Indoor environmental factors associated with wheezing illness and asthma in South Korean children: phase III of the International Study of Asthma and Allergies in Childhood

Background: The relationship between exposure to indoor environmental pollutants and incidence of asthma and wheezing illness in children is unclear. This study aimed to clarify this relationship by identifying the risk factors associated with these conditions in South Korean children aged 6–7 years. Methods: The parents or guardians of 3810 children aged 6–7 years who had participated in the International Study of Asthma and Allergies in Childhood and met the study criteria completed validated questionnaires regarding their children's asthma and wheezing illness, risk factors and exposure to indoor pollutants. The data were subjected to chi-square and multivariate logistic regression analysis to identify the factors significantly associated with asthma and wheezing illness. Results: Parental history of allergic disease (odds ratio [OR]: 1.729; 95% confidence interval [CI]: 1.447–2.066), living on the basement or semi-basement floor (OR: 1.891; 95% CI: 1.194–2.996) and living in housing that had been remodeled within the last 12 months (OR: 1.376; 95% CI: 1.101–1.720) were found to be significantly associated with wheezing illness. Parental history of allergic disease (OR: 2.189; 95% CI: 1.483–3.231), male sex (OR: 1.971; 95% CI: 1.369–2.838) and positive skin prick test (SPT) result (OR: 1.583; 95% CI: 1.804–3.698) were found to be significantly associated with current asthma. Conclusions: Although the risk factors for current asthma appear to be more related to the non-modifiable risk factors like sex, parental history of allergic diseases, SPT, the two groups are associated with exposure to modifiable indoor environmental factors.     

The effect of anesthetic techniques on neutrophil-to-lymphocyte ratio after laparoscopy-assisted vaginal hysterectomy

BackgroundSurgical stress can induce postoperative systemic leukocytic alterations, including leukocytosis, neutrophilia, or lymphopenia. The present study investigated whether the anesthetic technique could affect the leukocytic alterations, including neutrophil-to-lymphocyte (N/L) ratio, after gynecologic laparoscopy.MethodsForty patients scheduled for laparoscopy-assisted vaginal hysterectomy were randomly assigned into two groups: PR group, which received total intravenous anesthesia with propofol and remifentanil, and S group, which received inhalational anesthesia with sevoflurane. Differential counts of leukocytes with N/L ratio of peripheral blood were obtained just before induction (T1), at the end of surgery (T2), 2 hours after surgery (T3), and 24 hours (T4) after surgery.ResultsSignificant increase in total leukocytic count, neutrophil count, and N/L ratio, and decrease in lymphocytic count were observed at all time points after surgery in both groups. N/L ratio was significantly lower in group PR compared with group S at T3. The increase of N/L ratio in contrast to the value at T1 was significantly lower at T2 and T3 in group PR compared with that of group S.ConclusionTotal intravenous anesthesia with propofol and remifentanil resulted in transient but salient leukocytic alterations in the peripheral blood in terms of N/L ratio compared with inhalational anesthesia with sevoflurane in laparoscopy-assisted vaginal hysterectomy.     

Chronic Osteomyelitis of the Lumbar Transverse Process

Pyogenic spondylitis involving only the posterior element of a vertebra is rare. To the best of our knowledge, there have been no reports of osteomyelitis of the transverse process. We report here on a 45-year-old male with a one month history of swelling associated with lower back pain. The magnetic resonance imaging showed a paraspinal soft tissue mass, and computed tomography revealed a fine osteolytic lesion in the right transverse process of the 5th lumbar spine, and this was all consistent with chronic osteomyelitis. A mixed staphylococcal infection was identified. Open drainage, resection of the transverse process and intravenous injection of anti-staphylococcal antibiotics resolved the back pain and reduced the erythrocyte sedimentation rate to normal. Pyogenic osteomyelitis of the transverse process is extremely rare, which can cause a misdiagnosis or a delayed diagnosis. Careful consideration of this disease is needed when evaluating patients who complain of back pain.     

Conditional loss of TGF-beta signalling leads to increased susceptibility to gastrointestinal carcinogenesis in mice

Background:

Downregulation of TGF‐β receptors is implicated in colon cancer development. Inactivation of either of the two transmembrane serine/threonine kinases, TGF‐β1 types I/II receptors, is now implicated in carcinogenesis, especially gastrointestinal carcinogenesis.

Methods:

We generated transgenic mice, called pS2–dnRII or ITF–dnRII, of which the dominant negative mutant of the TGF‐β type II receptor was expressed under the control of tissue‐specific promoters, the pS2 promoter for stomach and ITF for intestine. They were either infected with H.pylori (ATCC 43504 strain, CagA⁺ and VacA⁺) or administered with azoxymethane to determine the significance of loss of TGF‐β signalling in gastrointestinal carcinogenesis.

Results:

Gastric adenocarcinoma developed in pS2–dnRII mice, whereas only chronic active gastritis was noted in wild‐type littermates after 36 weeks of H.pylori infection. Mice lacking in TGF‐β signalling specifically in the stomach showed a significantly higher proliferation cell nuclear antigen‐labelling index when infected with H.pylori than wild‐type littermates (P < 0.01). Development of colonic aberrant crypt foci was provoked in mice by intraperitoneal injections of azoxymethane, and ITF–dnRII mice showed significantly higher incidences of ACF and colon cancers than wild‐type littermates.

Conclusions:

Maintaining normal TGF‐β signalling in the gastrointestinal tract seems to be important either for preventing abnormal mucosal proliferation, or for suppressing or retarding carcinogenesis.

