• Title/Summary/Keyword: 임상적 연관성

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Association between Hypertriglyceridemic-Waist Phenotype and Metabolic Abnormalities in Hypertensive Adults (고혈압자의 고중성지방혈증-허리 표현형과 대사이상 사이의 연관성)

  • Kyung-A SHIN;Myung Shin KANG
    • Korean Journal of Clinical Laboratory Science
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    • v.55 no.2
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    • pp.113-120
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    • 2023
  • The hypertriglyceridemic-waist (HTGW) phenotype can predict the risk of coronary artery disease. This study evaluated the relationship between the HTGW phenotype and metabolic abnormalities in hypertensive adults. The test was conducted on adult hypertension patients aged 20 or older who underwent health checkups from January 2018 to December 2021 at general hospitals in Gyeonggi Province. The HTGW phenotype was triglyceride ≥150 mg/dL and waist circumference ≥90 cm for men and ≥85 cm for women. The prevalence of the HTGW phenotype in the study subjects was 17.9%. After adjusting for age, gender, and BMI, the odds ratio of the HTGW group was 5.09 (95% confidence interval [CI]: 3.545~7.309) for low HDL-cholesterol, 1.68 (95% CI: 1.176~2.411) for high LDL-cholesterol, was 2.92 (95% CI: 2.009~4.235) for high total cholesterol, 3.39 (95% CI: 2.124~5.412) for diabetes and 1.85 (95% CI: 1.286~2.674) for hyperuricemia compared to the normal triglyceride levels with the normal waist (NTNW) group. The area under curve values of the HTGW phenotype for diagnosing metabolic syndrome were 0.849 for all subjects, 0.858 for men, and 0.890 for women. In conclusion, the HTGW phenotype is closely related to metabolic abnormalities and is a useful indicator for monitoring adult hypertensive patients with metabolic syndrome.

Evaluation of clinical status of fixed prosthesis (고정성 보철물의 임상적 상태에 대한 평가)

  • Yun, Mi-Jung;Jeon, Young-Chan;Jeong, Chang-Mo
    • The Journal of Korean Academy of Prosthodontics
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    • v.47 no.2
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    • pp.99-107
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    • 2009
  • Statement of problem: Restoring and replacing teeth with fixed prostheses commonly used in dental practice. Because of improper oral hygiene care and inaccurate laboratory procedure, complications of fixed prostheses were found in the mouth of patients. Although many efforts have been continually made to obtain the data of long term prognosis of fixed prostheses, it was difficult to do it. Purpose: The purpose of this study was to evaluate the clinical status of fixed prostheses. Material and methods: In order to assess the clinical status of fixed prostheses, a total of 161 individuals(aged 17-85, 99 women and 62 men with 1596 unit of fixed prostheses, and 1169 abutments) who first visited the Department of Prosthodontics, Pusan National University Hospital, between April to September, in 2007 were examined. Results and conclusion: The results of this study were as follows: 1. Length of service of fixed prostheses was $8.6{\pm}0.6$ years(mean), 10.0 years(median). 2. Location of fixed prostheses was found to have no statistically significant influence on longevity of fixed prostheses(P>.05). But, the success rate was high in posterior region and in mandible where the failure rate was high in combination(P<.05). 3. Longevity of fixed prostheses made of metal was longest(mean: $13.0{\pm}9.3$, median: 14.0), gold, precious ceramic, non-precious ceramic trailing behind(P<.05). 4. Number of units in fixed prostheses was found to have no statistically significant influence on longevity of fixed prostheses(P>.05). But, the success rate was high in Single-unit and the failure rate was high in over 3-unit(P<.05). 5. Condition of opposing dentition was found to have no statistically significant influence on longevity of fixed prostheses(P>.05). But, the success rate was high in natural dentition(P<.05). 6. Defective margin(28.2%), dental caries(23.0%), periodontal disease(19.3%), periapical disease(16.9%) were frequent complications. In 30.1% of the cases, abutment state after removing fixed prostheses was needed to be extracted.

