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1.
Article in English | WPRIM | ID: wpr-926836

ABSTRACT

BACKGROUND/OBJECTIVES@#The effectiveness of natural compounds in improving athletic ability has attracted attention in both sports and research. Gynostemma pentaphyllum (Thunb.) leaves are used to make traditional herbal medicines in Asia. The active components of G.pentaphyllum, dammarane saponins, or gypenosides, possess a range of biological activities. On the other hand, the anti-fatigue effects from G. pentaphyllum extract (GPE) and its effective compound, gypenoside L (GL), remain to be determined.MATERIALS/METHODS: This study examined the effects of GPE on fatigue and exercise performance in ICR mice. GPE was administered orally to mice for 6 weeks, with or without treadmill training. The biochemical analysis in serum, glycogen content, mRNA, and protein expressions of the liver and muscle were analyzed. @*RESULTS@#The ExGPE (exercise with 300 mg/kg body weight/day of GPE) mice decreased the fat mass percentage significantly compared to the ExC mice, while the ExGPE showed the greatest lean mass percentage compared to the ExC group. The administration of GPE improved the exercise endurance and capacity in treadmill-trained mice, increased glucose and triglycerides, and decreased the serum creatine kinase and lactate levels after intensive exercise. The muscle glycogen levels were higher in the ExGPE group than the ExC group. GPE increased the level of mitochondrial biogenesis by enhancing the phosphorylation of peroxisome proliferator-activated receptor-γ coactivator-1α (PGC-1α) protein and the mRNA expression of nuclear respiratory factor 1, mitochondrial DNA, peroxisome proliferatoractivated receptor-δ, superoxide dismutase 2, and by decreasing the lactate dehydrogenase B level in the soleus muscle (SOL). GPE also improved PGC-1α activation in the SOL significantly through AMPK/p38 phosphorylation. @*CONCLUSIONS@#These results showed that GPE supplementation enhances exercise performance and has anti-fatigue activity. In addition, the underlying molecular mechanism was elucidated. Therefore, GPE is a promising candidate for developing functional foods and enhancing the exercise capacity and anti-fatigue activity.

2.
Article in English | WPRIM | ID: wpr-918634

ABSTRACT

BACKGROUND/OBJECTIVES@#Peroxisome proliferator-activated receptor-gamma co-activator-1α (PGC-1α) has a central role in regulating muscle differentiation and mitochondrial metabolism. PGC-1α stimulates muscle growth and muscle fiber remodeling, concomitantly regulating lactate and lipid metabolism and promoting oxidative metabolism.Gynostemma pentaphyllum (Thumb.) has been widely employed as a traditional herbal medicine and possesses antioxidant, anti-obesity, anti-inflammatory, hypolipemic, hypoglycemic, and anticancer properties. We investigated whether G. pentaphyllum extract (GPE) and its active compound, gypenoside L (GL), affect muscle differentiation and mitochondrial metabolism via activation of the PGC-1α pathway in murine C2C12 myoblast cells.MATERIALS/METHODS: C2C12 cells were treated with GPE and GL, and quantitative reverse transcription polymerase chain reaction and western blot were used to analyze the mRNA and protein expression levels. Myh1 was determined using immunocytochemistry.Mitochondrial reactive oxygen species generation was measured using the 2′7′-dichlorofluorescein diacetate assay. @*RESULTS@#GPE and GL promoted the differentiation of myoblasts into myotubes and elevated mRNA and protein expression levels of Myh1 (type IIx). GPE and GL also significantly increased the mRNA expression levels of the PGC-1α gene (Ppargc1a), lactate metabolismregulatory genes (Esrra and Mct1), adipocyte-browning gene fibronectin type III domaincontaining 5 gene (Fndc5), glycogen synthase gene (Gys), and lipid metabolism gene carnitine palmitoyltransferase 1b gene (Cpt1b). Moreover, GPE and GL induced the phosphorylation of AMP-activated protein kinase, p38, sirtuin1, and deacetylated PGC-1α. We also observed that treatment with GPE and GL significantly stimulated the expression of genes associated with the anti-oxidative stress response, such as Ucp2, Ucp3, Nrf2, and Sod2/i>. @*CONCLUSIONS@#The results indicated that GPE and GL enhance exercise performance by promoting myotube differentiation and mitochondrial metabolism through the upregulation of PGC-1α in C2C12 skeletal muscle.

