• 제목/요약/키워드: Urinary Tract

검색결과 645건 처리시간 0.035초

방사성동위원소 배뇨방광촬영술의 신장예후 예측성능 (Predictive Efficacy of Radioisotope Voiding Cystography for Renal Outcome)

  • 김석기;이동수;김광명;최황;정준기;이명철
    • 대한핵의학회지
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    • 제34권2호
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    • pp.135-143
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    • 2000
  • 목적: 방광요관역류는 감염과 동반될 경우 신장기능이 비가역적으로 손상될 수 있으므로 신기능의 손상이 오기 전에 역류를 제거하여야 한다. 방사성동위원소 배뇨방광촬영술에 의해 발견된 역류의 특징을 이용하여 신장의 예후를 예측할 수 있는지 그리고 어떤 특징이 중요한지 조사하였다. 대상과 방법: 35명의 환아(남 18, 여 17)의 66개의 신장을 대상으로 초기 DMSA 스캔을 시행하고 이어 방사성동위원소 배뇨방광촬영술을 한 후 다시 DMSA 추적 스캔, 초음파 및 임상소견으로 악화여부를 평가하였다. 방사성동위원소 배뇨방광촬영술에 나타난 각 배뇨시기별 역류량과 역류범위를 각각 또는 종합하여 단계별 다변량판별분석을 하였다. 결과: 충만시의 역류범위와 배뇨후기의 역류량과 역류범위가 유의한 판별능을 보였다. 역류량과 범위를 종합한 변수를 이용한 판별분석에서는 총 역류량이 유의한 변수이었다. 충만시의 역류범위과 배뇨후기의 역류량과 역류범위로 구성한 판별식은 재래식 역류등급으로 예후를 예측할 때 보다 양성예측율과 특이도가 높았다. 결론: 방사성동위원소 배뇨방광 촬영술에 나타난 각 배뇨시기별 역류의 양과 범위를 종합하여 신장의 예후를 예측할 수 있다.

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Incidentally Detected Adenocarcinoma Prostate in Transurethral Resection of Prostate Specimens: a Hospital Based Study from India

  • Varghese, Jophy;Kuruvilla, Priya Mariam;Mehta, Nisarg;Rathore, Ranjeet Singh;Babu, Manas;Bansal, Devesh;Pillai, Biju;Sam, Mohan P;Krishnamorthy, H
    • Asian Pacific Journal of Cancer Prevention
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    • 제17권4호
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    • pp.2255-2258
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    • 2016
  • Background: Awareness about prostate cancer has increased in the community, and prostate cancer screening examinations, including prostate specific antigen (PSA) assays, are now widely available. Prior to the PSA era, up to 27% of prostate cancers were detected incidentally at the time of transurethral resection of prostate (TURP). After PSA testing became widely available, the incidence of incidentally detected carcinoma prostate in TURP specimens without prior diagnosis reduced to 5-13%. However, the incidence of incidentally detected carcinoma prostate has been reported to vary across the globe since various factors can influence the identification of this malignancy in TURP specimens. In this paper, we focus on rates of incidentally detected prostate cancer in TURP specimens in our hospital and correlate it with various parameters. Materials and Methods: This retrospective study of histopathological findings of biopsy specimens was conducted for patients undergoing TURP during a period of 5 years from April 2010. The inclusion criteria were patients diagnosed with benign prostatic hyperplasia (BPH) (digital rectal examination (DRE) not showing any abnormally hard areas and normal age adjusted PSA values). Patients with elevated PSA, abnormal DRE, documented urinary tract infection and proved adenocarcinoma prostate (CaP) were excluded from the study. The total weight of prostatectomy specimen, occurrence of carcinoma prostate in the chips, percentage of total tissue resected showing malignancy and Gleason's scores were recorded. Results: A total of 597 patients belonging to the inclusion criteria were studied. The incidence of occult CaP in the study group was 5.2 % (31/597). Out of these, 8 belonged to T1a and 23 belonged to T1b stages. The age group 70 - 79 years had the maximum incidence of occult CaP. It was observed that the clinical grading of prostate did not have a bearing on the incidence of occult CaP whereas the weight of resected specimen correlated with the incidence of CaP. The incidence of occult CaP was greater with low volume prostates (<20 g). (P=0.15). Conclusions: The rate of incidentally detected adenocarcinoma prostate in patients undergoing TURP for clinically diagnosed BPH was found to be only 5.2 % in our study which is low when compared with similar studies done elsewhere. The age of the patient and weight of the resected specimen correlated with incidence of occult prostate cancer. The clinical grading of prostate by DRE however, demonstrated no correlation.

