Background: Sarcopenia is a skeletal muscle disorder that involves the loss of muscle mass and function. Handgrip strength (HGS) is the most commonly used tool to assess muscle strength to diagnose sarcopenia. HGS is also associated with various diseases and health outcomes. Thus, we aimed this study to examine the HGS status in Korean adults and relevant factors of HGS. Methods: Data was obtained from the 7th Korea National Health and Nutrition Examination Survey (KNHANES), a population-based nationwide survey. The estimated mean value of HGS was calculated in each age group. The mean HGS in men and women aged over 40 was compared according to the household income level, lifestyle factors, and comorbidities. Results: A total of 16,708 participants were included in this study. The mean HGS showed a maximum value in the 30s for both men and women, and then tended to decrease with increasing age. When analyzed for people aged 40 or older, the mean HGS was significantly higher in the current or past smoker, drinker, and aerobic exercise groups in both men and women. The mean HGS was lower in the group with comorbidities such as hypertension, dyslipidemia, type 2 diabetes, and bone diseases. Conclusion Our study found that the mean HGS was significantly different between those with and without underlying chronic diseases. In groups with relevant comorbidities, close monitoring for the development of sarcopenia and taking preventive measures such as exercise and nutritional support may be recommended.

Background: Sarcopenia is a skeletal muscle disorder that involves the loss of muscle mass and function. Handgrip strength (HGS) is the most commonly used tool to assess muscle strength to diagnose sarcopenia. HGS is also associated with various diseases and health outcomes. Thus, we aimed this study to examine the HGS status in Korean adults and relevant factors of HGS. Methods: Data was obtained from the 7th Korea National Health and Nutrition Examination Survey (KNHANES), a population-based nationwide survey. The estimated mean value of HGS was calculated in each age group. The mean HGS in men and women aged over 40 was compared according to the household income level, lifestyle factors, and comorbidities. Results: A total of 16,708 participants were included in this study. The mean HGS showed a maximum value in the 30s for both men and women, and then tended to decrease with increasing age. When analyzed for people aged 40 or older, the mean HGS was significantly higher in the current or past smoker, drinker, and aerobic exercise groups in both men and women. The mean HGS was lower in the group with comorbidities such as hypertension, dyslipidemia, type 2 diabetes, and bone diseases. Conclusion Our study found that the mean HGS was significantly different between those with and without underlying chronic diseases. In groups with relevant comorbidities, close monitoring for the development of sarcopenia and taking preventive measures such as exercise and nutritional support may be recommended.

The importance of adopting healthy exercise routines has been repeatedly emphasized to individuals with diabetes mellitus (DM). However, knowledge about the risk of exercise-induced hypoglycemia is limited. Regular exercise reduces and delays the onset of DM-related complications particularly in individuals who already have DM. However, an excessive exercise can lead to hypoglycemia. Excessive exercise in the evening can cause hypoglycemia while sleeping. Furthermore, if individuals with DM want to have a greater amount of exercise, the exercise duration rather than intensity must be increased. In weight resistance exercises, it is beneficial to first increase the number of repetitions, followed by the number of sets and gradually the weight of resistance. When performing intermittent high-intensity training within a short time period, hypoglycemia may develop for an extended period after exercise. In addition to adjusting exercise regimens, the medication doses must be modified accordingly. Delaying exercise, adjusting the number of snacks consumed prior to exercise, reducing insulin dose before exercise, and injecting insulin into the abdomen rather than the limbs prevent exercise-induced hypoglycemia prior to a spontaneous exercise. Ultimately, with personal knowledge on how to prevent hypoglycemia, the effects of exercise can be maximized in individuals with DM, and a healthy lifestyle can prevent future complications.

The importance of adopting healthy exercise routines has been repeatedly emphasized to individuals with diabetes mellitus (DM). However, knowledge about the risk of exercise-induced hypoglycemia is limited. Regular exercise reduces and delays the onset of DM-related complications particularly in individuals who already have DM. However, an excessive exercise can lead to hypoglycemia. Excessive exercise in the evening can cause hypoglycemia while sleeping. Furthermore, if individuals with DM want to have a greater amount of exercise, the exercise duration rather than intensity must be increased. In weight resistance exercises, it is beneficial to first increase the number of repetitions, followed by the number of sets and gradually the weight of resistance. When performing intermittent high-intensity training within a short time period, hypoglycemia may develop for an extended period after exercise. In addition to adjusting exercise regimens, the medication doses must be modified accordingly. Delaying exercise, adjusting the number of snacks consumed prior to exercise, reducing insulin dose before exercise, and injecting insulin into the abdomen rather than the limbs prevent exercise-induced hypoglycemia prior to a spontaneous exercise. Ultimately, with personal knowledge on how to prevent hypoglycemia, the effects of exercise can be maximized in individuals with DM, and a healthy lifestyle can prevent future complications.

