Status of Four Trace Elements in Elderly Patients with Online Hemodiafiltration.

BACKGROUND: Essential trace elements play key roles in multiple biological systems, and hemodialysis patients are at risk for deficiency of essential trace elements. The aim of the study was to assess the essential element status in end stage renal disease patients undergoing online hemodiafiltration (online HDF) in outpatient dialysis clinic. METHODS: A total of 28 Korean patients with regular online HDF were included. Blood samples were collected before and after one HDF session, and serum concentrations of zinc, copper, selenium, and manganese were simulta-neously measured by inductively coupled plasma mass spectrometry. RESULTS: Selenium, zinc, copper deficiencies were observed in 71.4%, 35.8%, and 21.4%, compared with the reference range. No patients revealed manganese deficiency. After the HDF, the post-HDF level significantly increased in all trace elements, compared with the pre-HDF (11.2% for selenium, 10.7% for copper, and 6.6% for zinc). However, 50% patients were still deficient for selenium at the post-HDF. CONCLUSIONS: Our data suggest that the patients undergoing online HDF are at an increased risk of trace element deficiency, especially for selenium.

Vancomycin AUC24 /MIC Ratio in Patients with Methicillin-Resistant Staphylococcus aureus Pneumonia.

BACKGROUND: Vancomycin is the treatment of choice for serious methicillin-resistant Staphylococcus aureus (MRSA) infections. The area under the concentration-time curve from 0 to 24 hr (AUC24 )/minimum inhibitory concentration (MIC) ratio was recently introduced as a parameter for assessing clinical outcome by S. aureus. This study was purposed to apply the vancomycin AUC24 /MIC in patients with MRSA pneumonia. METHODS: Forty-seven patients with confirmed lower respiratory infection caused by MRSA during 2011 were enrolled. All patients were treated with vancomycin. Clinical characteristics and laboratory data were collected. AUC24 /MIC values were calculated as previously reported and patients were divided into two groups based on the bacteriologic response, which was eradicated or not, and an AUC24 /MIC value (above or below 400). RESULTS: MRSA infections were eradicated in 39 patients but 8 patients had persistent MSRA infection in the following cultures. The mean AUC24 /MIC values and vancomycin concentrations were not statistically different between patients with and without MRSA eradication. All 13 patients with a vancomycin MIC of 2 mg/L had an AUC24 /MIC below 400. CONCLUSION: AUC24 /MIC might not be a reliable indicator for assessing treatment response of vancomycin in MRSA pneumonia. Relationship between vancomycin AUC24 /MIC and therapeutic outcome needs to undergo further studies, including sufficiently large sample size.

Prediction of fetal lung maturity using the lecithin/sphingomyelin (L/S) ratio analysis with a simplified sample preparation, using a commercial microtip-column combined with mass spectrometric analysis.

Fetal lung maturity is estimated using the lecithin/sphingomyelin ratio (L/S ratio) in amniotic fluid and it is commonly measured with thin-layer chromatography (TLC). The TLC method is time consuming and technically difficult; however, it is widely used because there is no alternative. We evaluated a novel method for measuring the L/S ratio, which involves a tip-column with a cation-exchange resin and mass spectrometry. Phospholipids in the amniotic fluid were extracted using methanol and chloroform. Choline-containing phospholipids such as lecithin and sphingomyelin were purified by passing them through the tip-column. LC-MS/MS and MALDI-TOF were used to directly analyze the purified samples. The L/S ratio by mass spectrometry was calculated from the sum peak intensity of the six lecithin, and that of sphingomyelin 34:1. In 20 samples, the L/S ratio determined with TLC was significantly correlated with that obtained by LC-MS/MS and MALDI-TOF. There was a 100% concordance between the L/S ratio by TLC and that by LC-MS/MS (kappa value=1.0). The concordance between the L/S ratio by TLC and that by MALDI-TOF was also 100% (kappa value=1.0). Our method provides a faster, simpler, and more reliable assessment of fetal lung maturity. The L/S ratio measured by LC-MS/MS and MALDI-TOF offers a compelling alternative method to traditional TLC.

Effects of Ginkgo biloba on haemostatic factors and inflammation in chronic peritoneal dialysis patients.

Ginkgo biloba extract decreased plasma D-dimer concentration, a marker of intravascular coagulation, in chronic peritoneal dialysis patients. Blood levels of fibrinogen, von Willebrand factor, hs-CRP, albumin and liver enzyme levels were not significantly changed. No bleeding episode was reported. These results suggest that Ginkgo biloba extract was effective in partially reversing the thrombogenic coagulation profile without increasing the risk of bleeding.

The effects of green tea ingestion over four weeks on atherosclerotic markers.

BACKGROUND: The objective of this study was to evaluate the effects of green tea ingestion over four weeks on atherosclerotic biological markers. METHODS: After a one-week baseline period, 12 healthy male volunteers aged 28--42 years drank 600 mL of green tea daily for four weeks. Lipid profile, oxidized low-density lipoprotein (ox-LDL), total antioxidant capacity (TAC), C-reactive protein (CRP) and soluble cell adhesion molecules were measured at baseline and after two and four weeks ingestion of green tea. RESULTS: There was no significant change in the concentrations of lipid profile, TAC, CRP, soluble intercellular adhesion molecule-1 (sICAM-1), or soluble E-selectin after ingestion of green tea. The levels of ox-LDL and soluble vascular cell adhesion molecule-1 (sVCAM-1) were significantly decreased after four weeks of green tea ingestion (Wilcoxon signed rank test, P=0.006). CONCLUSIONS: The results of this study suggest an in vivo anti-oxidative effect for green tea and an influence of green tea on atherosclerotic biological markers. The effect of green tea seen on ox-LDL and sVCAM-1 provides a potential mechanism for the cardiovascular benefits of regular ingestion of green tea.

Long-term effects of green tea ingestion on atherosclerotic biological markers in smokers.

OBJECTIVES: Smoking is a risk factor for coronary artery disease and triggers vascular injury by platelet aggregation and induces atherosclerosis through induction of oxidative stress. Green tea is known to have antioxidant capacity and anti-platelet activity. DESIGN AND METHODS: Twenty adult male smokers ingested 600 mL of green tea for 4 weeks. Their lipid profile, C-reactive protein (CRP), total antioxidant capacity, oxidized LDL, soluble VCAM-1, soluble ICAM-1, and soluble P-selectin were measured at baseline and 2 and 4 weeks after green tea ingestion. RESULTS: Plasma soluble P-selectin (sP-selectin) levels decreased significantly after 2 and 4 weeks of green tea ingestion compared with those before green tea ingestion (P < 0.001). Plasma concentrations of oxidized LDL decreased significantly after green tea ingestion (P < 0.05). CONCLUSIONS: The results of this study suggest the effect of green tea on sP-selectin and oxidized LDL.