• Title/Summary/Keyword: Physiology variables

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Detecting Potassium Imbalance: Whole Blood vs. Serum (전혈과 혈청에서의 칼륨 이상소견 검사의 차이)

  • Cho, Young-Duck;Choi, Sung-Hyuk;Yoon, Young-Hoon;Park, Sang-Min;Kim, Jung-Youn;Lim, Chae-Seung
    • The Korean Journal of Blood Transfusion
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    • v.23 no.2
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    • pp.162-168
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    • 2012
  • Background: Potassium, the most common cation in the intracellular space, plays a critical role in our physiology. Potassium imbalance may cause life-threatening problems, ranging from general weakness to cardiac arrest due to ventricular fibrillation. For emergency physicians, detection of such derangement within a short period of time is of critical importance. In this study, we wanted to determine whether analysis of whole blood samples can be used as a screening tool for potassium imbalance by comparative analysis of whole blood and serum samples. Methods: Two samples were drawn from 227 patients. The whole blood sample was taken from the radial artery and contained in a commercially available arterial blood collection syringe with a lithium-heparin coating. The serum sample was contained in a commercially available vacuum bottle in a non-additive silicone coated tube and transported to the laboratory. The study population was divided into three groups, patients with normal whole blood potassium, patients with decreased whole blood potassium, and patients with elevated whole blood potassium. Potassium levels for each group were coupled with serum potassium levels and compared. Results: No significant difference in potassium values was observed between whole blood and serum samples (P<0.05). Strong associations were observed among the three groups (normal range, hypokalemia, and hyperkalemia group). Compared to the normal group (r=0.851), the hyperkalemia group showed a stronger association between variables (r=0.897), and the hypokalemia group showed a weaker association (r=0.760). Their correlation coefficients were highly significant (P<0.05). Conclusion: Our study illustrates that point-of-care testing using whole blood with whole blood can be a reliable screening tool when treating patients with suspicious potassium abnormality, especially in hyperkalemia patients.

Preliminary Study on Usual Cold or Heat as a Risk Factor for Hypertension in an University Faculty (일개 대학 교직원 집단에서 고혈압의 위험요인으로서의 평소 한열 예비 연구)

  • Jung, Kyung Sik;Kim, Yun Young;Baek, Young Hwa;Jang, Eunsu
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.33 no.4
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    • pp.226-232
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    • 2019
  • This study was aimed to reveal that the usual cold or heat state was associated with hypertension and could be a risk. We emailed educational personnel in D university to join this study and 182 subjects participated in from March to December in 2016. The usual cold or heat diagnosis was conducted by two experts who had over 10 years expertise. The blood pressure was measured from the subjected after 10 minute rest with Jawon medical device. The hypertension was diagnosed by the guide of the Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure. The frequency analysis was used in general characteristics, Pearson's Correlation Coefficient analysis was conducted in among continuous variables, and chi-square test was also used between hypertension and cold or heat group. Logistic regression was analyzed to generate the odds ratios (ORs) and 95% confidence interval (CI) for hypertension. The cold score was suggested to have negative association with Body mass Index (BMI, -.374, p<.001), systolic blood pressure (-.333, p<.001), and diastolic pressure (-.261, p<.001). The heat score was analyzed to have positive association with Body mass Index (.413, p<.001), systolic blood pressure (.249, p<.001), and diastolic pressure (.156, p<.001). The distribution of the cold group (35.1%) and non-cold group (64.9%) in hypertension was significantly different (p=0.18). The distribution of the heat group (62.2%) and non-heat group (37.8%) was significantly different (p=0.27). The usual cold was associated with decreased ORs (ORs 0.405, 95% CI=0.191-0.857), and usual heat was associated with increased ORs (ORs 2.327, 95% CI=1.108-4.888). However, after adjusting body mass index, sex, and smoking, the association was not significantly different. It is possible that usual cold or heat associate with hypertension. Further study is needed to show that usual heat may be a independent risk factor for hypertension through follow up design.

