Biomedical subjects

S W Kim

Publications and source records attributed to S W Kim.

At least 145 records · Page 8Linked to original sources

PubMed2001

The numerical modelling and process simulation for the fault diagnosis of rotary kiln incinerator.

The numerical modelling and process simulation for the fault diagnosis of rotary kiln incinerator were accomplished. In the numerical modelling, two models applied to the modelling within the kiln are the combustion chamber model including the mass and energy balance equations for two combustion chambers and 3D thermal model. The combustion chamber model predicts temperature within the kiln, flue gas composition, flux and heat of combustion. Using the combustion chamber model and 3D thermal model, the production-rules for the process simulation can be obtained through interrelation analysis between control and operation variables. The process simulation of the kiln is operated with the production-rules for automatic operation. The process simulation aims to provide fundamental solutions to the problems in incineration process by introducing an online expert control system to provide an integrity in process control and management. Knowledge-based expert control systems use symbolic logic and heuristic rules to find solutions for various types of problems. It was implemented to be a hybrid intelligent expert control system by mutually connecting with the process control systems which has the capability of process diagnosis, analysis and control.

Equipment Failure↗

PubMed2001

Characteristics of geriatric patients seeking medication treatment for pathologic gambling disorder.

This study was constructed to compare geriatric patients seeking medication treatment for pathologic gambling disorder (PGD) with younger pathologic gamblers. This comparison study assessed three groups with PGD according to the Diagnostic and Statistical Manual of Mental Disorders, fourth edition: 16 subjects over the age of 60 years, 11 subjects between the ages of 20 and 30 years, and 46 subjects between the ages of 40 and 50 years. All subjects were evaluated in terms of demographic characteristics, clinical features of PGD, and treatment history. Geriatric gamblers had a later age of onset of gambling and developed pathologic gambling over a longer period of time. Geriatric subjects were more likely to play slot machines and demonstrate less variety in their choice of gambling activity. Geriatric gamblers were also more likely to gamble secondary to boredom. Geriatric subjects were as likely as the other age groups to report slight or no response to nonpharmacologic treatment. There appear to be some differences in the clinical features of PGD among geriatric subjects, and these differences may have treatment implications.

Adult↗

PubMed2001

Gentamicin decreases the abundance of aquaporin water channels in rat kidney.

The present study was performed to examine whether the gentamicin-induced urinary concentration defect is related to an altered regulation of aquaporin (AQP) water channels in the kidney. Male Sprague-Dawley rats were subcutaneously injected with gentamicin (20, 50 or 100 mg/kg per day) for 6 days. The protein expression of AQP1-3 channels and the catalytic activity of adenylyl cyclase were determined in the kidney. Gentamicin treatment resulted in renal failure associated with decreased tubular free water reabsorption and increased urinary flow rate. The expression of AQP2 proteins was significantly decreased in the kidney, in which the cortex was most susceptible, followed by the outer medulla and inner medulla in order. Gentamicin treatment also decreased the shuttling of AQP2, as evidenced by a decrease of its expression in the membrane fraction in proportion to that in the cytoplasmic fraction. The protein expression of AQP1 as well as that of AQP3 was also decreased in the cortex by treatment with the highest dose of gentamicin. The cAMP generation in response to arginine vasopressin or sodium fluoride was decreased by gentamicin, while that to forskolin was not significantly altered. These findings suggest that the primary impairment in the pathway leading to the generation of cAMP lies at the level of G proteins, resulting in a decreased expression of cAMP-mediated AQP channels. The gentamicin-induced urinary concentration defect may in part be accounted for by a reduced abundance of AQP water channels in the kidney.

Animals↗

PubMed2001

Bronchiolitis obliterans in the 1990s in Korea and the United States.

