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Effects of sun exposure and dietary vitamin D intake on serum 25-hydroxyvitamin D status in hemodialysis patients

  • Lee, Yeon Joo;Oh, Il Hwan;Baek, Hee Jun;Lee, Chang Hwa;Lee, Sang Sun
    • Nutrition Research and Practice
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    • v.9 no.2
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    • pp.158-164
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    • 2015
  • BACKGROUND/OBJECTIVES: Vitamin D deficiency is common in hemodialysis patients. The aim of this study was to identify whether or not sun exposure and dietary vitamin D intake have effects on serum 25-hydroxyvitamin D (25(OH)D) status in hemodialysis (HD) patients. The objective was to identify the main determinants of serum vitamin D status in the study subjects. SUBJECTS/METHODS: A cross-sectional study of 47 HD patients (19 males and 28 females) was performed. We assessed serum 25(OH)D and $1,25(OH)_2D$ levels between August and September 2012 and analyzed the prevalence of vitamin D deficiency in HD patients. To evaluate the determinants of serum 25(OH)D levels, we surveyed dietary vitamin D intake, degree of sun exposure, and outdoor activities. To compare biological variables, serum 25(OH)D was stratified as below 15 ng/ml or above 15 ng/ml. RESULTS: Mean 25(OH)D and $1,25(OH)_2D$ levels were $13.5{\pm}5.8ng/ml$ and $20.6{\pm}11.8pg/ml$, respectively. The proportions of serum 25(OH)D deficiency (< 15 ng/ml), insufficiency (15-< 30 ng/ml), and sufficiency (${\geq}30ng/ml$) in subjects were 72.4%, 23.4%, and 4.3%, respectively. Prevalence of vitamin D deficiency in female patients was 78.6%, whereas that in males was 63.2% (P = 0.046). Vitamin D intake and sun exposure time were not significantly different between the two stratified serum 25(OH)D levels. Dietary intake of vitamin D did not contribute to increased serum 25(OH)D levels in HD patients. The main effective factors affecting serum 25(OH)D status were found to be the sun exposure and active outdoor exercise. CONCLUSIONS: Hypovitaminosis D is common in HD patients and is higher in females than in males. Sun exposure is the most important determinant of serum 25(OH)D status in HD patients.

Association of the Nutritional Status and Essential Amino Acids Intake in Hemodialysis Patients (혈액투석환자에서 영양상태와 필수아미노산 섭취의 관련성 연구)

  • Kim, Hye-Jin;Kim, Su-An;Sohn, Cheong-Min
    • Journal of Nutrition and Health
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    • v.39 no.7
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    • pp.617-623
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    • 2006
  • The mortality and morbidity rate of hemodialysis patients (HD) remain high. Among many factors, protein and calorie malnutrition has been shown to be a major risk factor for increased mortality in the HD patients population. Malnutrition can be caused by insufficient amino acid intake, nutrient losses in dialysate, oxidant stress and muscle catabolism. In this study, we evaluated the association of markers of nutritional status and essential amino acids intake in HD patients. We investigated nutritional status of 41 HD patients (mean age: $64.2\;{\pm}\;11.5\;y$, men: 24, women: 27) by measuring anthropometric, biochemical parameters and food intakes by using 24 hr recall methods. Subject's total energy intake and total protein intake were $1,648.0\;{\pm}\;397.31\;kcal/day,\;79.2\;{\pm}\;27.2\;g/day$:, respectively. The animal protein intake was $42.7\;{\pm}\;22.1\;g/day$, essential amino acids intake was $23.4\;{\pm}\;9.92\;g/day$, and the ratio of essential amino acids to total protein intake was $29.6\;{\pm}\;5.42%$. There were significantly positive correlation between muscle mass and lean body mass with serum creatinine level (r=0.435, p<0.01; r=0.435, p<0,01). There were also significant positive correlation in muscle mass and lean body mass with pre hemodialysis blood urea nitrogen (preHD BUN) (r=0.329, p<0.05; r=0.329, p<0.05). There were no significant correlation in total energy intake and total protein intake per kg ideal body weight (IBW) to muscle mass and lean body mass. However, there were significantly positive correlation between the ratio of essential amino acids and muscle mass and lean body mass (r=0.368, p<0.05; r=0.405, p<0.01). And serum hematocrit concentration was positively correlated with the ratio of essential amino acids (r=0.032, p<0.05). The results of this study indicate that strong associations exist in essential amino acid intakes with malnutrition than total protein intakes in HD patient. In conclusion, specialized nutrition education should be necessary to efficiently improve the quality of protein intakes.