3.
Article in Korean | WPRIM | ID: wpr-894551

ABSTRACT

Immunoglobulin G4 (IgG4)-related kidney disease is a chronic immune-mediated fibro-inflammatory disorder characterized by multiple organ infiltration with IgG4-positive plasma cells, storiform fibrosis, and obliterative phlebitis or tumefactive lesions. Previous studies have explored IgG4-related kidney disease, increasing our understanding of its clinical manifestations, and pathological and radiologic findings. However, IgG4-related kidney disease can be misdiagnosed since it mimics malignancies. We report a case of a 77-year-old Korean man diagnosed with IgG4-related kidney disease with membranous proliferative glomerulonephritis, presenting with a renal pelvic mass suspected of being malignant.

4.
Korean Journal of Medicine ; : 139-142, 2021.
Article in English | WPRIM | ID: wpr-894534

ABSTRACT

Hypokalemia is a common finding in various clinical settings; it is associated with diuretic use and loss of potassium via the gastrointestinal tract. Less common causes are renal tubular acidosis, diabetic ketoacidosis, excess insulin, primary hyperaldosteronism, and medications, such as amphotericin B. Nafcillin, a narrow-spectrum penicillin class antibiotic, which is selectively prescribed for methicillin-susceptible Staphylococcal aureus infections, and is commonly associated with gastrointestinal side effects, such as nausea, vomiting, and abdominal pain. However, in rare cases it can cause hypokalemia, which is usually overlooked. Severe hypokalemia was detected in a 59-year-old male patient hospitalized due to traumatic cerebral hemorrhage who received 12 g of nafcillin per day for more than 2 weeks for sepsis caused by methicillin-sensitive Staphylococcus epidermidis. We confirmed the association between nafcillin and hypokalemia through further evaluation and a review of the relevant literature. Clinicians should be aware of hypokalemia as a complication when using high doses of nafcillin.

5.
Article in English | WPRIM | ID: wpr-894071

ABSTRACT

A 73-year-old male patient undergoing hemodialysis showed an abnormal liver function test after the transfusion of two units of red blood cell (RBC). The results of the pre-transfusion test were negative HBsAg and positive anti-HBs. On the other hand, the results of the post-transfusion test were positive HBsAg and negative anti-HBs. The other test results were positive HBeAg, positive HBV DNA, and positive anti-HBc IgG. It was reported as a blood transfusion reaction in doubt of a transfusion-transmitted hepatitis B virus (HBV) infection. An examination of the blood information management system data, health insurance data, medical records, and test of storage samples showed that it was not a blood transfusion reaction. It was believed to be an occult HBV infection in an immunosuppressive patient receiving hemodialysis. Hemodialysis patients have a high prevalence of hepatitis B and C, and are classified as a risk group of occult infections. This raises the need for HBV vaccination in dialysis patients. Virus infections can be activated in dialysis patients due to the patient's immune system and other causes. If a blood transfusion is performed during this period, attention is needed because it can be mistaken for viral transmission from blood products.

6.
Article in Korean | WPRIM | ID: wpr-902255

ABSTRACT

Immunoglobulin G4 (IgG4)-related kidney disease is a chronic immune-mediated fibro-inflammatory disorder characterized by multiple organ infiltration with IgG4-positive plasma cells, storiform fibrosis, and obliterative phlebitis or tumefactive lesions. Previous studies have explored IgG4-related kidney disease, increasing our understanding of its clinical manifestations, and pathological and radiologic findings. However, IgG4-related kidney disease can be misdiagnosed since it mimics malignancies. We report a case of a 77-year-old Korean man diagnosed with IgG4-related kidney disease with membranous proliferative glomerulonephritis, presenting with a renal pelvic mass suspected of being malignant.

