OBJECTIVETo investigate suitable biomarkers for workers exposure to trimethyltin chloride (TMT-cl).

METHODSUrinary samples of 44 male workers from five TMT-cl occupational poisoning incidents were collected. Methyltin mercaptide stabilizers and waste plastics used in the incidents were also collected. The levels of TMT-cl in all the samples were determined by gas chromatography. The concentration of blood potassium for each poisonings was determined compared to control group (50 male workers of a food company), and the correlation between blood potassium and urinary TMT-cl were also determined.

RESULTSTMT-cl was detected in urine of all the poisonings. The results were (0.869 +/- 0.392) microg/L (severe poisoning), (0.963 +/- 0.482) microg/L (moderate poisoning), (0.716 +/- 0.384) microg/L (mild poisoning) respectively and the difference was statistically significant (P < 0.01). But the severity of the clinical status did not seem to be closely correlated to the level of urinary TMT-cl (F = 1.88, P > 0.05). In the severe poisonings, there were no differences in urinary TMT-cl on day 4 after poisoning from day 1 (P > 0.05). In contrast, urinary TMT-cl was decreased significantly on day 4 than on day 1 in mild and moderate poisonings (P < 0.01). On day 21, levels of urinary TMT-cl of all the poisonings were higher than those of the workers exposed to TMT-cl who had no clinical status (P < 0.01). Blood potassium levels of exposed group was 77.3% which was significantly lower than normal value (P < 0.01). The concentration of blood potassium was lower than normal value (3.5 mmol/L) and was correlated with the severity of the clinical status (F = 4.45, P < 0.05). Level of urinary TMT-cl of exposed group was negatively correlated with blood potassium (r = -0.4456, P < 0.01).

CONCLUSIONLevel of urinary TMT-cl can be used as exposure biomarker of TMT-cl poisoning. Blood potassium is an early biomarker of effect for TMT-cl poisoning so as to find poisoning population early.

Adult ; Biomarkers ; blood ; urine ; Humans ; Male ; Middle Aged ; Occupational Exposure ; adverse effects ; Potassium ; blood ; Trimethyltin Compounds ; poisoning ; urine ; Young Adult

The effect of NaCl plus 3% chitosan on the systolic blood pressure of spontaneously hypertensive rats (SHR) were evaluated and compared with NaCl plus KCl (NaCl, 49.36% + KCl 49.36%) and chitosan or NaCl treatment alone. In SHR, administration of NaCl plus chitosan (44 mM Na/day) for two months significantly decreased the systolic blood pressure greater than of NaCl plus KCl and NaCl alone. NaCl plus chitosan resulted, though not statistically significant, in decreased urinary Na+ excretion and decreased blood urea nitrogen levels. Urinary creatinine of NaCl plus chitosan was slightly decreased compared to 3 treated groups. Serum electrolytes levels, however, remained unchanged. The combination of NaCl and chitosan may be superior to the conventional use of NaCl plus KCl or NaCl alone in the prevention of hypertension. Even though these supplementary diets have demonstrated potential anti-hypertensive effects in the experimental animal model, further research is needed before any recommendations can be made.
Angiotensin I/blood ; Angiotensin II/biosynthesis ; Animals ; Blood Pressure/*drug effects/physiology ; Blood Urea Nitrogen ; Body Weight/drug effects ; Chitosan/*administration & dosage ; Chlorides/blood/urine ; Creatinine/urine ; Heart/physiology ; Histocytochemistry ; Hypertension/*prevention & control ; Kidney/physiology ; Male ; Potassium/blood/urine ; Potassium Chloride/administration & dosage ; Random Allocation ; Rats ; Rats, Inbred SHR ; Sodium/blood/urine ; Sodium Chloride, Dietary/*administration & dosage ; Systole/drug effects/physiology

OBJECTIVESalt-sensitivity plays an important role in essential hypertension and is associated with more severe target organ injury and higher mortality in patients with essential hypertension. However, the pathologic mechanism of salt-sensitivity is poorly understood and endothelial dysfunction might be involved in salt-sensitive hypertension. We, therefore, observed the endothelial function changes by measuring plasma and urine nitric oxide (NO) concentrations in salt-sensitive (SS) normotensive and mild hypertensive subjects underwent various salt loading protocols and the effects of potassium supplement.

METHODSThirty-nine normotensive and mild hypertensive subjects (< 160/100 mm Hg), aged 16-60, were enrolled and the study protocol is as follows: 3 days baseline investigation, 1 week low-salt loading (3 g/day), 1 week. high-salt loading (18 g/day) and 1 week high-salt loading plus potassium chloride (4.5 g/day).

RESULTSPlasma and urine NO levels were significantly lower in SS (n = 8) subjects at baseline, low-salt and high-salt loading phases compared with salt-resistant subjects (SR, n = 31) and oral potassium supplement to SS subjects with high salt loading significantly increased plasma and urine NO levels.

CONCLUSIONEndothelial function is impaired in normotensive and mild hypertensive SS subjects. Oral potassium supplement could improve endothelial function in normotensive and mild hypertensive SS subjects.