뇌졸중환자(腦卒中患者) 290례(例)에 대(對)한 임상(臨床) 고찰(考察) (III) ('Clinical Observation on the 290 cases of Cerebrovascular Accident')

  • 강관호;전찬용;박종형
    • 대한한의학회지
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    • 제18권2호
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    • pp.223-244
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    • 1997
  • Clinical observation was done on 290 cases of patients who were diagnosed as CVA with brain CT, TCD, MRI scan and clinical observation. They were hospitalized in the oriental medical hospital of Kyung-Won University from 1st January to 31st December in 1996. 1. The cases were classified into the following kinds : cerebral infarction, cerebral hemorrhage, and transient ischemic attack. The most case of them was the cerebr진 infarction. 2. There is no significant difference in the frequency of strokes in male and female. And the frequency of strokes was highest in the aged over 50. 3. In cerebral infarction the most frequent lesion was the territory of middle cerebral artery, and in cerebral hemorrhage the most frequent lesion was the basal ganglia. 4. The most ordinary preceding disease was hypertension, and the next was diabetes. 5. The rate of recurrence was high in cerebral infarction. 6. The frequency of strokes seems to have no relation to the season. 7. The cerebral infarction occurred usually in resting and sleeping, and the cerebral hemorrhage in acting. 8. The course of entering hospital, most patients visited this hospital as soon as CVA occurred. And the half of patient visited this hospital within 2 days after CVA attack. 9. In the cases of patients who were unconscious at the admission, the prognosis was worse than that of the alert patients. 10. The common symptoms were motor disability and verbal disturbance. 11. The average duration of hospitalization was 27.4 days, and in case of cerebral hemorrhage the duration was prolonged. 12. The average time to start physical therapy was 13.3rd day after stroke in cerebral infarction and it was 19.9th day after stroke in cerebral hemorrhage. 13. The common complications were urinary tract infection, pneumonia, myocardial infarction and so on. 15. At the time of entering hospital, in most cases the blood pressure was high, but blood pressure was well controlled at the time of discharge. 16. Generally reported, hypercholesterolemia and hypertriglyceridemia are usually found in cerebral infarction. But in this study, they were found more frequently in cerebral hemorrhage than in infarction. 17, In the most cases, western and oriental medical treatments were given simultaneously. 18. In acute or subacute stage, the methods of smoothening the flow of KI(順氣), dispelling phlegm(祛痰), clearing away heat(淸熱) or purgation(瀉下) were frequently used. And in recovering stage, the methods of replenishing KI(補氣), tonifying the blood(補血) or tranquilization(安神) were frequently used.

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Can Reproductive Characteristics Predict Bladder Cancer in Women with Haematuria?

  • Yavuzcan, Ali;Caglar, Mete;Kayikci, Muhammet Ali;Basaran, Ekrem;Tekin, Ali;Ozdemir, Enver;Dilbaz, Serdar;Ustun, Yusuf;Cam, Haydar Kamil
    • Asian Pacific Journal of Cancer Prevention
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    • 제14권9호
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    • pp.5107-5110
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    • 2013
  • Background: Among women with haematuria, defining individuals under high risk for bladder cancer based on reproductive factors prior to cystoscopy would be of great benefit in the management of this condition. The aim of this study was to compare age and reproductive factors such as menopausal status, parity, age at first delivery and age at the last delivery between women who have haematuria with or without bladder cancer. Materials and Methods: A total of 463 patients underwent diagnostic cystoscopy in D$\ddot{u}$zce University Faculty of Medicine between 1 June 2008 and 1 June 2013. Female patients who presented with persistent microscopic or macroscopic haematuria and underwent standard evaluation for haematuria including urinalysis, urine culture, urine cytology, urinary tract imaging with excretory urography or computerized tomography with contrast enhancement and endoscopic evaluation of the urethra and bladder were included in this study. Exclusion criteria were tobacco use and high risk occupations for bladder cancer such as textile, dry cleaning, painting and etc. Forteen women had hematuria due to benign conditions, and 18 due to bladder cancer. Data were retrospectively retrieved from the medical records of Duzce University Hospital. Results: Patients with haematuria due to benign reasons did not significantly differ from patients who were found to have bladder cancer in terms of age (p=0.28), menopausal status (p=0.29), mean parity (p=0.38), being nulliparous (p=0.57), parity ${\geq}3$ (p=0.22), age ${\leq}18$ years at first delivery (p=1.00), age ${\geq}30$ years at last delivery (p=0.26), age ${\geq}35$ years at last delivery (p=0.23) and percentage of the patients with advanced age (${\geq}65$ years) (p=0.18). Conclusions: It is difficult to predict a high risk for developing bladder cancer in women with haematuria based solely on reproductive factors.