STUDY OBJECTIVES: Our current knowledge of pediatric bronchiolitis obliterans (BO) is based largely on a few small series of patients that were reported in the older literature. In these older cases, the mortality rate was high. This study was conducted to investigate the characteristics of pediatric BO cases in two different countries. DESIGN: We extracted specific information regarding predisposing factors, symptoms and signs, diagnostic studies, treatment, and outcome from the medical records of 31 children who received diagnoses of BO at four university medical centers in Korea and the United States in the 1990s. RESULTS: The large number of Asian children reflects a clustering of cases in Korea due to adenovirus and Mycoplasma pneumoniae epidemics. The characteristic diagnostic features of BO were present in 29 of 30 high-resolution CT (HRCT) studies. Seven of nine children who underwent biopsies had histologic confirmations of BO. In two patients whose biopsy results were nondiagnostic, the diagnosis was established by HRCT together with pulmonary function testing results that were consistent with nonreversible small airways obstruction. Fifteen children (48.4%) had evidence of hypoxemia. At present, all but one are alive. Patients with elevated severity-of-illness scores were observed to have increased likelihoods of lung transplantation or death. CONCLUSIONS: We conclude that BO has a good overall prognosis and that the mortality rate has declined over the past decade. This could be related primarily to the use of HRCT for accurate diagnosis and the availability of pediatric lung transplantation. BO cases in Korea were associated with infectious epidemics, whereas those in United States had variable predisposing factors.

Adenovirus Infections, Human↗

PubMed2001

Prevalence of Gs alpha mutations in Korean patients with pituitary adenomas.

The reported frequencies of Gs alpha mutations (gsp mutations) in growth hormone (GH)-secreting pituitary adenomas are variable (ranging from 4.4 to 43%), and the presence of these mutations in the other pituitary adenomas is still a matter of controversy. Previous clinical and biochemical analyses of patients with GH-secreting pituitary adenomas and gsp mutations produced conflicting results and did not demonstrate obvious characteristics. Therefore, we investigated the prevalence of gsp mutations in Korean patients with pituitary adenomas and elucidated the characteristics of these patients. Forty-four GH-secreting adenomas, 7 prolactin (PRL)-secreting adenomas and 32 clinically non-functioning adenomas were examined for the presence of point mutations in codon 201 and 227 of the Gs alpha gene using a nested PCR and direct sequencing of DNA extracted from fresh tissue or paraffin-embedded pituitary adenoma samples. Seven of the 44 GH-secreting pituitary adenomas had point mutations at codon 201 or 227; of these, five mutations were in codon 201 and two were in codon 227. In patients with gsp mutations, mean tumor size was significantly smaller than in patients without gsp mutations (15.9+/-8.7 mm vs. 24.9+/-14.9 mm, P<0.05). Age, sex, basal GH levels, GH response to oral glucose loading, GH response to octreotide and surgical outcome were not different in the two groups. One of the 32 clinically non-functioning pituitary adenomas had a point mutation at codon 201; none of the seven prolactinomas had these mutations. These results show that gsp mutations are not rare in Korean acromegalic patients and mean tumor size is significantly smaller in acromegalic patients with gsp mutations. Our results also confirm the low frequency of gsp mutations in clinically non-functioning pituitary adenomas and the absence of gsp mutations in prolactinoma.

Acromegaly↗

PubMed2001

The regression of unsuckled mammary glands during lactation in sows: the influence of lactation stage, dietary nutrients, and litter size.

