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Relative Association of Overhydration and Muscle Wasting with Mortality in Hemodialysis Patients: Assessment by Bioelectrical Impedance Analysis (혈액투석 환자에서 Bioelectrical Impedance Analysis를 활용하여 측정한 과수분량과 근육량 감소와 사망률의 상관관계)

  • Kim, Eunju;Seo, Sang Oh;Choi, Yu Bum;Lee, Mi Jung;Lee, Jeong Eun;Kim, Hyung Jong
    • The Korean Journal of Medicine
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    • v.93 no.6
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    • pp.548-555
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    • 2018
  • Background/Aims: Assessment of fluid status in hemodialysis patents is very important. Overhydration in hemodialysis is associated with generalized edema, cardiovascular complications, and hypertension. The aim of this study was to determine the factors correlated with mortality of hemodialysis patients, assessing body muscle mass and fluid status using bioelectrical impedance analysis (BIA). Methods: This study enrolled 93 patients who underwent hemodialysis between January 2010 and May 2015 at CHA Bundang Medical Center. Medical records of enrollees up to June 2017 were reviewed retrospectively. These included laboratory results (serum albumin, C-reactive protein [CRP], lipid profile, etc.) and BIA data (extracellular water, intracellular water, total body water, soft lean mass, fat free mass, skeletal muscle mass, etc.). Results: Eleven of 93 patients had expired by May 2017. Among the surviving subjects, mean age was younger, CRP levels were lower, albumin levels were higher, and extracellular water/total body water (ECW/TBW) ratios were lower than in the expired patient group. Kaplan-Meier survival analysis revealed that overhydration (ECW/TBW > 0.4) was associated with higher mortality. Conclusions: In hemodialysis patients, overhydration is an important factor in mortality, and BIA could be a reliable modality in its assessment. We suggest that, for hemodialysis patients, overhydration is more of a risk factor for mortality than is muscle wasting.

The Comparison Study on the Efficacy of Bucillamine Monotherapy and Bucillamine plus Methotrexate Combination Therapy in the Treatment of Rheumatoid Arthritis (류마티스 관절염 환자에서 Bucillamine 단독요법과 Bucillamine과 Methotrexate 병용요법의 치료효과에 대한 비교연구)

  • Lee, Young Ran;Suh, Okkyung;Jung, Sung Soo;Jun, Jae Bum;Yoo, Dae Hyun;Lee, Suk Hyang;Shin, Hyun Taek;Kim, Seong Yoon
    • Korean Journal of Clinical Pharmacy
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    • v.8 no.1
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    • pp.1-12
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    • 1998
  • Rheumatoid arthritis (RA) is a common systemic inflammatory disease which DMARDS have been widely used as a treatment modality both as monotherapy and combination therapy Bucillamine, one of newer DMARDS, has recently proven its efficacy as monotherapy in the treatment of RA. The objective of this study was to compare the efficacy and the safety of bucillamine monotherapy and bucillamine plus methotrexate combination therapy in the treatment of rheumatoid arthritis. Forty-nine mild RA patients were enrolled in this prospective, open-trial and were assigned to receive bucillamine 200 mg/day (n=18) or bucillamine 200 mg/day and methotrexate 7.5-15 mg/week (n=31) orally for 16 weeks. Concomitant use of NSAID and prednisolone <5 mg/day or equivalent dose of steroid were allowed. Both monotherapy group and combination therapy group have shown significant improvement in disease activities (Ritchie index, painful joints, swollen joints, morning stiffness, grip strength, ESR, RF, CRP, patient's self assessment of pain, physician's global assessment of disease activity) from the baseline. However, there was no statistically significant difference between two groups. The adverse effects were more frequently shown in combination therapy group than monotherapy group. In conclusion, in patients with mild RA monotherapy has shown to be equally efficacious as combination therapy with less side effects.

