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NT-proBNP Is Predictive of the Weaning from Continuous Renal Replacement Therapy
Han, Seung Seok,Bae, Eunjin,Song, Sang Hoon,Kim, Dong Ki,Kim, Yon Su,Han, Jin Suk,Joo, Kwon Wook TOHOKY UNIVERSITY MEDICAL PRESS 2016 The Tohoku journal of experimental medicine Vol.239 No.1
<P>Continuous renal replacement therapy (CRRT) is a dialysis modality used to treat patients with severe acute kidney injury. Nevertheless, there is limited information on the predictors of weaning from CRRT. The present study examined whether the N-terminal prohormone of brain natriuretic peptide (NT-proBNP) can predict weaning from CRRT, based on the fact that this cardiac neurohormone is known to predict kidney dysfunction. Plasma NT-proBNP and several other baseline parameters at the time of starting CRRT were retrieved from 160 patients. The odds ratio (OR) for weaning from the CRRT within two weeks was calculated using a multivariate stepwise logistic model. We calculated the cut off value predicting weaning outcome by using the receiver operating characteristic curve and corresponding Youden index, and then divided patients into high (n = 74) and low (n = 86) NT-proBNP groups. The high NT-proBNP group had a lower weaning rate than the low NT-proBNP group [adjusted OR, 0.36 (0.170-0.756); P = 0.007]. We additionally found other predictors of weaning, such as sex, serum creatinine, urine output, and the score from the Acute Physiology and Chronic Health Evaluation, but all of these were not better than NT-proBNP in the predictability of weaning outcome. Neutrophil gelatinase-associated lipocalin, a well-known biomarker of acute kidney injury and originating from kidney, was not related with the CRRT weaning, which indicated the usefulness of NT-proBNP in the cases of CRRT despite originating from heart. The present study addresses the potential of NT-proBNP as an independent predictor of weaning from CRRT.</P>
Kim, Hak-Ryul,Kim, Byoung-Ryun,Park, Rae-Kil,Yoon, Kwon-Ha,Jeong, Eun-Taik,Hwang, Ki-Eun TOHOKY UNIVERSITY MEDICAL PRESS 2017 The Tohoku journal of experimental medicine Vol.242 No.2
<P>Malignancy and tuberculosis are common causes of lymphocytic exudative pleural effusion. However, it is occasionally difficult to differentiate malignant pleural effusion from tuberculous pleural effusion. Vascular endothelial growth factor (VEGF) is a critical cytokine in the pathogenesis of malignant pleural effusion. Endocan is a dermatan sulfate proteoglycan that is secreted by endothelial cells. Importantly, endocan mediates the vascular growth-promoting action of VEGF. The aim of this study was to evaluate the diagnostic significance of VEGF and endocan in pleural effusion. We thus measured the levels of VEGF and endocan in the pleural effusion and serum samples of patients with lung cancer (n = 59) and those with tuberculosis (n = 32) by enzyme-linked immunosorbent assay. Lung cancer included 40 cases of adenocarcinoma, 13 of squamous cell carcinoma, and 6 of small cell carcinoma. Pleural effusion VEGF levels were significantly higher in the malignant group than in the tuberculosis group (2,091.47 +/- 1,624.80 pg/mL vs. 1,291.05 +/- 1,100.53 pg/mL, P < 0.05), whereas pleural effusion endocan levels were similar between the two groups (1.22 +/- 0.74 ng/mL vs. 0.87 +/- 0.53 ng/mL). The areas under the curve of VEGF and endocan were 0.73 and 0.52, respectively. Notably, the VEGF levels were similar in malignant pleural effusion, irrespective of the histological type of lung cancer. Moreover, no significant difference was found in the serum VEGF and endocan levels between patients with lung cancer and those with tuberculosis. In conclusion, high VEGF levels in pleural effusion are suggestive of malignant pleural effusion.</P>
Jeong, Sanghoon,Kim, Junghoon TOHOKY UNIVERSITY MEDICAL PRESS 2018 The Tohoku journal of experimental medicine Vol.244 No.2
<P>Dementia is one of the priority public health problems in the older population, and the number of people with dementia is steadily increasing. The longitudinal association of muscle strength with risk of new-onset cognitive dysfunction in a general population including middle and older adults remains unknown. The purpose of this study was to investigate the effects of low muscle strength on risk for new-onset cognitive dysfunction over 6 years using a large nationwide sample of cognitively healthy adults. Study participants included 6,435 middle and older adults (33,554 person-years of follow-up), using data from the Korean Longitudinal Study of Ageing 2006-2012. Muscular strength was measured using the maximum handgrip strength of each participant as an index of muscle quality. Low muscle strength was defined as one standard deviation below the mean using the handgrip strength index based on the study population. Cognitive function was evaluated using the Mini-Mental Status Evaluation. The hazard ratio (HR) for cognitive dysfunction significantly and linearly increased according to muscle strength status independent of potential confounding factors (HR: 1.36, 95% confidence interval [CI]: 1.18-1.56 for low vs. normal-high group). Using stratified analyses, a significant association between muscle strength status and risk of cognitive impairment was observed in those with low physical activity, but not those with high physical activity. We show that handgrip strength is associated with increased risk of new-onset cognitive dysfunction over 6 years of follow-up in cognitively healthy middle aged and older adults at baseline.</P>