• The Korean Journal of Medicine
• /
• 제99권4호
• /
• pp.165-168
• /
• 2024

Initiating dialysis at an advanced age is both a clinical challenge and an ethical dilemma, because the benefits in older adults with advanced chronic kidney disease may be offset by high rates of dialysis-related morbidity. Geriatric conditions, such as aging, frailty, functional impairment, and cognitive impairment, significantly influence the prognosis of elderly patients. Therefore, it becomes important to provide patients and families with prognostic information regarding timing of initiation, which is further complicated by the competing mortality risk. Shared decision-making by clinicians and patients can yield better clinical outcomes and quality of life. Through this approach, patients can opt for the most appropriate treatment based on their personal values, which often entails conservative management.

• 한국환경성돌연변이발암원학회지
• /
• 제23권4호
• /
• pp.115-130
• /
• 2003

Idiopathic Parkinson's disease (IPD) represents a common neurodegenerative disorder. While epidemiological studies have suggested a number of risk factors including age, gender, race, and inherited disorder, the cumulative evidence supports the view that environmental or occupational exposure to certain chemicals may contribute to the initiation and progress of Parkinsonism. More recently, clinical and laboratory investigations have led to the theory that dysregulation of iron, an essential metal to body function, may underlie IPD by initiating free radical reaction, diminishing the mitochondrial energy production, and provoking the oxidative cytotoxicity. The participation of iron in neuronal cell death is especially intriguing in that iron acquisition and regulation in brain are highly conservative and thus vulnerable to interference from other metals that bear the similar chemical reactivity. Manganese neurotoxicity, induced possibly by altering iron homeostasis, is such an example. In fact, the current interest in manganese neurotoxicology stems from two primary concerns: its clinical symptoms that resemble Parkinson's disease and its increased use as an antiknock agent to replace lead in gasoline. This article will commence with addressing the current understanding of iron-associated neurodegenerative damage. The major focus will then be devoted to the mechanism whereby manganese alters iron homeostasis in brain.

• Asian Pacific Journal of Cancer Prevention
• /
• 제17권1호
• /
• pp.45-50
• /
• 2016

Background: The tobacco epidemic is a heralding health menace, particularly among college students. Tobacco usage among young can have an especially devastating effect as they can be exposed for longer periods. Data to estimate the prevalence of tobacco use in young adults will be a valuable addition to the existing resources. Materials and Methods: An analytical cross-sectional study was therefore carried out in Mangalore city using a pre-tested, self-administered questionnaire adapted from the Global Youth Tobacco Survey (GYTS) with a representative sample of 720 students aged 18-20 years selected from degree colleges by multi-stage random sampling. Results: Prevalence of 'ever users' and 'current users' of smoking were 20.4% and 11.4%, respectively. The mean age at initiation of cigarette smoking was 16 years and the majority (31 %) smoked in public places. Interestingly, 84% of them knew about the harmful effects of cigarette smoking. About one half of smokers had some or most of their friends smoking. Multivariate analysis revealed gender (OR=8.585: CI-3.26-22.5), pocket money (OR=4.165; CI=1.76-9.82) and peer's smoking habit (OR= 5.15; CI-2.21-11.9) have higher odds as correlates of tobacco usage among college students. Conclusions: It is of prime importance to highlight the role of prevention of smoking initiation rather than subsequently trying to stop the habit. Comprehensive interventions embracing family, friends and social milieu are needed to reduce tobacco use among students in India.

• The Korean journal of internal medicine
• /
• 제39권4호
• /
• pp.640-649
• /
• 2024

Background/Aims: This study aimed to investigate the timing and predictors of death during treatment among patients with multidrug/rifampin-resistant tuberculosis (MDR/RR-TB) in South Korea. Methods: This was a retrospective cohort study that included MDR/RR-TB cases notified between 2011 and 2017 in South Korea. Results: Among 7,226 MDR/RR-TB cases, 699 (9.7%) died at a median of 167 days (IQR 51-358 d) from the initiation of MDR-TB treatment. The cumulative proportion of all-cause death was 35.5% at 90 days and 52.8% at 180 days from treatment initiation. TB-related deaths occurred at a median of 133 days (IQR 32-366 d), which was significantly earlier than the median of 184 days (IQR 68-356 d) for non-TB-related deaths (p = 0.002). In a multivariate analysis, older age was the factor most strongly associated with death, with those aged ≥ 75 years being 68 times more likely to die (aHR 68.11, 95% CI 21.75-213.26), compared those aged ≤ 24 years. In addition, male sex, comorbidities (cancer, human immunodeficiency virus, and end stage renal disease), the lowest household income class, and TB-specific factors (previous history of TB treatment, smear positivity, and fluoroquinolone resistance) were identified as independent predictors of all-cause death. Conclusions: This nationwide study highlights increased deaths during the intensive phase and identifies high-risk groups including older people and those with comorbidities or socioeconomic vulnerabilities. An integrated and comprehensive strategy is required to reduce mortality in patients with MDR/RR-TB, particularly focusing on the early stages of treatment and target populations.