Vehicle Localization Method for Lateral Position within Lane Based on Vision and HD Map (비전 및 HD Map 기반 차로 내 차량 정밀측위 기법)

  • Woo, Rinara;Seo, Dae-Wha
    • The Journal of The Korea Institute of Intelligent Transport Systems
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    • v.20 no.5
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    • pp.186-201
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    • 2021
  • As autonomous driving technology advances, the accuracy of the vehicle position is important for recognizing the environments around driving. Map-matching localization techniques based on high definition (HD) maps have been studied to improve localization accuracy. Because conventional map-matching techniques estimate the vehicle position based on an HD map reference dataset representing the center of the lane, the estimated position does not reflect the deviation of the lateral distance within the lane. Therefore, this paper proposes a localization system based on the reference lateral position dataset extracted using image processing and HD maps. Image processing extracts the driving lane number using inverse perspective mapping, multi-lane detection, and yellow central lane detection. The lane departure method estimates the lateral distance within the lane. To collect the lateral position reference dataset, this approach involves two processes: (i) the link and lane node is extracted based on the lane number obtained from image processing and position from GNSS/INS, and (ii) the lateral position is matched with the extracted link and lane node. Finally, the vehicle position is estimated by matching the GNSS/INS local trajectory and the reference lateral position dataset. The performance of the proposed method was evaluated by experiments carried out on a highway environment. It was confirmed that the proposed method improves accuracy by about 1.0m compared to GNSS / INS, and improves accuracy by about 0.04m~0.21m (7~30%) for each section when compared with the existing lane-level map matching method.

Preprocessed Cholesky-Factor Downdatings for Observation Matrices (관측행렬에 대한 전처리 Cholesky-Factor Downdating 기법)

  • Kim, Suk-Il;Lee, Chung-Han;Jeon, Joong-Nam
    • The Transactions of the Korea Information Processing Society
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    • v.3 no.2
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    • pp.359-368
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    • 1996
  • This paper introduces PGD(Preprocessed Givens Downdating)and PHD(Preprocessed Hyperbolic Downdating) algorithms, wherein a multiple-row observation matrix $Z^T$ is factorized into a partial Cholesky factor Rz, such that $Z^T$ = $Q_zR_z, Q_zQ^T_z=I$, and then Rz is recursively downdated by using GD(Givens Downdating)and HD(Hyperbolic Dondating), respectively. Time complexities of PGD and PHD algorithms are $pn^2$$5n^3/6$$pn^2$$n^3/3$ flops, respectively, if p$\geq$n, while those of the existing GD and HD are known to be $5pn^2/2$ and $2pn^2$ flops,, respectively. This concludes that the factorization of observation matrices, which we call preprocessing, would improve the overall performance of the downdating process. Benchmarks on the Sun SPARC/2 system also show that preprocessing would shorten the required downdating times compared to those of downdatings without preprocessing. Furthermore, benchmarks also show that PHD provides better performance than PGD.

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Cloning and Expression of an Insecticidal Crystal Protein CryIIA Gene from Bacillus thuringiensis subsp. kurstaki HD-1 (Bacillus thuringiensis subsp. kurstaki HD-1 CryIIA의 내독소 단백질 유전자의 클로닝 및 발현)

  • 김호산;김상현;제연호;유용만;서숙재;강석권;조용섭
    • Korean journal of applied entomology
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    • v.32 no.3
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    • pp.300-306
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    • 1993
  • The CryIIA gene encoding the insecticidal crystal protein of Bacillus thuringiens!s subsp. kurstalri HD-l has been cloned in Escherichia col!, and its nucleotide sequences were determined completely. 5kb Hindlli fragment harboring CryIIA gene was screened in the large ca. 225kb plasmid DNA by southern blot. HindlIT digested 5kb fragment was ligated into pUC19 and transformed in E. coli. The 4kb BamHI-HindlIT fragment containing the CryIIA gene was subcloned and named pSKIIA. DNA sequence analysis demonstrates that pSKIIA is the gene of an operon which is comprised of Lhree open reading frames (designated orn, orf2 and or£3). The CrylIA gene is composed of 3,952bp-long BamHI-Hindill DNA restriction fragment. The orf3 code for a polypeptide of 633 amino acid residues. The protoxin protein has a predicted molecular weight of 70,780. The E. coli derived protoxin gene product is biologICally active against three species of Lepidopteran (Plu.lelia maculipennis, He/iolhis assulta, Spodoptera litura) and a species of Dip Leran( Culex pipines) larvae in bioassay.

