Fimasartan attenuates renal ischemia-reperfusion injury by modulating inflammation-related apoptosis

Fimasartan, a new angiotensin II receptor antagonist, reduces myocyte damage and stabilizes atherosclerotic plaque through its anti-inflammatory effect in animal studies. We investigated the protective effects of pretreatment with fimasartan on ischemia-reperfusion injury (IRI) in a mouse model of ischemic renal damage. C57BL/6 mice were pretreated with or without 5 (IR-F5) or 10 (IR-F10) mg/kg/day fimasartan for 3 days. Renal ischemia was induced by clamping bilateral renal vascular pedicles for 30 min. Histology, pro-inflammatory cytokines, and apoptosis assays were evaluated 24 h after IRI. Compared to the untreated group, blood urea nitrogen and serum creatinine levels were significantly lower in the IR-F10 group. IR-F10 kidneys showed less tubular necrosis and interstitial fibrosis than untreated kidneys. The expression of F4/80, a macrophage infiltration marker, and tumor necrosis factor (TNF)-α, decreased in the IR-F10 group. High-dose fimasartan treatment attenuated the upregulation of TNF-α, interleukin (IL)-1β, and IL-6 in ischemic kidneys. Fewer TUNEL positive cells were observed in IR-F10 compared to control mice. Fimasartan caused a significant decrease in caspase-3 activity and the level of Bax, and increased the Bcl-2 level. Fimasartan preserved renal function and tubular architecture from IRI in a mouse ischemic renal injury model. Fimasartan also attenuated upregulation of inflammatory cytokines and decreased apoptosis of renal tubular cells. Our results suggest that fimasartan inhibited the process of tubular injury by preventing apoptosis induced by the inflammatory pathway.

Moderating Effect of Stress Coping Strategies on the Relationship between a National Statistics Office Workers' Occupational Stress and Mental Health / 신경정신의학

OBJECTIVES: This study examined the moderating effects of stress coping strategies on the relationship between occupational stress of national statistical office workers and mental health. METHODS: Subjects were 133 workers at a regional statistics office. Occupational stress, stress coping strategies, and mental health were examined using the Korean Occupational Stress Scale (KOSS), Ways of Coping Checklist, and The Symptom Check-List-90-R. Stress coping strategies were composed of problem-focused coping, social support coping, emotion-focused coping, and wishful thinking coping. RESULTS: Moderated regression indicated that the social support coping and emotion-focused coping style positively moderated the relationship between occupational stress and mental health in national statistical office workers. The social support coping style positively moderated the relationship between interpersonal conflict (KOSS subscale) and mental health in national statistical office workers. The emotion-focused coping style positively moderated the relationship between job insecurity (KOSS subscale) and mental health in national statistical office workers. The emotion-focused coping style negatively moderated the relationship between job demand (KOSS subscale) and mental health in national statistical office workers. CONCLUSION: The implications of this study included that negative results due to high occupational stress can be varied by use of suitable stress coping strategies.

Job Stress and Stress Coping Strategy among Workers in A Regional Statistics Office : A Preliminary Study / 정신신체의학

OBJECTIVES: The purpose of this preliminary study was to investigate job stress and stress coping strategy among workers in a regional statistics office. METHODS: A total of 133 workers in regional statistics office participated in this study and they were divided into two groups, survey group(n=109) and support group(n=24) depending on relation to statistical survey task. They were asked to respond to Short Form of Korean Occupational Stress Scale(KOSS-SF) and Stress Coping Strategy(SCS) to investigate sociodemographic characteristics, job stress, and stress coping strategy. RESULTS: The proportion of the 133 participants in the sample was 59(44.4%) of men, 74(55.6%) of women. There were no significant differences in KOSS-SF scores in relation to age, sex, education, and marital status, while the KOSS-SF scores were significantly different between the two groups. In regard to the subscales of KOSS-SF, the two groups had significant differences in insufficient job control, interpersonal conflict, job insecurity, and organization system. In addition, the total score of KOSS-SF had a negative correlation with problem-focused coping strategy and social support coping strategy of SCS. CONCLUSIONS: Our results suggest that workers of survey group had more job stress compared to those who works in support group in regional statistical office. In addition, in comparison with workers of support group, both men and women of survey group get stressed when they were confronted with interpersonal conflicts. Our results suggest that using problem-focused coping and social support coping strategy lowers job stress.