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A Domestic Outbreak of Bacterial Dysentery Caused by Extended-Spectrum β-Lactamase(ESBL)-producing Shigella sonnei (집단 발생한 Extended-spectrum β-lactamase(ESBL) 생산 Shigella sonnei 감염에 의한 세균성 이질에 관한 연구)

  • Lim, Hyun Taek;Lee, So Hee;Lee, Jung Hwa;Kim, Jeong Eun;Kim, Kyo Sun;Jeong, Eun Ju;Lee, Seung Hyun;Kang, Chang Gyu;Hong, Seong Jin
    • Clinical and Experimental Pediatrics
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    • v.48 no.10
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    • pp.1107-1115
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    • 2005
  • Purpose : An outbreak of ESBL-producing Shigella sonnei enteritis was unprecedented not only in Korea but throughout the world in the past. We intended to devise a management guideline for ESBL-producing shigellosis based on analysis of clinical manifestations and response to therapy. Methods : We analyzed 103 patients who were admitted to the hospital with acute GI symptoms and were shown positive result for S. sonnei on stool culture. We performed sensitivity test to the antibiotics and DNA sequencing of ESBL gene in the isolated S. sonnei colonies. In addition, we retrospectively analyzed their clinical characteristics, laboratory results, and clinical and microbiological responses to the antibiotics. Results : Among the clinical manifestations, fever was the most frequent(96.1%), followed by diarrhea(93.2%), abdominal pain(76.7%), headache(71.8%), vomiting(65.0%), and nausea(41.7%). The fever was sustained for average of 2.0 days and diarrhea for 3.9 days. Watery diarrhea was the most common(69%) followed by mucoid(26%), and bloody stool(5%). On peripheral blood smear, leukocytosis was noted in 53.4% of patients, and 78.6% of patients tested positive for serum CRP response. On stool direct smear, 11.7% of patients showed more than 50 WBCs/HPF, and 9.7% of patients between 5 to 20 WBCs/HPF. Stool occult blood was positive in 71% of patients. Production of CTX-M-14 type ESBL was reported for all S. sonnei strains isolated from this outbreak. Microbiological eradication rates to various antibiotics were as follows : 100%(9/9) to ciprofloxacin, 100% 5/5) to azithromycin, 6.9%(5/72) to cefdinir, 0%(0/8) to ceftriaxone, 12.5%(1/8) to ceftizoxime, 0%(0/ 8) to TMP/SMX, 42.9%(3/7) to ampicillin/sulbactam, 20%(1/5) to amoxicillin/clavulanic acid, and 68.8 %(11/16) to imipenem/cilastatin. Conclusion : It is presumed that azithromycin can be an attractive option for the treatment of ESBL-producing S. sonnei enteritis in pediatric population, given its cost-effectiveness and safety. Although ciprofloxacin is another cost-effective agent, its use in pediatric population may be a bit too premature.

Cloning and Expression of Serratia marcescens Coenzyme A(CoA) Transferase Gene in E. coli

  • Choi, Yong-Lark;Kim, Hae-Sun;Yoo, Ju-Soon;Kim, Yong-Gyun;Chung, Chung-Han
    • Journal of Life Science
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    • v.9 no.1
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    • pp.54-57
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    • 1999
  • We have got several clones from Serratia marcescens which stimulated the cells to use maltose as a carbon source in E. coli TP2139 (${\Delta}$lac, ${\Delta}$crp). One of the cloned genes, pCKB13, was further analyzed. In order to find whether the increased expression of the gene under the direction of maltose metabolism, we constructed several recombinant subclones. We have confirmed that the clone, pCKB13 codes Coenzyme A transferase gene by partial nucleotide sequencing in the terminal region. The enzyme activity of Coenzyme A transferase increased after introduction of the multicopy of the cloned gene in E. coli. The recombinant proteins expressed by multicopy and induction with IPTG, two polypeptide of 26-and 28-kDa, were confirmed by SDS-PAGE. Southern hybridization analysis confirmed that the cloned DNA fragment was originated from S. marcescens chromosomal DNA.

