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Quality of Anticoagulation and Treatment Satisfaction in Patients with Non-Valvular Atrial Fibrillation Treated with Vitamin K Antagonist: Result from the KORean Atrial Fibrillation Investigation II

  • Oh, Seil;Kim, June-Soo;Oh, Yong-Seog;Shin, Dong-Gu;Pak, Hui-Nam;Hwang, Gyo-Seung;Choi, Kee-Joon;Kim, Jin-Bae;Lee, Man-Young;Park, Hyung-Wook;Kim, Dae-Kyeong;Jin, Eun-Sun;Park, Jaeseok;Oh, Il-Young;Shin, Dae-Hee;Park, Hyoung-Seob;Kim, Jun Hyung;Kim, Nam-Ho;Ahn, Min-Soo;Seo, Bo-Jeong;Kim, Young-Joo;Kang, Seongsik;Lee, Juneyoung;Kim, Young-Hoon
    • Journal of Korean Medical Science
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    • v.33 no.49
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    • pp.323.1-323.12
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    • 2018
  • Background: Vitamin K antagonist (VKA) to prevent thromboembolism in non-valvular atrial fibrillation (NVAF) patients has limitations such as drug interaction. This study investigated the clinical characteristics of Korean patients treated with VKA for stroke prevention and assessed quality of VKA therapy and treatment satisfaction. Methods: We conducted a multicenter, prospective, non-interventional study. Patients with $CHADS_2{\geq}1$ and treated with VKA (started within the last 3 months) were enrolled from April 2013 to March 2014. Demographic and clinical features including risk factors of stroke and VKA treatment information was collected at baseline. Treatment patterns and international normalized ratio (INR) level were evaluated during follow-up. Time in therapeutic range (TTR) > 60% indicated well-controlled INR. Treatment satisfaction on the VKA use was measured by Treatment Satisfaction Questionnaire for Medication (TSQM) after 3 months of follow-up. Results: A total of 877 patients (age, 67; male, 60%) were enrolled and followed up for one year. More than half of patients (56%) had $CHADS_2{\geq}2$ and 83.6% had $CHA_2DS_2-VASc{\geq}2$. A total of 852 patients had one or more INR measurement during their follow-up period. Among those patients, 25.5% discontinued VKA treatment during follow-up. Of all patients, 626 patients (73%) had poor-controlled INR (TTR < 60%) measure. Patients' treatment satisfaction measured with TSQM was 55.6 in global satisfaction domain. Conclusion: INR was poorly controlled in Korean NVAF patients treated with VKA. VKA users also showed low treatment satisfaction.

Association of Low Serum Ionized Magnesium Level with Fever-Triggered Seizures in Epileptic Children (소아 뇌전증 환자에서 발열이 동반된 경련을 하는 것과 저 이온화 마그네슘 혈증과의 관련성)

  • Suh, Sunny;Kim, Kyungju;Byeon, Jung Hye;Eun, So-Hee;Eun, Baik-Lin;Kim, Gun-Ha
    • Journal of the Korean Child Neurology Society
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    • v.26 no.4
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    • pp.205-209
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    • 2018
  • Purpose: Several studies have shown that magnesium plays an important role in modulating N-methyl-D-aspartate (NMDA)-related seizures by blocking NMDA ion channel receptors. Clinicians usually measure total serum magnesium levels instead of biologically active ionized magnesium levels. We compared the serum ionized magnesium ($iMg^{2+}$) level between epileptic children with and without a history of fever-triggered seizure (FTS). Methods: All epileptic children who visited the outpatient clinic or pediatric emergency department at Korea University Guro Hospital between January 2015 and July 2017 were included. Only epileptic children aged 1-8 years who were newly diagnosed within 2 years were included. Results: There were 12 children with FTS and 16 without FTS. Median serum $iMg^{2+}$ level was 0.93 (0.85-1.14, quartile) mEq/L. Serum $iMg^{2+}$ level was significantly lower in epileptic children with FTS (0.86 mEq/L) compared to those without FTS (1.10 mEq/L) (P=0.005). No difference was noted in clinical variables between the two groups. Lower serum $iMg^{2+}$ level significantly increased the risk of having FTS in epileptic children based on multivariable logistic regression analysis (odds ratio [OR]=0.028). Conclusion: Serum $iMg^{2+}$ level was significantly lower in epileptic children with FTS than in those without FTS. Measurement of biologically active serum $iMg^{2+}$ level could be considered in epileptic children with recurrent FTS. A large-scale prospective study is warranted.

