Analysis of intake trends of kimchi, fruits and vegetables (1998–2020) and factors associated with the intake (2016–2020): based on the Korea National Health and Nutrition Examination Survey / 한국영양학회지

Purpose@#This study aimed to analyze the trends in kimchi, vegetable, and fruit consumption among the Korean population and identify the factors associated with this consumption.The goal was to provide fundamental data for developing appropriate guidelines to increase kimchi consumption by understanding its characteristics. @*Methods@#The analysis utilized data from the Korea National Health and Nutrition Examination Survey (KNHANES) conducted between 1998 and 2020. A total of 81,680 adults, aged 30 years or older, were included in the trend analysis. For the analysis of factors associated with kimchi, vegetable, and fruit intake, a subgroup of 22,122 adults aged 30 years or older from the KNHANES (2016-2020) was divided into two groups: 30–64 years old and 65 years old or older. Since the KNHANES data employed a complex sampling design, the statistical analysis was conducted using the appropriate complex sampling design method. @*Results@#The overall consumption of kimchi exhibited a declining trend among both men and women. Specifically, there was a significant decline in the intake of baechu kimchi among both genders. The decline in kimchi consumption above the standard was associated with a decrease in meal frequency and an increase in the frequency of eating alone. However, the patterns for unsalted vegetables and fruits differed compared to kimchi. @*Conclusion@#In this study, there was a decline in kimchi consumption among both men and women, and the potential factors associated with this trend included Westernized dietary habits, the presence of a spouse who influenced dietary habits, and an increased frequency of solitary dining due to the rise in single-person households. Therefore, it is necessary to develop dietary guidelines that consider these factors.

Beyond Hygiene: Commensal Microbiota and Allergic Diseases

Complex communities of microorganisms, termed commensal microbiota, inhabit mucosal surfaces and profoundly influence host physiology as well as occurrence of allergic diseases. Perturbing factors such as the mode of delivery, dietary fibers and antibiotics can influence allergic diseases by altering commensal microbiota in affected tissues as well as in intestine. Here, we review current findings on the relationship between commensal microbiota and allergic diseases, and discuss the underlying mechanisms that contribute to the regulation of allergic responses by commensal microbiota.

Vaccination with Klebsiella pneumoniae-derived extracellular vesicles protects against bacteria-induced lethality via both humoral and cellular immunity

The emergence of multidrug-resistant Klebsiella pneumoniae highlights the need to develop preventive measures to ameliorate Klebsiella infections. Bacteria-derived extracellular vesicles (EVs) are spherical nanometer-sized proteolipids enriched with outer membrane proteins. Gram-negative bacteria-derived EVs have gained interest for use as nonliving complex vaccines. In the present study, we evaluated whether K. pneumoniae-derived EVs confer protection against bacteria-induced lethality. K. pneumoniae-derived EVs isolated from in vitro bacterial culture supernatants induced innate immunity, including the upregulation of co-stimulatory molecule expression and proinflammatory mediator production. EV vaccination via the intraperitoneal route elicited EV-reactive antibodies and interferon-gamma-producing T-cell responses. Three vaccinations with the EVs prevented bacteria-induced lethality. As verified by sera and splenocytes adoptive transfer, the protective effect of EV vaccination was dependent on both humoral and cellular immunity. Taken together, these findings suggest that K. pneumoniae-derived EVs are a novel vaccine candidate against K. pneumoniae infections.

Gastric Schwannoma Diagnosed by Endoscopic Ultrasonography-Guided Trucut Biopsy

Schwannomas of the gastrointestinal (GI) tract are rare subepithelial tumors comprising approximately 3.3% to 12.8% of all mesenchymal tumors of the GI tract. On endoscopic ultrasound (EUS) they are seen as hypoechoic tumors arising most commonly from the 4th proper muscle layer. Although EUS helps to distinguish tumor characteristics, tissue sampling is required for differentiation with other more common tumors such as GI stromal tumors. Both EUS-guided fine needle aspiration and EUS-guided trucut biopsy (EUS-TCB) can be used for tissue sampling. However, only EUS-TCB allows core biopsy and a high yield of immunohistochemical staining. We report a case of a gastric schwannoma diagnosed by EUS-TCB.

