Journal of Yeungnam Medical Science

Original articles

Association of advanced chronic kidney disease with diabetic retinopathy severity in older patients with diabetes: a retrospective cross-sectional study: Geun Woo Lee, Chul Ho Lee, Seong Gyu Kim; J Yeungnam Med Sci. 2023;40(2):146-155. Published online May 26, 2022; DOI: https://doi.org/10.12701/jyms.2022.00206

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Background
Despite the recent increasing trend in the prevalence of type 2 diabetes among older individuals, the relationship between diabetic retinopathy (DR) and chronic kidney disease (CKD) in these patients remains unclear. This study investigated the severity of renal dysfunction according to the degree of DR in older patients with type 2 diabetes.
Methods
A total of 116 patients with diabetes and CKD stage ≥3 who visited both the nephrology and ophthalmology outpatient departments between July 2021 and January 2022 were screened. There were 53 patients in the no DR group, 20 in the nonproliferative DR (NPDR) group, and 43 in the proliferative DR (PDR) group.
Results
DR severity was related to the deterioration of renal function. The proportion of patients with advanced CKD significantly increased with DR severity (p for trend <0.001). In the multivariate regression model adjusted for age of ≥80 years, male sex, poorly controlled diabetes, macroalbuminuria, insulin use, diabetes duration of ≥10 years, cerebrovascular accident, hypertension, hyperlipidemia, and cardiovascular disease history, the odds ratio compared with the no DR group was approximately 4.6 for the NPDR group and approximately 11.8 for the PDR group, which were both statistically significant (p=0.025 and p<0.001, respectively).
Conclusion
DR severity in older patients with diabetes may be associated with deterioration of renal function and high prevalence of advanced CKD. Therefore, periodic examination for DR in older patients with diabetes is important for predicting renal function deterioration and CKD progression.

Citations

Citations to this article as recorded by

Diabetic Macular Edema Is Predictive of Renal Failure in Patients With Diabetes Mellitus and Chronic Kidney Disease
Shih-Hsiang Ou, Wei-Che Chang, Ling-Ying Wu, Shiow-Ing Wang, James Cheng-Chung Wei, Po-Tsang Lee
The Journal of Clinical Endocrinology & Metabolism.2024; 109(3): 761. CrossRef
Study on Correlation between Renal Function and Diabetic Retinopathy
卓越郑
Advances in Clinical Medicine.2024; 14(03): 513. CrossRef

The impact of quality of life measured by WHOQOL-BREF on mortality in maintenance hemodialysis patients: a single center retrospective cross-sectional study: Seong Gyu Kim, In Hee Lee; J Yeungnam Med Sci. 2023;40(1):49-57. Published online April 18, 2022; DOI: https://doi.org/10.12701/jyms.2022.00080

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Abstract PDF

Background
Several previous studies have reported that quality of life (QoL) in hemodialysis patients affects mortality. However, the 36-item Short Form Health Survey, which has been used mainly in previous studies, is complicated in terms of questionnaire composition and interpretation. This study aimed to identify the impact of QoL on mortality in hemodialysis patients using an easier and simpler diagnostic tool.
Methods
This retrospective study included 160 hemodialysis patients. QoL was evaluated using the World Health Organization Quality of Life Questionnaire-Brief version (WHOQOL-BREF). Psychosocial factors were evaluated using the Hospital Anxiety and Depression Scale, Multidimensional Scale of Perceived Social Support, Montreal Cognitive Assessment, and Pittsburgh Sleep Quality Index. We also evaluated medical factors, such as dialysis adequacy and laboratory results.
Results
The mean hemodialysis vintage was 70.7±38.0 months. The proportion of patients who were elderly was higher in the mortality group than in the surviving group, and the Charlson Comorbidity Index score was also higher in the former group. Of the four domains of the WHOQOL-BREF, the physical health and psychological scores of the mortality group were significantly lower than those of the survival group. When the score in the physical health domain or psychological domain was ≤10, the 10-year mortality rate after hemodialysis initiation increased by approximately 2.3- and 2-fold, respectively.
Conclusion
QoL may have a significant effect on mortality in patients undergoing hemodialysis. The WHOQOL-BREF is an instrument that can measure QoL relatively easily and can be used to improve the long-term prognosis of patients undergoing hemodialysis.

Citations

Citations to this article as recorded by

Application of standardized management and effect evaluation of chronic obstructive pulmonary disease patients using the big data center of the Internet of Things
Xiaoping Chen, Fei He, Yan Jiang, Xuezhen Chen, Yubing Yan
DIGITAL HEALTH.2024;[Epub] CrossRef

Case Reports

POEMS syndrome misdiagnosed as bone metastasis in a patient with thyroid cancer.: Sang Ah Baek, Hun Mo Ryoo, Sung Hwa Bae, Yoon Young Cho, Seong gyu Kim, Ga Young Kim, Min Keun Kim; Yeungnam Univ J Med. 2015;32(2):122-126. Published online December 31, 2015; DOI: https://doi.org/10.12701/yujm.2015.32.2.122