7.
Korean Journal of Medicine ; : 139-142, 2021.
Article in English | WPRIM | ID: wpr-902238

ABSTRACT

Hypokalemia is a common finding in various clinical settings; it is associated with diuretic use and loss of potassium via the gastrointestinal tract. Less common causes are renal tubular acidosis, diabetic ketoacidosis, excess insulin, primary hyperaldosteronism, and medications, such as amphotericin B. Nafcillin, a narrow-spectrum penicillin class antibiotic, which is selectively prescribed for methicillin-susceptible Staphylococcal aureus infections, and is commonly associated with gastrointestinal side effects, such as nausea, vomiting, and abdominal pain. However, in rare cases it can cause hypokalemia, which is usually overlooked. Severe hypokalemia was detected in a 59-year-old male patient hospitalized due to traumatic cerebral hemorrhage who received 12 g of nafcillin per day for more than 2 weeks for sepsis caused by methicillin-sensitive Staphylococcus epidermidis. We confirmed the association between nafcillin and hypokalemia through further evaluation and a review of the relevant literature. Clinicians should be aware of hypokalemia as a complication when using high doses of nafcillin.

8.
Article in English | WPRIM | ID: wpr-901775

ABSTRACT

A 73-year-old male patient undergoing hemodialysis showed an abnormal liver function test after the transfusion of two units of red blood cell (RBC). The results of the pre-transfusion test were negative HBsAg and positive anti-HBs. On the other hand, the results of the post-transfusion test were positive HBsAg and negative anti-HBs. The other test results were positive HBeAg, positive HBV DNA, and positive anti-HBc IgG. It was reported as a blood transfusion reaction in doubt of a transfusion-transmitted hepatitis B virus (HBV) infection. An examination of the blood information management system data, health insurance data, medical records, and test of storage samples showed that it was not a blood transfusion reaction. It was believed to be an occult HBV infection in an immunosuppressive patient receiving hemodialysis. Hemodialysis patients have a high prevalence of hepatitis B and C, and are classified as a risk group of occult infections. This raises the need for HBV vaccination in dialysis patients. Virus infections can be activated in dialysis patients due to the patient's immune system and other causes. If a blood transfusion is performed during this period, attention is needed because it can be mistaken for viral transmission from blood products.

9.
Korean Journal of Medicine ; : 404-408, 2020.
Article in Korean | WPRIM | ID: wpr-894518

ABSTRACT

Dapagliflozin is a recently developed oral anti-diabetic drug and SGLT2 inhibitor with well-known cardioprotective and renoprotective effects. Although a reduction of the glomerular filtration rate is induced by volume depletion and tubule-glomerular feedback during the early period after administering a SGLT2 inhibitor, the renal prognosis improves more with a decrease of proteinuria. However, the risk of acute kidney injury increases in heart failure and hypovolemia patients, and in those taking certain drugs, such as non-steroidal anti-inflammatory drugs, angiotensin-converting enzyme inhibitor/angiotensin II receptor blockers, or diuretics. We report acute kidney injury after dapagliflozin administration in a diabetic patient with acute cerebral infarction accompanied by right hemiplegia, motor aphasia, and dysphagia.

10.
Article | WPRIM | ID: wpr-831876

ABSTRACT

Gut microorganisms play critical roles in both maintaining host homeostasis and the development of diverse diseases. Gut dysbiosis, an alteration of the composition and function of gut microorganisms, is commonly seen in patients with chronic kidney disease (CKD). CKD itself contributes to a disruption of the symbiotic relationship between the gut microbiota and the host, while the resulting gut dysbiosis may play a part in stage progression of CKD. This bidirectional relationship supports the concept that the gut microbiota is considered a novel focus for the pathogenesis and management of CKD. This article examines the interaction between the gut microbiota and the kidney, the mutual effects of dysbiosis and CKD, and possible treatment options to restore gut eubiosis, and reduce CKD progression and its related complications.

11.
Korean Journal of Medicine ; : 404-408, 2020.
Article in Korean | WPRIM | ID: wpr-902222

ABSTRACT

Dapagliflozin is a recently developed oral anti-diabetic drug and SGLT2 inhibitor with well-known cardioprotective and renoprotective effects. Although a reduction of the glomerular filtration rate is induced by volume depletion and tubule-glomerular feedback during the early period after administering a SGLT2 inhibitor, the renal prognosis improves more with a decrease of proteinuria. However, the risk of acute kidney injury increases in heart failure and hypovolemia patients, and in those taking certain drugs, such as non-steroidal anti-inflammatory drugs, angiotensin-converting enzyme inhibitor/angiotensin II receptor blockers, or diuretics. We report acute kidney injury after dapagliflozin administration in a diabetic patient with acute cerebral infarction accompanied by right hemiplegia, motor aphasia, and dysphagia.

