• 제목/요약/키워드: Clinical practice

검색결과 4,402건 처리시간 0.033초

강황 추출물의 비알코올성 지방간 질환 개선 효과 (Improvement Effect of Non-alcoholic Fatty Liver Disease by Curcuma longa L. Extract)

  • 이영섭;이대영;권동렬;강옥화
    • 한국약용작물학회지
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    • 제28권4호
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    • pp.276-286
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    • 2020
  • Background: Non-alcoholic fatty liver disease (NAFLD) is a chronic liver disease associated with multiple metabolic disorders. The medicinal plant Curcuma longa L. is widely distributed in Asia and has been used to treat a spectrum diseases in clinical practice. To date, there are inadequate reports of the effects of C. longa 50% EtOH extract (CE) on NAFLD. Therefore, in this study, we evaluate the CE on an NAFLD animal and elucidate the mechanism of action. Methods and Results: C57BL/6J mice fed a methionine-choline deficient diet (MCD) were treated with CE or milk thistle, and changes in inflammation and stetosis were assessed. Experimental animals were divided into six group (n = 10); Normal, MCD, MCD + CE 50 mg/kg/day (CE 50), MCD + CE 100 mg/kg/day (CE 100), MCD + CE 150 mg/kg/day (CE 150), and the Control, MCD + Milk thistle 150 mg/kg/day (MT 150). Body weight, liver weight, liver function, and histological changes were assessed in experimental animals. Quantitative real-time polymerase chain reaction and western blot analyses were performed on samples collected after 4 weeks of treatment. We observed that CE administration improved MCD-diet-induced lipid accumulation, and triglyceride (TG) and total cholesterol (TC) levels in serum. Treatment with CE also decreased hepatic lipogenesis through modulation of the sterol regulatory element binding protein-1 (SREBP-1), CCAAT-enhancer binding protein α (C/EBPα), fatty acid synthase (FAS), and peroxisome proliferator-activated receptor γ (PPARγ) expresion. In addition, the use of CE increased adenosine monophosphate-activated protein kinase (AMPK) phosphorylation and inhibited the up-regulation of toll-like receptor (TLR)-2 and TLR-4 signaling and the production of inflammatory mediators. Conclusions: In this report, we observed that CE regulated lipid accumulation in an MCD dietinduced NAFLD model by decreasing lipogenesis. These data suggeste that CE could effectively protect mice against MCD-induced NAFLD, by inhibiting the TLR-2 and TLR-4 signaling cascades.

The Protective Effects of IGF-1 on Different Subpopulations of DRG Neurons with Neurotoxicity Induced by gp120 and Dideoxycytidine In Vitro

  • Lu, Lin;Dong, Haixia;Liu, Guixiang;Yuan, Bin;Li, Yizhao;Liu, Huaxiang
    • Biomolecules & Therapeutics
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    • 제22권6호
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    • pp.532-539
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    • 2014
  • Peripheral neuropathy induced by human immunodeficiency virus (HIV) infection and antiretroviral therapy is not only difficult to distinguish in clinical practice, but also difficult to relieve the pain symptoms by analgesics because of the severity of the disease at the later stage. Hence, to explore the mechanisms of HIV-related neuropathy and find new therapeutic options are particularly important for relieving neuropathic pain symptoms of the patients. In the present study, primary cultured embryonic rat dorsal root ganglion (DRG) neurons were used to determine the neurotoxic effects of HIV-gp120 protein and/or antiretroviral drug dideoxycytidine (ddC) and the therapeutic actions of insulin-like growth factor-1 (IGF-1) on gp120- or ddC-induced neurotoxicity. DRG neurons were exposed to gp120 (500 pmol/L), ddC ($50{\mu}mol/L$), gp120 (500 pmol/L) plus ddC ($50{\mu}mol/L$), gp120 (500 pmol/L) plus IGF-1 (20 nmol/L), ddC ($50{\mu}mol/L$) plus IGF-1 (20 nmol/L), gp120 (500 pmol/L) plus ddC ($50{\mu}mol/L$) plus IGF-1 (20 nmol/L), respectively, for 72 hours. The results showed that gp120 and/or ddC caused neurotoxicity of primary cultured DRG neurons. Interestingly, the severity of neurotoxicity induced by gp120 and ddC was different in different subpopulation of DRG neurons. gp120 mainly affected large diameter DRG neurons (> $25{\mu}m$), whereas ddC mainly affected small diameter DRG neurons (${\leq}25{\mu}m$). IGF-1 could reverse the neurotoxicity induced by gp120 and/or ddC on small, but not large, DRG neurons. These data provide new insights in elucidating the pathogenesis of HIV infection- or antiretroviral therapy-related peripheral neuropathy and facilitating the development of novel treatment strategies.

