Effect of Exercise on Serum C-Reactive Protein

BACKGROUND AND OBJECTIVES: Regular exercise protects us against numerous chronic diseases, and reduces the risk of cardiovascular disease. Also, C-reactive protein, a marker of inflammation, is known to be associated with the risk and prognosis of cardiovascular disease. The present study was designed to assess the effects of regular exercise on the level of high sensitive C-reactive protein (hsCRP). SUBJECTS AND METHODS: The serum level of hsCRP and the anthropometric indices of adiposity, metabolic variables, blood pressure (BP) and several cardiovascular risk factors were measured in 18445 subjects. A prospective study of 42 subjects with high baseline levels of hsCRP was conducted. After 3 months of regular aerobic exercise their hsCRP levels were rechecked and the association between regular exercise and hsCRP analyzed using a cross sectional and prospective study. RESULTS: Age, smoking, hypertension, diabetes and body mass index were found to be independent determinants of an elevated hsCRP level, but exercise was not found to be associated with a decreased hsCRP level in the cross-sectional study. In the prospective study, the mean serum hsCRP value was significantly reduced after 3 months in the exercise group (3.02+/-1.06 vs. 2.05+/-1.23 p=0.015), but not in the controls (3.03+/-1.09 vs. 2.57+/-1.11 p=0.104). However, the interval changes in hsCRP levels were not different in the exercise compared to the control group (p=0.660). CONCLUSION: These results suggest that exercise is not an independent determinant of the CRP level. Three months of regular aerobic exercise show a tendency to be associated with a reduction in the hsCRP level, but this putative effect of exercise on the hsCRP level was not significant in healthy subjects. Further larger sample, prospective cohort studies will be required to establish the effect of exercise on the hsCRP level.

Relationship between Heart Rate Reduction and Insulin Resistance in Normoglycemic Individuals

BACKGROUND AND OBJECTIVES: It is well known that, regardless of whether a person has cardiovascular diseases, the reduction of heart rate after exercise reflects the impairment of the autonomic nervous system. It is also a predictive factor of death rate and it correlates to insulin resistance. Therefore, we assessed these correlations in normoglycemic subjects. SUBJECTS AND METHODS: Exercise stress testing was performed according to the Bruce protocol. Anthropometric indices of adiposity, metabolic variables, blood pressure (BP) and several cardiovascular risk factors were measured. The HOMA index was used as the insulin resistance, and the impairment of the autonomic nervous system was assessed by measuring the reduction of heart rate for 2 minutes after the cessation of exercise. RESULTS: The reduction of heart rate during 2 minutes after the cessation of exercise statistically correlated with the HOMA index, gender, age, body mass index, the waist circumference, heart rate during rest, the maximum heart rate, serum total cholesterol concentration, serum high density lipoprotein cholesterol concentration and serum low density lipoprotein cholesterol concentration, (p<0.05). However, on multiple regression analysis, the HOMA index, gender, heart rate during rest, and the maximum heart rate significantly correlated to the reduction of heart rate during 2 minutes after the cessation of exercise. CONCLUSION: In individuals with normal serum glucose levels, even after adjustment was made for other factors, the reduction of heart rate after the cessation of exercise correlated to insulin resistance. Hence, in individuals with normal serum glucose levels, efforts to improve insulin resistance have to be made, and prospective study on this subject is required.

Serum iron parameters in patients with chronic liver disease according to etiology / 대한내과학회지

