Purpose: Rhabdomyolysis (RB) is a syndrome characterized by the decomposition of striated muscles and leakage of their contents into the bloodstream. Acute kidney injury (AKI) is the most significant and serious complication of RB and is a major cause of mortality in patients with RB. Severe RB (creatine kinase [CK] ${\geq}5,000$) has been associated with AKI. However, early prediction is difficult because CK can reach peak levels 1-3 days after the trauma. Hence, the aim of our study was to identify predictors of severe RB using initial patient information and parameters. Methods: We retrospectively analyzed 1,023 blunt trauma patients admitted to a single tertiary hospital between August 2011 and March 2018. Patients with previously diagnosed chronic kidney disease were excluded from the study. RB and severe RB were defined as a CK level ${\geq}1,000U/L$ and ${\geq}5,000U/L$, respectively. The diagnosis of AKI was based on RIFLE criteria. Results: The overall incidence of RB and severe RB was 31.3% (n=320) and 6.2% (n=63), respectively. On multivariable analysis, male sex (odds ratio [OR] 3.78, 95% confidence interval [CI] 1.43 to 10.00), initial base excess (OR 0.85, 95% CI 0.80 to 0.90), initial CK (OR 2.07, 95% CI 1.67 to 2.57), and extremity abbreviated injury scale score (OR 1.78, 95% CI 1.39 to 2.29) were found to predict severe RB. The results of receiver operating characteristic analysis showed that the best cutoff value for the initial serum CK level predictive of severe RB was 1,494 U/L. Conclusions: Male patients with severe extremity injuries, low base excess, and initial CK level >1,500 U/L should receive vigorous fluid resuscitation.
Attributable to their major function in pathogen recognition, the use of bovine leukocyte antigens (BoLA) as disease markers in immunological traits in cattle is well established. However, limited report exists on polymorphism of the BoLA gene in zebu cattle breeds by high resolution typing methods. Thus, we used a polymerase chain reaction sequence-based typing (PCR-SBT) method to sequence exon 2 of the BoLA class II DRB3 gene from 100 animals (Boran, n = 13; Sheko, n = 20; Fogera, n = 16; Horro, n = 19), Hanwoo cattle (n = 18) and Bangladesh Red Chittagong zebu (n = 14). Out of the 59 detected alleles, 43 were already deposited under the Immuno Polymorphism Database for major histocompatibility complex (IPD-MHC) while 16 were unique to this study. Assessment of the level of genetic variability at the population and sequence levels with genetic distance in the breeds considered in this study showed that Zebu breeds had a gene diversity score greater than 0.752, nucleotide diversity score greater than 0.152, and mean number of pairwise differences higher than 14, being very comparable to those investigated for other cattle breeds. Regarding neutrality tests analyzed, we investigated that all the breeds except Hanwoo had an excess number of alleles and could be expected from a recent population expansion or genetic hitchhiking. Howbeit, the observed heterozygosity was not significantly (p < 0.05) higher than the expected heterozygosity. The Hardy Weinberg equilibrium (HWE) analysis revealed non-significant excess of heterozygote animals, indicative of plausible over-dominant selection. The pairwise FST values suggested a low genetic variation among all the breeds (FST = 0.056; p < 0.05), besides the rooting from the evolutionary or domestication history of the cattle. No detached clade was observed in the evolutionary divergence study of the BoLA-DRB3 gene, inferred from the phylogenetic tree based on the maximum likelihood model. The investigation herein indicated the clear differences in BoLA-DRB3 gene variability between African and Asian cattle breeds.
