovascular disease (CVD) is a major cause of death, and its contribution to the overall disease burden is expected to increase. Therefore, there have been worldwide efforts to identify cardiovascular risk factors 1,2. Obesity is a well-established risk factor for CVD and mortality 3 ; however, recent studies have reported the localized distribution of body fat rather than overall obesity 4,5. In one study, regional fat distribution was shown to have a significant association with the risk of coronary heart disease after adjusting for body mass index (BMI) 4. Non-alcoholic fatty liver disease (NAFLD) can progress to liver cirrhosis and liver cancer, but its clinical manifestation is not confined to the liver. Moreover, it has been associated with an increased prevalence and incidence of CVD 6-8. NAFLD is a highly prevalent metabolic abnormality closely linked to the overweight and obesity epidemic 8-10. In tertiary liver centres, a majority of patients with NAFLD also have an increased BMI, but approximately 1 out of 8 NAFLD patients has normal BMI 11. Globally, the prevalence of NAFLD in the non-obese population has been widely reported, ranging from 3% to 30% 12. Coronary artery calcification (CAC) is a non-invasive predictor of the burden of coronary atherosclerosis and is evaluated using computed tomography (CT). CAC scores have been reported to be associated with increased
The incidence of thyroid cancer has increased rapidly worldwide, although most patients can survive for a long time without developing symptoms. While most thyroid cancers are treated with thyroidectomy alone, some patients are given additional radioactive iodine (RAI) in the form of 131I to treat thyroid cancer metastasis. RAI is associated with acute and chronic complications. Secondary malignancies are the most important in long-term cancer survivors. While many studies have reported the occurrence of acute myeloid leukemia after high-dose RAI, there are few reports on chronic myeloid leukemia (CML) after low-dose RAI treatment. Moreover, previous cases of CML following thyroid cancer were reported before the tyrosine kinase inhibitor (TKI) era. Here, we describe two cases of CML following thyroid cancer that were successfully treated with second-generation TKIs. (Korean J Med 2016;91:70-74) Keywords: Chronic myeloid leukemia; Thyroid cancer; Protein-tyrosine kinase 서 론 갑상선암의 발생률은 급격하게 증가하고 있으며, 대부분 의 환자에서는 5년 생존율이 100%에 육박할 정도로 장기 생 존이 가능하다고 보고되고 있다[1]. 갑상선암 환자에서 생존 율을 높이고 삶의 질을 향상시키기 위해 잔여 암을 제거하는 것은 매우 중요한 치료 전략으로, 131 I 형태의 방사성요오드 는 잔여 갑상선의 절제, 보조 요법 또는 전이암의 조절에 널 리 사용되고 있다[2]. 하지만, 방사선요오드는 침샘염, 구내 염, 골수형성 부전증을 일으키고 이차성 암을 유발하는 등의
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