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In this report, we analyzed the reactivity of N-acetyl-l-cysteine (NAC) with glucose degradation products (GDPs) and the stability of NAC in peritoneal dialysis fluids (PDFs) using RP-HPLC and LC-ESI-TOF-MS. NAC reduced the amount of 3,4-dideoxyglucosone-3-ene (3,4-DGE), most toxic among GDPs in PDFs by forming NAC−DGE conjugate under nonenzymatic conditions. NAC was retained as a reduced monomer form in the high-glucose compartment of dual-chambered neutral-pH type PDF, whereas it easily formed a homodimer in an incubation-time-dependent manner in other solutions. The present investigation suggests that NAC can be employed as an adjuvant added into the high-glucose compartment of neutral-pH type PDFs (N-PDF) to reduce GDP-mediated peritoneal membrane failure in patients on long-term peritoneal dialysis (PD) treatment.
Background and Objectives : Cigarette smoking is a major factor and the most modifiable risk factor for atherosclerosis. Endothelial dysfunction is an early event in atherosclerosis, before the structural change of the systemic arteries. We hypothesized that endothelial dysfunction might be present in the systemic arteries of young adult smokers and that this might be dose-dependent phenomenon. Therefore, we try to certify that smoking is associated with endothelial dysfunction in healthy young adults without other risk factor of atherosclerosis. Subjects and Methods : we studied noninvasively 29 subjects aged 3 to 4 decades without other risk factor of atherosclerosis, they were composed of the two groups, current smokers(n=15) and nonsmokers(n=14). Smoking history varied from 3 to 20 pack years. Using high-resolution ultrasound, vessel diameter and mean flow rate were measured at rest, during reactive hyperemia(with flow-mediated endothelium-dependent dilation), and after sublingual nitroglycerin(NG-induced endothelium-independent vasodilation). Result : Flow mediated endothelium dependent dilation was observed in the control subjects (9.4±3.44%) but was impaired in the smokers(5.8±2.51%)(p=0.004). NG-induced endothelium independent dilation is no difference in all subjects. Conclusion : Cigarette smoking is associated with endothelial dysfunction in healthy young adults.
Background: Up to now, no study have been reported about clinical features of ESRD patients at the initiation of dialysis and their outcomes in Korea. We studied the clinical features and survival predictors of ESRD patients at the initiation of dialysis therapy and their outcomes and we tried to identify the optimal point of starting dialysis therapy according to age, underlying disease, and other variables. Methods: We studied retrospectively clinical and laboratory variables of initiation in 364 patients who started dialysis therapy first at Korea University Guro hospital from 1987 to 1997. We divided patients into 3 groups by age, into 2 groups by underlying renal disease (DM vs. nonDM) and compared the above variables between 3 or 2 groups. We evaluated the outcome (alive vs. death) in 258 patients whose outcomes were identified. We identified the poor survival predictors of outcome according to alive/death group, and analized the relative risk of death according to level of serum creatinine (reference: 12.5∼15.0mg/dL) and serum albumin (reference: 4.0∼4.5g/dL). Results: 1) The distribution of patients by age, young age group, middle age group, old age group were 135.l% and 89. Those of patients by underlying renal disease, DM and nonDM were 80 and 284 respectively. 2) The most common underlying renal disease of young age group was chronic glomerulonephritis but that of old age group was diabetes mellitus. In old age group, levels of BUN, scum creatinine, and serum phosphate were lower than those in young age group (p$lt;0.001). In old age group, the indication of dialysis tended toward relative (p=0.098) and early referral was more common than in young age group. 3) DM group was older and more early referred than nonDM group. In DM group, blood cholesterol level was higher, but level of BUN, serum creatinine, albumin, phosphate and uric acid were lower than those in nonDM group. 4) In 258 patients whose outcomes were identified, elderly and DM had poorer outcomes in the respect of mortality and survival by Kaplan-Meier survival analysis method. In the comparison of death group and alive group, death group was older and had more DM as underlying renal disease and lower level of setum creatinine than alive group. 5) Relaive risk of death was higher in lower concentrations comparing to reference level of albumin and creatinine. Conclusion: Old age, DM as underlying renal disease, hypocreatinemia and hypmmatinemia were poor survival predictors. Then close observation and follow-up are warranted in patients with old age, DM, hypoalbuminemia, and hypocreatinemia. For more favorable prognosis in ESRD patients, early initiation of dialysis must be considered in patients who have these characteristics.
The bifurcation problem of thin walled structures in contact with rigid surfaces is formulated by adopting the multiple scales asymptotic technique. The general theory developed in this paper is very useful for the bifurcation analysis of waviness instabilities in the sheet metal forming. The formulation is presented in a full Lagrangian formulation. Through this general formulation, the bifurcation functional is derived within an error of O($(E^4)$) (E: shell's thickness parameter). This functional can be used in numerical solutions to sheet metal forming instability problem.