Study on the qualities of diet and life in Parkinson's disease patients according to their nutritional status

Assessment regarding the nutritional status of Parkinson's disease (PD) patients is important because their nutritional status influences the outcome of disease. The purpose of this study investigated the dietary habits, dietary quality, and quality of life for Korean PD patients according to their nutritional status. Seventy PD patients were recruited from K University Hospital (KMC IRB#0918-07) from February 2010 to October 2011. To diagnose PD, the United Kingdom Parkinson's Society Brain Bank standards were used by a neurology physician. The participants were interviewed and assessed using various tools, including a general questionnaire, anthropometrics, questionnaires for dietary habits, dietary diversity score (DVS), dietary variety score (DVS), diet quality index-international (DQI-I), beck depression inventory (BDI), the Korean version of mini mental state examination (K-MMSE), and 36-item short-form health survey (SF-36). The results of the study were as follows: 1) Most of the PD patients (69.0%) were at risk of malnutrition, and 8.5% and 22.5% of the subjects were malnourished and well-nourished, respectively. 2) Clinical symptoms (swallowing and chewing difficulties) were obvious, and the quality of diet (DDS, DVS, DQI-I) was low in the malnourished group (p < 0.01). 3) The malnourished group had significantly lower scores regarding SF-36 (quality of life) as well as that of cognitive function (p < 0.05). 4) The nutritional status of PD patients was significantly correlated with their depression (p < 0.05) and quality of life (p < 0.01). These results indicate that appropriate nutritional management will improve the nutritional status and quality of life as well as the cognitive function in Parkinson's disease patients.

Severe Leukopenia after Intravenous Cyclophosphamide Pulse Therapyin a Patient Having Cytochrome P450 2A6*1B / 대한류마티스학회지

Cyclophosphamide, a prodrug requiring metabolic activation by cytochrome P450 (CYP) enzymes, is used widely for proliferative lupus nephritis and various CYP isoenzymes have been demonstrated to be involved in the bioactivation of cyclophosphamide in humans, including CYP2A6, 2B6, 2C19, 2C9, 3A4, and 3A5. The response or adverse event after intravenous cyclophosphamide pulse therapy in lupus nephritis patient seems to be different for each individual and genetic polymorphism of CYP may explain the difference. Generally, wild types of CYP seem to be more active in the activation of cyclophosphamide than variant types of CYP. Here, we report a case of lupus nephritis with a genotype of CYP2A6*1B who suffered from severe leukopenia after intravenous cyclophosphamide pulse therapy.

Health-Related Quality of Life in Korean Patients with Chronic Diseases / 대한류마티스학회지

OBJECTIVE: Few studies have examined the impact of chronic diseases on populations using a comprehensive health-related quality of life (HRQOL) in Korea. We assessed HRQOL of patients with 16 common chronic diseases. METHODS: We interviewed patients with chronic diseases (n=980) and healthy control (n=288) using two HRQOL measurements: Korean Medical Outcome Study Short Form-36 (KSF-36) and Korena EuroQol-5 Dimensions (KEQ-5D), and questions on sociodemographic and clinical characteristics. RESULTS: Each illness had a distinctive profile. Among disease groups, the KSF-36 global health score was highest in DM and lowest in fibromyalgia. The KSF-36 physical component summary score was highest in DM and lowest in osteoarthritis . The KSF-36 mental component summary score was highest in hypertension and lowest in fibromyalgia. The KEQ-5D utility score was highest in DM and lowest in fibromyalgia. The KEQ-5D visual analog score was highest in DM and lowest in liver cirrhosis. In correlation analysis, the KSF-36 physical component summary, mental component summary and five domains in KEQ-5D were well correlated with each others. CONCLUSION: Health related quality of life in Korean patients with chronic disease is lower than healthy control. Patients with hypertension and DM registered the two highest scores in global health but patients with fibromyalgia reported the worst health experience in global health.We can compare the profiles of the groups and determine the relative impact on the patients of the various diseases and these data will provide a baseline of the current health related quality of life of individuals suffering from a variety of conditions.

Efficacy of High Dose Intravenous Immunoglobuline Therapy in Rheumatic Diseases / 대한류마티스학회지

OBJECTIVE: Although clearly demonstrated in idiopathic thrombocytopenic purpura, Kawasaki disease, the efficacy of intravenous immunoglobulins in the treatment of rheumatic diseases is still being debated. We investigated the effect of high dose intravenous immunoglobulins in selected rheumatic diseases. METHODS: Twenty nine patients with rheumatic diseases who had received high dose intravenous immunoglobulins were studied. There were 18 patients with systemic lupus erythematosus (SLE), 8 dermatomyositis/polymyositis (DM/PM) patients, 2 adult onset still's disease (AOSD) patients and 1 Henoch-schnlein purpura patient. They were treated with high dose intravenous immunoglobulins (each course consisted of 400 mg/kg for 5 days). Each patient received between 1-37 treatment courses. These patients were evaluated both by clinical outcome and by serologic profile that were taken before and after treatment. RESULTS: Clinical improvement was observed in 16 patients out of 29 patients. Nine patients of them could decrease daily prednisolone doses. The clinical manifestations that responded good were: skin rash and ulcer, high fever, vasculitis, hemolytic anemia, throm-bocytopenia, myositis. However lupus nephritis and interstitial lung disease did not benefit from the treatment. CONCLUSION: The high dose intravenous immunoglobulin treatment is good in patients with SLE, DM/PM and AOSD when they are steroid dependent or steroid resistant.