Validity and Utility of 6-minute-walk Test and WALK(Walking-Stair-Climbing) Test to Assess the Exercise Capacity in Hemodialysis Patients / 대한신장학회잡지

The survival rate in ESRD patients is increased in recent several years. Therefore the Quality of Life and rehabilitation became more important. To evaluate the validity and utility of the walk performance test such as the 6-minute-walk test and WALK test as a substitute of exercise ergometry, we examined the cycle ergometer-graded exercise test for physiologic exercise capacity(VO2max) and walk performance test in hemodialysis patients. The walk performance test was done 3 times of at least 48 hour interval before dialysis in randomly sampled 21 patients. The cycle ergometer-graded exercise test was done in interdialysis day. The result was as following : 1) The mean distance of 6 minute walk test was 472.6+/-105.2m(1st 448.9+/-111.6m, 2nd 479.1+/-89.8m, 3rd 489.9+/-113.4m) and Ratings of Perceived Exertion (RPE) overall 10.4+/-1.7(1st 10.3+/-2.1, 2nd 10.5+/-1.6, 3rd 10.5+/-1.6) and RPE leg 11.2+/-2.7(1st 11.0+/-2.8, 2 nd 11.1+/-2.5, 3rd 11.4+/-2.8). The difference between the test was not significant. 2) The mean time of walking-stair-climbing test was 62.9+/-5.0sec(1st 64.9+/-5.7sec, 2nd 61.9+/-5.7sec, 3rd 61.8+/-5.6sec) and RPE overall 10.7+/-1.9(1st 10.7+/-2.2, 2nd 10.9+/-2.3, 3rd 10.5+/-1.2) and RPE leg 10.9+/-2.7(1st 11.1+/-2.9, 2nd 10.9+/-2.6, 3rd 10.8+/-2.6). The difference between the test was not significant. 3) The VO2max was 13.8+/-5.3mL/kg/min and 46.5+/-14.8% of predicted value. 4) At the finish of the cycle ergometer-graded exercise test, the heart rate did not increase over 100 bpm in 13 patients. 5) The VO2max was significantly correlated with the age(r=-0.604, p<0.01), WALK test(r=-0.453, p<0.05), 6 minute walk test(r=0.561, p<0.05). In conclusion, the 6 minute walk test and WALK test are simple, reliable tests to assess the exercise capacity and predict VO2max in hemodialysis patients.

Validity and Utility of 6-minute-walk Test and WALK(Walking-Stair-Climbing) Test to Assess the Exercise Capacity in Hemodialysis Patients / 대한신장학회잡지

The survival rate in ESRD patients is increased in recent several years. Therefore the Quality of Life and rehabilitation became more important. To evaluate the validity and utility of the walk performance test such as the 6-minute-walk test and WALK test as a substitute of exercise ergometry, we examined the cycle ergometer-graded exercise test for physiologic exercise capacity(VO2max) and walk performance test in hemodialysis patients. The walk performance test was done 3 times of at least 48 hour interval before dialysis in randomly sampled 21 patients. The cycle ergometer-graded exercise test was done in interdialysis day. The result was as following : 1) The mean distance of 6 minute walk test was 472.6+/-105.2m(1st 448.9+/-111.6m, 2nd 479.1+/-89.8m, 3rd 489.9+/-113.4m) and Ratings of Perceived Exertion (RPE) overall 10.4+/-1.7(1st 10.3+/-2.1, 2nd 10.5+/-1.6, 3rd 10.5+/-1.6) and RPE leg 11.2+/-2.7(1st 11.0+/-2.8, 2 nd 11.1+/-2.5, 3rd 11.4+/-2.8). The difference between the test was not significant. 2) The mean time of walking-stair-climbing test was 62.9+/-5.0sec(1st 64.9+/-5.7sec, 2nd 61.9+/-5.7sec, 3rd 61.8+/-5.6sec) and RPE overall 10.7+/-1.9(1st 10.7+/-2.2, 2nd 10.9+/-2.3, 3rd 10.5+/-1.2) and RPE leg 10.9+/-2.7(1st 11.1+/-2.9, 2nd 10.9+/-2.6, 3rd 10.8+/-2.6). The difference between the test was not significant. 3) The VO2max was 13.8+/-5.3mL/kg/min and 46.5+/-14.8% of predicted value. 4) At the finish of the cycle ergometer-graded exercise test, the heart rate did not increase over 100 bpm in 13 patients. 5) The VO2max was significantly correlated with the age(r=-0.604, p<0.01), WALK test(r=-0.453, p<0.05), 6 minute walk test(r=0.561, p<0.05). In conclusion, the 6 minute walk test and WALK test are simple, reliable tests to assess the exercise capacity and predict VO2max in hemodialysis patients.

Immunogenicity and safety of recombinant hepatitis B vaccine (HG-II) in healthy adults according to 0-1-2 months vaccination schedule / 대한내과학회지

