Objectives: Much attention has been paid to sleep apnea syndrome (SAS) in the elderly because of its high prevalence. It is expected that SAS in the elderly has both similarities and differences compared to SAS in the young or middle-aged populations. The aim of this study was to elucidate the characteristics and consequences of SAS in the elderly. Methods: In this study we included 210 young or middle-aged adults between 23 and 59 years (20 women and 190 men) and 65 older adults between 60 and 83 years of age (16 women and 49 men). Respiratory disturbance indices (RDIs) of the study subjects were more than 5 in an overnight polysomnography. They completed the Epworth Sleepiness Scale (ESS) and Pittsburgh Sleep Quality Index (PSQI). Informations about body mass index (BMI), neck, waist, and hip measurements, and blood pressure were obtained. Results: No difference was observed between older adults with SAS (older SAS) and adults aged under 60 with SAS (SAS aged under 60) in RDI, apnea index, % time of oxygen saturation less than 90%, and PSQI. Obstructive apnea index and oxygen desaturation index (ODI) were lower in older SAS. Compared to SAS aged under 60, lowest oxygen saturation and central apnea index were higher in older SAS, but they were statistically not significant. BMI and neck circumference were significantly lower in older SAS compared to SAS aged under 60. Diastolic blood pressure was lower in older SAS compared to SAS aged under 60 with no difference in systolic blood pressure. Older SAS showed lower scores in ESS than SAS aged under 60. Significant correlation was observed between RDI and BMI in SAS aged under 60, but not in the case of older SAS. The relationships between RDI and neck circumference, systolic and diastolic pressure, and ESS were similar. Conclusions: The elderly with SAS were not over-weight and there was no relationship between body weight and the severity of SAS. Also, the behavioral and cardiovascular effects of SAS were not marked in the elderly, which might be partly explained by decreased ODI and relatively higher lowest oxygen saturation in older SAS. The normal aging process, aside from increased body weight, might contribute to the development of SAS in the elderly with modest complications.
Purpose :This study aimed to estimate age- and gender-specific cut points for metabolic syndrome (MS) components, including body mass index (BMI), blood pressure (BP), triglycerides, high-density lipoprotein (HDL) cholesterol, and glucose. Methods :Data from the 1998, 2001, and 2005 Korean NHANES (National Health and Nutrition Examination Survey) were analyzed (n=4164; 2,139 boys and 2,025 girls, aged 10-19 years). Height, weight, waist circumference (WC), BP, triglycerides, HDL cholesterol, and fasting glucose were measured. Results :BMI over $25kg/m^2$ represents the $85^{th}P$ (percentile) in 17-year-old boys and the $90^{th}P$ in 17-year-old girls. A level of WC higher than that of the cutoff points of Asian adults was found in the $90^{th}P$ of 17-year-old boys and girls. The $90^{th}P$ of boys aged 15 years old and the $95^{th}P$ of 13-year-old were included in the range of systolic BP over 130 mm Hg. Over the $75^{th}P$ of the group showed triglycerides greater than 110 mg/dL, (criterion of MS presented by NCEP-ATP III) and the $90^{th}P$ of the group showed triglycerides greater than 150 mg/dL by IDF. An HDL cholesterol level of 40 mg/dL represents the $25^{th}P$ in boys and the $10^{th}P$ in girls. A glucose level greater than 110 mg/dL represents the $95^{th}P$ and greater than 100 mg/dL represents the $90^{th}P$. Conclusion :Values of the $90^{th}P$ of MS components in late adolescent boys (WC, BP, and triglycerides) and girls (WC and triglycerides) were very high and in close proximity to the diagnostic criteria of adult MS.