The Effect of Adenoviral-mediated Gene Transfer of Bone Morphogenic Protein-7 on Peritoneal Fibrosis in an Animal Model of Peritoneal Dialysis / 대한신장학회지

PURPOSE: TGF-beta-induced epithelial-mesenchymal transition (EMT) is associated with peritoneal fibrosis during PD. We conducted this study to evaluate the effect of BMP-7 adenoviral gene transfer on the functional and structural changes of peritoneum and whether it is associated with peritoneal EMT using an animal PD model. METHODS: Forty Sprague-Dawley rats were divided into five groups; Control (C, n=8), Dialysis (D, n= 8), Rest (R, n=8), BMP-7 (B, n=8) and LacZ (L, n=8) group. Peritoneal function was assessed on baseline, 3rd, 6th, 8th weeks after PD. Immunohistochemistry for TGF-beta, VEGF, laminin and aquaporin-1 was performed in addition to morphometric analysis of peritoneum. Immunofluorescence staining with western blotting for alpha-SMA and E-cadherin, as markers of EMT, was performed. RESULTS: The thickness of submesothelial matrix was highest in D and significantly decreased in B compared to D, R and L. D/D0 glucose at 8 weeks was significantly increased in B and L compared to that of at 6 weeks, but there were no significant differences among R, B and L at 8 weeks. TGF-beta1 and VEGF expression was observed in submesothelial matrix in D and decreased in R, B and L. Peritoneal fibrosis and functional deterioration of peritoneal membrane were associated with EMT, which was partially reversed in R, B and L. CONCLUSIONS: BMP-7 gene transfer to peritoneum was not associated with the additive therapeutic effect on peritoneal function compared to the peritoneal rest, although it improved morphologic changes of peritoneum.

Effects of Lidocaine on the Dose-Response Curve of Cisatracurium / 대한마취과학회지

BACKGROUND: Lidocaine is useful as a local anesthetic and antiarrhythmic agent perioperatively. It may augment a neuromuscular block from both nondepolarizing and depolarizing muscle relaxants. Cisatracurium is a new muscle relaxant as an isomer of atracurium. We investigated the interaction of cisatracurium and lidocaine on the dose-response curve in vitro. METHODS: Institutional approvement was obtained. Forty male Sprague-Dawley rats (150 - 200 gm) were divided into four groups (control, lidocaine 0.01, 0.1, or 1ng/ml). The animals were anesthetized with 40 mg/kg pentobarbital. The hemidiaphragm with the phrenic nerve was dissected and mounted within 5 minutes in a bath containing 100 ml Kreb's solution at 32degreesC. The phrenic nerve was stimulated at supramaximal intensity by a Grass(R) S88 stimulator through an SIU5 isolation unit. A twitch height was measured by a precalibrated Grass FT88 force displacement transducer and recorded with a Grass 79 polygraph. After stabilization of the twitch response, cisatracurium was added to the solution to obtain an initial concentration of 50ng/ml with saline 1 ml or lidocaine 0.01, 0.1 or 1ng/ml. When a stable 3 - 5 twitch inhibition was obtained after the first dose, additional cisatracurium was added to the Kreb's solution in increments of 25ng/ml to more than a 90% neuromuscular block. The data was analyzed by repeated measures of ANOVA. RESULTS: There was a significant decrease in the effective dose of cisatracurium needed to depress the twitch response in lidocaine 0.1ng/ml and 1ng/ml groups compared with the control group and with the lidocaine 0.01ng/ml group. CONCLUSIONS: We concluded that lidocaine will increase the sensitivity to cisatracurium in the hemidiaphragm preparation of rats.

The Effect on the Self-Esteem Promotion Program on Self-Esteem and Mental Health of Adolescents with Minor Delinquency / 간호학회지

This research was performed to investigate the effectiveness of self-esteem promotion program(SEPP) to adolescents with minor delinquency on self-esteem and mental health. Samples of this study were 36 adolescents with signs of minor delinquency in the third grade of middle schools who reside in K city. Data analysis was conducted by chi-square test which tests the general homogeneity between the experiment group and the control group. To test hypothesis how SEPP affects on self-esteem, mental health, and delinquency, paired t-test was performed. The results were summarized as follow; 1. After the experimental treatment, self-esteem score was not statistically significant. 2. After the experimental treatment, mental health score was statistically significant. 3. After the experimental treatment, self reported delinquency score was statistically significant. As the result of this research, the SEPP increased the degree of mental health and decreased that of delinquency of the adolescents who committed minor delinquency. Self-esteem is difficult to be changed by itself in number for a short time, but there is potential effect, which can be expected the preceding changes of mental health and behavior of participants.

Measurement of Auto-PEEP in Anesthetized Patients Using a Laser-Flex Endotracheal Tube with Changes in Respiratory Rates and Tidal Volume / 대한마취과학회지

