• Journal of Preventive Medicine and Public Health
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• 제50권1호
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• pp.1-9
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• 2017

Objectives: By the end of the 2000s, the economic situation in many European countries started to deteriorate, generating financial uncertainty, social insecurity and worse health status. The aim of the present study was to investigate how the recent financial crisis has affected the lifestyle health determinants and behaviours of older adults living in the Mediterranean islands. Methods: From 2005 to 2015, a population-based, multi-stage convenience sampling method was used to voluntarily enrol 2749 older adults (50% men) from 20 Mediterranean islands and the rural area of the Mani peninsula. Lifestyle status was evaluated as the cumulative score of four components (range, 0 to 6), that is, smoking habits, diet quality (MedDietScore), depression status (Geriatric Depression Scale) and physical activity. Results: Older Mediterranean people enrolled in the study from 2009 onwards showed social isolation and increased smoking, were more prone to depressive symptoms, and adopted less healthy dietary habits, as compared to their counterparts participating earlier in the study (p<0.05), irrespective of age, gender, several clinical characteristics, or socioeconomic status of the participants (an almost 50% adjusted increase in the lifestyle score from before 2009 to after 2009, p<0.001). Conclusions: A shift towards less healthy behaviours was noticeable after the economic crisis had commenced. Public health interventions should focus on older adults, particularly of lower socioeconomic levels, in order to effectively reduce the burden of cardiometabolic disease at the population level.

• 동의신경정신과학회지
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• 제32권2호
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• pp.81-93
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• 2021

Objectives: Mild cognitive impairment (MCI) is condition of cognitive decline shown in transition from normal aging to dementia. Hominis placenta pharmacopuncture (HPP) is a treatment that combines effects of medication and acupuncture by injecting Hominis placenta into acupoints. The objective of this study was to evaluate the efficacy and safety of HPP for MCI. Methods: This was a randomized, double-blind, placebo-controlled, two-center clinical trial. Eligible patients were randomly allocated to either the HPP group or the placebo group. HPP or saline as placebo was administered to participants for eight weeks. Changes in symptoms were observed. The primary outcome was difference in mean change of Korean Version of the Montreal Cognitive Assessment (MoCA-K) score between the HPP group and the placebo group. Cognitive function, overall status of mood and sleep, and quality of life (QoL) were also assessed. Safety assessment and economic analysis were then conducted. Results: Thirty participants were enrolled. One participant in the placebo group dropped out. The score of MoCA-K increased after treatment. Its mean change was smaller in the HPP group than in the control group. HPP ameliorated Global Deterioration Scale and Korean Dementia Rating Scale subtests for attention, organization, and memory compared to the placebo. However, none of them was significantly different between the two groups. Mood, sleep, and QoL all improved more in the HPP group than in the placebo group, although differences between the two groups were not statistically significant. There was no adverse event probably related to the drug. HPP treatment needed KRW 345,000 more than the placebo group in improving Geriatric Quality of Life scale-Dementia score by one point for one year. Conclusions: Although HPP treatment did not significantly improve cognition, it changed behavioral and psychological symptoms in MCI.

• International Journal of Stem Cells
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• 제16권3호
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• pp.342-355
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• 2023