A Study on Consumer Characteristics According to Social Media Use Clusters When Purchasing Agri-food Online (온라인 농식품 구매시 소셜미디어 이용 군집에 따른 소비자특성에 대한 연구)

  • Lee, Myoung-Kwan;Park, Sang-Hyeok;Kim, Yeon-Jong
    • Asia-Pacific Journal of Business Venturing and Entrepreneurship
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    • v.16 no.4
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    • pp.195-209
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    • 2021
  • According to the 2019-2020 social media usage survey conducted by the Seoul e-commerce center, 5 out of 10 consumers have experienced shopping through social media. The cost of traditional advertising media has been reduced and advertising spending on social media has risen by 74%, indicating that social media is becoming a more important marketing element. While the number of users of social media has increased and corporate marketing activities have increased accordingly, research has been conducted in various aspects of marketing such as user motivation for social media, satisfaction, and purchase intention. There was no subdivided study on the differences in the social media usage frequency of consumers in actual purchasing behavior. This study attempted to identify differences in consumer characteristics by cluster in the agrifood purchase situation by grouping them by type according to the frequency of use of social media for consumers who purchase agri-food online. Product involvement, product need, and online purchase channel Consumer characteristics such as demographic distribution, perceived risk, and eating and lifestyle in each cluster were checked for the three agrifood purchase situations including choice, and types for each cluster were presented. To this end, questionnaire data on the frequency of social media use and online agrifood purchase behavior were collected from 245 consumers, and the validity of the measurement variables was secured through factor analysis and reliability analysis. As a result of cluster analysis according to the frequency of social media use, it was divided into three clusters. The first cluster was a group that mainly used open social media, and the second cluster was a group that used both open and closed social media and online shopping malls; The third cluster was a group with low online media usage overall, and the characteristics of each cluster appeared. Through regression analysis, the effect on product involvement, product need, and purchase channel selection when purchasing agri-food online through each of the three clusters was confirmed through regression analysis. As a result of the regression analysis, the characteristic of cluster 1 in the situation of purchasing agri-food online is a male in his 30s living in a rural area who has no reluctance to purchase agri-food on social media or online shopping malls. The characteristics of cluster 2 are mainly consumers who are interested in purchasing health food, and the consumer characteristics are represented. In the case of cluster 3, when purchasing products online, they purchase after considering quality and price a lot, and the consumer characteristics are represented as people who are more confident in purchasing offline than online. Through this study, it is judged that by identifying the differences in consumer characteristics that appear in the agri-food purchase situation according to the frequency of social media use, it can be helpful in strategic judgments in marketing practice on social media customer targeting and customer segmentation.

Study on relationship between caffeine intake level and metabolic syndrome and related diseases in Korean adults: 2013 ~ 2016 Korea National Health and Nutrition Examination Survey (한국 성인의 카페인 섭취 수준이 대사증후군 및 관련 질환과의 관련성 연구 : 2013~2016 국민건강영양조사 자료 활용)

  • Lee, Jung-Sug;Park, Hyoung-Seop;Han, Sanghoon;Tana, Gegen;Chang, Moon-Jeong
    • Journal of Nutrition and Health
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    • v.52 no.2
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    • pp.227-241
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    • 2019
  • Purpose: This study examined the relationship between caffeine intake and metabolic syndrome in Korean adults using the 2013 ~ 2016 Korea National Health and Nutrition Examination Survey data (KNHANES). Methods: The caffeine database (DB) developed by Food and Drug Safety Assessment Agency in 2014 was used to estimate the caffeine consumption. The food and beverage consumption of the 24 hr recall data of 2013 ~ 2016 KNHANES were matched to items in the caffeine DB and the daily caffeine intakes of the individuals were calculated. The sample was limited to non-pregnant healthy adults aged 19 years and older, who were not taking any medication for disease treatment. Results: The average daily caffeine intake was 41.97 mg, and the daily intake of caffeine of 97% of the participants was from coffee, teas, soft drinks, and other beverages. Multivariate analysis showed that the caffeine intake did not affect metabolic syndrome, hypertension, low HDL-cholesterol, and abdominal obesity. Diabetes and hypertriglyceridemia, however, were 0.76 (95% CI: 0.63 ~ 0.93), and 0.87 (95% CI: 0.77 ~ 0.98) in third quintile (Q3), and 0.66 (95% CI: 0.53 ~ 0.82) and 0.83 (95% CI: 0.73 ~ 0.94) in fourth quintile (Q4) compared to Q1, respectively. Therefore, caffeine intake of 3.66 ~ 45.81 mg per day is related to a lower risk of diabetes and hypertriglyceridemia. Conclusion: The study showed that adequate caffeine intake (approximately 45 mg) was associated with a lower prevalence of diabetes and hypertriglyceridemia. Therefore, it can be used as a guideline for the adequate level of caffeine intake for maintaining health.

