• Title/Summary/Keyword: Clinical studies

Search Result 8,480, Processing Time 0.036 seconds

Chronic Hereditary Tyrosinemia Type I with Novel Mutation in FAH Gene (FAH gene novel mutation을 가진 만성형 Hereditary tyrosinemia 1형)

  • Yang, Sungmin;Choi, Hyo Won;Kang, Yun Koo;Lee, Jin-Sung;Namgoong, Mee Kyung
    • Journal of The Korean Society of Inherited Metabolic disease
    • /
    • v.20 no.2
    • /
    • pp.55-62
    • /
    • 2020
  • A 22-month-old girl who had taken iron supplements due to iron deficiency anemia, presented bloody mucoid stool for one month. She had a bruise at the right periorbital area due to minor trauma and hepatosplenomegaly. Laboratory studies showed anemia, thrombocytopenia, elevated alkaline phosphatase (ALP), hypophosphatemia, decreased haptoglobin, hypocomplementemia, negative direct/indirect Coomb's test, normal vitamin D3 level and high PTHi. Wrist x-ray showed no signs of rickets. The abdominal ultrasound showed only accessory spleen. Tandem mass spectrometry was normal. During follow up, bloody stool regressed after seven days of withdrawal of iron supplement and cow milk, and the total CO2 level had been within 15-20 mEq/L with normal anion gap. NGS (next generation sequencing) panel test for evaluation of renal tubular acidosis showed negative results. After low dose steroid and vitamin D supplements under the impression of hypocomplementemic vasculitis, thrombocytopenia, C3/C4, decreased haptoglobin, and elevated ALP level became normal. At 57 months of age, laboratory findings showed elevated liver enzyme, ALP and gamma-glutamyl transferase again. And liver cirrhosis with splenomegaly and diffuse renal disease were reported with abdomen CT scan. Liver biopsy reported macro- and micronodular cirrhosis. Urine organic acid profile showed elevated succinylacetone level. Whole exome sequencing revealed novel compound heterozygous mutations (NM_00137.2:c.107T>C, NM_00137, 2:c.614T>C) in FAH gene and confirmed by Sanger sequencing. Consequently, the patient was diagnosed as chronic hereditary tyrosinemia type I. She started low phenylalanine/tyrosine diet and nitisinone treatment. Our case had presented symptoms very slowly, which is the first case of chronic tyrosinemia type I in South Korea.

Continuous Control of Acetaminophen Poisoning after Implementation of Regulation for Ease Access of Acetaminophen: Cohort Study from Emergency Department Based in-depth Injury Surveillance (아세트아미노펜 사용 편의성 증가 후 중독발생 위험의 지속적 관리 필요성)

  • Jo, Seung Jik;Gang, Hyun Young;Lee, Si Jin;Bae, Gyu Hyun;Lee, Eui Jung;Han, Kap Su;Kim, Su Jin;Lee, Sung Woo
    • Journal of The Korean Society of Clinical Toxicology
    • /
    • v.18 no.2
    • /
    • pp.57-65
    • /
    • 2020
  • Purpose: Since 2012, acetaminophen can be accessed easily not only at pharmacies but also at convenience stores. The relationship between the easy access of acetaminophen and the risk of poisoning has been controversial. Several studies also reported different results regarding the risk of acetaminophen poisoning after access to acetaminophen was relaxed. This study examined the long-term effects on the risk of acetaminophen poisoning after easy access to acetaminophen was implemented. Methods: This was a retrospective analysis of an emergency department (ED)-based in-depth Injury Surveillance Cohort by the Korea Center for Disease Control and prevention from 2011 to 2018. Poisoning cases were selected from the Cohort, and the incidence of acetaminophen poisoning and the characteristics of the cases of acetaminophen poisoning were analyzed. The purchase path and the amount of ingestion in acetaminophen poisoning were sub-analyzed from data of six EDs. Results: Of 57,326 poisoning cases, 4.0% (2,272 cases) were acetaminophen poisoning. Of 2,272 cases of acetaminophen poisoning, 42.8% (974 cases) required in-patient care after ED management. Two hundred and sixty-four of these 964 cases required intensive care. The rates of cases that required in-patient treatment and the rates of cases that required intensive care increased from 29.4% in 2011 to 48.1% in 2018, and from 3.1% in 2011 to 15.2% in 2018, respectively (p<0.001, p<0.001). In the poisoning group with in-depth toxic surveillance (n=15,908), the incidence and proportion of acetaminophen (AAP) poisoning increased from 55 cases per year to 187 cases per year and 4.9% to 6.1%, respectively (p=0.009, p<0.001, respectively). The most common age group of acetaminophen poisoning was teenagers, which is different from the most common age group of other pharmaceutical agents: the middle age group of 40-49 years (p<0.001). Of 15,908 in-depth toxic surveillance patients, 693 patients had AAP poisoning, of whom 377 cases (54.2%) purchased acetaminophen from a non-pharmacy. The proportions of the purchase path from non-pharmacy were 41.4% at 2011-12 and 56.4% (2013-18) (p=0.004). The amount of acetaminophen ingestion was 13.5±14.3 g at 2011-12 and 13.9±15.1 g at 2013-18 (p=0.794). Conclusion: Although the incidence of acetaminophen poisoning did not increase remarkably in the short term after the implementation of the new regulation, the incidence of acetaminophen poisoning has increased slightly during the study period of 2017-18. In addition, the proportion of the purchase path from non-pharmacies has increased since the emergence of new regulations for the easy access of acetaminophen in 2012. The incidence of acetaminophen poisoning might have been affected after the increasing accessibility of acetaminophen in convenience stores. Continuous control of acetaminophen poisoning is required. Furthermore, the prevention of acetaminophen poisoning should be focused on teenagers with specialized school education programs.

