BACKGROUND: Soluble adhesion molecules including soluble vascular cell adhesion molecule-1 (sVCAM-1) are released during an infalmmatory process such as artherosclerosis. Elevated sVCAM-1 also has been reported in diabetic nephropathy. But, the clinical significance of elevated of sVCAM-1 is not certain. We measured serum sVCAM-1 for the purpose to validate the clinical usefulness in diabetic nephropathy. METHODS: In this study, we measured serum sVCAM-1 in 12 normal subjects and 64 type 2 diabetic patients with proteinuria over 300 mg/day [median 24-h urine protein (range): 2.2 (0.3-18.7) g/day]. We evaluated the relationship of serum sVCAM-1 with lipoproteins including total cholesterol, LDL, oxidized LDL (oxLDL), HDL, and lipoprotein(a) (Lp(a)), with markers of inflammation including high-sensitivity CRP (hs-CRP), serum albumin and fibrinogen, and with renal parameters including 24-h urine protein, serum creatinine and homocysteine. RESULTS: In patients with diabetic nephropathy, median sVCAM-1 was 561 ng/mL (range 183-1304), which was significantly higher than that of normal subjects (324 ng/mL; 213-760, p< 0.05). In the diabetic nephropathy patients, sVCAM-1 was positively correlated with serum creatinine (r=0.34, p< 0.01), serum Lp(a) (r=0.27, p< 0.05) and 24-h urine protein (r=0.26, p< 0.05). In a multiple linear regression analysis, 24-h urine protein and serum Lp(a) were associated with an increased level of sVCAM-1 (r2=0.22, p=0.003). CONCLUSION: In summary, a positive correlation of sVCAM-1 with 24-h urine protein suggests that high sVCAM-1 may reflect increased production of sVCAM-1 due to more advanced renal injury. A positive association of sVCAM-1 and serum Lp(a) also suggests increased release of sVCAM-1 from associated atherosclerotic lesions in these patients. These results suggest that sVCAM-1 may be closely related with the renal function in patients with overt diabetic nephropathy.
Cholesterol, LDL ; Creatinine ; Diabetes Mellitus, Type 2* ; Diabetic Nephropathies ; Fibrinogen ; Homocysteine ; Humans ; Inflammation ; Linear Models ; Lipoprotein(a) ; Lipoproteins ; Proteinuria ; Serum Albumin ; Vascular Cell Adhesion Molecule-1*

Systemic capillary leak syndrome is a rare condition characterized by recurrent episodes of generalized edema and severe hypotension associated with paraproteinaemia. We experienced a case of recurrent systemic capillary leak syndrome. A 30-year-old woman had flu-like syndrome with fever, chill, and sore throat. Two days later, she presented progressive generalized edema and weight gain of 4 kg. Biological examination showed hemoconcentration, leukocytosis, and hypoalbuminemia without proteinuria. A radiograph of the chest showed pleural effusion. She had no evidence of heart failure, renal failure, or a protein losing enteropathy, and no abnormalities of liver function. Anti-neuclear antibody and antibodies to ds-DNA were negative. C3 and C4 were decreased. Serum protein electrophoresis showed oligoclonal banding consisting of IgG bands. Bone marrow biopsy was normal and there was no Bence-Jones protein in urine. She experienced a progressive reduction in her weight and a resolution of the peripheral edema without specific treatment. Five months later, she was readmitted with severe episode of shock. After a total of 10 L of fluid was administered intravenously, pulmonary edema developed. Intravenous steroid and theophylline were given which resulted in clinical improvement, accompanied by diuresis. Oral theophylline has been administered for prevention of this crisis up to the present time.
Adult ; Antibodies ; Biopsy ; Bone Marrow ; Capillary Leak Syndrome* ; Diuresis ; DNA ; Edema ; Electrophoresis ; Female ; Fever ; Heart Failure ; Humans ; Hypoalbuminemia ; Hypotension ; Immunoglobulin G ; Leukocytosis ; Liver ; Pharyngitis ; Pleural Effusion ; Protein-Losing Enteropathies ; Proteinuria ; Pulmonary Edema ; Renal Insufficiency ; Respiratory System* ; Respiratory Tract Infections* ; Shock ; Theophylline ; Thorax ; Weight Gain

