Effects of adlay, buckwheat, and barley on transit time and the antioxidative system in obesity induced rats

In the present study, we examined whether four grains including adlay (AD), buckwheat (BW), glutinous barley (GB), and white rice (WR) affect the duration of food residence in the gastrointestinal tract and hepatic enzyme activities in rats fed different combinations of the grains. The rats were raised for 4 weeks on a high fat diet based on the American Institute of Nutrition-93 (AIN-93G) diets containing 1% cholesterol and 20% dietary lipids. Forty male rats were divided into four groups and raised for 4 weeks with a diet containing one of the grains. Corresponding to the dietary fiber contents of the experimental grains, gut transit time was shortest in the rats fed GB and increased in the order of BW, AD, and WR. In addition, the accumulated shortest transit time occurred in the GB group. Gut transit time affected weight gain and major organ weight, as it was closely related to the absorption of nutrients. The level of thiobarbituric acid reactive substance (TBARS) in liver was higher in rats fed WR, AD, BW, and GB, indicating that the other grains decreased oxidative stress in vivo more than WR. Glutathione, glutathione peroxidase, and glutathione S-transferase levels in the AD, BW, and GB groups were significantly higher than those in the WR group. In conclusion, reduced colonic transit time has been implicated in reducing the incidence of colon cancer, as evidenced by populations consuming diets rich in fiber. Whole grains such as AD, BW, and GB may contribute to a significant supply of antioxidants to prevent oxidative stress if they are consumed in large amounts.

Comparison of Benefit Estimation Models in Cost-Benefit Analysis: A Case of Chronic Hypertension Management Programs

PURPOSE: Cost-benefit analysis is one of the most commonly used economic evaluation methods, which helps to inform the economic value of a program to decision makers. However, the selection of a correct benefit estimation method remains critical for accurate cost-benefit analysis. This paper compared benefit estimations among three different benefit estimation models. METHODS: Data from community-based chronic hypertension management programs in a city in South Korea were used. Three different benefit estimation methods were compared. The first was a standard deterministic estimation model; second, a repeated-measures deterministic estimation model; and third, a transitional probability estimation model. RESULTS: The estimated net benefit of the three different methods were $1,273.01, $-3,749.42, and $-5,122.55 respectively. CONCLUSION: The transitional probability estimation model showed the most correct and realistic benefit estimation, as it traced possible paths of changing status between time points and it accounted for both positive and negative benefits.

Evaluation of Efficiency of Community Visiting Health Service Units: A Demonstration of Using Data Envelopment Analysis (DEA) / 간호행정학회지

PURPOSE: The aim of this study was to evaluate the efficiency of community visiting health service units using DEA and to compare the results with those of traditional evaluation methods. METHODS: Data were collected using 2008 annual reports of 10 districts in one city. Input variables were number of staff and operational budget per year and output variables were number of managed household per nurse, rate of controlled hypertension, and diabetes mellitus. EMS Window version 3.1 was used to measure efficiency score and bootstrapping Chi-square test was applied to identify differences between efficient and non-efficient unit by organizational factors. RESULTS: The average efficiency score of 10 community visiting health services was about 66%. Only two of the units operated program efficiently. The career of the staff was one among other factors associated with efficiency. The evaluation results from the traditional method and DEA were totally different. CONCLUSION: These results indicate that, evaluation methods have very important and significant effects on the evaluation results of community visiting health service units. The DEA method is recommend as an alterative method for evaluating community visiting health service.

Antibiotic-induced Severe Neutropenia with Multidrug-Dependent Antineutrophil Antibodies Developed in A Child with Streptococcus pneumoniae Infection

Drug-induced neutropenia (DIN), particularly that in which antibiotic-dependent antineutrophil antibodies have been detected, is a rare disorder. We report the case of a child with pneumococcal pneumonia, who experienced severe neutropenia during various antibiotic treatments. We detected 4 kinds (cefotaxim, augmentin, vancomycin, and tobramycin) of antibiotic-dependent antineutrophil antibodies by using the mixed passive hemagglutination assay (MPHA) technique with this child.