Bioactive compounds in food for age-associated cognitive decline: A systematic review (인지기능 개선을 위한 식품유래 생리활성소재에 대한 체계적 문헌고찰)

  • Kang, Eun Young;Cui, Fengjiao;Kim, Hyun Kyung;Go, Gwang-woong
    • Korean Journal of Food Science and Technology
    • /
    • v.53 no.3
    • /
    • pp.278-289
    • /
    • 2021
  • The rapid aging of society has led to a surge in cognitive dysfunction in the elderly. As there is limited evidence for the development of dementia in medicine, a shift in focus on prevention strategies using bioactive compounds in food is required. This systematic review evaluated the effects of various bioactive compounds on age-associated cognitive decline. The literature was searched for terms related to bioactive compounds in cognitive decline and article selection was limited to clinical randomized controlled trials for a single bioactive compound. We identified 21 studies that evaluated the strength of the evidence. ω-3 fatty acids and vitamin B presented a strong evidence level, whereas vitamin D and E, anserine/carnosine, and chromium were defined as having moderate levels of evidence. ω-3 fatty acids relieved cognitive decline and reduced amyloid β-related protein accumulation. Vitamin B decreased homocysteine levels, which is accompanied by alleviation of cognitive function. In conclusion, ω-3 and vitamin B have the potential to improve age-associated cognitive decline.

A Study of Test-Retest Reliability and Interrater Reliability of the Sensory Processing Scale for Children (SPS-C) (아동감각처리척도(Sensory Processing Scale for Children; SPS-C)의 검사-재검사 신뢰도와 검사자간 신뢰도 연구)

  • Kim, Kyeong-Mi;Kim, Ga-Yeon;Lee, Seung-Jin
    • The Journal of Korean Academy of Sensory Integration
    • /
    • v.20 no.2
    • /
    • pp.11-21
    • /
    • 2022
  • Objective : This study examined the test-retest reliability and interrater reliability of the Sensory Processing Scale for Children (SPS-C). Method : Senventy primary caregivers of children with sensory processing difficulties and 3 years old participated in the study. The subjects were recruited through child development centers, welfare centers, and acquaintances located in Seoul, Gyeonggi-do, Busan, and Gyeongsang-do. The test-retest reliability verification targeted 20 main caregivers of children with difficulty in sensory processing. Re-evaluation was performed within 7 to 14 days after the initial evaluation, and Pearson's correlation coefficient was used to confirm the relevance between the two time points, and the Intraclass correlation coefficient was used to confirm the degree of agreement. The interrater reliability verification was conducted with 18 primary caregivers and 18 subsidiary caregivers of children with sensory processing difficulties. Each caregiver evaluated the same child, and the Intraclass correlation coefficient was used to confirm the agreement between the two sets of caregivers. Results : The test-retest reliability was Pearson's correlation coefficient r=.914 and intraclass correlation coefficient ICC=.939, indicating a high level of relevance and agreement. The interrater reliability was an Intraclass correlation coefficient ICC=.727, which showed a moderate level of agreement, but the tactile area (ICC=.455) and proprioceptive area (ICC=.439) were not statistically significant and showed a low degree of agreement. Conclusion : Through this study, it was confirmed that the children's Sensory Processing Scale for Children (SPS-C) is a stable evaluation tool with test-retest reliability and interrater reliability verified, and it will be able to provide help in standardization studies for future clinical use.

