BACKGROUND: As Korea advances into the ageing society, the number of elderly person receiving dialysis has increased. Two-year survival rate of the patients who received hemodialysis was 84.2% in 1996. But there is no estimate on the survival rate of the patients over age 65. Elderly persons are more prone to have dialysis complications and have more problems in cardiovascular system. The following is a 5-year-study on the elderly ESRD patients who underwent hemodialysis. METHODS: In this retrospective study, 825 patients had received hemodialysis at Seoul Paik Hospital from Jan. 1997 to Dec. 2002. The elderly group was consisted of 35 patients over age 65 and the non-elderly group was consisted of 43 patients below age 65 who received hemodialysis. And they had been traced for more than six months. The patient`s age, sex, occupation and whether the patient was married or not, had been compiled. Also taken into consideration was etiology, complications, initial laboratory data, electrocardiography, abdominal sonography, echocardiography, ftmndus examination, cause of death. RESULTS: Average age of the elderly and the non-elderly group was 70.1 and 47.4 years(p<0.00). nd parathyroid hormone were different between the two groups(p<0.05), other laboratory data were not. Prevalence of diabetes mellitus and hypertensive nephrosclerosis were not either. The overall 1, 2, 5 year survival rate was 97.3%, 93.4%, 73.7%. And the 5-year survival rate was 88.6% in the non-elderly group and it was 54.1% in the elderly group(Kaplan-Meier method). Causes of death were sepsis(n=3), cerebrovas cular accident(n=2), myocardial infarction, pneumonia and gastrointestinal bleeding, malignancy, withdrawal of treatment(1 patient respectively) in the elderly group and were myocardial infarction, withdrawal of treatment in the non-elderly group(n=2). CONCLUSION: The 5-year survival rate of the elderly patients was lower than the non-elderly(p<0.001). The contributing factor of death was not etiology but cormobid condition according to ageing process and socioeconomic circumstance. In other words, it was cardiovascular disease, infection due to impaired immune system and withdrawal of treatment due to economic problems. So it would be necessary to monitor carefully these factors for the elderly hemodialysis patients to improve survival..
Aged* ; Cardiovascular Diseases ; Cardiovascular System ; Cause of Death ; Diabetes Mellitus ; Dialysis ; Echocardiography ; Electrocardiography ; Hemorrhage ; Humans ; Immune System ; Kidney Failure, Chronic ; Korea ; Myocardial Infarction ; Nephrosclerosis ; Occupations ; Parathyroid Hormone ; Pneumonia ; Prevalence ; Renal Dialysis* ; Retrospective Studies ; Seoul ; Survival Rate

The identification for skeletal remains is one of roles of forensic medicine. For this purpose, dating, i.e., estimating the birth year and death year is expected as useful, however has not yet been practically applied. A dating method using radiocarbon analysis was recently introduced and related studies have been reported. In this study, we tried to confirm the applicability of radiocarbon dating for the identification of skeletal remains and to develop formulas to estimate the death year. Thirty-four autopsy cases from the National Forensic Service, from December 2014 to July 2022, with known death year were selected for inclusion. For each case, two samples were taken: the spongy bone of the femur head, and the compact bone of the femur midshaft. For each sample, radiocarbon analysis was carried out and the corresponding femur year were calculated using the bomb peak curve. The differences between the femur year and the death year were determined and analyzed on the influence of variables. A formula for estimating the death year was developed and the applicability of the formula was determined. The results showed that the difference between death year and femur head year was 14.2 years on average. In male, the difference between death year and femur head year increased with age, however, it did not show any difference according to age in female. The estimation formula of death year was as follows: (In male) Death year=0.993×(Femur head year)+0.288×(Age)+15.061, (In female) Death year=0.769×(Femur head year)-0.218×(Age)+489.676. The formula for male had relatively high explanatory power (adjusted R2=0.710), however, the formula for female had low explanatory power (adjusted R2=0.588). This study is meaningful because it is the largest single study of its kind, to date, and uses specific and identical skeleton (femur head/femur midshaft) to increase the accuracy of the death year estimation. We expect that the results of this study will be supplemented through additional research in the future.