Polymorphisms of HLA-DRB1 and -DQB1 Genes in Korean Patients with Pulmonary Tuberculosis (한국인 폐결핵 환자에서 HLA-DRB1 및 -DQB1 유전자의 다형성에 관한 연구)

  • Park, Myoung Hee;Song, Eun Young;Kwon, Sung Youn;Park, He Jin;Han, Sung Koo;Shim, Young Soo
    • Tuberculosis and Respiratory Diseases
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    • v.54 no.4
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    • pp.367-377
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    • 2003
  • Background : It is well known that only 10% of those infected with Mycobacterium tuberculosis actually develop clinical disease, indicating the existence of host genetic factors regulating disease expression. In this study, we investigated HLA-DRB1 and -DQB1 gene polymorphisms in Korean patients with pulmonary tuberculosis (PTB). Methods : HLA-DRB1 and -DQB1 gene polymorphisms were investigated in 67 PTB patients without previous treatment history, 38 drug-sensitive (DS) and 29 multidrug-resistant (MDR) cases, and 200 healthy controls. HLA-DRB1 typing was done using reverse SSO (sequence specific oligonucleotide) and PCR-SSCP (single strand conformational polymorphism) methods and DQB1 typing was done using PCR-RFLP (restriction fragment length polymorphism), PCR-SSCP and PCR-SSP (sequence specific primer) methods. Results : Among the PTB patients, MDR-TB cases showed frequencies of DRB1*0701 and *08032 increased by about two-fold compared to those of normal controls, and likewise for their associated DQB1 alleles, DQB1*0202 and *0601 (15.5% vs. 34.5%, p=0.01). The frequency of HLA-DQB1*0609 was significantly increased in PTB patients (4.0% vs. 14.9%, p=0.004), showing similar increases in both DS and MDR cases. There was also an association of HLA alleles with the clinical severity of the disease according to the extent of lung lesion. Significantly increased frequencies of DRB1*08032 (4.2% vs. 32.6%, p=0.007) and DQB1*0601 (12.5% vs. 34.9%, p=0.047) were observed in more advanced (moderately & far advanced/DS and far advanced/MDR), compared with less advanced (minimal/DS and moderately advanced/MDR) lung lesions. Although DRB1*0701, DQB1*0202 and DQB1*0609 showed significant increases in different subsets of the disease, these HLA alleles did not show consistent association with disease severity. Conclusion : HLA-DRB1*08032 and DQB1*0601 alleles were associated with genetic susceptibility to MDR-TB in Korean patients, and also with disease severity and progression of PTB.

Clinical Implication of Images of Island : Based on Dreams, Sand Trays and Art Work of Four Korean Women (분석심리학적 관점에서 본 '섬' 상징의 임상적 적용 : 꿈, 모래상자, 그림작업에 출현한 섬 이미지 중심으로)

  • Jin-Sook Kim
    • Sim-seong Yeon-gu
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    • v.32 no.1
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    • pp.1-16
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    • 2017
  • The purpose of this paper is to illustrate the nature of Objective Psyche based on island related case materials. Theoretical background starts with psychological meaning of islands, a kind affective symbol rather than cognitive image, and creation myths as the story of man's awareness of the world; Chaos as archaic identity (unconscious), islands as emergence of the ego from unconscious. In alchemical symbolism, island related to coagulatio, the operation which turns something into earth, the realm of ego. In addition, related parts of Hindu creation myths, Korean giant woman creator Sulmoonde-halmang, and legends of "Relocation of Island/Mountain" will be presented to integrate with case materials. Case A : Starts with a dream of killing a huge dragon and dead body became an island. The dragon in the water was seen as Spirit of Mercurius, the autonomous spirit, connecting of the ego with the Self. The act of killing related to Primeval being which needs to be killed to be transformed. Myths of Eskimo, The Eagle's Gift, the giant woman creator in Korea, and Marduk, the Babylonian hero will be integrated. Case B : Prior to introduce six island images in sand trays, a dream of a giant serpent (python) wound around her body will be presented to portray her situation. By relating Jung's "The Sermons to the Dead," her effort to make the solid island regarded as an act of bringing order out of original oneness (pleroma). Then stresses the importance to coagulate archetypal image Case C : A vignette of active imagination seminar where island image emerged will be described. Her endeavor of focusing on inner image related to the Hindu Creator, Cherokee creation myth, as well as Sulmoonde-halmang. As a motif of growing island, Samoan creation myth, and Legend of Mountain, Mai were incorporated. Colors in her art work regarded as expression of inner need, and importance of expressing inner feeling images as a mean to coagulate volatile emotional and spiritual content. Case D : A dream and art work of terminally ill woman; embracing the tip of the island with gushing up water will be presented. Her island and replenishing water image regard as "an immortal body," corresponds to the Philosophers' Stone for she accepted her death peacefully after the dream. Also related to "The Mercurial Fountain" in Rosarium Philosophorum, and aqua permanence, an allegory of God.