Journal of Physiology & Pathology in Korean Medicine
/
v.22
no.2
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pp.487-496
/
2008
The purpose of this study is to investigate clinical frequency and priority of five pattern identification settled by Korean Standard Differentiation of the Symptoms and Sign for Stroke. The present study was done over 177 hospitalized patient with stroke in the Daejeon University Oriental Medical Hospital in the period of November 2006 to July 2007. Stroke patients had been interviewed by residents and specialists who studied standard operation procedures in Fundamental study for Standardization and Objectification of Differentiation and Pattern Identification of Syndrome of Oriental Medicine for Stroke. In Heat-transformation pattern group, men showed significantly high frequency and in Deficiency of Gi pattern group, women showed significantly high frequency. In Heat-transformation pattern group, the indicators such as 'aversion to heat during fever', 'flushed face', 'full and rapid pulse', 'dryness of the eyes, 'yellow coating of the tongue', 'feverishness of the limbs', 'dryness of the eyes' showed significantly high frequency. In Dampphlegm syndrome group, the indicators such as 'white coating of the tongue', 'yellowish face', 'thick coating of the tongue', 'wheezing in the throat with sputum', 'swollen tongue', 'slippery pulse' showed significantly high frequency. In Deficiency of Gi pattern group, the indicators such as 'pale tongue', 'lassitude', 'pale face', 'weakness pulse' showed significantly high frequency. In Deficiency of Eum group, the indicators such as 'short and rapid pulse', 'mirror-like tongue' showed significantly high frequency. For more sensitive Korean Standard Differentiation of the Symptoms and Signs for Stroke, Large scale study is to be done, giving weight on the important indicators.
Vitamin C is an important physiological antioxidant which neutralizes reactive oxygen species (ROS) and reduces the oxidative stress in the body. Although it has been associated with various diseases, few studies have reported the dose-response relationship between vitamin C intake, storage and functions in the body, including its antioxidant function. The criteria to establish the Dietary Reference Intakes for Koreans (KDRIs) for vitamin C were based on the changes in plasma concentrations and saturation of leukocytes according to intake levels and the effects on antioxidant capacity and risk of metabolic diseases. When establishing the 2020 vitamin C KDRI, while there was no change in the criteria from those of 2015, the reference values were recalculated and revised to reflect changes such as the new standard weight by age. As the number of people consuming dietary supplements has increased over the last decade, only about 10% of adults consume less than the average total vitamin C, but the proportion of adolescents and elderly who consume less than the average is high. On the other hand, as the intake of vitamin C supplements increases, the proportion of people consuming excessive vitamin C is also increasing. There is a body of opinion that it is necessary to establish a vitamin C KDRI for smokers or people with chronic diseases such as the metabolic syndrome, but these standards have not been established due to the lack of supporting scientific evidence. As a result, studies to establish vitamin C KDRI for Korean smokers and patients with the metabolic syndrome, as well as studies on the excessive intake of vitamin C due to supplementation and interactions with other nutrients, are needed.
Objetcives : Cancer cachexia is a common syndrome in advanced cancer patients, which is characterized by profound changes in protein, fat and carbohydrate metabolism, resulting in anorexia, weight loss, muscle wasting and poor performance status. We studied the journals of Chinese herb medicine about cancer cachexia and reported the results. Methods : This study attempted to analyze the contents of the research papers concerning the treatment of cancer cachexia presented in the journals of Chinese medicine published in China over the period between 2000 and 2009. Results & Conclusions : The principles for medical treatment were invigorating Ki(益氣), invigorating the spleen(健脾), regulating the stomach(和胃), nourishing the blood(養血), nourishing Eum(補陰), promoting the circulation of Ki(行氣), removing the phlegm(化痰), removing blood stasis(祛瘀) etc. The used herbs were Poria(茯笭), Astragali Radix(黃芪), Atractylodis Macrocephalae Rhizoma(白朮), Codonopsis Pilosulae Radix(黨蔘), Dioscoreae Rhizoma(山藥), Citri Pericarpium(陳皮), Angelicae Gigantis Radix(當歸), Coicis Pemen(薏苡仁), Paeoniae Radix Alba(白芍藥) etc. The effetcive rate of treatment with Chinese herb medicine group was comparable or even more effetcive. Chinese herb medicine group had little side effetcs. Chinese medicine herb treatment to inhibit cancer cachexia has many possibilities.