Silica nanoparticles, which are applicable in many industrial fields, have been reported to induce cellular changes such as cytotoxicity in various cells and fibrosis in lungs. Because the immune system is the primary targeting organ reacting to internalized exogenous nanoparticles, we tried to figure out the immunostimulatory effect of silica nanoparticles in macrophages using differently sized silica nanoparticles. Using U937 cells we assessed cytotoxicity by CCK-8 assay, ROS generation by CM-H2DCFDA, intracellular Ca++ levels by staining with Fluo4-AM and IL-8 production by ELISA. At non-toxic concentration, the intracellular Ca++ level has increased immediately after exposure to 15 nm particles, not to larger particles. ROS generation was detected significantly in response to 15 nm particles. However, all three different sizes of silica nanoparticles induced IL-8 production. 15 nm silica nanoparticles are more stimulatory than larger particles in cytotoxicity, intracellular Ca++ increase and ROS generation. But IL-8 production was induced to same levels with 50 or 100 nm particles. Therefore, IL-8 production induced by silica nanoparticles may be dependent on other mechanisms rather than intracellular Ca++ increase and ROS generation.
Enzyme-Linked Immunosorbent Assay ; Fibrosis ; Immune System ; Interleukin-8 ; Lung ; Macrophages ; Nanoparticles ; Silicon Dioxide ; Sincalide ; U937 Cells

Although esophageal tuberculosis is a rare disease throughout the world, esophageal tuberculosis should be included as one of differential diagnosis made in Korea where the prevalence of tuberculosis is still high. Esophageal tuberculosis might be mistaken for carcinoma due to lack of specific symptom, diagnostic study or pathologic diagnosis in clinical setting. The diagnosis would be difficult when esophageal ulcerative lesions or submucosal tumor are present, especially. When the result after a biopsy is not confirmative, the diagnosis can be made with the detection of mycobacteria by microbiologic study or polymerase chain reaction. We experienced three patients with esophageal tuberculosis; a 41-year-old woman with dysphagia, a 34-year-old woman with dysphagia and odynophagia, and a 52-year-old woman with epigastric pain. Esophageal submucosal tumors were found in all the patients with upper gastrointestinal endoscopy. The diagnosis of tuberculosis were finally made by removal of tumor and biopsy or tuberculosis polymerase chain reaction. They all got improved after the treatement with anti-tuberculosis medications. Herein, we report 3 cases of esophageal tuberculosis with review of related literatures.
Adult ; Biopsy ; Deglutition Disorders ; Diagnosis ; Diagnosis, Differential ; Endoscopy, Gastrointestinal ; Female ; Humans ; Korea ; Middle Aged ; Polymerase Chain Reaction ; Prevalence ; Rare Diseases ; Tuberculosis* ; Ulcer

PURPOSE: Postoperative ileus (POI) is an impairment of coordinated gastrointestinal (GI) motility that develops as a consequence of abdominal surgery and is a major factor contributing to patient morbidity and prolonged hospitalization. The aim of this study was to investigate the effects of different 5-hydroxytryptamine 4 (5-HT4) receptor agonists, which stimulate excitatory pathways, on a POI model. MATERIALS AND METHODS: The experimental model of POI in guinea pigs was created by laparotomy, gentle manipulation of the cecum for 60 seconds, and closure by suture, all under anesthesia. Different degrees of restoration of GI transit were measured by the migration of charcoal. Colonic transit was indirectly assessed via measurement of fecal pellet output every hour for 5 hours after administration of various doses of mosapride, tegaserod, prucalopride, and 5-HT. RESULTS: Charcoal transit assay showed that various 5-HT4 receptor agonists can accelerate delayed upper GI transit in a dose-dependent manner. However, fecal pellet output assay suggested that only prucalopride had a significant effect in accelerating colonic motility in POI. CONCLUSION: Although mosapride, tegaserod, and prucalopride produce beneficial effects to hasten upper GI transit in the POI model, prucalopride administered orally restores lower GI transit as well as upper GI transit after operation in a conscious guinea pig. This drug may serve as a useful candidate for examination in a clinical trial for POI.
Administration, Oral ; Animals ; Benzamides/pharmacology ; Benzofurans/administration & dosage/*pharmacology ; Charcoal/pharmacokinetics ; Colon/drug effects ; Dose-Response Relationship, Drug ; Gastrointestinal Motility/*drug effects ; Guinea Pigs ; Ileus/*surgery ; Indoles/pharmacology ; Laparotomy ; Male ; Morpholines/pharmacology ; Postoperative Complications/drug therapy ; Serotonin/pharmacology ; Serotonin 5-HT4 Receptor Agonists/*pharmacology

