• Title/Summary/Keyword: Medical control

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Identification of novel susceptibility genes associated with bone density and osteoporosis in Korean women

  • Bo-Young Kim;Do-Wan Kim;Eunkuk Park;Jeonghyun Kim;Chang-Gun Lee;Hyun-Seok Jin;Seon-Yong Jeong
    • Journal of Genetic Medicine
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    • v.19 no.2
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    • pp.63-75
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    • 2022
  • Purpose: Osteoporosis is a common calcium and metabolic skeletal disease which is characterized by decreased bone mass, microarchitectural deterioration of bone tissue and impaired bone strength, thereby leading to enhanced risk of bone fragility. In this study, we aimed to identify novel genes for susceptibility to osteoporosis and/or bone density. Materials and Methods: To identify differentially expressed genes (DEGs) between control and osteoporosis-induced cells, annealing control primer-based differential display reverse-transcription polymerase chain reaction (RT-PCR) was carried out in pre-osteoblast MC3T3-E1 cells. Expression levels of the identified DEGs were evaluated by quantitative RT-PCR. Association studies for the quantitative bone density analysis and osteoporosis case-control analysis of single nucleotide polymorphism (SNPs) were performed in Korean women (3,570 subjects) from the Korean Association REsource (KARE) study cohort. Results: Comparison analysis of expression levels of the identified DEGs by quantitative RT-PCR found seven genes, Anxa6, Col5a1, Col6a2, Eno1, Myof, Nfib, and Scara5, that showed significantly different expression between the dexamethason-treated and untreated MC3T3-E1 cells and between the ovariectomized osteoporosis-induced mice and sham mice. Association studies revealed that there was a significant association between the SNPs in the five genes, ANXA6, COL5A1, ENO1, MYOF, and SCARA5, and bone density and/or osteoporosis. Conclusion: Using a whole-genome comparative expression analysis, gene expression evaluation analysis, and association analysis, we found five genes that were significantly associated with bone density and/or osteoporosis. Notably, the association P-values of the SNPs in the ANXA6 and COL5A1 genes were below the Bonferroni-corrected significance level.

The National Status of Tuberculosis Using Nationwide Medical Records Survey of Patients with Tuberculosis in Korea

  • Park, Yoon-Sung;Hong, Sung-Jin;Boo, Yoo-Kyung;Hwang, Eun-Suk;Kim, Hyun Jung;Cho, Seung-Hee;Na, Kyung-In;Cho, En-Hi;Shin, Sang-Sook
    • Tuberculosis and Respiratory Diseases
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    • v.73 no.1
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    • pp.48-55
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    • 2012
  • Background: The epidemiology of tuberculosis (TB) has been assessed based on the data of the analysis of TB patients notified to the surveillance system in Korea. However, the national status of TB is not validated through this surveillance system. The objective is to determine the epidemiology of TB and to understand the accurate status of TB patients treated in private institutions. Methods: Medical records of 53,579 patients who had been diagnosed with TB in 2008 were analyzed. Results: Among 53,579 patients, the number of sputum smear positive cases was 15,639(29.2%) and the number of new cases was 39,191 (73.1%). The drug resistance rate of new cases was 5.3%, while the rate stood at 13.3% for TB patients with treatment history. The number of multi-drug resistant TB (MDR-TB) patients was 2,472 (4.6%), which consists of 2.9% of new cases and 9.3% of TB patients with prior treatment history. The number of extensively drug-resistant TB patients was 749 (1.4%), consisting of 1.1% of new cases and 2.2% of TB patients with prior treatment history. In terms of treatment outcomes, 66.4% of all TB patients, 70.5% of new cases, 64.4% of relapse cases, and 46.8% of MDR-TB cases were cured or completed. It was inferred that in 2008, the total number of TB patients reached 70,767, 145.6 per 100,000 people (95% confidence interval, 145.5~145.7). Conclusion: We conclude that the medical records review of the Health Insurance Review and Assessment Service (HIRA) data can be very effective in promoting the understanding of the current status of TB in private institutions.

'Simultaneous Modulated Accelerated Radiation Therapy' (SMART) Intensity-Modulated Radiotherapy in the Treatment of Nasopharyngeal Carcinoma : the Asan Medical Center (비인강암의 세기조절방사선치료기술을 이용한 동시차등조사가속치료의 예비성적)

