Background: The purpose of this study was to investigate whether tidal volume (TV) of 8 mL/kg without positive end-expiratory pressure (PEEP) and TV of 6 mL/kg with or without PEEP in pressure-controlled ventilation-volume guaranteed (PCV-VG) mode can maintain arterial oxygenation and decrease inspiratory airway pressure effectively during one-lung ventilation (OLV). Methods: The study enrolled 27 patients undergoing thoracic surgery. All patients were ventilated with PCV-VG mode. During OLV, patients were initially ventilated with TV 8 mL/kg (group TV8) without PEEP. Ventilation was subsequently changed to TV 6 mL/kg with PEEP ($5cmH_2O$; group TV6+PEEP) or without (group TV6) in random sequence. Peak inspiratory pressure ($P_{peak}$), mean airway pressure ($P_{mean}$), and arterial blood gas analysis were measured 30 min after changing ventilator settings. Ventilation was then changed once more to add or eliminate PEEP ($5cmH_2O$), while maintaining TV 6 mL/kg. Thirty min after changing ventilator settings, the same parameters were measured once more. Results: The $P_{peak}$ was significantly lower in group TV6 ($19.3{\pm}3.3cmH_2O$) than in group TV8 ($21.8{\pm}3.1cmH_2O$) and group TV6+PEEP ($20.1{\pm}3.4cmH_2O$). $PaO_2$ was significantly higher in group TV8 ($242.5{\pm}111.4mmHg$) than in group TV6 ($202.1{\pm}101.3mmHg$) (p=0.044). There was no significant difference in $PaO_2$ between group TV8 and group TV6+PEEP ($226.8{\pm}121.1mmHg$). However, three patients in group TV6 were dropped from the study because $PaO_2$ was lower than 80 mmHg after ventilation. Conclusion: It is postulated that TV 8 mL/kg without PEEP or TV 6 mL/kg with $5cmH_2O$ PEEP in PCV-VG mode during OLV can safely maintain adequate oxygenation.
Coronavirus disease 2019 (COVID-19) is a contagious disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). This study aimed to investigate the status of renal function in patients with COVID-19. The study surveyed a total of 649 patients hospitalized with COVID-19 at a hospital located in southern Gyeonggi Province, South Korea over a one month period in January 2021. The parameters analyzed were blood urea nitrogen (BUN), creatinine, sodium, potassium, chloride, and estimated glomerular filtration rate (eGFR). The BUN and creatinine of the COVID-19 patients were found to be higher than the normal reference range, specially in males, and in the elderly (60s and 80s or older). The serum electrolyte levels of the patients were observed to be within the reference intervals. Of the subjects, males over 80 years of age had a Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) of 60 mL/min/1.73 m2 or less. Recent research suggests that some severe cases of COVID-19 are showing signs of kidney damage, even in those with no prior underlying kidney disease. Thus, assessment of kidney function using multiple indicators could help diagnose abnormal renal function in patients with COVID-19.
Objective: Effects of inulin supplementation in diet of Haidong chicks under hypoxic conditions on production performance, intestinal morphologic change, microflora contents and the incidence of ascites were studied. Methods: Commercial male chicks (360) were randomly divided into 6 groups and were fed diets supplemented with 0, 0.05, 0.075, 0.1, 0.125, and 0.15 g/kg of inulin, respectively. Results: The body weight gain and feed intake were improved in chicks fed the diets supplemented with 0.1 and 0.125 g/kg of inulin, from d 1 to d 42 (p<0.05); moreover, blood parameters were positively affected when inulin was included in the diets and the thickness of the intestinal wall and muscle tissue in duodenum, jejunum, and ileum tended to increase (p<0.05), and the villi height and crypt depth in duodenum, jejunum, and ileum (p<0.05). Regarding the number of goblet cells in duodenum, jejunum and ileum tended to increase when chicks were fed the diets supplemented with 0.075, 0.1, 0.125, and 0.15 g/kg (p<0.05) of inulin. When chicks were fed diets supplemented with 0.75 or 0.1 g/kg of inulin, a significant reduction of Escherichia coli counts in the cecum was observed; for a contrary, a significant increment of Bifidobacterium and Lactobacillus was observed in cecum and ileum. Finally, supplementing the feed with inulin determined an overall reduction of ascites incidences in comparison to the control group. Conclusion: Thus, the results observed in the present study clearly suggest that the diet supplementation with a quantity of inulin ranging between 0.1 and 0.125 g/kg, can improve growth performances, intestinal morphology, internal microbial balance and ascites incidence, in broiler chicks raised at high altitude area. Even though these findings may be of interest for the poultry industry, they may particularly be relevant in those areas characterized by high altitude such as Northwest China regions.