Usefulness of the procalcitonin test in young febrile infants between 1 and 3 months of age

  • Lee, In Sul;Park, Young Jin;Jin, Mi Hyeon;Park, Ji Young;Lee, Hae Jeong;Kim, Sung Hoon;Lee, Ju Suk;Kim, Cheol Hong;Kim, Young Don;Lee, Jun Hwa
    • Clinical and Experimental Pediatrics
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    • 제61권9호
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    • pp.285-290
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    • 2018
  • Purpose: To study the usefulness of the procalcitonin (PCT) test in young febrile infants between 1 and 3 months of age. Methods: We evaluated the medical records of 336 febrile infants between 1 and 3 months of age who visited the Emergency Department or outpatient department of Samsung Changwon Hospital from May 2015 to February 2017, and analyzed the clinical characteristics between infants in the serious bacterial infection (SBI) group and non-SBI group. Results: Among the 336 infants, 38 (11.3%) had definitive SBI (bacteremia, n=3; meningitis, n=1; urinary tract infection, n=34). The mean PCT ($6.4{\pm}11.9ng/mL$) and C-reactive protein (CRP) level ($3.8{\pm}2.6mg/dL$), and the absolute neutrophil count (ANC) ($6,984{\pm}4,675$) for patients in the SBI group were significantly higher than those for patients in the non-SBI group (PCT, $0.3{\pm}1.2ng/mL$; CRP, $1.3{\pm}1.6mg/dL$; ANC, $4,888{\pm}3,661$). PCT had lower sensitivity (43.6%), but higher specificity (92.6%) and accuracy (86.9%) than CRP (92.3%, 25.3%, and 33.0%) for identifying SBI. The area under the receiver operating characteristic curves (AUCs) for definitive SBI were PCT 77.0%, CRP 80.8%, WBC 56.8%, ANC 67.8%, and PLT 48.1%. The AUCs for definitive SBI were PCT+CRP 85.4%, PCT+WBC 77.2%, PCT+ANC 81.3%, CRP+WBC 80.1%, and CRP+ANC 81.6%. Conclusion: Our results suggest that the PCT test or a combination of PCT and CRP tests is a more accurate and specific biomarker to detect and rule out SBIs.

급성 신우신염의 진단을 위한 영상 검사의 유용성 (The Significance of Renal Imaging Studies in the Diagnosis of Acute Pyelonephritis)

  • 한혜정;김지희;이인실;이혜선
    • Childhood Kidney Diseases
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    • 제11권2호
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    • pp.212-219
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    • 2007
  • 목 적 : 소아의 급성 신우신염은 어릴수록 증상이 비특이적이어서 진단이 어렵고 신반흔이 발생할 위험이 높으나, 조기 진단 및 적절한 치료로써 신반흔의 유병률을 줄일 수 있다. 소아의 발열성요로 감염 환아에서 급성 신우신염의 조기 진단을 위한 요로계 영상 검사를 비교함으로써, 연령별 유용성에 대해 살펴보고자 하였다. 방 법 : 발열성 요로 감염으로 진단받고, 급성기에 DMSA 스캔과 신초음파 및 배뇨중 방광 요도조영술을 시행했던 총 53명(2세 미만 34명, 2세 이상 19명)을 대상으로 하여, 두 연령군 사이에 영상검사의 민감도 및 그 연관성을 관찰하였다. 결 과 : DMSA 스캔의 신피질 결손율은 2세 미만에서 23.5%로서, 2세 이상의 63.2%에 비해 유의하게 낮았다(P<0.05). DMSA 스캔의 신피질결손은 말초 혈액 백혈구 증가와 연관이 있을 뿐, 발열 기간, ESR, CRP와는 연관이 없었고, 신초음파 이상소견 및 방광 요관 역류 유무와도 유의한 연관성 이 없었다. 결 론 : 2세 미만에서는 DMSA 스캔의 민감도가 낮아서 급성 신우신염의 진단에 어려움이 있고, DMSA 스캔만으로 방광 요관 역류의 유무를 예측할 수 없으므로 배뇨성 방광 요도 조영술을 함께 시행하는 것이 필요할 것으로 사료된다.

