Kim, Se-Yun;Lee, Yu Ho;Kim, Yang-Gyun;Moon, Ju-Young;Chin, Ho Jun;Kim, Sejoong;Kim, Dong Ki;Kim, Suhnggwon;Park, Jung Hwan;Shin, Sung Joon;Choi, Bum Soon;Lim, Chun Soo;Lee, Minjung;Lee, Sang-ho
Kidney Research and Clinical Practice
/
v.37
no.4
/
pp.373-383
/
2018
Background: Several epidemiologic studies have suggested that the urine sodium excretion (USE) can be estimated in lieu of performing 24-hour urine collection. However, this method has not been verified in patients with chronic kidney disease (CKD) or in an interventional study. The purpose of this study was to evaluate the usefulness of estimating USE in a prospective low-salt diet education cohort (ESPECIAL). Methods: A new formula was developed on the basis of morning fasting urine samples from 228 CKD patients in the ESPECIAL cohort. This formula was compared to the previous four formulas in the prediction of 24-hour USE after treatment with olmesartan and low-salt diet education. Results: Most previously reported formulas had low predictability of the measured USE based on the ESPECIAL cohort. Only the Tanaka formula showed a small but significant bias (9.8 mEq/day, P < 0.05) with a low correlation (r = 0.34). In contrast, a new formula showed improved bias (-0.1 mEq/day) and correlation (r = 0.569) at baseline. This formula demonstrated no significant bias (-1.2 mEq/day) with the same correlation (r = 0.571) after 8 weeks of treatment with olmesartan. Intensive low-salt diet education elicited a significant decrease in the measured USE. However, none of the formulas predicted this change in the measured urine sodium after diet adjustment. Conclusion: We developed a more reliable formula for estimating the USE in CKD patients. Although estimating USE is applicable in an interventional study, it may be unsuitable for estimating the change of individual sodium intake in a low-salt intervention study.
Background: To examine survival rates and renal function after partial nephrectomy (PN) and radical nephrectomy (RN) in patients with chronic kidney disease (CKD). Methods: We studied 4,332 patients who underwent PN or RN for pathological T1a-T2N0M0 renal cell carcinoma from 1988 to 2014. Patients were divided into two subgroups of CKD stage I-II and stage III. Kidney function, and survival outcomes were compared between groups. Results: We included 1,756 patients with CKD I-II and 276 patients with CKD III in the final pair-matched analysis. Kidney function was significantly better preserved in the PN than in the RN group among all patients. However, the beneficial effect of PN on kidney function gradually disappeared over time in CKD III patients. The 5-year overall survival (OS) rates after PN and RN differed in patients with CKD I-II disease (99.4% vs. 96.5%, respectively, P = 0.015). The 5-year OS rates after surgery were not affected by mode of nephrectomy in CKD III patients (97.8% vs. 93.5%, P = 0.103). The 5-year cancer-specific survival rates did not differ between treatment groups in all CKD stage. Cox hazard analysis showed that the operative method was a significant factor for OS in CKD I-II patients (hazard ratio [HR], 0.320; confidence interval [CI], 0.122-0.840; P = 0.021). However, PN was not beneficial in terms of OS in CKD III patients (HR, 0.395; CI, 0.086-1.172; P = 0.117). Conclusion: PN is associated with a higher OS rate and better kidney function in patients with preoperative CKD stage I and II, but not in those with CKD stage III.