Background and Objectives: Osteoblasts are derived from bone marrow mesenchymal stem cells (BMMSCs) and play important role in bone remodeling. While our previous studies have investigated the cell subtypes and heterogeneity in osteoblasts and BMMSCs separately, cell-to-cell communications between osteoblasts and BMMSCs in vivo in humans have not been characterized. The aim of this study was to investigate the cellular communication between human primary osteoblasts and bone marrow mesenchymal stem cells. Methods and Results: To investigate the cell-to-cell communications between osteoblasts and BMMSCs and identify new cell subtypes, we performed a systematic integration analysis with our single-cell RNA sequencing (scRNA-seq) transcriptomes data from BMMSCs and osteoblasts. We successfully identified a novel preosteoblasts subtype which highly expressed ATF3, CCL2, CXCL2 and IRF1. Biological functional annotations of the transcriptomes suggested that the novel preosteoblasts subtype may inhibit osteoblasts differentiation, maintain cells to a less differentiated status and recruit osteoclasts. Ligand-receptor interaction analysis showed strong interaction between mature osteoblasts and BMMSCs. Meanwhile, we found FZD1 was highly expressed in BMMSCs of osteogenic differentiation direction. WIF1 and SFRP4, which were highly expressed in mature osteoblasts were reported to inhibit osteogenic differentiation. We speculated that WIF1 and sFRP4 expressed in mature osteoblasts inhibited the binding of FZD1 to Wnt ligand in BMMSCs, thereby further inhibiting osteogenic differentiation of BMMSCs. Conclusions: Our study provided a more systematic and comprehensive understanding of the heterogeneity of osteogenic cells. At the single cell level, this study provided insights into the cell-to-cell communications between BMMSCs and osteoblasts and mature osteoblasts may mediate negative feedback regulation of osteogenesis process.

• 생물정신의학
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• 제23권2호
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• pp.63-68
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• 2016

Objectives Haenyeo are Korean professional women breath-hold divers in Jeju island. The aim of this study was to investigate the clinical characteristics of depressed Haenyeo group, compared to non-Haenyeo depressed group. Methods This study included 75 Haenyeo and 340 non-Haenyeo with depressive disorders recruited from the Dementia Early Detection Program in Jeju island. Structural diagnostic interviews were performed using the Korean version of Mini International Neuropsychiatric Interview. All patients completed the questionnaires, including the Subjective Memory Complaints Questionnaire (SMCQ), the Patient Health Questionnaire-15 (PHQ-15), and the Blessed dementia scale. Depression was evaluated by the Korean version of short form the Geriatric Depression Scale (K-SGDS) and cognition was assessed by the Korean version of the Consortium to Establish a Registry for Alzheimer's Disease (CERAD) assessment packet. Results Although the mean scores of the K-SGDS were similar between Haenyeo and non-Haenyeo depressed groups, the Haenyeo group showed a higher mean score on the PSQ-15 (p < 0.001, ANCOVA adjusting for age, the K-SGDS and education). The Haenyeo group showed poorer performance on the Korean Version of Frontal Assessment Batter (p < 0.001), the Mini-Mental State Examination in the Korean version of the CERAD Assessment Packet (p < 0.018), the word fluency test (p < 0.001), and the word list memory test (p = 0.012) in ANCOVA adjusting for age and education. The mean SMCQ score was higher in the Haenyeo depressed group than in the non-Haenyeo depressed group. Conclusions The Haenyeo depressed group shows cognitive dysfunction, especially frontal lobe dysfunction, compared to the non-Haenyeo depressed group, indicating the Haenyeo depressed group may have more severe frontolimbic dysfunction due to chronic exposure to hypoxia. The Haenyeo depressed group suffers more somatic symptoms than the non-Haenyeo depressed group.

• 농촌의학ㆍ지역보건
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• 제31권1호
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• pp.1-8
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• 2006

65세 이상 노인들을 대상으로 거주형태와 생활요인 등이 노인 우울장애와 얼마나 관련 있는지 파악하고자 본 연구를 수행하였다. 경주시에 거주하는 65세 이상의 노인들 중 요양시설노인 50명, 재가노인 72명, 독거노인 34명 등 총 156명을 대상으로 저자들이 자체 개발한 설문지로 조사하였다. 우울장애 검사는 한국형 노인우울검사를 사용하였다. 한국형 노인우울검사의 점수를 기준으로 할 때, 정상은 56.4%(88명)이었고 우울군의 양성률은 43.6%(68명)이었다. 경도 우울군은 21.8%(34명), 중등도 우울군은 7.1%(11명), 고도 우울군은 14.7%(23명)의 양성률을 보였다. 단변량분석에서 성별, 결혼상태, 거주형태, 가전제품, 한달 용돈, 학력, 외출횟수 등이 우울장애와 유의한 관련이 있었다. 요양시설노인의 경우 중등도 우울군은 10.0%(5명), 심도 우울군은 32.0%(16명)로 요양시설노인이 재가노인 및 독거노인에 비해 유의하게 우울장애 양성률이 높았다(p<0.05). 로지스틱 회귀분석에서 요양시설노인군이 재가노인군에 대해 교차비가 16.08(95% 신뢰구간: 3.60-71.88), 한 달 용돈이 10만원 미만 노인군이 10만원 이상 노인군에 대해 교차비가 14.84(95% 신뢰구간: 4.35-50.63) 이었다.