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THE USE OF NUMERICAL MODELS IN SUPPORT OF SITE CHARACTERIZATION AND PERFORMANCE ASSESSMENT STUDIES FOR GEOLOGICAL REPOSITORIES

  • Neerdael, Bernard;Finsterle, Stefan
    • Nuclear Engineering and Technology
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    • v.42 no.2
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    • pp.145-150
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    • 2010
  • The paper is describing work being developed in the frame of a 5-year IAEA Coordinated Research Programme (CRP) started in late 2005. Participants gained knowledge of modelling methodologies and experience in the development and use of rather sophisticated simulation tools in support of site characterization and performance assessment calculations. These goals were achieved by a coordinated effort, in which the advantages and limitations of numerical models are examined and demonstrated through a comparative analysis of simplified, illustrative test cases. This knowledge and experience should help them address these issues in their own country's nuclear waste program. Coordination efforts during the first three years of the project aimed at enabling this transfer of expertise and maximizing the learning experience of the participants as a group. This was accomplished by identifying common interests of the participants (i.e., Process Modelling and Total System Performance Assessment methodology), and by defining complementary tasks that are solved by the members. Synthesis of all available results by comparative assessments is planned in the coming months. The project will be completed end of 2010. This paper is summarizing activities up to November 2009.

Effects of the Supportive Program on the Chronic Arthritis Patients (지지 프로그램이 만성 관절염환자의 생리적, 사회$\cdot$심리적 상태와 건강지각에 미치는 효과)

  • Kim Myung-Ja;Sohng Kyeong-Yae;Kil Suk-Yong
    • Journal of Korean Public Health Nursing
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    • v.14 no.2
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    • pp.203-215
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    • 2000
  • The purpose of this study is to identify the effects of the supportive program for arthritis patients. who are attending a rheumatoid arthritis clinic. To achieve this purpose. this study adopted a quasi-experimental. pre- and post-test research design. comparing experimental group with control one. Supportive program was composed of in-depth. 3 times of direct interview and 2 times of advice using telephone for 8 weeks. The object of these interviews and phone was focused on the improvement of patients' preception for health. During this period. the level of pain, hemato-immunologic indices(ESR, CRP). self-efficacy, depression. and perception for health were measured in both grooups. Data were analysed by $x^2-test$, t-test. repeated measures ANOVA and Pearson's correlations. The results were as follows : 1. There were no significant differences in physiological data. 2. The feeling of self-efficacy was significantly increased in experimental group(P=.012), 3. There was no significant differences in depression. 4. The perception for health status was significantly increased in experimental group(P=.002). Thus, the supportive program. which is focused on the close interpersonal communication. proved to be effective. This result justifies the following suggestion that the role of the nursing professionals in out-patient clinic should be extended for more qualified care for the patients.

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Dynamic Gene Expression Profiling of Escherichia coli in Carbon Source Transition from Glucose to Acetate

  • Oh Min-Kyu;Cha Mee-Jeong;Lee Sun-Gu;Rohlin Lars;Liao James C.
    • Journal of Microbiology and Biotechnology
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    • v.16 no.4
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    • pp.543-549
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    • 2006
  • DNA microarray was used to study the transcription profiling of Escherichia coli adapting to acetate as a sole carbon source. Bacteria grown in glucose minimal media were used as a reference. The dynamic expression levels of 3,497 genes were monitored at seven time points during this adaptation. Among the central metabolic genes, the glycolytic and glucose phosphotransferase genes were repressed as the bacteria entered stationary phase, whereas the glyoxylate pathway, TCA cycle, and gluconeogenic genes were induced. Distinct induction or repression patterns were recognized among different pathway genes. For example, the repression of glycolytic genes and the induction of gluconeogenic ones started immediately after glucose was depleted. On the other hand, the regulation of the pentose phosphate pathway genes and glyoxylate genes gradually responded to the glucose depletion or was more related to growth in acetate. When the whole genome was considered, many of the CRP, FadR, and Cra regulons were immediately responsive to the glucose depletion, whereas the $\sigma^s$, Lrp, and IHF regulons were gradually responsive to the glucose depletion. The expression profiling also provided differential regulations between isoenzymes; for example, malic enzymes A (sfcA) and B (maeB). The expression profiles of three genes were confirmed with RT-PCR.