During lactation in the sow, mammary glands that are not regularly suckled undergo regression. This study characterizes the regression of unsuckled mammary glands and how that regression is affected by dietary nutrients and litter size. Sixty-nine primiparous sows were fed one of four diets containing combinations of two protein levels (32 or 65 g lysine/d) and two energy levels (12 or 17.5 Mcal ME/d) during lactation. Litter size was adjusted to 10. Sows were killed on d 0, 5, 10, 14, 21, or 28 of lactation. In another experiment, twenty-eight primiparous sows were allotted to have different litter sizes and were killed on d 21 of lactation. The day before slaughter, teat order of each litter was observed. After death, mammary glands were removed and dissected. Skin and extraneous fat pads were removed from the mammary glands and individual glands were separated. Each gland was weighed, cut in half to measure cross-sectional area, and ground for chemical analysis. The amounts of dry tissue, protein, fat, ash, and DNA were measured. Only glands observed to be unsuckled were included in the results. Regression of unsuckled mammary glands occurred rapidly during the first 7 to 10 d of lactation, as indicated by a decline in wet weight, dry weight, protein, fat, DNA, and cross-sectional area. The rate of regression was slowed after the early lactation period. The rate of regression of unsuckled glands was affected by dietary nutrient levels. Dietary energy level affected (P < 0.05) the decline in wet and dry weights, protein, fat and DNA content, and cross-sectional area, whereas dietary protein level affected (P < 0.05) the decline in dry weight and fat content. At d 5 of lactation, the wet weight of unsuckled mammary glands in sows fed the high-energy high-protein diet was 91% greater (P < 0.05) than in sows fed the low-energy low-protein diet. Effects of litter size on size and composition of unsuckled glands were not significant by d 21 of lactation. Unsuckled mammary glands regress rapidly during early lactation, and the rate of regression is affected by dietary nutrient intake.

Animal Feed↗

PubMed2001

Nutritional value of fish meals in the diet for young pigs.

A series of three experiments was conducted to evaluate the nutritional value of fish meals as protein sources in young pigs' diets. Four fish meals (menhaden; mackerel, dried at 85 degrees C and 70 degrees C; and herring, dried at 70 degrees C) were tested. For the first experiment, eight pigs (2 wk old) were surgically fitted with ileal cannulas and used to measure apparent digestibility of the fish meals over the age period of 3 to 7 wk. Compared with menhaden fish meal, mackerel and herring fish meals yielded higher (P < 0.05) ileal digestibility values for threonine, serine, alanine, valine, histidine, lysine, and arginine and also for the average of all amino acids. Ileal digestibility was increased (P < 0.05) as pigs grew. For the second experiment, four different diets each containing different fish meals were fed to 120 pigs to evaluate growth performance over the age period of 3 to 7 wk. Average daily gain was higher (P < 0.07) in pigs fed diets containing either mackerel or herring fish meal than in pigs fed menhaden fish meal during 3 to 5 wk of age and was highest (P < 0.07) in pigs fed a diet containing mackerel fish meal during 5 to 6 wk of age. Gain/feed was higher (P < 0.05) in pigs fed diets containing mackerel and herring fish meals than in pigs fed menhaden fish meal. Mackerel dried at 70 degrees C showed the highest value from the previous two experiments and was chosen to measure the relative bioavailability in comparison to spray-dried porcine plasma. A classical slope-ratio design was used to measure relative bioavailability of mackerel fish meal compared to porcine plasma protein. This study showed that mackerel dried at 70 degrees C can replace spray-dried porcine plasma with the same bioavailability during d 17 to 29 postpartum with additional crystalline lysine and amino acid supplementation to match amino acid profile of the spray-dried porcine plasma.

Animal Feed↗

PubMed2001

Standardized ileal protein and amino acid digestibility by growing pigs and sows.

Experiments were conducted to determine the effect of the physiological condition of swine on standardized ileal digestibility coefficients (SID). The apparent ileal digestibility coefficients were determined for crude protein and amino acids in six feed ingredients (corn, barley, wheat, soybean meal, canola meal, and meat and bone meal) in growing pigs and in gestating and lactating sows. Growing pigs and lactating sows were given free access to their diets, whereas gestating sows were allowed to consume only 2 kg of feed daily. The nonspecific (basal) endogenous losses of protein and amino acids were determined under similar feeding regimens after feeding a protein-free diet. The SID for crude protein and amino acids were calculated by correcting the apparent ileal digestibility coefficients for the nonspecific endogenous losses of protein and amino acids. With a few exceptions, there were no differences (P > 0.05) in the SID for crude protein and amino acids between growing pigs and lactating sows. Overall, gestating sows had higher (P < 0.05) SID for crude protein and all amino acids, except for tryptophan and aspartate, compared with growing pigs. Likewise, the SID of most amino acids obtained by gestating sows were higher (P < 0.05) than those obtained by lactating sows. Interactions (P < 0.05) between animals and diets were observed for gestating sows compared with growing pigs as well as gestating sows compared with lactating sows. As a consequence, it is not possible to extrapolate data from one feed ingredient to another. On most occasions, the lowest SID among the indispensable amino acids was calculated for threonine, valine, and lysine. It is concluded that gestating sows fed 2 kg of feed per day have higher standardized digestibility coefficients than do growing pigs and lactating sows given free access to their diets. This difference may be due to differences in daily feed intake rather than to the physiological status of the animals.

