Risk factors and renal outcomes of low bone mineral density in patients with non-dialysis chronic kidney disease.

Bone disorder is a common complication of chronic kidney disease (CKD). The clinical usefulness of bone mineral density (BMD) in CKD is not well known. Our study shows that low BMD is associated with physical activity and dietary Na/K intake ratio and can predict poor renal outcome in non-dialysis CKD. PURPOSE: Despite evidence of a link between bone mineral disorders and chronic kidney disease (CKD), the clinical implications of bone mineral density (BMD) in CKD are not well established. We investigated risk factors and renal outcomes of low BMD in CKD. METHODS: We analyzed data from the KNOW-CKD. BMD measured by dual-energy x-ray absorptiometry was classified by T score: normal (T score ≥ - 1.0), osteopenia (- 1.0 > T score > - 2.5), and osteoporosis (T score ≤ - 2.5) of the lumbar spine, hip, or femoral neck. Logistic regression analysis to assess risk factors of low BMD (T score < - 1.0) and Cox proportional hazards models to estimate risk of incident end-stage renal disease (ESRD). RESULTS: Low BMD was prevalent (osteopenia 33%; osteoporosis 8%) in 2128 adults with CKD (age 54 ± 12 years; male 61%). Over a median follow-up of 4.3 years, there were 521 cases of incident ESRD. Lower BMD was associated with female sex, older age, low eGFR, low BMI, and lifestyle factors of physical activity (odds ratio (OR) = 0.62, 95% confidence interval (0.49-0.77)) and spot urine Na/K ratio (1.07 (1.00-1.15)). In adjusted Cox models, low BMD was associated with increased incident ESRD (hazard ratio (HR) = 1.14 (0.92-1.41) for osteopenia; 1.43 (1.01-2.04) for osteoporosis, P for trend < 0.05) compared with the reference of normal BMD. The association between low BMD and ESRD was similar according to T score discordance classification. CONCLUSIONS: Low BMD was associated with modifiable lifestyle factors including low physical activity and high dietary Na/K intake ratio. The presence of low BMD is associated with poor renal outcomes in non-dialysis CKD.

Preservation of fruit and vegetable discards with sodium metabisulfite.

Two series of experiments were performed to investigate the aerobic preservation of fruit and vegetable discards (FVD) using sodium metabisulfite (SMB). In Exp. 1, metabisulfite was applied at 0, 2, 4, 6, and 8 g/kg FVD for 0, 3, 6, 9, and 12 d. Metabisulfite treatment at 6 and 8 g/kg FVD was highly effective in controlling putrefaction and preserving the nutrient components for 6 and 9 d, respectively. In the pilot-scale experiment (Exp. 2), SMB was applied at 0 and 8 g/kg FVD in a 600-L bucket for 0, 6, and 9 d in an outdoor environment. The SMB treatment was highly effective in maintaining the integrity and freshness of FVD, suppressing microbial proliferation, and preserving the nutrient constituents. Under the conditions of this study, SMB effectively preserved FVD in an aerobic environment, enabling their more efficient long-term recycling through livestock feed or development of value-added products.

Stemmed DNA nanostructure for the selective delivery of therapeutics.

DNA has emerged as a biocompatible biomaterial that may be considered for various applications. Here, we report tumor cell-specific aptamer-modified DNA nanostructures for the specific recognition and delivery of therapeutic chemicals to cancer cells. Protein tyrosine kinase (PTK)7-specific DNA aptamer sequences were linked to 15 consecutive guanines. The resulting aptamer-modified product, AptG15, self-assembled into a Y-shaped structure. The presence of a G-quadruplex at AptG15 was confirmed by circular dichroism and Raman spectroscopy. The utility of AptG15 as a nanocarrier of therapeutics was tested by loading the photosensitizer, methylene blue (MB), to the G-quadruplex as a model drug. The generated MB-loaded AptG15 (MB/AptG15) showed specific and enhanced uptake to CCRF-CEM cells, which overexpress PTK7, compared with Ramos cells, which lack PTK7, or CCRF-CEM cells treated with a PTK7-specific siRNA. The therapeutic activity of MB/AptG15 was tested by triggering its photodynamic effects. Upon 660 nm light irradiation, MB/AptG15 showed greater reactive oxygen species generation and anticancer activity in PTK7-overexpressing cells compared to cells treated with MB alone, those treated with AptG15, and other comparison groups. AptG15 stemmed DNA nanostructures have significant potential for the cell-type-specific delivery of therapeutics, and possibly for the molecular imaging of target cells.