• KIEAE Journal
• /
• 제12권6호
• /
• pp.11-22
• /
• 2012

The paper aims to establish planning elements of planned-ecovillages, and analyze the cognizance of residents as well as experts' evaluation so as to examine the awareness of actual residents. The planned-ecovillage allows residents to participate in the organization of the ecovillage to the construction stage. Unlike general ecovillages, planned-ecovillages have a difference as they introduce planning elements by autonomous decision-making through discussions and meetings among residents. The present age is at its turning point. While a fatal impact to human life, including energy shortage and environmental pollution are expected, we may be able to suggest an alternative solution and triggered the initiation, such as a future-oriented ecovillage that enables environmentally-friendly and sustainable living, namely planned-ecovillages.

• Asian Pacific Journal of Cancer Prevention
• /
• 제16권17호
• /
• pp.7535-7540
• /
• 2015

Background: Early initiation of smoking and chewing of diverse forms of tobacco among youth in India is a significant driver for tobacco epidemic in India. Several socio-demographic factors are predictors of tobacco use in populations, especially among youth. Interventions which address these socio-demographic factors can help policy makers to curb new initiations and avert morbidity and mortality due to tobacco use. Objective: To study the various sociodemographic variables associated with tobacco use among youth in India. Materials and Methods: Secondary analysis of data from the Global Adult Tobacco Survey-India 2009-10 for the age group of 15-24 years was performed and predictors of smoking and smokeless tobacco were analyzed using data on occupation, education, and other sociodemographic factors. Results: In India there are a total of 51.3 million (22.1%) youth (15-24 years) tobacco users. Of these 35.1 million consumes chewable tobacco (15.1%), 16.2 million smoke (7%) and 1.6 million are dual users (3.1%). Males, urban, less educated, un-employed and those belonging to middle class preferred smoking over chewing; whereas, females, rural, students and those belonging to low socio-economic class are predictors of smokeless tobacco use. The major determinants of dual users are male sex, poor socio-economic strata and student class. The overall tobacco use was higher among males, rural populations, lower socioeconomic strata and un-employed class. Conclusions: India's youth is more susceptible to the tobacco addiction, especially of smokeless tobacco. Youth from rural India especially students, girls and those from poor socio-economic strata prefer to use smokeless tobacco products whereas urban, male and those less educated prefer smoking tobacco products. More population-based and region-focused research is needed to understand initiation patterns into tobacco use among youth so as to inform policymakers to devise new policy measures to curb the growing epidemic.

• Journal of Chest Surgery
• /
• 제57권1호
• /
• pp.36-43
• /
• 2024

Background: Coronavirus disease 2019 (COVID-19) can lead to acute respiratory failure, which frequently necessitates invasive mechanical ventilation and extracorporeal membrane oxygenation (ECMO). However, the limited availability of ECMO resources poses challenges to patient selection and associated decision-making. Consequently, this retrospective single-center study was undertaken to evaluate the characteristics and clinical outcomes of patients with COVID-19 receiving ECMO. Methods: Between March 2020 and July 2022, 65 patients with COVID-19 were treated with ECMO and were subsequently reviewed. Patient demographics, laboratory data, and clinical outcomes were examined, and statistical analyses were performed to identify risk factors associated with mortality. Results: Of the patients studied, 15 (23.1%) survived and were discharged from the hospital, while 50 (76.9%) died during their hospitalization. The survival group had a significantly lower median age, at 52 years (interquartile range [IQR], 47.5-61.5 years), compared to 64 years (IQR, 60.0-68.0 years) among mortality group (p=0.016). However, no significant differences were observed in other underlying conditions or in factors related to intervention timing. Multivariable analysis revealed that the requirement of a change in ECMO mode (odds ratio [OR], 366.77; 95% confidence interval [CI], 1.92-69911.92; p=0.0275) and the initiation of continuous renal replacement therapy (CRRT) (OR, 139.15; 95% CI, 1.95-9,910.14; p=0.0233) were independent predictors of mortality. Conclusion: Changes in ECMO mode and the initiation of CRRT during management were associated with mortality in patients with COVID-19 who were supported by ECMO. Patients exhibiting these factors require careful monitoring due to the potential for adverse outcomes.