BACKGROUND: Iron is essential for life, but iron overload state cause potentially fatal health risk. There is growing evidence that only mildly increased amounts of hepatic iron can be damaging, particulary if combined with other hepatotoxic factors such as alcoholic or chronic viral hepatits B,C. The aim of this study was to assess the serum iron status of patients with various forms of hepatitis and cirrhosis of liver and to determine the correlation between the degree of hepatocyte damage (expressed as ALT activity) and status of serum iron parameters. METHODS: Our research involved 107 patients (69 male ranging in age from 27-67 and 38 female ranging in age from 32-62) diagnosed with chronic viral hepatitis B or type C, alcoholic hepatitis or cirrhosis of the liver. Serum iron parameters such as serum iron, ferritin, TIBC, and aminotransferase measured as necroinflammatory activity in Chronic hepatitis. RESULTS: There was no difference s-iron level between chronic hepatitis and cirrhosis but, significantly higher in alcoholic hepatitis and cirrhosis than viral hepatitis and cirrhosis respectively. s-Ferritin level was significantly higher in cirrhosis than hepatits group, and more higher in alcoholic hepatitis and cirrhosis than viral hepatitis and cirrhosis respectively. In chronic hepatitis groups, there are significant correlation between ALT and s-ferritin level regardness of etiology. CONCLUSION: Serum iron overload state was prominent in alcoholic hepatitis and cirrhosis than viral hepatitis and cirrhosis. High serum ferritin level can predict hepatocyte damage in chronic hepatitis.

The Relationship of the Hypertension, Insulin Resistance, and Metabolic Syndrome in the Serum Uric Acid Level

BACKGROUND AND OBJECTIVE: The relationship between serum uric acid and metabolic syndrome variables has not been reported in Korea. Therefore, whether the circulating levels of serum uric acid are independently related to hypertension, insulin resistance and the variables of metabolic syndrome were assessed. SUCJECTS AND METHODS: A total of 53,477 health screen examinees were enrolled and divided into four groups (Quartile 1:6.29 mg/dL) according to their serum uric acid level. The blood pressure, lipid profiles, fasting plasma glucose, waist circumference, HOMA, high sensitivity CRP and apolipoprotein were compared between the four groups. RESULTS: There was a positive association between blood pressure and the serum uric acid level (p<0.001). After adjustment for covariates the prevalence of hypertension due to uric acid was 1.192 (95% CI, 1.038-1.368 p=0.013), and 1.408 (95% CI, 1.221-1.623 p<0.001) times higher in subjects in the third and fourth uric acid level quartiles, respectively, compared to the subjects in the first quartile. Insulin resistance and metabolic syndrome variables were positively correlated with the serum uric acid level. The number of metabolic syndrome variables was also increased with an elevated serum uric acid level. CONCLUSION: Our study suggests that serum uric acid levels were independently associated with hypertension, insulin resistance and the variables of metabolic syndrome in the Korean population. Although the serum uric acid level was normal value, the risk of metabolic syndrome was increased with an elevated serum uric acid level. However, because of the cross-sectional nature of our study, these findings should be confirmed in prospective cohort studies.

Detection of the New O3:K6 Strain of Vibrio parahaemolyticus by Group-Specific Polymerase Chain Reaction / 대한임상병리학회지

BACKGROUND: Recently, a new serotype O3:K6 has caused a pandemic of Vibrio parahaemolyti-cus infection. The new O3:K6 serovar differs from the old O3:K6 strains at least in 7 base positions within a 1,346 bp region of the toxRS gene involved in the regulation of the virulence. We per-formed a group-specific polymerase chain reaction (GS-PCR) test for detection of the new O3:K6 strains using species-specific primers. METHODS: A total of 48 V. parahaemolyticus were isolated from clinical specimens of patients with diarrhea in different geographic areas of Seoul (Hanyang University Hospital, 20 cases), Inchon (Gachon Medical Center, 26 cases) and Gwangju (Chonnam University Hospital, 2 cases) from 1998 to 2001 in Korea. All isolates were examined for the presence of tdh/trh genes and ure-ase activity. The serovars of isolates were determined by slide agglutination tests with specific anti-sera (O3:K6/O4:K68). A GS-PCR method, detecting the new O3:K6 clone, was used in this study. RESULTS: All these isolates carried the tdh gene but not the trh gene and did not produce urease. The thirty three of the 48 samples (69%) were positive using the GS-PCR method. Thirty of thirty three cases (91%) were O3:K6 using the slide agglutination test. The three cases (9%) were O4:K68. CONCLUSIONS: We confirmed the epidemicity of the new V. parahaemolyticus O3:K6 using the GS-PCR method in Korea.