• 보건교육건강증진학회지
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• 제23권3호
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• pp.99-119
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• 2006

Objectives: This study intends to understand the difference within group of social support level and the effect of social support to health behaviors and health status of the elderly by selecting the old of local society as target. Methods: Data were obtained from self-administered questionnaire of 8,688 persons, older than 65 years, living in a community. We measured the sociodemographic characteristics, social support(family support, other support, quality of support), physical health state(subjective health status, number of chronic disease), physical function state(activities of daily living; ADL, instrumental activities of daily living; IADL), cognition state(mini-mental state examination-Korean; MMSE-K) and depression state(short form of geriatric depression scale; SGDS), health behaviors(smoking, drinking, exercise, eating habit). Univariate, multinominal logistic regression and covariance structure analysis were employed to analyze factors affecting on the social support of the elderly. Results: When considering the degree of social support by the sociodemographic characteristics of the older adults, the family support, other support and quality of support is better when the old is male, young, high education and self-reported living status is good and it has significance statistically. When considering the relation between social support and health status, the family support, other support and quality of support is better when the old's subjective and objective physical health status is good. The family support, other support and quality of support is better when the old's subjective health status is better. The other support and quality of support is better when the old's ADL(activities of daily living) and IADL(instrumental activities of daily living) are good. The family support, other support and quality of support is better when the old's cognitive function and depression state is better. When considering the relation between social support and health behaviors, in case of smoking and drinking, the quality of support, family support and other support is better when the old smokes and drinks rather than the old does not. In case of exercise and eating habit, the family support, other support and quality of support is better when the old exercises and eats regularly rather than the old does not. It has significance statistically. From the result of performing covariance structure analysis by structural equation modeling(SEM) with two endogenous variable(health behaviors and health status) and one exogenous variable(social support), factor loading of health status is 0.74 and factor loading of health behaviors is 0.05. The social support explains health status of 55.4% and health behaviors of 2.9%. Conclusions: This study has the meaning that it finds the difference of social support generating from inside of the group for the old residing in city and country and specifies the effect that the difference of social support influences to health status and health behaviors. From now on, in the development of health improvement strategy of the olds, it is necessary to approach from inclusive aspect while considering psychosocial factor such as social support and social economical factor as well as health status.

• 생물정신의학
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• 제20권2호
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• pp.45-53
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• 2013

Objectives Non-major depression with fewer symptoms than required for a Diagnostic and Statistical Manual of Mental Disorders-4th edition diagnosis of major depressive disorder (MDD) has consistently been found to be associated with functional impairment. In this study, we aim to estimate the cognitive impairment and the quality of life in elderly patients with subsyndromal depression (SSD) compared with non-depressive elderly (NDE). Methods The Korean version of Mini International Neuropsychiatric Interview was administered to 194 outpatients with depression and 108 normal controls. SSD is defined as having five or more current depressive symptoms with core depressive symptoms (depressive mood or loss of interest or pleasure) during more than half a day and more than seven days over two weeks. Depression was evaluated by the Korean form of Geriatric Depression Scale of a 15-item short version. Global cognition was assessed by Mini-Mental State Examination in the Korean version of CERAD assessment packet (MMSE-KC). Subjective cognitive impairment was assessed by the Subjective Memory Complaint Questionnaire. Quality of life was evaluated by the Korean Version of Short-Form 36-Item Health Survey. Results The mean score of the MMSE-KC in the SSD group was lower than that in the NDE group with adjustment for age, gender, and education [F = 4.270, p = 0.04, analysis of covariance (ANCOVA)]. If we defined those having Z-score of MMSE-KC < -1.5 as a high risk group of cognitive impairment, the odds ratio for the high risk group of cognitive impairment was 1.86 [95% confidence intervals (CI) 1.04-3.34] in SSD and 7.57 (95% CI 3.50-16.40) in MDD compared to NDE. The scores of physical component summary (F = 9.274, p = 0.003, ANCOVA) and mental component summary (F = 53.166, p < 0.001, ANCOVA) in the SSD group were lower than those in the NDE group with adjustment for age, gender, and education. Conclusions The subjects with SSD, as well as those with MDD, showed impairment of global cognition and also experienced low quality of life in both physical and mental aspects, compared to the NDE group.