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Abstract PDF: Polyneuropathy, organomegaly, endocrinopathy, monoclonal gammopathy, and skin changes (POEMS) syndrome is a monoclonal plasma cell disorder. Patients with POEMS syndrome also have various clinical manifestations including generalized edema, pleural effusion, ascites, papilledema, and sclerotic bone lesions. These manifestations can lead to a misdiagnosis or delayed diagnosis. We recently experienced a 51-year-old male patient with POEMS syndrome whose sclerotic bone lesion was misdiagnosed as malignant bone metastasis of papillary thyroid carcinoma. We reassessed the patient and found polyneuropathy, hepatosplenomegaly, hypothyroidism, partial hypopituitarism, immunoglobulin G lambda-type monoclonal gammopathy, hypertrichosis, ascites, and multiple sclerotic bone lesions, all of which led us to a diagnosis of POEMS syndrome. Treatment with thalidomide and dexamethasone resulted in clinical and radiological improvement. The patient has remained in remission after peripheral blood stem cell transplantation.

Relapsed plasmacytoma in central nervous system after complete remission of extramedullary plasmacytoma.: Sun Mi Kang, Seong Gyu Kim, Ji Ho Seo, Ji Yoon Kim, Woo Jung Sung, Sung Hwa Bae, Hun Mo Ryoo; Yeungnam Univ J Med. 2014;31(1):43-47. Published online June 30, 2014; DOI: https://doi.org/10.12701/yujm.2014.31.1.43

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Abstract PDF: Extramedullary plasmacytoma (EMP) is a rare disease that occurs in 3% to 5% of patients with plasma cell disorder. It occurs most commonly in the upper respiratory tract and the oral cavity. Very few EMP cases have been reported in the central nervous system (CNS). We report herein an unusual case of EMP in the nasal cavity that recurred in the CNS without systemic involvement. A 67-year-old man visited our hospital due to a month-long bout with exophthalmos. He was diagnosed with EMP in the nasal cavity, paranasal sinus, and orbital cavity. He received radiotherapy to which he had complete responses. After 2 years, he visited our hospital because of a month-long headache. He was diagnosed with EMP recurrence in the CNS via brain magnetic resonance imaging and cerebrospinal fluid analysis. He was treated with whole brain radiotherapy and intrathecal chemotherapy with methotrexate, but he expired due to pneumonia.

Two Cases of Nasopharyngeal Carcinoma Treated with Co-60 HDR ICR.: Sei One Shin, Cheol Hoon Kang, Seong Gyu Kim, Myung Se Kim; Yeungnam Univ J Med. 1990;7(1):197-201. Published online June 30, 1990; DOI: https://doi.org/10.12701/yujm.1990.7.1.197

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Abstract PDF: The primary treatment modality of malignant tumors of the nasopharynx is radiation therapy owing to its inaccessibility to surgical intervention. Over the last two decades there were many changes in techniques of delivery, which include the use of higher doses of radiotherapy, the use of wide radiation field, including the elective radiation of the whole neck, the combined use of brachy- and teletherapy, and the use of split-course therapy. In spite of these advances local and regional recurrences remain the major cause of death. As a boost therapy after external irradiation, high-dose-rate intracavitary irradiation using remote control afterloading system (RALS) was used in two patients. Our results were satisfactory, however, this procedure should only be performed by those who have developed enough expertise in the use of intracavitary techniques for the treatment of nasopharyngeal cancer and have a supportive team including a physicist, dosimetrist, nurse, and trained technologist.

Original Articles

Effects of same TDF Factors on Body Weight of Mice and Peripheral Blood Picture.: Sei One Shin, Seong Gyu Kim, Myung Se Kim; Yeungnam Univ J Med. 1987;4(2):89-96. Published online December 31, 1987; DOI: https://doi.org/10.12701/yujm.1987.4.2.89

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Abstract PDF: Using same TDE factors, the authors studied the effects of whole abdominal irradiation on body weight and peripheral blood picture in 30±3 day old mice. Fractions of 100 and 200 cGy were given five times a week to the final TDF factors 17, 33, and 49. Total 80 mice were irradiated with orthovoltage x-ray machine. Our results can be summarized as follows: There were no significant differences by sex. Body weight was progressively decreased by the duration for irradiation, but no remarkable difference by fractional dose. Hemoglobin level showed no remarkable change by fractional dose or TDF factors. Leukopenic changes showed that severity of decrease seems to be more related to TDF factors. There were no significant changes of differential count by TDF factors of total doses.

A Study on Equivalent Square Field in High Energy Photon Beam.: Seong Gyu Kim, Sei One Shin, Myung Se Kim; Yeungnam Univ J Med. 1987;4(2):83-88. Published online December 31, 1987; DOI: https://doi.org/10.12701/yujm.1987.4.2.83

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Abstract PDF: An analytic expression for equivalent square fields and a table are derived using the empirical representations obtained from the measured field size dependence of output for square field in a phantom. The expression is applicable to radiation fields that consistent with the following two assumptions imposed on these representations. 1) It is a linear function of the logarithm of the field area. 2) It is approximately the same function for both square and circular field of similar areas. In this paper, the derived tables and BJR table were consulted.

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