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급성 신우신염 환아들의 나이에 따른 Dimercaptosuccinic Acid Renal Scan 민감도 (Sensitivity of Dimercaptosuccinic Acid(DMSA) Renal Scan in Children with Acute Pyelonephritis)

  • 장경아;양정아;하태선;박혜원;이준호
    • Childhood Kidney Diseases
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    • 제7권1호
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    • pp.38-43
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    • 2003
  • 목적 : 소아에서는 임상증상만으로 요로감염의 정확한 진단이 어려우므로 DMSA renal scan은 급성 신우신염의 조기 진단과 감별에 중요한 방법이다. 급성 신우신염 환자에서 환자 연령에 따른 DMSA renal scan의 양성률, 신장초음파의 이상여부, 방광요관역류 동반율을 비교해 보고자 하였다. 또 DMSA renal scan과 신장초음파 결과 및 DMSA renal scan과 방광요관역류와의 상관관계를 알아보았다. 방법 : 2001년 3월부터 2002년 9월까지 급성신우신염으로 진단된 67명의 환아를 대상으로 나이에 따라 2세 이하의 소아 57명을 그룹 I으로, 2세 이상의 소아 10명을 그룹 II로 나누었다. 이 환아를 대상으로 DMSA renal scan, VCUG, 신장초음파의 결과를 이용한 후향적 연구를 실시하였다. 결과 : 급성 신우신염 환아에서 DMSA renal scan의 양성률은 나이에 따라서 차이가 없었다. DMSA renal scan과 방광요관역류 등급정도와는 통계학적 의미가 있었으나, 나이에 따른 방광 요관역류와는 통계학적 의미는 없었다. DMSA renal scan과 신장초음파 이상여부와는 의미가 없었다. 나이에 따른 신장초음파 이상여부와도 통계학적 의미는 없었다. 결론 : 현재로서는 DMSA renal scan은 급성 신우신염이 의심되거나, 세균뇨가 있는 환자에게서 감별 진단시 힘들이지 않고, 비교적 경제적 부담이 적은 중요한 검사 방법이다.

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수용성 카이토산에 의한 체내 방사성스트론튬의 제거 (Removal of Radiostrontium ($^{85}Sr$) from the Rat by Water Soluble Chitosan)

  • 김광윤;범희승;김희경;최근희;김지열
    • 대한핵의학회지
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    • 제27권1호
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    • pp.123-129
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    • 1993
  • $^{85}Sr$만을 투여한 대조군에 비해 $^{85}Sr$의 오염에 앞서 3% 카이토산을 체내에 투여한 경우 $^{85}Sr$의 체내 잔존율이 서서히 낮아지는 경향을 보였다. 그 배출효과에 있어서 위장관에 의해 1일 1회 5일간의 연속투여군에서는 1회 단일투여의 경우와 유사하게 나타났으나 수용성 카이토산의 경우 1회 투여군에서는 불용성에 비해 큰 차이를 보이지 않았고, 1일 1회 5일 간의 연속 투여군에서는 약2배 이상 그 배출율이 증가하여 연속적으로 투여하였을 때 방사선 스트론튬이 체내대사에 영향을 줄 수 있음을 시사하였다. 배출물의 경우 변증으로 대부분이 배출되며 카이토산의 투여군에서는 뇨를 통한 배출은 대조군에 비해 높게 나타났고 수용성 카이토산의 투여군에 의해 방사성 스트론륨의 소화관 흡수가 저해되어 결과적으로 배출이 촉진될 뿐만 아니라 골대사 중에 작용하여 표적 기관으로부터 $^{85}Sr$을 추출시키는데도 관여할 가능성을 시사했다. 결론적으로 본 실험에서는 수용성 카이토산과 불용성 카이토산이 방사능 방호약제로 유효하게 쓰일 수 있으며 그중 3% 수용성 카이토산은 연속적으로 투여 한 경우 $^{85}Sr$의 체내 대사에 영향을 미쳐 장기간 투여시 $^{85}Sr$을 체외로 배출시 키는데 기여 할 수 있으리라 기대된다.

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뇌졸중(腦卒中)에 관(關)한 임상통계적(臨床統計的) 연구(硏究) (Clinical Observation on C.V.A.)