성인 고지혈증 선별 검사의 비용-효과 분석 (Cost-Effectiveness Analysis of a Hyperlipidemia Mass Screening Program in Korea)

  • 차연순;강영호;이무송;강위창;전성훈;김기락;이상일
    • Journal of Preventive Medicine and Public Health
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    • 제35권2호
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    • pp.99-106
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    • 2002
  • Objective : Until now, there have been no evidence-based guidelines produced for the mass screening of hyperlipidemia cases in Korea. This study was done to find the most efficient strategy for a hyperlipidemia-screening program among Korean adults, Method : Seven alternative strategies for hyperlipidemia screening were formulated and compared ir terms of cost-effectiveness. Cost and effectiveness were estimated from social perspectives and using a two-stage screening process (initial testing and additional testing for positives from the first test). A computerized database (based on persons who had visited a health promotion center in one teaching hospital for a routine health check-up) was used to determine the cost and the outcome of various strategies. Official data was used in calculating direct and indirect costs. Effectiveness was measured according to the number of persons who needed clinical intervention for hyperlipidemia. A stratified analysis, considering age group and sex, was then done. Sensitivity analyses, focusing on several uncertain parameters, were also done. Results : Of the seven test alternatives available, the most cost-effective strategy was a screening program, which consisted of an initial test of total cholesterol, high-density lipoprotein cholesterol and triglyceride. There was some variation in the rank of the cost-effectiveness ratios for the seven alternatives dependent on age group or gender. Conclusions : Current hyperlipidemia screening practice, for National Health Insurance beneficiaries, tests only the total cholesterol level with a cut-off value of 260mg/dl as an initial screening test. It is not the best strategy for cost-effectiveness, and should be modified. Different screening strategies taking age group and sex into account should be developed and used for the efficient mass screening of hyperlipidemia cases among Korean adults.

간호대학생의 다문화 인식, 문화적 민감성이 문화 간 의사소통능력에 미치는 영향 (Influence of Multicultural Awareness and Cultural Sensitivity on Intercultural Communication Skills of the Korean Nursing Students)

  • 이은미;김선희
    • 한국산학기술학회논문지
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    • 제18권4호
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    • pp.459-468
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    • 2017
  • 본 연구는 간호대학생의 다문화 인식과 문화적 민감성이 문화 간 의사소통에 미치는 영향을 파악하고자 실시하였다. 대상자는 1개 광역시와 2개 지역도시에 소재한 3개 대학교의 간호학과에 재학 중이며, 임상실습을 1학기 이상 이수한 간호대학생 3, 4학년으로 총 353명이었다. 자료는 자가보고식 질문지로 수집하였으며, 자료 분석은 t-검정, 분산분석, Pearson의 상관계수 단순회귀분석과 다중회귀분석을 이용하여 분석하였다. 대상자의 문화 간 의사소통능력은 다문화 교육경험 유무, 외국인 친구 유무, 영어능력, 해외 체류경험 유무, 해외 체류기간에 따라 통계적으로 유의한 차이를 나타냈다. 또한 대상자의 문화간 의사소통능력은 다문화 인식과 문화적 민감성과 유의한 상관관계를 나타냈다. 다중회귀분석결과 대상자의 문화 간 의사소통능력에 영향을 미치는 요인은 다문화 인식, 다문화 교육경험, 영어능력이었고 설명력은 41.3%였다. 또한 단순회귀분석결과 해외 체류경험이 있는 대상자의 해외 체류기간의 설명력은 2.5%이었다. 따라서 간호대학생의 의사소통능력을 향상시키기 위해서는 다문화 인식을 증가시킬 수 있는 방안과 해외 체험을 고려한 다문화 교육과 언어능력의 증진방안을 개발하는 것이 필요하다.

