• Kidney Research and Clinical Practice
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• 제37권4호
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• pp.384-392
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• 2018

Background: A very low protein diet (VLPD) with ketoacid analogs of essential amino acids (KA/EAA) administration can remarkably influence protein synthesis and metabolic disturbances of patients with advanced chronic kidney disease (CKD), and may also slow the decline in renal function. Methods: A retrospective cohort study was carried out to monitor renal progression and metabolic and nutritional status among 140 patients with CKD stage III or IV. One group (n = 70) was on a low protein diet (LPD) with 0.6 g of protein intake, and another group (n = 70) was on a VLPD with 0.3 g of protein and KA/EAA supplementation of 100 mg/kg/day for 12 months. Results: At 12-month follow-up, estimated glomerular filtration rate (GFR) significantly decreased from $41.6{\pm}10.2$ to $36.4{\pm}8.8mL/min/1.73m^2$ (P < 0.001) and urine protein increased from $0.6{\pm}0.5$ to $0.9{\pm}1.1g/day$ (P = 0.017) in the LPD group, but no significant changes in estimated GFR and urine protein were found in the VLPD plus KA/EAA group. A significant mean difference in rate of change in estimated GFR ($-5.2{\pm}3.6mL/min/1.73m^2$ per year; P < 0.001) was observed between the two groups. After Cox regression analysis, treatment with VLPD plus KA/EAA significantly protected against the incidence of declining GFR > 10% annually (adjusted hazard ratio, 0.42; 95% confidence interval, 0.23-0.79; P = 0.006) and significant correlations were found between using VLPD plus KA/EEA and increased GFR. Conclusion: VLPD supplementation with KA/EAA is associated with delayed renal progression while preserving the nutritional status in the patients with CKD. Co-administration of VLPD and KA/EAA may prove an effective alternative to conservative management of CKD.

• 당뇨병
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• 제19권3호
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• pp.135-139
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• 2018

The sodium-glucose cotransporter-2 inhibitor (SGLT2i) is a new anti-hyperglycemic agent that have function to concomitantly inhibit the reabsorption of glucose and sodium in the renal proximal convoluting tubule. Recent two cardiovascular outcome trials showed that a lower risk of cardiovascular events with SGLT2i in people with type 2 diabetes. In addition, prior real-world data demonstrated similar SGLT2i effects, but these studies were limited to the United States and Europe. Thus, the CVD-REAL (Comparative Effectiveness of Cardiovascular Outcomes in New Users of Sodium-Glucose Cotransporter-2 Inhibitors) 2 Study was investigated cardiovascular outcomes in those initiated on SGLT2i versus other glucose-lowering drugs (oGLDs) across 6 countries in the Asia Pacific, the Middle East, and North American regions. In Korea, 336,644 episodes of initiation in SGLT2i or oGLD group between September 2014 and December 2016 were identified in Korea National Health Insurance database after propensity score matching. SGLT2i users was associated with a lower risk of all-cause death (hazard ratio [HR], 0.72; 95% confidence interval [CI], 0.67~0.77), hospitalization for heart failure (HHF) (HR, 0.87; 95% CI, 0.82~0.92), all-cause death or HHF (HR, 0.81; 95% CI, 0.78~0.85), myocardial infarction (HR, 0.81; 95% CI, 0.74~0.89), and stroke (HR, 0.82; 95% CI, 0.78~0.86) compared with oGLD users. In conclusion, initiation of SGLT2i had a lower risk of cardiovascular events in people with type 2 diabetes compared with oGLDs.

• 임상이비인후과
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• 제29권2호
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• pp.182-189
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• 2018

Background and Objectives : There were few literatures about the relationship between upper airway disorders and cardiovascular risk factors such as hypertension, although an association between impaired lower respiratory function and cardiovascular alterations was often reported. Our purpose was to assess the relationships between chronic sinusitis and hypertension. Materials and Methods : Three hundred subjects with bilateral chronic sinusitis who underwent functional endoscopic sinus surgery between 2015and 2017 were evaluated. Six hundred forty subjects without any nasal diseases were enrolled as a control group. Blood pressure and body mass index (BMI) were measured using a standardized method, and subjects were asked about current use of any antihypertensive medication, history of diabetes, smoking and alcohol drinking habits.Sinusitis group was assessed by nasal endoscopic examination, paranasal sinus CT scan and allergy test. Results : Average systolic and diastolic blood pressures were statistically significantly higher in subjects with sinusitis than control group. Chronic rhinosinusitis was associated with a 1.415-fold (95% confidence interval 1.053-1.930) increased hazard of hypertension after multivariate adjustment. Conclusions : These results suggest that sinusitis is associated with high blood pressure. Therefore patients with sinusitis may need special attention for blood pressure control. Further studies need to be performed to elucidate the pathogenesis behind such associations.