Amino Acids↗

PubMed2001

Nutrient mobilization from body tissues as influenced by litter size in lactating sows.

Twenty-eight primiparous sows were used to study nutrient mobilization among body tissues as influenced by litter size in lactating sows. Litter size was set to 6, 7, 8, 9, 10, 11, or 12 pigs within 48 h postpartum by cross-fostering. Four sows were allotted to each litter size group. Sows had 11.5 +/- 1.3 Mcal of ME and 39.3 +/- 4.4 g of lysine per day and were killed on d 20.6 +/- 1.1 of lactation. Liver, gastrointestinal tract (GIT, composed of the empty stomach, empty small and large intestines, cecum and rectum), reproductive tract, and other organs (excluding liver, GIT, reproductive tract, and mammary gland) were separated from the carcass. Gastrointestinal tracts were manually stripped of contents and flushed with water to remove digesta. Hot carcasses were split longitudinally at the midline after removing mammary glands and internal organs. Individual organs and carcasses were weighed then ground for chemical analysis. Dry matter, crude protein, fat, and ash contents were measured. As litter size increased, protein mobilization was linearly increased (P < 0.05) in carcass, GIT, and reproductive tract. Protein mobilization in liver was quadratically affected by litter size (P < 0.05). Fat mobilization was not affected by litter size. The amount of protein mobilized from carcass, GIT, liver, and reproductive tract in sows increased by 641 g as litter size increased by one pig from 6 to 12 pigs after a 21-d lactation. Carcass contributed the largest amount of protein (600 g for an additional pig) among body tissues, whereas the reproductive tract contributed the highest percentage (26%) of its protein among body tissues. Protein efficiency from milk to litter weight gain was 72% as litter size increased during a 21-d lactation. In feeding lactating sows, effect of litter size on nutrient mobilization from various tissues should be considered for minimizing the excess tissue mobilization during lactation.

Animal Nutritional Physiological Phenomena↗

PubMed2001

Dynamic ideal protein and limiting amino acids for lactating sows: the impact of amino acid mobilization.

The limiting amino acids for lactating sows were determined using 28 primiparous sows that were intentionally underfed both energy and protein during a 21-d lactation. Groups of four sows were allotted to litter-size treatments of 6, 7, 8, 9, 10, 11, or 12 by cross-fostering as needed within 48 h postpartum. Sows were killed on d 21 of lactation. The carcass, liver, gastrointestinal tract, reproductive tract, mammary gland, and other viscera were separated, weighed, ground, and analyzed for dry matter, crude protein, and amino acids. Simple linear equations were obtained for each amino acid within tissues as a function of litter size. The mobilization of amino acids from carcass, liver, gastrointestinal tract, reproductive tract, and other viscera increased as litter size increased. Amino acids were accreted to mammary glands as litter size increased (2.65 g lysine/21 d for each one-pig increase in litter size). Milk production needs were estimated (49.9 g lysine/21 d for each one-pig increase in litter size). The quantity of each amino acid required additionally as litter size increased was obtained from the difference between amino acid needs for milk production and mammary gland growth and those provided from tissue mobilization. The relative ratio among amino acids that are required additionally (ideal amino acid pattern) was compared with the relative ratio of amino acids that can be provided from a corn-soybean meal lactation diet. From the comparison, it was shown that threonine and lysine are the first-limiting amino acids, followed by valine, when tissue mobilization occurs during lactation. Lysine is the first-limiting amino acid, and valine becomes second-limiting followed by threonine, when sows do not mobilize body tissues during lactation. Thus, the limiting order of essential amino acids changes depending on feed intake and tissue mobilization of sows during lactation. Proper feeding of lactating sows should consider the expected degree of tissue mobilization during lactation.