Similarities and differences between alpha-tocopherol and gamma-tocopherol in amelioration of inflammation, oxidative stress and pre-fibrosis in hyperglycemia induced acute kidney inflammation

  • Shin, Hanna;Eo, Hyeyoon;Lim, Yunsook
    • Nutrition Research and Practice
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    • 제10권1호
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    • pp.33-41
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    • 2016
  • BACKGROUND/OBJECTIVES: Diabetes mellitus (DM) is a major chronic disease which increases global health problems. Diabetes-induced renal damage is associated with inflammation and fibrosis. Alpha (AT) and gamma-tocopherols (GT) have shown antioxidant and anti-inflammatory effects in inflammation-mediated injuries. The primary aim of this study was to investigate effects of AT and GT supplementations on hyperglycemia induced acute kidney inflammation in alloxan induced diabetic mice with different levels of fasting blood glucose (FBG). MATERIALS/METHODS: Diabetes was induced by injection of alloxan monohydrate (150 mg/kg, i.p) in ICR mice (5.5-week-old, male) and mice were subdivided according to their FBG levels and treated with different diets for 2 weeks; CON: non-diabetic mice, m-DMC: diabetic control mice with mild FBG levels (250 mg/dl ${\leq}$ FBG ${\leq}$ 450 mg/dl), m-AT: m-DM mice fed AT supplementation (35 mg/kg diet), m-GT: m-DM mice with GT supplementation (35 mg/kg diet), s-DMC: diabetic control mice with severe FBG levels (450 mg/dl < FBG), s-AT: s-DM mice with AT supplementation, s-GT: s-DM mice with GT supplementation. RESULTS: Both AT and GT supplementations showed similar beneficial effects on $NF{\kappa}B$ associated inflammatory response (phosphorylated inhibitory kappa B-${\alpha}$, interleukin-$1{\beta}$, C-reactive protein, monocyte chemotactic protein-1) and pre-fibrosis (tumor growth factor ${\beta}$-1 and protein kinase C-II) as well as an antioxidant emzyme, heme oxygenase-1 (HO-1) in diabetic mice. On the other hands, AT and GT showed different beneficial effects on kidney weight, FBG, and oxidative stress associated makers (malondialdehyde, glutathione peroxidase, and catalase) except HO-1. In particular, GT significantly preserved kidney weight in m-DM and improved FBG levels in s-DM and malondialdehyde and catalase in m- and s-DM, while AT significantly attenuated FBG levels in m-DM and improved glutathione peroxidase in m- and s-DM. CONCLUSIONS: the results suggest that AT and GT with similarities and differences would be considered as beneficial nutrients to modulate hyperglycemia induced acute renal inflammation. Further research with careful approach is needed to confirm beneficial effects of tocopherols in diabetes with different FBG levels for clinical applications.

Low consumption of fruits and dairy foods is associated with metabolic syndrome in Korean adults from outpatient clinics in and near Seoul

  • Song, SuJin;Kim, Eun-Kyung;Hong, Soyoung;Shin, Sangah;Song, YoonJu;Baik, Hyun Wook;Joung, Hyojee;Paik, Hee Young
    • Nutrition Research and Practice
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    • 제9권5호
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    • pp.554-562
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    • 2015
  • BACKGROUND/OBJECTIVES: The aim of this study was to examine differences in nutrient intake and food consumption by the presence of metabolic syndrome in Korean adults. SUBJECTS/METHODS: Study subjects in this cross-sectional study were recruited from four outpatient clinics in and near the Seoul metropolitan area of South Korea between 2006 and 2012. A total of 668 subjects (413 men and 255 women) aged ${\geq}30y$ were included in the final data analyses. For each subject, daily nutrient intake and food consumption were calculated using three days of dietary intake data obtained from a combination of 24-hour recalls and dietary records. To evaluate food consumption, mean number of servings consumed per day and percentages of recommended number of servings for six food groups were calculated. Metabolic syndrome was defined using the National Cholesterol Education Program Adult Treatment Panel III criteria. The general linear model was performed to examine differences in nutrient intake and food consumption by sex and the presence of metabolic syndrome after adjustment for potential confounding variables. RESULTS: Nutrient intake did not differ by the presence of metabolic syndrome in both men and women. Men with metabolic syndrome had lower consumption and percentage of the recommendation for fruits compared with those without metabolic syndrome (1.6 vs. 1.1 servings/day, P-value = 0.001; 63.5 vs. 49.5%, P-value = 0.013). Women with metabolic syndrome showed lower consumption and percentage of the recommendation for dairy foods than those without metabolic syndrome (0.8 vs. 0.5 servings/day, P-value = 0.001; 78.6 vs. 48.9%, P-value = 0.001). CONCLUSIONS: Low intakes of fruits and dairy foods might be associated with the risk of having metabolic syndrome among Korean adults. Dietary advice on increasing consumption of these foods is needed to prevent and attenuate the risk of metabolic syndrome.