UI14SDF100CW is a chewable tablet of sildenafil citrate, which was developed to improve compliance through convenience of administration. The purpose of this study was to compare the pharmacokinetic (PK) properties of sildenafil citrate chewable tablets (UI14SDF100CW) and conventional sildenafil citrate film-coated tablets ($Viagra^{(R)}$, Pfizer). A randomized, open-label, single dose, two-treatment, two-period, two-way crossover study was conducted in 60 healthy male volunteers. In each period, the subjects received a single oral dose of UI14SDF100CW or $Viagra^{(R)}$ (both tablets contain 140.45 mg of sildenafil citrate, which is equivalent to 100 mg of sildenafil). Serial blood samples were collected up to 24 h post-dose for PK analysis. The plasma concentration of sildenafil was determined using a validated HPLC-MS/MS assay. PK parameters of sildenafil were calculated using non-compartmental methods. The plasma concentration-time profiles of sildenafil in both formulations were similar. For UI14SDF100CW, the $C_{max}$ and $AUC_{last}$ of sildenafil were $1068.69{\pm}458.25$ (mean${\pm}$standard deviation) mg/L and $3580.59{\pm}1680.29h{\cdot}mg/L$, and the corresponding values for $Viagra^{(R)}$ were $1146.84{\pm}501.70mg/L$ and $3406.35{\pm}1452.31h{\cdot}mg/L$, respectively. The geometric mean ratios (90% confidence intervals) of UI14SDF100CW to $Viagra^{(R)}$ for $C_{max}$ and $AUC_{last}$ were 0.933 (0.853-1.021) and 1.034 (0.969-1.108), respectively, which met the bioequivalence criteria of Korean regulatory agency. In conclusion, UI14SDF100CW and $Viagra^{(R)}$ showed similar PK properties. Therefore, UI14SDF100CW can be an alternative to sildenafil for the treatment of erectile dysfunction, providing better compliance.
Purpose: We investigated the association of effector memory (EM) CD8+ T cell and CD4+ T cell immunity with metabolic syndrome (MS). Methods: Surface and intracellular staining of peripheral blood mononuclear cells was performed. Anti-interleukin-7 receptor-alpha (IL-7Rα) and CX3CR1 antibodies were used to stain the subsets of EM CD8+ T cells, while anti-interferon-gamma (IFN-γ), interleukin-17 (IL-17), and forkhead box P3 (FOXP3) antibodies were used for CD4+ T cell subsets. Results: Of the 47 obese children, 11 were female. Children with MS had significantly higher levels of serum insulin (34.8±13.8 vs. 16.4±6.3 µU/mL, p<0.001) and homeostasis model assessment of insulin resistance (8.9±4.1 vs. 3.9±1.5, p<0.001) than children without MS. Children with MS revealed significantly higher frequencies of IL-7Rαlow CD8+ T cells (60.1±19.1% vs. 48.4±11.5%, p=0.047) and IL-7RαlowCX3CR1+ CD8+ T cells (53.8±20.1% vs. 41.5±11.9%, p=0.036) than children without MS. As the serum triglyceride levels increased, the frequency of IL-7RαlowCX3CR1+ and IL-7RαhighCX3CR1- CD8+ T cells increased and decreased, respectively (r=0.335, p=0.014 and r=-0.350, p=0.010, respectively), in 47 children. However, no CD4+ T cell subset parameters were significantly different between children with and without MS. Conclusion: In obese children with MS, the changes in immunity due to changes in EM CD8+ T cells might be related to the morbidity of obesity.
