OBJECTIVES: To investigate the relationship between polymorphisms of secreted frizzled related protein (sFRP) genes, circulating osteoprotegerin (OPG), and soluble receptor activator of NF-kB ligand (sRANKL), and bone mineral density (BMD) in postmenopausal Korean women. METHODS: The sFRP1 c.3132C>T, rs16890444, sFRP2 c.-38C>G, and sFRP5 c.20G>C, and c.34A>T polymorphisms were analyzed by Taqman assay and dierect DNA sequencing in 170 postmenopausal Korean women. Serum CrossLaps (CTX), bone alkaline phosphatase (BAP), OPG, and sRANKL were measured by enzyme linked immunosorbent assay. The BMD at the lumbar spine and femoral neck was determined by dual energy X-ray absorptiometry. RESULTS: The sFRP2 c.-38C>G, and sFRP5 c.34A>T polymorphisms were not observed. No significant differences in adjusted BMD of lumbar spine and femoral neck and in risk for osteoporosis were noted among single genotypes of the sFRP genes polymorphisms measured or haplotype genotypes composed of the sFRP1 c.3132C>T and rs16890444 polymorphisms. No statistical significances in serum levels of bone chemical markers except BAP were observed according to single or haplotype genotypes. Serum BAP was significantly higher in women with the GG genotype than those in women with the GC genotype of the sFRP5 c.20G>C polymorphism. CONCLUSIONS: The sFRP1 c.3132C>T, rs16890444 and sFRP5 c.20G>C polymorphisms do not affect BMD at the lumbar spine and femoral neck in postmenopausal Korean women.
Alkaline Phosphatase ; Bone Density ; Collagen ; Enzyme-Linked Immunosorbent Assay ; Female ; Femur Neck ; Genotype ; Haplotypes ; Humans ; NF-kappa B ; Osteoporosis ; Osteoprotegerin ; Peptide Fragments ; Polymorphism, Genetic ; Sequence Analysis, DNA ; Spine

BACKGROUND/OBJECTIVES: Evidence indicates that berry anthocyanins are anti-atherogenic, antioxidant, and anti-inflammatory. However, berries differ vastly in their anthocyanin composition and thus potentially in their biological and metabolic effects. The present study compared hypolipidemic, antioxidant, and anti-inflammatory properties of blueberry (BB), blackberry (BK), and blackcurrant (BC) in a diet-induced obesity (DIO) mouse model. MATERIALS/METHODS: Male C57BL/6J mice were fed a high fat (HF; 35% fat, w/w) control diet or a HF diet supplemented with freeze-dried 5% BB, 6.3% BK or 5.7% BC for 12 weeks (10 mice/group) to achieve the same total anthocyanin content in each diet. Plasma lipids, antioxidant status and pro-inflammatory cytokines were measured. The expression of genes involved in antioxidant defense, inflammation, and lipid metabolism was determined in the liver, epididymal adipose tissue, proximal intestine, and skeletal muscle. Histological analysis was performed to identify crown-like structure (CLS) in epididymal fat pads to determine macrophage infiltration. RESULTS: No differences were noted between the control and any berry-fed groups in plasma levels of liver enzymes, insulin, glucose, ferric reducing antioxidant power, superoxide dismutase, and tumor necrosis factor α. However, BK significantly lowered plasma triglyceride compared with the HF control and other berries, whereas BC significantly reduced F4/80 mRNA and the number of CLS in the epididymal fat pad, indicative of less macrophage infiltration. CONCLUSIONS: The present study provides evidence that BB, BK and BC with varying anthocyanin composition differentially affect plasma lipids and adipose macrophage infiltration in DIO mice, but with no differences in their antioxidant capacity and anti-inflammatory potential.
Adipose Tissue ; Animals ; Anthocyanins ; Blueberry Plant* ; Cytokines ; Diet ; Fruit ; Glucose ; Humans ; Inflammation ; Insulin ; Intestines ; Lipid Metabolism ; Liver ; Macrophages ; Male ; Mice* ; Muscle, Skeletal ; Obesity* ; Plasma* ; RNA, Messenger ; Rubus* ; Superoxide Dismutase ; Triglycerides ; Tumor Necrosis Factor-alpha