Amino Acids↗

PubMed2001

Folate-PEG-folate-graft-polyethylenimine-based gene delivery.

Folate-polyethylene glycol-folate-grafted-polyethylenimine (FPF-g-PEI) was synthesized by linking folic acid to both ends of a mono-functional PEG and then grafting to PEI. The graft ratio was determined using Beer's law by measuring the UV absorbance at 363 nm. The pH profile, diameter and shape of the carriers were determined. Transfection efficiencies were optimized in normal smooth muscle cells (SMC) and CT-26 colon adenocarcinoma cells using plasmid DNA encoding luciferase reporter gene. Free folic acid was shown to inhibit transfection with FPF-2.3 g-PEI at neutral charge ratio. Relative toxicity between PEI and the modified carrier was measured using MTT colorimetric assay. Therapeutic potential of pmIFN-gamma complexed with these polymeric carriers in terms of gene expression was determined at protein and mRNA levels using ELISA and RT-PCR. FPF-g-PEI was determined to have 2.3 folate-PEG-folate (FPF) linear polymers grafted to each PEI molecule. The average molecular weight was measured to be approximately 33,500 Mw and the pH profile was characteristic of endosomal disruption capacity. Atomic Force Microscopy (AFM) and Dynamic Laser Light Scattering (DLLS) indicated FPF-2.3 g-PEI and PEI (at 2 w/w ratio) efficiently condensed plasmid DNA resulting in oblique spheroid polyplexes with a mean diameter of approximately 150 nm. FPF-2.3 g-PEI was superior to PEI in terms of cytotoxicity and transfection efficiency in cancer cells. Smooth muscle cells showed no specificity for folate tethered complexes, where PEI/pLuc complexes yielded higher efficiencies.

Carrier Proteins↗

PubMed2001

Bioactive polymers for biohybrid artificial pancreas.

To address the solution for some of the obstacles, such as low insulin secretion, limited lifespan and aggregation of transplanted islets, encountered in developing a biohybrid artificial pancreas (BAP), polymeric materials including a reversible polymeric extracellular matrix (ECM), crystallized glucagon-like peptide-1, and oxygen carrying polymers, were prepared and their potential utilities in designing a compact and rechargeable BAP were investigated. For a synthetic, reversible ECM, high molecular weight N-isopropylacrylamide copolymer with a small amount of acrylic acid (2 mole%) was synthesized by conventional radical polymerization in benzene, and its aqueous solution above a critical polymer concentration displayed a sol-gel transition temperature near physiological temperature (33-35 degrees C) without noticeable hysteresis. The physicochemical properties of the gel with islet compatibility proved that the synthetic ECM is an appropriate matrix which can make a BAP rechargeable. Glucagon-like peptide-1 (GLP-1, 7-37) is known to have a strong stimulatory effect on insulin secretion, particularly at high glucose concentrations. When zinc-crystallized GLP-1 was entrapped along with islets in a hollow fiber macrocapsule device, insulin secretion was enhanced at a high glucose concentration (300 mg/dl) with a >85% increase in insulin secretion after an induction period. The cross-linked hemoglobin with difunctional PEO (Hb-C) was prepared to increase the high molecular weight of Hb. This prevents diffusional loss when enclosed in an immunoprotecting membrane. The Hb-C, entrapped in microcapsules, enhanced insulin secretion and improved the viability of microencapsulated islets by promoting oxygen supply to islets. The introduction of the synthetic ECM, crystallized GLP-1, and Hb-C into a BAP may provide a basis for designing a compact and rechargeable BAP (macrocapsule).

Animals↗

PubMed2001

Metabolic characteristics and prevalence of osteoporosis among women in Tae-An area.

