• Title/Summary/Keyword: 한국병원

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Effectiveness of Internet-based Interventions on HbA1c Levels in Adult Patients with Diabetes: A Meta-Analysis of Randomized Controlled Trials (인터넷 기반 중재프로그램을 통한 성인 당뇨 환자의 HbA1c 중재효과: 메타분석)

  • Jung, Chang Suk;Noh, Hyun Jung;Gu, Min Jeong;Kim, Yi Young;Lee, Soon Young
    • Journal of health informatics and statistics
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    • v.43 no.4
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    • pp.307-317
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    • 2018
  • Objectives: This study aimed to verify the effectiveness of Internet-based intervention programs for adults with diabetes by conducting a meta-analysis of studies conducted since 2000. Methods: We conducted a systematic review of research papers published in domestic and overseas journals from January 2000 to December 2015, and selected 9 papers that met the analysis criteria. Data analysis was performed using the open source statistical software R 3.5.0, to analyze the effectiveness of Internet-based interventions on experimental and control groups. Results: The analysis showed that intervention programs for controlling HbA1c levels in adult patients with diabetes most commonly comprised 7 sessions on Internet-based management (77.8%), and the most common frequency of application of intervention programs was 4 session in 6 months (33.4%). The present meta-analysis revealed statistically significant effects of Internet-based intervention activities (SMD = 0.92, 95% CI 0.45-1.40). The analysis of the effect size according to the intervention period showed that the 3-month, 6-month, and 12-month interventions reported in eight studies (89%) had a high effect on the Internet-based intervention group. Conclusions: The results of this study confirm the effectiveness of Internet-based intervention programs for adult patients with diabetes. The need for research on the utilization of Internet-based intervention programs for the steady management of diabetes, a chronic disease; for the development of specific guidelines for intervention activities; and for establishing appropriate protocols are acknowledged.

Development of the Korean version of Postconcussional Syndrome Questionnaire (한글판 뇌진탕후증후군 척도의 개발)

  • Yoon, Mi-Ri;Ko, Young-Hoon;Han, Chang-Su;Joe, Sook-Haeng;Jeon, Sang-Won;Han, Chang-Woo
    • Korean Journal of Psychosomatic Medicine
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    • v.23 no.1
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    • pp.26-35
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    • 2015
  • Objectives:The purpose of this study was to evaluate reliability and validity of the Korean version of the Postconcussional Syndrome Questionnaire(KPCSQ) which was originally developed in 1992 by Lees-Haley. Methods:Patients with traumatic brain injury were recruited from April 2009 to December 2011 from the Korean University Ansan Hospital. We selected patients that met the ICD-10 diagnostic criteria of postconcussional syndrome and organic mental disorder including organic mood disorder, organic emotionally labile disorder, organic anxiety disorder and organic personality disorder. The KPCSQ, Trait and State Anxiety Inventory(STAI-I, II), and Center for Epidemiologic Studies Depression Scale(CESD) were administered to all subjects. Factor analysis of the items were performed and test-retest correlation were evaluated. Internal consistency of the KPCSQ and its subscales was assessed with Cronbach's alpha. External validity of the KPCSQ were examined by correlation coefficient with the STAI-I, II, and CESD. Results:The Cronbach's alpha coefficient of the total PCSQ was 0.956. The test-retest reliability coefficient was 0.845. The PCSQ showed significant correlation with STAI-I, II and CESD. The factor analysis of the PCSQ yielded 4 factors model. Factor 1 represented 'affective and cognitive symptoms', factor 2 represented 'somatic symptoms', factor 3 represented 'infrequent symptoms' and factor 4 represented 'exaggeration or inattentive response'. There was no significant difference between the PCS group and the organic mental disorder group in the score on each measure. The scores on KPCSQ and its subscales in the subjects that had scored 5 or more in 'exaggeration or inattentive response' are significantly higher than those in the subjects had scored 4 in 'exaggeration or inattentive response'. Conclusions:This study suggests that the Korean version of PCSQ is a valid and reliable tool for assessing psychiatric symptomatology of patients with traumatic brain injury. Further investigations with greater numbers of subjects are necessary to assess the clinical usefulness of the KPCSQ.