PURPOSE: Small intestinal function returns first after surgery, and then the function of the stomach returns to normal after postoperative ileus (POI). The aim of this study was to investigate inflammatory responses in the muscle coat of stomach and small intestine in guinea pig POI model. MATERIALS AND METHODS: The distance of charcoal migration from pylorus to the distal intestine was measured. Hematoxylin and eosin (H&E) and immunohistochemical stain for calprotectin were done from the histologic sections of stomach, jejunum and ileum obtained at 3 and 6 hour after operation. Data were compared between sham operation and POI groups. RESULTS: The distance of charcoal migration was significantly reduced in the 3 and 6 hour POI groups compared with sham operated groups (p<0.05). On H&E staining, the degree of inflammation was significantly higher in the stomach of 3 hour POI groups compared with jejunum and ileum of POI groups or sham operated groups (p<0.05). Calprotectin positive cells were significantly increased in the muscle coat of stomach of 3 hour POI groups compared with jejunum and ileum of POI groups or sham operated groups (p<0.05). There was strong association between the degree of inflammation and calprotectin positive cells in stomach. CONCLUSION: Postoperative ileus induced by cecal manipulation significantly increased the degree of inflammation and calprotectin positive cells in the muscle coat of stomach as a remote organ. The relevance of degree of inflammation and the recovery time of ileus should be pursued in the future research.
Animals ; Charcoal ; Guinea Pigs ; Ileus/*immunology ; Male ; Muscle, Smooth/*immunology ; Stomach/*immunology

BACKGROUND/AIMS: GC7101, an extract of Lonicera Flos, is a novel developing drug for reflux esophagitis and functional dyspepsia. However, the drug's exact pharmacological mechanism of action remains unclear. This study assessed the effects of GC7101 on gastrointestinal (GI) motor function. METHODS: We used male guinea pigs to evaluate the effects of GC7101 on GI motility. The contraction of antral circular muscle in the presence of different doses of GC7101 was measured in a tissue bath. The prokinetic effects of GC7101 were tested using the charcoal transit assay from the pylorus to the most distal point of migration of charcoal mixture. To clarify the mechanism of action of GC7101, atropine, dopamine and the selective 5-hydroxytryptamine 4 receptor antagonist, GR113808 were used. RESULTS: The maximal amplitude of circular muscle contraction was induced by 5 mg mL(-1) GC7101. The area under the curve of contraction was significantly increased at 5 mg mL(-1) GC7101. Addition of 10(-6) M atropine, 10(-8) M dopamine or 10(-7) M GR 113808 to GC7101 5 mg mL(-1) decreased the amplitude and area under curve compared to GC7101 5 mg mL(-1) alone. GC7101 accelerated GI transit in a dose dependent manner except 100 mg kg(-1). Delayed GI transit caused by atropine, dopamine and GR 113808 was restored by GC7101 50 mg kg(-1). CONCLUSIONS: GC7101, an extract of Lonicera Flos, exerts a gastric prokinetic effect in guinea pig through cholinergic, antidopaminergic and serotonergic mechanisms. Therefore, GC7101 might be a novel drug for the treatment of functional dyspepsia.
Animals ; Area Under Curve ; Atropine ; Baths ; Charcoal ; Dopamine ; Dyspepsia ; Esophagitis, Peptic ; Gastrointestinal Motility ; Guinea Pigs ; Humans ; Lonicera ; Male ; Muscle Contraction ; Pylorus ; Serotonin

