In 22 end-stage renal disease patients on regular hemodialysis, echocardiographic study including 2-D Doppler echocardiogrphy was performed to evaluate the effect of hemodialysis on cardiac performance and the degree of valvular regurgitation. After hemodialysis, there were significant improvement of ventricular contractility and reduction of circulating volume in accordance with the reduction of degree of valvular regurgitation in comparison with before hemodialysis. We postulate that the reduction of valvular regurgitation after hemodialysis is caused by relief of hypervolemic state.
Echocardiography* ; Echocardiography, Doppler ; Humans ; Kidney Failure, Chronic ; Renal Dialysis*

BACKGROUND: Menopause is an independent risk factor in metabolic syndrome which induced an alteration of the lipid metabolism by hormonal changes. Apolipoprotein A5 gene (APOA5) was related to the regulation of triglyceride and high density lipoprotein cholesterol (HDL-C) level with biosynthesis and decomposition. This study was conducted to investigate the relationship between APOA5 polymorphism and metabolic syndrome in Korean postmenopausal women. METHODS: This study included 307 postmenopausal women with anthropometric and biochemical measurement in 2010-2011. The polymorphism of APOA5 was analyzed by polymerase chain reaction-restriction fragment length polymorphism method with MseI restriction enzyme. RESULTS: The metabolic syndrome prevalence with TT genotype was significantly lower than the frequency in those with TC/CC (27.09%, 38.46%, and 45.71% for TT, TC, and CC, respectively; P < 0.05). Multiple regression analysis of metabolic syndrome risk factors indicated that postmenopausal women with CC genotype had a higher risk with 3 times than that in TT genotype (P < 0.05). APOA5 C carriers showed an increased risk of triglyceride level (odd ratio, 2.93 and 1.85 for CC and TC+CC, respectively; P < 0.05). Interestingly, HDL-C was related to triglyceride directly in comparison to APOA5. CONCLUSION: The results of this study indicate that APOA5 has an influence on serum triglyceride and HDL-C, which contribute to metabolic syndrome in Korean postmenopausal women.
Apolipoproteins ; Apolipoproteins A ; Cholesterol ; Cholesterol, HDL ; Female ; Genotype ; Humans ; Lipid Metabolism ; Lipoproteins ; Menopause ; Metabolic Syndrome X ; Polymorphism, Single Nucleotide ; Prevalence ; Risk Factors ; Triglycerides

Background: Staphylococcus aureus and S. pseudintermedius are the major etiological agents of staphylococcal infections in humans, livestock, and companion animals. The misuse of antimicrobial drugs has led to the emergence of antimicrobial-resistant Staphylococcus spp., including methicillin-resistant S. aureus (MRSA) and methicillin-resistant S. pseudintermedius (MRSP). One novel therapeutic approach against MRSA and MRSP is a peptide nucleic acid (PNA) that can bind to the target nucleotide strands and block expression. Previously, two PNAs conjugated with cell-penetrating peptides (P-PNAs), antisense PNA (ASP)-cmk and ASP-deoD, targeting two essential genes in S. aureus, were constructed, and their antibacterial activities were analyzed. Objectives: This study analyzed the combined antibacterial effects of P-PNAs on S. aureus and S. pseudintermedius clinical isolates. Methods: S. aureus ATCC 29740 cells were treated simultaneously with serially diluted ASPcmk and ASP-deoD, and the minimal inhibitory concentrations (MICs) were measured. The combined P-PNA mixture was then treated with S. aureus and S. pseudintermedius veterinary isolates at the determined MIC, and the antibacterial effect was examined. Results: The combined treatment of two P-PNAs showed higher antibacterial activity than the individual treatments. The MICs of two individual P-PNAs were 20 and 25 μM, whereas that of the combined treatment was 10 μM. The application of a combined treatment to clinical Staphylococcus spp. revealed S. aureus isolates to be resistant to P-PNAs and S.pseudintermedius isolates to be susceptible. Conclusions These observations highlight the complexity of designing ASPs with high efficacy for potential applications in treating staphylococcal infections in humans and animals.