Seroprevalence and Risk Factors for Severe Fever with Thrombocytopenia Syndrome among the Korea National Park Service Workers (국립공원 종사자의 중증열성혈소판감소증후군 혈청유병률 및 위험요인)

  • Kim, Dong-Hwi;Kim, Kye-Hyung;Yi, Jongyoun;Ko, Mee Kyung;Park, Sung-Jun;Yoo, Seok-Ju;Lee, Kwan;Park, Ji-Hyuk
    • Journal of agricultural medicine and community health
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    • v.46 no.3
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    • pp.162-170
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    • 2021
  • Objectives: This study was carried out to understand the seroprevalence and risk factors for severe fever with thrombocytopenia syndrome (SFTS) among the Korea National Park Service (KNPS) workers. Methods: We used the stored serum samples (763) and survey results collected from the previous investigation on scrub typhus and Lyme disease among the KNPS workers during 2016-2017. The serum samples were analyzed by double-antigen sandwich enzyme-linked immunosorbent assay, which was used to test the total antibody including IgG and IgM. Results: The SFTS seroprevalence among the KNPS worrkers was 1.4%. In multivariate logistic analysis, the national park exploration programs (odds ratio, 3.48; 95% confidence interval, 1.01-12.01) was significantly associated with the seroprevalence of SFTS. Conclusion: This study was the first serological study of SFTS among forestry workers in South Korea. Although the KNPS workers are at a high-risk group of SFTS, the prevention activities related to the working environment and habit was insufficient. Thus, systematic prevention education and training for the KNPS workers need to be strengthened.

Incidence and Procedure-Related Risk Factors of Delirium in Patients Admitted to an Intensive Care Unit (중환자실 입원 환자의 섬망 발생과 처치 관련 위험인자)

  • Ahn, Jee Seon;Oh, Jooyoung;Park, Jaesub;Kim, Jae-Jin;Park, Jin Young
    • Korean Journal of Psychosomatic Medicine
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    • v.27 no.1
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    • pp.35-41
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    • 2019
  • Objectives : Although delirium is a common complication among patients hospitalized in intensive care units(ICUs), little is known about the roles that diagnostic and therapeutic procedures play in its development. This study investigates the procedure-related risk factors of delirium in ICU patients. Methods : All the consecutive patients admitted to the ICU between June 2016 and May 2017 were routinely evaluated for delirium by psychiatrists. In total, 1156 patients met the inclusion criteria and were retrospectively analyzed. A multiple logistic regression analysis was conducted to investigate independent risk factors of delirium development while adjusting for other characteristics. Results : The age, Acute Physiology and Chronic Health Evaluation (APACHE II) score, proportion of patients who had undergone an operation, and proportion of patients who were foley catheterized, mechanically ventilated, and physically restrained were higher in the delirium group. The multiple logistic regression analysis confirmed that the use of restraint was an independent risk factor of delirium (odds ratio : 10.006 ; 95% confidence interval : 6.120-16.360 ; p<0.001). The patient factors independently associated with delirium were an advanced age and a higher APACHE II score. The incidence of delirium was 15.3%. Conclusions : There is a high prevalence of delirium influenced by potentially harmful procedures in patients in ICU settings. The use of physical restraint had the strongest association with the development of delirium. These findings advocate the need to target procedure-related risk factors such as the use of restraints as preventive intervention measures for ICU delirium.