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Fatigue and Fatigue-regulation Behavior in Hemodialysis Patients (혈액투석 환자의 피로와 피로조절행위)

  • Kim, Hye-Won
    • Journal of Digital Convergence
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    • v.10 no.5
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    • pp.301-305
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    • 2012
  • This study was performed to examine the relationship between fatigue and fatigue-regulation behavior in Hemodialysis(HD) patients. Methods: The subjects for this study were 107 patients on HD who were registered in a hospital in Seoul. The data were collected from August 2 to August 14, 2010. The collected data were analyzed by the SPSS WIN 12.0 program. Results: The mean score of fatigue was 77.1 which means their experience of high level fatigue. Frequency of the fatigue-regulation behavior and the mean of efficiency of the fatigue-regulation behavior was 8.8 and 22.8. Positive correlation was found between fatigue and fatigue-regulation behavior (r=.45, p=.000). Conclusion: It is considered that the study emphasizes for the healthcare providers to recognize fatigue as the important nursing issue for HD patients. And it is necessary to develop an evidence-based nursing intervention program for regulating fatigue in HD patients.

Evaluation of Clinical Usefulness of Instant Nutritional Assessment Scale for the Nutritional Status and Prognosis of Hemodialysis Patients (만성질환자의 영양상태와 예후판정에 대한 간이영양평가 도구의 유용성 평가 -혈액투석환자를 중심으로-)

  • Sohng Kyeong-Yae;Kim Myung-Ja
    • Journal of Korean Academy of Fundamentals of Nursing
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    • v.4 no.2
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    • pp.337-349
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    • 1997
  • The prognosis of maintenance hemodialysis (HD) patients is closely related to their nutritional status. It is important to develop and use of a reliable, useful and easy method of nutritional assessment scale for evaluation of nutritional status and progression of the patients. This study was initiated to evaluate the clinical usefulness of Instant Nutritional Assessment Scale(INAS) by cross-sectional and longitudinal studies. One hundred HD patients entered a continuing nutritional study and followed for 1 year. The results were as follow ; 1. 24% of patients was normal to mild, 43% was moderate and 33% was severe deficit of nutritional status. 2. The mean INAS score of the patients was 8.00(S. D.=2.83), and there didn't reveal any differences in INAS score by general characteristics. The mean transferrin score was 1.98, whih was the highest of 5 nutirtional parameters of INAS. Only 7 patients had within nomal range of transferrin concentration. 3. Within one year since this study was initiated, 10 patients died. Six of them were with severe deficit and one of them was normal to mild deficit groups. The death rate in severe deficit group was higher than that of normal to mild deficit group (P=.0640). 4. Occurrence of acute complication during HD in severe deficit guoup was higher than that of normal to mild deficit group(P=.001). 5. The number of consultation to the doctor and hospital admission in severe deficit group was higher than that of normal to mild deficit group(P=.0001). 6. INAS score was significantly correlated with occurrence of acute complications during HD and the number of consultation to the doctor. In conclusion, INAS based on the levels of body mass index, midarm circumference, triceps skinfold thickness, transferrin concentration and total lymphocyte count seems to be a reliable predictive nutritional index for prognosis. So nurses are encouraged to adopt INAS in care of the chronically illed patients. Recommendations for further research was suggested.

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Enhancing Mulberry Leaf Meal with Urea by Pelleting to Improve Rumen Fermentation in Cattle