The Incidence and Characteristics of Patients with Small Ruptured Aneurysms (<5 mm) in Subarachnoid Hemorrhage

  • Choi, Joon-Ho;Park, Hyun-Seok
    • Journal of Korean Neurosurgical Society
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    • 제60권4호
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    • pp.424-432
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    • 2017
  • Objective : Small unruptured aneurysms (<5 mm) are known for their very low risk of rupture, and are recommended to be treated conservatively. However, we encounter many patients with small ruptured aneurysms in the clinical practice. We aimed to investigate the incidence and characteristics of patients with small ruptured aneurysms. Methods : We reviewed all patients admitted to our hospital with subarachnoid hemorrhage from January 2005 to December 2015. The patients were divided into two groups : those with aneurysms <5 mm (group S) and those with aneurysms ${\geq}5mm$ (group L). The patient's age and sex, size and location of aneurysms, and risk factors such as hypertension, diabetes, alcohol use, and smoking were compared between the two groups. Results : Eight-hundred eleven patients were diagnosed with ruptured aneurysms, and 337 (41.6%) were included in group S. The mean size of all aneurysms was $6.10{\pm}2.99mm$ (range, 0.7-37.7); aneurysms with a diameter of 4-5 mm accounted for the largest subgroup of all aneurysms. Female sex was significantly associated with the incidence of small ruptured aneurysms (odds ratio [OR] 1.50, 95% confidence intervals [CI] 1.02-2.19, p=0.037). Despite female predominance in the incidence of small ruptured aneurysms, the proportion of small ruptured aneurysms in young (<50 years) men was high. In men, there were no significant differences regarding the location of the aneurysms between group S and group L (p=0.267), with the most frequent location being the anterior communicating artery (ACoA) in both group S (50.9%) and group L (51.4%). However, in women, there were significant differences regarding the location of the aneurysms between group S and group L (p=0.023), with the most frequent locations being the ACoA (33.0%) in group S, and the posterior communicating artery (30.6%) in group L. In women, two locations were significantly associated with small (<5 mm) ruptured aneurysms: the ACoA (OR 2.14, 95% CI 1.01-4.54, p=0.047) and anterior cerebral artery (OR 3.54, 95% CI 1.19-10.54, p=0.023). Multiplicity and smoking were significantly associated with large (${\geq}5mm$) ruptured aneurysms in women. The use of alcohol was related to small ruptured aneurysms in men over 50 years of age (OR 2.23, 95% CI 1.03-4.84, p=0.042). Conclusion : In this study, small (<5 mm) ruptured aneurysms exhibited different incidences by age, sex, location, and risk factors such as multiplicity, smoking, and alcohol use.

The association of PBX1 polymorphisms with overweight/obesity and metabolic alterations in the Korean population

  • Ban, Ju-Yeon;Kang, Soon-Ah;Jung, Kyung-Hee;Kim, Hak-Jae;Uhm, Yoon-Kyung;Kim, Su-Kang;Yim, Sung-Vin;Choe, Bong-Keun;Hong, Seung-Jae;Seong, Yeon-Hee;Koh, In-Song;Chung, Joo-Ho
    • Nutrition Research and Practice
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    • 제2권4호
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    • pp.289-294
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    • 2008
  • Pre-B-cell leukemia transcription factor 1 (PBX1), which is located on chromosome 1q23, was recently reported to be associated with type 2 diabetes mellitus. We examined whether single nucleotide polymorphisms (SNPs) of the PBX1 gene are associated with overweight/obesity in a Korean population. We genotyped 66 SNPs in the PBX1 gene and investigated their association with clinical phenotypes found in 214 overweight/obese subjects and 160 control subjects using the Affymetrix Targeted Genotyping chip array. Seven SNPs (g.+75l86C>T, g.+78350C>A, g.+80646C>T, g.+138004C>T, g.+185219G>A, g.+191272A>C, and g.+265317T>A) were associated with the risk of obesity in three models (codominant, dominant, and recessive) (P=0.007-0.05). Haplotype 1 (CAC) and 3 (TAC) of block 3 and haplotype 2 (GGAAT) of block 10 were also strongly associated with the risk of obesity. In the control group, subjects that had homozygote for the major allele for both g.+185219G>A and g.+191272A>C showed lower high density lipoprotein-cholesterol (HDL-C) level compared to those possessing the minor allele, suggesting that the association between the homozygote for the major allele for both g.+185219G>A and g.+191272A>C and HDL-C is attributable to the increased risk of obesity. This study suggests that the PBX1 gene is a possible risk factor in overweight/obese patients.