Capsule Endoscopy for Suspected Small Bowel Bleeding in Patients with Portal Hypertension

BACKGROUND/AIMS: In Korea, limited data are available on small bowel bleeding in patients with portal hypertension. This study reports on the use of capsule endoscopy in cases of suspected small bowel bleeding in patients with portal hypertension. METHODS: Capsule endoscopy was used at our hospital to evaluate small bowel disease in 501 cases from July 2003 to June 2010. Of those cases, nine patients with portal hypertension due to liver cirrhosis with suspected small bowel bleeding were selected for the study. A retrospective analysis was performed using data from medical records. RESULTS: Six of the nine (66.7%) patients were males with an average age of 53.4 years. The average hemoglobin level was 8.1 g/dL. Abnormalities noted during capsule endoscopy included portal hypertensive enteropathy in all nine cases (100%), jejunal varices in four (44.4%), jejunal and ileal angiodysplasia in five (55.5%), multiple small bowel erosions in one (11.1%), granularity of the jejunal mucosa in one (11.1%), and small bowel erythema in three (33.3%). Active bleeding from jejunal varices was detected in two patients (22.2%). Despite having no obvious active bleeding during the capsule endoscopy, four patients (44.4%) were diagnosed with portal hypertensive enteropathy with obscure small bowel bleeding. CONCLUSIONS: Capsule endoscopy is a useful diagnostic tool for the evaluation of small bowel bleeding in patients with portal hypertensive enteropathy. Additional prospective and multicenter studies on the use of capsule endoscopy are needed to evaluate the incidence and clinical importance of portal hypertensive enteropathy.

A Case of Henoch-Schonlein Purpura Involving Colon Mimicking Colon Cancer / 대한소화기내시경학회지

Henoch-Schonlein purpura is the most common form of systemic vasculitis in children but occurs rarely in adults. Henoch-Schonlein purpura has characteristic features of a purpuric skin rash, abdominal pain, arthralgia, and abnormal urinary findings. Gastrointestinal tract involvement is characterized by abdominal pain and gastrointestinal bleeding. Recently, we experienced a case of Henoch-Schonlein purpura with gastrointestinal involvement mimicking colon cancer in a 41-year-old female who complained of erythematous macules, arthralgia, and abdominal pain. The initial colonoscopic findings and computed tomographs failed to rule out colon cancer, but serial endoscopic examinations and clinical manifestations revealed colonic involvement of Henoch-Schonlein purpura.

A Case of Ischemic Colitis Results from the Bleeding on Gastric Dieulafoy Lesions / 대한소화기내시경학회지

Ischemic colitis is the most common ischemic injury of the gastrointestinal tract. It can result from ischemia caused by compromised blood flow to the mesenteric arteries. Colonic ischemia may be precipitated by several conditions, although a cause is not clearly identified in most cases. A 63-year-old man was admitted because of loss of consciousness with melena. After endoscopic bleeding control of Dieulafoy lesions of the stomach, hematochezia occurred during the in-hospital care period. A sigmoidoscopy and computed tomography scan were conducted to evaluate the hematochezia, and ischemic colitis was diagnosed. Here, we report a case of ischemic colitis associated with massive upper gastrointestinal bleeding.

Comparison of the ambulatory blood pressure with the clinical blood pressure and electrocardiographic left ventricular hypertrophy / 대한내과학회지