Analysis of online breast-feeding consultation on the website of the Korean Pediatric Society / 소아과

PURPOSE: Since the infant formula milk has been produced in Korea, it has faced a low rate of breast milk feeding, though breast milk feeding is a little increasing. Therefore, the Korean Pediatric Society launched its website for breast-feeding consultation to provide information to the general public and enhance the health of growing infants. The consultation results were analyzed to identify the problems that mothers encounter during breast-feeding. METHODS: From August 1, 2004 to July 31, 2007, 1001 mothers who visited the online consultation webpage (www. pediatrics.or.kr) of the Korean Pediatric Society asked 1,021 questions. The questions were divided into 3 major categories and 14 specific categories. Interesting questions asked more than 100 times were retrospectively analyzed. RESULTS: The results for the major categories were as follows: 413 questions (40.3%) were on how to breast-feed, 315 (30.8%) on problems of feeding mothers, and 293 (28.8%) on problems of the fed babies. In the specific categories, 22.2% of the questions were on how to breast-feed. With the increasing number of working couples and working mothers, many questions were asked on the problems of breast-feeding after returning from work. CONCLUSION: The author expects that analyses of these consultations will contribute to the enhancement of information on the consultation website, thus enabling to provide clearer answers to people's increased interest in and concerns on breast-feeding. Furthermore, this research will help to establish correct breast-feeding practice.

Pre-engraftment Syndrome in Hematopoietic Stem Cell Transplantation

The clinical findings of fever and skin rash with or without evidence of fluid retention, which mimic engraftment syndrome, have been observed during the pre-engraftment period in patients undergoing hematopoietic stem cell transplantation. In order to characterize this newly observed clinical syndrome called pre-engraftment syndrome (pES), we retrospectively analyzed the clinical records of 50 patients. Three out of 14 patients (23.1%) who underwent cord blood stem cell transplantation developed non-infectious fever, skin rash, and tachypnea 4-15 days prior to neutrophil engraftment. Two patients spontaneously recovered with fluid restriction and oxygen inhalation. One patient died of a complicated pulmonary hemorrhage in spite of aggressive supportive therapy and steroid treatment. Four out of 23 patients (17.4%) who underwent allogeneic bone marrow transplantation developed non-infectious fever and skin rash 4 to 5 days prior to neutrophil engraftment. All four of these patients recovered with only steroid treatment. These characteristic findings were not observed in patients who had undergone autologous peripheral blood stem cell transplantation. Interestingly, the speed of neutrophil engraftment was significantly faster for the patients suffering from pre-engraftment syndrome. The close observation and further pathophysiological research are required to better understand this syndrome.

Patterns of Obesity during Anti-cancer Chemotherapy in Children with Acute Lymphoblastic Leukemia

BACKGROUND: We evaluated the pattern as well as the predictive factors of obesity in children with acute lymphoblastic leukemia (ALL) according to body mass index (BMI) changes that occur during anticancer chemotherapy. METHODS: We reviewed the medical records of 58 patients who were diagnosed with ALL between 1995 and 2006 at the Department of Pediatrics at Hanyang University Hospital and Dong-A University Hospital. Five relapsed cases were excluded. The heights and weights of 55 children were measured at diagnosis, after induction, after consolidation, before maintenance and at the end of therapy. We analyzed the body mass index (BMI, kg/m(2)) for each treatment phase and evaluated the BMI differences for patients who received or did not receive cranial radiotherapy. RESULTS: The BMI increased in five children (10.4%) among the 48 children who were not obese at diagnosis. According to the treatment phase, the BMI of study patients significantly increased during induction and during chemotherapy. Even though the BMI also significantly increased according to the treatment phases in the children who underwent cranial radiotherapy, the BMI differences between patients that received or did not receive cranial radiotherapy were not statistically significant. CONCLUSION: We suggest that the risk for obesity in children with ALL should be considered even during chemotherapy. Physical activities, including physiotherapy, should be encouraged to prevent obesity, particularly during the long-term use of corticosteroids and during hospital admission.

A Case of Jarcho-Levin Syndrome with Fusion of Both Kidneys in a Newborn Infant

The Jarcho-Levin syndrome is a rare genetic disorder characterized by a short neck, short trunk, and a constricted thorax, and is due to multiple vertebral and rib defects. The small size of the thorax frequently leads to respiratory insufficiency and death in neonates or infants. This syndrome also combines with various kinds of anomalies, especially renal anomalies. We report an infant with Jarcho-Levin syndrome combined with fusion of both kidneys who was referred from a local obstetric clinic for cyanosis and respiratory difficulty.

