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Vitamin D Deficiency and Related Factors in Patients at a Hospice (일개 호스피스 병동에서 비타민 D 결핍 현황 및 관련인자)

  • Moon, Kyoung Hwan;Ahn, Hee Kyung;Ahn, Hong Yup;Choi, Sun Young;Hwang, In Cheol;Choi, Youn Seon;Yeom, Chang Hwan
    • Journal of Hospice and Palliative Care
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    • v.17 no.1
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    • pp.27-33
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    • 2014
  • Purpose: Although vitamin D deficiency is more commonly found in cancer patient than in non-cancer patients, there have been little data regarding the prevalence of vitamin D deficiency in cancer patients at the very end of life. We examined vitamin D deficiency in terminally ill cancer patients and related factors. Methods: This study was based on a retrospective chart review of 133 patients in a hospice ward. We collected data regarding age, sex, serum 25-hydroxyvitamin D level, cancer type, physical performance, current medications and various laboratory findings. We investigated factors related to serum vitamin D levels after multivariate adjustment for potential confounders. Serum 25-hydroxyvitamin D<20 ng/mL was considered deficient and <10 ng/mL severely deficient. Results: Ninety-five percent of the patients were serum vitamin D deficient. Severe vitamin D deficiency was more common in male patients, non-lung cancer patients, $H_2$ blocker users and non-anticonvulsant users. Elevated levels of serum alanine aminotransferase (ALT) were also associated with low serum vitamin D levels. Multiple regression analysis showed that severe vitamin D deficiency was associated with male gender (aOR 3.82, 95% CI: 1.50~9.72, P=0.005), $H_2$ blocker users (aOR 3.94, 95% CI: 1.61~9.65, P=0.003) and elevated serum ALT levels (aOR 4.52, 95% CI: 1.35~15.19, P=0.015). Conclusion: Vitamin D deficiency was highly prevalent among terminally ill cancer patients. Severe vitamin D deficiency was more common in male patients, $H_2$ blocker users, and patients with elevated ALT levels.

Vitamin B5 and B6 Contents in Fresh Materials and after Parboiling Treatment in Harvested Vegetables (채소류의 수확 후 원재료 및 데침 처리에 의한 비타민 B5 및 B6 함량 변화)

  • Kim, Gi-Ppeum;Ahn, Kyung-Geun;Kim, Gyeong-Ha;Hwang, Young-Sun;Kang, In-Kyu;Choi, Youngmin;Kim, Haeng-Ran;Choung, Myoung-Gun
    • Horticultural Science & Technology
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    • v.34 no.1
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    • pp.172-182
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    • 2016
  • This study was aimed to determine the changes in vitamin $B_5$ and $B_6$ contents compared to fresh materials after parboiling treatment of the main vegetables consumed in Korea. The specificity of accuracy and precision for vitamin $B_5$ and $B_6$ analysis method were validated using high-performance liquid chromatography (HPLC). The recovery rate of standard reference material (SRM) was excellent, and all analysis was under the control line based on the quality control chart for vitamin $B_5$ and $B_6$. The Z-score for vitamin $B_6$ in food analysis performance assessment scheme (FAPAS) proficiency test was -1.0, confirming reliability of analytical performance. The vitamin $B_5$ and $B_6$ contents in a total of 39 fresh materials and parboiled samples were analyzed. The contents of vitamin $B_5$ and $B_6$ ranged from 0.000 to 2.462 and from 0.000 to $0.127mg{\cdot}100g^{-1}$, respectively. The highest contents of vitamin $B_5$ and $B_6$ were $2.462mg{\cdot}100g^{-1}$ in fresh fatsia shoots (stem vegetables), and $0.127mg{\cdot}100g^{-1}$ in fresh spinach beet (leafy vegetables), respectively. Moreover, the vitamin $B_5$ and $B_6$ contents for parboiling treatment in most vegetables were reduced or not detected. In particular, the contents of vitamin $B_5$ in parboiled fatsia shoots and vitamin $B_6$ in parboiled yellow potato and spinach beet were decreased 20- and 4-fold compared with fresh material, respectively. These results can be used as important basic data for utilization and processing of various vegetable crops, information for dietary life, management of school meals, and national health for Koreans.