Propagation Dynamics Associated with Resonant Magnetic Perturbation Fields in High-Confinement Mode Plasmas inside the KSTAR Tokamak.

The propagation dynamics of resonant magnetic perturbation fields in KSTAR H-mode plasmas with injection of small edge perturbations produced by a supersonic molecular beam injection is reported for the first time. The results show that the perturbation field first excites a plasma response on the q=3 magnetic surface and then propagates inward to the q=2 surface with a radially averaged propagation velocity of resonant magnetic perturbations field equal to 32.5 m/ s. As a result, the perturbation field brakes the toroidal rotation on the q=3 surface first causing a momentum transport perturbation that propagates both inward and outward. A higher density fluctuation level is observed. The propagation velocity of the resonant magnetic perturbations field is larger than the radial propagation velocity of the perturbation in the toroidal rotation.

Yield survey and nutritional evaluation of garlic stalk for ruminant feed.

BACKGROUND: Very limited information exists on the ruminal degradation kinetics of nutrients in garlic stalk. The present study aimed to survey the annual yield of garlic stalk in Korea and determine its feed-nutritive value for ruminants. METHODS: In Experiment 1, garlic stalk was incubated in situ in the rumen of two Hanwoo steers (360 ± 15 kg body weight) and removed after 12, 24, or 48 h to determine the ruminal degradation kinetics of DM and NDF. Rice straw was also included for comparison. In Experiment 2, In Experiment 2, six male Corriedale sheep were randomized to two dietary treatments to determine the apparent digestibility of nutrients in garlic stalk. Diets included a control ration without garlic stalk (60% concentrate mix +40% ryegrass) or a treatment ration (70% control diet +30% garlic stalk). RESULTS: The Korean national yield of garlic stalk (sun-dried basis) in 2016 was estimated to be 31,910 tons, with the southern coastal regions producing the highest quantity. Compared with rice straw, garlic stalk had lower NDF, higher ADF, and greater effective degradabilities of DM and NDF, resulting in a greater TDN value (56.3%), which was higher than that obtained for rice straw (43.7%). CONCLUSION: These results provide basic information on the ruminal DM and NDF degradation kinetics of garlic stalk, which would be helpful for the efficient utilization of this by-product in ruminant diets.

Immune-camouflaged graphene oxide nanosheets for negative regulation of phagocytosis by macrophages.

Signal regulatory protein alpha (SIRPα) is highly expressed in macrophages of the reticuloendothelial system and in tumor-associated macrophages, whereas tumor cells express the surface membrane protein, CD47, which interacts with SIRPα to negatively regulate phagocytosis. In this study, we modified the surfaces of graphene oxide (GO) nanosheets with a CD47-like SIRPα-binding peptide (SP). The presence of SP on GO nanosheets reduced the macrophage uptake to a greater extent than the PEGylation of such nanosheets. This reduced uptake was found to be mediated by the activation of Src homology region 2 domain-containing phosphatase 1 (SHP-1) and the downstream inhibition of myosin assembly, which is necessary for phagosome formation. Unlike SP-coated GO nanosheets, PEGylated GO nanosheets did not affect myosin assembly or phagocytosis. After in vivo systemic administration, the clearance of SP-coated GO nanosheets was slower than that of PEGylated GO nanosheets, and this difference increased with repeated administration. Finally, SP-coated GO nanosheets showed a higher distribution to tumor tissues than PEGylated GO nanosheets or a physical mixture of SP and GO nanosheets. Our findings indicate that immune-camouflaged GO nanosheets with natural CD47-like SIRPα-binding molecules can reduce the nonspecific loss of such nanosheets through macrophage uptake, thereby enhancing their blood circulation and tumor delivery after multiple injections.

Effect of microbial inoculant or molasses on fermentative quality and aerobic stability of sawdust-based spent mushroom substrate.