BACKGROUND: We evaluated the optimal concentrations of eye opening and orientation after propofol- fentanyl TCI by CSDT of the pharmacokinetic model using DiprifusorTM in adults retrospectively. Furthermore, we tried to compare those data with the cases of using propofol TCI alone that had been reported. METHODS: After obtaining informed consent and IRB approval, 124 patients of ASA class I or II scheduled for elective surgery were allocated into 3 groups according to age. Three groups were group 1 (n = 40): 18 - 29 years, group 2 (n = 42): 30 - 39 years, group 3 (n = 42): 40 - 54 years. Propofol infusion was started at a propofol target concentration (CT) of 6 microgram/ml by using DiprifusorTM. Anesthesia was mostly maintained with propofol CT 3.5 microgram/ml and fentanyl CT 1.5 ng/ml using a Stelpump and 67% nitrous oxide in oxygen. We estimated the average concentrations of propofol at eye opening and orientation in each group with DiprifusorTM, and we also evaluated the correlation coefficient. RESULTS: Total requirements of propofol in cases of propofol-fentanyl TCI were decreased by 18-26% than in propofol TCI alone. The average concentrations of propofol at eye opening and orientation after surgery were 1.2 - 1.4 microgram/ml. The times to show eye opening and orientation after surgery from stopping of nitrous oxide and infusion were 10.4 - 14.5 min in the propofol-fentanyl group compared with 7.5 - 11 min using propofol TCI alone. CONCLUSIONS: We concluded that the optimal concentrations of propofol at eye opening and orientation after surgery in cases of combination with fentanyl were 1.2 - 1.4 microgram/ml instead of 1.4 - 1.6 microgram/ml with using propofol alone.
Adult ; Anesthesia ; Ethics Committees, Research ; Fentanyl ; Humans ; Informed Consent ; Nitrous Oxide ; Oxygen ; Propofol* ; Retrospective Studies

Sargassum fusiforme has traditionally been widely consumed in Asia as a food, and it has gained much attention due to its high nutritional, pharmaceutical, and industrial value. This study aimed to examine the promotional effects of ethanol extract (ET) and fraction obtained from ethyl acetate (FR) of S. fusiforme on hair growth in C57BL/6 mice and HaCaT cells. Five-week-old mice were used to compare hair regrowth during application of ET and FR for 21 days. Hair regrowth was evaluated by macroscopic observation and verified by hematoxylin-eosin tissue staining. Levels of mRNA expression of factors relevant to the hair growth cycle such as keratinocyte growth factor (KGF), vascular endothelial growth factor (VEGF), and transforming growth factor-beta1 (TGF-beta1) were examined by quantitative polymerase chain reaction (qPCR). Our results showed that ET and FR successfully promoted hair regrowth in shaved C57BL/6 mice at a dose >20 mg/kg. Moreover, ET and FR were effective in stimulating expression of KGF and VEGF mRNAs in a dose-dependent manner, whereas TGF-beta1 was not activated. These results indicate that ET and FR of S. fusiforme effectively promoted hair growth and gene expression relevant to hair growth cycles in both in vitro and in vivo models.
Alopecia ; Animals ; Asia ; Ethanol ; Fibroblast Growth Factor 7 ; Gene Expression ; Hair* ; Mice ; Polymerase Chain Reaction ; RNA, Messenger ; Sargassum* ; Transforming Growth Factor beta1 ; Vascular Endothelial Growth Factor A