BACKGROUND: Green Cross HG-II vaccine is recombinant hepatitis B vaccine derived from yeast Hansenula polymorpha. Its immunogenicity and safety using 0-1-6 months vaccination schedule were proven. This prospective study is conducted to evaluate immunogenicity and safety of HG-II according to 0-1-2 months schedule. METHODS: 20 g of HG-II vaccine was given intramuscularly at 0, 1, and 2 months to 118 healthy adults seronegative for hepatitis B markers. Sera were assessed for anti-HBs by radioimmunoassay at 1 months and 7-10 months after completion of vaccination. RESULTS: 113 of 118 (95.8%) completed vaccination schedules. The seroconversion rate at 1 month after completion of vaccination was 93.8% (106/113) and protective titers of anti-HBs developed in 82.3% (93/113). The geometric mean titer (GMT) of anti-HBs was 64.91 mIU/ml in all seroconverted vaccinee. There was no incapacitating serious side effect associated with vaccinations. The seropositive rate at 7-10 months after vaccination was 95.3% (81/85) with protective rate of 84.7% (72/85). The anti-HBs titers were decreased in 51.8% (44/85) of vaccinee. The GMT was 80.04 mIU/ml. The protective rate and GMT were 98.0%, 129.43 mIU/ml in the group with anti-HBs titer > or = 50 mIU/ml at 1 month after vaccination, and 64.71%, 19.62 mIU/ml in the group with anti-HBs <50 mIU/ml. CONCLUSION: Green Cross HG-II vaccine is safe and effective in protecting hepatitis B at 0-1-2 months vaccination schedule. However, the booster injection should be recommended for maintenance of immunogenicity, especially in the vaccinee with anti-HBs titer less than 50 mIU/ml at 1 month after vaccination.

Actinobacillus actinomycetemcomitans Indeces Apoptosis of Jurkat Cell Line Through the Cleavage of Poly (ADP-ribose) Polymerase

No abstract available.

Identification of a Lymphocyte Mitogenic Factor Produced by Actinobacillus actinomycetemcomitans

Actinobacillus actinomycetemcomitans, a gram-negative, capnophiTic bacterium, is associated with several human diseases including periodontal disease. Products of A. actinomycetemcomitans exert immunomodulatory effects on various lymphoid populations, some of which may be implicated in the pathogenesis of periodontitis. It has been recently suggested that some of periodontopathic bacterial products might possess superantigenic (SAg) activities. In order to examine SAg activity of A. actinomycetemcomitans, we tried to purify immunomodulating factor (IMF) which can induce proliferation of mouse splenocytes and human PBMC. IMF fraction was obtained from the culture supernatant of A. actinomycetemcomitans by alcohol precipitation, ultrafiltration, size exclusion chromatography, and dye ligand affinity chromatography which has been widely used for the puri5cation of known SAgs. SDS-PAGE analysis showed that the factor migrated to a molecular mass of 40 kDa. The concentration of IMF which elicited maximal proliferative response of mouse splenocytes was ranged 1-10 ug/ml of protein on day 3 in culture. Human PBMC gave a similar response profile to IMF, but their maximal response was obtained by lower concentraion of IMF on day 2 in culture. This activity of IMF was heat and proteinase K sensitive and was not blocked by co-incubation with polymyxin B, a ligand for the lipid A region of lipopolysaccharide. T cell-enriched fraction of mouse splenocytes obtained by nylon wool column lost the response to IMF. Even though mitomycin C-treated antigen presenting cells were added to T cell-enriched fraction, the response to IMF was feeble as compared to unfractionated cells. Splenocytes depleted of T cells by anti-Thy 1.2 and complement also did not respond to IMF. These findings demonstrated that T cells are responsible for a minor proportion of the observed proliferation induced by IMF and the help of these cells are essential to the most of the proliferating cells which may be B cells. This observation was confirmed by flow cytometric analysis of responding lymphocyte subpopulations. These results indicate that IMF of A. actinomycetemcomitans does not act in a manner consistent with known SAgs but is more relevant to the explanation of pathologic findings of periodontal lesions.

Thre Cases of Mucinous Ductal Ectasia of the Pancreas Which Were Diagnosed by Duodenoscopic Findings / 대한소화기내시경학회지

We have experienced three cases of mucinous ductal ectasia of the pancreas. They showed the characteristic duodenoscopic findings and underlying pathology was hyperplasia in two cases and adenocarcinoma in one case. When endoscopic retrograde pancreatography was performed, bulging ampulla of Vater, patulous ampullary orifice and mucus leakage from papillary orifice were noted. Also cyst-like dilatation of main duct or side branch of the uncinate process were observed.

Acetylcholine Induced Coronary Spasm in Patients with Acute Myocardial Infarction with Angiographically Normal or Near Normal Coronary Arteries

Recent studies suggest that coronary endothelial dysfunction in atherosclerosis may contribute to the predisposition both for coronary spasm as well as for thrombus formation. The integrity of at least one aspect of endothelial function can be assessed by the intracoronary administration of acetylcholine. Eleven(13.4%, mean age 48+13, male 11) out of 82 consecutive patients with acute myocardial infarction showed angiographically normal or near normal coronary arteries at 7~10 in-hospital days. Ten(91%) had history of heavy smoking and 7 patients(64%) had no history of previous angina. Anterior myocardial infarction was in 8 and inferior in 3 patients. After intracoronary administration of acetylcholine(incremental dose of 20, 50ug for the right and 20, 50, 100ug for the left), 9(82) of 11 infarct related arteries showed total or subtotal occlusion, but only in 3(17%) out of 18 non-infarct related arteries of 10 patients. Multivessel spasm was noticed in 3. Ergonovine test(graded doses of 0.05, 0.1 and 0.2 mg intravenously) was performed 30 minutes after completion of acetylcholine test in 5 patients. In 1 patients, acetylcholine test was positive and but ergonovine test was negative. Conclusion : 1) Eleven(13.4%) out of 82 patients with acute myocardial infarction had angiographically normal coronary arteries. 2) Ach positive responses of infarct-related arteries are more frequent(82%) than that of non-infarct related arteries(17%), suggesting that the infarction might be related to coronary artery spasm. 3) Positive Ach responses of non-infarct related arteries occurred in 30% of Patients. 4) Ach and Erg induced vasospasm developed at the same site in 5, which suggests that local hyperreactivity might be related to spasm.