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Gut and Liver ; : 37-46, 2020.
Article in English | WPRIM | ID: wpr-833107


As ultrasound (US) is simple and less invasive than other imaging modalities, this technique is widely used for mass screening. However, visualizing the entire pancreas due to complicated anatomy, obesity and overlying gas can be difficult. US plays a key role in the diagnosis of pancreatic carcinoma (PC), of which tumors smaller than 10 mm (TS1a) and pancreatic carcinoma in situ are expected to have good prognosis. To detect these forms of PC, main pancreatic duct (MPD) dilatation (3 mm or more) and pancreatic cysts (5 mm or larger) are US findings of high-risk individuals (HRIs), and these subjects should be observed periodically. Scanning maneuvers are also important for both screening for PC and follow-up of HRIs. As lesions in the groove area and ventral pancreas do not affect the MPD or extrahepatic bile duct, we should pay attention to these areas. Visualization of the tail is also challenging due to gas and stool in the alimentary tract. As the position of the pancreas changes depending on the body posture, and several different body positions should be employed, such as the right lateral decubitus, sitting, and upright positions, rather than only applying strong compression with the transducer. In cases with poor visualization, the liquid-filled stomach method is highly recommended.

Medical Principles and Practice. 2017; 26 (5): 433-437
in English | IMEMR | ID: emr-190421


Objective: To investigate the relationship between urine pH and metabolic syndrome [MetS] and its components, while controlling for covariates

Subjects and Methods: This crosssectional study was conducted on 5,430 Japanese subjects [4,691 without MetS; 739 with MetS] undergoing health assessments. Partial correlation analysis and analysis of covariance were used for controlling confounding parameters [age, gender, levels of serum uric acid and high-sensitivity C-reactive protein, estimated glomerular filtration rate, and smoking and drinking status]. Using multiple logistic regression analyses, adjusted odds ratios [ORs] and 95% confidence intervals [CIs] for MetS incidence were calculated across urine pH categories. Path analysis was used to determine the relationship between MetS and urine pH

Results: Subjects with MetS had significantly lower urine pH [5.9 +/- 0.7] than those without MetS [6.0 +/- 0.7] [ p < 0.001]. Partial correlation analysis showed that systolic and diastolic blood pressure, and triglyceride and fasting plasma glucose levels were negatively correlated with urine pH, while high-density lipoprotein cholesterol was positively correlated with urine pH. Analysis of covariance indicated that urine pH decreased with an increasing number of metabolic abnormalities. Adjusted ORs [95% CI] for the presence of MetS in subjects with urine pH 5.5-6.0 and pH <5.5 were 1.34 [1.04-1.73] and 1.52 [1.09-2.13], respectively [reference: subjects with a urine pH >6.0]

Conclusion: The MetS and its components were independently associated with lower urine pH