Acidification of Pig Slurry with Sugar for Reducing Methane Emission during Storage (메탄 배출 저감을 위한 설탕을 이용한 돈 슬러리의 산성화)

  • Im, Seongwon;Oh, Sae-Eun;Hong, Do-giy;Kim, Dong-Hoon
    • Journal of the Korea Organic Resources Recycling Association
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    • v.27 no.3
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    • pp.81-89
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    • 2019
  • The major problem encountered during the storage of pig slurry (PS) is the release of huge amounts of greenhouse gases (GHGs), which are dominated by methane ($CH_4$). To reduce this, concentrated sulfuric acid has been used as an additive to control the pH of pig slurry to 5.0-6.0. However, other low-risk substitutes have been developed due to some limitations to its use, such as corrosiveness, and hazards to animal and human health. In this study, sugar addition was proposed as an eco-friendly approach for limiting $CH_4$ emission from PS during storage. The pH of PS has been reduced from $7.1{\pm}0.1$ (control) to $5.8{\pm}0.1$, $4.6{\pm}0.1$, $4.4{\pm}0.1$, $4.1{\pm}0.1$, and $4.0{\pm}0.1$, by the addition of 10, 20, 30, 40, and 50 g sugar/L, respectively. Lactate, acetate, and propionate were detected as the dominant organic acids and at sugar concentration above 20 g/L, lactate concentration represented 42-72% (COD basis) of total organic acids. For 40 d of storage, $20.6{\pm}2.3kg\;CO_2\;eq./ton\;PS$ was emitted in the control. Such emission, however, was found to be reduced to $8.7{\pm}0.4$ and $0.4{\pm}0.1kg\;CO_2\;eq./ton\;PS$ at 10 and 20 g/L, respectively. Small amount of $CH_4$ from PS at 10 g/L was emitted until 30 d of storage, while for rest of storage period, it has increased to $8.7{\pm}0.4kg\;CO_2\;eq./ton\;PS$ ( 40% of the control) when methanogens have recovered by increasing pH to 7.0. By the end of storage, VS and COD removal in the control reached 24% and 27%, while their ranges reached 15-4% and 12-17% in the sugar added experiments, respectively. It was found that more than 90% of COD removal was done by aerobic biological process.

Estimation of Heading Date using Mean Temperature and the Effect of Sowing Date on the Yield of Sweet Sorghum in Jellabuk Province (평균온도를 이용한 전북지역 단수수의 출수기 추정 및 파종시기별 수량 변화)

  • Choi, Young Min;Choi, Kyu-Hwan;Shin, So-Hee;Han, Hyun-Ah;Heo, Byong Soo;Kwon, Suk-Ju
    • KOREAN JOURNAL OF CROP SCIENCE
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    • v.64 no.2
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    • pp.127-136
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    • 2019
  • Sweet sorghum (Sorghum bicolor L. Moench), compared to traditional crops, has been evaluated as a useful crop with high adaptability to the environment and various uses, but cultivation has not expanded owing to a lack of related research and information in Korea. This study was conducted to estimate heading date in 'Chorong' sweet sorghum based on climate data of the last 30 years (1989 - 2018) from six regions (Jeonju, Buan, Jeongup, Imsil, Namwon, and Jangsu) in Jellabuk Province. In addition, we compared the growth and quality factors by sowing date (April 10, April 25, May 10, May 25, June 10, June 25, and July 10) in 2018. Days from sowing to heading (DSH) increased to 107, 96, 83, 70, 59, 64, and 65 days in order of the sowing dates, respectively, and the average was 77.7 days. The effective accumulated temperature for heading date was $1,120.3^{\circ}C$. The mean annual temperature was the highest in Jeonju, followed in descending order by Jeongup, Buan, Namwon, Imsil, and Jangsu. The DSH based on effective accumulated temperature gradually decreased in all sowing date treatments in the six regions during the last 30 years. DSH of the six regions showed a negative relationship with mean temperature (sowing date to heading date) and predicted DSH ($R^2=0.9987**$) calculated by mean temperature was explained with a probability of 89% of observed DSH in 2017 and 2018. At harvest, fresh stem weight and soluble solids content were higher in the April and July sowings, but sugar content was higher in the May 10 ($3.4Mg{\cdot}ha^{-1}$) and May 25 ($3.1Mg{\cdot}ha^{-1}$) sowings. Overall, the April and July sowings were of low quality and yield, and there is a risk of frost damage; thus, we found May sowings to be the most effective. Additionally, sowing dates must be considered in terms of proper harvest stage, harvesting target (juice or grain), cultivation altitude, and microclimate.

