OBJECTIVES: This study was conducted to investigate the effect of a 6-week low-calorie diet (LCD) program including high protein-low carbohydrate protein bar on weight loss, blood pressure, and blood lipid profile in 40 overweight women according to dietary compliance.METHODS: Subjects were 62 healthy overweight women (BMI ≥ 23.0 or body fat percentage ≥ 28%), aged 20~59 yrs who were provided a high protein-low carbohydrate protein bar (each 35 g, 154 kcal, protein energy %: 28.6%, carbohydrate energy %: 38.7%) as part of dinner for 6 weeks. Forty subjects who completed the whole diet program were categorized into high compliance (HC) group (days of eating protein bar ≥ 5 weeks) or low compliance (LC) group (days < 5 weeks).RESULTS: Energy intake significantly decreased from 1,867.5 kcal at baseline to 1,137.4 kcal at 6 weeks for the HC group and from 1,971.7 kcal to 1,362.2 kcal for the LC group, respectively. On the other hand, a significant increase in protein energy percentage was observed in each group (HC group: 3.5%, LC group: 2.2%). Both groups showed significant decreases in weight (HC group: 1.8 kg, LC group: 1.1 kg), BMI, fat mass, systolic blood pressure, total cholesterol, and LDL-cholesterol. Reduction of body fat percentage and diastolic blood pressure were only observed in the HC group.CONCLUSIONS: The inclusion of a high protein-low carbohydrate protein bar as part of a low-calorie diet for a short period can be effective to achieve weight loss and concomitantly improve blood cholesterol level without serious physiological side effects. More evident results can be achieved by eating a diet with low calorie diet including high protein-low carbohydrate protein bar for more than 5 weeks.
Adipose Tissue ; Blood Pressure ; Caloric Restriction ; Cholesterol ; Compliance ; Diet ; Eating ; Energy Intake ; Female ; Hand ; Humans ; Meals ; Overweight ; Weight Loss

Background: The central line has been frequently used for drug and nutrition supply and regular blood sampling of patients with chronic diseases. However, this procedure is performed in a highly sensitive area and has several potential complications. Therefore, peripherally inserted central catheters (PICC), which have various advantages, are being extensively used. Although the number of PICC procedures is increasing, the anatomy for safe procedures has not yet been properly established. Therefore, we studied basic anatomical information for safe procedures. Methods: We used 20 fixed cadavers (40 arms) donated to the Korea University College of Medicine. The mean age was 76.75 years (range, 48–94 years). After dissection of each arm, the distribution pattern of the basilic vein and close structures was recorded, and some important parameters based on bony landmarks were measured. In addition, the number of vein branches (axillary region) and basilic vein diameter were also checked. Results: The mean length from the insertion site to the right atrium was 38.39 ± 2.63 cm (left) and 34.66 ± 3.60 cm (right), and the basilic vein diameter was 4.93 ± 1.18 mm (left) and 4.08 ± 1.49 mm (right). The data showed significant differences between the left and right arms (P < 0.05). The mean distance from the basilic vein to brachial artery was 8.29 ± 2.78 mm in men and 7.81 ± 2.78 mm in women, while the distance to the ulnar nerve was 5.41 ± 1.67 mm in men and 5.52 ± 2.06 mm in women. Conclusion According to these results, the right arm has a shorter distance from the insertion site to the right atrium, and the left arm has a wider vein diameter, which is advantageous for the procedure. In addition, the ulnar nerve and brachial artery were located close to or behind the insertion site. Therefore, special attention is required during the procedure to avoid damaging these important structures.

