IRB review points for studies utilizing paraffin blocks archived in the pathology laboratory / 영남의대학술지

In the personalized medicine era, utilizing paraffin blocks in pathology archives for investigating human diseases has come into the limelight. This archived material with clinical data will reduce the research time and could prevent new patient recruitment to obtain tissue for research. However, the clause indicating the necessity of consent from human material providers in the Korean Bioethics and Safety Act has made the Institutional Review Board (IRB) deny permission to use paraffin blocks for research without consent, and alternatively to get the same before starting an experiment. Written consent may be waived off in studies using paraffin blocks with anonymous status or conditions not linked to personal information by applying the paragraph 3, article 16 of the current Bioethics and Safety Act. Also, the IRB should recommend researchers to preserve the blocks as medical records of patients in long-term archives.

IRB review points for studies utilizing paraffin blocks archived in the pathology laboratory / 영남의대학술지

In the personalized medicine era, utilizing paraffin blocks in pathology archives for investigating human diseases has come into the limelight. This archived material with clinical data will reduce the research time and could prevent new patient recruitment to obtain tissue for research. However, the clause indicating the necessity of consent from human material providers in the Korean Bioethics and Safety Act has made the Institutional Review Board (IRB) deny permission to use paraffin blocks for research without consent, and alternatively to get the same before starting an experiment. Written consent may be waived off in studies using paraffin blocks with anonymous status or conditions not linked to personal information by applying the paragraph 3, article 16 of the current Bioethics and Safety Act. Also, the IRB should recommend researchers to preserve the blocks as medical records of patients in long-term archives.

A study on revitalization of primary healthcare organizations through development of standard functions

Primary care lays the foundation of national healthcare systems, but it has been weak in playing its role correctly because of legal and environmental attributes surrounding the healthcare industry in Korea. This study is conducted to concretize the definition and scope of primary care and to deduce its standard functions to contribute to establishing the healthcare delivery system and appropriate healthcare systems embracing socio-environmental leverage. The term primary healthcare institution was adopted based on literature review to achieve the research goal. The principle diseases appropriate for the primary healthcare institution based on ambulatory care sensitive conditions were analyzed, and the standard functions were deduced by matching these diseases with current procedural terminologies using CrossCoder package. Based on the analysis, the primary healthcare institution-specific diseases were 53 specific diseases under 23 broad disease groups. The standard functions were deduced in three categories of the standard functions of the entire primary healthcare institutions with 100% frequency, common standard functions with 70% frequency, and peculiar standard functions specific to diseases or body systems. These functions included outpatient evaluation and measurement, various factor tests through blood collection, and X-ray. Establishing the standard functions for the primary healthcare institution can promote patient reliability on primary care, alleviate health demand congestion toward large-sized advanced healthcare institutions. Furthermore, it contributes to establishing and reinforcing other healthcare policies related to the healthcare reimbursement system and referral system, and fosters primary care physician education. Most importantly, it reduces the national health expenditures by realizing efficient and effective healthcare delivery.

Analysis of the Chemical Constituents of Agaricus brasiliensis

This study examined the chemical composition of A. blasiliensis and the chemical structural properties of an immuno-stimulating polysaccharide. The amino acids, free sugars, and organic acids by HPLC and fatty acids by GC were analyzed. The immuno-stimulating substance from A. blasiliensis was extracted with hot water and purified by ethanol precipitation. It underwent ion exchange chromatography on DEAE-cellulose and gel filtration on Toyopearl HW 65F. Through GP-HPLC, the substance was found to be homogeneous. Its chemical structure was determined by 13C-NMR. Fatty acids, organic acids, and sugar alcohol composition consisted exclusively of linoleic acid, fumaric acid and mannitol, respectively. The amino acids were mainly glutamic acid, glycine, and arginine. By 13C-NMR analysis, the immuno-stimulating substance was identified as beta-(1-->3) (1-->6)-glucan, composed of a backbone with (1-->3)-linked D-glucopyranosyl residues branching a (1-->6)-linked D-glucopyranosyl residue. The beta-glucan from A. blasiliensis showed pronounced immuno-stimulating activity on the antibody-production ability of B-lymphocytes by the hemolytic suspension assay. In these results, A. blasiliensis was estimated to have potent pharmacological properties and potential nutritional values.