Effects of seaweed supplementation on blood glucose concentration, lipid profile, and antioxidant enzyme activities in patients with type 2 diabetes mellitus

The present study was carried out to evaluate the physiological effects of seaweed supplementation on blood glucose levels, lipid profile, and antioxidant enzyme activities in subjects with type 2 diabetes mellitus. Subjects were randomized into either a control group or a seaweed supplementation group. Pills with equal parts of dry powdered sea tangle and sea mustard were provided to the seaweed supplementation group three times a day for 4 weeks. Total daily consumption of seaweed was 48 g. We found that total dietary fiber intake was 2.5 times higher in subjects receiving seaweed supplementation than in the control group. Accordingly, fasting blood glucose levels (p<0.01) and 2-hour postprandial blood glucose measurements (p<0.05) were decreased significantly in those ingesting seaweed. Furthermore, the serum concentrations of triglycerides were decreased and high-density lipoprotein cholesterol was increased significantly in seaweed supplement group (p<0.05). However, the concentrations of total cholesterol and low-density lipoprotein cholesterol were not affected by seaweed supplementation. The level of thiobarbituric acid reactive substances in erythrocytes was significantly lower with seaweed supplementation compared to controls (p<0.05). Catalase and glutathione peroxidase activities with seaweed supplementation were higher than the controls (p<0.05), but superoxide dismutase activity was not affected. We, therefore, conclude that ingestion of seaweed influences glycemic control, lowers blood lipids, and increases antioxidant enzyme activities.

The Association between Cytogenetic Abnormalities and Clinical Outcomes Based on Prognostic Factors of the Children Cancer Group (CCG) in Pediatric Patients with Acute Leukemia: Two Institutional Retrospective Studies

BACKGROUND: We investigated the incidence of cytogenetic abnormalities as well as the correlation of the cytogenetic abnormalities and clinical outcomes based on the prognostic factors of the Children Cancer Group (CCG) in children with acute leukemia. METHODS: We retrospectively reviewed the cytogenetic studies and clinical data from 99 children that were diagnosed with acute leukemia and treated with CCG regimens in two institutions. A conventional cytogenetic analysis was performed. RESULTS: The incidence of cytogenetic abnormalities was 51 (51.5%) in 99 patients, and 27 (39.7%) in acute lymphoblastic leukemia (ALL) patients and 24 (77.4%) in acute myelogenous leukemia (AML) patients. The most frequent cytogenetic abnormality was hyperdiploidy and t(8:21) in the ALL and AML patients, respectively. The overall survival rate (OS)/disease free survival rate (DFS) of the ALL patients was 74.0%/73.9%. The OS/DFS of the standard risk group (88.8%/85.2%) was significantly higher than that of the high-risk group (49.4%/39.3%) in the ALL patients (P=0.0005/P<0.0001). There was no significant difference in the survival rates according to the type of cytogenetic abnormalities among the ALL patients for the standard/high risk groups, based on the CCG prognostic factors. The OS/DFS of the AML patients were 43.4% and 41.7%, respectively, without significant differences of the survival rates according to the type of chromosomal abnormalities. CONCLUSION: There were significant differences of OS/DFS based on the risk groups in ALL patients when evaluated with the CCG prognostic factors (standard/high) and chromosomal abnormalities (good/ poor), respectively. However, there was no significant correlation between type of cytogenetic abnormalities and clinical outcomes based on the CCG prognostic factors in children with ALL as well as with AML.

Hypercalcemia and Extensive Osteolytic Lesion with Increased Plasma Prostaglandin E2 Level in a Child with Acute Lymphoblastic Leukemia

In this report, we present a rare case of childhood ALL with hypercalcemia and extensive osteolytic lesions. The case was a 7-year-old girl presenting with vomiting and aggravating bone pain. Radiologic examinations showed severe osteolytic lesions of the skull and extremities. Laboratory findings revealed low hemoglobin, normal WBC count with absent circulating blasts, and an increased serum calcium level. Serum intact PTH and 1,25-(OH)2 vitamin D3 levels were below the normal ranges and parathyroid hormone-related peptide (PTHrP) was not detected, whereas serum levels of prostaglandin E2 were elevated. The hypercalcemia resolved with specific antileukemic chemotherapy along with supportive care. The elevated plasma prostaglandin E2 levels decreased slightly after complete remission with induction chemotherapy. These findings suggest that increased plasma prostaglandin E2 levels may be one of the pathogenetic mechanisms responsible for the occurrence of hypercalcemia in this patient.

