• 제목/요약/키워드: Frailty effect

검색결과 39건 처리시간 0.021초

정보적군집 크기를 가진 군집화된 구간 중도절단자료 분석을 위한결합모형의 적용 (Statistical Analysis of Clustered Interval-Censored Data with Informative Cluster Size)

  • 김양진;유한나
    • Communications for Statistical Applications and Methods
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    • 제17권5호
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    • pp.689-696
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    • 2010
  • 구간중도 절단자료는 감염 자료, 종양 발생 자료등 그 발생 시간을 정확하게 관측할 수 없는 경우에 흔히 발생되는 자료로 정확한 사건 발생 시간대신에 발생 전 마지막 관측시점과 발생 후 첫 번째 관측시점으로 구성된다. 이러한 종류의 자료는 Sun (2006)에 의해 자세하게 논의되었으며 관측 개체간의 독립성 가정 하에서 여러 가지 방법들에 의해 분석되어져 왔다. 본 논문에서는 관측 개체들이 군집으로부터 발생하여 더 이상독립성 가정이 적절하지 못한 경우를 고려한다. 특히 반응변수인 사건 발생 시간이 군집의 크기와 연관되어 있을 때, 이를 고려하기 위한 결합 모형을 제시한다. 제안된 모형은 림프계 필라리아병의 실제 자료에 적용한다.

국민기초생활보장제도 수급탈출의 기간의존성 (Duration Dependence in the Exit Rate from National Basic Livelihood Protection Program)

  • 이원진
    • 한국사회복지학
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    • 제63권4호
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    • pp.83-107
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    • 2011
  • 본 연구는 한국복지패널 1~4차년도 조사 자료를 활용하여 국민기초생활보장제도 수급탈출의 기간의존성을 분석하였다. 수급기간이 길어질수록 수급탈출률이 낮아지는 기간의존성의 존재는 복지의존을 시사하는 중요한 증거가 될 수 있다. 실증적 분석 결과, 성, 연령, 교육수준, 결혼지위, 건강상태, 취업 형태 등의 관찰된 특성을 통제한 후에도 수급기간이 길어질수록 수급탈출률이 낮아지는 현상이 관찰되지만, 관찰되지 않은 이질성을 통제하면 수급기간의 영향이 통계적으로 유의하지 않은 것으로 나타났다. 이러한 결과에 따르면, 수급기간이 길어질수록 수급탈출률이 낮아지는 현상의 상당부분은 수급자 집단의 이질성으로 인한 허위관계이고 수급탈출의 기간의존성은 크지 않은 것으로 판단된다.

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노쇠 환자의 보행장애 및 인지 기능 저하에 대한 운동요법을 병행한 한방치료 증례보고 (A Case Report of Oriental Medical Treatments Combined with Exercise Therapy on the Frail Elderly Patient with Gait Disturbance and Cognitive Decline)

  • 장선정;박정오;허동석
    • 한방재활의학과학회지
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    • 제23권3호
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    • pp.211-217
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    • 2013
  • 2013년 3월 9일부터 6월 11일까지 대전대학교 부속 대전한방병원 한방재활의학과에 부동(immobility)으로 노쇠가 진행되어 보행장애 및 인지 기능 저하가 발생한 노인 입원환자 1명을 대상으로, 운동요법을 병행한 한방치료가 증상 호전에 미치는 영향에 대해 다음과 같은 결론을 얻었다. 1. 치료 후 양하지 도수근력검사는 4등급으로 근력이 향상되었다. 2. 슬관절 신전 수동운동범위는 -30/-30에서 0/-5도로 호전되었다. 3. 한국형 간이 정신상태 검사는 7점에서 25점으로 호전되었다.