A study on the production of allergen panels / 천식및알레르기

BACKGROUND AND OBJECTIVE: The selection of allergen panels is a prerequisite to effectively test for innumerable allergens scattered throughout the environment. However, the selection of the pre-existing panel has been vague and contains some allergens that have not been verified as being common in Korea. This study was aimed to produce allergen panels in Korea. METHODS: For 12 months in 1996, sera were tested by the chemiluminescent assay of Multiple allergen simultaneous test (MAST-CLA: Immunosystems, Mountain view, U.S.A.). A total of 2, 467 specimens that either tested positive or were negative but had high total IgE level were pooled together. The pooled ser a were assayed for 60 allergens supplied by Dexall Acti Tip System (Dexall biomedical Labs. Inc., Gaithersburg, U.S.A.), a recently developed enzyme immunoassay. According to the Allerg Ens Unit (Allergen Unit:AU), 12 of the most frequently encountered and 6 of the leaot frequent allergens with reactions between classes 3 and trace were selected. RESULTS: The 12 most frequently encountered allergens were : Dermatophagoides pteronyssinus, Dermatophagoides farinae, house dust, timothy grass, perennial rye, mugwort, birch, oak, hazel nut, common ragweed, alder and dog dander. The 6 least frequently encountered were : wheat, egg-white, cat epithelium, milk, cockroach and shrimp. CONCLUSION: The 12 allergens we chose proposed to be the minimally required panel of frequently encountered allergens in allergy testing. We conclude that the 12 most frequent allergens should be tested with the total IgE level as a major panel (panel-M) and that the 6 least frequently encountered allergens may be tested separately when needed, as a minor panel (panel-m).

An Evaluation of the Statistical Techniques used in the 1995-1996 editions of the Korean Journal of Clinical Pathology / 대한임상병리학회지

BACKGROUND: Quantitative experiment and analysis of the result with statistical techniques are an essential part of the medical article for acquiring objective confidence. But errors on application, calculation, and interpretation of statistics and insufficient explanation of the used statistical technique deprive the reader of reliance on the article. We identified the statistical errors that were commonly encountered and which researchers and readers should recognize in the Korean Journal of Clinical Pathology (KJCP) in order to improve the quality of the statistics in the article. METHODS: We identified the frequency of the statistical errors from the 193 articles in the 1995 - 1996 editions of the KJCP. There were seven kinds of statistical errors that were most frequently observed. Each different kind of error in the same article were counted separately, but two or more of the same kind of error in an article were counted as one. RESULTS: Seventy-five statistical errors were identified. Seven kind of the most common errors and the observed numbers of the every kind of error were as follow : 1. Using P value without the statistical name (12), 2. Performing t test instead of the analysis of variance (ANOVA) test in comparing the means of three or more groups (11), 3. Omitting the F test on the unpaired t test in small different sized samples (10), 4. Mentioning the statistical technique without using it (9), 5. Mentioning the predictive value without prevalence (7), 6. Not performing multiple comparison after the significant ANOVA test (5), 7. Not using the P value with the correlation coefficient (r) (5). CONCLUSIONS: There were 75 statistical errors in the 1995-1996 editions of the KJCP. Not mentioning the name of the statistical technique used was the most frequently observed error. The authors' careful application of the basic statistics would be the real solution of the problem.