Understanding the metabolic changes in women is one of the important ways to prevent and treat osteoporosis. To reveal the metabolic characteristics of 289 healthy women aged between 35-65 yr in Tae-An, Korea we evaluated the association between bone mass assessed by broadband ultrasound attenuation (BUA) using quantitative ultrasound 2 (QUS2) and various parameters such as age, body mass index, serum levels of alkaline phosphatase, calcium, phosphorus, parathyroid hormone, 25(OH)D, and urinary ratios of calcium/creatinine and deoxypyridinoline (Dpyd)/creatinine. Among the subjects, 3.0% were osteoporotic, and 40.9% were osteopenic. When the subjects were classified according to their years since menopause (YSM) and age, the prevalence of osteoporosis increased along with an increase of YSM and age. Bone turnover markers such as serum alkaline phosphatase and fasting urinary Dpyd/creatinine were significantly higher in the group with low bone mass than in the normal group. In summary, this study shows, by use of biochemical markers of bone turnover and QUS2, the prevalence of osteoporosis in women aged between 35-65 in Tae-An was 3.0% and the risk of low bone mass increased with the bone turnover markers.

Adult↗

PubMed2001

Systemic lupus erythematosus complicated with cerebral venous sinus thrombosis : a report of two cases.

A rare manifestation of systemic lupus erythematosus (SLE) is cerebral venous sinus thrombosis (CVST), in which early diagnosis and aggressive therapy are of prime importance for favorable outcome. The pathogenesis of CVST is largely unknown, but it is thought to be caused by cerebral vasculitis, antiphospholipid antibodies or other conditions associated with enhanced coagulability. We describe two cases of SLE with CVST which were not associated with antiphospholipid antibodies. Both cases were treated with immunosuppressants (intravenous methylprednisolone and cyclophosphamide pulse therapy) and anticoagulant drugs (heparin and subsequent maintenance therapy with warfarin). There was a marked improvement of neurologic symptoms with the disappearance of thrombus in a follow-up MRI. The possibility of CVST should be considered in any patients with SLE who show neuropsychiatric manifestations.

Adult↗

PubMed2001

Obesity as a risk factor for non-insulin-dependent diabetes mellitus in Korea.

Most Korean patients with non-insulin-dependent diabetes mellitus (NIDDM) have been reported not to be obese, and many of them lost weight significantly during the course of their disease. In this regard, a retrospective cohort study was conducted to determine the relationship between body mass index (BMI, kg/m2) and the risk for NIDDM among Koreans. Subjects who had received a medical examination from 1990 to 1991 and who were available for the detection of NIDDM until September 1999 were included. Subjects who initially had diabetes or were diagnosed as diabetic within 1 yr after enrollment were excluded. We reviewed the medical records of final cohort of 2,531 subjects. Follow-up of this cohort revealed 117 cases with diabetes with an incident of 7.8 per 1,000 person-years. Compared with those with BMI less than 23 kg/m2, the adjusted relative risks for diabetes mellitus for those with BMI of 23-24.9, 25-26.9, and greater than 27 kg/m2 were 0.85 (0.47-1.50), 1.29 (0.72-2.31), and 3.38 (1.22-4.63), respectively, for men (p for trend<0.01) and as for 9.14 (1.99-41.8), 7.36 (1.47-36.8), and 14.5 (3.03-69.2), respectively, for women (p for trend<0.01). These data indicate a direct relationship between obesity and the risk for the development of diabetes, emphasizing the importance of weight control for the prevention of NIDDM in Koreans.

Adolescent↗

PubMed2001

Altered renal expression of aquaporin-2 water channels in rats with experimental two-kidney, one clip hypertension.

The present study was aimed at examining the regulation of aquaporin (AQP)-2 water channels in the kidney in two-kidney, one clip (2K1C) hypertension. Rats were made 2K1C hypertensive for 6 weeks, and their expression of AQP2 channel proteins was determined in the clipped and contralateral kidneys. To examine the upstream affecting AQP2 channels, adenylyl cyclase activity was also determined. Along with the hypertension, in the clipped kidney, the abundance of AQP2 proteins was significantly decreased in the cortex, outer and inner medulla, while their trafficking remained unaltered. Concomitantly with the reversal of the blood pressure at 24 hours following removal of the clip, the AQP2 abundance also returned to the control level. The arginine vasopressin-evoked generation of cAMP was decreased in the clipped kidney, which again was reversed to the control level following removal of the clip. In contrast, the expression of AQP2 channels as well as the activity of adenylyl cyclase remained unaltered in the contralateral kidney. These results indicate an altered regulation of AQP2 water channels in the clipped kidney in 2K1C hypertension.

