0
selected
-
1.
MDCT urography for detecting recurrence after transurethral resection of bladder cancer: comparison of nephrographic phase with pyelographic phase.
Kim, JY, Kim, SH, Lee, HJ, Kim, MJ, Kim, YH, Cho, SH
AJR. American journal of roentgenology. 2014;(5):1021-7
Abstract
OBJECTIVE The purpose of this study was to prospectively compare nephrographic phase MDCT urography performed with oral hydration and a diuretic with standard pyelographic phase MDCT in the detection of recurrence after transurethral resection. SUBJECTS AND METHODS The study included 140 MDCT urographic examinations of 121 patients (87 men, 34 women; age range, 46-88 years) at risk of urinary tract cancer recurrence. Acquisition was performed 60 seconds (nephrographic phase) and 420 seconds (pyelographic phase) after contrast injection. Two radiologists independently recorded the presence of recurrent lesions in each phase. The reference standard was histologic findings and prospective clinical decision. Distention and opacification were compared for each radiologist in each segment in each phase by kappa statistic and Spearman rank coefficient. Generalized estimating equations for logistic regression analysis were used to compare performance for each radiologist and phase and were adjusted for possibility within patient correlation. RESULTS Urinary tract distention was rated significantly better at the pyelographic phase for all segments (p < 0.001). The degree of opacification provided by each radiologist for the same segment showed high correlation. There were 59 bladder recurrences in 38 patients and 19 upper tract recurrences in 13 patients. For recurrence detection in the bladder, the overall accuracy was significantly higher for the nephrographic phase than the pyelo-graphic phase (91.7% [354/386] vs 83.2% [321/386], p = 0.038). For recurrence detection in the upper tract, the overall accuracy was significantly higher in the nephrographic phase than in the pyelographic phase (86.7% [260/300] vs 80% [240/300], p = 0.028). CONCLUSION Use of nephrographic phase MDCT urography is associated with a higher rate of detection of urinary tract recurrence than is pyelographic phase MDCT, which suggests the value of this technique for evaluating the urinary tract after transurethral resection.
-
2.
Coenzyme Q10 in combination with steroid therapy for treatment of sudden sensorineural hearing loss: a controlled prospective study.
Ahn, JH, Yoo, MH, Lee, HJ, Chung, JW, Yoon, TH
Clinical otolaryngology : official journal of ENT-UK ; official journal of Netherlands Society for Oto-Rhino-Laryngology & Cervico-Facial Surgery. 2010;(6):486-9
Abstract
OBJECTIVE To evaluate the therapeutic efficacy of coenzyme Q10 added to systemic steroid in patients with idiopathic sudden sensorineural hearing loss. DESIGN A controlled prospective study. SETTING Asan medical center, University of Ulsan College of Medicine. PARTICIPANTS Between August 2007 and October 2008, the first 60 patients diagnosed with sudden sensorineural hearing loss were managed with systemic steroid treatment for 2 weeks including 5-day hospitalisation. And the second 60 patients were managed with coenzyme Q10 for 2 weeks added to previous management. MAIN OUTCOME MEASURES We evaluated auditory function by pure tone audiometry and speech discrimination score. Auditory evaluations were performed before and 3 months after treatment using Siegel's criteria. The degree of improvement in four-tone average hearing and speech discrimination score was calculated from the results before and after treatment. RESULTS The total hearing improvement rate after the treatment was 75.0% (90/120 patients) in this study. Although 47 patients (78.3%) of coenzyme Q10 group showed better hearing improvement than 43 patients (71.7%) of control group, there was no significant difference. However, the coenzyme Q10 group showed significantly higher improvement in speech discrimination score. CONCLUSION From this study, we suggest that coenzyme Q10 may have beneficial effects in the treatment of sudden sensorineural hearing loss.
-
3.
[Long-term clevudine therapy in nucleos(t)ide-naïve and lamivudine-experienced patients with hepatitis B virus-related chronic liver diseases].