Identification of Mycobacterium Species by Multiplex PCR-Restriction Fragment Length Polymorphism Assay / 감염

BACKGROUND: Recently the clinical significance of several mycobacterial species has been increased and there is a growing need to identify mycobacteria to the species level. We evaluated multiplex polymerase chain reaction (PCR) and restriction fragment length polymorphism (RFLP) assay for identification of mycobacterial isolates. METHODS: Reference strains of 6 species of mycobacteria and 88 clinical isolates were lysed by boiling method. The lysates were used for multiplex PCR reactions incorporating three pairs of PCR primers, which were expected to amplify fragments from the 65-kDa gene common to all mycobacteria, genes of M. tuberculosis complex and M. avium, respectively. The resultant amplicons were digested with the restric-tion enzymes PspEI and HaeIII. Multiplex PCR products and digested products were visualized by electrophoresis on agarose gels. RESULTS: Six reference strains yielded compatible results. Eighty-eight clinical isolates were identified as M. tuberculosis complex (81 strains), M. avium (2 strains), M. intracellulare (2 strains), M. fortuitum biovariant peregrinum (2 strains), and M. gordonae III (1 strain). CONCLUSION: Multiplex PCR-RFLP assay appears to be a reliable method for rapid identification of mycobacteria to species level.

Diagnostic usefulness of serum gamma-glutamyl transferase ( GGT ) activity in fatty liver and relationship with other factors / 대한내과학회지

BACKGROUND: Gamma-glutamyl transferase(GGT) has found wide application as a diagnostic test in hepatobiliary disease, and has been used as the best single marker of alcohol intake. In spite of the wide use of GGT in clinical practice, knowledge concerning the distribution and the determinants of this risk factor in the normal population is spared in Korea. We tried to obtain a better evaluation of specificity of serum GGT by analysis of a large population of health examination. METHODS: GGT was measured in 17,140 males aged 17-86 years and 12,125 females aged 18-90 years screened in a health survey program. RESULTS: In multiple regression analyses, serum GGT level showed strong positive association with fatty liver, body mass index, serum levels of AST, ALT triglyceride, uric acid, alkaline phosphatase, systolic blood pressure, and diastolic blood pressure, and weakly positive association with serum levels of creatinine, total cholesterol, and fasting blood sugar. In females, menopause were positively associated with GGT. CONCLUSIONS: An elevated serum GGT levels is a strong indicator of hepatobiliary dysfunction or fatty liver. However, proper interpretation of a serum GGT elevation should be carefully considered in correlation with clinical data and laboratory findings.

Quantitative Analysis of Urinary Organic Acids by Gas Chromatography-Mass Spectrometry / 대한임상병리학회지

BACKGROUND: Analysis of urinary organic acids is an important procedure for the diagnosis of inherited disorders of amino acid and organic acid metabolism. Analysis of urinary organic acids by gas chromatography-mass spectrometry (GC-MS) were initially developed for qualitative purposes, and quantitative anlytical procedure have seldom been extensively studied if at all. The purpose of this study is to evaluate a quantitative procedure for profiling organic acids with GC-MS. METHODS: Urine samples (1.5 mL) were extracted with ethylacetate, and derivated to trimethylsilyl derivatives. The compounds were analysed with MD-800 GC-MS (Fisons, Manchester, U.K.). The quantitation was done by establishment of calibration curves with the standard solutions of 74 organic acids. A response factor for internal standard was used to quantify organic acids of which the standards were not available. Extraction efficiencies for 51 organic acids were evaluated. Interassay and intraassay imprecisions were estimated from the analysis of two quality control specimens with the different concentrations of organic acids. RESULTS: Extraction efficiencies varied from 7.9 0.2% to 182.7 4.8% according to organic acids. Interassay imprecisions of specimen I and II were 4.1~60.7% and 10.7~84.9%, respectively. Intraassay imprecisions were 1.7~24.3% and 2.8~38.1%, respectively. But interassay imprecisions for clinically important analytes were below 20%. CONCLUSIONS: The described method for quantification of urinary organic acids with GC-MS is a acceptable routine method for screening of urinary organic acids. The result that imprecisions of clinically significant organic acids were less than 20% suggests that the method would be acceptable not only for diagnosis, but also for follow-up.