Effects of Mushroom Supplementation on Blood Glucose Concentration, Lipid Profile, and Antioxidant Enzyme Activities in Patients with Type 2 Diabetes Mellitus

The present study was carried out to evaluate the physiological effects of mushroom supplementation on blood glucose levels, lipid profile, and antioxidant enzyme activities in subjects with type 2 diabetes mellitus. Subjects were randomized into either a control group or mushroom supplementation group. Mushroom supplementation was provided 3 times a day for 4 weeks. We found that total dietary fiber intake was about 2.5 times higher (30.3 g vs. 12.3 g) in subjects receiving mushroom supplementation than in the control group. Two groups maintained the same food intake and amount of activity, exercise during the supplementation. We observed no difference in age, height, weight, BMI (body mass index), blood pressure between the groups. Nutrient intake did not differ appreciably between the two groups, except for fiber intake, during the supplementation. Fasting blood glucose levels and 2-hour postprandial blood glucose levels were significantly lower in those ingesting mushroom than in controls. Furthermore, the concentrations of low-density lipoprotein cholesterol were decreased significantly in the mushroom supplementation group. Small changes were observed in the concentration of total cholesterol, triglyceride, high-density lipoprotein cholesterol of those supplemented with mushroom, but these changes were not statistically significant. Activities of superoxide dismutase and catalase with mushroom supplementation were higher than in controls, but and glutathione peroxidase activity was not affected. The levels of thiobarbituric acid reactive substance of mushroom group were lower than control group, but were not siginificant. We conclude that addition of mushroom influences glycemic control and may be effective in lowering blood lipids and improving antioxidant enzyme activities. Accordingly, such effects may reduce risk factors for cardiovascular disease in patients with type 2 diabetes. However, to confirm these effects and to make dietary recommendations for patients with type 2 diabetes, further studies are necessary.

A Case of Congenital Bilateral Choanal Atresia associated with Athelia in Neonate

Choanal atresia is the congenital failure of one or both posterior nasal apertures to communicate with the nasopharynx. Coexisting congenital anomalies are 20% to 50% of patients. Bilateral choanal atresia almost always presents respiratory distress, sucking difficulty and cyanosis relieved by crying in the newborn. Bilateral choanal atresia in newborns and infants carries significant morbidity and mortality, therefore, prompt correction is required. Athelia is the absence of the nipple-areola complex. It is a rare entity that can be either congenital or acquired. Congenital athelia is always associated with amastia and a syndrome. We report a case of choanal atresia associated athelia, in term baby.

Shock Index, Serum Lactate Level, and Arterial-End Tidal Carbon Dioxide Difference as Hospital Mortality Markers and Guidelines of Early Resuscitation in Hypovolemic Shock

PURPOSE: To determine whether differences in arterial and end-tidal carbon dioxide [P(a-et)CO2], shock index, and serum lactate levels are helpful for predicting the outcome of resuscitation in hypovolemic shock patients in the emergency department. METHODS: A prospective study of end-tidal carbon dioxide (EtCO2)-derived variables and patient outcomes in hypovolemic shock was conducted in the emergency department of a university hospital from January 2005 to February 2006. A total of fifty-eight hypovolemic shock patients over 20 years old were included. During resuscitation, patients received volume replacement including blood transfusions, as well as vasopressor or inotropic therapy if needed. RESULTS: Twenty-one patients died in the hospital. At the time of admission (hour 0) and after resuscitation (hour 4), there were no differences related to age, respiration and heart rate, CVP, arterial blood gases, or EtCO2 between survivors and non-survivors. Non-survivors had significantly higher shock index scores, serum lactate levels, and P(a-et) CO2 than the survivors. The Receiver operator characteristic (ROC) curves at hour 4 hour for P(a-et)CO2 were as effective for predicting mortality as were the shock index and serum lactate levels. Shock index > 1.0, P(a-et)CO2 > 4 mmHg, and serum lactate > 5.0 mmol/L after resuscitation were all associated with a high early mortality rate (p=0.074, 0.001, 0.000, respectively). CONCLUSION: P(a-et)CO2, shock index, and serum lactate levels are predictive of in-hospital mortality and may be useful as guidelines in the resuscitation of hypovolemic shock patients in the emergency department.