Background: There is a dearth of research on the factors linked with adverse events (AEs) associated with nirmatrelvir/ritonavir (NMVr) and molnupiravir (MOL), particularly in the elderly. Therefore, this study aimed to investigate self-reported AEs and identify factors associated with the occurrence of AEs following NMVr or MOL treatment among survey participants aged 60 years or older in South Korea. Methods: This nationwide survey was conducted through in-person interviews using structured questionnaires, from July 24 to August 31, 2023. Eligible participants included individuals aged 60 years or older who had been diagnosed with coronavirus disease 2019 (COVID-19) and received NMVr or MOL. The study outcomes included self-reported demographic, lifestyle, and health characteristics associated with the occurrence of AEs.Multivariate logistic regression analysis was used to estimate the adjusted odds ratio (aOR) and 95% confidence interval (CI) of each characteristic in participants with and without AEs. Results: Of the 520 participants, 123 (23.7%) experienced at least one AE with oral COVID-19 treatment: 21.0% (96/458) for NMVr and 43.5% (27/62) for MOL. None of the participants reported any serious AEs. Increased odds of AE occurrence were observed in participants treated with MOL compared to those treated with NMVr (aOR, 3.05; 95% CI, 1.67–5.57), a history of two or more compared to one COVID-19 diagnosis (1.93; 1.03–3.62), and selfreported health status as “Unhealthy” compared to “Healthy” (2.65; 1.31–5.36). Conclusion No AEs required further evaluation to change treatment strategies in elderly patients on NMVr or MOL. Several factors, including the use of MOL, history of COVID-19, and reported health status, were associated with an increased incidence of AEs. Both treatments may still be useful choices for patients with non-severe COVID-19 aged 60 years or older. However, close monitoring of unidentified potential harm and further investigation of the factors associated with the occurrence of AEs are needed.

PURPOSE: The biologic behavior of tumor cells is partially controlled by the microenvironment. We investigated the expression levels of several genes involved in metastasis and drug response in RENCA cells growing in ectopic (skin) and orthotopic (kidney) sites. MATERIALS AND METHODS: Murine renal carcinoma cells were injected into kidney (orthotopic) and subcutis (ectopic) of syngeneic mice. Mice were treated with doxorubicin (DXR) (8 mg/kg) on days 8 and 15 after tumor cell implantation. Drug response was measured both in vivo and ex vivo by measuring tumor size and MTT assay. We also performed an in situ mRNA hybridization to estimate the expression levels of mdr (multidrug resistance), EGFR (epidermal growth factor receptor) and type IV collagenase. RESULTS: RENCA cells growing in the kidney of syngeneic mice produced metastatic lesions in the lung (57% of mice), while the same cells growing in the subcutis did not. Tumors growing in the kidney were more resistant to DXR than tumors growing in the subcutis. MTT assays revealed that tumor cells derived from kidney were more resistant to DXR than those cells from subcutis. In situ hybridization analyses showed that transcripts of EGFR and type IV collagenase genes in kidney tumors were higher than those of subcutaneous tumors but mdr expression showed no difference between the two tumors. CONCLUSION: These results demonstrate that the organ environment influences the drug responsive ness and the expression of EGFR and type IV collagenase genes in murine renal cell carcinoma cells.
Animals ; Carcinoma, Renal Cell* ; Collagenases ; Doxorubicin ; Gene Expression Regulation* ; In Situ Hybridization ; Kidney ; Lung ; Mice* ; Neoplasm Metastasis ; Receptor, Epidermal Growth Factor ; RNA, Messenger

BACKGROUND: Dendritic cells (DCs) are increasingly being utilized for anti-cancer immunotherapy. Acute myeloid leukemia (AML) blasts are able to generate leukemia-derived DC. Advances in culture techniques and AML-DC characterization justify possible clinical applications. We investigated the ability of AML, acute lymphoblastic leukemia (ALL) and biphenotypic acute leukemia (BAL) blasts to differentiate into DCs in vitro and the qualified function of the leukemia-derived DCs. METHODS: Leukemia cells from 11 patients with AML, 3 patients with ALL and 2 patients with BAL were cultured with GM-CSF, IL-4 and with or without SCF. Cultured leukemia cells were evaluated by phenotype, mixed lymphocyte reaction (MLR), cytokine production and cytotoxic T cell (CTL) inducing activity. RESULTS: DCs were generated with GM-CSF and IL-4 from the leukemic blasts in 72% of the AML patient cells. MHC class I/II, CD11c and ICAM-1 were highly expressed in the AML-derived DCs. MLR and enzyme linked immunospot (ELISPOT) assays demonstrated that AML-DCs were able to induce T cell proliferation and activation into IFN-gamma secreting effector cells. The ALL blasts from two out of three patients differentiated into DCs with MHC class I/II+, CD11c+ only in the presence of GM-CSF, SCF and IL-4 for 14 days. CONCLUSION: These results suggest that functionallyactive DCs can be differentiated from AML blasts using GM-GSF and IL-4 and ALL, BAL blasts were differentiated into DCs only under stem cell-DC culture conditions.
Cell Proliferation ; Culture Techniques ; Dendritic Cells ; Granulocyte-Macrophage Colony-Stimulating Factor ; Humans ; Immunotherapy ; Intercellular Adhesion Molecule-1 ; Interleukin-4 ; Leukemia* ; Leukemia, Biphenotypic, Acute ; Leukemia, Myeloid, Acute ; Lymphocyte Culture Test, Mixed ; Phenotype ; Precursor Cell Lymphoblastic Leukemia-Lymphoma