• 한국작물학회지
• /
• 제44권2호
• /
• pp.143-148
• /
• 1999

Soil moisture condition is an important limiting factor in growth and yield in rice culture. The purpose of this study was to compare the influence on the growth, yield and Quality of rice subjected to soil moisture stress (SMS) at different growth stages. Ajaponica rice cultivar, Dongjinbyeo, was cultured under flooded conditions in a plastic container filled with silty loam soil. The container was subjected to SMS until the initial wilting point (IWP) coincided with about 10% in soil moisture content and about-200 kPa in soil matric potential, and was then irrigated again, at 6 and 5 of main growth stage in 1996 and 1997, respectively. At maturity, the plant height, tiller number, leaf area and top dry weight were decreased more in SMS treatments at the early stage than the late stage. The averaged yield index of SMS to control in both years was lowest at meiosis (62.5%), which primarily resulted from lower percent ripened grain and 1,000 grain weight, and second＇ reduced the spikelet number per panicle and panicle number per hill, and followed at tillering stage (68.5%) which resulted from the lower production in tiller number and top dry matter during and after SMS treatment. The percent-age of read rice in SMS plants varied with the treatment stage as order of lower at meiosis (44.0%), heading (53.9%), panicle initiation (70.1%), tillering (72.1%), ripening (75.8%) and 5 days after transplanting (DAT) (79.0%). Protein content in brown rice was slightly larger in SMS at late growth stage than the control, while the contents of fat and ash differed very little between SMS and control. Contents of Mg and K and Mg/K in brown rice with SMS were lower at some treatment stages such as at ripening or panicle initiation.

• 생명과학회지
• /
• 제14권5호
• /
• pp.840-846
• /
• 2004

본 연구는 한국산 겨우살이 lectin유전자 (A 및 B chain) 을 효모 (Saccharmyces cerevisiae) 에 형질 전환시키는 시스템을 사용한 것으로, 효모내 효과적인 lectin유전자 발현을 위하여 유전자 상에 Kozak translation initiation sequence를 PCR을 이용 삽입, 변형시켜 재 클로닝 하였다. 변형된 lectin A 및 B 유전자를 포함하는 재조합 플라스미드는 S. cerevisiae INVSc (MATa, his3 $\Delta$l, leu2, trpl-289, ura3-52) 에 형질전환 되었다. 형질전환된 효모는 ABI 3700 system을 이용한 DNA 염기서열 분석을 통해 확인되었고 재조합 한국산겨우살이 lectin 발현을 위해 2% galactose를 사용하여 유도발현되었다. 재조합 lectin A 및 B 단백질은 SDS-PACE 및 western blotting 분석을 수행한 결과 약 29kDa 크기로 확인되었다. 재조합 lectin은 세포내 가용성 단백질 1mg중 1.24∼l.75 $\mu\textrm{g}$ 수준으로 발현되어짐을 ELISA 분석을 통해 확인하였다. 한편 lectin 유전자는 galartose 유도발현 후 36시간이 되 었을 때 발현량이 최대가 되었으며 lectin A 유전자의 경우 48 시간 이후에는 발현이 억제되었다.

• 한국운동역학회지
• /
• 제27권4호
• /
• pp.257-262
• /
• 2017

Objective: This study aimed to investigate the differences in skiing time and vertical ground reaction force (vGRF) between the basic parallel turn and short turn. Method: Eleven alpine ski instructors (age: $28.73{\pm}4.29yrs$, height: $172.36{\pm}6.30cm$, body mass: $71.45{\pm}9.16kg$, career: $11.09{\pm}2.70yrs$) participated in this study. Each skier was asked to perform a basic parallel turn and short turn on a $16^{\circ}$ groomed slope. A foot pressure measurement system was used to measure the skiing time and vGRF under the three plantar regions (forefoot, midfoot, rearfoot). Results: Skiing time decreased significantly in all three phases during the short turn (p<.05). In the initiation phase, the vGRF showed a greater decrease on the midfoot and rearfoot during the short turn (p<.05). In the steering phase 1, the vGRF showed a greater increase on the forefoot and decreased on the midfoot during the short turn (p<.05). In the steering phase 2, the vGRF showed a greater increase on the forefoot and rearfoot during the short turn (p<.05). Conclusion: Our findings proved that the skiing time and vGRF changed during the short turn. Consequently, we suggest that recreational skiers should decrease the skiing time of the steering phase compared to that of the initiation phase and increase the vGRF on the forefoot and rearfoot in the steering phase.