Microbiological Hazard Analysis for HACCP System Application to Non Heat-Frozen Carrot Juice (비가열냉동 당근주스의 HACCP 시스템 적용을 위한 미생물학적 위해 분석)

  • Lee, Ung-Soo;Kwon, Sang-Chul
    • Journal of Food Hygiene and Safety
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    • v.29 no.2
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    • pp.79-84
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    • 2014
  • This study has been performed for about 270 days at analyzing biologically hazardous factors in order to develop HACCP system for the non heat-frozen carrot juice. A process chart was prepared by manufacturing process of raw agricultural products of non heat-frozen carrot juice, which was contained water and packing material, storage, washing, cutting, extraction of the juice, internal packing, metal detection, external packing, storage and consignment (delivery). As a result of measuring Coliform group, Staphylococcus aureus, Salmonella spp., Bacillus cereus, Listeria Monocytogenes, Enterohemorrhagic E. coli before and after washing raw carrot, Standard plate count was $4.7{\times}10^4CFU/g$ before washing but it was $1.2{\times}10^2CFU/g$ detected after washing. As a result of testing airborne bacteria (Standard plate count, Coliform group, Yeast and Fungal) depending on each workplace, number of microorganism of in packaging room, shower room and juice extraction room was detected to be 10 CFU/Plate, 60 CFU/Plate, 20 CFU/Plate, respectively. As a result of testing palm condition of workers, as number of Standard plate count, Coliform group and Staphylococcus aureus was represented to be high as $6{\times}10^4CFU/cm^2$, $0CFU/cm^2$ and $0CFU/cm^2$, respectively, an education and training for individual sanitation control was considered to be required. As a result of inspecting surface pollution level of manufacturing facility and devices, Coliform group was not detected in all the specimen but Standard plate count was most dominantly detected in scouring kier, scouring kier tray, cooling tank, grinding extractor, storage tank and packaging machine-nozzle as $8.00{\times}10CFU/cm^2$, $3.0{\times}10CFU/cm^2$, $4.3{\times}10^2CFU/cm^2$, $7.5{\times}10^2CFU/cm^2$, $6.0{\times}10CFU/cm^2$, $8.5{\times}10^2CFU/cm^2$ respectively. As a result of analyzing above hazardous factors, processing process of ultraviolet ray sterilizing where pathogenic bacteria may be prevented, reduced or removed is required to be controlled by CCP-B (Biological) and critical level (critical control point) was set at flow speed is 4L/min. Therefore, it is considered that thorough HACCP control plan including control criteria (point) of seasoning fluid processing process, countermeasures in case of its deviation, its verification method, education/training and record control would be required.

Comparison of Success Rates after Silicone Tube Intubation with or without Lacrimal Endoscopy for Epiphora (눈물흘림 환자에서 눈물길미세내시경의 사용 여부에 따른 실리콘관삽입술의 성공률 비교)

  • Choi, Min Gyu;Lee, Jeong Kyu
    • Journal of The Korean Ophthalmological Society
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    • v.59 no.11
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    • pp.1001-1008
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    • 2018
  • Purpose: To compare the success rates between silicone tube intubation using a lacrimal endoscope and using a conventional nasal endoscope alone in adult patients suffering from epiphora. Methods: We conducted a retrospective chart review of 80 eyes of 55 patients who underwent silicone tube intubation from January 2014 to June 2017. Patients were preoperatively diagnosed with syringing and dacryocystography. The silicone tube was removed 3 months after surgery and success rates were evaluated at 4 and 12 months. Success rates were analyzed by dividing the patients into two groups, according to lacrimal endoscope use. Results: A lacrimal endoscope was used in 40 eyes. In the group using a lacrimal endoscope, preoperative diagnoses were partial obstruction in 26 eyes and complete obstruction in 14 eyes. In the group without lacrimal endoscope use, preoperative diagnoses were partial obstruction in 35 eyes and complete obstruction in 5 eyes (p = 0.018). The success rates at 4 and 12 months after surgery in the two groups (with and without lacrimal endoscope use) were 87.5% and 80.0% and 72.0% and 62.1% (p = 0.546 and p = 0.565), respectively. The success rates of patients with partial obstruction in the two groups were 92.3% and 82.9% at 4 months and 71.4% and 69.2% at 12 months (p = 0.448 and p = 1.000), respectively. The success rates of patients with complete obstruction in the two groups were 78.6% and 60.0% at 4 months and 72.7% and 33.3% at 12 months (p = 0.570 and p = 0.505), respectively. Site differences, the degree of obstruction, and lacrimal endoscope use had a significant impact on the success rate at 4 and 12 months (p = 0.001 and p = 0.022, respectively). Conclusions: Although silicone tube intubation using a lacrimal endoscope cannot guarantee a significant success rate, it is possible to observe the anatomical structure of the nasolacrimal pathway in real time, such that the appropriate diagnosis and treatment can be performed simultaneously. Because patients diagnosed as having a complete obstruction had a good success rate, we can extend indication of silicone tube intubation as a less invasive approach.