12.
Article in English | WPRIM | ID: wpr-716081

ABSTRACT

Hepatitis C virus (HCV) infection in chronic kidney disease (CKD) is associated with increased liver-related morbidity and mortality rates, accelerated progression to end-stage renal disease, and risk of cardiovascular events. CKD patients with HCV infection require antiviral therapy. Pegylated interferon (peg-IFN) plus ribavirin was the standard of care for HCV-infected CKD patients before the introduction of first-generation direct-acting antiviral (DAA) oral anti-HCV agents. Peg-IFN-based treatment has a low virologic response rate and poor compliance, resulting in a high dropout rate. Recently, several clinical trials of all-DAA combination regimens have reported excellent antiviral efficacy and few adverse drug reactions in HCV-infected patients with CKD. These positive results have revolutionized the treatment of chronic HCV infection in this population. In this review, we address the impact of chronic HCV infection in CKD patients, and discuss their management using next-generation DAAs.


Subject(s)
Compliance , Drug-Related Side Effects and Adverse Reactions , Hepacivirus , Hepatitis C , Hepatitis , Humans , Interferons , Kidney Failure, Chronic , Kidney Transplantation , Mortality , Renal Insufficiency, Chronic , Ribavirin , Standard of Care
14.
Article in English | WPRIM | ID: wpr-715282

ABSTRACT

The nutritional support of acutely ill patients is very important and early enteral nutrition is recommended. Feeding via the nasogastric route is used widely for its ease of access if the patient cannot maintain volitional food intake. If the position of the tip or side holes of the nasogastric tube (NGT) is above the gastroesophageal junction, there is the possibility of retention and solidification of the administered enteral feeding formula in the esophagus. Therefore, the tip of the NGT should be checked carefully; a chest radiograph to confirm its position can be considered, especially in patients with a higher risk of aspiration and gastroesophageal reflux. In addition, careful consideration of the risk factors that can trigger esophageal obstruction is required when feeding patients in the intensive care unit. This paper describes two unusual cases of esophageal obstruction caused by the solidification of residue of an enteral feeding formula.


Subject(s)
Eating , Enteral Nutrition , Esophagogastric Junction , Esophagus , Gastroesophageal Reflux , Humans , Intensive Care Units , Nutritional Support , Radiography, Thoracic , Risk Factors
15.
Article in English | WPRIM | ID: wpr-716444

ABSTRACT

BACKGROUND/OBJECTIVE: There is intense interest in soy isoflavone as a hormone replacement therapy for the prevention of postmenopausal osteoporosis. A new kind of isoflavone-enriched whole soy milk powder (I-WSM) containing more isoflavones than conventional whole soy milk powder was recently developed. The aim of this study was to investigate the effects of I-WSM on bone metabolism in ovariectomized mice. MATERIALS/METHODS: Sixty female ICR mice individually underwent ovariectomy (OVX) or a sham operation, and were randomized into six groups of 10 animals each as follows: Sham, OVX, OVX with 2% I-WSM diet, OVX with 10% I-WSM diet, OVX with 20% I-WSM diet, and OVX with 20% WSM diet. After an 8-week treatment period, bone mineral density (BMD), calcium, alkaline phosphatase (ALP), tartrate-resistant acid phosphatase (TRAP) 5b, osteocalcin (OC), procollagen 1 N-terminal propeptide (P1NP), and osteoprotegenin (OPG) were analyzed. RESULTS: BMD was significantly lower in the OVX group compared to the Sham group but was significantly higher in OVX + 10% I-WSM and OVX + 20% I-WSM groups compared to the OVX group (P < 0.05). Serum calcium concentration significantly increased in the OVX + 10% and 20% I-WSM groups. Serum ALP levels were significantly lower in the OVX + 10% and 20% I-WSM groups compared to the other experimental groups (P < 0.05). OC was significantly reduced in the OVX group compared to the Sham group (P < 0.05), but a dose-dependent increase was observed in the OVX groups supplemented with I-WSM. P1NP and OPG levels were significantly reduced, while TRAP 5b level was significantly elevated in the OVX group compared with the Sham group, which was not affected by I-WSM (P < 0.05). CONCLUSIONS: This study suggests that I-WSM supplementation in OVX mice has the effect of preventing BMD reduction and promoting bone formation. Therefore, I-WSM can be used as an effective alternative to postmenopausal osteoporosis prevention.