BACKGROUND: Bone mineral density (BMD) is influenced by many factors. Despite the reported association between body components and BMD, most of these studies investigated the relationship between absolute muscle mass or fat mass and BMD in postmenopausal women or elderly subjects. The aim of this study is to investigate the association between muscle mass deficits (MMD) estimated from bioelectrical impedance analysis (BIA) and lumbar spinal BMD in Korean adults 20 to 49 years of age. METHODS: This cross-sectional study included 1,765 men and women who visited a health promotion center for a routine checkup. The lumbar spinal BMD was measured by dual energy X-ray absorptiometry. Body composition analysis was performed using BIA. RESULTS: The mean age of the subjects was 40.2±6.3 years. Ten thousand subjects (56.7%) were males and 126 subjects (7.1%) belonged to the low BMD (Z-score ≤-2.0). MMD had the strongest influence on BMD after adjusting for all covariates. The adjusted odds ratio of Group 3 (MDD >2.6 kg) for low BMD was 2.74 (95% CI, 1.46-5.15) after adjusting for age, gender, body mass index, height, and smoking. CONCLUSIONS: MMD estimated by BIA showed a significant association with BMD and could be regarded as an independent risk factor for low BMD in adults 20 to 49 years of age. These findings support that interventions such as physical activity or lifestyle changes may simultaneously modify both muscle and bone health in this age group.
Absorptiometry, Photon ; Adult* ; Aged ; Body Composition ; Body Mass Index ; Bone Density* ; Cross-Sectional Studies ; Electric Impedance* ; Female ; Health Promotion ; Humans ; Life Style ; Male ; Motor Activity ; Muscles ; Odds Ratio ; Osteoporosis ; Risk Factors ; Smoke ; Smoking ; Spine*

PURPOSE: Although there are more than a hundred techniques, including the transabdominal and the perineal approaches, for the repair of the rectal prolapsed, none of them is perfect. The best repair should be chosen not only to correct the prolapse but also to restore defecatory function and to improve fecal incontinence throughout the patient's lifetime. The aim of this retrospective review is to evaluate clinical outcomes of the Delorme's procedure for the management of the complete rectal prolapse. METHODS: A total of 19 patients (13 females and 6 males) with complete rectal prolapses were treated by using the Delorme's procedure in St. Vincent's Hospital, The Catholic University of Korea, from February 1997 to February 2007. Postoperative anal incontinence was evaluated using the Cleveland Clinic Incontinence Score. RESULTS: All 19 patients had incontinence to liquid stool, solid stool, and/or flatus preoperatively. Three (15.8%) patients reported recurrence of the rectal prolapse (at 6, 18, 29 months, respectively, after the operation). Information on postoperative incontinence was available for 16 of the 19 patients. Twelve of the 16 patients (75%) reported improved continence (5 [31.3%] were improved and 7 [43.7%] completely recovered from incontinence) while 4 patients had unchanged incontinence symptoms. One (6.3%) patient who did not have constipation preoperatively developed constipation after the operation. CONCLUSION: The Delorme's procedure is associated with a marked improvement in anal continence, relatively low recurrence rates, and low incidence of postoperative constipation. This allows us to conclude that this procedure still has its own role in selected patients.
Constipation ; Fecal Incontinence ; Female ; Flatulence ; Humans ; Incidence ; Korea ; Prolapse ; Rectal Prolapse ; Recurrence ; Retrospective Studies

BACKGROUND: The causes of hemolytic disease of the newborn are discrepancies of ABO group, Rh(D) or other RBC antigens. The discrepancies of Rh subgroups except Rh(D) and K typing can be seen rarely. The clinical symptoms of those types are mild and most clinicians have no interest in them. However, there exist some serious cases that need exchange transfusion. For that, we detected Rh subgroup phenotyping and Kell typing in blood obtained from cord and pregnant women and the frequency of discrepancy. METHODS: We examined the cord and mother's blood collected from 317 pregnant women from May to November, 1997. Rh(D) typing was done using slide method with anti-D (Dade, USA), and other Rh subgroup phenotyping using column agglutination test on MicroTyping system with Rh-K gel card (DiaMed, Switzerland). Irregular antibody screening was done in the cases of discrepancy. RESLUTS: The most frequent phenotype of Rh subgroup was CDe (41.3%) and then CcDEe (39.3%), but the K typing showed 0%. 90 cases of 317 pair-samples (28.4%) showed discrepancies between pregnant women and their neonates. The most frequent type of Rh discrepancy was c+E (50%) and then C or E (11.1%). 62 cord samples which obtained from neonates of Kyungpook and Chonnam provinces showed discrepancies, were all negative in the irregular antibody screening test. CONCLUSIONS: Rh subgroup phenotyping and irregular antibody screening in cord blood by column agglutination test is thought to be helpful in early diagnosis and treatment of hemolytic disease of the newborn, as a sufficient amount of cord blood can be collected easily rather than neonatal blood.
Agglutination Tests ; Blood Group Antigens* ; Early Diagnosis ; Female ; Fetal Blood ; Gyeongsangbuk-do ; Humans ; Infant, Newborn* ; Jeollanam-do ; Mass Screening ; Phenotype ; Pregnant Women*