• 대한영양사협회학술지
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• 제25권1호
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• pp.30-43
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• 2019

This study compared the predictive models for the growth kinetics of Staphylococcus aureus in ham rice balls. In addition, a semi-quantitative risk assessment of S. aureus on ham rice balls was conducted using FDA-iRISK 4.0. The rice was rounded with chopped ham, which was mixed with mayonnaise (SHM), soy sauce (SHS), or gochujang (SHG), and was contaminated artificially with approximately $2.5{\log}\;CFU{\cdot}g^{-1}$ of S. aureus. The inoculated rice balls were then stored at $7^{\circ}C$, $15^{\circ}C$, and $25^{\circ}C$, and the number of viable S. aureus was counted. The lag phases duration (LPD) and maximum specific growth rate (SGR) were calculated using a Baranyi model as a primary model. The growth parameters were analyzed using the polynomial equation as a function of temperature. The LPD values of S. aureus decreased with increasing temperature in SHS and SHG. On the other hand, those in SHM did not show any trend with increasing temperature. The SGR positively correlated with temperature. Equations for LPD and SGR were developed and validated using $R^2$ values, which ranged from 0.9929 to 0.9999. In addition, the total DALYs (disability adjusted life years) per year in the ham rice balls with soy sauce and gochujang was greater than mayonnaise. These results could be used to calculate the expected number of illnesses, and set the hazard management method taking the DALY value for public health into account.

• 한국임상수의학회지
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• 제36권1호
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• pp.68-73
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• 2019

We determined the risk factors for displacement of the abomasum (DA), and the relationships between DA and postpartum disorders, milk yield, and reproductive performance in dairy cows. Initially, we identified the risk factors for DA using data regarding cow health and calving season from 2,208 lactations. Then, we compared the incidence of postpartum disorders, culling, death, and reproductive performance between cows with DA and their control herdmates (each n = 57). In addition, serum metabolites concentrations and milk yield were compared between cows with DA and controls (each n = 33). Ketosis (odds ratio [OR] = 9.27, p < 0.0001) and twin calves (p = 0.06) increased the risk of DA. Cows with a parity of three had a higher risk (OR = 5.23, p < 0.01) of DA than primiparous cows. Serum total cholesterol concentration was lower but non-esterified fatty acid, ${\beta}-hydroxybutyrate$, and alanine aminotransferase concentrations were higher after calving in cows with DA than in controls (p < 0.05). The removal rate from the herd by 2 months after calving was higher (p < 0.05) but milk yield 1 and 2 months after calving (p < 0.01) and the rate of first insemination by 150 days postpartum were lower (hazard ratio = 0.49, p < 0.05) in cows with DA than controls. In conclusion, higher parity, twin calves, and ketosis are risk factors for DA in dairy cows, which is associated with a higher removal rate from the herd, lower milk yield, a longer calving to first insemination interval, and unfavorable levels of metabolites related to energy and liver function.

• 전기전자학회논문지
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• 제24권4호
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• pp.1188-1191
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• 2020

본 논문에서는 블루투스와 스마트워치를 사용하여 운전자 및 탑승자의 사고 감지, 납치 감지, 차량 내 아동 방치 감지, 주차 위치 기록, 스마트키 기능을 수행하는 자동차 안전 및 편의 서비스를 제안한다. 스마트폰에 기반한 기존 서비스는 스마트 폰을 차량 내에 거치하거나 가방 내에 휴대하는 경우가 많아서 사고 및 납치 상황 등을 정확하게 감지하지 못하는 경우가 많다. 이에 반하여 스마트워치는 사용자가 늘 착용하고 있으며 심박수도 모니터링할 수 있으므로 사고 및 납치 상황 등을 좀 더 정확하게 감지할 수 있다. 제안하는 서비스는 스마트워치의 가속도 센서, GPS 센서, 심박 센서, 블루투스 링크 상태 등의 정보를 통해 운전자 및 탑승자에게 발생하는 다양한 상황을 파악하고 사고 통보, 상황 녹음 등 필요한 동작을 수행한다. 또한 제안하는 서비스는 차량과 OBD-II로 연결되어 도어 개폐, 비상등 점멸 등 필요한 동작을 수행한다.

• Journal of Preventive Medicine and Public Health
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• 제54권6호
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• pp.395-403
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• 2021

Objectives: Previous studies have shown that participation in social activities (SA) can prevent cognitive decline (CD) and that living arrangements (LA) can affect cognitive function. This study aimed to evaluate the effects of SA and LA on CD, as well as their interactions, using longitudinal data. Methods: Data were used from the 2006-2018 Korean Longitudinal Study for Aging, which followed 10 254 adults older than 45 years over a 12-year period. CD was defined as a ≥4-point score decrease in the Mini-Mental Status Exam over 2 years. We developed an extended Cox proportional hazards model for time-dependent covariates to estimate the hazard ratio (HR) of CD in 4 groups: (1) socially active and living with others, (2) socially active and living alone, (3) socially inactive and living with others (SILO), and (4) socially inactive and living alone (SILA). The model was stratified by gender and adjusted for important confounders. Results: The HR of CD was significantly higher in the SILO group in men (HR,1.36; 95% confidence interval [CI], 1.08 to 1.78) and in the SILA group in women (HR, 1.72; 95% CI, 1.08 to 2.75). However, the interaction term for gender was not significant. Conclusions: Among socially inactive elderly adults, the HR of CD was elevated in men who lived with others and in women who lived alone, although the interaction term for gender was not significant. Socially inactive men who live with others and socially inactive women who live alone are particularly encouraged to participate in SA to prevent CD.