Subject(s)
Acid Phosphatase , Alkaline Phosphatase , Animals , Bone Density , Bone Remodeling , Calcium , Diet , Female , Functional Food , Hormone Replacement Therapy , Humans , Isoflavones , Metabolism , Mice , Mice, Inbred ICR , Osteocalcin , Osteogenesis , Osteoporosis, Postmenopausal , Ovariectomy , Procollagen , Soy Milk , Soybeans
16.
Article in Korean | WPRIM | ID: wpr-719790

ABSTRACT

OBJECTIVE: The purpose of this study was to describe and understand self-care status of the aged diabetic patients with noncompliance after hospital discharge. METHODS: A qualitative research method was used for the study design. The participants were 15 diabetic patients aged 65 or older who had been admitted more than two times for hyperglycemia in the past 1 year in a general hospital in Daegu. Data were collected from November 1 2015 to March 1 2016 through in-depth personal interview. RESULTS: Patients' knowledge level on causes and symptoms of diabetes was low. Most participants rarely and irregularly checked blood sugar at home. They were under a lot of stress from their family. Due to old age and illness they did not have sufficient physical activity and they have had rarely regular meals. They considered the self-care education program unnecessary and there was limitations of accessibility for education. CONCLUSIONS: The aged diabetic patients who had the repeat admission did not perform self-care activities properly and had problems especially in blood glucose check, support from their family, and health education after returning home. More personalized and community-based self-management education programs will be necessary.


Subject(s)
Blood Glucose , Education , Health Education , Hospitals, General , Humans , Hyperglycemia , Meals , Methods , Motor Activity , Qualitative Research , Self Care
17.
Article in English | WPRIM | ID: wpr-16851

ABSTRACT

BACKGROUND: Although the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation has been recommended for accurate estimates of glomerular filtration rate (eGFR), there is little information regarding differences in GFR estimates obtained using the Cockcroft-Gault (CG) or Modification of Diet in Renal Disease (MDRD) equations in East Asian cancer patients. We investigated discrepancies in GFR and toxicities in patients treated with cisplatin-based chemotherapy using three equations equations. METHODS: A total of 229 patients were retrospectively recruited. We calculated eGFR using the three equations and separated patients into three categories based on GFR 50 (group C) mL/min/1.73m2. We analyzed chemotherapy toxicities. RESULTS: The mean eGFR calculated using the CG was the lowest of the values derived using the three equations. Estimates using the MDRD and CKD-EPI equations resulted in reclassifying 32 (71.1%) and 33 (73.3%) of 45 patients, originally placed in group B using the CG into group C. However, only 1 (7.7%) of 13 patients placed in group B using the MDRD were reclassified into group C using the CKD-EPI. Twenty-eight of 45 patients classified into group B using the CG equation were treated with reduced doses of cisplatin. However, these patients did not show significant differences in toxicities compared with other patients taking full doses of cisplatin. CONCLUSION: The CG equations underestimated GFR compared to the MDRD and CKD-EPI equations. Therefore, when GFR is estimated using CG equations, East Asian cancer patients may receive insufficient doses of chemotherapeutic agents, including cisplatin.


Subject(s)
Asians , Cisplatin , Cooperative Behavior , Diet , Drug Therapy , Epidemiology , Glomerular Filtration Rate , Humans , Renal Insufficiency, Chronic , Retrospective Studies
18.
Article in English | WPRIM | ID: wpr-218947

