PURPOSE: Observational results on seasonal variation of interdialytic weight gain in patients with end-stage renal disease treated with hemodialysis are controversial till now. There has been no report about it for Korean patients. The relation of interdialytic weight gain and climatic factors was studied in one region of Korea. METHODS: From Jan. 2002 to Dec. 2002, fifty patients receiving conventional and regular hemodialysis three times a week in Hanyang University Hospital, Seoul, Korea, where there is distinct seasonal variation in monthly temperature, relatively humidity, and duration of sunshine, were analyzed. For each patient, body weight and blood pressure were measured before and after each dialysis treatment three times per week for one year. The monthly mean values for interdialytic weight gain and blood pressure in relation to the monthly values for climatic factors were then analyzed. RESULTS: The seasonal pattern of interdialytic weight gain was evident throughout the one-year period. The monthly mean temperature was highest in July and lowest in January and mean monthly interdialytic weight gain was lowest in July and highest in December. The difference of mean interdialytic weight gain between July and January was significant (p< 0.05). Interdialytic weight was inversely correlated with monthly mean temperature, mean maximal temperature, and mean minimal temperature(r= -0.721 with p=0.008, r=-0.714 with p=0.009, and r= -0.717 with p=0.009, respectively) but not with mean relatively humidity and duration of sunshine. Mean predialysis systolic and diastolic blood pressure were not related to changes in temperature, relative humidity, and duration of sunshine. CONCLUSION: Interdialytic weight gain in patients with end-stage renal disease treated on hemodialysis was correlated with seasonal variation in temperature, with higher values in the winter and lower values in the summer. It would be better to consider this finding to treat hemodialysis patients.
Blood Pressure ; Body Weight ; Dialysis ; Humans ; Humidity ; Kidney Failure, Chronic ; Korea ; Renal Dialysis* ; Seasons* ; Seoul ; Sunlight ; Weight Gain*

We investigated the effect of low dose radiation on diabetes induced suppression of neurogenesis in the hippocampal dentate gyrus of rat. After 0.01 Gy, 0.1 Gy, 1 Gy and 10 Gy radiation was delivered, the dentate gyrus of hippocampus of streptozotocin (STZ)-induced diabetic rats were evaluated using immunohistochemistry for 5-bromo-2-deoxyuridine (BrdU), caspase-3, and terminal deoxynucleotidyl transferase-mediated nick end-labeling (TUNEL) staining. The number of BrdU positive cells in the non-diabetic rats, diabetic rats without radiation, diabetic rats with 0.01 Gy radiation, diabetic rats with 0.1 Gy radiation, diabetic rats with 1 Gy radiation and diabetic rats with 10 Gy radiation were 55.4+/-8.5/mm2, 33.3+/-6.4/mm2, 67.7+/-10.5/mm2, 66.6+/-10.0/mm2, 23.5+/-6.3/mm2 and 14.3+/-7.2/mm2, respectively. The number of caspase-3 positive cells was 132.6+/-37.4/mm2, 378.6+/-99.1/mm2, 15.0+/-2.8/mm2, 57.1+/-16.9/mm2, 191.8+/-44.8/mm2 and 450.4+/-58.3/mm2, respectively. The number of TUNEL-positive cells was 24.5+/-2.0/mm2, 21.7+/-4.0/mm2, 20.4+/-2.0/mm2, 18.96+/-2.1/mm2, 58.3+/-7.9/mm2, and 106.0+/-9.8/mm2, respectively. These results suggest low doses of radiation paradoxically improved diabetes induced neuronal cell suppression in the hippocampal dentate gyrus of rat.
Rats, Sprague-Dawley ; Rats ; Radiotherapy/methods ; Neurons/*metabolism ; Male ; In Situ Nick-End Labeling ; Hippocampus/*cytology/metabolism/radiation effects ; Diabetes Mellitus, Experimental/radiotherapy ; Dentate Gyrus/drug effects/*radiation effects ; Cell Proliferation ; Caspase 3/metabolism ; Bromodeoxyuridine/pharmacology ; Apoptosis ; Animals