Background: Owing to the coronavirus disease 2019 pandemic, being exposed to work from home and work during nonwork time simultaneously can lead to sleep disturbance; however, their combined effect is unclear. We aimed to investigate the combined effect of work from home and work during nonwork time on sleep disturbance. Methods: This study used data from the Sixth Korean Working Condition Survey and included 27,473 paid workers. Logistic regression analysis was conducted to investigate the relationship between work from home, work during nonwork time, and sleep disturbance according to sex. We re-classified participants into 4 groups based on their working from home (No/Yes) and working during nonwork time (No/Yes). The relative excess risk due to interaction was calculated to examine the effect of exposure to both telecommuting and non-regular work hours on sleep disturbance. Results: Workers exposed to work from home and work during nonwork time had significantly higher risks of sleep disturbance for all, men, and women workers (OR [95% CI]: 1.71 [1.46-2.02], 1.79 [1.43-2.23], and 1.64 [1.29-2.08] for work from home and 3.04 [2.70-3.42], 3.61 [3.09-4.22], and 2.41 [2.01-2.90] for work during nonwork time, respectively). Compared to those who were not exposed to both factors, when workers had both job factors, the ORs (95% CI) of sleep disturbance for all, men, and women were 3.93 (2.80-5.53), 5.08 (3.21-8.03), and 2.91 (1.74-4.87), respectively. The relative excess risk due to interaction of work from home and work during nonwork time was not significant for sleep disturbance. Conclusions: Work from home and work during nonwork time were each associated with sleep disturbance, but the interaction between the two factors on sleep disturbance was not observed in both men and women.
Objectives Syndrome differentiation and treatment (辨證論治) is one of the core theories in Korean medicine and syndrome differentiation (辨證) constitutes a branch of disease diagnosis in Korean medicine. Yoon Gil-Young, one of the modern outstanding scholar of basic medical science in Korean medicine, wrote on basic theories of Korean medicine such as physiology, pathology, formula science, etc. Hereby we will analyze and discuss his works to understand his recognition of historical changes in the syndrome differentiation. Methods We conducted researches into the two works of Yoon Gil-Young's, which are "The Clinical Formula Science of Eastern Medicine (東醫臨床方劑學)" and "The theory of Four-Constitution Medicine (四象體質醫學論)". From Yoon's academic standpoint which connects the basic medical science with the clinical medicine, we analyzed his opinion about syndrome differentiation and its historical changes. Results According to Yoon's research work on syndrome differentiation and its historical changes, the development of syndrome differentiation, which goes in harmony with the history of Korean medicine, has its deep root in " Huangdi's Internal Classic (黃帝內經)" and "Treatise on Cold Damage and Miscellaneous Diseases (傷寒雜病論)". And through "Treatise on the Spleen and Stomach (脾胃論)" and the articles of warm disease (溫病論), the theory of syndrome differentiation became extended to the whole clinical diagnostic field in Korean medicine, finally including the achievements in "Treasured Mirror of Eastern Medicine (東醫寶鑑)", "Longevity and Life Preservation in Eastern Medicine (東醫壽世保元)". Conclusions Yoon Gil-Young recognized that the system of syndrome differentiation was developed in accordance with the theories from the "Treatise on Cold Damage and Miscellaneous Diseases", then the "Treatise on the Spleen and Stomach" and the articles of warm disease. The four-constitution medicine in Korea and Koho school in Japan which lays emphasis on abdominal signs also contributed to its development. Syndrome differentiation can be categorized basically into three states of intrinsic cold (本寒), intrinsic deficiency (本虛), intrinsic heat (本熱) according to the deficiency and excess in human body metabolism.