Emphysematous cystitis is a rare disease that is associated with diabetes mellitus, neurogenic bladder, chronic genitourinary infection, and malignancy. Fever, chill, abdominal pain, and urinary difficulties were the most frequent presenting symptoms associated with emphysematous cystitis. We report a case of incidentally detected asymptomatic emphysematous cystitis in a 67 years old female patient with diabetic nephropathy. We review characteristic features of all 19 cases that has been reported in korean medical journals till now. Risk factors for this condition appear to be female sex, old age, and diabetes mellitus.
Abdominal Pain ; Aged ; Cystitis* ; Diabetes Mellitus ; Diabetic Nephropathies ; Female ; Fever ; Humans ; Korea* ; Rare Diseases ; Risk Factors ; Urinary Bladder, Neurogenic

Interferon-alpha is an established therapy for the patients with myeloproliferative disease. Unusual immune-mediated side effects have been reported during treatment. Among them, renal and cardiac toxicities are rare complications. Recently we experienced a case of hemolytic uremic syndome found in a 40-year old male undergoing interferon-alpha therapy for chronic myelogenous leukemia, chronic phase. On admission, his chief complaints were generalized edema and azotemia. Bone marrow biopsy revealed transformation into accelerated phase. bcl/abl gene was positive. Peripheral blood smear showed hemolytic anemia. Despite prompt diagnosis, institution of plasmapheresis, and steroid, his renal function did not recover, as expected. Hemolytic uremic syndrome was a chronic form of renal toxicity due to interferon-alpha. In this case, renal function did not recovered to normal level. However, early detection of renal toxicity such as proteinuria or acute tubular necrosis, and the discontinuation of interferon-alpha could achieve the recovery of normal renal function. Therefore, periodic examination of renal function should be performed in the patients with the use of long-term interferon-alpha.
Adult ; Anemia, Hemolytic ; Azotemia ; Biopsy ; Bone Marrow ; Diagnosis ; Edema ; Hemolytic-Uremic Syndrome ; Humans ; Interferon-alpha* ; Leukemia, Myelogenous, Chronic, BCR-ABL Positive* ; Male ; Necrosis ; Plasmapheresis ; Proteinuria

PURPOSE: Peritonitis remains one of most important complications of long-term peritoneal dialysis. This study was prospectively performed to compare the ability of identifying the causative organism for continuous ambulatory peritoneal dialysis (CAPD) peritonitis between bedside inoculation into BACTEC culture bottles and method involving centrifugation of effluent followed by plating into solid and liquid media. METHODS: We studied 38 patients with CAPD peritonitis (M:F=21:17, age 53+/-13 years) between July, 2005 and May, 2006. They had 50 episodes of CAPD peritonitis during the study period. From each peritonitis patient, two aliquots of peritoneal effluent were obtained at the same time. One aliquot was inoculated into two BACTEC culture bottles (aerobic and anaerobic, each 10 mL). The other aliquot was inoculated into thioglycollate broth (TGB, 10mL) and also spread on solid culture media (SCM) after centrifuge 50 mL of effluents. We compared positive-culture results, time from inoculation to identification of growth, and causative organism between these two culture methods. RESULTS: The BACTEC culture method was superior to the TGB & SCM culture method in identifying microorganisms (80% vs. 56%, respectively, p=0.01). Especially, there was significant difference in identifying the gram-positive bacteria between the BACTEC culture method and the TGB & SCM culture method [52% (26/50) vs 36% (18/50), p=0.001]. CONCLUSION: This study indicated that direct inoculation in BACTEC culture media is superior, especially for the gram-positive bacteria, to TGB & SCM in identifying the causative organisms in CAPD peritonitis patients.
Centrifugation ; Culture Media ; Gram-Positive Bacteria ; Humans ; Peritoneal Dialysis ; Peritoneal Dialysis, Continuous Ambulatory ; Peritonitis ; Prospective Studies