In the first experiment, the effect of two novel Lactobacillus plantarum strains was studied on the fermentation of spent mushroom substrate (SMS) through 10d of ensiling. Based on lactic acid production and lactic acid bacteria population, L. plantarum KU5 was identified as the best strain for fermentation with a 5-L bag silo. Spent mushroom substrate was ensiled with 0.5% (v/w) L. plantarum KU5 without or with 5% molasses. Silages treated with microbial inoculant and molasses had the lowest pH and the highest fermentative odors. In a second set of experiments similar to the above 5-L silo study, the simultaneous application of L. plantarum KU5 inoculant and molasses to 80-L silos improved fermentability and aerobic stability of SMS silages. For similar treatment using ton-bag silos, aerobic stability decreased and NH3-N content increased dramatically. In conclusion, sawdust-based SMS for animal use was successfully ensiled with L. plantarum KU5 inoculant and molasses.

Clinical outcomes in Asian elderly kidney transplant recipients: a multicenter cohort study.

BACKGROUND: The kidney transplantation rate in elderly patients is increasing rapidly. However, the clinical outcomes of kidney transplantation in elderly patients have not yet been thoroughly evaluated. METHODS: This multicenter cohort study included adult kidney transplant recipients (KTRs) admitted to five major tertiary hospitals in Korea between 1997 and 2012. A total of 3,565 adult participants were enrolled. Patient survival, allograft survival, and biopsy-proven acute rejection (BPAR) of 242 elderly recipients (≥ 60 years) were assessed and compared with those of a younger population. RESULTS: Patients were divided into five groups according to age at time of transplantation. The proportion of elderly patients was 6.7 % (mean age, 63.1 ± 2.7 years; n = 242). The numbers of male patients (69.4%), those with diabetes mellitus history (36.3%), and those with pretransplantation ischemic heart disease history (17.7%) were significantly higher in the elderly group than in the younger age groups. Elderly patients were more likely to receive a cadaveric kidney, and overall mortality rates were significantly higher in the elderly patients (1-year survival 93.3%, 5-year survival 91.3%). However, death-censored allograft survival rate and BPAR were not affected by patient age (P = .104 and .501, respectively). Among the elderly, BPAR and female donors were independent risk factors for allograft loss. CONCLUSION: The overall survival rate of the elderly KTRs was significantly lower than that of younger KTRs. However, the death-censored allograft survival rate did not differ between groups. Kidney transplantation should not be stagnated especially in elderly patients with end-stage renal disease.

Responses of blood glucose, insulin, glucagon, and Fatty acids to intraruminal infusion of propionate in hanwoo.

This study was carried out to investigate the effects of intraruminal infusion of propionate on ruminal fermentation characteristics and blood hormones and metabolites in Hanwoo (Korean cattle) steers. Four Hanwoo steers (average body wt. 270 kg, 13 month of age) equipped with rumen cannula were infused into rumens with 0.0 M (Water, C), 0.5 M (37 g/L, T1), 1.0 M (74 g/L, T2) and 1.5 M (111 g/L, T3) of propionate for 1 hour per day and allotted by 4×4 Latin square design. On the 5th day of infusion, samples of rumen and blood were collected at 0, 60, 120, 180, and 300 min after intraruminal infusion of propionate. The concentrations of serum glucose and plasma glucagon were not affected (p>0.05) by intraruminal infusion of propionate. The serum insulin concentration at 60 min after infusion was significantly (p<0.05) higher in T3 than in C, while the concentration of non-esterified fatty acid (NEFA) at 60 and 180 min after infusion was significantly (p<0.05) lower in the propionate treatments than in C. Hence, intraruminal infusion of propionate stimulates the secretion of insulin, and decreases serum NEFA concentration rather than the change of serum glucose concentration.

Rotation characteristics during the resonant magnetic perturbation induced edge localized mode suppression on the KSTAR.