BACKGROUND: The Htr3a antagonist, ondansetron, has been reported to prolong the QT interval and induce Torsades de pointes in the treatment of postoperative nausea and vomiting. To explore the mechanisms underlying these findings, we examined the effects of ondansetron on the mouse cardiac voltage-gated K⁺ (Kv) channel. METHODS AND RESULTS: Ondansetron increased QT intervals in late pregnant (LP) mice. We measured the Kv channels in freshly isolated left ventricular (LV) myocytes from non-pregnant (NP) and late pregnant (LP) mice, using patch-clamp electrophysiology. Ondansetron blocked Kv current at a dose of 50 µM, and reduced the amplitude of peak current densities in a dose-dependent manner (0, 1, 5, 50 µM), in LP but not in NP mice. In contrast, serotonin and the Htr3 agonist, m-CPBG, increased Kv current densities in NP, but not in LP mice. Interestingly, during pregnancy, serum serotonin levels were markedly increased, suggesting the saturation of the effect of serotonin. Immunostaning data showed that Kv4.3 protein and Htr3a co-localize at the membrane and t-tubule of cardiomyocytes. Moreover, Kv4.3 membrane trafficking was enhanced in response to Htr3a-mediated serotonin stimulation in NP, but not in LP mice. Membrane analysis showed that serotonin enhances Kv4.3 membrane trafficking in NP, but not LP mice. CONCLUSION: Ondansetron reduced Kv current densities, and reduced the Kv4.3 membrane trafficking in LP mouse ventricular cardiomyocytes. This data suggests that QT prolongation by ondansetron is mediated by the reduction of Kv current densities and Kv4.3 membrane trafficking.
Animals ; Electrophysiology ; Membranes ; Mice* ; Muscle Cells* ; Myocytes, Cardiac ; Ondansetron* ; Postoperative Nausea and Vomiting ; Pregnancy ; Serotonin ; Torsades de Pointes

BACKGROUND/OBJECTIVES: Understanding the mechanism of chewing and swallowing food is important when creating a proper diet for older adults. This study investigated whether texture-modified model foods can reduce the difference in chewing and swallowing parameters between healthy community-living young and older adults. SUBJECTS/METHODS: In total, 35 older and 20 young adults (mean age: 75 and 25 years, respectively), matched for sex and number of teeth, were recruited and their unstimulated salivation and tongue pressure were measured. Simultaneous assessment of chewing and swallowing characteristics was conducted using surface electromyography and a videofluoroscopic swallowing study while the participants ingested 8 g of model food with one to four levels of hardness. RESULTS: The average tongue pressure and salivation among older adults were 61% and 49.7%, respectively, of the corresponding values observed in young adults. The older adult group used significantly (P < 0.05) increased muscle force with more chewing cycles (P < 0.05) than the young adult group, which was maintained even when consuming foods with the lowest hardness, although without chewing. However, the age effect on oral processing time existed only for the hardest foods. Swallowing difficulties among older adults were demonstrated by the significant increase in vallecula aggregation time. The total food intake duration was significantly (P < 0.05) longer in older adults than in young adults, regardless of food hardness. CONCLUSIONS There were measurable differences in the process of chewing and swallowing food between young and older adults, which can be improved with food hardness control. Adjusting food hardness may help food intake in healthy older adults.

Methods: We developed a questionnaire related to VFSS protocols and test diet. It was sent to the expert physicians who directly implementing VFSS in 35 training hospitals, which were sent out and collected by e-mail from December 7, 2017 to February 19, 2018. Among them, 12 out of 28 hospitals selected randomly and we conducted field survey including observing the process of the VFSS. Results: The most common protocol was to provide a test sample with 7 stages (28.1%). In the order of provided test samples, ‘the small amount of liquid’ was the most provided in the 1st stage (53.1%). Among the used samples of thin liquid level, the mixing ratio of the liquid samples and barium was not uniform among each institution. ‘Yogurt (semi-solid type)’ was the most commonly used sample for ‘nectar thick’ and ‘honey thick’ diet. Various samples were used on ‘pudding thick’ diet. Conclusion These results indicate that, in the 32 Korean general hospitals, each hospital uses samples depending on experience or according to its own standards rather than unified standard among the institutions. Thus, the protocols for each hospital are not standardized, which make them difficult to the accurate sharing of information about the test results. Therefore, it will be necessary to make a consensus for the protocol and establish nationwide standard of VFSS through future research