Anti-obesogenic Effect of Brassica juncea Extract on Bisphenol-A Induced Adipogenesis of 3T3-L1 Cells (비스페놀 A (Bisphenol-A)로 유도된 지방세포 분화에 미치는 갓 추출물의 항오비소겐 효과)

  • Lee, Se-jeong;Na, Uoon-Joo;Choi, Sun-Il;Han, Xionggao;Men, Xiao;Lee, Youn Hwan;Kim, Hyun Duk;Kim, Yoon Jung;Lee, Ok-Hwan
    • Journal of Food Hygiene and Safety
    • /
    • v.36 no.6
    • /
    • pp.528-536
    • /
    • 2021
  • The purpose of the study was to investigate the content of sinigrin, an index component, in Brassica juncea extract and to evaluate the differentiation of lipocytes, inhibition of production of reactive oxygen species (ROS) and reduction of protein production by lipogenic factors (PPARγ, C/EBPα, aP2) in the processing of Brassica juncea extract and sinigrin in 3T3-L1 preadipocytes which induces Bisphenol A (BPA), an endocrine disrupting environmental hormone. From the investigation, the content of sinigrin in Brassica juncea extract, measured by HPLC, is found to be 21.27±0.2 mg/g. The XTT assay result on BPA-derived 3T3-L1 adipocytes shows there is no cytotoxicity found from 180 µM of sinigrin and 300 ㎍/mL of Brassica juncea extract. Moreover, both intracellular lipid accumulation and ROS production during differentiation of lipocyte are significantly reduced in cells processed with Brassica juncea extract and sinigrin. Lastly, it was also found that the production of transcription factors of lipocyte differentiation, PPARγ, C/EBPα and aP2, were found to be suppressed by the application of Brassica juncea extract and sinigrin. Such results reveals that Brassica juncea is effective in not only suppressing lipid accumulation in the environmental hormone bisphenol A-derived lipocyte, but also in reducing the ROS. The sinigrin-containing Brassica juncea is highly expected to be used in natural functional supplements that prevents the lipid metabolism disorders caused by BPA. There are necessities for additional clinical research and follow-up studies on the in vivo model to verify the relevant mechanisms.

Atorvastatin and Fluvastatin Can Reduce IL-1β-induced Inflammatory Responses in Human Keratinocytes (Atorvastatin 그리고 fluvastatin 약물의 IL-1β-유도 염증반응 억제 효과)

  • Choe, Yeong-In;Moon, Kyoung Mi;Yoo, Jae Cheal;Byun, June-Ho;Hwang, Sun-Chul;Moon, Dong Kyu;Woo, Dong Kyun
    • Journal of Life Science
    • /
    • v.31 no.4
    • /
    • pp.418-424
    • /
    • 2021
  • Skin inflammation (dermatitis) is caused by varying skin damage due to ultraviolet radiation and microbial infection. Currently prescribed drugs for dermatitis include anti-histamine and steroid drug classes that soothe inflammation. However, incorrect or prolonged use of steroids can cause weakening of skin barriers as well as osteoporosis. Therefore, treating dermatitis with a drug that has minimal side effects is important. Statins, also known as 3-hydroxy-3-methylglutaryl-coenzyme A reductase inhibitors, are cholesterol-lowering drugs that have been widely treated for hyperlipidemia and cardiovascular diseases. Interestingly, recent studies have shown the anti-inflammatory effects of statins in both experimental and clinical models for of osteoarthritis. This study investigated the possible anti-inflammatory effects of atorvastatin and fluvastatin in human keratinocytes (HaCaT cells), which are crucial components of skin barriers. Stimulation of HaCaT cells with IL-1β increased the expression of the COX2 protein, a major player of inflammatory responses. However, this induction of the COX2 protein was downregulated by pretreatments with atorvastatin and fluvastatin. Treatment with IL-1ß-induced the upregulation of other inflammatory genes (such as iNOS and MMP-1) and these expressions were similarly lowered by these two statin drug treatments. Taken together, these results indicated that atorvastatin and fluvastatin can reduce IL-1β-induced inflammatory responses in HaCaT cells. In conclusion, the findings suggest that atorvastatin and fluvastatin can be potential modulators for ameliorating skin inflammation.