Clinical and Polysomnographic Characteristics of REM Sleep-Dependent Obstructive Sleep Apnea (REM 수면 의존성 폐쇄성 수면무호흡증 환자의 임상적 특성과 수면 변인에 관한 연구)

  • Lee, Yu-Jin;Lee, Soon-Jeong;Kang, Dong-Jin
    • Sleep Medicine and Psychophysiology
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    • v.15 no.2
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    • pp.77-81
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    • 2008
  • Introduction: REM sleep which shows characteristic muscle atonia and increased resistance of upper respiratory track is known to be vulnerable to sleep apnea. Previous studies reported that REM sleep-dependent (or related) obstructive sleep apnea syndrome (REM-dependent OSA) could be one of sleep disordered breathing. The present study aimed to investigate clinical findings and polysomnographic variables of REM-dependent OSA. Methods: Fifty-six patients diagnosed with mild to moderate obstructive sleep apnea by overnight polysomnography (5$53.7{\pm}16.7$ years, 42 males). REM-dependent OSA was defined as AHI-REM/AHI-NREM ratio>2. We compared clinical and polysomnographic findings between REM-dependent OSA and No REM-dependent OSA patients. Results: Among 56 patients, 37.5% (n=21, average age of $52.3{\pm}19.7$ years, 14 males) met the REM-dependent OSA criteria. There were no significant differences in age, sex and body mass index between two groups. After controlling for age, sex, body mass index and periodic leg movements index, REM-dependent OSA patients showed significantly lower AHI, lower number of oxygen desaturation events and higher stage 2 sleep proportion compared to No REM-dependent OSA patients (p=0.010, p=0.006, p=0.031, respectively). After controlling for age, sex, body mass index and periodic legs movements index, AHI-REM was positively correlated with the number of oxygen desaturation events in REM-dependent OSA group (p=0.002). Conclusion: Current results suggested that 37.5% of patients with mild to moderate severity of obstructive sleep apnea could be classified into REM-dependent OSA. REM-dependent OSA was more common in mild severity of OSA, equally prevalent in both sexes and accompanied with sleep architecture changes, i.e. increased proportion of stage 2. In addition, apneic events during REM sleep in REM-dependent OSA were related to oxygen desaturation.

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Clinical Significance of the Ghrelin Concentrations in Plasma and Tumor Tissue from Patients with Gastric Cancer (위암 환자의 혈장 및 종양 조직에서 측정된 그렐린 농도의 임상적 의의)