The purpose of this study is to investigate the mechanism of alternative responses to low dose irradiation for neuronal cell proliferation in the dentate gyrus of rats. To determine the effect of a single exposure to radiation, rats were irradiated with a single dose of 0.1, 1, 10 or 20 Gy. To determine the effect of the cumulative dose, the animals were irradiated daily with 0.01 Gy or 0.1 Gy from 1 to 4 days. The neuronal cell proliferation was evaluated using immunohistochemistry for 5-bromo-2'-deoxyuridine (BrdU), Ki-67 and terminal deoxynucleotidyl transferase-mediated dUTP nick end-labeling (TUNEL) staining. Four consecutive daily irradiations with a 0.01 Gy/fraction increased the number of BrdU-positive and Ki-67-positive cells in a dose dependent manner, but this did not affect the number of TUNEL-positive cells. However, there was not a dose dependent relationship for the 0.1 Gy/fraction irradiation with the number of BrdU, Ki-67 and TUNEL positive cells. Our data support the explanation that the adaptive response, induced by low-dose radiation, in the hippocampus of rats is more likely a reflection of the perturbations of cell cycle progression.
Rats, Sprague-Dawley ; Rats ; Radiation Dosage ; Neurons/*cytology/*radiation effects ; Neuronal Plasticity/*radiation effects ; Male ; Dose-Response Relationship, Radiation ; Dentate Gyrus/*cytology/*radiation effects ; Cell Survival/radiation effects ; Cell Proliferation/*drug effects ; Animals ; Adaptation, Physiological/radiation effects

Alcohol abuse and cigarette smoking have been on the rise worldwide and it has been reported that alcohol and nicotine influence serotonergic neuronal activity in the dorsal raphe. Serotonin (5-hydroxytryptamine, 5-HT) has been implicated in the pathophysiology of various neuropsychiatric disorders. In the present study, the effects of alcohol and nicotine on the synthesis of 5-HT and the expression of tryptophan hydroxylase (TPH), the rate limiting enzyme of 5-HT synthesis, in the dorsal and median raphe of young rats were investigated via immunohistochemistry. The numbers of the 5-HT-positive and TPH-positive cells in raphe nuclei were reduced by alcohol and nicotine treatment, and these numbers were reduced more potently by co-administration of alcohol and nicotine. Based on the results, it can be suggested that the pathogenesis of alcohol- and nicotine-induced neuropsychological disorders involves alcohol- and nicotine-induced suppression of 5-HT synthesis and TPH expression in raphe, and that this may be of particular relevance in the consumption of alcohol and nicotine during adolescence.
Adolescent ; Alcoholism ; Animals ; Humans ; Immunohistochemistry ; Nicotine* ; Raphe Nuclei ; Rats* ; Serotonergic Neurons ; Serotonin* ; Smoking ; Tryptophan Hydroxylase* ; Tryptophan*

BACKGROUND: Although osteoporosis is increasing in the elderly population, attempts to analyze the patterns of medical service utilization for osteoporosis are currently not sufficient. The medical services and treatment patterns were investigated using Korea's National Health Insurance claims data, which includes all of the Korean population. METHODS: Through the patient identification algorithm developed by using the administrative claims data in 2007, the adult patients (between 50-100 years) with osteoporosis were identified. The age and gender of the patients who used medical service for osteoporosis were described, in relation with six dichotomous variables. The medical service use patterns such as the type of medical institution and conducting bone mineral density measurement were investigated. RESULTS: The number of patients who used medical service were 1,230,580 (females 89.9%). Sixty one point six percent of the patients were prescribed osteoporosis medicine (indicated for osteoporosis only), and 12.9% of the patients had experienced osteoporotic fracture. The primary medical institutions for treatment were clinics (54.3%), while hospitals were mainly used among the patients with a history of fracture and disease or drug use that may induce secondary osteoporosis. The number of visited medical institutions was 6.4 (as an outpatient) and 0.2 (as admissions) during 6 months. The proportion of patients who conducted bone mineral density measurements within one year before and after the diagnosis of osteoporosis was 66.7% and DXA was the most frequently used densitometry (46.3%). The average number of days for the prescriptions for osteoporosis medicine was 70 days. CONCLUSION: In order to prevent further osteoporotic fractures, appropriate management and treatment should be implemented for osteoporosis patients. To do this, we need to understand the current state of medical service utilization and the treatment of osteoporosis using the National Health Insurance claims data.
Adult ; Aged ; Bone Density ; Densitometry ; Humans ; National Health Programs ; Osteoporosis ; Osteoporotic Fractures ; Prescriptions