체중지지 훈련이 만성 뇌졸중 환자의 체중지지능력 및 균형에 미치는 영향 (Effect of Weight Bearing Exercise on Weight Bearing and Balance for Patients with Chronic Stroke)

  • 이종식;남기원;김경윤;윤장원;박종항
    • The Journal of Korean Physical Therapy
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    • 제24권4호
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    • pp.253-261
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    • 2012
  • Purpose: In this study, the following experiment was conducted to see how to apply the sprinter pattern in proprioceptive neuromuscular facilitation (PNF) and functional weight bearing exercise affected balance capabilities and weight bearing among chronic stroke patients. Methods: The subjects included 27 subjects who had been diagnosed with hemiplegia due to stroke. A total of 12 sessions was held, 3 sessions a week over 4 weeks, were provided to the groups. The control group received general rehabilitation program, and the experimental group performed sprinter pattern in PNF or functional weight bearing exercise. The weight bearing capability and static balance capability test was implemented by using Good-Balance System and Frailty and Injuries Cooperative Studies of Intervention Techniques, while the dynamic balance capability test was carried out by using Four Square Step Test and Timed "Up and Go". Results: The paretic/nonparetic side weight bearing by application of each exercise showed that there were no significant differences in variation among each groups on before exercise, after exercise, 2 weeks after exercise. Static balance test by application of each exercise showed that there were significant differences after exercise and 2 weeks after exercise. Dynamic balance test by application of each exercise showed that there were significant differences after exercise and 2 weeks after exercise. Conclusion: To put the results together, the application of sprinter pattern and functional weight bearing exercise was effective in improving static and dynamic balance capabilities. Therefore, these exercises are helpful to improve balance in patients with stroke.

Effects of Horse Meat Hydrolysate on Oxidative Stress, Proinflammatory Cytokines, and the Ubiquitin-Proteasomal System of C2C12 Cells

  • Hee-Jeong Lee;Dongwook Kim;Kyoungtag Do;Chang-Beom Yang;Seong-Won Jeon;Aera Jang
    • 한국축산식품학회지
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    • 제44권1호
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    • pp.132-145
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    • 2024
  • Sarcopenia, the age-related muscle atrophy, is a serious concern as it is associated with frailty, reduced physical functions, and increased mortality risk. Protein supplementation is essential for preserving muscle mass, and horse meat can be an excellent source of proteins. Since sarcopenia occurs under conditions of oxidative stress, this study aimed to investigate the potential anti-muscle atrophy effect of horse meat hydrolysate using C2C12 cells. A horse meat hydrolysate less than 3 kDa (A4<3kDa) significantly increased the viability of C2C12 myoblasts against H2O2-induced cytotoxicity. Exposure of C2C12 myoblasts to lipopolysaccharide led to an elevation of cellular reactive oxygen species levels and mRNA expression of proinflammatory cytokines, including tumor necrosis factor-α and interleukin 6, and these effects were attenuated by A4<3kDa treatment. Additionally, A4<3kDa activated protein synthesis-related proteins through the protein kinase B/mechanistic target of rapamycin pathway, while decreasing the expression of activity and degradation-related proteins, such as Forkhead box O3, muscle RING finger protein-1, and Atrogin-1 in dexamethasone-treated C2C12 myotubes. Therefore, the natural material A4<3kDa has the potential of protecting against muscle atrophy, while further in vivo study is needed.

근육의 성질에 관한 성별 차이 비교 연구 - 청년과 노년에서의 근 긴장도, 탄성, 경직도 지수와 두 나이대 간 지수 변화를 중심으로 (A Comparative Study of Gender-Differences on Muscular Properties, Focusing on Tone, Elasticity, Stiffness, and Their Changes between Young and Old Age Groups)