Effect of Wildlife Access on Microbial Safety of Irrigation Water Used in the Cultivation of Chinese Cabbage in Goesan (야생동물 출입이 괴산 지역 배추 재배 농업용수의 미생물 안전성에 미치는 영향)

  • Yun, Bohyun;Lim, Sang-Jin;Park, Young-Chul;Hung, Nguyen Bao;Park, Daesoo;Kim, Won-Il;Jung, Gyu Seok;Ham, Hyeonheui;Kim, Hyun Ju;Ryu, Kyoungyul;Kim, Se-Ri
    • Journal of Food Hygiene and Safety
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    • v.33 no.6
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    • pp.447-452
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    • 2018
  • Water is an important component in the production of fresh produce. It is mainly used for irrigation and application of pesticides and fertilizers. Several outbreaks cases related to fresh produce have been reported and water has been identified as the most likely source. On the other hand, wildlife has been identified as a possible source of the waterborne pathogens. The purpose of this study was to investigate the effect of wildlife access on irrigation water used in the cultivation of Chinese cabbage in Goesan. The frequency of wild animals access to upstream water source and the contamination level of bacteria such as Escherichia coli and Enterococci of irrigation water used in Chinese cabbage farm was examined. A total of 37 wildlife including the wild bear and water deer were observed in upstream of water source during the cultivation of Chinese cabbage. The result indicated the presence of hygienic indicator bacteria from the upstream where there is no human access. The contamination range of coliforms, E. coli, and Enterococcus spp. Detected in the irrigation water were 2.13~4.32 log MPN / 100 mL, 0.26~2.03 log MPN / 100 mL, and 1.43~3.49 log MPN / 100 mL, respectively. Due to low water temperatures, the contamination levels of coliform bacteria and E. coli in the irrigation water during harvesting time was lower compared to those recorded during transplanting of Chinese cabbage. However, no significant difference was detected in the number of Enterococci during the cultivation of Chinese cabbage. The results indicated the need to manage the microbial risk in irrigation water to enhance safety in cultivation of Chinese cabbage.

A Critical Review about Application of IUCN Red List Criteria at Regional Level to Korean Endangered Vascular Plants Assessed by the Ministry of Environment, Republic of Korea (환경부 멸종위기 관속식물 지정 기준으로 사용된 IUCN 지역 적색목록 평가 분석)

  • Chang, Chin-Sung;Kwon, Shin-Young;Son, Sungwon;Kim, Hui
    • Journal of Korean Society of Forest Science
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    • v.107 no.4
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    • pp.361-377
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    • 2018
  • The aim of this study was to examine whether the guideline by the Ministry of Environment (ME) successfully and appropriately applied the IUCN Red List criteria at regional level and the rare and endangered national list considered eligible. A certain number of vascular plants, which are widely distributed in the world or in east Asia, deemed to be ineligible for assessment at a regional level as Not Applicable category (NA), because it occurs at very low numbers in South Korea. Among 377 vascular plant taxa evaluated by the ME, NA included 238 species, which represented 63.1%. The number of synonymized species or illegitimate name species were 13 species, which accounted for 3.4%. 21 species (9.3%) were threatened at global level and 103 species were possibly candidates species list for Red List assessments at regional level in the near future. The proportion of NA or waiting list was 66.6% among the list assessed by the ME. The most common errors involved incorrectly application of species extinction in case of population extinction in South Korea to the assessment and provided incorrect interpretation of the Red List criteria at regional level. The most assessments proposed by ME were not backed up without quantitative data quality, justifications, and sources. It is suggested that the risk of extinction should be reassessed at least in the Korean peninsula within the light of their overall distribution including far eastern Russia and North eastern China in north and for Japan and Taiwan in south for regional assessment. The results obtained here using the IUCN criteria at regional level showed that the list proposed by the ME produced an overestimation of the number of threatened vascular plants. Also, the misapplication of the term 'species extinction' for regional assessment was open to some degree of subjectivity and misinterpretation.