Predictors of Success of Selective Laser Trabeculoplasty Adjusted for Intraocular Pressure Variations (단안 선택적 레이저섬유주성형술에서 안압 변동을 보정한 성공예측인자의 분석)

  • Lee, Jun Seok;Lee, Chong Eun;Seo, Sam;Lee, Kyoo Won
    • Journal of The Korean Ophthalmological Society
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    • v.59 no.12
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    • pp.1166-1172
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    • 2018
  • Purpose: To investigate the efficacy, and identify predictors of success of selective laser trabeculoplasty (SLT) in open-angle glaucoma (OAG) patients after adjusting for intraocular pressure (IOP) changes in the untreated fellow eye. Methods: This retrospective chart review included 52 eyes of 52 OAG patients who underwent SLT in one eye and were followed-up for at least 1 year after the procedure. The IOP was measured before the treatment, at 1, 2, and 3 months posttreatment, and every 3 months thereafter. To account for the possible influence of IOP fluctuations on laser outcomes, post-laser IOP values of the treated eye of each patient were also analyzed, after adjusting for IOP changes in the untreated fellow eye. Success was defined as an IOP decrease ${\geq}20%$ of the pretreatment IOP. The success rate was determined based on Kaplan-Meier survival analysis and factors predictive of success were analyzed using the Cox proportional hazard model. Results: The mean pretreatment IOP was $23.17{\pm}6.96mmHg$. The mean IOP reduction was $5.59{\pm}4.78mmHg$ (29.7%) and the success rate was 65.4% at 1 year. The adjusted mean IOP reduction was $4.70{\pm}4.67mmHg$ (23.9%) and the adjusted success rate was 53.9%. Pretreatment IOP was associated with SLT success; the higher the pretreatment IOP, the greater the post-laser IOP reduction (p = 0.025). Age and mean deviation index did not show a significant association with SLT success (p = 0.066 and p = 0.464, respectively). Conclusions: SLT is a safe and effective alternative method of IOP reduction in OAG patients. Herein, pretreatment IOP was the only factor significantly associated with SLT success. IOP fluctuations of the untreated eye should be considered for a better understanding of the impact of treatment.

The Prognostic Factors Affecting the Occurrence of Subsequent Unprovoked Seizure in Patients Who Present with Febrile Seizure after 6 Years of Age (6세 이후 열경련 환자의 비열성발작으로 진행되는 위험 인자)

  • Lee, Hyeon Ju;Kim, Seung Hyo
    • Journal of the Korean Child Neurology Society
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    • v.26 no.4
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    • pp.215-220
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    • 2018
  • Purpose: Few reports have described the prognostic factors affecting the occurrence of subsequent unprovoked seizure in patients who present with febrile seizure (FS) after 6 years of age. We investigated the prognostic factors affecting the development of unprovoked seizures after FS among patients from Jeju Island. Methods: We included patients who developed FS after 6 years of age, who presented to our outpatient clinic between January, 2011 and June, 2017. Clinical data were obtained through chart reviews and phone call interviews. We used logistic regression analysis to analyze the risk factors associated with the occurrence of subsequent unprovoked seizure. Results: Of the 895 patients who presented to our hospital due to their febrile seizure, 83 developed FS after 6 years of age. Among them, 3 patients were prescribed antiepileptic drugs before the onset of the unprovoked seizure, and 4 patients developed an unprovoked seizure before 6 years of age. Thus, overall, 76 patients were included in the study. 51 patients developed first FS before 6 years of age. In the remaining patients, the first FS developed after 6 years of age. The mean observational period since the last outpatient follow-up visit was 3.2 years (median 3.04 years, range: 1.42-4.71 years). Among them, 21% developed an unprovoked seizure. Logistic regression analysis showed that electroencephalographic (EEG) abnormalities served as an independent risk factor for a subsequent unprovoked seizure. Conclusion: EEG is the proper diagnostic tool to predict the risk of a subsequent unprovoked seizure in patients with FS after 6 years of age.