Meningitis associated with tsutsugamushi is not a rare disease and simple, effective treatments are available. However, the diagnosis of meningitis is important since it is potentially associated with significant mortality rates. Case 1 : A 47-year-old woman had a headache and high fever with chills for 3 days. She fell into a stupor, and her blood pressure dropped to 80/60 mmHg on the fifth day of admission to the hospital. The patient was treated with 200 mg of doxycycline given intravenously. Case 2 : A 48-year-old woman was admitted with a 7-day history of fever with chills, severe headache, vomiting, and a generalized non-pruritic erythematous maculopapular rash. The patient was treated with 200 mg of doxycycline given orally. CSF examinations revealed predominantly lymphocytic pleocytosis in all cases. The indirect immunofluorescent antibody titer for Orientia tsutsugamushi were 1:20,480 in case 1 and 1:5, 120 in case 2. We report two cases of meningitis associated with tsutsugamuschi disease.
Blood Pressure ; Chills ; Diagnosis ; Doxycycline ; Exanthema ; Female ; Fever ; Headache ; Humans ; Leukocytosis ; Meningitis* ; Middle Aged ; Mortality ; Orientia tsutsugamushi ; Rare Diseases ; Stupor ; Vomiting

Mycotic aneurysms are rare inflammatory neurovascular lesions. Ruptured mycotic aneurysm manifesting as subdural hematoma is extremely rare. A 72-year-old male patient was admitted to our hospital with headache and drowsiness. Computer tomography (CT) of brain and CT angiography revealed subdural hematoma and an aneurysm located at the M4 segment of the left middle cerebral artery (MCA). Cerebral angiogram revealed 2 aneurysms; one located at the left distal MCA and the other at the bifurcation of left MCA. Laboratory studies showed leukocytosis and elevated inflammatory factors. The patent was treated with antibiotic therapy for 4 weeks. The follow-up CT and cerebral angiography showed that the mycotic aneurysm was completely resolved, and the patient was nearly free of symptoms.
Aged ; Aneurysm ; Aneurysm, Infected ; Angiography ; Brain ; Cerebral Angiography ; Follow-Up Studies ; Headache ; Hematoma, Subdural ; Humans ; Leukocytosis ; Male ; Middle Cerebral Artery ; Sleep Stages

OBJECTIVE: In the so-called primary intracerebral hemorrhage (ICH), lobar and deep ICH were mainly due to cerebral amyloid angiopathy and deep perforating arterial disease. Our aim was to identify specifics of warfarin associated ICH (WAICH) and to focus on differences in susceptibility to warfarin according to the underlying vasculopathies, expressed by ICH location. MATERIALS AND METHODS: We identified all subjects aged > or = 18 years who were admitted with primary ICH between January 1, 2007 and September 30, 2012. We retrospectively collected demographic characteristics, the presence of vascular risk factors and pre-ICH medication by chart reviews. We categorized ICH into four types according to location: lobar, deep, posterior fossa, and undetermined. We investigated characteristics (including hematoma volume and expansion) of ICH according to the location of ICH. RESULTS: WAICH accounted for 35 patients (5.6%) of 622 ICH cases. In WAICH, 13 patients (37.1%) had lobar ICH and 22 patients (60.0%) had non-lobar ICH. Compared to other locations of ICH, lobar ICH showed an excess risk of WAICH (OR 2.53, 95% CI 1.03-6.21, p = 0.042). The predictors of lobar location of ICH were warfarin (OR 2.29, 95% CI 1.05-5.04, p = 0.038) and diabetes mellitus (DM) (OR 0.54, 95% CI 0.29-0.98, p = 0.044). The lobar location of ICH showed significant association with larger hematoma volume (p = 0.001) and high ratio of hematoma expansion (p = 0.037) compared with other locations of ICH. CONCLUSION: In our study, warfarin showed significant association with lobar ICH and it caused larger hematoma volume and more expansion of hematoma in lobar ICH.
Cerebral Amyloid Angiopathy ; Cerebral Hemorrhage ; Diabetes Mellitus ; Hematoma ; Humans ; Intracranial Hemorrhages* ; Retrospective Studies ; Risk Factors ; Warfarin*