BACKGROUND: This study compared the results of 24 hour ambulatory blood pressure monitoring with the clinical blood pressure measurements, and we investigated the relationship of the blood pressure measurement and left ventricular hypertrophy, as determined by routine 12 lead electrocardiography. METHODS: We studied 204 healthy adults with no prior history of heart disease or antihypertensive medication. The clinic blood pressure was measured 3 times and the average was taken. We compared the clinic blood pressure with the daytime blood pressure of the 24 hour ambulatory blood pressure monitoring, and we compared the blood pressure with the sum of the voltage of the S wave on V1 and the R wave on V5. RESULTS: The average of the daytime ambulatory blood pressure of all the patients was 135.33+/-13.73 mmHg for the systolic pressure and 86.55+/-10.14 mmHg for the diastolic pressure. The average of the clinic blood pressure measurement was 140.10+/-17.41 mmHg for the systolic pressure and 88.84+/-10.14 mmHg for the diastolic pressure. The clinic blood pressure averaged higher than the daytime ambulatory blood pressure by 5 mmHg on the systolic pressure and 2 mmHg on the diastolic pressure (p<0.001). The normal ambulatory blood pressure limits were estimated as those that best correlated with 140/90 mmHg at the clinic. The estimated value was 135/87 mmHg for the daytime ambulatory blood pressure (p+/-0.001). The incidence of white coat hypertension was 10.8%. The sum of the voltage on electrocardiography showed a positive linear relationship with all the blood pressure measurements. The daytime systolic blood pressure showed the strongest correlation with the 24 hour ambulatory blood pressure monitoring (r=0.283, p+/-0.001). CONCLUSIONS: We found a linear relation and we analyzed the differences between the clinical and 24 hour ambulatory blood pressure. A daytime ambulatory blood pressure value of 135/87 mmHg was a suitable upper normal limit for the corresponding cutoff value of the clinic blood pressure. Left ventricular hypertrophy showed the strongest relationship with the daytime systolic blood pressure among the results of the 24 hour ambulatory blood pressure monitoring.

The Safety and Effectiveness of Medium Endoscopic Sphincterotomy with Endoscopic Papillary Large Balloon Dilation for Removing Difficult Common Bile Duct Stones / 대한소화기내시경학회지

BACKGROUND/AIMS: Mechanical lithotripsy is generally used when it is difficult to endoscopically remove common bile duct (CBD) stones. However, this procedure not only requires extensive experience, but it is also time consuming. Medium endoscopic sphincterotomy (medium EST) combined with endoscopic papillary large balloon dilation (EPLBD) is recently being increasingly used; therefore, the aim of this study was to evaluate the safety and effects of medium EST with EPLBD for patients with CBD stones that are difficult to remove. METHODS: 41 patients with CBD stones that were difficult to remove by conventional endoscopic methods were enrolled in this study. EPLBD was performed after medium EST. The size of the stones, the procedure time, complications and the total number of sessions needed for stone removal were analyzed. RESULTS: The mean size of the CBD stones was 18.2 +/- 7.7 mm, and the mean number of stones was 2.7. Additional mechanical lithotripsy for complete removal was required in 9.7% (4/41) of the patients. Procedure related complications occurred in 7% (3/41): bleeding in 1 case and acute pancreatitis in 2 cases. CONCLUSIONS: Medium EST with EPLBD was a safe and effective treatment modality for CBD stones that were difficult to remove. Further prospective randomized studies are needed for comparing the effectiveness and safety between conventional EST and medium EST with EPLBD for removing difficult CBD stones.

The Safety and Effectiveness of Medium Endoscopic Sphincterotomy with Endoscopic Papillary Large Balloon Dilation for Removing Difficult Common Bile Duct Stones / 대한소화기내시경학회지

BACKGROUND/AIMS: Mechanical lithotripsy is generally used when it is difficult to endoscopically remove common bile duct (CBD) stones. However, this procedure not only requires extensive experience, but it is also time consuming. Medium endoscopic sphincterotomy (medium EST) combined with endoscopic papillary large balloon dilation (EPLBD) is recently being increasingly used; therefore, the aim of this study was to evaluate the safety and effects of medium EST with EPLBD for patients with CBD stones that are difficult to remove. METHODS: 41 patients with CBD stones that were difficult to remove by conventional endoscopic methods were enrolled in this study. EPLBD was performed after medium EST. The size of the stones, the procedure time, complications and the total number of sessions needed for stone removal were analyzed. RESULTS: The mean size of the CBD stones was 18.2 +/- 7.7 mm, and the mean number of stones was 2.7. Additional mechanical lithotripsy for complete removal was required in 9.7% (4/41) of the patients. Procedure related complications occurred in 7% (3/41): bleeding in 1 case and acute pancreatitis in 2 cases. CONCLUSIONS: Medium EST with EPLBD was a safe and effective treatment modality for CBD stones that were difficult to remove. Further prospective randomized studies are needed for comparing the effectiveness and safety between conventional EST and medium EST with EPLBD for removing difficult CBD stones.