Alternative Immunossays

  • Barnard, G.J.R.;Kim, J.B.;Collins, W.P.
    • Korean Journal of Animal Reproduction
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    • v.9 no.2
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    • pp.133-139
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    • 1985
  • An immunoassay may be defined as an analytical procedure involving the competitive reaction between a limiting concentration of specific antibody and two populations of antigen, one of which is labelled or immobillized. The advent of immunoassay has revolutionised our knowledge of reproductive physiology and the practice of veterinary and clinical medicine. Radioimmunoassay (RIA) was the first of these methods to be developed, which meausred the analyte with good sensitivity, accuracy and precision (1,2). The essential components of RIA are:-(i) a limited concentration of antibodies, (ii) a reference preparation, and (iii) an antigen labelled with a radioisotope (usually tritium or iodine-125). Most procedures invelove isolating the antibody-bound fraction and measuring the amount of labelled antigen. Good facilities are available for scintilltion counting, data reduction nd statistical analysis. RIA is undergoing refinement through:-(i) the introduction of new techniques to separate the antibody-bound and free fractions which minimize the misclassification of labelled antigen into these compartments, and the amount of non-specfic binding. (3), (ii) the development of non-extration for the measurement of haptens (4), (iii) the determination of a, pp.rent free (i.e. non-protein bound) analytes (5), and (iv) the use of monoclonal antibodies(6). In 1968, Miles and Hales introduced in important new type of immunoassay which they termed immunora-diometric assay (IRMA) based on t도 use of isotopically labelled specific antibodies(7) in a move from limited to excess reagent systems. The concept of two-site IRMAs (with a capture antibody on a solid-phase, and a second labelled antibody to a different antigenic determinant of the analyte) has enabled the development of more sensitive and less-time consuming methods for the measurement of protein hormones ovar wide concentration of analyte (8). The increasing use of isotopic methos for diverse a, pp.ications has exposed several problems. For example, the radioactive half-life and radiolysis of the labelled reagent limits assay sensitivity and imposes a time limit on the usefulness of a kit. In addition, the potential health hazards associated with the use and disposal of radioactive cmpounds and the solvents and photofluors necessary for liquid scientillation counting are incompatable with the development of extra-laboratory tests. To date, the most practical alternative labels to radioisotopes, for the measurement of analytes in a concentration > 1 ng/ml, are erythrocytes, polystyrene particiles, gold sols, dyes and enzymes or cofactors with a visual or colorimetric end-point(9). Increased sensitivity to<1 pg/ml may be obtained with fluorescent and chemiluminescent labels, or enzymes with a fluorometric, chemiluminometric or bioluminometric end-point. The sensitivity of any immunoassay or immunometric assay depends on the affinity of the antibody-antigen reaction, the specific activity of the label, the precision with which the reagents are manipulated and the nonspecific background signal (10). The sensitivity of a limited reagent system for the measurement of haptens or proteins is mainly dependent upon the affinity of the antibodies and the smalleest amount of reagent that may be manipulated. Consequently, it is difficult in practice to improve on the sensitivity obtained with iodine-125 as the label. Conversely, with excess reagent systems for the measurement of proteins it is theoretically possible to increase assay sensitivity at least 1000 fold with alternative luminescent labels. To date, a 10-fold improvement has been achieved, and attempts are being made to reduce the influence of other variables on the specific signal from the immunoreaction.

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Utility of the APACHE II score as a neurological prognostic factor for glufosinate-intoxicated patients with alert mental status (의식이 명료한 글루포시네이트 중독환자의 신경학적 예후인자로서 APACHE II의 유용성)

  • Rok Lee;Tae Yong Shin;Hyung Jun Moon;Hyun Jung Lee;Dongkil Jeong;Dongwook Lee;Sun In Hong;Hyun Joon Kim
    • Journal of The Korean Society of Clinical Toxicology
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    • v.21 no.2
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    • pp.135-142
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    • 2023
  • Purpose: In patients with glufosinate poisoning, severe neurological symptoms may be closely related to a poor prognosis, but their appearance may be delayed. Therefore, this study aimed to determine whether the Acute Physiology and Chronic Health Evaluation II (APACHE II) score could predict the neurological prognosis in patients with glufosinate poisoning who present to the emergency room with alert mental status. Methods: This study was conducted retrospectively through a chart review for patients over 18 years who presented to a single emergency medical center from January 2018 to December 2022 due to glufosinate poisoning. Patients were divided into groups with a good neurological prognosis (Cerebral Performance Category [CPC] Scale 1 or 2) and a poor prognosis (CPC Scale 3, 4, or 5) to identify whether any variables showed significant differences between the two groups. Results: There were 66 patients (67.3%) with good neurological prognoses and 32 (32.8%) with poor prognoses. In the multivariate logistic analysis, the APACHE II score, serum amylase, and co-ingestion of alcohol showed significant results, with odds ratios of 1.387 (95% confidence interval [CI], 1.027-1.844), 1.017 (95% CI, 1.002-1.032), and 0.196 (95% CI, 0.040-0.948), respectively. With an APACHE II score cutoff of 6.5, the AUC was 0.826 (95% CI, 0.746-0.912). The cutoff of serum amylase was 75.5 U/L, with an AUC was 0.761 (95% CI, 0.652-0.844), and the AUC of no co-ingestion with alcohol was 0.629 (95% CI, 0.527-0.722). Conclusion: The APACHE II score could be a useful indicator for predicting the neurological prognosis of patients with glufosinate poisoning who have alert mental status.