Kim, Myung Soo;Chung, Ho Seok;Hwang, Eu Chang;Jung, Seung Il;Kwon, Dong Deuk;Hwang, Jun Eul;Bae, Woo Kyun;Park, Jae Young;Jeong, Chang Wook;Kwak, Cheol;Song, Cheryn;Seo, Seong Il;Byun, Seok-Soo;Hong, Sung-Hoo;Chung, Jinsoo
Journal of Korean Medical Science
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v.33
no.51
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pp.325.1-325.10
/
2018
Background: To evaluate survival outcomes and prognostic factors for overall survival (OS) in patients with metastatic renal cell carcinoma (mRCC) who received sunitinib (SU) and pazopanib (PZ) as first-line therapy in real-world Korean clinical practice. Methods: Data of 554 patients with mRCC who received SU or PZ at eight institutions between 2012 and 2016 were retrospectively reviewed. Based on the targeted therapy, the patients were divided into SU (n = 293) or PZ (n = 261) groups, and the clinicopathological variables and survival rates of the two groups were compared. A multivariable Cox proportional hazard model was used to determine the prognostic factors for OS. Results: The median follow-up was 16.4 months (interquartile range, 8.3-31.3). Patients in the PZ group were older, and no significant difference was observed in the performance status (PS) between the two groups. In the SU group, the dose reduction rate was higher and the incidence of grade 3 toxicity was more frequent. The objective response rates were comparable between the two groups (SU, 32.1% vs. PZ, 36.4%). OS did not differ significantly between the two groups (SU, 36.5 months vs. PZ, 40.2 months; log-rank, P = 0.955). Body mass index, Eastern Cooperative Oncology Group PS > 2, synchronous metastasis, poor Heng risk criteria, and liver and bone metastases were associated with a shorter OS. Conclusion: Our real-world data of Korean patients with mRCC suggested that SU and PZ had similar efficacies as first-line therapy for mRCC. However, PZ was better tolerated than SU in Korean patients.
Christina Rossetti's novella Maude displays Tractarian influences in terms of Holy Eucharist, Puseyism, and the doctrine of Reserve. Tractarianism is High Church revival movement of nineteenth century. In the story a teenage girl, Maude went through hard time receiving Holy Eucharist due to self-consciousness and internal guilt according to Puseyism. She felt guilty when she enjoyed worldly things and outward beauty. Due to guilt Maude refused to receive Holy Communion, which is complete connection to God. Her cousin, Agnes suggested that in refusing Holy Communion Maude is following her own will not God's will. Later Maude overcame Puseyite thought of self-hatred and reconciled with her identity as a poet and a woman. Maude oscillates between concealing and revealing, secrecy and truth, sincerity and affectation, and modesty and display. Her marvelous poetic talent makes people praise her but she withholds private feelings and attempts to divert attention from herself. Like Maude herself, the meaning of her poems is at times reserved and withheld. This tendency goes with the doctrine of Reserve in Tractarianism. The doctrine of Reserve utilizes indirect methods to reveal divine attributes because finite human being can not accept infinite God. The doctrine of Reserve sees to it that the expression will be veiled, indirect, subdued and self-effacing. Rossetti adapts a poetic method of Reserve when Maude has anxiety over 'display and poetry' and generates the reticence, secrecy, mystery, renunciation, modesty and detachment. According to Mary Arseneau, by veiling and expressing herself through symbols she can rise above the self and employ the phenomenal to suggest a noumenal reality. Thus the poetry becomes an expression of longing for the divine. The poem "Three Nuns" exemplifies Maude's maturity and gradual progress in the relationship with God. Rossetti suggests the vision full of hopes and promises of reuniting with God. In conclusion, in some sense, authoritative and conservative Tractarianism affects Rossetti both ways. On the one hand, it makes Rossetti abnegate herself and leads her to asceticism, on the other hand, it makes Rossetti express her faith in God and write amazing devotional poems such as "Three Nuns". A poem within the poem has three voices that are in perfect harmony. In the poem the first and second nun show hesitation to fully commit to God's will and the desire for the world prevents them from having heavenly joy. Third nun reveals spiritual maturity and sings new life in God where their hopes and joys begin. Rossetti expresses the procedure of spiritual growth through the poem "Three Nuns". For Rossetti, self-abnegation and self-expression both are involved in the doctrine of Reserve, Puseyism and Holy Communion.
Purpose: Obesity and headache are two highly prevalent diseases both in childhood and adolescent. In this study, we assessed the prevalence of obesity in pediatric headaches patients in a single institution in Korea, and differences according to age, sex, headache type, frequency, intensity, and disability. Methods: We retrospectively reviewed the medical records of 340 subjects (6-18 years of age) who visited the Pediatric Headache Clinic of Bucheon St. Mary's Hospital during the period from January 2015 through March 2018. Data on age, sex, height and weight, as well as headache type, frequency, intensity and disability, were collected. Body Mass Index (BMI) percentile was calculated based on the 2017 Korean Children Adolescence Growth Chart. Results: 17.6% of the pediatric headache patients were obese. The prevalence of obesity in male patients was higher than females (Male 23.8% VS Female 11.6%, P=0.002). There were no significant differences in obesity rate according to age, headache type, frequency, intensity, and disability. Conclusion: The prevalence of obesity in the pediatric headache population was 17.6% which is higher than 10.1% in general population (Korea National Health and Nutrition Examination Survey, KNHANES, 2013).