The Effects of 12 Weeks of Circuit Training on Inflammatory Markers, Blood Lipids and Body Composition in Obese Middle-aged Women (12주간의 순환운동이 비만 중년여성의 혈중 염증 표지자와 혈중 지질 및 신체구성에 미치는 효과)

  • Byun, Jaechul
    • Journal of The Korean Society of Integrative Medicine
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    • v.7 no.1
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    • pp.65-74
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    • 2019
  • Purpose : The purpose of this study was to determine the effects of 12 weeks of circuit training on inflammatory markers, blood lipids, and body composition of obese middle-aged women. Methods : Twenty-four obese women were randomly divided into three groups (circuit exercise training, CT; aerobic exercise training, AT; resistance exercise training, RT). All the subjects participated in the exercise program for 60 minutes, 3 times a week for 12 weeks. Results : Significant differences found in the participants pre-and post exercise training C-reactive protein (CRP), fibrinogen, and adiponectin levels. The CT participants experience an expected increase in their adiponectin levels. Significantly improved blood TC, LDL-C, HDL-C, and TG levels were found after 12 weeks of exercise. The AT and CT groups showed greater improvements in their HDL-C, LDL-C, and TG levels than the RT group. Significant differences were found in the participants pre-and post-exercise training body weight, body fat percentage, and body mass index (BMI). Conclusion : The CT participants body fat percentages decreased more than the RT group's percentages. In conclusion, obese women who completed 12 weeks of circuit exercise training (aerobics + resistance exercise) had significant improvements in their inflammatory markers, blood lipids, and body fat percentage.

Experimental study on Cervi Cornu on Adjuvant Arthritis in rats (록각(鹿角)의 Adjuvant 관절염(關節炎)에 대한 실험적(實驗的) 연구(硏究))

  • Shin, Ji-Won;Park, Jai-Young;Park, Hee-Soo
    • Journal of Pharmacopuncture
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    • v.5 no.1 s.8
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    • pp.113-133
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    • 2002
  • Objective: To investigate effects of Cervi Cornu on Adjuvant Athritis in rats, the edema inhibit rate, the anaJgesic effects, the number of WBC, RA facter, Platelet, the quantity of CRP, total protein, albumin and globuline in the blood serum were measured in the arthritis part. Results: The results obtained as fonows ; 1. After arthritis of Sprague dawley(SD) rats was induced by injecting Freund's complete adjuvant for 2 weeks, any treatment was not for Control group, acupunctured for Treat Ⅰ group. normal saJine was ora] administrated for the Treat Ⅱ group, Cervi Cornu Ex. was oral administrated for Treat Ⅲ, and Cervi Cornu Herbal-acupullcture was injected for Trea Ⅳ group during 2 weeks every other day. Selected point was on pressure pain point in both groups. And then the edema inhibit rate were checked. The edema inhibit rate was $46.03\%$ in Treat I group, $43.24\%$ Treat IV group, $37.44\%$ in Treat III. there was significance in the edema inhibit rate between Control group and Treat group, in order of Treat Ⅰ, Ⅳ, Ⅲ.(p<0.05) 2. The analgesic effects was $7.58{\pm}1.80$(${\times}10$gm) in Control group. $11.00{\pm}1.10$(${\times}10$gm) in Treat Ⅰ group. $99.92{\pm}1.28$(${\times}10$gm) in Treat Ⅲ group and $14.67{\pm}1.03$(${\times}10$gm) in Treat Ⅳ group. There was significance in the analgesic effects between Control group and Treat group(p<0.05) 3. The number of WBC was $14.72{\pm}1.48$(${\times}10^3$㎕) in control Group, $10.26{\pm}1.13$(${\times}10^3$㎕) in Treat Ⅰ group, $11.00{\pm}1.13$(${\times}103$㎕) in Treat Ⅱ Group and $9.63{\pm}1.75$(${\times}10^3$㎕) in Treat Ⅳ group. There was significance in the number of WBC between Control group and Treat group(p<0.05) 4. The content of total protein in the blood serum were $6.13{\pm}0.05$g/dl in control group, $5.73{\pm}0.14$g/dl in Treat I group, $5.88{\pm}0.13$g/dl in Treat Ⅲ group and $5.90{\pm}0.13$g/dl in Treat IV group. There was significance in The content of total protein in the blood serum between Control group and Treat group(p<0.05) 5. The contests of albumin in the blood serum were $2.32{\pm}0.12$g/dl in the Control group, $2.35{\pm}0.05$g/dl in Treat Ⅰ group, $2.35{\pm}0.05$g/dl in Treat Ⅱ group, $2.30{\pm}0.06$g/dl in Treat Ⅲ group, $2.42{\pm}0.08$g/dl in Treat IV group. There was no significance in The content of albumin in the blood serum between Control group and Treat group(p<0.05) 6. The contests of globulin in the blood semm were $3.68{\pm}0.08$g/dl in the Control group, $3.43{\pm}0.12$g/dl in Treat Ⅰ group, $3.55{\pm}0.10$g/dl in Treat IV group. There was significance in The content of globulin in the blood serum between Control group and Treat group(p<0.05) 7. The numbers of RA factor were $3.47{\pm}0.54$IU/ml in Control group and $2.38{\pm}0.50$IU/ml in Treat Ⅱ group. There was significance inThe numbers of RA factor between Control group and Treat group(p<0.05) 8. The numbers of platelet were $1126.33{\pm}1126.33{\pm}85.93{times}10^3$/㎕ in Control group, $1043.33{\pm}80.80{times}10^3$/㎕ in Treat Ⅰ group, $1116.82{\pm}77.93{times}10^3$/㎕ in Treat Ⅱ group, $1164.17{\pm}94.02{times}10^3$/㎕l in Treat Ⅲ group, $1076.67{\pm}54.84{times}10^3$/㎕ in Treat Ⅳ group. There was no significance in The numbers of platelet between Control group and Treat group(p<0.05) 9. The quantity of CRP were $0.05{\pm}0.01$mg/ml in Control group, $0.05{\pm}0.01$mg/ml in Treat Ⅰ group, $0.06{\pm}0.01$mg/ml in Treat Ⅱ group, $0.05{\pm}0.00$mg/ml in Treat Ⅲ group, $0.05{\pm}0.00$mg/ml in Treat Ⅳ group. There was no significance in The quantity of CRP between Control group and Treat group(p<0.05) Concluslon : From these results, it is shown Cervi Comu Herbal-acupuncture more efffective thaJJ Cervi Cornu Ex. on Adjuvant Arthritis in rats.