BACKGROUND: Elevated plasma total homocysteine is a risk factor for cardiovascular diseases. The authors investigated the parameters such as habit, body index, cardiovascular risk factors, nutrition relative to the plasma homocysteine concentration. METHODS: The subjects were 6,223 adults (3,377 males, 2,846 females) who were over 18 years of age and visited a health promotion center of a university hospital from March 2002 to January 2003. We assessed the relationship between the homocysteine level and the following parameters: sex, age, weight, body mass index, waist circumference, smoking, alcohol, systolic and diastolic blood pressure (BP), triglyceride, total cholesterol, high density lipoprotein cholesterol, creatinine, albumin and hemoglobin. RESULTS: The homocysteine levels was 10.5+/-5.9micromol/L in males, 7.3+/-2.6micromol/L in female. Thus it was significantly higher in males (P <0.001). After adjusting for variables that affect the homocysteine, the subjects over the age of 54 showed 10.7micromol/L (9.5, 12.0, 95% Confidence Interval), which was significantly (P=0.002) higher than the below the age of 38 groups 8.5micromol/L (7.8, 9.2, 95% CI). Non-smoking group showed 8.6micromol/L (8.4, 8.9, 95% CI), while over 28 pack-year group showed 9.6micromol/ L (9.2, 10.0, 95% CI), which was significantly (P <0.000) higher than the non-smoking groups. For the group with systolic BP over 132mmHg, it was 9.3micromol/L (8.8, 9.5, 95% CI). This was significantly (P=0.004) higher than 8.7micromol/L (8.4, 9.0, 95% CI) in the group whose systolic BP was less than 108 mmHg. The homocysteine was 10.4micromol/L (10.1, 11.7, 95% CI) for the group with creatinine over 1.0 mg/dL, which was significantly (P <0.000) higher than 7.9micromol/L (7.6, 8.2, 95% CI) in the group whose creatinine was less than 0.8 mg/dL. CONCLUSION: After adjusting for variables that affect the homocysteine, significant difference in its values was found between males and females. The homocysteine was significantly increased in the group whose age, systolic BP, amount of smoking, and creatinine were higher.
Adult ; Blood Pressure ; Body Weight ; Cardiovascular Diseases ; Cholesterol ; Cholesterol, HDL ; Creatinine ; Female ; Health Promotion ; Homocysteine* ; Humans ; Male ; Plasma ; Risk Factors ; Smoke ; Smoking ; Triglycerides ; Waist Circumference

PURPOSE: To investigate the effect of low dose radiation on neuronal cell proliferation in diabetic rats. MATERIALS AND METHODS: A group of rats (first group) were divided into three subgroups (nondiabetic control, nondiabetic 0.1 Gy and nondiabetic 10 Gy groups) to determine the effect of radiation on normal hippocampal neuronal cell proliferation. A further group of rats (second group) were divided into six subgroups (nondiabetic control, diabetic control, diabetic 0.01 Gy, diabetic 0.1 Gy, diabetic 1 Gy and diabetic 10 Gy groups) to determine the effect of radiation on hippocampal neuronal cell proliferation under diabetic conditions. Using immunohistochemistry for 5-bromo-2'-deoxyuridine (BrdU), the number of neuronal cells in the dentate gyrus of all the groups was counted. RESULTS: The number of BrdU-positive cells in the dentate Gyrus of the nondiabetic control, nondiabetic 0.1 Gy and nondiabetic 10 Gy subgroups of the first group were 45.96+/-3.42, 59.34+/-5.20 and 19.26+/-2.98/mm2, respectively. The number of BrdU-positive cells in the dentate gyrus of the diabetic control, diabetic 0.01 Gy, diabetic 0.1 Gy, diabetic 1 Gy and diabetic 10 Gy subgroups of the second group were 55.44+/-8.57, 33.33+/-6.46, 67.75+/-10.54, 66.63+/-10.05, 23.59+/-6.37 and 14.34+/-7.22/mm2, respectively. CONCLUSION: Low dose radiation enhances cell proliferation in the dentate gyrus of STZ-induced diabetic rats.
Animals ; Bromodeoxyuridine ; Cell Proliferation* ; Dentate Gyrus ; Hippocampus ; Immunohistochemistry ; Neurons* ; Rats*