The Effect of Milk Consumption on Blood Lipid Levels of the Korean College Women

This research was conducted to study the effect of milk consumption on blood lipid levels of Korean college women. According to milk intake from food frequency questionnaire (FFQ), top 20% of subjects were classified as high group(HG) and bottom 20% as low group (LG). Body weight, height and blood pressure were measured and BMI was calculated from the anthropometric data, but there was no significant difference between the groups. Blood samples were collected and analyzed for total cholesterol (TC), triglycerides (TG) and lipoprotein fractions. There was no significant difference in the blood level of albumin, total protein and hemoglobin between two groups, and all blood parameters were in the normal range. Blood lipid levels of two groups were not significantly different, but HDLcholesterol level were higher in HG (p < 0.05). Therefore, according to the result of the research, it is considered that drinking a pack of milk (200 ml) everyday, the average intake of dairy products of HG, is advisable to promote good health without increasing of cardiovascular disease (CVD) risk.

c-Met Expression in Colorectal Carcinoma and Adenomas: Correlation with Clinicopathologic Parameters

PURPOSE: Hepatocyte growth factor (HGF) stimulates proliferation, migration, and morphogenesis of epithelial cells by specifically binding to its receptor c-met. Abnomalities of the c-met oncogene have been studied in cancers of many organs including thyroid, lung, pancreas, and stomach. However, little is known about the clinical significance of c-met oncogene abnormalities in colorectal carcinomas. In this study, we investigated over- expression of the c-met protein in colorectal adenomas and adenocarcinomas, and analyzed the clinicopathologic significance of this over-expression. METHODS: Expression of the c-met protein localized in colorectal adenoma and adenocarcinoma tissues was analyzed by using immunohistochemistry. The results were compared with clinicopathologic parameters to find clinical correlation. RESULTS: c-met protein was detected in 42.5% (17/40) of colorectal cancers and in 10.0% (4/40) of colorectal adenomas (P= 0.001). In colorectal cancer, the proportion of expression of c-met protein was 0% (0/40) in stage I, 47.6% (10/40) in stage II, 53.8% (7/40) in stage III and, 0% (0/40) in stage IV. c-met protein expression was 18.8% (3/40) in tumors with invasion into the muscularis propria (MP), and 58.3% (14/40) in tumors with invasion beyond the MP. The depth of tumor invasion was a statistically significant factor (P=0.022) for c-met expression. CONCLUSIONS: The c-met protein expression was related to the depth of invasion of colorectal cancer and showed a significant difference in its rate of expression between adenoma and adenocarcinomas.

Effect of Ephedrine Infusion on the Prevention of Hypotension during Epidural Anesthesia / 대한마취과학회지

BACKGROUND: There has been no consensus on the best way to prevent hypotension during epidural anesthesia. We undertook the present study to evaluate the effect of ephedrine infusion along with fluid preloading in prevention of hypotension. METHODS: Eighty patients undergoing total abdominal hysterectomy were divided into 4 groups. The Group 1 and 2 were preloaded with 1000 ml lactated Ringer's solution(LR), Group 3 with 200 ml LR, and Group 4 with 500 ml of colloid(10% pentastarch) solution. In the group 1, normal saline was infused at 12 ml/min after bupivacaine injection into epidural space. In the Group 2, 3, and 4, ephedrine(mixed in normal saline) was infused after beginning of anesthesia at 1 mg/min. RESULTS: Systolic arterial pressure after epidural blockade was significantly lower in preloading of only LR(Group 1) than those with ephedrine infusion groups(Group 2, 3, and 4). In all groups the heart rate was not changed significantly during the course of the study. The central venous pressure increased after fluid preloading in all groups, but the magnitude of increase was relatively small in Group 3. Hypotension occurred in 45% of the patients who received only LR(Group 1) vs 10% of those who received pentastarch(Group 4)(p<0.05). The incidence of hypotension(20%) was same in Group 2 and 3. CONCLUSIONS: Infusion of ephedrine could be an alternative method to prevent hypotension during epidural anesthesia. Similar incidence of hypotension in Groups 2 and 3 challenges our perception of the value of crystalloid preload.