PURPOSE: The purpose of this study was to evaluate the effect of abdominal massage on alleviating pain caused by the injection of recombinant gonadotropin for In Vitro Fertilization (IVF) among infertile women. METHODS: This study employed a nonequivalent control group non-synchronized design. A total sample of 149 infertile women who never experienced in vitro fertilization was recruited at C fertility center. Seventy women were assigned into experimental group and 79 into controls. The experimental group had been informed to do abdominal massage prior to the injection and to record their subjective pain using visual analogue scale. The control group had been informed to record their subjective pain in the same way just after the injection. RESULTS: Compared to the pre-tested pain scores, the pain scores in experimental group were significantly reduced by 0.7 points, whereas the control group increased by 0.9 points (t=-4.55, p=.001). CONCLUSION: This study confirms that the use of abdominal massage prior to the injection is an effective way to alleviate pain on injection site. This massage may be a useful intervention for infertile women about pain alleviation.
Female ; Fertility ; Fertilization in Vitro* ; Gonadotropins ; Humans ; In Vitro Techniques* ; Massage*

Degree of HLA matching between donor and recipient is a well-known risk factor affecting the renal allograft function and survival. This study presents long-term clinical outcomes of kidney transplantation between HLA identical siblings from a single center. A total of 60 patients (pts), who has been followed up more than 10 years were identified and constituted the cohort of this study. The graft and patient survival were estimated with Kaplan-Meier's analysis method. Causes of graft loss and pts' death, episode of acute and chronic rejection, allograft function, and long-term complications were reviewed from medical records. Before 1984, azathioprine (AZA) and steroids were used for immunosuppression, but cyclosporine (regular oral solution, regular capsules or microemulsion preparation) and a low dose steroid has been the mainstay of immunosuppression since 1984. Earlier 37 pts were treated with AZA/steroids protocol (AZA group) and later 23 pts were immunosuppressed with cyclosporine (CsA)/steroids protocol (CsA group). Mean duration of follow-up months was 151 in AZA and 114 in CsA group respectively. Mean age of recipients at the time of transplantation was 34.1 years in AZA and 34.7 years in CsA group. Ten year graft survival in each group were 67.6% and 65.2% (p=0.672) and patient survival were 82.7% and 80.0% (p=0.833) respectively. Adoption of CsA/steroids protocol since 1984 did not significantly improve the graft and patient survival comparing AZA/steroids protocol. During the period, 12 patients died of various causes. The leading causes of patient death were cerebrovascular disease (3) and infection (3). Twenty-two grafts were lost: 13 in AZA and 9 in CsA group. The common causes of graft loss were pts' death with functioning graft (12), chronic rejection (5), and poor compliance (4). We could not find any differences in the causes of mortality and graft loss between the AZA and CsA groups. Mean serum creatinine in the chronic rejection-free pts at post-transplant 10 year were 1.4 and 1.3 mg/dl in or CsA group. CsA/steroids protocol did not improve the long-term outcome in HLA matched pairs. Long surviving transplant recipients continue to experience a variety of medical and surgical complications. For this reason, continued follow-up by experienced medical personnel is essential. Measures need to be taken to prevent and manage these late complications. Continued investigation into new and better immunosuppressive modalities is essential in an attempt to prevent the long-term consequences of maintenance immunosuppression.
Allografts ; Azathioprine ; Capsules ; Cohort Studies ; Compliance ; Creatinine ; Cyclosporine ; Follow-Up Studies ; Graft Survival ; Humans ; Immunosuppression ; Kidney Transplantation* ; Kidney* ; Medical Records ; Mortality ; Risk Factors ; Siblings* ; Steroids ; Tissue Donors ; Transplantation ; Transplants