Antibacterial and Antioxidant Potential of Methanol Extract of Viburnum sargentii Seeds (Viburnum sargentii 종자 메탄올 추출물의 항균 및 항산화 활성에 대한 연구)

  • Patil, Maheshkumar Prakash;Seong, Yeong-Ae;Kang, Min-jae;Singh, Alka Ashok;Niyonizigiye, Irvine;Kim, Gun-Do;Lee, Jong-Kyu
    • Journal of Life Science
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    • v.29 no.6
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    • pp.671-678
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    • 2019
  • Antibacterial and antioxidant activities of plant sources have attracted a wide range of interest across the world over the last decade. This is due to the growing concern for safe and alternative sources of antibacterial and antioxidant agents. In this study, we focused on the antibacterial and antioxidant activities and the chemical composition of a methanol extract from Viburnum sargentii seeds. The chemical composition was determined by gas chromatography-mass spectroscopy (GC-MS), and the antibacterial activity was screened by a disc diffusion assay. The minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC) were determined using the microbroth dilution and spread plate method, respectively. The V. sargentii extract showed growth inhibition activity on all tested Gram-positive (Listeria monocytogenes, Staphylococcus aureus, and Staphylococcus saprophyticus) and Gram-negative (Escherichia coli, Pseudomonas putida, and Proteus vulgaris) pathogenic bacteria. The MIC and MBC ranged from 0.156~1.25 mg/ml for Gram-positive and 0.625~5.0 mg/ml for Gram-negative tested bacteria. The GC-MS results revealed the presence of several phytochemicals such as ${\beta}-sitosterol$ and vitamin E, which are known for their pharmacological applications. The antioxidant activities of V. sargentii extract were investigated by three different methods: the 2,2-diphenyl-1-picrylhydrazyl free radical scavenging assay, the reducing power assay, and the total antioxidant capacity assay. The results showed a concentration-dependent antioxidant potential for all three used methods. In sum, our findings suggest that the methanol extract of V. sargentii seeds has the potential to inhibit the growth of pathogenic bacteria and provide antioxidant compounds, making it therefore worthy of further investigation.

The Characteristics of Child and Adolescent Suicide Attempters Admitted to a University Hospital (일 대학병원에 자살 시도 후 입원한 소아청소년들의 특성)

  • Bang, Yeon-Sik;Lee, Jinhee;Min, Seongho;Ahn, Joung-Sook;Park, Ki-Chang;Kim, Min-Hyuk
    • Korean Journal of Psychosomatic Medicine
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    • v.26 no.2
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    • pp.135-144
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    • 2018
  • Objectives : The purpose of this study was to identify the differences of demographic and clinical characteristics between child-adolescents who received medical inpatient care and non-hospitalized adolescents after suicide attempts. Methods : The study included 35 child-adolescents who were hospitalized (Admission group) and 114 child-adolescents who were not hospitalized (Non-Admission group) as a result of a suicide attempt from 2009 to 2015. We compared sociodemographic, clinical, and suicide attempt-related characteristics through a chi-square test and logistic regression analysis to evaluate the differences between the two groups. Results : Child-adolescents of this study most commonly attempted suicide by poisoning, and for motivation of interpersonal problems. Admission group had significantly fewer attempts through injury by sharp objects (${\chi}^2=4.374$, p=0.037) and attempted suicide with a higher chance of actually dying when compared to Risk-Rescue Rating Scale (t=1.981, p=0.049). In addition, Admission group had relatively common motivation for academic problems (${\chi}^2=12.082$, p=0.001) and less motivation for interpersonal difficulties. (${\chi}^2=9.869$, p=0.002) Psychiatric diagnosis at the time of visiting the emergency department showed higher rates of depression in the admission group than Non-Admission group (${\chi}^2=8.649$, p=0.003). The results of logistic regression showed that depression affects hospitalization (OR=2.783, 95% CI 1.092-7.089, p=0.032). Conclusions : This study is meaningful in that it revealed the social and clinical characteristics of all child-adolescents who were hospitalized at a university hospital after attempting suicide. This study identified differences in motivation, methods, and psychiatric diagnosis of hospitalized adolescents and those who were not. Therefore, the results may help adolescent suicide attempters to get a discriminatory approach based on their admission.