Shin, Chanok;Lee, Na Yeong;Han, Ji Yoon;Yoo, Il Han;Eom, Tae Hoon;Bin, Joong Hyun;Kim, Young Hoon;Chung, Seung Yun;Lee, In Goo
Journal of the Korean Child Neurology Society
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v.26
no.4
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pp.269-271
/
2018
Purpose: The use of anticonvulsants can cause side effects such as reduction of bone mineral density, requiring attention in growing children. The aim of our study is to investigate the effects of different anticonvulsants on bone mineral density in epileptic patients treated with monotherapy. Methods: We retrospectively reviewed medical records of 60 subjects who visited the Pediatric Epilepsy Clinic of Bucheon St. Mary's Hospital from January 2013 to December 2017. Bone mineral density was measured with dual photon absorptiometry every 6 months. Results: The number of patients treated with oxcarbazepine, valproate and levetiracetam was 31, 16 and 13, respectively. Reduction of bone mineral density was seen in 8 out of 31 patients (25.8%, P=0.10) treated with oxcarbazepine, 9 out of 16 patients treated with valproate (56.3%, P=0.04) and 4 out of 13 patients treated with levetiracetam (30.8%, P=0.50). Conclusion: There was a significant reduction of bone mineral density in patients treated with valproate compared to the other anticonvulsants in our study. We believe attention to bone mineral density is required in children treated with anticonvulsants.
Journal of Korean Society of Occupational and Environmental Hygiene
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v.29
no.3
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pp.322-335
/
2019
Objectives: The goal of this study is to standardize industry, process, and job within work environment measurement information. Methods: We selected 180 work environment measurement reports on 30 industries from a database monitored from 2014 to 2016 by the Korea Industrial Health Association. Ten industrial hygienists, each with over five years of experience in measurement, conducted a primary standardization of 180 reports. Two professional industrial hygienists with more than 20 years of experience each reviewed and revised the results of the primary standardization. We also examined the validity on the usefulness of the standardized database by the two industrial hygienists. Results: The final standardization results were classified into eight major categories, 23 sub-major categories, 39 minor categories, 53 unit categories and 70 sub-unit categories in the Korean Standard Industrial Classification (KSIC) 10th revision. A total of 161 processes were standardized, and there were 148 processes with K2B codes. Standard job was coded into 13 job groups including operator, automobile maintenance, nurse, maintenance, manager, excavating machine operator, forklift driver, radiologist, clinical pathologist, signer, researcher, kitchen assistant, and concrete reinforcement ironworker. Conclusions: Although the standardized information in this study may be only a part of the total information, it can be useful for improvement of the K2B system. Additional research is needed for an ongoing clean-up of data in the K2B and re-calibration and reclassification of standard processes until the future national exposure monitoring system is fully established.
Kim, Yun Jae;So, Byung Hak;Kim, Hyung Min;Jeong, Won Jung;Cha, Kyeong Man;Kim, Seong Wook
Journal of The Korean Society of Clinical Toxicology
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v.12
no.2
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pp.63-69
/
2014
Purpose: The aim of this study is to investigate the difference between male and female in some clinically meaningful aspects and to prevent intentional poisoning in children and adolescents. Methods: Retrograde medical records review of patients who visited the emergency department of two secondary hospitals for drug ingestion from March 2010 through March 2013 was performed. Unintentional ingestion or ingestion by others was excluded. Results: A total of 138 cases were reported, male 25.4% (n=35), female 74.6% (n=103). The reason for poisoning was intentional in 132 cases (95.7%) and misuse in six cases (4.3%). In female patients, non-prescription drugs was the most common cause of intentional poisoning (68.9%). Male patients tend to use life substances for intentional poisoning more frequently (20.0%) than female (3.9%). Seven male patients and 12 female patients had previous psychiatric history and 34.3% of male and 41.7% of female were consulted to the psychiatric department. Conclusion: Female adolescents are more likely to ingest drugs intentionally for suicide attempt than males of comparable ages. The drugs they ingested were, in many cases, obtained with ease from the drug store nearby and, remarkably, most of the drugs they obtained in that way were acetaminophen-containing. This suggests that some guidelines or control in the pharmacy that restrict children or adolescents from obtaining potentially or possibly life-threatening drugs might be necessary. In addition, education regarding drugs is thought to be necessary in school for teenagers as they tend to misuse them with incorrect acknowledgement.