The Clinical Efficacy of Bidirectional Cavopulmonray Shunt in Young Infants (유아 환아에서 양방향성 상대정맥-폐동맥 단락술의 임상적 효율성)

  • Lee Sak;Park Han-Ki;Hong Soon-Chang;Kwak Young-Tae;Cho Bum-Koo;Park Young-Hwan
    • Journal of Chest Surgery
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    • v.39 no.3 s.260
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    • pp.177-183
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    • 2006
  • Background: The bidirectional cavopulmonary shunt (BCPS) is one of the primary palliative procedures for complex congenital heart disease. It has many advantages, but it is known to have high risks in young infants. Material and Method: From 1995 to 2003, 48 infants under the age of one year underwent BCPS. All the patients were Fontan candidates due to functional univentricular heart physiology. There were no significant differences in preoperative variables, except in mean age (67.58$\pm$3.78 vs. 212.91$\pm$13.44 days), and mean body weight (4.51$\pm$0.29 vs. 6.62$\pm$0.27 kg), between group A (<3 months, n=12) and group B ($\ge$3 months, n=36). Result: In group A, the arterial oxygen saturations serially measured were significantly lower. Hospital mortality was $25\%$, and $19\%$, respectively. During follow up, there were 2 late mortalities in group A, and 5 in group B. Conclusion: This study showed that operative risk in young infants was comparable to that of older patients, and BCPS could be a good option as a primary palliative procedure, and may eliminate other repeated palliative procedures which could be the risk factors for Fontan candidates. However, in high-risk patients accompanying pulmonary hypertension, or heterotaxia syndrome, other palliative procedures should be considered.

Predictions of VO2max Using Metabolical Responses in Submaximal Exercise and 1,200 m Running for Male, and the Validity of These Prediction Models (성인 남성의 최대하 운동시 대사반응 및 1,200 m 달리기 기록을 이용한 최대산소섭취량 추정식 개발 및 타당도)

  • Im, J.H.;Jeon, Y.J.;Jang, H.K.;Kim, H.J.;Kim, K.H.;Lee, B.K.
    • Exercise Science
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    • v.21 no.2
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    • pp.231-242
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    • 2012
  • The purpose of this study was to develop the prediction model of VO2max using submaximal metabolic responses from the Bruce protocol, HR responses at several stages and 1,200 m running record, and to compare and analyse the validity of these prediction models. The subjects were consisted of 255 male(133 male for 1,200 m running). They were participated maximal exercise testing with Bruce protocol, and the metabolic responses were measured in the end of the first(3 minute), second stage(6 minute), and 1,200 m running record. Measurement items were VO2(㎖/kg/min), VCO2(㎖/kg/min), VE(L/min), HR(bpm) of 3 and 6 minute, time to HR 150 bpm and 170 bpm, HR difference between Bruce protocol 6 and 3 minute, 1,200 m running record. Analyzing with all variables using enter method, the multiple R of total variable model was 0.642(p<.01), SEE was 4.38 ㎖/kg/min, CV was 10.8 %, but multicolinearity was appeared. The multiple R of 3 minutes model 1 and model 2 were 0.341 and 0.461, SEE was 6.05 and 5.72 ㎖/kg/min, CV was 14.9 and 14.1%, and multicolinearity did not appeared. The multiple R of 6 minutes model 1 and model 2 were 0.350 and 0.456, SEE was 6.03 and 5.74 ㎖/kg/min, CV was 14.9 and 14.2%, and multicolinearity did not appeared. The R of HR 170 and HR 170 model were 0.151 and 0.154, SEE were 6.36~6.37 ㎖/kg/min, CV were 15.7%. The R of 1,200 m running model was 0.444, SEE was 4.82 ㎖/kg/min, CV were 11.9%. In conclusion, with considering usefulness and convenience through the validity of these prediction models, the prediction model of VO2max recommended 6 and 3 minute model, and the validity of HR model and 1,200 m running model were moderately low.