Thyroid hormones are known to influence the production and secretion of pulmonary surfactant. The objective of this study was to explore the relationship between respiratory distress syndrome (RDS) and thyroid hormones. This was a retrospective study of preterm infants at 24–33 weeks gestational age from April 2017 to February 2019. T₃, free T₄ (fT₄), and thyroid-stimulating hormone (TSH) were measured 1, 3, and 6 weeks after birth. Multivariate logistic regression analyses were performed to determine the relationship between RDS and TSH. A total of 146 infants were enrolled. Of these, 60 had RDS, 72 had no RDS, and 14 were excluded. T₃ and TSH were lower in the RDS groups (p < 0.05) on the day of birth. Multivariate logistic regression analysis indicated that lower serum TSH levels immediately after birth were associated with a higher incidence of RDS (OR, 0.89; 95% CI, 0.81–0.97). The TSH level was associated with the incidence of RDS. This suggests that suppression of the hypothalamus–pituitary axis function contributes to RDS, which is the result of surfactant deficiency.

Patients with chronic kidney disease (CKD) have a high incidence of left ventricular diastolic dysfunction (LVDD), which increases the risk of heart failure and mortality. We assessed fluid overload as an independent risk factor for LVDD in patients with decreased kidney function and compared its impact on the E/e′ ratio as a parameter for assessing left ventricular diastolic functions between patients undergoing continuous ambulatory peritoneal dialysis (CAPD) and those with non-dialysis CKD stage 5 (CKD5) using propensity score matching (PSM). After PSM, 222 patients (CAPD, n = 111; CKD5, n = 111) were included. Fluid balance was assessed using bio-impedance spectroscopy and LVDD was determined by echocardiography based on an E/e′ ratio of >15. The CKD5 group had a significantly higher E/e′ ratio (p = 0.002), while fluid overload (OH/ECW) did not differ significantly between the groups. In the CAPD group, there were no significant differences in OH/ECW between patients with and without LVDD (p = 0.517). However, in the CKD5 group, patients with LVDD showed a significantly higher OH/ECW (p = 0.001). In a regression analysis investigating factors associated with the E/e′ ratio, OH/ECW was not significantly associated with the E/e′ ratio in the CAPD group (p = 0.087), but in the CKD5 group, it was independently correlated (p = 0.047). The factors closely associated with LVDD varied depending on dialysis dependence. While fluid overload independently influenced LVDD in non-dialysis patients, it was not statistically significant in patients with CAPD. Early assessment and management of volume status are crucial in addressing LVDD in patients with advanced-stage CKD.

Yong Hyuk Kim, Hyeoi Jin Kim. J Obes Metab Syndr 2026;35:381-4. https://doi.org/10.7570/jomes26042

Background: Various hormones are known to influence the production and secretion of pulmonary surfactant. But the relationship between respiratory distress syndrome (RDS) and thyroid hormone has yet to be clarified. Methods: 126 infants with gestational age between 24 and 34 weeks who were hospitalized at the neonatal ICU of the Wonju Severance Christian Hospital from April 2017 to February 2019 were included in the study. Infants were divided into 3 groups by gestational age – 24 weeks 0 days to 28 weeks 0 days, 28 weeks 0 days to 31 weeks 0 days, and 31 weeks 0 days to 33 weeks 0 days, each with 18, 34, and 74 subjects, respectively. Among the subjects, there were 56 infants with RDS and 70 infants without RDS.Results: The group with lowest gestational age showed T₃ and fT₄ level that was lower than those of other groups (p<0.05) on the day of birth but there was no difference in the TSH level (p=0.129). T₃ and TSH level were lower in the RDS group compared with the control group on the day of birth (p<0.05). Free thyroxine (fT₄) level was higher in the control group on the day of birth but without any significant difference. Multiple logistic regression analysis showed that lower serum TSH levels on the day of birth was associated with a higher incidence of RDS (p<0.05).Conclusion: The incidence of RDS was significantly higher in infants with lower serum TSH levels at birth, but there was no significant difference in RDS incidence according to serum thyroid hormone levels.

Objectives: Few studies have analyzed surgical site infections associated with hypofractionated RT. The purpose of this study was to identify risk factors for surgical site infections with a particular focus on volumetric parameters that reflect the size of the volumes treated, including tumors, surgical cavities, and breasts. Methods: A total of 145 early breast cancer patients who were surgically staged 0—II undergoing hypofractionated RT on the whole breast were retrospectively reviewed. Tumor size (cm) was measured from surgical pathology. Surgical cavity volume (cc) and breast volume (cc) were calculated by segmenting each axial slice of simulation CT. The cavity-to-breast ratio (%) was calculated as surgical cavity volume/breast volume × 100. Results: The incidence of surgical site infection was 4.8% at a median of 6.3 months after the completion of RT. In univariate analysis, tumor size (OR 2.01, p = 0.025), surgical cavity volume (OR 1.03, p = 0.013), cavity-to-breast ratio (OR 1.29, p = 0.005), and BMI (OR 1.23, p = 0.014) were significantly associated with surgical site infection. In multivariate analysis, the cavity-to-breast ratio (OR 1.24, p = 0.039) remained significantly associated with surgical site infection. Conclusions: This study highlights the importance of volumetric parameters, specifically the cavity-to-breast ratio, as significant predictors of surgical site infection in a pure cohort of early breast cancer patients undergoing breast-conserving surgery and hypofractionated RT. Tailored approaches, including the use of prophylactic antibiotics, prophylactic aspiration, and close follow-up, may reduce the morbidity associated with surgical site infection and prevent the potential compromise of tumor outcomes.