Distributional Characteristics and Evaluation of the Population Sustainability, Factors Related to Vulnerability for a Polygonatum stenophyllum Maxim. (층층둥굴레(Polygonatum stenophyllum Maxim.)의 분포특성과 개체군의 위협요인 및 지속가능성 평가)

  • Kim, Young-Chul;Chae, Hyun-Hee;Ahn, Won-Gyeong;Lee, Kyu-Song;Nam, Gi-Heum;Kwak, Myoung-Hai
    • Korean Journal of Environment and Ecology
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    • v.33 no.3
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    • pp.303-320
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    • 2019
  • Plants interact with various biotic and abiotic environmental factors. It requires much information to understand the traits of a plant species. A shortage of information would restrict the assessment, especially in the evaluation of what kind of factors influence a plant species to face extinction. Polygonatum stenophyllum Maxim. is one of the northern plants of which Korea is the southern distribution edge. The Korean Ministry of Environment had designated it to be the endangered species until December 2015. Although it is comparatively widespread, and a large population has recently been reported, it is assessed to be vulnerable due to the low population genetic diversity. This study evaluated the current distribution of Polygonatum stenophyllum Maxim. We investigated the vegetational environment, population structures, phenology, soil environment, and self-incompatibility based on the results. Lastly, we evaluated the current threats observed in the habitats. The habitats tended to be located in the areas where the masses at the edge of the stream accumulated except for those that were located on slopes of some mountainous areas. Most of them showed a stable population structure and had re-established or recruited seedlings. Polygonatum stenophyllum Maxim. had the difference in time when the shoots appeared above the ground depending on the depth of the rhizome located in the underground. In particular, the seedlings and juveniles had their rhizome located shallow in the soil. Visits by pollinator insects and success in pollination were crucial factors for bearing of fruits by Polygonatum stenophyllum Maxim. The threats observed in the habitat of Polygonatum stenophyllum Maxim. included the expansion of cultivated land, construction of new buildings, and construction of river banks and roads. Despite such observed risk factors, it is not likely that there would be rapid population reduction or extinction because of its widespread distribution with the total population of more than 2.7 million individuals and the new populations established by the re-colonization.

Development of remote control automatic fire extinguishing system for fire suppression in double-deck tunnel (복층터널 화재대응을 위한 원격 자동소화 시스템 개발 연구)

  • Park, Jinouk;Yoo, Yongho;Kim, Yangkyun;Park, Byoungjik;Kim, Whiseong;Park, Sangheon
    • Journal of Korean Tunnelling and Underground Space Association
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    • v.21 no.1
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    • pp.167-175
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    • 2019
  • To effectively deal with the fire in tunnel which is mostly the vehicle fire, it's more important to suppress the fire at early stage. In urban tunnel, however, accessibility to the scene of fire by the fire fighter is very limited due to severe traffic congestion which causes the difficulty with firefighting activity in timely manner and such a problem would be further worsened in underground road (double-deck tunnel) which has been increasingly extended and deepened. In preparation for the disaster in Korea, the range of life safety facilities for installation is defined based on category of the extension and fire protection referring to risk hazard index which is determined depending on tunnel length and conditions, and particularly to directly deal with the tunnel fire, fire extinguisher, indoor hydrant and sprinkler are designated as the mandatory facilities depending on category. But such fire extinguishing installations are found inappropriate functionally and technically and thus the measure to improve the system needs to be taken. Particularly in a double-deck tunnel which accommodates the traffic in both directions within a single tunnel of which section is divided by intermediate slab, the facility or the system which functions more rapidly and effectively is more than important. This study, thus, is intended to supplement the problems with existing tunnel life safety system (fire extinguishing) and develop the remote-controlled automatic fire extinguishing system which is optimized for a double-deck tunnel. Consequently, the system considering low floor height and extended length as well as indoor hydrant for a wide range of use have been developed together with the performance verification and the process for commercialization before applying to the tunnel is underway now.