Lee, HJ, Eun, JR, Lee, CH, Hwang, JS, Suh, JI, Kim, BS, Jang, BK
The Korean journal of hepatology. 2009;(2):179-92
Abstract
BACKGROUNDS/AIMS: Clevudine is an effective antiviral nucleoside analogue, but there are few data regarding its long-term effects, resistance, and safety. The aim of this study was to evaluate the long-term clinical efficacy of clevudine over a 1-year treatment period in nucleos(t)ide-naive and lamivudine-experienced chronic hepatitis B patients. METHODS Nucleos(t)ide-naive (group A, n=196) and lamivudine-experienced (serum hepatitis B virus, HBV DNA >2,000 copies/mL without resistant mutants at the start of clevudine therapy, group B, n=75) patients were included in this study. Basic clinical characteristics including age, sex, the presence of cirrhosis, laboratory data, and hepatitis B surface antigen (HBeAg) positivity were similar between the two groups. Pretreatment serum levels of HBV DNA were 7.4 and 6.6 log(10) copies/mL (P<0.001). The mean treatment duration was 8 months for both groups (range for group A: 3-21 months; range for group B: 3-20 months). Genotypic analysis for resistant mutations in the reverse transcriptase of HBV was performed after viral breakthrough. RESULTS After 1 year of therapy, 75.0% and 51.9% of groups A and B, respectively, had HBV DNA levels of <2,000 copies/mL (P=0.032), and HBeAg seroconversion rates were 16.9% and 16.7%, respectively. The rates of viral breakthrough at 1 year were 10.0% (8/80) and 44.4% (12/27), respectively (P<0.001). Proven sites of mutation of HBV DNA polymerase in naive patients were, for example, L80I, L180M, A181V/T, M204I and V207I. Ten patients complained of prominent fatigue and revealed elevated serum levels of aspartate aminotransferase (AST) and creatine phosphokinase (CPK). Two of these patients presented with severe myopathy from which they recovered completely after quitting clevudine. CONCLUSIONS Clevudine is one of the recommended first-line medicines for the treatment of chronic hepatitis B, but it is not free from resistance, particularly in patients with a history of previous lamivudine treatment, but also in naive patients. Clevudine should be avoided in previously lamivudine-exposed patients. In addition, reelevation of serum AST and CPK levels is not a rare occurrence, and close observation and follow-up tests are essential.
-
4.
The effect of 24 months of combination statin and extended-release niacin on carotid intima-media thickness: ARBITER 3.
Taylor, AJ, Lee, HJ, Sullenberger, LE
Current medical research and opinion. 2006;(11):2243-50
Abstract
OBJECTIVE The ARBITER 2 trial showed that extended-release niacin (ERN) when added to statin monotherapy slowed the progression of carotid atherosclerosis over 12 months. Whether longer treatment with ERN would have a greater effect on carotid intima-media thickness (CIMT) is unknown. RESEARCH DESIGN AND METHODS We examined the long-term effects of ERN on high density lipoprotein (HDL-C) cholesterol and CIMT during 12-24 months treatment with ERN in ARBITER 2 participants who were either continued or were crossed over (from placebo) to ERN 1000 mg daily. MAIN OUTCOME MEASURES Among 149 subjects completing ARBITER 2, 130 (88%) enrolled in ARBITER 3. The prespecified primary endpoints were the within-group change in CIMT and HDL-C in patients receiving placebo for 12 months (n = 71), ERN for 12 months (comprised of subjects from ERN treatment during ARBITER 2 (n = 78) and those crossed over to ERN from placebo after ARBITER 2 (n = 47)), and ERN for 24 months spanning ARBITER 2 and 3 (n = 57). Five subjects discontinued the study due to flushing side effects. The study was completed by 104 subjects (47 crossed over from placebo; 57 with ERN continued from ARBITER 2). RESULTS HDL-C increased in the ERN group from 39.5 +/- 6.7 to 48.6 +/- 13.3 mg/dl (p < 0.001) along with modest reductions in LDL-C and TG. Among 125 participants treated with ERN for 12 months, there was a net regression of CIMT of -0.027 +/- 0.011 mm (p < 0.001 vs. placebo). Among 57 participants treated with ERN for 24 months, there was additional significant regression of CIMT of -0.041 +/- 0.021 mm (p = 0.001 vs. placebo). Controlling for changes in LDL and triglycerides, only changes in HDL-C were independently associated with regression of CIMT (beta = -0.25; p = 0.001). CONCLUSION When added to statin therapy, ERN significantly increases HDL-C and induces atherosclerosis regression measured by CIMT over 24 months. Limitations to this study include its open-label design and the inability to relate CIMT effects to clinical outcomes.