A Case of Panhypopituitarism with Rhabdomyolysis / 대한내분비학회지

Rhabdomyolysis is the consequence of extensive muscle injury with the release of muscle cell constituents into plasma. It can arise from trauma and also from a variety of nontraumatic causes. Trauma, drugs, toxins and infection are the major causes of rhabdomyolysis, but it is rarely associated with metabolic disorders such as severe electrolyte disturbance, diabetic ketoacidosis, hyperosmolar nonketotic coma, hypothyroidism and thyrotoxicosis. There have been several reported cases of metabolic rhabdomyolysis, but panhypopituitarism as a cause has never been identified. We experienced a case of acute rhabdomyolysis associated with panhypopituitarism. Thus, So we report this case with the review of related literature. Metabolic disorder is a rare cause of rhabdomyolysis, but it should always be considered in a patient having and unexplained increased of the creatine kinase concentration

A Case of Kallmann's Syndrome with Unilateral Renal Aplasia and Diabetes Mellitus / 대한내분비학회지

Kallmann's syndrome is defined as the combination of hypogonadotropic hypogonadism and anosmia/hyposmia. The syndrome is a result of defect in the embryonic migratory pathway of gonadotropin-releasing hormone, which synthesizes neurons and olfactory axons. The hypogonadotropic hypogonadism results due to absence of or incomplete pubertal development and may be associated with anosmia, hyposmia, midline defect(color blindness, cleft-lip, cleft-palate, unilateral renal agenesis, sensorineural deafness), cryptorchidism and skeletal anomaly. Till date in Korea, few cases of Kallmann's syndrome have been reported but there are no available reports on cases of Kallmann's syndrome with unilateral renal aplasia and diabetes mellitus. We handled a case of Kallmann's syndrome associated with unilateral renal agenesis and diabetes mellitus. In the current work, we present a peculiar case as afore mentioned with the review of related literature.

A Case Study of Death by Bullet with Fired Blank Cartridge / 대한법의학회지

An university student passed away by an unidentified bullet in a reserve force exercise. An X-ray could not find any bullet from the thorax. The post-mortem examination revealed that the victim had been killed by a 5.56 mm (diameter) bullet. The striation mark of the fatal bullet was coincided with a test fired bullet of a suspect's machine gun. However only blank cartridges had been fired according to the firing range records. Also, the examiner found that the mouth diameter of the fatal blank cartridge case is narrower than the others. In order to explain the strange happening, various situation of blank cartridge firing was considered. The examiner group noticed that the diameter of a blank cartridge mouth fired from an unexpelled bullet including gun may change. The authors test fired a blank cartridge case with a gun including an unexpelled bullet, and compared the shape of the mouth with the fatal blank cartridge case. The mouth shapes of two blank cartridges were coincided. The authors could conclude that the an unidentified suspect charged a bullet in the muzzle of the suspect's gun, and the bullet expelled by the gas pressure of the fatal blank cartridge case.

TRAIL-Mediated Apoptosis in Human Liver Chang Cells / Journal of the Korean Cancer Association, 대한암학회지

PURPOSE: Tumor necrosis factor (TNF)-related apoptosis inducing ligand (TRAIL)/APO-2L is a member of the TNF family that can kill a wide variety of tumor cells, but not normal cells. This study was designed to investigate the down stream target proteins in TRAIL-mediated apoptosis of human liver, Chang cells. MATERIALS AND METHODS: The expressions of DR4/DR5 in hepatoma cells, including Chang, HepG2 and Hep3B cells, were determined by RT-PCR. Cell viability was measured by MTT assay and apoptosis was assessed by DNA fragmentation assay. The catalytic activity of caspase- family proteases, including caspase-3 and -9, was tested by using fluorogenic biosubstrates. Expression of apoptotic mediators, including procaspase-3 and PARP proteins, was measured by Western blotting. The expression profile of proteins in Chang cells by using two-dimensional (2-D) gel electrophoresis and MALDI-TOF. RESULTS: The results demonstrated that TRAIL (100 ng/ml) induced the apoptotic death of Chang cells, as characterized by the ladder-pattern fragmentation of genomic DNA. TRAIL increased the enzymatic activity of caspase- 3, corresponding to the time of appearance of cleaved PARP and caspase-9. In 2-D gel electrophoresis and MALDI- TOF analysis, the comparison of control versus apoptotic cells in the protein expressions revealed that signal intensity of 7 spots were decreased, whereas 6 spots were increased among 300 spots. These spots were resolved and identified as a protein information by MALDI-TOF. CONCLUSION: We suggested that TRAIL induces the apoptotic death of Chang cells via proteome alterations inducing caspase cascade.