Measuring rotation profiles with a reliable spatial resolution is one of the critical diagnostics in understanding the plasma behavior especially for the edge transport. In the KSTAR experiments, it has been consistently observed from the charge exchange spectroscopy measurements that the magnetic perturbations not only suppresses edge localized modes (ELMs) but also reduces toroidal rotations. In this paper, toroidal velocities of the carbon impurity and their profile evolutions during ELMy and ELM-suppressed phases are presented. The rotation profiles are shown to collapse immediately after an ELM burst and continue to build up until the next burst that accompanies another collapse. Toroidal rotations following the resonant magnetic perturbations applications are observed to be reduced along with the ELMs suppressed.

Maintenance Crude Protein Requirement of Penned Female Korean Spotted Deer (Cervus nippon).

This study was conducted to evaluate the protein requirement for maintenance of 2-year-old female Korean spotted deer. In the course of the experiment, each of three hand-reared female spotted deer was fed three diets that were iso-calorically formulated to contain low (approximately 7%), medium (12%), and high (17%) levels of crude protein (CP). Each of six trials included a 5-day transition, a 10-day preliminary, and a 7-day collection period. Dietary protein levels affected the apparent digestibility of CP (p<0.05) but not the apparent digestibility of dry matter, organic matter, or acid detergent fiber. All of the deer showed a positive CP balance on all of the diets. The maintenance CP requirement estimated by regression analysis was 4.17 g/kg metabolic body weight (W(0.75))·d. The maintenance digestible CP requirement was 1.42 g/kg W(0.75)·d. The metabolic fecal CP was 1.95 g/kg W(0.75)·d. The blood urea nitrogen of spotted deer increased (p<0.05) as the dietary protein levels increased.

Ensiling Characteristics and the In situ Nutrient Degradability of a By-product Feed-based Silage.

This study was conducted to evaluate the ensiling characteristics and the in situ degradability of a by-product feed (BF)-based silage. Before ensilation, the BF-based mixture was composed of 50% spent mushroom substrate, 21% recycled poultry bedding, 15% ryegrass straw, 10.8% rice bran, 2% molasses, 0.6% bentonite, and 0.6% microbial inoculant on a wet basis and ensiled for up to 4 weeks. The BF-based silage contained on average 39.3% moisture, 13.4% crude protein (CP), and 52.2% neutral detergent fiber (NDF), 49% total digestible nutrient, and 37.8% physically effective NDF1.18 on a dry matter (DM) basis. Ensiling the BF-based silage for up to 4 weeks affected (p<0.01) the chemical composition to a small extent, increased (p<0.05) the lactic acid and NH3-N content, and decreased (p<0.05) both the total bacterial and lactic acid bacterial counts from 10(9) to 10(8) cfu/g when compared to that before ensiling. These parameters indicated that the silage was fermented and stored well during the 4-week ensiling period. Compared with rice or ryegrass straws, the BF-based silage had a higher (p<0.05) water-soluble and filterable fraction, a lower insoluble degradable DM and CP fraction (p<0.05), a lower digestible NDF (p<0.05) fraction, a higher (p<0.05) DM and CP disappearance and degradability rate, and a lower (p<0.05) NDF disappearance and degradability rate. These results indicated that cheap, good-quality BF-based roughage could be produced by ensiling SMS, RPB, rice bran, and a minimal amount of straw.

Rotational resonance of nonaxisymmetric magnetic braking in the KSTAR tokamak.

One of the important rotational resonances in nonaxisymmetric neoclassical transport has been experimentally validated in the KSTAR tokamak by applying highly nonresonant n=1 magnetic perturbations to rapidly rotating plasmas. These so-called bounce-harmonic resonances are expected to occur in the presence of magnetic braking perturbations when the toroidal rotation is fast enough to resonate with periodic parallel motions of trapped particles. The predicted and observed resonant peak along with the toroidal rotation implies that the toroidal rotation in tokamaks can be controlled naturally in favorable conditions to stability, using nonaxisymmetric magnetic perturbations.

Effect of estradiol on the expression of renal sodium transporters in rats.