-
5.
Effects of medicinal herb tea on the smoking cessation and reducing smoking withdrawal symptoms.
Lee, HJ, Lee, JH
The American journal of Chinese medicine. 2005;(1):127-38
Abstract
Medicinal herbs (21 species) were screened for the antioxidant activity and nicotine degradation activity (NDA) in vitro. Eleven of them with higher antioxidant activity and NDA were selected for preparation of the medicinal herb tea (MHT) and the effects of MHT on smoking cessation and reducing smoking withdrawal symptoms were evaluated in 100 male human smokers. Among these medicinal herbs, Eugenia aromaticum and Astragalus membranaceus Bunge showed the highest antioxidant activity (IC50 of 30.0 microg/mL) and NDA (1.81), respectively. MHT showed relatively high antioxidant activity (IC50 of 50.6 microg/mL) and NDA (1.23). The urinary cotinine level, a metabolite of nicotine, increased in the first 2 weeks and greatly decreased from the 2nd to 4th week in the MHT taking group, which indicates that MHT accelerates the conversion of nicotine into cotinine. Human groups taking MHT for 4 weeks underwent reduced smoking withdrawal symptoms compared to the non-MHT taking subjects, and 38% of subjects taking MHT succeeded in smoking cessation, while only 12% of non-MHT taking subjects succeeded in quitting smoking.
-
6.
Impact of postprandial hypertriglyceridemia on vascular responses in patients with coronary artery disease: effects of ACE inhibitors and fibrates.
Bae, JH, Bassenge, E, Lee, HJ, Park, KR, Park, CG, Park, KY, Lee, MS, Schwemmer, M
Atherosclerosis. 2001;(1):165-71
Abstract
We analyzed vascular responses (endothelial function, oxidant stress) to postprandial hypertriglyceridemia (PHTG) in patients with coronary artery disease (CAD) to reveal potential therapeutical effects of angiotensin converting enzyme inhibition (ACE-I) and of lipid lowering (fibrate). The study population (n=39, mean age: 60 years) consisted of four groups, all of which had angiographically documented CAD. A high fat group (n=9) consumed a high fat meal, a low fat group (n=9) a low fat meal, and ACE-I (n=10) or fibrate (n=11) groups consumed a high fat meal plus lisinopril or fenofibrate. Serum triglycerides (TG) increased significantly 2 h after eating a test meal in all groups with the exception of the low fat group. In the high and low fat groups changes of serum TG were positively correlated (r=0.664, P<0.005) with changes of phorbol ester-activated leukocyte superoxide anion radical (O(2-.)) formation and were negatively correlated (r=-0.488, P<0.05) with flow-mediated brachial artery dilation (FMD). There was a negative correlation (r=-0.419, P=0.094) between FMD and changes of O(2-.) formation in the high and low fat groups. In the ACE-I and fibrate groups, O(2-.) formation decreased 2 h after eating a test meal (from 5.34+/-1.01 to 3.81+/-1.15 nmol/10(6)cells per min, P<0.01, and from 4.66+/-0.91 to 4.26+/-0.97 nmol/10(6)cells per min, P=0.374, respectively). However, endothelial function did not show any significant changes 2 h after eating a test meal in all groups. PHTG increases oxidant stress and further deteriorates endothelial function, even in patients with CAD. Both ACE-I and fibrates have an antioxidant effect but no acute beneficial effects in terms of endothelial function under conditions of PHTG in CAD patients.