  • An, Ji-Yeong;Choi, Min-Gew;Hong, Seong-Kweon;Baik, Yong-Hae;Noh, Jae-Hyung;Sohn, Tae-Sung;Kim, Sung
    • Journal of Gastric Cancer
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    • v.5 no.4 s.20
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    • pp.238-245
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    • 2005
  • Purpose: Ghrelin, produced primarily in the gastrointestinal tract, including the stomach, has been reported to reflect nutritional status and to control homeostasis by influencing food intake and adiposity. The purpose of this study is to evaluate nutritional status, as well as plasma and gastric tissue ghrelin levels, in patients with gastric cancer who underwent a gastrectomy. Materials and Methods: Eighty patients were analyzed by the degree of weight loss $(weight\;loss{\geq}5%\;or\;<5%)$ and the extent of gastrectomy (subtotal or total gastrectomy). Blood samples were collected from all patients preoperatively and postoperatively especially at seven days. Gastric tissues, including tumor and normal tissues, were obtained from the resected stomach. levels of plasma and tissue ghrelin were measured with a commercial ELISA kit. Results: There were no significant differences in the clinical characteristics and ghrelin levels of plasma, gastric tumor tissue and normal tissue by the degree of weight loss. The ghrelin levels in plasma and tumor tissue showed no correlations with each other while the ghrelin level in tumor tissue was significantly lower than that in normal tissue. The degree of cellular differentiation also had an association with ghrelin production. A gastrectomy proved to decrease significantly plasma ghrelin levels, body mass index, and biochemical markers, regardless of the extent of gastric resection. Conclusion: These results show that gastric cancer affects the production of ghrelin in the gastric mucosa and that ghrelin is mainly produced in stomach even though it could be partially covered by endogenous ghrelin from other organs following a gastrectomy. However, we should further investigate which other factors have an impact on energy consumption, ghrelin secretion, and changes in ghrelin levels after a gastrectomy.

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Evaluation of the Bioequivalence of Simvastatin 20mg Tablets in Healthy Volunteers (조코 정에 대한 엘바스타 정의 생물학적 동등성 평가)

  • Yun, Hwi-yeol;Kang, Wonku;Kwon, Kwang-il
    • Korean Journal of Clinical Pharmacy
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    • v.15 no.1
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    • pp.41-45
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    • 2005
  • 심바스타틴은 cholesterol 생합성 과정에서 속도 조절 효소인 HMG-CoA reductase의 강력한 상경적 길항약으로서 고지혈증 치료에 널리 쓰이는 약물이다. 심바스타틴 제제인 MSD 사의 조코 20 mg정을 대조약으로 하여 시험약인 유영 제약의 엘바스타 20mg정의 생물학적 동등성 평가를 하기 위해 22명의 건강한 지원자를 모집하였다. 지원자를 두 군으로 나누어 2정씩 투여하였고 $2{\times}2$ 교차시험을 실시하였다. 심바스타틴의 혈장 중의 농도를 정량하기 위하여 발리데이션된 LC/MS/MS를 사용하였다. 채혈 시간은 투약 전 및 투약 후 0.5, 1, 1.5, 2, 2.5, 3, 4, 6, 8, 10, 12 시간에 걸쳐 총 12시점에 걸쳐 시행하였다. 생물학적 동등성을 판정하기 위한 파라미터로 12시간까지의 혈장 중 농도곡선 하 면적 ($AUC_{12hr}$)과 최고 혈중 농도($C_{max}$)를 사용하였다. 12시간 까지의 혈중 농도 곡선 하 면적의 기하 평균은 $17.30ng{\cdot}ml/hr$(시험약)과 $17.35ng{\cdot}ml/hr$(대조약)으로 나타났다. 최고 혈중 농도의 경우 각 각 5.08 ng/ml(시험약)과 5.20 ng/ml(대조약)으로 관찰 되었다. $AUC_{12hr}$의 경우 로그변환한 평균치 차의 $90{\%}$ 신뢰구간이 log0.8510 - log1.1694이었고, $C_{max}$의 경우 log0.8176 - log1.1649로 계산되어 두 항목 모두 log0.8-log1.25이어야 한다는 식품의약품 안전청과 FDA의 기준을 모두 만족시켰다. 이상의 결과를 종합하면 시험약 엘바스타 정 20mg은 대조약 조코정 20 mg에 대하여 생물학적 동등한 것으로 판정되었다.트리머 전기비저항 탐사를 수행하였다. 이를 통해 하저에 케이블을 설치하는 방식에 비해 매우 신속하고 경제적으로 하저에 분포하는 이상대의 분포범위와 발달방향을 규명할 수 있었다.대에 대해 가장 효과적이다. 모델과 현장 적용 결과들을 통해 GRM SSM 방법을 이용하여 불규칙한 굴절면을 가진 지층들에 대해 좀 더 신뢰할 수 있는 정밀한 탄성파 속도를 산출할 수 있음을 보여주고 있다.별한 주의를 기울여야 한다.EX>$\alpha/\beta$=10인 경우 $62.0\~121.9\;Gy_{10}$ (중앙값: $93.0\;Gy_{10}$)의 분포를, ${\alpha/\beta}=3$인 경우 $93.6\~187.3\;Gy_3$ (중앙값=$137.6\;Gy_3$ )의 분포를 보였다. MD-BED $Gy_3$는 직장합병증 발생과의 관계는 통계적으로 유의하였고, 방광합병증과는 유의하지 않았다. 직장합병증과의 연관성은 MD-BED $Gy_3$보다 개별 환자의 직장전벽 총 선량 BED값인 R-BED $Gy_3$가 훨씬 더 높았다. 요도카테터 풍선의 후방지점이 대변하는 방광의 총 선량 BED값인 V-BED $Gy_3$도 방광합병증과 경향성 테스트에서 통계적 유의성을 보였다. 하지만, 어떠한 방사선선량도 골반제어율과 의미 있는 상관관계를 보이지 않았다. 본 기관에서 주치의의 선호도에 따라 강내근접치료가 외부방사선치료의 중간에 시행되는 형태인 샌드위치기법과 외부방사선치료 후반부에 시행되는 순차적 기법으로 구분하였을 때, 두 방식간 치료성적 및 합병증의 차이는 없었다. 총 치료기간에 대한 분석에서는 치료기간이 길어질수록 재발 위험이 커지는 경향을 보였으나, 나이 및 병기, 종양의 크기, MD-BED $Gy_{10}$