Relationship of body iron stores with the development of nonalcoholic fatty liver disease / 대한내과학회지

BACKGROUND: Although numerous reports have shown the influence of the iron overload state on the development of nonalcoholic fatty liver disease (NAFLD), there have been few reports on the prevalence of NAFLD according to the body iron stores. The aim of the present study was to determine the relationship of body iron stores with the development of NAFLD in apparently healthy women. METHODS: The present cross-sectional study was performed with data obtained from 5,249 women (mean age: 40.6+/-8.9 years), that received an annual health check-up. All components of metabolic syndrome criteria, anthropometric parameters, fasting insulin levels, level of C-reactive protein and serum iron tests were measured in each subject. RESULTS: The prevalence of NAFLD was significantly different according to body iron status (normal iron store/iron store depletion/iron deficient erythropoiesis/iron deficiency anemia: 10.6%/4.1%/6.5%/11.2%, p<0.001). Multivariate analysis revealed that age (odds ratio [OR]=1.284; 95% confidence interval [CI]: 1.1161.507) per 10 years), being overweight (OR=1.952; 95% CI: 1.3952.732), diabetes mellitus (OR=1.694; 95% CI: 1.198-2.397), hypertriglyceridemia (OR=2.434; 95% CI: 1.737-3.409), abdominal obesity (OR=3.559; 95% CI: 2.538-4.992), insulin resistance (OR=2.665; 95% CI: 1.979-3.587), anemia (OR=2.015; 95% CI: 1.150-3.532) and stored iron depletion (OR=0.580; 95% CI: 0.405-0.830) were profoundly associated with the development of NAFLD. CONCLUSION: The present study reveals a possible correlation between the development of NAFLD and body iron stores, and stored iron depletion and anemia seem to be key factors for this correlation.

Gossypiboma (Textiloma) due to Retained Surgical Gauze / 대한소화기학회지

No abstract availble.

Changes of Enzyme Activities and Compositions of Abnormal Fruiting Bodies Grown under Artificial Environmental Conditions in Pleurotus ostreatus

This study investigated the biochemical changes of abnormal fruiting bodies grown under artificial environmental conditions in P. ostreatus. Abnormal mushroom growth during cultivation damages the production of good quality mushroom. This study showed that different environmental conditions produced morphological changes in the fruiting bodies of P. ostreatus. The fruiting bodies with morphological changes were collected and examined for differences in biochemical properties, enzyme activities, and carbohydrates composition. The enzyme activities assay showed that glucanase and chitinase activities decreased when the temperature was below or above the optimum cultivation temperature for P. ostreatus. The biochemical compositions of the abnormal mushroom were significantly different from the normal fruiting bodies. It was suggested that the changes in the biochemical composition of abnormal mushroom were caused by the unfavorable environmental conditions during mushroom cultivation.

Genetic and Environmental Factors that Influence on Erythropoietin Resistance in Patients on Hemodialysis / 대한신장학회잡지