Adenylyl Cyclases↗

PubMed2001

Pseudomonas aeruginosa as a potential cause of antibiotic-associated diarrhea.

Although Pseudomonas aeruginosa is not generally considered as a cause of antibiotic-associated diarrhea, several cases of diarrhea caused by P. aeruginosa have been reported. We experienced seven cases of nosocomial diarrhea presumably caused by P. aeruginosa, which was the predominant organism isolated from stool cultures. Clostridium difficile toxin was also positive in one patient. No other potential or recognized enteropathogens were identified from stools. All patients had underlying diseases and had been receiving antibiotics before the diarrheal onset. All of the seven P. aeruginosa isolates were resistant to previously given antibiotics. Diarrhea stopped three days after withdrawal of probable offending antibiotics without specific treatment in two patients. The other five patients having continuous diarrhea despite withdrawal of probable offending antibiotics, were successfully treated with antipseudomonal agents. The median duration of diarrhea after the initiation of treatment was 6.3 days. These data suggest that P. aeruginosa can be a potential cause of antibiotic-associated diarrhea. Further investigations are warranted to evaluate the possible etiologic role of P. aeruginosa in antibiotic-associated diarrhea.

Adult↗

PubMed2001

The predictive parameters of erythropoietin hyporesponsiveness in patients on continuous ambulatory peritoneal dialysis.

BACKGROUND: The present study was aimed at investigating the predictive parameters of erythropoietin (epoetin) hyporesponsiveness in patients on continuous ambulatory peritoneal dialysis (CAPD). METHODS: We studied 40 patients with end-stage renal disease who had been receiving CAPD for at least 6 months and epoetin therapy for at least more than 2 months. Pearson's simple correlation and multiple stepwise linear regression analysis was used to discover what parameter can predict epoetin resistance. We expressed epoetin resistance index (ERI) as weekly epoetin dose/hematocrit/body weight'. The dose of epoetin is titrated by about 25% every 2 to 4 weeks to maintain a target hematocrit level between 33% and 36%. RESULTS: We analyzed the relationship between ERI and other predictive parameters by Pearson's correlation. These results showed ERI has a statistically significant correlation with transferrin saturation (TS) (r = -0.327, p = 0.042), total weekly Kt/Vurea (r = -0.423, p = 0.018), serum albumin level (r = -0.458, p = 0.003), normalized protein catabolic rate (nPCR) (r = -0.479, p = 0.006), normalized protein equivalent of total nitrogen appearance (nPNA) (r = -0.488, p = 0.005) and serum C-reactive protein (CRP) (r = 0.332, p = 0.036). Regression analysis was performed using stepwise linear regression for multiple variables to discover the most independent variable which is correlated with ERI. ERI was entered as a dependent variable, whereas the other parameters (age, duration of peritoneal dialysis, serum albumin level, CRP, serum ferritin, total weekly Kt/Vurea, nPCR, nPNA, serum iPTH, serum aluminium, TS) were entered as independent variables. This analysis showed CRP is the most significant variable and, if CRP is excluded, nPNA is the significant variable. CRP has a statistically significant correlation with serum albumin level (r = -0.418, p = 0.007) and total weekly Kt/Vurea (r = -0.366, p = 0.043). High CRP group has more increased level of ERI (p < 0.05), age (p < 0.05) and serum creatinine level (p < 0.05) than normal control, but more decreased level of serum albumin (p < 0.01) and serum iron levels (p < 0.05). CONCLUSION: These results indicate that CRP is the most important predictor of epoetin hyporesponsiveness.

Adult↗