The Acute Effect of Estrogen on Vascular Responses and Plasma Endothelin-1 Level in Postmenopausal Women

BACKGROUND AND OBJECTIVES: Although estrogen replacement therapy has been associated with reduction of cardiovascular events in postmeno-pausal women (PMW), the underlying mechanisms are pooly understood. Because the beneficial effect of estrogen on vasomotor function and production of vasoconstrictive endothelin-1 may be a mechanism by which cardiovascular disease events are reduced, we accessed the acute effect of estrogen on endothelial dependent, independent vasodilaton and plasma endothelin-1 level and investigated whether the acute effect of estrogen on vascular response is related to reduced circulating plasma endothelin-1 level. MATERIALS AND METHOD: The diameter of the brachial artery at rest, during reactive hyperemia (FMV) and to response to nitroglycerine (NMV) were measured using high resolution ultrasound. Twenty-one PMW, 523 years old, 8 of whom had hypercholesterolemia were included and randomized to receive placebo, conjugated estrogen 2.5 mg and 5.0 mg with one week between each investigation. FMV and plasma endothelin-1 were assessed before and 30 minutes after iv administration of each substance. Sublingual nitroglycerine (NG) was given at the end of each investigation and NMV was measured. RESULTS: FMV and plasma endothelin-1 were not changed after placebo administration. FMV increased sinigicantly only after administration of CE 5.0 mg in healhy PMW and both after administration of CE 2.5 and 5.0 mg in PMW with hypercholesterolemia. NG induced more significant vasodilation after administration of estrogen than placebo in only PMW with hypercholesterolemia. Plasma endothelin-1 level decreased significantly after administration of CE 5.0 mg in PMW with hypercholesterolemia. We could not find direct correlation between increase of FMV and decrease of plasma endothelin-1 level. CONCLUSION: IV administration of conjugated estrogen improves endothelium-dependent vasodilation in PMW and may improve endothelium-independent vasodilation in PMW with hypercholesterolemia. These finding may be partly originated by reduced plasma endothelin-1 level after estrogen administration.

Electron microscopic observation of Chlamydia pneumoniae / 대한임상병리학회지

BACKGROUND: Chlamydia pneumoniae causes pneumonia and upper respiratory tract infection and has been recently reported to be associated with coronary atherosclerosis. The difference between C. pneumoniae and other Chlamydia spp. has been demonstrated by serologic study, DNA analysis and ultrastructural observation. However, studies concerning the developmental cycle of C. pneumoniae are relatively short. This study was conducted to investigate the morphological changes and developmental characteristics of C pneumoniae in the HeLa cell. METHODS: To observe the intracellular inclusion of C. pneumoniae, the cultured HeLa cell monolayer was stained with Jones' iodine and Giemsa. The ultrastructures were examined with an electron microscope at 6, 24, 48, 72 and 96 hr after inoculation of elementary bodies. RESULTS: The C. pneumoniae organisms which formed intracytoplasmic inclusion bodies in HeLa cells were negative on iodine stain. In Giemsa-stained preparation, the inclusion bodies of variable sizes with a bluish purple color were identified in the cytoplasm of infected HeLa cells. After 6 hrs of infection, the elementary bodies with electron-dense spicule shaped substance of C. pneumoniae were enclosed by the HeLa cell membrane and were taken the host cell by endocytosis. After 24 hrs of infection, the electron-dense material in the elementary bodies were disappearing and the elementary bodies were transforming into reticulate bodies. After 48 hrs of infection, the reticulate bodies of C. pneumoniae were seen dividing by binary fission. Small electron-dense round bodies(miniature bodies) appeared near completion of division. After 72 hrs of infection. about half of the reticulate bodies were transformed into elementary bodies. Newly formed elementary bodies had a pear-shaped structure and large periplasmic space. After 96 hrs of infection. mature elementary bodies with condensed electron-dense material and a rigid outer membrane were observed. Miniature bodies were located in the cytoplasm of the elementary bodies. CONCLUSIONS: These unique morphological changes in HeLa cell culture show the developmental characteristics of C. pneumoniae.

Statistical Techniques Used in 1981-1995 Edition of Korean Journal of Clinical Pathology / 대한임상병리학회지

No abstract available.

A case of aplastic anemia induced by D-penicillamine / 대한혈액학회지

No abstract available.