  • 방재훈;한진석;최예진;이나경
    • 대한통합의학회지
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    • 제10권3호
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    • pp.199-208
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    • 2022
  • Purpose : The study aimed to examine gender-differences in muscle tone, elasticity, and stiffness of the erector spinae in young and old subjects. This study also aimed to assess the effect of aging on muscle tone, elasticity, and stiffness of the erector spinae in men and women, and compare the trend of the aging effect between the two gender groups. Methods : With the muscle in the relaxed state and subjects in the prone position, a myotonometer was used to quantify muscle tone, elasticity, and stiffness, of the erector spinae in 102 participants[46 males (29 young subjects, aged 22.48±2.23 years and 17 old subjects, aged 76.35±3.71 years), 56 females (40 young subjects, aged 20.38±1.43 years and 16 old subjects, aged 74.56±5.40 years)]. Results : The tone and stiffness of the erector spinae muscles were greater in men than in women for both age groups (p<.001-.01), while elasticity did not show a significant difference between men and women. For the direction of change, both male and female groups showed significantly increased tone and stiffness, and decreased elasticity with increasing age (p<.001). For age-related changes, a different tendency was observed between men and women. Men showed a greater increase in tone than women with aging. in contrast, both men and women exhibited a similar decrease or increase in elasticity and stiffness. Conclusion : Gender-differences in the erector spinae in terms of muscle tone and stiffness were observed. Regardless of the age, men had higher muscle tone and stiffness than women, but not elasticity. The erector spinae muscles showed age-related changes in all aspects of muscle tone, elasticity, and stiffness, in both men and women. Notably, men presented greater variation than women in the amount of increase of muscle tone with aging. These findings have implications for musculoskeletal therapeutic approaches, and gender-customized tuning may be indicated for designing exercise interventions to prevent and manage gender-sensitive muscular injuries or diseases and frailty.

Strategies for Managing Dementia Patients through Improving Oral Health and Occlusal Rehabilitation: A Review and Meta-analysis

  • Yeon-Hee Lee;Sung-Woo Lee;Hak Young Rhee;Min Kyu Sim;Su-Jin Jeong;Chang Won Won
    • Journal of Korean Dental Science
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    • 제16권2호
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    • pp.128-148
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    • 2023
  • Dementia is an umbrella term that describes the loss of thinking, memory, attention, logical reasoning, and other mental abilities to the extent that it interferes with the activities of daily living. More than 50 million individuals worldwide live with dementia, which is expected to increase to 131 million by 2050. Recent research has shown that poor oral health increases the risk of dementia, while oral health declines with cognitive decline. In this narrative review, the literature was based on the "hypothesis" that dementia and oral health have a close relationship, and appropriate oral health and occlusal rehabilitation treatment can improve the quality of life of patients with dementia and prevent progression. We conducted a literature search in PubMed and Google Scholar databases, using the search terms "dementia," "major neurocognitive disorder," "dentition," "occlusion," "tooth loss," "dental prosthesis," "dental implant," and "occlusal rehabilitation" in the title field over the past 30 years. A total of 131 studies that scientifically addressed dementia, oral health, and/or oral rehabilitation were included. In a meta-analysis, the random effect model demonstrated significant tooth loss increasing the dementia risk 3.64-fold (pooled odds ratio=3.64, 95% confidence interval [2.50~5.32], P-value=0.0348). Tooth loss can be an important indicator of cognitive function decline. As the number of missing teeth increases, the risk of dementia increases. Loss of teeth can lead to a decrease in the ascending information to the brain and reduced masticatory ability, cerebral blood flow, and psychological atrophy. Oral microbiome dysbiosis and migration of key bacterial species to the brain can also cause dementia. Additionally, inflammation in the oral cavity affects the inflammatory response of the brain and the complete body. Conversely, proper oral hygiene management, the placement of dental implants or prostheses to replace lost teeth, and the restoration of masticatory function can inhibit symptom progression in patients with dementia. Therefore, improving oral health can prevent dementia progression and improve the quality of life of patients.