Study(V) on Development of Charts and Equations Predicting Allowable Compressive Bearing Capacity for Prebored PHC Piles Socketed into Weathered Rock through Sandy Soil Layers - Analysis of Results and Data by Parametric Numerical Analysis - (사질토를 지나 풍화암에 소켓된 매입 PHC말뚝에서 지반의 허용압축지지력 산정도표 및 산정공식 개발에 관한 연속 연구(V) - 매개변수 수치해석 자료 분석 -)

  • Park, Mincheol;Kwon, Oh-Kyun;Kim, Chae Min;Yun, Do Kyun;Choi, Yongkyu
    • Journal of the Korean Geotechnical Society
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    • v.35 no.10
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    • pp.47-66
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    • 2019
  • A parametric numerical analysis according to diameter, length, and N values of soil was conducted for the PHC pile socketed into weathered rock through sandy soil layers. In the numerical analysis, the Mohr-Coulomb model was applied to PHC pile and soils, and the contacted phases among the pile-soil-cement paste were modeled as interfaces with a virtual thickness. The parametric numerical analyses for 10 kinds of pile diameters were executed to obtain the load-settlement relationship and the axial load distribution according to N-values. The load-settlement curves were obtained for each load such as total load, total skin friction, skin friction of the sandy soil layer, skin friction of the weathered rock layer and end bearing resistance of the weathered rock. As a result of analysis of various load levels from the load-settlement curves, the settlements corresponding to the inflection point of each curve were appeared as about 5~7% of each pile diameter and were estimated conservatively as 5% of each pile diameter. The load at the inflection point was defined as the mobilized bearing capacity ($Q_m$) and it was used in analyses of pile bearing capacity. And SRF was appeared above average 70%, irrespective of diameter, embedment length of pile and N value of sandy soil layer. Also, skin frictional resistance of sandy soil layers was evaluated above average 80% of total skin frictional resistance. These results can be used in calculating the bearing capacity of prebored PHC pile, and also be utilized in developing the bearing capacity prediction method and chart for the prebored PHC pile socketed into weathered rock through sandy soil layers.

Disappearance of Hysteria(Conversion Disorder) and the Evolutionary Brain Discord Reaction Theory (히스테리아(전환장애)의 소실과 진화적 뇌신경 부조화 반응 가설)

  • Song, Ji Young
    • Korean Journal of Psychosomatic Medicine
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    • v.24 no.1
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    • pp.28-42
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    • 2016
  • Objectives : The author tried to find out reasons why and how hysteria(and conversion disorder) patient numbers, which were so prevalent even a few decades ago, have decreased and the phenotype of symptoms have changed. Methods : The number of visiting patients diagnosed with conversion disorder and their phenotype of symptoms were investigated through chart reviews in a psychiatric department of a University hospital for the last 12 years. Additionally, the characteristics of conversion disorder patients visiting the emergency room for last 2 years were also reviewed. Those results were compared with previous research results even if it seemed to be an indirect comparisons. The research relied on Briquet P. and Charcot JM's established factors of the vicissitudes of hysteria(and conversion disorder) which has been the framework for more than one hundred and fifty years since hysteria has been investigated. Results : The author found decreased numbers and changes of the phenotype of the hysteria patients(and conversion disorder) over the last several decades. The decreased numbers and changes of the symptoms of those seemed to be partly due to several issues. These issues include the development of the diagnostic techniques to identify organic causes of hysteria, repeated changes to the symptom descriptions and diagnostic classification, changes of the brain nervous functions in response to negative emotions, and the influence of human evolution. Conclusions : The author proposed that the evolutionary brain discord reaction theory explains the causes of disappearance of and changes to symptoms of hysteria(conversion disorder). Most patients with hysteria(conversion disorder) have been diagnosed in the neurological department. For providing more appropriate treatment and minimizing physical disabilities to those patients, psychiatrists should have a major role in cooperating not only with primary care physicians but with neurologists. The term 'hysteria' which had been used long ago should be revived and used as a term to describe diseases such as somatic symptom disorder, functional neurological symptoms, somatization, and somatoform disorders, all of which represent almost the same vague concept as hysteria.