작업치료사를 위한 운동성 평가도구의 교육효과 (The Effect of Education on Motor Skill Assessment Tool for Occupational Therapists)

  • 최정실;김민주
    • 대한지역사회작업치료학회지
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    • 제10권2호
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    • pp.63-72
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    • 2020
  • 목적 : 본 연구는 운동발달을 평가하고, 발달성협응장애를 판별할 수 있는 운동성 평가도구인 Movement Assessment Battery for Children-2(MABC-2)을 활용하기 위해 6시간의 교육과정을 통하여 작업치료사의 평가역량이 향상될 수 있는지를 규명하고자 하였다. 연구방법 : 본 연구에 MABC-2를 임상에서 사용하길 희망하는 작업치료사 33인이 참여하였다. MABC-2 전문가 2인이 교육 참여자들에게 6시간의 교육을 실시하였다. 이론 강의(2시간)는 MABC-2 소개와 운동평가도구의 연구동향, 실습강의(4시간)는 MABC-2 평가항목 소개, 녹화된 평가 장면 관찰, 도구를 사용하여 직접 평가실습을 경험한 후 준비된 사례영상을 보고 채점과 결과분석을 실시하였다. 교육의 효과를 검증하기 위해 모든 교육과정을 마친 후 MABC-2의 전문가 1인과 교육에 참여한 작업치료사 33명이 동시에 평가동영상 샘플을 보면서 평가지에 원점수를 기록하였다. 이중 운동성 평가도구의 경험이 없는 23인의 자료를 활용해 평가자간 신뢰도를 산출하여 교육의 효과성을 검증하였다. 결과 : 본 연구에 참여한 작업치료사는 평균 5년 3개월의 경력을 지닌 30세 이상의 여성으로 약 70%의 교육생은 MABC-2 외에 국내에서 사용 중인 운동성 평가도구를 임상에 적용해 본 경험이 없었다. MABC-2 전문가가 제공한 교육을 받은 작업치료사들과 전문가 간의 ICC 결과는 .95이상으로 높은 평가자간 신뢰도가 확보되었다(p<.001). 결론 : 이론과 실습으로 구성된 6시간의 교육과정에 참여한 작업치료사의 평가자간 신뢰도가 .95이상으로 나타났으며, 운동기술 평가도구를 적절하게 활용할 수 있는 평가역량이 향상되었다. 이를 통하여 MABC-2에 관한 특정한 교육을 제공할 경우 작업치료사가 새로운 평가도구를 적절하게 활용할 수 있으며, 이를 통해 평가와 관련한 직무능력을 향상시킬 수 있을 것으로 판단된다.

Maternal and fetal outcomes of pregnancies in kidney donors: A 30-year comparative analysis of matched non-donors in a single center

  • Yoo, Kyung Don;Lee, Hajeong;Kim, Yaerim;Park, Sehoon;Park, Joong Shin;Hong, Joon Seok;Jeong, Chang Wook;Kim, Hyeon Hoe;Lee, Jung Pyo;Kim, Dong Ki;Oh, Kook-Hwan;Joo, Kwon Wook;Kim, Yon Su
    • Kidney Research and Clinical Practice
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    • 제37권4호
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    • pp.356-365
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    • 2018
  • Background: Woman kidney donors face obstetric complication risks after kidney donation, such as gestational hypertension and preeclampsia. Studies on childbirth-related complications among Asian women donors are scarce. Methods: This retrospective cohort study included woman donors aged 45 years or younger at the time of kidney donation in a single tertiary hospital between 1985 and 2014. Pregnancy associated complications were investigated using medical records and telephone questionnaires for 426 pregnancies among 225 donors. Matched non-donor controls were selected by propensity score and the maternal and fetal outcomes were compared with those of donors. Primary outcomes were differences in maternal complications, and secondary outcomes were fetal outcomes in pregnancies of the donor and control groups. Results: A total of 56 cases had post-donation pregnancies. The post-donation pregnancies group was younger at the time of donation and older at the time of delivery than the pre-donation pregnancies group, and there were no differences in primary outcomes between the groups except the proportion receiving cesarean section. Comparison of the complication risk between post-donation pregnancies and non-donor matched controls showed no significant differences in gestational hypertension, preeclampsia, or composite outcomes after propensity score matching including age at delivery, era at pregnancy, systolic blood pressure, body weight, and estimated glomerular filtration ratio (odds ratio, 0.63; 95% confidence interval, 0.19-2.14; P = 0.724). Conclusion: This study revealed that maternal and fetal outcomes between woman kidney donors and non-donor matched controls were comparable. Studies with general population pregnancy controls are warranted to compare pregnancy outcomes for donors.