Lee, Ho Jin;You, Soon Tae;Sung, Jae Hoon;Kim, Il Sup;Hong, Jae Taek
Journal of Korean Neurosurgical Society
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v.64
no.6
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pp.913-921
/
2021
Objective : Accurate measurement of T1 slope (a component of T1s minus cervical lordosis [CL]) is often constrained by anatomical limitations. In this situation, efforts should be made to find the exact meaning of T1s-CL and whether there are any alternatives to it. Methods : We enrolled 117 patients who received two-level anterior cervical discectomy and fusion (ACDF). Occipital slope, C2 slope (C2s), C7 slope (C7s), T1, O-C2 angle (O-C2A), C2-7 angle (C2-7A), O-C7 angle (O-C7A), T1s-CL, C7-T1 angle (C7-T1A), and C2-7 sagittal vertical axis were measured. We determined 16° (T1s-CL) as the reference point for dividing subjects into the mismatch group and the balance group, and a comparative analysis was performed. Results : The mean value of C7-T1A was constantly maintained within 2.6° peri-operatively. In addition, C2s and T1s-CL showed the same absolute change (Δ|0.8|°). The mean values of T1s-CL of the mismatch and balance groups were 23.0° and 7.6°, respectively. The five factors with the largest differences between the two groups were as follows : C2s (Δ13.3°), T1s-CL (Δ15.4°), O-C2A (Δ8.7°), C2-7A (Δ14.7°), and segmental angle (Δ7.9°) before surgery. Only four factors showed statistically significant change between the two groups after ACDF : T1s-CL (Δ4.0° vs. Δ0.2°), C2s (Δ3.2° vs. Δ0.7°), O-C2A (Δ2.6° vs. Δ1.3°), C2-7A (Δ6.3° vs. Δ1.3°). A very strong correlation between T1s-CL and C2s was also found (r=|0.88-0.96|). Conclusion : C2s itself may be the essential key to represent T1s-CL. The amounts and directions of change of these two factors (T1s-CL and C2s) were also almost identical. The above phenomenon was re-confirmed once again through the correlation analysis.
Journal of The Korean Society of Integrative Medicine
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v.9
no.3
/
pp.165-173
/
2021
Purpose : Myofascial decompression is frequently mentioned as a method applied to cupping. The purpose of this study is to evaluate and compare active range of motion (AROM), muscle strength, and functional movement by applying myofascial decompression to the hamstrings. Methods : This study evaluated AROM, muscle strength, and functional movement by applying active movement myofascial decompression and static myofascial decompression to the dominant leg, respectively, in a crossover design conducted with normal adults (n=21) in their average 20s enrolled at G University in G city, Gyeongsangbuk-do. Active movement myofascial decompression was implemented for five minutes at a rate of 100 bpm to make the beats in flexion and extension respectively. Static myofascial decompression was only performed for five minutes while at rest. All of these interventions were performed at a cupping depth of two mm. After a one-week washout period, static was applied again to compare the same dependent variables. Results : Regarding AROM and muscle strength, both groups showed significant differences in the before and after results (p<.05). However, in the Functional Reach Aspect and Single Leg Hop test, the active movement myofascial decompression group showed better results. There was no statistical difference between the Active movement myofascial decompression group and Static myofascial decompression group in any dependent variable (p<.05). Conclusion : As a result of this experiment, both active movement myofascial decompression and static myofascial decompression had a positive effect on dependent variable. Therefore this study is meaningful in that it is easier and simpler to see the effect on flexibility, muscle strength, and functional movement just by implementing movement myofascial decompression.
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