  • 윤진구;조기호;김영석;이경섭
    • 대한한방내과학회지
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    • 제10권1호
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    • pp.25-38
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    • 1989
  • Clinical observation was done on 1092 cases of cerebrovascular disease which were confirmed by Brain CT scan in Oriental Medical Hospital in Kyung Hee Univ. from May 1987 to May 1988. Specially, clinical prognosis of 250 patients who had been hospitalized for over 4 weeks, were obserbed. The results were obtained as follows; 1. In this study, Occlusive CVD was 77.9%, Cerebral hemorrhage was 18.8%, Subarachnoid hemonhage was 0.8%. 2. The ratio of male to female was 1.4:1. In the age distribution, 60th decade, 50th decade, 40th decade, 30th's, 20th's were in order of frequency and specially 60th decade was 35.53% over 70th decade was 17.1% in ratio. 3. The most common preceding disease of CVD was hypertension (54.21%) and diabetes mellitus (19.96%) was second. 4. Almost, the duration of hospitalization was 2-4 weeks in 34.8%, within 4 weeks in 78.02%. 5. Primary attack was 75.7%, 2nd attack was 17.9%, over 3rd attack was 3.1% in ratio of recurrence. 6. The level of consciousness was Grade I in 96.4%, Grade II in 3.2%, Grade III in 1% at attack. 7. A few complications of C.V.A. were observed in the studies: pneumonia was noted frequently in 3.2%, bed sore, urinary tract infection, gastro intestinal bleeding in order of frequency. 8. The ratio of neurologic deficiency in occlusive CVD decreased from 51.9% to 29.3% in upper limb, 52.6% to 24.4% in lower limb, and that in cerebral hemorrhage decreased from 69.5% to 25% in upper limb, 50% to 20% in lower limb. 9. The ratio of left side hemiplegia to right was 1.04:1 in male, 1:1.18 in female. 10. The herb medications for C.V.A. were various Chungg-Paesagantang, Sunghanggeonggisan were used most frequently to Chungyeold, Geopung, Soongi, Haldam and Chungsimtang, the drugs for Bogiheol were used as discharge. In these oriental medical therapy of C.V.A. objective diagnosis and more various therapeutic method must be obtained through east-west medical co-operation.

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흰쥐에서 트리플루살의 위장관 및 간 초회통과효과 (Gastrointestinal and Hepatic First-pass Effects of Triflusal in Rats)

  • 조혜영;정태진;이용복
    • Journal of Pharmaceutical Investigation
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    • 제31권4호
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    • pp.265-271
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    • 2001
  • In order to elucidate the influence of intestinal and hepatic first-pass effect on the pharmacokinetics of triflusal, the biotransformation of triflusal in the gastrointestinal tract and liver was designed. Moreover, we tried to establish an HPLC method applicable for bioassay and available to pharmacokinetics, not only with the simultaneous determination of triflusal and its active metabolite, 2-hydroxy-4-trifluoromethyl benzoic acid (HTB), but also with improving sensitivity. After the administration of triflusal (10 mg/kg) and HTB (10 mg/kg) into femoral vein, portal vein (only triflusal) and oral route (only triflusal), pharmacokinetic parameters were investigated from the plasma concentration-time profiles of triflusal and HTB in rats. An HPLC method was developed for the simultaneous determination of triflusal and HTB in rat plasma, urine and bile. The HPLC analysis was carried out using a C18 column and acetonitrile-methanol-water (25:10:65, v/v/v) as the mobile phase and UV detection at 234 nm. Furosemide was used as the internal standard. The calibration curves were linear over the concentration range $0.05-5.0\;{\mu}g/ml$ for triflusal and $0.2-200.0\;{\mu}g/ml$ for HTB with correlation coefficients greater than 0.999 and with intra-day or inter-day coefficients of variation not exceeding 10.0%. This assay procedure was applied to the study of metabolite pharmacokinetics of triflusal and HTB in rats. It was supposed that triflusal was almost metabolized in vivo because urinary and biliary excreted amounts of triflusal could be ignored as it was lower than 1.2% of the administered dose. According to the gastrointestinal and hepatic biotransformation pathways of triflusal, it was found that triflusal was hydrolyzed by about 5% in intestine and metabolized by about 53% in liver, and that the bioavailability of triflusal after oral administration of triflusal was 0.44, and also that the fraction of total elimination rate of triflusal which formed HTB in liver $(F_{mi},\;%)$ was about 98%. These results showed that triflusal was almost metabolized in liver, and the total elimination of triflusal in the body was dependent to the formation rate of HTB from triflusal in liver.

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