BACKGROUND: The interferon-gamma (IFN-γ) releasing assay (IGRA) is widely used for latent tuberculosis infection (LTBI) diagnosis. We evaluated the analytical performance of a new automated chemiluminescent immunoanalyzer-based IGRA (CLIA-IGRA), AdvanSure I3 (LG Life Sciences, Seoul, Korea) and compared it with that of the QuantiFERON-TB Gold In-Tube (QFT-GIT) assay. METHODS: Repeatability and reproducibility were evaluated at four levels. Detection capability, including limit of blank (LoB), limit of detection (LoD), and limit of quantification (LoQ), was evaluated using IFN-γ standard material (National Institute for Biological Standards and Control code: 87/586). Agreement between the results of two assays was evaluated using 341 blood samples from healthcare workers and patients at a tertiary care hospital. To determine the cut-off value of CLIA-IGRA for diagnosing LTBI, the ROC curve was analyzed. RESULTS: Repeatability and reproducibility were 4.86–7.00% and 6.36–7.88% CV, respectively. LoB, LoD, and LoQ were 0.022, 0.077, and 0.249 IU/mL, respectively. IFN-γ values between CLIA-IGRA and QFT-GIT showed a strong correlation within the analytical measurable range of both assays, especially when the value was low. Qualitative comparison of the two assays yielded a 99.1% overall agreement (kappa coefficient=0.98). A cut-off value of 0.35 IU/mL was appropriate for diagnosing LTBI. CONCLUSIONS CLIA-IGRA is a reliable assay for LTBI diagnosis, with performance similar to that of QFT-GIT.

Background and Objectives: Ambient particulate matter (PM) in real urban air pollution (RUA) is an environmental health risk factor associated with increased cardiac events. This study investigated the threshold level to induce arrhythmia, as well as arrhythmogenic mechanism of RUA that mainly consisted of PM <2.5 μm in aerodynamic diameter close to ultrafine particles. Methods: RUA was artificially produced by a lately developed pyrolysis based RUA generator.C57BL/6 mice were divided into 4 groups: a control group (control, n=12) and three groups with exposure to RUA with the concentration of 200 µg/㎥ (n=12), 400 µg/㎥ (n=12), and 800 µg/㎥ (n=12). Mice were exposed to RUA at each concentration for 8 hr/day and 5 day/week to mimic ordinary human activity during 3 weeks. Results: The QRS and QTc intervals, as well as intracellular Ca2+ duration, apicobasal action potential duration (APD) gradient, fibrosis, and inflammation of left ventricle of mouse hearts were increased dose-dependently with the increase of RUA concentration, and significantly increased at RUA concentration of 400 µg/㎥ compared to control (all p<0.001). In mice exposed to RUA concentration of 800 µg/㎥ , spontaneous ventricular arrhythmia was observed in 42%, with significant increase of inflammatory markers, phosphorylated Ca2+ /calmodulindependent protein kinase II (CaMKII), and phospholamban (PLB) compared to control. Conclusions RUA could induce electrophysiological changes such as APD and QT prolongation, fibrosis, and inflammation dose-dependently, with significant increase of ventricular arrhythmia at the concentration of 400 µg/㎥ . RUA concentration of 800 µg/㎥ increased phosphorylation of CaMKII and PLB.

Background and Objectives: Ambient particulate matter (PM) in real urban air pollution (RUA) is an environmental health risk factor associated with increased cardiac events. This study investigated the threshold level to induce arrhythmia, as well as arrhythmogenic mechanism of RUA that mainly consisted of PM <2.5 μm in aerodynamic diameter close to ultrafine particles. Methods: RUA was artificially produced by a lately developed pyrolysis based RUA generator.C57BL/6 mice were divided into 4 groups: a control group (control, n=12) and three groups with exposure to RUA with the concentration of 200 µg/㎥ (n=12), 400 µg/㎥ (n=12), and 800 µg/㎥ (n=12). Mice were exposed to RUA at each concentration for 8 hr/day and 5 day/week to mimic ordinary human activity during 3 weeks. Results: The QRS and QTc intervals, as well as intracellular Ca2+ duration, apicobasal action potential duration (APD) gradient, fibrosis, and inflammation of left ventricle of mouse hearts were increased dose-dependently with the increase of RUA concentration, and significantly increased at RUA concentration of 400 µg/㎥ compared to control (all p<0.001). In mice exposed to RUA concentration of 800 µg/㎥ , spontaneous ventricular arrhythmia was observed in 42%, with significant increase of inflammatory markers, phosphorylated Ca2+ /calmodulindependent protein kinase II (CaMKII), and phospholamban (PLB) compared to control. Conclusions RUA could induce electrophysiological changes such as APD and QT prolongation, fibrosis, and inflammation dose-dependently, with significant increase of ventricular arrhythmia at the concentration of 400 µg/㎥ . RUA concentration of 800 µg/㎥ increased phosphorylation of CaMKII and PLB.