Purpose: Parenteral nutrition (PN) not only provides nutritional support but also plays a crucial role in the treatment of children with intestinal failure. The aim of this study was to evaluate the clinical significance and clinical outcomes of long-term PN. Methods: Retrospective cohort study was conducted using the medical records of patients treated at Seoul National University Children's Hospital. This study included 19 patients who received PN for over six months. Most patients received home PN. Results: The indications for PN included short bowel syndrome, chronic intestinal pseudo-obstruction, and intractable diarrhea of infancy. The median age of PN initiation was 1.3 years, and the median treatment duration was 2.9 years. Two patients were weaned from PN; 14 continued to receive PN with enteral feedings; and 3 patients died. The overall survival rates at 2 and 5 years were 93.3% and 84.0%, respectively. The incidence of catheter-related bloodstream infections was 2.7/1,000 catheter-days and was associated with younger age at PN initiation and lower initial height Z-score. Six patients developed catheter-related central vein thrombosis, with an incidence of 0.25/1,000 catheter-days. Eleven patients experienced PN-associated liver disease (PNALD), and one patient underwent multi-visceral transplant. The patients with PNALD exhibited lower final heights and body weight Z-scores. All patients experienced micronutrient deficiencies transiently while receiving PN. Conclusion: PN is an important and safe treatment for pediatric intestinal failure. PNALD was linked to final anthropometric poor outcomes. Micronutrient deficiencies were common. Anthropometric measurements and micronutrient levels must be monitored for successful PN completion.
Liraglutide (SaxendaR) is prescribed to induce and sustain weight loss in obese patients. The starting dose of liraglutide is 0.6 mg/day for 1 week, which is increased by 0.6 mg/day every week until the full maintenance dose of 3 mg/day is achieved. Such dose titration is needed to prevent side effects, which primarily include gastrointestinal problems such as nausea, diarrhea, constipation, vomiting, dyspepsia, and abdominal pain. A 35-year-old, reportedly healthy obese man receiving liraglutide treatment for obesity visited the emergency room complaining of generalized weakness and dizziness accompanied by repeated diarrhea and vomiting. He reported over 20 episodes of diarrhea starting the day after liraglutide dose escalation from 1.2 mg/day to 1.8 mg/day. Laboratory findings suggested pre-renal acute kidney injury, including serum creatinine 4.77 mg/dl, blood urea nitrogen (BUN) 37 mg/dl, estimated glomerular filtration rate (eGFR) 15 ml/min/1.73 m2, and Fractional excretion of sodium 0.08. After volume repletion therapy, his renal function recovered to a normal range with laboratory values of creatinine 1.08 mg/dl, BUN 14 mg/dl, and eGFR 88 ml/min/1.73 m2. This case emphasizes the need for caution when prescribing glucagon-like peptide-1 receptor agonists, including liraglutide, given the risk of serious renal impairments induced by volume depletion and dehydration through severe-grade diarrhea and vomiting.