BACKGROUND: Although estradiol has been thought to perform an important role in blood pressure regulation, the effects of estradiol on the expression of renal sodium transporters are not fully understood. METHODS: Female Sprague-Dawley rats were treated with 17ß-estradiol or vehicle for 10 days after ovariectomy, and after both ovariectomy and adrenalectomy to eliminate the effect of aldosterone. RESULTS: In the ovariectomized (OVX) rats, estradiol decreased the abundance of the Na-K-2Cl cotransporter (NKCC2) (31.5% of control (OVX), p < 0.01), Na-Cl cotransporter (NCC) proteins (40.5% of control (OVX), p < 0.01) and α- and γ-subunits of the epithelial sodium channel (ENaC) (44.7% and 11.0% of control (OVX), p < 0.01). Estradiol also reduced plasma aldosterone levels (OVX + 17ß-estradiol vs. OVX, 116.3 ± 44.4 vs. 184.2 ± 33.4 pmol/l, p < 0.05) and systolic blood pressure (OVX + 17ß-estradiol vs. OVX, 115 ± 4 vs. 132 ± 2 mmHg, p < 0.05). In rats having undergone adrenalectomy and ovariectomy, estradiol did not reduce systolic blood pressure, or the expression of sodium transporters. CONCLUSION: Estradiol decreased systolic blood pressure, plasma aldosterone levels, and the expression of renal sodium transporters. After aldosterone was eliminated, estradiol did not affect blood pressure or the expression of sodium transporters, which indicates that the effect of estradiol on the renal sodium transporters is at least partly influenced by aldosterone.

A comparison of outcomes between concurrent chemoradiotherapy and radiotherapy alone in cancer of the uterine cervix: a single institutional experience.

PURPOSE: To compare failure patterns and evaluate prognostic factors related to survival rates after concurrent chemoradiotherapy (CCRT) or radiotherapy (RT) alone in cervical cancer. MATERIALS AND METHODS: From January 1996 to December 2006, 218 patients with cervical cancer (FIGO Stage IB2 - III) treated with CCRT or RT alone as primary treatments were included, retrospectively. One-hundred eight patients were treated with CCRT and 110 with RT alone. RESULTS: There was no significant difference in failure patterns between the treatment groups, but distant metastasis was the predominant pattern in both groups. The frequent metastatic sites were supraclavicular lymph node, lung, and brain. Treatment group, diabetes, and FIGO Stage were found to be significant for overall survival (OS) and disease-free survival (DFS), and initial hemoglobin level for DFS. CONCLUSION: Distant metastasis is the predominant failure pattern and diabetes is one of the independent prognostic factors to survival rates in this study.

Effect of indigenous herbs on growth, blood metabolites and carcass characteristics in the late fattening period of hanwoo steers.

This study was conducted to evaluate the effects of indigenous herbal supplements on growth, blood metabolites and carcass characteristics in the late fattening period of Hanwoo steers. In a 6 month feeding trial, thirty Hanwoo steers (647±32 kg) were allotted to one of 5 treatment groups, control (basal diet contained lasalocid), licorice, clove, turmeric and silymarin, with six steers per pen. All groups received ad libitum concentrate and 1 kg rice straw/animal/d throughout the feeding trial. Blood samples were collected at the beginning, middle, and the end of the experiment and the steers were slaughtered at the end. Blood glucose, triglyceride, total protein, and albumin concentrations were higher in the turmeric treatment compared with other treatments. Blood urea nitrogen and creatinine concentrations were highest (p<0.003 and p = 0.071, respectively) in steers treated with silymarin. Alanine aminotransferase activity was lower (p<0.06) for licorice and silymarin compared with the control group. There were no alterations in serum aspartate aminotransferase and gamma glutamyltransferase activities as a consequence of herb treatments (p = 0.203 and 0.135, respectively). Final body weight, body weight gain, average dairy gain and dry matter intake were not significantly different among treatments. Yield grade, marbling score and quality grade were higher for silymarin group than those of the control group (p<0.05). Therefore, the results suggest that silymarin can be used an effective dietary supplement as an alternative to antibiotic feed additive and a productivity enhancer, providing safe and more consumer acceptable alternative to synthetic compounds during the late fattening period of steers.

Effects of electron-cyclotron-resonance-heating-induced internal kink mode on the toroidal rotation in the KSTAR Tokamak.