     

Preformulation studies and characterization of proposed chondroprotective agents: glucosamine HCl and chondroitin sulfate

PURPOSE: Glucosamine HCl and chondroitin sulfate are proposed chondroprotective agents commonly used as dietary supplements. This study examined the physicochemical and mechanical properties of chondroitin sulfate, glucosamine HCl powder, and glucosamine HCl granulation obtained from various sources. METHODS: The particle size distributions of the materials were determined using sieve analysis and time-of-flight techniques. Polarized light microscopy was used to examine particle morphology. Powder x-ray diffraction studies, moisture sorption isotherms, deformation behavior, powder flow, and compaction characteristics were also investigated. The polarized light microscopy and x-ray diffraction patterns showed that chondroitin sulfate is amorphous while glucosamine HCl is crystalline. Particle sizes of chondroitin sulfate and glucosamine HCl varied widely, depending on their source or manufacturing technique (e.g., granulation). The studied samples of shark-derived chondroitin sulfate had a small median particle size (4 microns) compared to that derived from bovine cartilage (17 microns). Different moisture sorption profiles were obtained for the glucosamine HCl granulations studied. Glucosamine HCl granulation from Supplier I showed no observable moisture sorption, while the granulation from Supplier II showed an approximately 5% weight gain. Conversely, chondroitin sulfate was extremely hygroscopic and deliquescent. The Carr's indices for glucosamine HCl samples ranged from 12.5 to 31.5; for chondroitin sulfate the values were 25.2 and 53.6. The compression analysis showed that all chondroitin sulfate samples exhibited plastic deformation behavior, with the shark-derived chondroitin sulfate forming superior compacts when compared to the bovine. The dominant mechanism of compression of glucosamine HCl powder was brittle fracture, whereas wet granulated glucosamine HCl exhibited plastic deformation with enhanced mechanical strength. CONCLUSIONS: The physicochemical and mechanical characteristics between the various dietary supplements studied varied greatly. Data obtained from this study provide an understanding of the physicomechanical behavior of chondroitin sulfate and glucosamine HCl. Application of this knowledge would facilitate development of stable solid dosage forms containing these materials.     

A novel compound heterozygous mutation in the CYP17 (P450 17alpha-hydroxylase) gene leading to 17alpha-hydroxylase/17,20-lyase deficiency

Mutations in the CYP17 gene impair steroid biosynthesis in the adrenals and gonads and often cause 17alpha-hydroxylase/17,20-lyase deficiency, leading to amenorrhea, sexual infantilism, and hypokalemic low aldosterone hypertension. Several CYP17 mutations resulting in 17alpha-hydroxylase/17,20-lyase deficiency have been reported previously. In the present study, we found a novel CYP17 mutation from the molecular analysis of a Korean patient with primary amenorrhea with a 46,XX karyotype, and hypokalemic hypertension. We sequenced all 8 exons of the CYP17 gene that were amplified from patient's genomic DNA using polymerase chain reaction (PCR) and found a compound heterozygous mutation in the CYP17 structural gene; a 1-base deletion and a 1-base transversion (TAC-->AA) at codon 329, leading to the production of a truncated protein (1-417 amino acids), and a 3-base deletion (TCC, either 350-351 or 351-352 codon) in the other allele. Restriction enzyme digestion analysis of patient's and parental DNA showed that the 1-base deletion and the 3-base deletion are inherited from mother and father, respectively. Here we conclude that these novel compound heterozygous mutations might account for the patient's clinical manifestations of 17alpha-hydroxylase/17,20-lyase deficiency.     

Apolipoprotein B subspecies in chylomicrons isolated from a patient with chyluria

The diagnosis and the clinical course of a 17-year-old white male with chyluria are reported. Cloudy, milky urine appeared spontaneously, in the absence of edema or any signs or symptoms of parasitic infection. Pedal lymphangiography demonstrated the presence of a lymphatic renal fistula, and digital subtraction angiography showed aneurysmal dilatation of the aorta at the level of the renal arteries. This case provided an opportunity to ascertain which of the forms of apolipoprotein B were present in lymph chylomicrons. Apolipoprotein B is needed for chylomicron secretion. It exists in several forms--B-100, B-74, B-48, and B-26. After a meal consisting of fat, chylomicrons in which apolipoprotein B-48 was virtually the only apolipoprotein B present appeared in the urine, while apolipoprotein B-100 was the only apolipoprotein B present in the plasma very low-density lipoproteins. Chyluria disappeared two weeks after institution of a low-fat diet. This case illustrates an interesting, rare cause of chyluria. Because of the presence of chyluria, it was also demonstrated that chylomicrons in which apolipoprotein B-48 is virtually the only apolipoprotein B present are a physiologically normal product of the intestine.     

Prevalence of alcohol use disorder in a South Korean community

Abstract Background This study investigated the prevalence of alcohol use disorder in a Korean community and compared the results with 1984 epidemiological data. Method A sample of 1,059 residents aged 18–64 years was interviewed using the Korean version of the Composite International Diagnostic Interview (K-CIDI). The results obtained were compared with those of a 1984 epidemiological study. Results Lifetime prevalence of alcohol use disorder was 15.6% (abuse 6.8%, dependence 8.8 %) and 1-year prevalence 7.5% (abuse 2.5%,dependence 5 %).The male-to-female ratio of life-time prevalence was 5.8,which markedly decreased with decreasing age. A cohort effect, i. e. increases of lifetime prevalence in younger cohorts, was observed, with the exception of the 60- to 64-year-old cohort. The mean age of onset was 27.7 years (male 28.2 years, female 24.2 years). When the results of the present study were compared with those of the 1984 study, it was found that, during the past 15 years, lifetime prevalence has decreased, prevalence ratios of abuse and dependence have become reversed, and the male-to-female ratio has decreased. Conclusion Remarkable changes in the pattern of prevalence, which have occurred between 1984 and 1999, may be attributed to significant sociocultural changes and to a decrease in the proportion of a high-risk cohort in the populations.