BACKGROUND: Erythropoietin (EPO) requirement to reach a specified target hemoglobin level varies in patients on dialysis, the reasons being multifactorial. Angiotensin II has been shown to stimulate proliferation of early erythroid progenitors via erythropoietin and the plasma level of angiotensin II has been strongly associated with angiotensin converting enzyme (ACE) gene polymorphism. EPO resistance index (ERI, weekly rhEPO dose/hematocrit/body weight) is a collective responsiveness between EPO and hematocrit. We have evaluated whether ACE gene polymorphism might exert effect on ERI and also have analysed various laboratory parameters that could affect erythropoietin requirement in HD patients. METHODS: We have compared various demographic data and laboratory parameters, including age, sex, months on dialysis, body mass index (BMI), EPO requirement, ERI, high sensitivity C-reactive protein (hsCRP), ferritin, albumin, hematocrit, iPTH, Kt/V, normalized protein catabolic rate (nPCR), cause of renal failure and whether or not patients were on ACE inhibitor or Angiotensin receptor blocker (ARB), in 199 patients on hemodialysis therapy [M: F 94: 105, Age 61+/-13, duration of dialysis 63 (3-287 months)] according to ACE gene polymorphism (II, ID, DD). We also have assessed independent association of ERI with demographic variables and laboratory parameters using linear regression analysis. RESULTS: There was statistically significant difference (p=0.034) in ERI in the II/ID group compared to the DD group and it was lower in the DD group. But there was no statistically significant difference in other demographic data and laboratory parameters according to ACE gene polymorphism. In the linear regression analysis, lower BMI (p<0.001), female gender (p=0.001), and ACE gene polymorphism (non-DD vs. DD, p=0.027) were determined to be independent factors affecting high ERI. CONCLUSION: ACE gene polymorphism could be determining factor of EPO requirement in patients on hemodialysis. Improving nutritional status might be helpful in reducing EPO requirement and we should consider the gender difference in determining EPO dose in patients on hemodialysis.

Methods of Smoking Cessation

No abstract available.

Smoking and Atherosclerotic Cardiovascular Disease

No abstract available.

A Study on the Serum Lipoperoxide Level in the Normal Korean and in the Cases with Various Diseases

Serum Lipoperoxide levels were studied in 50 normal Korean and in the following patients; 26 patients with diabetes mellitus, 20 patients with hypertension, 14 patients with ischemic heart disease, 8 patients with cerebrovascular accident and 6 patients with nephrotic syndrome. The results obtained are summarized as follows; 1. In normal Korean, the average serum lipoperoxide level was 2.62+/-0.27 nmoles M.D. A./ml, with no difference by the sex. 2. In the cases with various disease which in supposed to be related to abnormal lipid metabolism, that is, diabetes mellitus, hypertension, ischemic heart disease, nephrotic syndrome, the serum lipoperoxide value showed statistically significant elevation compared to that of the normal control (p0.05). 3. The serum lipoperoxide level was coarsely related with the serum concentration of cholesterol and total lipid, the correlation coefficient of which were 0.34 and 0.35 respectively (p<0.05).

A Study on the Serum Lipoperoxide Level in the Normal Korean and in the Cases with Various Diseases

Serum Lipoperoxide levels were studied in 50 normal Korean and in the following patients; 26 patients with diabetes mellitus, 20 patients with hypertension, 14 patients with ischemic heart disease, 8 patients with cerebrovascular accident and 6 patients with nephrotic syndrome. The results obtained are summarized as follows; 1. In normal Korean, the average serum lipoperoxide level was 2.62+/-0.27 nmoles M.D. A./ml, with no difference by the sex. 2. In the cases with various disease which in supposed to be related to abnormal lipid metabolism, that is, diabetes mellitus, hypertension, ischemic heart disease, nephrotic syndrome, the serum lipoperoxide value showed statistically significant elevation compared to that of the normal control (p0.05). 3. The serum lipoperoxide level was coarsely related with the serum concentration of cholesterol and total lipid, the correlation coefficient of which were 0.34 and 0.35 respectively (p<0.05).

Plasma CRP, apolipoprotein A-1, apolipoprotein B and Lp(a) according to thyroid function status / 대한내과학회지