It is observed that the magnitude of the toroidal rotation speed is reduced by the central electron cyclotron resonance heating (ECRH) regardless of the direction of the toroidal rotation. The magnetohydrodynamics activities generally appear with the rotation change due to ECRH. It is shown that the internal kink mode is induced by the central ECRH and breaks the toroidal symmetry. When the magnetohydrodynamics activities are present, the toroidal plasma viscosity is not negligible. The observed effects of ECRH on the toroidal plasma rotation are explained by the neoclassical toroidal viscosity in this Letter. It is found that the neoclassical toroidal viscosity torque caused by the internal kink mode damps the toroidal rotation.

17α-hydroxlyase/17, 20-lyase deficiency in three siblings with primary amenorrhea and absence of secondary sexual development.

BACKGROUND: 17α-hydroxlyase/17, 20-lyase deficiency (17OHD) is a rare phenotype of congenital adrenal hyperplasia that can cause primary amenorrhea. CASE: Three phenotypically female siblings visited the adolescent gynecologic clinic complaining of primary amenorrhea and absence of secondary sexual developments. All had constant high blood pressure and showed a hypergonadotropic hypogonadal state with high progesterone and low testosterone levels. Two were genotypically females and one was genotypically a male; all were confirmed to have 17OHD, and estrogen replacement, glucocorticoids, and antihypertensive drugs were Prescribed to the patients. SUMMARY AND CONCLUSION: Identifying a 17OHD patient complaining of primary amenorrhea in a gynecologic clinic is important for proper management.

Effects of Supplementing Microbially-fermented Spent Mushroom Substrates on Growth Performance and Carcass Characteristics of Hanwoo Steers (a Field Study).

This study evaluated the effect of dietary supplementation of microbially-fermented spent mushroom substrates (MFSMS) on weight gain, carcass characteristics, and economic efficiency of Hanwoo steers. Highly cellulolytic bacteria (Enterobacter spp. and Bacillus spp.) isolated from spent mushroom substrates (SMS) stacks were inoculated (1% v/v) into the SMS, which was anaerobically fermented and fed to the steers for 12.6 months during the growing and fattening periods. Growing Hanwoo steers were assigned to the control group without supplementation of Microbially-fermented SMS (MFSMS), to a treatment group with 50% of MFSMS (1/2 of the ad libitum group), and to a treatment group with ad libitum access to SMS (the ad libitum group). All the groups were fed the formulated feed and rice straw. The voluntary intake (DM basis) of MFSMS was 1.6 kg/d during the growing period and 1.4 kg/d during the fattening period. The voluntary rice straw intake decreased by 6 to 11%, but the total voluntary DMI increased by 7 to 15% with MFSMS fed. The increased DMI with MFSMS supplementation resulted in a tendency of increased (p = 0.055) live weight gain by 8 to 12% compared with the control group. At slaughtering, the supplementation of MFSMS increased (p<0.05) the ribeye area by an average of 10 cm(2). In conclusion, feeding MFSMS improved growth performance and carcass traits of Hanwoo steers and could successfully replace a part of conventional roughage such as rice straw commonly used in Asian countries.

The effects of oral iron supplementation on the progression of anemia and renal dysfunction in patients with chronic kidney disease.

AIMS: Oral iron traditionally has been administered to patients with chronic kidney disease (CKD). However, there are limited data on the effect of oral iron in CKD patients. Here, we evaluate the effects of oral iron therapy on renal anemia and progression of renal disease in CKD patients. METHODS: Anemic patients with nondialytic CKD who were naive to erythropoiesis-stimulating agents (ESAs) were recruited for the prospective observational study. The participants were classified into oral iron or control group, and they were asked to keep their treatment status for 1 year. The primary outcomes were change in Hb and estimated glomerular filtration rate (eGFR). RESULTS: A total of 182 participants were enrolled and 138 completed a 12-month follow-up. No change in Hb level was observed during the follow-up period in the iron group, whereas a significant decrease in Hb was observed in the control group. Oral iron supplementation was effective, especially in patients with eGFR < 30 ml/min/1.73 m2. The changes in eGFR did not differ between the two groups. The incidences of drug-related adverse events were equivalent in two groups. CONCLUSIONS: Oral iron supplementation might attenuate the progression of anemia in nondialytic CKD patients without ESAs and not impact kidney function.