  • Lee Sang-Wook;Back Geum-Mun;Yi Byong-Yong;Choi Eun-Kyung;Kim Jong-Hoon;Ahn Seung-Do;Shin Seong-Soo;Kim Sang-Yoon;Nam Soon-Yuhl;Choi Seung-Ho;Kim Sung-Bae;Song Si-Yeol
    • Korean Journal of Head & Neck Oncology
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    • v.19 no.1
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    • pp.9-15
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    • 2003
  • Purpose: To introduce our early experience with intensity-modulated radiotherapy (IMRT) in the treatment of nasopharyngeal carcinoma. Methods and Materials: Eight patients who underwent IMRT for no disseminated nasopharyngeal carcinoma at the Asan Medical Center between September 2001 and November 2002 were evaluate by prospective analysis. According to the 1997 American Joint Committee on Cancer staging classification, 5 had Stage III, and 3 had Stage IVB disease. The IMRT plans were designed to be delivered as a 'Simultaneous Modulated Accelerated Radiation Therapy' (SMART) using the 'step and shoot' technique with a MLC (multileaf collimator). Daily fractions of 2.2-2.5Gy and 1.9-2Gy were prescribed and delivered to the GTV and CTV and clinically negative neck node, respectively. The prescribed dose was 70A-79.0Gy to the gross tumor volume (GTV), 60Gy to the clinical target volume (CTV) and metastatic nodal station, and 46Gy to the clinically negative neck. All patients also received weekly cisplatin during radiotherapy. Acute and late normal tissue effects were graded according to the Radiation Therapy Oncology Group (RTOG) radiation morbidity scoring criteria. Results: Follow-up period was ranging from 5 to 18 months. All patients showed complete response and loco-regional control rate was 100% but one patient died of malnutrition due to treatment related toxicity. There were no Grade 3 or 4 xerostomia and all patients had experienced improvement of salivary gland function. Conclusion: 'Simultaneous Modulated Accelerated Radiation Therapy' (SMART) boost intensity-modulated radiotherapy technique allows parotid sparing as evidenced both clinically and by dosimetry. Initial tumor response and loco-regional control was promising. It is clinically feasible. A larger population of patients and a long-term follow-up are needed to evaluate ultimate tumor control and late toxicity.

Effects of Pharmacoacupuncture for Obesity: A Systematic Review and Meta-Analysis (비만에 대한 약침의 효과: 체계적 문헌고찰과 메타분석)

  • Seyun Kim;Mi-Yeon Song;Won-Seok Chung;Hyungsuk Kim;Woo-Chul Shin;Junhyuk Kang;Joonwon Seo;Sangwoo Seo;Seung Ho Yu;Jung-Hyun Lim;Su-Hwan Ji;Jae-Heung Cho
    • Journal of Korean Medicine for Obesity Research
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    • v.23 no.2
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    • pp.112-124
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    • 2023
  • Objectives: Obesity is a chronic metabolic disease that negatively affects quality of life and health. It is associated with various disease and its prevalence is on the rise. Although various treatments for obesity are used, they have several adverse effects. Pharmacoacupuncture is a widely used method for treating various diseases and has the advantage of having fewer adverse effects. This systematic review and meta-analysis evaluate the efficacy of pharmacoacupuncture in treating obesity. Methods: Eight electronic databases were searched from their inception to August 2023. Only randomized controlled trials were included in this review. Intervention groups included pharmacoacupuncture. Control groups had no limitation. The primary outcome was body mass index (BMI), and the secondary outcomes were body weight (BW), waist circumference (WC), and adverse effects. Continuous outcome data were presented as mean differences (MD) with 95% confidence intervals (CI). Results: Four randomized controlled trials (RCTs) involving 139 participants were included in this systematic review and meta-analysis. Results revealed that BMI ((MD)=-0.98, 95% CI -1.84 to -0.11, Z=2.22, P=0.03, I2=0%), WC (MD=-4.29, 95% CI -7.51 to -1.08, Z=2.62, P=0.009, I2=38%) were significantly improved in the intervention groups compared to control groups. Adverse effects were reported in two studies. Conclusions: This systematic review and meta-analysis suggests that pharmacoacupuncture is an effective and safe therapy for simple obesity. Further detailed studies should be conducted on effects of pharmacoacupuncture for obesity to increase reliability.

A Study on Legal Protection, Inspection and Delivery of the Copies of Health & Medical Data (보건의료정보의 법적 보호와 열람.교부)