Comparison of health indicators and lifestyle according to atherogenic index of plasma in Korean adults in their 20s and 30s (한국 20-30대 성인의 Atherogenic Index of Plasma에 따른 건강지표 및 생활습관비교)

  • Bora Hwang;Yoon Jung Yang
    • Journal of Nutrition and Health
    • /
    • v.56 no.2
    • /
    • pp.168-183
    • /
    • 2023
  • Purpose: Cardiovascular disease is one of the major causes of death not only in Korea but also worldwide. Atherogenic index of plasma (AIP) has been extensively investigated, but studies on nutritional intake and eating habits are scarce. The purpose of this study was to analyze the general characteristics, dietary habits, and nutritional status of Korean adults based on their AIP values using data from the 2013-2015 Korea National Health and Nutrition Examination Survey. Methods: A total number of 3,040 adults in their 20s and 30s were included as study subjects. They were divided into quintiles according to their AIP values. Comparisons were then made among the general information, eating habits, and nutritional intake statuses of the groups. Results: The averages of AIP were different by age, obese status, education, occupation, alcohol drinking frequency, smoking, and exercise in men. As for women, the averages of AIP were different by age, obese status, education, occupation, alcohol drinking frequency, and smoking status. Except for high-density lipoprotein (HDL)-cholesterol, higher AIP values in men were associated with significant increasing trends in health indicators, including systolic and diastolic blood pressure, fasting blood glucose, insulin, hemoglobin A1c, total cholesterol, triglyceride, and low-density lipoprotein (LDL)-cholesterol. As for women, as AIP increased, systolic and diastolic blood pressure, fasting blood glucose, insulin, total cholesterol, triglyceride, and LDL-cholesterol showed significant increasing trends except HDL-cholesterol. HDL-cholesterol showed a significant decreasing trend as AIP increased in men and women. In the high AIP group of women, the frequency of breakfast was lower, whereas the frequency of alcohol beverage consumption was higher. Conclusion: Among young adults, the risk of arteriosclerosis was higher in obese, smoking, and non-exercise individuals. More frequent alcohol drink consumption in women is associated with a higher risk of arteriosclerosis. Therefore, weight and lifestyle management are necessary for the prevention of atherosclerosis among young adults.

Current Status and Actual Conditions of the Use of Occupational Therapy Evaluation Tools in Relation to the Type of Therapy Institution (국내 아동작업치료 기관별 평가도구 사용 현황 및 실태에 관한 연구)

  • Gil, Young-Suk;Yoo, Doo-Han
    • The Journal of Korean Academy of Sensory Integration
    • /
    • v.21 no.1
    • /
    • pp.47-58
    • /
    • 2023
  • Objective : This study aimed to investigate the current status and actual use of assessment tools by institutions in the field of occupational therapy with children in Korea. Methods : The study was conducted with 67 occupational therapists working with children in Korea. To investigate the use of evaluation tools by area, knowledge of the evaluation tools, and desire to participate in further education, the questionnaires used in studies by Lee, Hong, and Park (2018) and Kim (2015) were modified and supplemented according to the child evaluation tools currently in usein institutions in Korea. For data collection, we distributed Google questionnaires to child occupational therapists for 3 weeks using convenience sampling. Excel was used to analyze the use of the evaluation tools according to institution. Technical statistics and frequency analyses were used to verify the general characteristics, evaluation-related information, status of evaluation tool use, knowledge levels relating to evaluation tools, and desire to participate in education. A t-test was used for the evaluation tool status. Results : Welfare centers used the most evaluation tools, with an average of 11.1, followed by university hospitals, rehabilitation hospitals, clinics, and daycare centers. There were differences in the choice of tools used, hospital with the Jebsen-Taylor hand function test and the Wee-FIM (Functional Independence Measure) being the most frequently applied. Centers, daycare centers, and welfare center the Sensory Profile test and clinical observation were also used often. Regarding the level of knowledge of evaluation tools and the desire to participate further in education, 30 (44.8%) of the respondents had not completed their education, and 42 (62.7%) rated their knowledge level as generally low. When asked about the importance of using a manual to guide them in their use of evaluation tools, 66 (98.6%) answered positively, and 66 (98.6%) answered that they needed specialized training in the use of evaluation tools. Conclusion : This study makes it possible to understand the use and status of evaluation tools as used by different institutions in Korea in the field of child occupational therapy It is anticipated that it will provide the basis for introducing existing evaluation tools and preparing new evaluation tools to be used in this field in Korea.