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An Effect of Endocrinological Changes related to the Stress on the Submandibular Gland in Rats (스트레스와 관련된 내분비계 변화가 백서 악하선 조직에 미치는 영향에 관한 실험적 연구)

  • Chang, Bong-Youl;Kim, Sung-Hoon;Chun, Yang-Hyun;Hong, Jung-Pyo
    • Journal of Oral Medicine and Pain
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    • v.25 no.3
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    • pp.279-289
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    • 2000
  • 현대에는 날로 복잡해지는 생활양식의 변화에 따라 다양한 스트레스에 노출되고 그로 인한 면역계, 신경계 또는 각종 장기의 기능이상이 점차로 증가되고 있다. 최근 치과에 내원하는 환자들 중 구강건조증을 호소하는 환자들의 다수는 스트레스에 노출되어 있고, 임상적으로도 방사선 타액선 기능 검사에서 타액선, 특히 악하선의 기능이 현저하게 저하되어 있는 소견을 관찰할 수 있 다. 더욱이 이는 타액선 조영술에서 이미 보고된 바 있는 면역성 질환인 $Sj\ddot{o}gren$ 증후군과는 다른 양상으로 관찰되고 있어, 이에 본인은 백서에 스트레스와 관련이 깊은 내분비적 환경 변화를 유도함으로써 이와같은 변화가 악하선 조직의 병리적 변화와 어떠한 연관성을 갖는 지를 관찰하고자 본 실험을 시행하였다. 생후 7주된 Sprague-Dawley계 웅성 백서(165-209g/bw) 40마리를 2 개의 실험군(부신 제거군 : ADX 군, 부신 제거 후 dexamethasone 투여군 : DEX 군)으로 나누어 실험하였다. ADX 군은 외과적으로 부신을 제거한 후 다른 조건을 부여하지 않았고, DEX 군은 외과적으로 부신을 제거한 후 매일 dexamethasone($1.5*10^{-46}mg/g$ I.V./day)을 투여하였으며, 이들을 각각 실험 후 즉시, 1일, 3일, 5일, 7일에 희생시켰다. 그 후에는 즉시 악하선을 적출하여 면역조직화학법으로 Clusterin의 발현 정도 및 부위를 관찰하였다. 그 결과는 다음과 같았다. 1. 광학현미경 하에서, 양 군 모두 유의할만한 조직학적 변화는 관찰되지 않았다. 2. ADX 군에서는 실험기간 전반에 걸쳐 도관세포와 선포세포에서 clusterin이 발현되었다. 3. DEX 군에서는 소수의 선세포에서 국소적으로 clusterin이 관찰되었으나, 전반적으로 도관세포, 선포세포에서 공히 clusterin이 관찰되지 않았다. 부신을 제거한 군에서는 실험기간 전반에 걸쳐 clusterin이 발현되었는데, 이는 clusterin이 스트레스의 생리적 반응의 결과로서 세포보호작용을 한다는 사실에 기초하여 볼 때, 부신을 제거하였을 때도 스트레스를 받았을 때와 같은 영향이 백서의 악하선에 가해졌을 것으로 생각된다. 반면, 부신제거후 glucocorticoid agonist인 dexamethasone을 투여하였을 때, clusterin이 감소 내지 관찰되지 않았던 것은 부신제거에 의해 악하선에 가해졌던 영향을 dexamethasone이 길항하여 나타난 결과로 볼 수 있어, 스트레스에 의해 부신으로부터 분비되는 glucocorticoid가 타액선을 보호하는데 중요한 작용을 하는 것을 시사한다.