BACKGROUND: Alterations of lipid profiles are well known in thyroid dysfunction. Hypothyroidism is associated with premature atherosclerosis. This relation has been attributed to increased levels of total cholesterol, low density lipoprotein cholesterol and apolipoprotein B. However, there have been dissenting reports of abnormalities in serum lipid concentrations in patients with subclinical hypothyroidism. Serum Lp(a), an independent risk factor of atherosclerosis, is predicted according to thyroid function status. C-reactive protein (CRP) is very sensitive acute phase reactant and independently associated with the occurrence of atherosclerosis. Overt hypothyroidism is a cause of atherosclerosis, so it is expected that serum level of CRP may be related with thyroid dysfunction. However, no study has been performed about it. The objective of the study was to evaluate the relation of plasma CRP, apo A1, apo B and Lp(a) with thyroid function. METHODS: We undertook this study in 54 patients with hyperthyroidism, 35 patients with subclinical hyperthyroidism, 29 patients with overt hypothyroidism, 194 patients with subclinical hypothyroidism and 100 age and sex matched healthy control subjects. Serum CRP and Lp(a) were measured by immuno-nephelometry. RESULTS: There were no significant differences of serum CRP, Lp(a), HDL-C and apo A1 according to thyroid dysfunction. Serum total cholesterol level was lower in hyperthyroidism than in overt hyperthyroidism, subclinical hypothyroidism, subclinical hyperthyroidism and healthy control subjects (p<0.05). Serum LDL-C level was lower in hyperthyroidism than overt hypothyroidism (p<0.05). Serum triglyceride level was higher in overt hypothyroidism than in hyperthyroidism and healthy control subjects (p<0.05). Serum apo B level was lower in hyperthyroidism than in overt hyperthyroidism, subclinical hypothyroidism and healthy control subjects (p<0.05). CONCLUSION: Serum CRP and Lp(a), risk factors of atherosclerosis, were not significantly different according to thyroid dysfunction. Increased risk for atherosclerosis in overt hypothyroidism seems not to be associated with serum CRP level.

Effects of smoking, alcohol, exercise, level of education, and family history on the metabolic syndrome in Korean adults / 대한내과학회지

BACKGROUND: People with the metabolic syndrome are at increased risk for cardiovascular mortality. Metabolic syndrome is caused by interplay between genetic and many environmental factors. Although several environmental factors have diverse effect on the development of metabolic syndrome, few studies have examined their relation in Koreans. This study was performed to estimate the effects of smoking, alcohol consumption, exercise, education level and family history on the components of metabolic syndrome in Korean adults and to observe the relative risk of developing metabolic syndrome defined by NCEP-ATP III according to these factors. METHODS: This study was performed in 4341 subjects (2059 men, 2282 women, mean age 42.3+/-10.4). We gathered the smoking, alcohol drinking, exercise, family history and education level by self-administered questionnaire at the health promotion center. Height, weight, waist circumference, blood pressure were examined. Fasting serum triglyceride, high density lipoprotein cholesterol, fasting glucose were measured. RESULTS: Multivariate-adjusted odds ratio of hypertriglyceridemia was 1.4 (95% CI 1.0~1.8) and low HDL-C (high density lipoprotein cholesterol) was 1.9 (95% CI 1.3~2.6) in subjects who smoked more than 20 PYS compared to nonsmokers. Also relative risk of developing metabolic syndrome in smokers (more than 20 PYS) was 1.9 (95% CI 1.1~3.7) compared to nonsmokers. Alcohol consumption had a significant protective effect against low HDL-C in all categories compared to nondrinkers (adjusted OR 0.6~0.2). In people with lack of exercise, the odds ratio of high waist circumference was 4.1 (95% CI 1.31~8.6), high triglyceride was 1.3 (95% CI 1.0~1.8), low HDL-C was 1.5 (95% CI 1.5~2.0) when compared to subjects with regular exercise. Relative risk for metabolic syndrome was 1.7 (95% CI 0.9~2.8). The adjusted odds ratio of high blood pressure was 1.3 (95% CI 1.1~1.6) and high fasting glucose was 1.7 (95% CI 1.1~2.5) in subjects with family history compared to subjects without family history. Relative risk for the metabolic syndrome was 1.5 (95% CI 1.1~2.1) in subjects with family history. Relative risk for the presence of the metabolic syndrome in subjects with lowest education level was 2.0 (95% CI 1.2~3.4) when compared to subjects with the highest education level. Significant associations were found between low education and high waist circumference (OR 4.5, 95% CI 1.5~14.0) and low HDL-C (OR 1.2, 95% CI 1.0~1.4) and high blood pressure (OR 2.1, 95% CI 1.6~2.9). CONCLUSION: Smoking was associated with dyslipidemia. Alcohol consumption increased HDL-C and was associated with abdominal obesity. Lack of exercise was associated with obesity and dyslipidemia. Family history was associated with hypertension and diabetes. Low education level was strongly associated with hypertension and abdominal obesity. Since subjects with low education level and family history were associated with increased risk for metabolic syndrome and thus developing cardiovascular disease, particular attention should be paid in these subjects.