Kolahi, Sousan;Gargari, Bahram Pourghassem;Abbasi, Mehran Mesgari;Jafarabadi, Mohammad Asghari;Shishavan, Neda Ghamarzad
Nutrition Research and Practice
/
제9권2호
/
pp.186-191
/
2015
BACKGROUND/OBJECTIVES: Rheumatoid arthritis (RA) is associated with an excess mortality from cardiovascular disease which is likely attributed to an atherogenic lipid profile. Among nutritional factors vitamin K has been recently focused as a pivotal nutrient in improvement of lipid related markers. Thus, this study was designed to determine the effects of vitamin K on lipid profile in this disease. SUBJECTS/METHODS: Fifty eight patients with definitive RA were participated in the present double blind placebo controlled study. They were randomly allocated into two groups to receive vitamin $K_1$ as phylloquinone [10 mg/day] (n = 30) or placebo pills (n = 28), for eight weeks. In order to control the effects of probable confounders dietary intakes, anthropometric measurements including weight and height, clinical status using disease activity score-28 (DAS-28), physical activity and anxiety status were evaluated at baseline. Moreover, serum levels of lipid related markers including total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C) and triglyceride (TG) were measured at baseline and at the end of intervention. RESULTS: There were no significant differences between the two groups regarding any of the baseline characteristics. After adjusting for some relevant confounders, in comparison between two groups, we observed no significant changes in lipid related markers at the end of intervention. Also, there was no significant difference between before and after intervention values within groups (P > 0.05). CONCLUSIONS: Function of vitamin $K_1$ in lipid profile modification remains still controversial. This study showed that vitamin $K_1$ has no effect on lipid profile in women with rheumatoid arthritis. Further studies with a longer follow-up are required to determine the effects of vitamin K on atherogenic lipid profile.
Gobjectives and Methods to investigate into the course of incurable and relapse renal stones' differentiation of symptoms and signs and to effectively improve treatment of incurable and relapse renal stones through Oriental Medicine. To search for the papers about treatment of incurable and relapse renal stones from 1994 till 2004, and re-search papers about treatment for indicated differentiation of disease. Result and conclusions : 1. It is the kidney vacuity additionally the deficiency of qi(氣) in middle-burner that the incurable and relapse renal stones' differentiation of disease. 2. The cause is taking an overdose of attacking renal stones to eliminate dampness and heat medicine, aging, chrome disease. a sex act excess, insufficiency of congenital qi(氣), insufficient exercise, wrong treatment and stress. 3. Herb medicines are constituted supplementing kidney drugs for inhibition of renal stone's creation, drugs to diuresis and dissolve calculi, and drugs 10 exclude stasis blood(瘀血) on account of renal stones. 4. Anti-renal stone measures me sufficiently drinking water, not eating greasy food. taking medicine for supplementing kidney, diuresis and dissolve calculi by periods, and drinking substitute water to boll down medical herb as Lysimachiae Herba (金錢草) Polygoni Avicularis Herba(篇蓄).
The different growth steps of human show the different energetic phenomenon such as the strength of triple energizer, the sale of extra meridian, and the stability of 12 meridians. So we have to understand the physiological and pathological phenomena on this point of view. Especially atopic dermatitis means the loss of adaptability under the lack of genuine energy. If you approach to this disease not with any perception of excess or deficiency of the human genuine energy but with simple symptom enumeration or partial diagnosis, it will be dangerous. So we must approach to this disease with more concrete and objective body-centered standard. Thus when we cure and diagnose infants with this disease, we should focus on stablizing the "Energy of Earth(土)" digestive ability, under the consideration of inducement to the enough "Byun-Jeung-Hu(變蒸候)" and the function of Triple Energizer. Through this process we can lead infants to the beginning equipment state(始全). Until 7 years old, we should stabilize the Link Vessel(維脈) by clarifying interior and exterior classification of Nutritive Element and Defensive Energy to control the child's energy of metal(金), water(水), wood(木) and fire(火) in the basis of the energy of earth(土). And also we should stabilize the Heel Vessel(?脈) through the Water and Fire complement each other to control the movements and to control sleep and awakening. Through this process, we can lead children to the basal equipment state(本全). After then, until adolescent phase, we should control 12 meridian and 8 extra meridian by leading vital function to be harmonized and prosperous on the basis of the meridian to reach the mature equipment state(旣全). Adult atopic dermatitis should be controlled through conciliation between meridian and internal organs by differentiating male from female.