  • Jeong, Yong-Yeub
    • The Korean Society of Law and Medicine
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    • v.13 no.1
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    • pp.359-395
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    • 2012
  • In a broad term, health and medical data means all patient information that has been generated or circulated in government health and medical policies, such as medical research and public health, and all sorts of health and medical fields as well as patients' personal data, referred as medical data (filled out as medical record forms) by medical institutions. The kinds of health and medical data in medical records are prescribed by Articles on required medical data and the terms of recordkeeping in the Enforcement Decree of the Medical Service Act. As EMR, OCS, LIS, telemedicine and u-health emerges, sharing and protecting digital health and medical data is at issue in these days. At medical institutions, health and medical data, such as medical records, is classified as "sensitive information" and thus is protected strictly. However, due to the circulative property of information, health and medical data can be public as well as being private. The legal grounds of health and medical data as such are based on the right to informational self-determination, which is one of the fundamental rights derived from the Constitution. In there, patients' rights to refuse the collection of information, to control recordkeeping (to demand access, correction or deletion) and to control using and sharing of information are rooted. In any processing of health and medical data, such as generating, recording, storing, using or disposing, privacy can be violated in many ways, including the leakage, forgery, falsification or abuse of information. That is why laws, such as the Medical Service Act and the Personal Data Protection Law, and the Guideline for Protection of Personal Data at Medical Institutions (by the Ministry of Health and Welfare) provide for technical, physical, administrative and legal safeguards on those who handle personal data (health and medical information-processing personnel and medical institutions). The Personal Data Protection Law provides for the collection, use and sharing of personal data, and the regulation thereon, the disposal of information, the means of receiving consent, and the regulation of processing of personal data. On the contrary, health and medical data can be inspected or delivered of the copies, based on the principle of restriction on fundamental rights prescribed by the Constitution. For instance, Article 21(Access to Record) of the Medical Service Act, and the Personal Data Protection Law prescribe self-disclosure, the release of information by family members or by laws, the exchange of medical data due to patient transfer, the secondary use of medical data, such as medical research, and the release of information and the release of information required by the Personal Data Protection Law.

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The Isokinetic exercise and effects of combined exercises on the change of postural control, functional status in patients with osteoarthritis of the knee (등속성 운동과 복합 운동이 퇴행성 슬관절염 여성의 근기능, 균형능력, 기능적 능력 및 관절기능상태에 미치는 영향)

  • Jo, Jean-Man;Kim, Jin-Woo
    • The Korean Journal of Emergency Medical Services
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    • v.11 no.1
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    • pp.11-25
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    • 2007
  • Objective: The purpose of this study was to investigate the effects of combined exercise on the change of postural control, functional status in patients with osteoarthritis of the knee. Methods : The subjects were consisted of 24 women patients fifties and sixties with knee osteoarthritis. Each group had a exercise for 30 minutes per day and three times a week during 8 weeks period. Was used to measure muscular function(60, $180^{\circ}/sec$), postural control. functional capacity(15 M walking test, Rising form a chair test, stair climbing and descending test) and the functional state of a joint(WOMAC). Results: This study results in following 1. In case of muscular function have significantly increased in both groups. 2. There was no significant difference in the postural control of the bilateral between two groups. However, the postural control of a isokinetic exercise program group showed a significant difference in the bilateral side(overall, $M{\cdot}L$ stability index). Especially, the change of postural control in the isokinetic plus postural control exercise program group decreased more significantly in the bilateral(overall, $A{\cdot}P$ stability index). 3 It was significantly decreased in climbing and descending the stairs, and rising from the chair, although functional capacity decreased in lam walking in both groups. 4. The functional state of a joint(WOMAC) showed a significant decrease in both groups. Conclusion : In order to improve the functional status and postural control of patients with osteoarthritis of the knee, performing exercise programming of isokinetic plus balance will be more effective than the exercise program composed of only the isokinetic exercise program.

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Short-term Glycemic Control and the Related Factors in Association with Compliance in Diabetic Patients (당뇨병 환자의 치료순응도에 따른 단기간 혈당조절정도와 관련 요인)

  • Kim, Gui-Young;Kim, Bo-Wan;Park, Jae-Yong
    • Journal of Preventive Medicine and Public Health
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    • v.33 no.3
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    • pp.349-363
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    • 2000
  • Objectives : Generally, it seemed that the therapeutic result in diabetic patients was changed by compliance. This study was conducted on the basis of assumption that the therapeutic result id diabetic patients could control according to compliance. This study was conducted to analyze the related factors in association with compliance to drug, diet and exercise therapy. Methods : 224 diabetic patients in Kyungpook National University Hospital were selected through the interviews and HbA1c values from 1 Jan. to 28 Feb.1997. The drug compliance was tested by regularity of drug administration, the diet compliance was tested by restriction of food, exactly allocation, balance of nutrient, measuring food and the exercise compliance was tested by regularity of exercise per day. We assessed compliance by percentage, $x^2-test$ and generalized logit regression model(method:enter). Results : The significant variable was the satisfaction to medical personnels in drug, the knowledge to disease in diet, the participation of the diabetic education in exercise therapy and the satisfaction to medical personnels in HbA1c. Using the generalized logit model(method : enter) in compliance change, the significant variables were the satisfaction to medical personnels and the complication in drug; the significant variables were the age at the first diagnosis, the family history, the concern of health, the knowledge of disease, the self-exertion for therapy and the complication in diet: the only significant variable was the gender in exercise therapy. Conclusions : The degree of glycemic control in diabetic patients was influenced by compliance. In order to improve patient's compliance, we must foster the knowledge on the diseases, lead participation for diabetic education. Because the satisfaction to medical personnels was the important variables, we must build up good relationship between doctors and patients.

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