Degree of HLA matching between donor and recipient is a well-known risk factor affecting the renal allograft function and survival. This study presents long-term clinical outcomes of kidney transplantation between HLA identical siblings from a single center. A total of 60 patients (pts), who has been followed up more than 10 years were identified and constituted the cohort of this study. The graft and patient survival were estimated with Kaplan-Meier's analysis method. Causes of graft loss and pts' death, episode of acute and chronic rejection, allograft function, and long-term complications were reviewed from medical records. Before 1984, azathioprine (AZA) and steroids were used for immunosuppression, but cyclosporine (regular oral solution, regular capsules or microemulsion preparation) and a low dose steroid has been the mainstay of immunosuppression since 1984. Earlier 37 pts were treated with AZA/steroids protocol (AZA group) and later 23 pts were immunosuppressed with cyclosporine (CsA)/steroids protocol (CsA group). Mean duration of follow-up months was 151 in AZA and 114 in CsA group respectively. Mean age of recipients at the time of transplantation was 34.1 years in AZA and 34.7 years in CsA group. Ten year graft survival in each group were 67.6% and 65.2% (p=0.672) and patient survival were 82.7% and 80.0% (p=0.833) respectively. Adoption of CsA/steroids protocol since 1984 did not significantly improve the graft and patient survival comparing AZA/steroids protocol. During the period, 12 patients died of various causes. The leading causes of patient death were cerebrovascular disease (3) and infection (3). Twenty-two grafts were lost: 13 in AZA and 9 in CsA group. The common causes of graft loss were pts' death with functioning graft (12), chronic rejection (5), and poor compliance (4). We could not find any differences in the causes of mortality and graft loss between the AZA and CsA groups. Mean serum creatinine in the chronic rejection-free pts at post-transplant 10 year were 1.4 and 1.3 mg/dl in or CsA group. CsA/steroids protocol did not improve the long-term outcome in HLA matched pairs. Long surviving transplant recipients continue to experience a variety of medical and surgical complications. For this reason, continued follow-up by experienced medical personnel is essential. Measures need to be taken to prevent and manage these late complications. Continued investigation into new and better immunosuppressive modalities is essential in an attempt to prevent the long-term consequences of maintenance immunosuppression.
Allografts ; Azathioprine ; Capsules ; Cohort Studies ; Compliance ; Creatinine ; Cyclosporine ; Follow-Up Studies ; Graft Survival ; Humans ; Immunosuppression ; Kidney Transplantation* ; Kidney* ; Medical Records ; Mortality ; Risk Factors ; Siblings* ; Steroids ; Tissue Donors ; Transplantation ; Transplants

OBJECTIVES: To investigate the relationship between single nucleotide polymorphism (SNP)s in Wnt antagonist genes, and production of osteoprotegerin (OPG) and soluble receptor activator of NF-kappaB ligand (sRANKL) by whole blood cells after hormone therapy (HT) in postmenopausal Korean women. MATERIALS AND METHODS: The Dkk1 c.318A>G, Dkk2 c.437G>A, Dkk3 c.1003A>G polymorphisms and sFRP3 c.970C>G, sFRP4 c.958C>A, and c.1019G>A polymorphisms, and sFRP5 c.20G>C polymorphisms were analyzed by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP), direct sequencing, and Taqman assay in 75 postmenopausal Korean women receiving estrogen-progestogen therapy. The production of OPG and sRANKL by lipopolysaccharide-stimulated whole blood cells (WBC) before and after HT of 6 months were also measured. RESULTS: Changes in the production of OPG and sRANKL by lipopolysaccharide-stimulated WBC, and in ratios of sRANKL(x1,000)/OPG after HT of 6 months were not different according to SNPs in Wnt signal pathway genes except Dkk1 c.318A>G SNP. The AA genotype of Dkk1 c.318A>G SNP showed significantly higher changes (p<0.05) in ratios of sRANKL(x1,000)/OPG compared to other genotypes. There were no significant differences in changes in the production of OPG and sRANKL, and in ratios of sRANKL(x1,000)/OPG among combined genotypes of sFRP4 c.958C>A, and c.1019G>A polymorphisms after HT. CONCLUSIONS: Dkk1 c.318A>G SNP are related with changes in ratios of sRANKL(x1,000)/OPG in terms of the production of OPG and sRANKL by lipopolysaccharide-stimulated whole blood cells after HT.
Blood Cells ; Female ; Genotype ; Humans ; NF-kappa B ; Osteoprotegerin ; Polymorphism, Single Nucleotide ; Receptor Activator of Nuclear Factor-kappa B ; Signal Transduction