• 동서간호학연구지
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• 제2권1호
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• pp.96-106
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• 1997

In Chinese medicine, the activities of removing and solving the inner cause are called the regimen in preventing the disease and the good condition of mind emphasizes us to practice ourselves the doctrine of regimen of the mind to promote the health and long life of the living body, in other words, it means we should have clean mind, less desire, less thought, less agony and widely open our emotion and will, and it also means the raising of good nature, the moral cultivation, and we can be healthy when we live by good virtus as the root of regiem. The meaning of the Qi has been expanded more and more since its origination throught the process of practice and perception of man. 1) Matter is changed to the smoke when burned, the energy of water becomes the rain in the sky and the rain raises all living creatures by making them wet. Throught these changes of circulation, men could realize the energy to be the common and original matter of forming all the creatures. 2) The direction of showing the breathing of men in and out has been expended. 3) It was widely understood as the meaning of showing vitality of men, and it was the original root of chinese medicine. 4) It was expended to be showing spirit of nature such as the sun, moon, star, sky, land, mountain and the moral spirit of men as peacefullness. By the original meaning of the word of energy expanded to the wider side of sky, land, men and things, nature, society, man and the moral spirit could get the unified basis of the matter. As the above, the word of Qi has been used in wider meaning at this time from the past. In other words, all things in the universe come into being and extinct by the chang of motion of the Qi and it is recognized to be the living activity in human body. The Qi-kong based on this energy and the motion applied to our daily life are very extensive (Lee, Hye - lung, 1997). Here are the summaries of the effect of the Qi-kong ; 1) The physical constitution is strenthened, physiological function is prosperous and we are free from various geriatric disease and psychosomatic disease not to mention the cold and indigestion. 2) It maintains the clear spirit, elevates intelligence, strengthens the spiritual power and demonstrates the potentiality at the amximum. 3) It maintain beautiful figure and clean skin never losing the charm but full of energy and vitality. 4) It keeps the balanced body never suffering from the unbalance of the bones, various and neuralgia. 5) It maintain the spiritual comfort, the natural posture in everything and real happiness (Lee, Hye-Jung, 1997 : Suh, Yong Kyu, 1989). Chinese medicine mentions the motion by Qi with Qi - kong. But the motion does not require special method in Western medicine. I t is the only way of living of our ancestor indaily life. It is maintaining the healthy lifr by training the Qi, and it is the motion of being with the nature with the open mind in breathing rather than artificially restricting our daily life, it is the motion of the body.

• 한국산학기술학회논문지
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• 제20권10호
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• pp.303-308
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• 2019