Clinical Effect of Procetofene(Lipanthyl(R)) on the Serum Lipids in the Hyperlipidemic Patients

We observed the levels of serum cholesterol, triglyceride and HDL-cholesterol in 28-hyperlipidemic patients after treatment with procetofene(Lipanthyl(R)), a new hypolipidemic agent. The results were as follows. 1. The hyperlipidemic patients were 7 cases of pure hypercholesterolemia, 12 cases of mixed hyperlipidemia and 9 cases of pure hypertriglyceridemia. 2. All the patients were treated with daily dose of 200 to 400mg, usually 300mg, and duration of more than 12 weeks. 3. The serum cholesterol decreased significantly at the rate of 29% in pure hypercholes terolemia and 29% in mixed hyperlipidemia after treatment for 12 weeks. 4. The serum triglyceride decreased significantly at the rate of 58% in mixed hyperlipidemia and 42% in pure hypertriglyceridemia after treatment for 12 weeks. 5. The serum HDL-cholesterol increased at the rate of 10% in pure hypercholesterolemia, 14% in mixed hyperlipidemia and 26% in pure hypertriglyceridemia after treatment for 12 weeks, but the increase rate was statistically significant only in pure hypertriglyceridemia. 6. Transient epigastric discomfort was complained by 2 patients, but subsided spontaneously with continuous treatment. 7. In view of these results, procetofene appears to be an effective and well tolerated agent for the treatment of all the types of hyperlipidemia.

A Case of Cryptococcal Hepatitis

A case of cryptococal hepatitis in a 4-year-old girl was presented with a brief review of the literature. She was admitted with the chief complaints of jaundice, abdominal pain, and semicomatose mental state. Treatment was started including dexamethasone under impression of fulminant hepatitis. During treatment massive G-I bleeding appeared which required eleven pints of blood and 20 days for control. Upper G-I series revealed duodenal ucer. And explolparotomy was performed because of free air in the peritoneum. Operative liver biopsy done at that time revealed many cryptococci in the biopsy tissue. Therefore we treated her with-5-fluorocytosine and the result was good. Follow-up of her for a year and half revealed that she was in here good general condition. Therefore we consider that secondary change in liver such as cirrhosis has not yet occurred in her.

Studies on the Effect of Vinyl Mulching on Pleurotus Cultivation: Control of Mushroom Diseases on Pleurotus ostreatus (II)

Perforated vinyl mulching technique was performed on oyster mushroom beds for controlling mushroom diseases. Mycelium under vinyl sheets were safely protected from outside undesirable microorganisms. One of two mushroom farms showed 75% of disease incidence, the other 40% and National Institute of Agricultural Science and Technology (NIAST) 13% in the conventional growing method, whereas 12%, 14%, and 5% in the vinyl mulching cultivation method. Waterlogging caused mushroom bed worse, and Trichoderma spp. were infested on the conventional mushroom bed. Disease incidence investigated in other case was 25% to 30% in the conventional growing method, whereas 5 to 9% in the vinyl mulching cultivation method. Yields in conventional method were 6.5 to 7.2 kg/m2 and those in vinyl mulching method were 7.6 to 8.1 kg/m2. So it was suggested that vinyl mulching technique was good for prevention from disease and elevation of productivity.