The frequency distribution of cardiovascular disease are changing recently due to the development of living environment. Unfortunately there are few epidemiological studies of cardiovascular diseases in general population, we tried to estimate the recent trend of cardiovascular diseases studying hospitalized patients in nationwide 13 large hospitals during a year of 1985. The hypertensive disease (24.1%) was the most common cardiovascular disease and the next were cerebrovascular disease (15.8%), arrhythmias (12.2%), ischemic heart disease (9.7%), congenital heart disease (9.1%), and rheumatic heart disease (5.4%) in order. This results showed that hypertensive disease and cerebrovascular disease are still the major cardiovascular disease and ischemic heart disease and arrhythmias are increased. But chronic rheumatic heart disease is declined compared with previous studies in hospitalized patients.
Adolescent ; Adult ; Aged ; Cardiovascular Diseases/*epidemiology ; Coronary Disease/*epidemiology ; Female ; Humans ; Korea ; Male ; Middle Aged ; Rheumatic Heart Disease/*epidemiology

PURPOSE: In order to provide effective hospice care, adequate length of survival (LOS) in hospice is necessary. However the reported average LOS is much shorter. Analysis of LOS in hospice has not been reported from Korea. We evaluated the duration of LOS and the factors associated with LOS at our hospice center. MATERIALS AND METHODS: We retrospectively examined 446 patients who were admitted to our hospice unit between January 2010 and December 2012. We performed univariate and multivariate analysis for analysis of factors associated with LOS. RESULTS: The median LOS was 9.5 days (range, 1 to 186 days). The LOS of 389 patients (86.8%) was< 1 month. At the time of admission to hospice, 112 patients (25.2%) were completely bedridden, 110 patients (24.8%) had mouth care only without intake, and 134 patients (30.1%) had decreased consciousness, from confusion to coma. The median time interval between the day of the last anticancer treatment and the day of hospice admission was 75 days. By analysis of the results of multivariate analysis, decreased intake and laboratory results showing increased total white blood cell (WBC), decreased platelet count, increased serum creatinine, increased aspartate aminotransferase (AST), alanine aminotransferase (ALT), and lactate dehydrogenase (LDH) level were poor prognostic factors for survival in hospice. CONCLUSION: Before hospice admission, careful evaluation of the patient's performance, particularly the oral intake, and total WBC, platelet, creatinine, AST, ALT, and LDH level is essential, because these were strong predictors of shorter LOS. In the future, conduct of prospective controlled studies is warranted in order to confirm the relationship between potential prognostic factors and LOS in hospice.
Alanine Transaminase ; Aspartate Aminotransferases ; Blood Platelets ; Coma ; Consciousness ; Creatinine ; Hospice Care ; Hospices* ; Humans ; Korea ; L-Lactate Dehydrogenase ; Leukocytes ; Mouth ; Multivariate Analysis ; Platelet Count ; Prognosis ; Retrospective Studies ; Survival Analysis

This research aimed to investigate the changes in ethical issues in everyday clinical practice recognized by critical care nurses during two observation periods. We conducted a retrospective analysis of data obtained by prospective questionnaire surveys of nurses in the intensive care units (ICU) of a tertiary university-affiliated hospital in Seoul, Korea. Data were collected prospectively during two different periods, February 2002-January 2003 (Period 1) and August 2011-July 2012 (Period 2). Significantly fewer cases with ethical issues were reported in Period 2 than in Period 1 (89 cases [2.1%] of 4,291 ICU admissions vs. 51 [0.5%] of 9,302 ICU admissions, respectively; P < 0.001). The highest incidence of cases with identified ethical issues in both Periods occurred in MICU. The major source of ethical issues in Periods 1 and 2 was behavior-related. Among behavior-related issues, inappropriate healthcare professional behavior was predominant in both periods and mainly involved resident physicians. Ethical issue numbers regarding end-of-life (EOL) care significantly decreased in the proportion with respect to ethical issues during Period 2 (P = 0.044). In conclusion, the decreased incidence of cases with identified ethical issues in Period 2 might be associated with ethical enhancement related with EOL and improvements in the ICU care environment of the studied hospital. However, behavior-related issues involving resident physicians represent a considerable proportion of ethical issues encountered by critical care nurses. A systemic approach to solve behavior-related issues of resident physicians seems to be required to enhance an ethical environment in the studied ICU.
Critical Care Nursing/*ethics ; Humans ; *Intensive Care Units ; Nurses ; Retrospective Studies ; Terminal Care ; Tertiary Care Centers