Background: It remains unclear whether a combination of glycemic variability and glycated hemoglobin (HbA1c) status leads to a higher incidence of cardiovascular disease (CVD).Therefore, to investigate CVD risk according to the glucose control status during early diabetes, we examined visit-to-visit HbA1c variability among patients with type 2 diabetes (T2DM). Methods: In this 9-year retrospective study, we measured HbA1c levels at each visit and tracked the change in HbA1c levels for 3 years after the first presentation (observation window) in newly diagnosed T2DM patients. We later assessed the occurrence of CVD in the last 3 years (target outcome window) of the study period after allowing a 3-year buffering window. The HbA1c variability score (HVS; divided into quartiles, HVS_Q1–4) was used to determine visit-to-visit HbA1c variability. Results: Among 4,817 enrolled T2DM patients, the mean HbA1c level was < 7% for the first 3 years. The group with the lowest HVS had the lowest rate of CVD (9.4%; 104/1,109 patients).The highest incidence of CVD of 26.7% (8/30 patients) was found in HVS [≥ 9.0%]_Q3, which was significantly higher than that in HVS [6.0–6.9%]_Q1 (P = 0.006), HVS [6.0–6.9%]_Q2 (P = 0.013), HVS [6.0–6.9%]_Q3 (P = 0.018), and HVS [7.0–7.9%]_Q3 (P = 0.040). Conclusion To our knowledge, this is the first long-term study to analyze the importance of both HbA1c change and visit-to-visit HbA1c variability during outpatient visits within the first 3 years. Lowering glucose levels during early diabetes may be more critical than reducing visit-to-visit HbA1c variability.

Background: We evaluated patients visiting a tertiary university hospital due to a diagnosis of diabetes with a goal of achieving blood glucose control and evaluated blood glucose persistence over 7 years according to the change in blood glucose evident at 3 months after the first visit. Methods: Patients treated from 2009 to 2013 were categorized into four groups according to the change in HbA1c levels during the first 3 months of follow-up (Best_group, ≥ 1.6% decrease; Better_group, 0.5–1.5% decrease; Neutral_group, maintained at −0.4% to +0.4%; Worse_group, ≥ 0.5% increase). Each patient’s blood glucose control status was then monitored for 7 years. The incidence of stroke and acute coronary syndrome during this period was confirmed. Results: Overall, 9,776 patients were included. HbA1c values were lower in the Best_group than in the other groups at all time points (all P < 0.001). The rate of reaching targets of < 6.5% or < 7.0% HbA1c decreased over time; the rate at which the estimated glomerular filtration rate decreased to < 30 or < 60 mL/min/1.73m 2 increased over time (all trends, P < 0.01). Conclusion Blood glucose control status in the first 3 months after initiating hospital care enabled estimation of the patient’s glycemic control status for the next 7 years. In cases with poor initial blood glucose control, a new or more active method of blood glucose control should be sought.

BACKGROUND: As a potent antigen presenting cell and a powerful inducer of antigen specific immunity, dendritic cells (DCs) are being considered as a promising anti-tumor therapeutic module. The expected therapeutic effect of DCs in renal cell carcinoma was tested in the mouse model. Established late-stage tumor therapeutic (E-T) and minimal residual disease (MRD) model was considered in the in vivo experiments. METHODS: Syngeneic renal cell carcinoma cells (RENCA) were inoculated either subcutaneously (E-T) or intravenously (MRD) into the Balb/c mouse. Tumor cell lysate pulsed-DCs were injected twice in two weeks. Intraperitoneal DC injection was started 3 week (E-T model) or one day (MRD model) after tumor cell inoculation. Two weeks after the final DC injection, the tumor growth and the systemic immunity were observed. Therapeutic DCs were cultured from the bone marrow myeloid lineage cells with GM-CSF and IL-4 for 7 days and pulsed with RENCA cell lysate for 18 hrs. RESULTS: Compared to the saline treated group, tumor growth (E-T model) or formation (MRD model) was suppressed in pulsed-DC treated group. RENCA specific lymphocyte proliferation was observed in the RENCA tumor-bearing mice treated with pulsed-DCs. Primary cytotoxic T cell activity against RENCA cells was increased in pulsed-DC treated group. CONCLUSION: The data suggest the possible anti-tumor effect of cultured DCs in established or minimal residual disease/metastasis state of renal cell carcinoma. Systemic tumor specific immunity including cytotoxic T cell activity was modulated also in pulsed-DC treated group.
Animals ; Bone Marrow ; Carcinoma, Renal Cell* ; Dendritic Cells* ; Granulocyte-Macrophage Colony-Stimulating Factor ; Immunotherapy* ; Interleukin-4 ; Lymphocytes ; Mice* ; Neoplasm, Residual