Current Status of Informed Consent Form for Acupotomy in Korean Medicine Hospitals and Development of a Standard Informed Consent Form Using Delphi Method (한방병원의 침도 시술 동의서의 현황 조사와 델파이 기법을 활용한 표준 시술 동의서 개발)

  • Jihun Kim;Bonhyuk Goo;Hyongjun Kim;Kyoungsuk Seo;Myungjin Oh;Myungseok Ryu;Sang-Hoon Yoon;Kwang Ho Lee;Hyun-Jong Lee;Jungtae Leem;Hyungsun Jun;Jeong Ihn Sook;Sung Woon Choi;Tae Wook Lee;Yeonhak Kim;Yoona Oh;Kunhyung Kim;Gi Young Yang;Eunseok Kim
    • The Journal of Korean Medicine
    • /
    • v.45 no.1
    • /
    • pp.182-201
    • /
    • 2024
  • Objectives: This study was conducted to develop a standard acupotomy consent form that takes into account the unique characteristics of Korean Medicine. The study was motivated by the increasing importance of patient autonomy and the growing number of legal disputes related to medical malpractice in the clinical field of Korean Medicine. Methods: The analysis phase of the study involved a survey of the current status of acupotomy consent forms in Korean Medicine hospitals nationwide. The items of each form were analyzed based on the contents of the Medical law and the standard contract for medical procedures of the Fair Trade Commission (FTC). In the development and evaluation phase, the items and contents of the acupotomy consent form were evaluated using a 5-point Likert scale and content validity was assessed through two rounds of Delphi surveys. In the improvement phase, the contents of the consent form were revised based on the results of a survey of inpatient and outpatient patients in the Department of Acupuncture and Moxibustion at Pusan National University Korean Medicine Hospital, and real-time online meeting. The final version of the standard acupotomy consent form was completed after undergoing proofreading and corrections by a linguistics expert. Results: Only 30% of Korean Medicine hospitals have implemented acupotomy consent forms. The items of the consent forms did not fully include the items presented in the Medical act and the standard contract for medical procedures of the FTC. To address this issue, two rounds of Delphi surveys and a real-time discussion were conducted with a panel of 12 experts on 27 preliminary items of consent forms. The items and contents that met the criteria for content validity ratio, convergence, and consensus were derived. Based on the derived items and content, a standard acupotomy consent form was developed. Conclusions: The standard consent form for acupotomy is anticipated to ensure patient autonomy and enhance transparency and liability in acupotomy. Furthermore, it is expected to serve as evidence in case of medical disputes related to acupotomy and contribute as a reference document for the development of standard consents forms for various procedures of Korean Medicine. However, the limitations of the study include that the survey of consent forms was limited to only training hospitals of Korean Medicine, and the standard consent form is only applicable to adults in Korea. Future studies are needed to address these limitations.

Development of a Tool to Measure Knowledge of Clinical Dental Hygienists on Precautions for Dental Treatment of Dementia Patients (임상 치과위생사의 치매 환자 치과 진료 시 주의 사항에 관한 지식측정 도구 개발)

  • Nahyun Kim;So-Jung Mun;Hie-Jin Noh;Sun-Young Han
    • Journal of Korean Dental Hygiene Science
    • /
    • v.6 no.2
    • /
    • pp.79-89
    • /
    • 2023
  • Background and Objectives: The prevalence of dementia is steadily increasing each year, and preceding studies continue to explore the association between dementia and oral health. Dental hygienists require specialized competencies to provide appropriate dental healthcare services, necessitating the development of a tool for the objective measurement of their knowledge levels. This study aimed to develop a knowledge assessment tool for dental hygienists concerning considerations for dental care for patients with dementia. Methods: The study constructed preliminary items based on a literature review and then conducted expert validation, a pilot survey, and the main survey. The main survey was conducted among 220 dental hygienists. Validity and reliability analyses were conducted with the collected data to select the final items, and the correctness rates for each selected item were verified. Results: As a result of the analysis of the collected data, 18 items were eliminated out of a total of 40 preliminary items, leaving a total of 6 factors and 22 items. The Cronbach's α value for the selected items was 0.791. The six factors are as follows: 'Considerations during dental treatment for dementia patients' (5 items), 'medication side effects in dementia patients' (4 items), 'oral care methods for dementia patients' (4 items), 'communication with dementia patients' (4 items), 'psychological reactions of dementia patients' (3 items), and 'guidance for dementia patients' (2 items). The item with the highest correctness rate was item 2 of the 'guidance for dementia patients' category at 98.6%, while the item with the lowest correctness rate was item 2 of the 'psychological reactions of dementia patients' category at 5.9%. Conclusion: This study validated the reliability and validity of the knowledge assessment tool, which lays the foundation for future research on dental hygienists and dementia. It contributes essential data for ongoing education, development of educational programs, and establishing operational guidelines in healthcare institutions.