Asian populations are thought to receive significant health benefits from traditional diets rich in soybeans due to high isoflavone contents. However, available epidemiologic data only weakly support this hypothesis. The present study was carried out to assess the pharmacokinetics of isoflavones in South Korean women after ingestion of soy-based foods. Twenty-six healthy female volunteers (20-30 y old) consumed three different soy products (i.e., isogen, soymilk, and fermented soybeans) with different aglycone/glucoside ratios. Plasma and urine isoflavone concentrations were measured by high-performance liquid chromatography (HPLC) after ingestion of one of the soy products. Pharmacokinetic parameters were determined using the WinNonlin program. The area under the curve (AUC) for plasma daidzein levels of the soymilk group (2,101 +/- 352 ng . h/mL) was significantly smaller than those of the isogen (2,628 +/- 573 ng . h/mL) and fermented soybean (2,593 +/- 465 ng . h/mL) groups. The maximum plasma concentration (Cmax) of daidzein for the soymilk group (231 +/- 44 ng/mL) was significantly higher than those of the isogen (160 +/- 32 ng/mL) and fermented soybean (195 +/- 35 ng/mL) groups. The half-lives of daidzein and genistein in the soymilk group (5.9 and 5.6 h, respectively) were significantly shorter than those in the individuals given isogen (9.6 and 8.5 h, respectively) or fermented soybean (9.5 and 8.2 h, respectively). The urinary recovery rates of daidzein and genistein were 42% and 17% for the isogen group, 46% and 23% for the fermented soybean group, and 33% and 22% for the soymilk group. In conclusion, our data indicated that soy products containing high levels of isoflavone aglycone are more effective for maintaining plasma isoflavone concentrations. Additional dose-response, durational, and interventional studies are required to evaluate the ability of soy-based foods to increase the bioavailability of isoflavones that positively affect human health.
Asian Continental Ancestry Group ; Biological Availability ; Chromatography, Liquid ; Diet ; Eating ; Female ; Genistein ; Humans ; Insurance Benefits ; Isoflavones ; Plasma ; Soybeans

OBJECTIVES: In rural areas of Korea, where public transportation infrastructure is lacking and alternative systems are poor, the elderly experience inconveniences in using healthcare, although their need is high. This study aimed to analyze the association between the convenience of transportation and unmet healthcare needs among the rural elderly. METHODS: The data used were collected in the 2016 Community Health Survey among rural elderly individuals aged 65 or older. Dependent variable was the unmet healthcare needs, explanatory variable was the convenience of transportation. The elderly were divided into 3 groups: with no driver in the household, with a driver, and the elderly individual was the driver (the self-driving group). Covariates were classified into predisposing, enabling, and need factors. They included gender, age, education, income, economic activity, household type, motor ability, subjective health level, number of chronic diseases, anxiety/depression, and pain/discomfort. The data were analyzed using logistic regression and stratification. RESULTS: A significant association was found between the convenience of transportation and unmet healthcare needs. When examined unadjusted odds ratio of the group with a driver in the household, using the group with no driver as a reference, was 0.61 (95% confidence interval [CI], 0.54 to 0.68), while that of the self-driving group was 0.34 (95% CI, 0.30 to 0.38). The odds ratios adjusted for all factors were 0.69 (95% CI, 0.59 to 0.80) and 0.79 (95% CI, 0.67 to 0.91). CONCLUSIONS We confirmed a significant association between inconvenient transportation and unmet healthcare needs among the rural elderly even after adjustment for existing known factors. This implies that policies aimed at improving healthcare accessibility must consider the means of transportation available.