Rectal burns caused by hot water enema have been reported only occasionally and the majority of them were treated in a conservative manner. Although intractable rectal stricture caused by rectal burn is rare, it may be treated by endoscopic intervention or surgery. A 52-year-old woman who had used various methods of enema to treat her chronic constipation eventually undertook a hot water enema herself. After that, anal pain and constipation became aggravated prompting her to visit our clinic. Although various nonoperative treatments including endoscopic stenting were performed, her obstructive symptom did not improve and endoscopic findings had not changed. Hence, we performed a laparoscopic proctosigmoidectomy and transanal coloanal anastomosis with ileal diversion to treat the disease, and as a result, her obstructive symptom improved well. Corrective surgery such as resection of involved segment with anastomosis may be beneficial in relieving obstructive symptoms of an intractable rectal stricture caused by hot water enema.
Burns ; Constipation ; Constriction, Pathologic ; Enema ; Female ; Humans ; Middle Aged ; Stents ; Water

Rectal burns caused by hot water enema have been reported only occasionally and the majority of them were treated in a conservative manner. Although intractable rectal stricture caused by rectal burn is rare, it may be treated by endoscopic intervention or surgery. A 52-year-old woman who had used various methods of enema to treat her chronic constipation eventually undertook a hot water enema herself. After that, anal pain and constipation became aggravated prompting her to visit our clinic. Although various nonoperative treatments including endoscopic stenting were performed, her obstructive symptom did not improve and endoscopic findings had not changed. Hence, we performed a laparoscopic proctosigmoidectomy and transanal coloanal anastomosis with ileal diversion to treat the disease, and as a result, her obstructive symptom improved well. Corrective surgery such as resection of involved segment with anastomosis may be beneficial in relieving obstructive symptoms of an intractable rectal stricture caused by hot water enema.
Burns ; Constipation ; Constriction, Pathologic ; Enema ; Female ; Humans ; Middle Aged ; Stents ; Water

No abstract available.
Duodenal Ulcer* ; Humans ; Recurrence*

BACKGROUND/AIMS: Intestinal cholesterol absorption includes intestinal Niemann-Pick C1-like 1 (NPC1L1) and is an important target pathway in nonalcoholic fatty liver disease (NAFLD). We investigated the expression of NPC1L1 and its correlation with liver X receptor (LXR) expression in peripheral mononuclear (PMN) cells in patients with NAFLD. METHODS: We evaluated intestinal expression of NPC1L1 in 25 NAFLD patients and 28 healthy controls. We calculated the mRNA expression levels of LXR and farnesoid X receptor (FXR), which are master players of cholesterol metabolism in PMN cells. The protein expression of ABCA1, ABCG5/8, NPC1L1, SREBP, LXR, FXR, and CD36 was measured on tissue samples from the duodenum and ileum. RESULTS: The expression of LXR (p = 0.01) and FXR (p = 0.03) in PMN cells was increased in the NAFLD group compared to the control group. Duodenal NPC1L1 decreased in the NAFLD group compared to the healthy controls (3.38 ± 1.4 vs. 2.42 ± 1.2, p = 0.05). NPC1L1 expression in the duodenum was negatively correlated with LXR expression in PMN cells. Expression of LXR and FXR in the ileum was also negatively correlated with the expression of LXR in PMN cells. CONCLUSIONS Duodenal NPC1L1 expression was decreased in NAFLD and was negatively correlated with LXR expression in PMN cells.