Melanin is produced in melanocytes and stored in melanosomes. In spite of its beneficial sun-protective effect, abnormal accumulation of melanin results in esthetic problems. Hydroquinone, competing with tyrosine, is a major ingredient in topical pharmacological agents. However, frequent adverse reactions are amongst its major limitation. To solve this problem, several alternatives such as arbutin, kojic acid, aloesin, and 4-n-butyl resorcinol have been developed. Herein, we classify hypopigmenting agents according to their mechanism of action; a) regulation of enzyme, which is subdivided into three categories, i) regulation of transcription and maturation of tyrosinase, ii) inhibition of tyrosinase activity, and iii) post-transcriptional control of tyrosinase; b) inhibition of melanosome transfer, and c) additional mechanisms such as regulation of the melanocyte environment and antioxidant agents.
Arbutin ; Chromones ; Glucosides ; Hydroquinones ; Hypopigmentation ; Melanins ; Melanocytes ; Melanosomes ; Monophenol Monooxygenase ; Pyrones ; Resorcinols ; Tyrosine

BACKGROUND/AIMS: With the enormous increase in the amount of data, the concept of big data has emerged and this allows us to gain new insights and appreciate its value. However, analysis related to gastrointestinal diseases in the viewpoint of the big data has not been performed yet in Korea. This study analyzed the data of the blog's visitors as a set of big data to investigate questions they did not mention in the clinical situation. METHODS: We analyzed the blog of a professor whose subspecialty is gastroenterology at Gangnam Severance Hospital. We assessed the changes in the number of visitors, access path of visitors, and the queries from January 2011 to December 2013. RESULTS: A total of 50,084 visitors gained accessed to the blog. An average of 1,535.3 people visited the blog per month and 49.5 people per day. The number of visitors and the cumulative number of registered posts showed a positive correlation. The most utilized access path of visitors to the website was blog.iseverance.com (42.2%), followed by Google (32.8%) and Daum (6.6%). The most searched term by the visitors in the blog was intestinal metaplasia (16.6%), followed by dizziness (8.3%) and gastric submucosal tumor (7.0%). CONCLUSIONS: Personal blog can function as a communication route for patients with digestive diseases. The most frequently searched word necessitating explanation and education was 'intestinal metaplasia'. Identifying and analyzing even unstructured data as a set of big data is expected to provide meaningful information.
Blogging/*statistics & numerical data ; Databases, Factual ; Dizziness/prevention & control ; Gastrointestinal Diseases/*prevention & control ; Humans ; Internet ; Metaplasia/prevention & control ; Stomach Neoplasms/prevention & control ; User-Computer Interface

BACKGROUND/AIMS: With the enormous increase in the amount of data, the concept of big data has emerged and this allows us to gain new insights and appreciate its value. However, analysis related to gastrointestinal diseases in the viewpoint of the big data has not been performed yet in Korea. This study analyzed the data of the blog's visitors as a set of big data to investigate questions they did not mention in the clinical situation. METHODS: We analyzed the blog of a professor whose subspecialty is gastroenterology at Gangnam Severance Hospital. We assessed the changes in the number of visitors, access path of visitors, and the queries from January 2011 to December 2013. RESULTS: A total of 50,084 visitors gained accessed to the blog. An average of 1,535.3 people visited the blog per month and 49.5 people per day. The number of visitors and the cumulative number of registered posts showed a positive correlation. The most utilized access path of visitors to the website was blog.iseverance.com (42.2%), followed by Google (32.8%) and Daum (6.6%). The most searched term by the visitors in the blog was intestinal metaplasia (16.6%), followed by dizziness (8.3%) and gastric submucosal tumor (7.0%). CONCLUSIONS: Personal blog can function as a communication route for patients with digestive diseases. The most frequently searched word necessitating explanation and education was 'intestinal metaplasia'. Identifying and analyzing even unstructured data as a set of big data is expected to provide meaningful information.
Blogging/*statistics & numerical data ; Databases, Factual ; Dizziness/prevention & control ; Gastrointestinal Diseases/*prevention & control ; Humans ; Internet ; Metaplasia/prevention & control ; Stomach Neoplasms/prevention & control ; User-Computer Interface