Adult ; Antihypertensive Agents ; Blood Pressure ; Endothelium ; physiology ; Female ; Humans ; Hypertension ; epidemiology ; physiopathology ; Male ; Nitric Oxide ; blood ; urine ; Potassium, Dietary ; administration & dosage

Primary aldosteronism is defined as hypertension, hypokalemia, increased serum aldosteron, decreased serum renin activity. It has been known that prolonged hypokalemia, renal cyst formation and impairment of renal function. However, nephrocalcinosis associated with primary aldosteronism is rarely reported. A 31-year-old male was admitted to our hospital because of abdominal pain and uncontrolled hypertention which developed 2 years earlier. At admission, blood pressure 180/100 mmHg. Biochemical findings indicated sodium 146 mEq/L, potassium 2.3 mEq/L, BUN 8.2 mg/dL, creatinine 1.1 mg/dL, calcium 10.7 mg/dL, phosphate 5.7 mg/dL, magnesium 1.8 mg/dL. Twenty-four hour urine collection indicated sodium 108 mEq, potassium 32 mEq, calcium 75 mg, phosphate 72 mg, magnesium 8.0 mg. The hormone study revealed PTH 22.7 pg/mL (normal: 9~55 pg/mL), ACTH 8 pg/mL (normal: 6~56.7 pg/mL), aldosterone 51.0 ng/dL (normal: 1~16 ng/dL), plasma renin activity below 0.01 ng/mL/hr (normal: 0.15~233 ng/mL/hr). Abdominal sonography showed homogenous increased medullary echoes and multiple calcification. The abdomen CT showed adrenal mass (1 x 1 cm) consistent with adrenal tumor. Adrenalrectomy was performed on the 16th hospital day and clinical symptoms, blood pressure and hypokalemia improved shortly after operation.
Abdomen ; Abdominal Pain ; Adrenocorticotropic Hormone ; Adult ; Aldosterone ; Blood Pressure ; Calcium ; Creatinine ; Humans ; Hyperaldosteronism* ; Hypertension ; Hypokalemia ; Magnesium ; Male ; Nephrocalcinosis* ; Plasma ; Potassium ; Renin ; Sodium ; Urine Specimen Collection

Purpose: In order to identify the stone risk factors for stone patients with hypertension, we analyzed the stone metabolic studies of stone patients with hypertension and stone patients without hypertension. Materials and Methods: Between January 1998 and December 2005, we analyzed 92 urinary calculi patients with hypertension, and we also 210 urinary calculi patients who had no history of hypertension as a control group. Hypertension was defined as systolic blood pressure >140 mmHg or a diastolic pressure >90mmHg or both, or those patients who were on drug therapy for hypertension. We evaluated such metabolic risk factors as calcium, sodium, potassium, chloride, uric acid, oxalate, phosphorus, the total urine volume and urine citrate level of the 24-hour urine collection, and the uric acid, calcium, phosphorus, cholesterol, triglyceride from the serum. Results: The mean age was 53.2+/-11.2 in the hypertensive group and 48.4+/-14.0 in the normotensive group. There were significant differences between the hypertensive group and the normotensive group for the body mass index (BMI) (28.7+/-0.9kg/m2 vs 25.1+/-1.1kg/m2, respectively), weight (73.2+/-3.2kg vs 67.4+/-2.1kg respectively) and urine calcium (262.4+/-21.7 mg/day vs 205.2+/-22.3mg/day respectively), uric acid (662.7+/-184.3mg/ day vs 578.3+/-179.2 mg/day respectively). Moreover, there were significant differences between the two groups for total cholesterol (198.5+/-47.4mg/dl vs 167.1+/-42.5 mg/dl respectively) and triglyceride (207.5+/-109.5mg/dl vs 160.8+/-107.1 mg/dl respectively). Conclusions: Our results suggest that higher urinary calcium excretion and higher uric acid excretion appear to be the characteristic risk factors in the hypertensive group. Hypercholesterolemia, hypertriglyceridemia and an excessive BMI are also related to stone patients with hypertension.
Blood Pressure ; Body Mass Index ; Calcium ; Cholesterol ; Citric Acid ; Drug Therapy ; Humans ; Hypercholesterolemia ; Hypertension* ; Hypertriglyceridemia ; Phosphorus ; Potassium ; Risk Factors* ; Sodium ; Triglycerides ; Uric Acid ; Urinary Calculi ; Urine Specimen Collection

PURPOSE: The purpose of this study was to examine the effects of a face-to-face self-management educational program on knowledge, self-care practice and kidney function in patients with chronic kidney disease (CKD) before kidney replacement therapy. METHODS: This study employed a nonequivalent control group, non-synchronized design. Data were collected from 61 patients with CKD visiting an outpatient department of nephrology in a university hospital in Seoul, South Korea. The experimental group (n=31) took the pre-test, then after 3 weeks, face-to-face education and individualized consultation (1st intervention), after a week of self-practice, the 1st post-test, followed by re-enforcement education and consultation (2nd intervention), and 4 weeks later, the 2nd post-test. The control group (n=30) took the pre-test and post-tests at 4 and 8 weeks. RESULTS: Scores for knowledge of CKD and self-care practice over time improved significantly in the experimental group compared to the control group. Kidney function did not improve significantly in the experimental group. CONCLUSION: Health care providers can identify various and individualized needs, and provide effective education and consultation through face to face self-management for patients with chronic irreversible illnesses. Nurses can coordinate for these program by designing and providing systematic and effective education.
Adult ; Aged ; Blood Urea Nitrogen ; Calcium/blood ; Creatinine/blood ; Female ; Glomerular Filtration Rate ; *Health Knowledge, Attitudes, Practice ; Hemoglobins/analysis ; Humans ; Kidney/*metabolism ; Male ; Middle Aged ; *Patient Education as Topic ; Phosphates/blood ; Potassium/urine ; Program Evaluation ; Renal Insufficiency, Chronic/*psychology ; Renal Replacement Therapy ; *Self Care ; Sodium/urine