Purpose: Hyperglycemia accelerates the formation of advanced glycation end products (AGEs), a group of compounds formed via non-enzymatic glycation/glycoxidation. Type 2 diabetes mellitus (T2DM) is related to oxidative stress, resulting in some overgeneration of AGEs. The accumulation of AGEs in T2DM patients leads to increased inflammation, DNA damage, tissue damage, progression of diabetic microvascular disease, and nephropathy. Heme oxygenase-1 (HO-1) is an intracellular enzyme that catalyzes the oxidation of heme. Expression of HO-1 in the endothelium and in muscle monocytes/macrophages was upregulated upon exposure to reactive oxygen species or oxidized low-density lipoprotein. Cells activated by oxidative stress are reported to release HO-1 in the serum. In the current study, we discuss the oxidative status according to the level of AGEs and the association of HO-1 with AGEs or urinary DNA damage marker in type 2 diabetic Korean patients. Methods: This study enrolled 36 diabetic patients. Subjects were classified into two groups by serum AGEs level (Low AGEs group: < 0.85 ng/mL serum AGEs; High AGEs group: ≥ 0.85 ng/mL serum AGEs). Body composition was measured using bioelectrical impedance analysis. Blood and urinary parameters were measured using commercial kits. Results: No significant differences were observed in the general characteristics and body composition between the two groups. Serum HO-1 concentration was significantly higher in the High AGEs group than in the Low AGEs group. After adjustment of age and gender, a correlation was performed to assess the association between serum HO-1 and serum AGEs or urinary 8-hydroxy-2'-deoxyguanosine (8-OHdG). Our results indicate that serum HO-1 is positively correlated with serum AGEs and urinary 8-OHdG. Conclusion: Taken together, our results indicate that in diabetes patients, a high level of HO-1 is associated with a high concentration of AGEs and 8-OHdG, probably reflecting a protective response against oxidative stress.
Background: Occupational hazards in crop farms vary diversely based on different field operations as soil management, harvesting processes, pesticide, or fertilizer application. We aimed at evaluating the immunological status of crop farmers, as limited systematic investigations on immune alteration involved with crop farming have been reported yet. Methods: Immunological parameters including plasma immunoglobulin level, major peripheral immune cells distribution, and level of cytokine production from activated T cell were conducted. Nineteen grape orchard, 48 onion open-field, and 21 rose greenhouse farmers were participated. Results: Significantly low proportion of natural killer (NK) cell, a core cell for innate immunity, was revealed in the grape farmers (19.8±3.3%) in comparison to the onion farmers (26.4±3.1%) and the rose farmers (26.9±2.5%), whereas cytotoxic T lymphocyte proportion was lower in the grape and the onion farmers than the rose farmers. The proportion of NKT cell, an immune cell implicated with allergic response, was significantly higher in the grape (2.3±0.3%) and the onion (1.6±0.8%) farmers compared with the rose farmers (1.0±0.4%). A significantly decreased interferon-gamma:interleukin-13 ratio was observed from ex vivo stimulated peripheral blood mononuclear cells of grape farmers compared with the other two groups. The grape farmers revealed the lowest levels of plasma IgG1 and IgG4, and their plasma IgE level was not significantly different from that of the onion or the rose farmers. Conclusion: Our finding suggests the high vulnerability of workplace-mediated allergic immunity in grape orchard farmers followed by open-field onion farmers and then the rose greenhouse farmers.