Clinical Outcomes after Modified Fasting Therapy Supplied with Gamrosu: A Retrospective Observational Study (감로수(甘露水)를 이용한 절식요법의 임상결과에 관한 후향적 관찰연구)

  • Shin, Seung-Uoo;Kim, Dong-Hwan;Shin, Hyun-Taeg;Oh, Dal-Seok
    • Journal of Korean Medicine for Obesity Research
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    • v.16 no.1
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    • pp.36-49
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    • 2016
  • Objectives: Two historical evidence supported the concept of Gamrosu. The first one was Jeho-tang, a selected thirst quencher in Chosun Dynasty and the second one was Saeng-Maek-san, Dongeuibogam's recommendation as one of the qi-vigorating summer beverages. Gamrosu is a modified fasting therapy beverage which is manufactured from those two prescriptions and the carbohydrates (420.6 kcal/d). A retrospective observational study was conducted to evaluate the clinical outcomes. Methods: Thirty-three cases were reviewed at three local Korean Medical clinics that each site's participant has finished the modified fasting for 10 consecutive days. Clinical outcomes were reviewed at pre- and post-fasting sessions by retrieving the changes of body composition, blood pressure, blood chemistries & urine tests, and subjective symptoms & fatigue scores. Results: Demographics of the observed participants were 17 of male and 16 of female. Post-Gamrosu session, -6.89% of body weight, -8.97% of body fat mass were reduced with the nutrition indices being improved (P<0.001). -8.72% of systolic blood pressure, -39.86% of serum triglyceride, -6.75% of fast blood sugar and -8.12% of waist circumference were improved (P<0.05). The levels of high sensitivity C-reactive protein (-58.34%), CRP (-43.55%) and eosinophil (-21.30%) showed the significant diminished profiles (P<0.05). Liver/kidney functions and the standard of electrolytes were maintained within normal range in stable manners. The fatigue scale scores indicated significant lower scores. Conclusions: Taken together, obesity-related clinical outcomes after a modified fasting therapy with Gamrosu were sufficiently feasible and the observed findings should be considered for further prospective clinical studies.