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Pattern Clustering of Symmetric Regional Cerebral Edema on Brain MRI in Patients with Hepatic Encephalopathy (간성뇌증 환자의 뇌 자기공명영상에서 대칭적인 지역 뇌부종 양상의 군집화)

  • Chun Geun Lim;Hui Joong Lee
    • Journal of the Korean Society of Radiology
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    • v.85 no.2
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    • pp.381-393
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    • 2024
  • Purpose Metabolic abnormalities in hepatic encephalopathy (HE) cause brain edema or demyelinating disease, resulting in symmetric regional cerebral edema (SRCE) on MRI. This study aimed to investigate the usefulness of the clustering analysis of SRCE in predicting the development of brain failure. Materials and Methods MR findings and clinical data of 98 consecutive patients with HE were retrospectively analyzed. The correlation between the 12 regions of SRCE was calculated using the phi (φ) coefficient, and the pattern was classified using hierarchical clustering using the φ2 distance measure and Ward's method. The classified patterns of SRCE were correlated with clinical parameters such as the model for end-stage liver disease (MELD) score and HE grade. Results Significant associations were found between 22 pairs of regions of interest, including the red nucleus and corpus callosum (φ = 0.81, p < 0.001), crus cerebri and red nucleus (φ = 0.72, p < 0.001), and red nucleus and dentate nucleus (φ = 0.66, p < 0.001). After hierarchical clustering, 24 cases were classified into Group I, 35 into Group II, and 39 into Group III. Group III had a higher MELD score (p = 0.04) and HE grade (p = 0.002) than Group I. Conclusion Our study demonstrates that the SRCE patterns can be useful in predicting hepatic preservation and the occurrence of cerebral failure in HE.

The Relationship between Anterior Disc Displacement without Reduction and Development of Anterior Open Bite (비정복성 관절원판변위와 전치부 개교합 발생간의 관계)

  • Hur, Yun-Kyung;Ko, Myung-Yun;Ahn, Yong-Woo
    • Journal of Oral Medicine and Pain
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    • v.32 no.3
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    • pp.293-303
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    • 2007
  • The purpose of this paper is to evaluate if there is a relationship between anterior disc displacement without reduction and development of anterior open bite, and a relation between occurrence of open bite and occlusal appliance therapy. In general, the statistically significant differences were found between the Group 1 and 2 and normal mean group. The variables that represent mandibular size and form, showed a statistical significance in all 3 groups. Also 3 groups patients had a smaller ANB, a larger FMA than normal mean group. When we compared the 3 groups with respect to all cephalometric measurements by One-way analysis of variance (ANOVA), group 1 and 2 patients had a larger FMA, a larger SN to mandibular plane angle, a larger maxillomandibular plane angle, a larger occlusal plane to mandibular plane angle, a smaller total posterior facial height/total anterior facial height(%), and a larger gonial angle than group 3. The statistically significant differences were not found between the Group 1 and 2, and skeletal patterns were similar. Thus, morphologic features of patients with vertical discrepancies may represent a risk factor for the development of anterior open bite with or without occlusal appliance treatment. In case of patients with vertical discrepancy, we may have to be more careful when inducing a change of the vertical dimension.