Cultural Characteristics of Veiled Lady Mushroom, Dictyophora spp

This study was carried out to obtain the basic data for artificial culture of veiled lady mushroom (Dictyophora spp). The optimal conditions for the mycelial growth were 25degrees C and pH 5.0 for all isolates except the optimal temperature of 30degrees C for D. echinovolvata ASI 32002 and Phallus rugulosus . The optimal medium for Dictyophora spp. was PBA (potato bamboo sawdust extract agar) medium. The strain ASI 32002, D. echinovolvata , grew faster than. D. indusiata ASI 32003 and Phallus rugulosus ASI 25007 on the medium. Carbon sources such as glucose, maltose and inuline were favorable for stimulating a mycelial growth of the two strains of ASI 32002 and ASI 32003. Asparagine and glutamine appeared to be favorable to the strain ASI 32002 and ASI 32003, where as alanine, one of nitrogen source also favorable to the strain ASI 32002. The optimum C/N ratio of the two isolates of ASI 32002 and ASI 32003 was about 25 : 1 when 2% glucose as carbon source was mixed with the basal medium. While, in the case of 4% as carbon source, the optimum C/N ratio was about 30 : 1.

Effect of Diet and Apoliprotein E (Apo E) Polymorphism on the Variation of Serum Lipid Profile in Korean Males

BACKGROUNG AND OBJECTIVES: Diet is the basic and principal therapeutic modality for hyperlipidemia. However, diet therapy alone showed variable responses in lowering lipid levels in different studies. This research is to prove the effect of diet and Apo E polymorphism on the variation of serum lipid profile in Korean males. MATERIALS AND METHODS: To evaluate the gene-diet interation, serum total cholesterol (Chol), triglycerides (TG), HDL-cholesterol and LDL-cholesterol (HDLc, LDLc), lipoprotein (a) (Lp (a)), and fasting blood glucose (FBS) were measured with Apo E genotyping in vegeterians (group A, n=154) and in healthy Korean male adults (group B, n=150) of similar mean age (50.1 vs. 49.3). RESULTS: Lipid profiles showed significantly lower levels in group A compared to group B (Chol 168.3+/-30.5 mg/dL vs. 181.3+/-33.4 mg/dL, p<0.001;TG 131.0+/-62.9 mg/dL vs. 149.4+/-76.7 mg/dL, p=0.023;HDLc 56.0+/-11.0 mg/dL vs. 56.9+/-11.5 mg/dL, p=0.509;LDLc 92.5+/-28.1 mg/dL vs 100.6+/-29.9 mg/dL, p=0.016;Lp (a) 22.1+/-14.6 mg/dL vs. 26.9+/-13.8 mg/dL, p=0.004;FBS 85.1+/-14.1 mg/dL vs. 102.7+/-16.6 mg/dL, p<0.001). The Apo E genotyping showed Epsilon3/3, 64.1%; Epsilon3/4, 20.7%;Epsilon2/3, 11.8%;Epsilon2/2, 1.3%;Epsilon4/4, 0.6% in the combined groups. The distribution was similar in both groups. Chol and LDLc were significantly (p<0.05) higher in Epsilon3/4 allele group compared to other allele groups among non-vegetarians. On the other hand, Chol and LDLc were significantly (p<0.01) lower in vegetarians compared to non-vegetarians only in Epsilon3/4 allele group. CONCLUSION: Vegetarian diet significantly lowered Chol, TG, LDLc, Lp (a) and FBS levels. Significant lipid lowering effect of vegetarian diet was noted in Apo E allele Epsilon3/4 group which had significantly higher Chol and LDLc levels without diet intervention. These data suggest that the influence of diet on serum lipid profiles differ according to apo E genotypes.

An Improved Compost Using Cotton Waste and Fermented Sawdust Substrate for Cultivation of Oyster Mushroom

A composting technique was assessed to enhance efficiency in oyster mushroom substrate. Poplar sawdusts and by-product of winter mushroom added by 10% of rice bran were composted outdoors at 20degrees C to 28degrees C for 12 days. The duration of fermentation was shortened 3 days in fermented sawdust plot. The yield obtained from waste cotton substrate with fermented poplar sawdust was 742 g, whereas the yield from control 663 g. In addition, the substrate with by-product of winter mushroom was the most effective to composting. It was useful to apply the fermented sawdust and by-product to waste cotton for compost and sporophore production of oyster mushroom.