BACKGROUND: The aim of the present study was to detect and quantify auto-positive end-expiratory pressure (auto-PEEP) in anesthetized patients using a Laser-Flex endotracheal tube (Mallincrodt, ID, 6.0 mm), by comparing the effects of changes in tidal volume and respiratory rate. METHODS: All patients (n = 30) undergoing elective surgery were anesthetized, paralyzed and intubated with a ID 8.0 mm endotracheal tube (n = 10, control), ID 6.0 mm endotracheal tube (n = 10, group S), or ID 6.0 mm Laser-Flex endotracheal tube (n = 10, group L), respectively. After anesthetic induction, ventilator settings using a Siemens Servo 900C were changed for a tidal volume of 8, 10 ml/kg, respiratory rates of 10, 12 or 14 breaths/min. Peak airway pressure was measured and auto-PEEP was quantified using an end-expiratory occlusion method. Data recorded on the Bicore CP-100 pulmonary monitor was transfered to a PC and analyzed by processing software (ANADAT). RESULTS: In group S and L, peak airway pressure and auto-PEEP were higher than control group and increased during an increase in tidal volume (P < 0.05). But they were increased significantly during an increase of respiratory rate, only when the tidal volume was 10 ml/kg (P < 0.05). CONCLUSIONS: There was an increase of auto-PEEP in anesthetized patients using a Laser-Flex endotracheal tube during incremental changes of tidal volume and respiratory rates.

Anesthesia for Noncardiac Surgery in Heart Transplanted Patients: 2 cases report / 대한마취과학회지

With the introduction of cyclosporine, heart transplantation has become a widely accepted treatment for patients with end-stage heart failure. Number of operation increased steadily during recent 6 years with many postoperative follow up cases. A number of survivors are now presenting for non-cardiac surgery. Cardiac transplanted patients present anesthesiologists with challenging problems related to the infection in immunosuppressed patients, rejection phenomena, denervated heart pathophysiology with altered hemodynamic function of their own and under circumstances of stress and drug therapies. We experienced 2 cases of general anesthesia for noncardiac surgery in heart transplanted patients without important hemodynamic changes. Preoperative evaluation including heart status, rejection, immunosuppressive drug therapy and its complications is mandatory. These patients present few problems during anesthesia if adequate hydration, aseptic technique, selection of proper vasoactive drugs are provided.

Effects of Atracurium in the Patients with Myasthenia Gravis Undergoing Thymectomy / 대한마취과학회지

BACKGROUND: Myasthenia gravis is an autoimmune neuromuscular disorder that shows increased sensitivity to nondepolarizing muscle relaxants. Atracurium is eliminated by Hofmann elimination and ester hydrolysis. We studied the onset and duration of atracurium in patients with myasthenia gravis. METHODS: Ten patients undergoing thymectomy for myasthenia gravis and ten patients of ASA Class I-II without liver, kidney and neuromuscular disease for orthopedic surgical procedures were assigned. Anesthesia was induced with thiopental (4~5 mg/kg) and maintained with inhalation of N2O:O2 (1:1) and enflurane (1.0~2.0 vol%). Atracurium (0.5 mg/kg) was given as a muscle relaxant and then intubation was performed after twitch response was depressed more than 80%. Neuromuscular relaxation was assessed by TOF (T1) at the adductor pollicis with supramaximal stimulation of ulnar nerve at 2 Hz every 12 seconds. The onset and the duration of 5, 25, 50, 75% recovery time of T1 and the recovery index were recorded. RESULTS: Onset of block was shortened and recovery time of 5, 25, 50, 75% and recovery index were prolonged in patients with myasthenia gravis. Conlusions: In patients with myasthenia gravis, atracurium induced rapid onset time and prolonged recovery time of 5, 25, 50, 75% and recovery index.

A Survey on Anthropometric and Nutritional Status of children in Three Different Kinds of Kindergartens in Cheonan

According to economical status, malnutrition and overnutrition coexist among preschool children in Korea. Malnutrition have been a serious problem for children in some of rural. Many children have deficiencies of some nutrients such as riboflavin A, and simultaneously they have overcarloric intakes with empty calorie foods. Preschool children have nutritional problems which can affect the growth and development. To investigate whether nutritional intakes can influence on the growth or not, nutritional intakes and anthropometric measurements were determined for infants aged 4~6 years old in three different kinds of preschools. Daily nutrient intakes were calculated by the combination of a direct measurement and 24 hour recall, and the diet consumption patterns were determined by diet quality index. Overall growth of infants in Cheonan area was under the normal growth in Korea. Preschool children in orphanage consumed almost all nutrients much less than the recommended daily allowances, on the other hands, children in private preschool had over-intakes of nutrients when it is compared with the daily requirements. However, the scores of the diet quality index were similar in three preschools since children in private preschool consumed more fat and junk food than those in orphanage. The weight and height of preschool children in orphanage was lower than those in private preschools. This was due to the lower consumption of the important nutrients in infants in orphanage. The consumption of all nutrients except fat did not show any correlation with height or weight. The quality index of fat, cholesterol, grains and protein intakes was higher in children in private preschool than in orphanage. In conclusions, 1)the private preschool children had worse nutrient intake patterns. Better consumption of vitamin B2, calcium and grains were, bigger height and chest circumferences children obtained. 2)Since most of energy intake of preschool children came from junk foods, they needed to consume more supplementation of vitamins and minerals, which is necessary for normal growth. 3)It is desirable for the children to cut down junk foods and empty calorie foods.