• 대한의생명과학회지
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• 제28권4호
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• pp.260-275
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• 2022

Sterile alpha motif (SAM) domains bind to various proteins, lipids, and RNAs. However, these domains have not yet been analyzed as prognostic biomarkers. In this study, SAM domain containing 13 (SAMD13), a member of the SAM domain, was evaluated to identify a novel prognostic biomarker in various human cancers, including hepatocellular carcinoma (HCC). Moreover, we identified a correlation between SAMD13 expression and immune cell infiltration in HCC. We performed bioinformatics analysis using online databases, such as Tumor Immune Estimation Resource, UALCAN, Kaplan-Meier plotter, LinkedOmics, and Gene Expression Profiling Interactive Analysis2. SAMD13 expression in HCC samples was significantly higher than that in normal liver tissue; additionally, SAMD13 was higher in primary tumors, various stages of cancer and grades of tumor, and status of nodal metastasis. Higher SAMD13 expression was also associated with poorer prognosis. SAMD13 expression positively correlated with CD8+ T cells, CD4+ T cells, B cells, neutrophils, macrophages, and dendritic cells. In the analysis of SAMD13 co-expression networks, positively related genes of SAMD13 were associated with a high hazard ratio in different types of cancer, including HCC. In biological function of SAMD13, SAMD13 mainly include spliceosome, ribosome biogenesis in eukaryote, ribosome, etc. These results suggest that SAMD13 may serve as a novel prognostic biomarker for HCC diagnosis and provide novel insights into tumor immunology in HCC.

• Journal of Korean Neurosurgical Society
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• 제66권1호
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• pp.82-89
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• 2023

Objective : Rathke's cleft cysts (RCCs) are nonneoplastic cysts. Most of them are asymptomatic and stable; when symptomatic, RCCs are surgically fenestrated and drained. However, the outcomes remain unclear. The authors evaluated the outcomes of RCC decompression. Methods : Between 2004 and 2019, 32 RCCs were decompressed in a single tertiary institution. The clinical characteristics, intraoperative findings, postoperative complications, and endocrinological and surgical outcomes were retrospectively reviewed. Patients who underwent sequential imaging at least twice and at least 12 months after surgery were included in the analysis. Results : Patients' mean age was 40.8±14.9 years, and 62.5% were women. The mean follow-up duration was 62.3±48.6 months. In 21 patients (65.6%), no residual cysts were identified on postoperative magnetic resonance imaging. Of the 18 patients with preoperative visual field defects, 17 (94.4%) experienced postoperative visual improvement. Postoperative complications included endocrinological deterioration in 11 patients (34.4%), permanent diabetes insipidus in 11 (34.4%), infection in four (12.5%), intrasellar hemorrhage in three (9.4%), and cerebrospinal fluid leak in two (6.3%). Follow-up images revealed cyst recurrence in nine patients (28.1%), an average of 20.4 months after surgery; in three patients, the cysts were symptomatic, and resection was repeated. Multivariable analysis revealed that postoperative endocrinological deterioration was the only independent factor associated with cyst recurrence (p=0.028; hazard ratio, 6.800). Conclusion : Our findings showed that although only cyst fenestration for decompression was performed to preserve pituitary function, more pituitary dysfunction occurred than expected. Besides, the postoperative hormonal deterioration itself acted as a risk factor for cyst recurrence. In conclusion, surgery for RCC should be more careful.

• 한국안전학회지
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• 제38권1호
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• pp.70-77
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• 2023

Gas has replaced coal or petroleum as primary fuel because of its convenience. However, gas has risk of fire, explosion, or poisoning. To reduce gas-related accidents, many strategic projects have been being carried based on 'Gas Safety Management Basic Plans' on a domestic scale. In spite of those projects, the gas-related accident rate did not decrease over past decades. Thus, this study was conducted to analyze the effectiveness of ongoing projects, and to find out ways to make improvements. Conventional statistical analyses on accident data published by gas-related institutions were not useful to determine meaningful attributes to predict future. Whereas, accident case analyses adopted in the present study discovered differences in the type of people and their unsafe acts for each gas type. Meanwhile, the overall average priority of projects was not high in the aspect of System Safety Precedence. If the current trend is maintained, with sigmoid functions, it can be estimated that mean annual accident rate will decrease by only 2.0% in the next two decades. To improve the current trend, the present study made conclusions as followings: (1) safety projects should be designed with careful consideration of accident traits including gas type, unsafe acts, and persons involved and (2) alternative strategies should include system considerations such as minimum hazard design and safety devices prior to mere education or training. To summarize briefly, the present state related with gas accidents highlights the necessity of a system-based multidisciplinary approach.