  • Tan, N.D.;Wanapat, M.;Uriyapongson, S.;Cherdthong, A.;Pilajun, R.
    • Asian-Australasian Journal of Animal Sciences
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    • v.25 no.4
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    • pp.452-461
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    • 2012
  • Four, ruminally fistulated crossbred (Brahman${\times}$native) beef cattle with initial body weight of $420{\pm}15kg$ were randomly assigned according to a $4{\times}4$ Latin square design. The dietary treatments were mulberry leaf pellet (MUP) supplementation at 0, 200, 400 and 600 g/hd/d with rice straw fed to allow ad libitum intake. All steers were kept in individual pens and supplemented with concentrate at 5 g/kg of body weight daily. The experiment was 4 periods, and each lasted 21 d. During the first 14 d, all steers were fed their respective diets ad libitum and during the last 7 d, they were moved to metabolism crates for total urine and fecal collection. It was found that increasing MUP levels resulted in linearly increasing rice straw and total intakes (p<0.05). Ruminal temperature and pH were not significantly affected by MUP supplementation while $NH_3$-N concentration was increased (p<0.05) and maintained at a high level (18.5 mg/dl) with supplementation of MUP at 600 g/hd/d. Similarly, viable total bacteria in the rumen and cellulolytic bacteria were enriched by MUP supplementation at 600 g/hd/d. However, the rumen microbial diversity determined with a PCR-DGGE technique showed similar methanogenic diversity between treatments and sampling times and were similar at a 69% genetic relationship as determined by a UPGMA method. Based on this study, it could be concluded that supplementation of MUP at 600 g/hd/d improved DM intake, ruminal $NH_3$-N, and cellulolytic bacteria thus iimproving rumen ecology in beef cattle fed with rice straw.

Nutritional education for management of osteodystrophy (NEMO) trial: Design and patient characteristics, Lebanon

  • Karavetian, Mirey;Abboud, Saade;Elzein, Hafez;Haydar, Sarah;de Vries, Nanne
    • Nutrition Research and Practice
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    • v.8 no.1
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    • pp.103-111
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    • 2014
  • This study aims to determine the effect of a trained dedicated dietitian on clinical outcomes among Lebanese hemodialysis (HD) patients: and thus demonstrate a viable developing country model. This paper describes the study protocol and baseline data. The study was a multicenter randomized controlled trial with parallel-group design involving 12 HD units: assigned to cluster A (n = 6) or B (n = 6). A total of 570 patients met the inclusion criteria. Patients in cluster A were randomly assigned as per dialysis shift to the following: Dedicated Dietitian (DD) (n = 133) and Existing Practice (EP) (n = 138) protocols. Cluster B patients (n = 299) received Trained Hospital Dietitian (THD) protocol. Dietitians of the DD and THD groups were trained by the research team on Kidney Disease Outcomes Quality Initiative nutrition guidelines. DD protocol included: individualized nutrition education for 2 hours/month/HD patient for 6 months focusing on renal osteodystrophy and using the Trans-theoretical theory for behavioral change. EP protocol included nutrition education given to patients by hospital dietitians who were blinded to the study. The THD protocol included nutrition education to patients given by hospital dietitian as per the training received but within hospital responsibilities, with no set educational protocol or tools. Baseline data revealed that 40% of patients were hyperphosphatemics (> 5.5 mg/dl) with low dietary adherence and knowledge of dietary P restriction in addition to inadequate daily protein intake ($58.86%{\pm}33.87%$ of needs) yet adequate dietary P intake ($795.52{\pm}366.94$ mg/day). Quality of life (QOL) ranged from 48-75% of full health. Baseline differences between the 3 groups revealed significant differences in serum P, malnutrition status, adherence to diet and P chelators and in 2 factors of the QOL: physical and social functioning. The data show room for improvement in the nutritional status of the patients. The NEMO trial may be able to demonstrate a better nutritional management of HD patients.

Effect of Grain Specific Gravity on Seedling Growth and Vascular Bundle Development of Two Rice Cultivars (벼종자의 비중차이가 유묘생장 및 유관속 발달에 미치는 영향)

  • Chae, Je-Cheon;Lee, Dong-Jin
    • KOREAN JOURNAL OF CROP SCIENCE
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    • v.41 no.1
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    • pp.62-67
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    • 1996
  • High density (HD) grains is associated with seedling vigor. Studies were conducted on the relationship of different grain densities and vascular bundle(VB) development and seedling growth. IR58 (indica type) and Unbong 7 (japonica type) were used in this experiment. HD grains had more and bigger VB in the leaf blade and sheath than poor density grain at seedling stage. IR58 had more large VB at the leaf compared with Unbong 7. Higher development of VB in seedling of HD grains can increase transport of assimilate and growth rate. Plant height, leaf number, root growth and dry weight increased with increasing grain density from poor to high. The total area of large VB in the leaf blade and sheath was highly correlated with the dry weight. Higher number and larger area of VB and dry weight can be obtained by using HD grains and these initial advantages can contribute to high yield potential.

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