65세 남자환자에서 전신마취하 관절경 어깨 수술후 갑자기 발생한 사지 마비 증례를 보고하고자 한다. 환자는 술 후 급격한 사지 마비 증상을 보였으며 마취 관리상 특별한 문제는 없었다. 환자의 수술시 자세와 관련하여 마취 유도시에 기관삽관을 위한 과도한 경추 신전은 시행되지 않았으며 수술중 자세에서도 경추부의 과도한 회전이나 신전 또한 진행되지 않았다. 그러나 수술이 종료된 후 근이완의 완전한 회복과 의식 및 자발호흡은 확인되었으나 사지 마비 증상 및 배뇨장애 증상을 보였다. 신속히 시행한 경추부 자기공명 영상에서 경추간판에 의한 척수 신경 압박 소견 보이는 척추성 경추증 증상을 보였다. 환자는 21일간의 고농도 스테로이드 정주 요법을 포함한 보존적 치료 후에 감각 및 운동신경의 완전한 회복을 보이고 다른 신경학적 이상 소견은 보이지 않은 채로 퇴원하였다. 외상과 관련 없이 사지 마비로 나타나는 수술후 척추성 경추증의 발생은 흔하지 않다. 본 증례를 통해 수술후 발생한 비외상성 척추성 경추증 발생에 대해 타 증례 보고와 비교 분석하여 고찰해 보고자 한다. 임상 의사는 60세 이상의 노년층에서의 수술후 사지 마비에 대해 척추성 경추증의 원인 기여에 대해서도 고려하기를 권고한다.

• 대한한방내과학회지
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• 제31권1호
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• pp.1-10
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• 2010

Objectives : It is necessary that the international classification of diseases (ICD) be examined in order to comprise the third revision of the Korean Classification of Disease on Oriental Medicine (KCD-OM) and disease classification in the oriental internal medicine field. It is essential that the selection, classification and definition of disease and pattern names of oriental concepts in internal medicine be clear. Since 2008, the fifth revision of the Korean Classification of Disease (KCD-5) has been used in Korea. It was required to use the reference classification from the Oriental medicine area based on the ICD-10. Methods : In this review, the necessity for, meaning of and content of the third revision are briefly described. The ICD system was reviewed and KCD-OM was reconstructed. How diagnosis in the oriental internal medicine area had changed is discussed. Review and Results : In 1973, the disease classification of oriental medicine was established the basis on the contents of Dongeuibogam. It was irrespective of the ICD. As to the classification system in the Oriental internal medicine field, systemic disease was comprised of wind, cold, warm, wet, dryness, heat, spirit, ki, blood, phlegm and retained fluid, consumptive disease, etc. Diseases of internal medicine comprised a system according to the five viscera and the six internal organs and followed the classification system of Dongeuibogam. The first and second revisions were of the classification system based on the curriculum in 1979 and 1995. In 1979, in the first revision, geriatric disease and idiopathic types of disease were deleted, and skin disease was included among surgery diseases. This classification was expanded to 792 small classification items and 1,535 detailed classification items to the dozen disease classes. In 1995, in the second revision, it was adjusted to 644 small classes and 1,784 detailed classification items in the dozen disease classes. KCD-OM3 did KCD from this basis. It added and comprised the oriental medical doctor's concept names of diseases considering the special conditions in Korea. KCD-OM3 examined the KCD-OMsecond revised edition (1994). It improved the duplex classification, improper classifications, etc. It is difficult for us to separate the disease names and pattern names in oriental medicine. We added to the U code and made one classification system. By considering the special conditions in Korea, 169 codes (83 disease name codes, 86 pattern name codes) became the pre-existence classification and links among 306 U codes of KCD-OM3. 137 codes were newly added in the third revision. U code added 3 domains. These are composed of the disease name (U20-U33, 97 codes), the disease pattern name (U50-U79, 191 codes) and the constitution pattern name of each disease (U95-U98, 18 codes). Conclusion : The introduction of KCD-OM3 conforms to the diagnostic system by which oriental medical doctors examine classes used with the basic structure of the reference classification of WHO and raises the clinical study and academic activity of the Korean oriental medicine and makes the production of all kinds of nation statistical indices possible. The introduction of KCD-OM3 promotes the diagnostic system by which doctors of Oriental medicine examine classes using the association with KCD-5. It will raise the smoothness and efficiency of oriental medical treatment payments in the health insurance, automobile insurance, industrial accident compensation insurance, etc. In addition, internationally, the eleventh revision work of the ICD has been initiated. It needs to consider incorporating into the International Classification of Diseases some of every country's traditional medicine.