Purpose: Vitamin D deficiency may cause bone loss and increased inflammation, which are well-known symptoms of periodontal disease. This study investigated whether serum 25-hydroxyvitamin D (25(OH)D) levels are associated with periodontal disease status and tooth loss. Methods: Cross-sectional data from 5,405 individuals aged ≥50 years (2,253 males and 3,152 females) were obtained from the 2008-2010 Dong-gu study, a prospective cohort study of risk factors for chronic diseases. Periodontal examinations were conducted to evaluate the number of remaining teeth, the periodontal probing depth (PPD), the clinical attachment level (CAL), and bleeding on probing. The percentages of sites with PPD ≥4 mm and CAL ≥4 mm were recorded for each participant. The severity of periodontitis was classified using the Centers for Disease Control and Prevention and the American Academy of Periodontology case definitions. Serum 25(OH)D levels were classified as reflecting severe deficiency, deficiency, insufficiency, or sufficiency. Multivariate linear regression analysis was performed to assess the associations of serum 25(OH)D levels with periodontal parameters and the number of remaining teeth after adjusting for confounders including age, smoking status, alcohol consumption status, month of blood collection, and physical activity. Multivariate logistic regression was used to evaluate the association between serum vitamin D levels and severe periodontitis. An overall statistical analysis and a stratified analysis by sex were performed. Results: Overall, the rates of severe deficiency, deficiency, insufficiency, and sufficiency were 6.5%, 67.9%, 22.4%, and 3.2%, respectively. After adjustment for confounders, vitamin D levels were directly associated with the number of remaining teeth, an association that was significant in males, but not in females. Sufficient serum 25(OH)D was associated with a low frequency of severe periodontitis. Conclusions: This population-based cross-sectional study indicates that low serum 25(OH) D is significantly associated with tooth loss and severe periodontitis in Koreans aged 50 years and older.
This study was conducted to investigate the effects of different salinity on growth, survival and hematological parameters of juvenile chum salmon (Oncorhynchus keta). The fish were tested at salinity 0, 10, 20 and 30‰ for 30 days with three replicated groups. After the 30 days, the survival rate was 87.5% or more for 0, 10, 20‰ and significantly decreased to 75% at 30‰. Weight gain, specific growth rate, feed efficiency, daily feed intake, daily protein intake and protein efficiency ratio were the highest at 10‰. In the plasma components, the alanine aminotransferase (ALT) was significantly decreased at 10, 20 and 30‰ in compared with 0‰, whereas sodium (Na+) and chloride (Cl-) was significant increased and there was no significant change in the total protein (TP) and potassium (K+). In conclusion, the optimal salt concentration for the growth of juvenile chum salmon (11~33 g) was confirmed to be 10‰, but the association with the change in blood composition should be further studied.
Park, Jeong Yun;Shin, Eun-Jung;Kim, Rhieun;Kim, Sukyeong;Park, Choon-Seon;Park, Taezoon;Choi, Yun-Kyoung;Heo, Young-Hee
Quality Improvement in Health Care
/
v.28
no.1
/
pp.45-54
/
2022
Purpose: The study aims to identify the theme list and priority criteria of patient safety theme reports in South Korea. Methods: The survey was conducted twice, and the importance of each criterion and theme was measured on a nine-point scale using the Delphi technique by a panel of 19 patient safety experts. The criteria included severity, universality, preventability, and organizational-social impact. Descriptive statistics such as frequency, percentage, mean, standard deviation, median, and interval quartile range were used to analyze the data. Results: The parameters were assigned a weighted average of 35% for severity, 20% for universality, 30% for preventability, and 15% for organizational-social impact, respectively. The final top three rankings were surgery safety, blood transfusion safety, and medication safety. In addition to expert opinion, for the theme that is selected based on the priority ranking, one to five sub-topics can be derived from the theme based on the priority ranking, societal demands, or the yearly priority list of patient safety incidents. Conclusion: It is recommended that the official patient safety center distribute the report in the form of a summary that can be utilized nationwide at medical institutions, government institutions, and other places. Updates, as well as accumulated theme reports, will serve as the baseline data for the proposal of the system and for the policy designed to implement and improve institutions' safety practices as a standard of domestic patient safety practice guidelines.
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