The study was designed to assess the effect of iron and cereal supplementation on children's iron nutritional status in social welfare institutions. Dietary survey was carried out methods of food weighing and record by interview (n = 74). A nutritional intervention study was carried out through supplementing iron supplements and cereal for 4 weeks in 4 - 12 years old children. Children received daily 40 mg elemental Fe as iron protein succinylate (n = 23) and 3.6 mg elemental Fe as 100 g cereal (n = 24), respectively. Blood samples were drawn before and after supplementation. Nutrients which children's intake was less than two-thirds of the RDA were vitamin A, vitamin B-1, vitamin B-2, calcium and iron. The mean daily intake of iron was 5.1 mg for male and 4.9 mg for female, and 52.3% for male and 45.4% for female of Korean RDA. The proportion of children with iron depletion assessed by TIBC (> 360 microgram/dl) and serum ferritin (< 20 ng/ml) were 56.6% and 58.7%, respectively. The proportion of children with the iron deficient erythropoiesis assessed by serum iron (< 70 microgram/dl), Hb (< 12 g/dl), Hct (< 36%) were 76.0%, 58.7%, 64.0%, respectively. After iron supplements treatment, Hb (p < 0.001), Hct (p < 0.001), serum iron (p < 0.001), transferrin saturation (p < 0.001) and serum ferritin (p < 0.01) increase significantly and only TIBC decreased slightly. After cereal supplementation, in anemic children, Hct (p < 0.001), serum iron (p < 0.001) and transferrin saturation (p < 0.001) were significantly increased. The effect of iron supplements and cereal supplementation in children with iron deficient erythropoiesis were more effective to improve the iron nutritional status than children with iron depletion. It was concluded that cereal supplementation program in anemic children was also effective to improve iron nutritional status.
Anemia ; Calcium ; Child* ; Child, Institutionalized ; Clinical Trial ; Edible Grain* ; Erythropoiesis ; Female ; Ferritins ; Humans ; Iron* ; Male ; Nutritional Status* ; Social Welfare* ; Transferrin ; Vitamin A ; Vitamins

Alveolar capillary dysplasia with misalignment of pulmonary veins (ACD/MPV) is an autosomal dominant, fatal developmental disorder of the lungs, with a mortality rate of about 100%. ACD/MPV is caused by mutations in FOXF1. Herein, we describe a newborn boy with ACD/MPV carrying a novel pathogenic variant of FOXF1. The patient developed respiratory distress and severe pulmonary hypertension on the first day of life. Despite aggressive cardiorespiratory management, including veno-venous extracorporeal membrane oxygenation, his condition deteriorated rapidly, and he died within the first month of his life. Lung histology showed the characteristic features of ACD/MPV at autopsy. Sequence analysis of FOXF1 from genomic DNA obtained from autopsied lung tissue revealed that the patient was heterozygous for a novel missense variant (c.305T>C; p.Leu102Pro). Further analysis of both parents confirmed the de novo occurrence of the variant. To the best of our knowledge, this is the first report of genetically confirmed ACD/MPV in Korea.
Autopsy ; DNA ; Extracorporeal Membrane Oxygenation ; Female ; Humans ; Hypertension, Pulmonary ; Infant, Newborn* ; Korea ; Lung ; Male ; Mortality ; Parents ; Persistent Fetal Circulation Syndrome* ; Sequence Analysis

Bacterial morphology can be altered by various factors, including antibiotics. Unusually shaped, large, swollen organisms were observed in a urine culture obtained from a patient who had no history of antibiotic therapy. The organism was identified as Escherichia coli by the Vitek 2 system and by DNA sequencing of 16S rRNA and gyrB. The patient had no symptoms except fever, which subsided without medication. Microbiology laboratories should be aware of the potential appearance of such bacilli to avoid confusion with fungi and other naturally occurring filamentous organisms.
Anti-Bacterial Agents ; Atypical Bacterial Forms ; Escherichia ; Escherichia coli ; Fever ; Fungi ; Humans ; Sequence Analysis, DNA

BACKGROUND/OBJECTIVES: A dietary restriction on the intake of fermentable oligosaccharides, disaccharides, monosaccharides, and polyols (FODMAPs) has been reported to be effective in the treatment of gastrointestinal (GI) tract complications. Enteral nutrition (EN) is widely used for patients who cannot obtain their nutritional requirements orally, but many studies have reported EN complications, especially diarrhea, in up to 50% of patients. SUBJECTS/METHODS: We performed a single-center, non-randomized, controlled trial to determine the effects of a low-FODMAP enteral formula on GI complications in patients in intensive care units (ICUs). Patients in the ICU who needed EN (n = 66) were alternately assigned to the low-FODMAP group (n = 33) or the high-FODMAP group (n = 33). RESULTS: Anthropometric and biochemical parameters were measured, and stool assessment was performed using King's Stool Chart. We excluded patients who received laxatives, GI motility agents, proton pump inhibitors, antifungal agents, and antibiotics other than β-lactams. There were no differences in GI symptoms during 7 days of intervention, including bowel sound, abdominal distension, and vomiting between the 2 groups. However, diarrhea was more frequent in the high-FODMAP group (7/33 patients) than the lowFODMAP group (1/33 patients) (P = 0.044). CONCLUSIONS Our results suggest that a low-FODMAP enteral formula may be a practical therapeutic approach for patients who exhibit enteral formula complications. Our study warrants further randomized clinical trials and multicenter trials.