PURPOSE: Constipation is a frequent complaint among dialysis patients. However, factors that contribute to constipation in these patients have not been evaluated rigorously. The aim of study was to assess the prevalence and factors that contribute to constipation in patients with End-Stage Renal Disease (ESRD) undergoing hemodialysis (HD) or peritoneal dialysis (PD). METHODS: Patients undergoing HD or PD for more than six months in the six dialysis centers were asked to complete a self-administered questionnaire that is designed to assess constipation by Rome- III criteria. Beck depression inventory (BDI) were assessed. A total of 146 patients (HD 91, PD 55) completed the study. RESULTS: The prevalence of constipation was 33% in 91 HD patients and 31% in 55 PD patients. Prevalence of constipation was 32% and did not differ by dialysis mode. Older age, unemployed state, high cumulative illness rating scale and high BDI were associated with constipation. In multivariate analysis, BDI was an independent factor associated with constipation. The prevalence of constipation was 18% and 50% for patients with BDI <15 and > or =15, respectively. The odd ratio for constipation in patients with BDI > or =15 was 3.4 (95% CI, 1.4-8.1). CONCLUSION: Careful psychogenic attention must be paid to ESRD patients with constipation.
Constipation ; Depression ; Dialysis ; Humans ; Kidney Failure, Chronic ; Multivariate Analysis ; Peritoneal Dialysis ; Prevalence ; Renal Dialysis ; Surveys and Questionnaires

Thoracic endometriosis is an uncommon disease that has four main forms: catamenial pneumothorax, hemothorax, hemoptysis, and pulmonary nodules. Since the growth of endometrial tissue depends on the presence of estrogen, thoracic endometriosis usually occurs in menstruating women between 25 and 35 years of age. Menstrual disturbances are common in women with chronic kidney disease (CKD). However, they could be reversed after kidney transplantation. Therefore, previously asymptomatic endometriosis may become symptomatic after kidney transplantation. A 49-year-old woman with CKD underwent kidney transplantation. A month later, she experienced dyspnea, and hemothorax in her right hemithorax. However, there was no evidence of infectious diseases and malignancy in thoracentesis, pleural biopsy, and computed chest tomography (CT). The serum and pleural fluid levels of his carbohydrate antigen 125 were elevated. Hemothorax secondary to pleural endometriosis was suspected. We tried hormonal therapy, and the hemothorax disappeared. At the sixth-month follow-up, there was no recurrence of hemothorax.
Biopsy ; Communicable Diseases ; Dyspnea ; Endometriosis* ; Estrogens ; Female ; Follow-Up Studies ; Hemoptysis ; Hemothorax* ; Humans ; Kidney Transplantation* ; Kidney* ; Middle Aged ; Pleura ; Pneumothorax ; Recurrence ; Renal Insufficiency, Chronic ; Thorax

The aim of the current study was to analyze the active ingredients and to screen the pharmacological properties of freshwater laver, Prasiola japonica, the only species grown in Korea. According to results of gas chromatography-mass spectrometry assay, components from P. japonica were more diverse than those from sea laver. Of particular interest, our results indicated that ethanol extract of P. japonica (PJE) contained loliolide, sorbitol, mannitol, and alverine, which were known to have an anti-oxidant, anti-oral microbial, osmotic diuresis, and smooth muscle relaxant, respectively. In addition, five solvent fractions of PJE (water, butanol, chloroform, ethyl acetate, and hexane) significantly inhibited the production of lipopolysaccharide-induced nitric oxide and a higher amount (>100 microg/mL) of chloroform, ethyl acetate, and hexane fraction were considered to play a specific role in cancer cell death. PJE and its solvent fractions found to be effective scavengers of free radicals, particularly, hydroxyl radicals. Glucose uptake in L6 myoblast cell line that stably expresses the glucose transporter type 4 (GLUT4) proteins was also remarkably enhanced upon treatment with solvent fractions, remarkably chloroform fraction. Taken together, we concluded that P. japonica may have potent pharmacological properties and thus contribute to development of novel natural candidates for various disease targets.
Acetates ; Benzofurans ; Cell Death ; Cell Line ; Chloroform ; Diuresis ; Ethanol ; Free Radicals ; Fresh Water* ; Gas Chromatography-Mass Spectrometry ; Glucose ; Glucose Transporter Type 4 ; Korea ; Mannitol ; Mass Screening* ; Muscle, Smooth ; Myoblasts ; Nitric Oxide ; Porphyra ; Propylamines ; Proteins ; Sorbitol