Background: Patients with chronic kidney disease (CKD) are at a high risk of stroke-related morbidity, mortality, and bleeding. However, the overall risk/benefit of anticoagulant therapy among patients with CKD remains unclear. Methods: The MEDLINE, EMBASE, and CENTRAL databases were comprehensively searched until July 31, 2020, to investigate the safety and efficacy of apixaban in patients with stage 4 or 5 CKD, as compared with warfarin. The primary outcome was an incidence of major bleeding. Secondary outcomes included composite bleeding (major, clinically relevant, and minor bleeding), venous thromboembolism (VTE), stroke, and death. Results: In total, seven studies consisting of 10,816 patients were included. Compared with warfarin, apixaban was associated with a reduced risk of major bleeding (OR 0.49, 95% CI 0.41-0.58). In terms of composite bleeding, apixaban tended to pose a significantly lower risk than warfarin (OR 0.51, 95% CI 0.37-0.71). There was no difference between apixaban and warfarin with respect to the risk of stroke or death (stroke: OR 1.23, 95% CI 0.49-3.12; death: OR 0.73, 95% CI 0.45-1.18). Conclusion: Among patients with stage 4 or 5 CKD, the use of apixaban was associated with a lower risk of bleeding compared to warfarin and was also found to pose no excess risk of thromboembolic events.
Objective : Alcoholic liver disease (ALD) is caused by excess alcohol intake. In the liver, alcohol breakdown results formation of toxic byproducts that lead to damage to tissue. This study is to investigate the therapeutic effects of Paeoniae Radix Alba and Puerariae Radix combination (PP) on ALD. Methods : PP was analyzed for polyphenolic compounds and free radical scavenging activity. ALD mouse model was induced by feeding ethanol and water (Control), silymarin (50 mg/kg), low-dose (PP: 100 mg/kg) or high-dose (PP: 200 mg/kg) was orally administrated to ALD mice for 14 days. The serum was assessed with levels of AST, ALT, total bilirubin, total cholesterol, and triglyceride. Liver tissues were evaluated for ROS levels, degree of liver damage and protein expression. Results : The 3:1 (Paeoniae Radix Alba:Puerariae Radix) ratio showed the best antioxidant values for the experiment. In ALD model, levels of AST, ALT, total bilirubin, total cholesterol, and triglyceride were significantly increased in the Control and the levels were decreased by treatment of PP. In addition, increased ROS, ONOO- and MDA levels in the Control were reduced in the PP groups. Western blot analysis figured out that proteins related to ROS and cholesterol metabolism were higher in ALD than in PP-treated ALD. Antioxidant enzyme expression was low in the control group and increased by PP treatment. Conclusion : Our results suggest that PP has the potential to be a medicine in ALD in terms of regulating oxidative stress and adjusting lipid metabolism.
Objectives: This study investigated the pattern identification (PI) and clinical index of Parkinson's disease (PD) for personalized diagnosis and treatment. Methods: This prospective observational multi-center study recruited 100 patients diagnosed with PD from two Korean medicine hospitals. To cluster new subtypes of PD, items on a PI questionnaire (heat and cold, deficiency and excess, visceral PI) were evaluated along with pulse and tongue analysis. Gait analysis was performed and blood and feces molecular signature changes were assessed to explore biomarkers for new subtypes. In addition, unified PD rating scale II and III scores and the European quality of life 5-dimension questionnaire were assessed. Results: The clinical index obtained in this study analyzed the frequency statistics and hierarchical clustering analysis to classify new subtypes based on PI. Moreover, the biomarkers and current status of herbal medicine treatment were analyzed using the new subtypes. The results provide comprehensive data to investigate new subtypes and subtype-based biomarkers for the personalized diagnosis and treatment of PD patients. Ethical approval was obtained from the medical ethics committees of the two Korean medicine hospitals. All amendments to the research protocol were submitted and approved. Conclusions: An objective and standardized diagnostic tool is needed for the personalized treatment of PD by traditional Korean medicine. Therefore, we developed a clinical index as the basis for the PI clinical evaluation of PD. Trial Registration: This trial is registered with the Clinical Research Information Service (CRIS) (KCT0008677)
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