OBJECTIVE: To identify the center of extensor indicis (EI) muscle through cadaver dissection and compare the accuracy of different techniques for needle electromyography (EMG) electrode insertion. METHODS: Eighteen upper limbs of 10 adult cadavers were dissected. The center of trigonal EI muscle was defined as the point where the three medians of the triangle intersect. Three different needle electrode insertion techniques were introduced: M1, 2.5 cm above the lower border of ulnar styloid process (USP), lateral aspect of the ulna; M2, 2 finger breadths (FB) proximal to USP, lateral aspect of the ulna; and M3, distal fourth of the forearm, lateral aspect of the ulna. The distance from USP to the center (X) parallel to the line between radial head to USP, and from medial border of ulna to the center (Y) were measured. The distances between 3 different points (M1– M3) and the center were measured (marked as D1, D2, and D3, respectively). RESULTS: The median value of X was 48.3 mm and that of Y was 7.2 mm. The median values of D1, D2 and D3 were 23.3 mm, 13.3 mm and 9.0 mm, respectively. CONCLUSION: The center of EI muscle is located approximately 4.8 cm proximal to USP level and 7.2 mm lateral to the medial border of the ulna. Among the three methods, the technique placing the needle electrode at distal fourth of the forearm and lateral to the radial side of the ulna bone (M3) is the most accurate and closest to the center of the EI muscle.
Adult ; Cadaver* ; Electrodes ; Electrodiagnosis ; Electromyography* ; Fingers ; Forearm ; Head ; Humans ; Needles* ; Ulna ; Upper Extremity

PURPOSE: Bioactive molecules critical to intracellular signaling are contained in extracellular vesicles (EVs) and have cardioprotective effects in ischemia/reperfusion (IR) injured hearts. This study investigated the mechanism of the cardioprotective effects of EVs derived from hypoxia-preconditioned human mesenchymal stem cells (MSCs). MATERIALS AND METHODS: EV solutions (0.4 µg/µL) derived from normoxia-preconditioned MSCs (EVNM) and hypoxia-preconditioned MSCs (EVHM) were delivered in a rat IR injury model. Successful EV delivery was confirmed by the detection of PKH26 staining in hearts from EV-treated rats. RESULTS: EVHM significantly reduced infarct size (24±2% vs. 8±1%, p < 0.001), and diminished arrhythmias by recovering electrical conduction, INa current, and Cx43 expression. EVHM also reversed reductions in Wnt1 and β-catenin levels and increases in GSK3β induced after IR injury. miRNA-26a was significantly increased in EVHM, compared with EVNM, in real-time PCR. Finally, in in vitro experiments, hypoxia-induced increases in GSK3β expression were significantly reduced by the overexpression of miRNA-26a. CONCLUSION: EVHM reduced IR injury by suppressing GSK3β expression via miRNA-26a and increased Cx43 expression. These findings suggest that the beneficial effect of EVHM is related with Wnt signaling pathway.
Animals ; Arrhythmias, Cardiac ; Connexin 43 ; Extracellular Vesicles* ; Heart ; Humans* ; In Vitro Techniques ; Mesenchymal Stromal Cells* ; Rats ; Real-Time Polymerase Chain Reaction ; Reperfusion Injury* ; Wnt Signaling Pathway