(17)O NMR Study On Water Exchange Rate of Paramagnetic Contrast Agents

PURPOSE: The water exchange rate between bulk water and bound water is an important parameter in deciding the efficiency of paramagnetic contrast agents. In this study, we evaluated the water exchange rates of various Gd-chelates using oxygen-17 NMR technique. MATERIAL AND MEHTODS: The samples (Gd-DTPA, Gd-DTPA-BMA, Gd-DOTA, Gd-EOB-DTPA) were prepared by mixing 5% (17)O-enriched water (Isotech, USA). The pH of the samples was adjusted to physiological value (pH=7.0) by buffer solution. The variable temperature (17)O-NMR measurements were performed using Bruker-600 (14.1 T, 81.3 MHz) spectrometer. Bruker VT-1000 temperature control units were used to stabilize the temperature. The (17)O spin-spin relaxation times (T2) were measured using Carr-Purcell-Meiboom-Gill (CPMG) pulse sequence with 24 echo trains. The variable temperature T2 relaxation data were then fitted into Solomon-Bloembergen equations using least square fit algorithm to estimate the water exchange times. RESULTS: From the measured (17)O-NMR relaxation rates, the determined water exchange rates at 300K are : 0.42 microsecond for Gd-DTPA, 1.99 microsecond for Gd-DTPA-BMA, 0.27 microsecond for Gd-DOTA, and 0.11 microsecond for Gd-EOB-DTPA. The Gd-DTPA-BMA showed slowest exchange whereas Gd-EOB-DTPA had fastest water exchange rate. In addition, it was found that the water exchange rates of all samples had exponential temperature dependence with different decay constant. CONCLUSION: (17)O-NMR relaxation rate measurements, when combined with variable temperature technique, provide a solid tool for studying water exchange rate, which is very important in investigating the detailed mechanism of relaxation enhancement effect of the paramagnetic contrast agents.

Determination of Electron Spin Relaxation Time of the Gadolinium-Chealted MRI Contrast Agents by Using an X-band EPR Technique

PURPOSE: To determine the electronic spin relaxation times, T1e, of three commercially available Gd-chelated MR contrast agents, Gd-DTPA, Gd-DTPA-BMA and Gd-DOTA, using Electron Paramagnetic Resonance(EPR) technique. Material and Methods: The paramagnetic MR contrast agents, Gd-DTPA(Magnevist), Gd-DTPA-BMA(OMNISCAN) and Gd-DOTA(Dotarem), were used for this study. The EPR spectra of these contrast agents, which were prepared 2:1 methanol/water solution, were obtained at low temperatures, from-160degrees C~-20degrees C. The glassy-state EPR spectra for these contrast agents were then fitted by the simulation spectra generated with different zero-field splitting (ZFS) parameters by a computer simulation program 'GE N', which generates the EPR powder spectrum using a given ZFS in 3X3 tensor. Finally, the spin relaxation times of the contrast agents were then determined from the T2e, D, and E values of the best simulation spectra using the McLachlan's theory of average relaxation rate. Results: The electronic transverse spin relaxation times, T2e's, of Gd-DTPA, Gd-DTPA-BMA and Gd-DOTA were 0.113ns, 0.147ns and 1.81ns respectively. The g-values were 1.9737, 1.9735 and 1.9830 and the electronic spin relaxation times, T1e's, were 18.70ns, 33.40ns and 1.66micros, respectively. Conclusion: The results of these studies reconfirm that the paramagnetic MR contrast agents with larger ZFS parameters should have shorter T1e's. Among three contrast agents used for this study, Gd-DOTA chelated with cyclic ligand structure shows better electronic property then the others with linear structure. Thus, it is concluded that the exact determination of ZFS parameters is the important factor in evaluating relaxation enhancement effect of the agents and in developing new contrast agents.