ABSTRACT

BACKGROUND: Volume overload results in higher mortality rates in patients on continuous ambulatory peritoneal dialysis (CAPD). The ratio of bioimpedance (RBI) might be a helpful parameter in adjusting dry body weight in CAPD patients. This study examined whether it is possible to distinguish between non-hypervolemic status and hypervolemic status in CAPD patients by using only RBI. METHODS: RBI was calculated as follows: RBI = impedance at 50 kHz/impedance at 500 kHz. Based on the experts’ judgements, a total of 64 CAPD patients were divided into two groups, a non-hypervolemic group and a hypervolemic group. The RBI was measured from right wrist to right ankle (rw-raRBI) by bioimpedance spectroscopy (BCM®, Fresenius Medical Care) before and after the peritosol was emptied. Other RBIs were measured from the right side of the anterior superior iliac spine to the ipsilateral ankle (rasis-raRBI) to control for the electro-physiological effects of peritoneal dialysate. RESULTS: The mean rw-raRBI of non-hypervolemic patients was higher than that of hypervolemic patients in the presence (1.141 ± 0.022 vs. 1.121 ± 0.021, P < 0.001) of a peritosol. Likewise, the mean rasis-raRBI of non-hypervolemic patients was higher than that of hypervolemic patients (presence of peritosol: 1.136 ± 0.026 vs. 1.109 ± 0.022, P < 0.001; absence of peritosol: 1.131 ± 0.022 vs. 1.107 ± 0.022, P < 0.001). CONCLUSION: The volume status of CAPD patients was able to be simply expressed by RBI. Therefore, this study suggests that when patients cannot be analyzed using BCM, RBI could be an alternative.


Subject(s)
Ankle , Body Weight , Electric Impedance , Humans , Mortality , Peritoneal Dialysis , Peritoneal Dialysis, Continuous Ambulatory , Pilot Projects , Spectrum Analysis , Spine , Wrist
19.
Article in Korean | WPRIM | ID: wpr-80037

ABSTRACT

BACKGROUND: Chronic red blood cell (RBC) transfusion is widely practiced as part of supportive care in patients with chronic anemia. However, there were few reports on the actual situation in Korea. Therefore, we studied the current status of chronic RBC transfusion. METHODS: Among patients who received RBC transfusions at a regional hospital from January 2011 to December 2015, patients who were consistently transfused with more than 15 units of RBC for more than one year were included. We retrospectively analyzed the status of RBC transfusion, including the laboratory findings related to transfusion using medical records. RESULTS: A total of 58 patients were included in the study. The mean age of patients was 66.4 years, and there were 24 hematologic malignancies (41.4%), 20 malignant tumors (34.5%), and 14 chronic diseases (24.1%). The mean hemoglobin level at the beginning of transfusion was 7.0 g/dL, and eight patients (13.8%) showed RBC alloimmunization as the transfusion proceeded. The mean serum ferritin level at the initial phase of transfusion was 475.3 ng/mL and increased to 1,462 ng/mL during the late phase of transfusion. CONCLUSION: Since the number of elderly patients treated with chronic diseases including tumors is expected to increase significantly, patients with chronic transfusions are also expected to increase. It is necessary to research and prepare measures such as establishment of guidelines.


Subject(s)
Aged , Anemia , Chronic Disease , Erythrocyte Transfusion , Erythrocytes , Ferritins , Hematologic Neoplasms , Humans , Korea , Medical Records , Retrospective Studies
20.
Article in Korean | WPRIM | ID: wpr-149533

ABSTRACT

Acute kidney injury (AKI) is one of the most common manifestations encountered in clinical practice. It is associated with high morbidity and mortality in cirrhotic pre- and post-transplantation patients. Hepatorenal syndrome (HRS), a special form of AKI in cirrhotic patients, was recognized as a consequence of renal vasoconstriction from systemic/renal hemodynamic alterations developed in advanced cirrhosis with portal hypertension. Recently, multiple factors—such as infection/inflammation, underlying glomerulonephritis, bile cast, or increased abdominal pressure—have been considered to contribute to renal dysfunction in cirrhotic patients, which were presumed to induce HRS. Moreover, in addition to changing the definition of AKI in the nephrologic guidelines, the new AKI definition for early diagnosis and intervention based on characteristics of liver cirrhosis has been proposed in an international meeting. This article provides a comprehensive and recent review of AKI definition, laying out the topics in accordance with the pathophysiologic mechanisms and therapeutic interventions of AKI in cirrhotic patients with portal hypertension.


Subject(s)
Acute Kidney Injury , Bile , Early Diagnosis , Fibrosis , Glomerulonephritis , Hemodynamics , Hepatorenal Syndrome , Humans , Hypertension, Portal , Liver Cirrhosis , Mortality , Vasoconstriction
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