Functional Aspects of the Obesity Paradox in Patients with Severe Coronavirus Disease-2019: A Retrospective, Multicenter Study

  • Jeongsu Kim;Jin Ho Jang;Kipoong Kim;Sunghoon Park;Su Hwan Lee;Onyu Park;Tae Hwa Kim;Hye Ju Yeo;Woo Hyun Cho
    • Tuberculosis and Respiratory Diseases
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    • 제87권2호
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    • pp.176-184
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    • 2024
  • Background: Results of studies investigating the association between body mass index (BMI) and mortality in patients with coronavirus disease-2019 (COVID-19) have been conflicting. Methods: This multicenter, retrospective observational study, conducted between January 2020 and August 2021, evaluated the impact of obesity on outcomes in patients with severe COVID-19 in a Korean national cohort. A total of 1,114 patients were enrolled from 22 tertiary referral hospitals or university-affiliated hospitals, of whom 1,099 were included in the analysis, excluding 15 with unavailable height and weight information. The effect(s) of BMI on patients with severe COVID-19 were analyzed. Results: According to the World Health Organization BMI classification, 59 patients were underweight, 541 were normal, 389 were overweight, and 110 were obese. The overall 28-day mortality rate was 15.3%, and there was no significant difference according to BMI. Univariate Cox analysis revealed that BMI was associated with 28-day mortality (hazard ratio, 0.96; p=0.045), but not in the multivariate analysis. Additionally, patients were divided into two groups based on BMI ≥25 kg/m2 and underwent propensity score matching analysis, in which the two groups exhibited no significant difference in mortality at 28 days. The median (interquartile range) clinical frailty scale score at discharge was higher in nonobese patients (3 [3 to 5] vs. 4 [3 to 6], p<0.001). The proportion of frail patients at discharge was significantly higher in the nonobese group (28.1% vs. 46.8%, p<0.001). Conclusion: The obesity paradox was not evident in this cohort of patients with severe COVID-19. However, functional outcomes at discharge were better in the obese group.

발아 서목태 가수분해물의 근위축 억제 효과 (Germinated Rhynchosia nulubilis Hydrolysate Ameliorates Dexamethasone-induced Muscle Atrophy by Downregulating MAFbx Expression in C2C12 Cells and C57BL/6 Mice)

  • 이원경;김은지;김상곤;구영민;길영숙;신승미;안민주;강민철;하영술
    • 생명과학회지
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    • 제33권3호
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    • pp.277-286
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    • 2023
  • 스테로이드 유발 근위축은 장기간 코르티코스테로이드 요법의 일반적인 부작용이며 근육량과 기능의 현저한 감소로 이어질 수 있다. 발아된 Rhynchosia Nulubilis (GRH)는 항염증 및 항산화 특성이 있는 것으로 밝혀진 전통적인 약용 식물이다. 그러나 근 감소 억제 효능에 대하여는 보고된 바가 없다. 본 연구에서는 덱사메타손에 의해 유도된 근위축 C2C12 근관세포 모델과 마우스 모델에서 근위축 억제 활성에 대한 GRH의 영향을 평가하였다. 또한 골격근에 대한 GRH 효과의 기본이 되는 분자 경로를 확인하였다. May Grunwald-Giemsa 염색을 통한 근관 세포 염색 결과는 GRH 처리군에서 근관의 길이와 면적이 증가함을 보여주었다. 또한, muscle ring-finger protein-1 (MuRF-1)와 muscle atrophy F-box (MAFbx) 발현이 GRH 처리군에서 유의하게 감소하였다. 더욱이 덱사메타손에 의해 유도된 근위축 C57BL/6 마우스에서 트레드밀을 사용한 지구력 측정과 악력측정기를 이용한 악력 측정을 통한 근육 기능을 평가한 결과 GRH를 경구 투여한 마우스의 근육 기능이 향상되었다. 또한 이러한 결과는 근육 조직에서 GRH에 의한 MAFbx의 발현 억제를 통해 일어남을 확인하였다. 결론적으로 GRH는 MAFbx 발현을 억제하여 유비퀴틴-프로테아좀 경로를 차단함으로써 덱사메타손에 의해 유발된 근위축을 개선할 수 있을 것이다.