Clozapine Administration Potentiate Platelet Activation in Patients with Schizophrenia : Retrospective Study (클로자핀을 투여한 조현병 환자에서 혈소판 활성 증가에 관한 후향적 연구)

  • Kim, Hyun-Ah;Lee, Jong Wook;Kim, Seung-Jun;Oh, Hong-Seok;Im, Woo Young;Kim, Ji-Woong
    • Korean Journal of Psychosomatic Medicine
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    • v.26 no.2
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    • pp.188-193
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    • 2018
  • Objectives : Clozapine is a widely prescribed antipsychotic drug for schizophrenia and is known to increase the risk of cardiovascular disease due to its metabolic side effects. However, little is known about the effect of clozapine on the platelet activation, another important factor in the development of cardiovascular disease. In this study, we tried to investigate the effect of clozapine on platelet activity in patients with schizophrenia by comparing the mean platelet component (MPC) values before and after the clozapine administration. Methods : A retrospective review of medical records of patients with schizophrenia, who newly started clozapine treatment from September 1st, 2003 to April 30th, 2007 at the Department of Psychiatry, Konyang University Hospital in Republic of Korea was performed. The final statistical analysis included 14 participants. Bayer ADVIA $120^{(R)}$ system was used to measure MPC. Results : Among the 14 participants, five subjects were males (28.60%), and ten subjects were females (71.40%). The mean age of participants was $37.50{\pm}11.64years$. Average of duration of illness was $91.00{\pm}93.96months$, with the mean dosage of clozapine taken by participants at the time of the last blood test was $337.50{\pm}109.52mg$. The mean MPC measurement before and after receiving clozapine was $26.12{\pm}2.22g/dL$ and $25.14{\pm}2.08g/dL$ respectively. Wilcoxon signed rank test showed that there was a statistically significant decrease in MPC levels after clozapine administration (V=16, p=0.024). Conclusions : Decreased MPC levels after clozapine administration implies that clozapine may increase platelet activation which could have an adverse effect on the occurrence of thromboembolic disease. Our findings also suggest that careful monitoring of the risk factors of cardiovascular diseases, such as platelets activity, is necessary when administering clozapine.

Proanthocyanidins Suppresses Lipopolysaccharide-stimulated Inflammatory Responses via Heme Oxygenase-1 Induction in RAW264.7 Macrophages (프로안토시아니딘의 항염증효과)

  • Cheon, Hye-Jin;Park, Sun Young;Jang, Hee-Ji;Cho, Da-Young;Jung, Jiwon;Park, Gimin;Jeong, Kyeong Mi;Kim, Jin-Kyung
    • Journal of Life Science
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    • v.29 no.4
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    • pp.484-491
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    • 2019
  • Proanthocyanidins are naturally occurring polyphenolic compounds abundant in many vegetables, plant skins (rind/bark), seeds, flowers, fruits, and nuts. Numerous in vitro and in vivo studies have demonstrated myriad effects potentially beneficial to human health, such as antioxidation, immunomodulation, DNA repair, and antitumor activity. Among immune cells, macrophages are crucial players in a variety of inflammatory responses to environmental conditions. However, it has been widely reported that macrophages cause chronic inflammation and are involved in a variety of diseases, such as obesity, diabetes, metabolic syndrome, and cancer. In this study, we report the suppressive effect of proanthocyanidins via the heme oxygenase-1 (HO-1)-related system, on the immune response of the LPS-stimulated mouse macrophage cell line RAW264.7. Increased HO-1 expression at mRNA and protein levels were found in proanthocyanidins-treated RAW264.7 cells. Further, proanthocyanidins enhanced nuclear factor-erythroid 2-related factor 2 translocation into the nucleus. RAW264.7 cells were treated with lipopolysaccharide (LPS) with or without proanthocyanidins, and inflammatory mediator expression levels were assessed. Proanthocyanidins treatment resulted in the attenuation of nitric oxide production and inducible nitric oxide synthase expression in LPS-stimulated RAW264.7 cells. In addition, mRNA and protein expression of proinflammatory cytokines, such as tumor necrosis factor-${\alpha}$ and interleukin-6, was inhibited by proanthocyanidins treatment in LPS-stimulated RAW264.7 cells. These findings support proanthocyanidins as a promising anti-inflammatory agent.