A Case Study of Strong Wind Event over Yeongdong Region on March 18-20, 2020 (2020년 3월 18일-20일 영동지역 강풍 사례 연구)

  • Ahn, Bo-Yeong;Kim, Yoo-Jun;Kim, Baek-Jo;Lee, Yong-Hee
    • Journal of the Korean earth science society
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    • v.42 no.5
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    • pp.479-495
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    • 2021
  • This study investigates the synoptic (patterns of southern highs, northern lows, and lows rapidly developed by tropopause folding), thermodynamic, and kinematic characteristics of a strong wind that occurred in the Yeongdong region of South Korea on March 18-20, 2020. To do so, we analyzed data from an automatic weather station (AWS), weather charts, the European Centre for Medium-range Weather Forecasts (ECMWF) reanalysis, rawinsonde, and windprofiler radars. The daily maximum instantaneous wind speed, exceeding 20 m s-1, was observed at five weather stations during the analysis period. The strongest instantaneous wind speed (27.7 m s-1) appeared in the Daegwallyeong area. According to the analysis of weather charts, along with the arrangement of the north-south low-pressure line, the isobars were moved to the Yeongdong area. It showed a sine wave shape, and a strong wind developed owing to the strong pressure gradient. On March 19, in the northern part of the Korean Peninsula, with a drop in atmospheric pressure of 19 hPa or more within one day, a continuous strong wind was developed by the synoptic structure of the developing polar low. In the adiabatic chart observed in Bukgangneung, the altitude of the inversion layer was located at an altitude of approximately 1-3 km above the mountaintop, along with the maximum wind speed. We confirmed that this is consistent with the results of the vertical wind field analysis of the rawinsonde and windprofiler data. In particular, based on the thermodynamic and kinematic vertical analyses, we suggest that strong winds due to the vertical gradient of potential temperature in the lower layer and the development of potential vorticity due to tropopause folding play a significant role in the occurrence of strong winds in the Yeongdong region.

Clinical Spectrum and Short-term Effects of Enzyme Replacement Therapy for Mucopolysaccharidosis Type II (제2형 뮤코다당증의 임상적 스펙트럼과 효소대치요법의 단기간 효과)

  • Cheon, Chong Kun;Hwu, Wuh-Liang
    • Journal of The Korean Society of Inherited Metabolic disease
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    • v.18 no.3
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    • pp.78-86
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    • 2018
  • Purpose: We aimed to delineate clinical spectrum and short-term effects after enzyme replacement therapy (ERT) for 5 mucopolysaccharidosis type II (MPS II). Methods: Five patients were diagnosed with MPS II by clinical findings, enzyme activity, and genetic testing. Idursulfase was administered by intravenous infusion at a dose of 0.5 mg/kg every week. Observational chart analysis of patients, who underwent systematic investigations more than 12 months after initiation of ERT was done retrospectively. Results: Three patients were classified as having the attenuated type, and 2 patients were classified as having the severe type. The median age at the diagnosis was 9.6 years (range 3.4-26 years). Four different mutations in 5 Korean patients (4 families) with MPS II were identified, among which two were novel mutations (1 small insertion mutation: p.Thr409Hisfs*22, and 1 missense mutation: p.Gly134Glu). Two severe type sibling patients with the same mutation had different clinical manifestation. Urinary glycosaminoglycan excretion decreased within the twelve months of ERT (P=0.043). Liver and spleen volumes showed reductions that were maintained in all patients (P=0.043 and P=0.043, respectively). Improvements were also noted in left ventricular mass index (P=0.042), shoulder flexion (P=0.043), shoulder abduction (P=0.039), knee flexion (P=0.043), elbow flexion (P=0.042), and respiratory distress index (P=0.041). Conclusion: This study demonstrates that Korean patients with MPS II are clinically heterogeneous and indicates that idursulfase is relatively effective in several clinical parameters including heart size and respiratory distress index without infusion-related reactions in patients with MPS II.

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