Epidemiological investigation on the outbreak of foodborne and waterborne disease due to Norovirus with delayed notification (노로바이러스에 기인한 수인성·식품매개감염병 집단발생의 지연신고에 대한 역학조사)

  • Ha, Mikyung;Kim, Hyeongsu;Kim, Yong Ho;Na, Min Sun;Yu, Mi Jung
    • Journal of agricultural medicine and community health
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    • v.43 no.4
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    • pp.258-269
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    • 2018
  • Objectives: There was an outbreak of foodborne and waterborne disease among high school students at Okcheon in June, 2018. First attack occurred June $5^{th}$ but seven days later it was notified. The purpose of this investigation was to evaluate the pathogen of outbreak and cause of delayed notification. Methods: First, we did a questionnaire survey for 61 cases and 122 controls to find what symptoms they had and whether they ate foods or drank water from June $2^{nd}$ to June $12^{th}$. Second, we investigated the environment of cafeteria and drinking water. Third, we examined specimen of cases and environment to identify bacteria or virus. Results: Attack rate of this outbreak was 7.8%. Drinking water was strongly suspected as a source of infection in questionnaire survey but we could not find the exact time of exposure. Norovirus was identified in specimen of cases (2 students), drinking water (at main building and dormitory) and cafeteria (knife, dishtowel, hand of chef) Conclusions: We decided norovirus as the pathogen of this outbreak based on the clinical features of cases with diarrhea vomiting, abdominal pain and recovery within 2 or 3 days after onset, outbreak due to drinking water and microbiologic examination, And the cause of delayed notification might be the non-existence of the nurse teacher at that time and the lack of understanding of teachers on immediate notification under the outbreak. To prevent the delayed notification, notification system about outbreak of foodborne and waterborne disease in school is needed to be improved.

The Changing Patterns and Predisposing Factors of Delirium at End of Life in Palliative Care Unit (완화 병동에서 임종기 섬망의 변화 양상과 선행 요인)

  • Rim, Mi-Roo;Kang, Sang-Gu;Choi, Seo-Hyeon;Cho, Jinhyun;Lee, Moon-Hee;Kim, Hye-Young;Bae, Jae-Nam;Lee, Jeong-Seop;Kim, Won-Hyoung
    • Korean Journal of Psychosomatic Medicine
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    • v.26 no.2
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    • pp.94-101
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    • 2018
  • Objectives : The purpose of this study is to investigate the change pattern and the leading factors of delirium in the palliative ward from 2 weeks before to the end of life. Methods : From October 2015 to August 2017, a retrospective chart review was conducted on the final 180 patients of 207 patients with terminal cancer patients at the Inha University Hospital. Clinical records were collected during palliative care hospitalization. Patients were diagnosed with three subtypes of delirium through the Richmond Agitation Sedation Scale and the Nursing Delirium Screening Scale, which were evaluated daily. Results : The prevalence of delirium 13 days before death was 46%, of which 18.3% were hyperactive subtypes, 13.8% were hypoactive subtypes, and mixed subtypes were 13.8%. And hyperactive delirium gradually decreased with the approach to the end of the day, and the mixed subtype gradually increased until 4 days before the end of life. Of the patients, the day before death, 86.9% were diagnosed with delirium. In multivariate analysis, hematologic malignancy was associated with a lower rate of delirium at the end of life than gastrointestinal cancer. Overweight was associated with hyperactive, mixed, and hypoactive delirium. Conclusions : Most palliative care patients experienced delirium at the end of life. Overweight was considered as a protective factor that reduced the all subtypes of delirium at the end of life. Further prospective studies are needed to reveal the prevalence of terminal delirium, and their risk factors.