Khalid, Shahzaib;Syed, Muhammad Shehram Shah;Saba, Erum;Pirzada, Nasrullah
International Journal of Computer Science & Network Security
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v.22
no.5
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pp.175-181
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2022
COVID-19 is an acute respiratory syndrome that affects the host's breathing and respiratory system. The novel disease's first case was reported in 2019 and has created a state of emergency in the whole world and declared a global pandemic within months after the first case. The disease created elements of socioeconomic crisis globally. The emergency has made it imperative for professionals to take the necessary measures to make early diagnoses of the disease. The conventional diagnosis for COVID-19 is through Polymerase Chain Reaction (PCR) testing. However, in a lot of rural societies, these tests are not available or take a lot of time to provide results. Hence, we propose a COVID-19 classification system by means of machine learning and transfer learning models. The proposed approach identifies individuals with COVID-19 and distinguishes them from those who are healthy with the help of Deep Visual Embeddings (DVE). Five state-of-the-art models: VGG-19, ResNet50, Inceptionv3, MobileNetv3, and EfficientNetB7, were used in this study along with five different pooling schemes to perform deep feature extraction. In addition, the features are normalized using standard scaling, and 4-fold cross-validation is used to validate the performance over multiple versions of the validation data. The best results of 88.86% UAR, 88.27% Specificity, 89.44% Sensitivity, 88.62% Accuracy, 89.06% Precision, and 87.52% F1-score were obtained using ResNet-50 with Average Pooling and Logistic regression with class weight as the classifier.
Objectives Obesity and climacteric symptom are affected by various cultural, social and psychological factors. This study is performed to recognize the relationship between obesity, climacteric symptom, and other social and psychological factors such as self-esteem, depression, eating attitude, stress response and social readjustment rating. Methods SRRS(social readjustment rating scale), SES(self-esteem scale), SRI(stress response inventory), BDI(Beck depression inventory), KEAT-26 (Korean Eating Attitude Test-26) and Kuperman index were given to 43 peri-menopausal women aged 45-55 and BMI ${\geq}23$. They were given written consent and this study is performed under the permission of institutional review board of Kyung Hee East-west Neo Medical Center. And height, body weight, waist circumference were measured. These variables were treated by correlation and regression analysis for finding effect factors of climacteric symptom. Result BMI and WC were not related to climacteric symptom. There were significant correlation between KEAT-26(r=0.4388, p=0.004), SES (r=-0.4748, p=0.001), SRI(r=0.6941, p<0.001), BDI(r=0.6354, p<0.001) and Kuperman index. In multiple regression, SRI was find to be a prediction factor of Kuperman index.(Kuperman index=19.033+0.7SRI($R^2$=0.490)). Conclusion Climacteric symptom is related to self-esteem, eating attitude, depression and stress response. And the most important prediction factor of climacteric symptom is stress response. So managing of stress response may be essential to treating climacteric syndrome. And it is necessary to study about climacteric symptom with many other effective factors of various peri-menopausal subjects.
Kim, Young Ok;Kim, Sun Hui;Cho, Chang Yee;Choi, Young Youn;Kook, Jin Hwa;Hwang, Tae Ju
Clinical and Experimental Pediatrics
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v.46
no.8
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pp.769-776
/
2003
Purpose : The survival rate of very low birth weight infants(VLBWI) has improved by virtue of specialized neonatal care. This study was performed to analyze the changes in incidence, survival rate and morbidity of VLBWI who admitted to Chonnam National University Hospital from 1996 to 2001. Methods : We enrolled 565 VLBWI, and compared the incidence and the survival rate according to the birth weight or gestational weeks between period I(1996 to 1998) and period II(1999 to 2001). The mortality rate according to the postnatal age, cause of death, morbidity and days of hospital stay were also compared. Morbidity is categorized into 'short term' which is curable until discharge, and 'long term' causing any types of sequelae after discharge. Results : Incidence of VLBWI significantly increased in period II over period I(6.0% vs. 11.0%, P< 0.001). The survival rate also increased in period II(71.8% vs. 80.1%, P<0.05), especially in 1,000 to 1,249 gm of birth weight(P<0.001) and in 28 to 30 weeks of gestation(P<0.001). The most common cause of death was respiratory distress syndrome in period I; however it was sepsis in period II. Although overall and short term morbidity rate increased, long term morbidity and days of hospital stay didn't increase in period II. Conclusion : Although the incidence of VLBWI significantly increased and the survival improved in period II compared to period I, especially in 1,000 to 1,249 gm of birth weight and 28 to 30 weeks of gestation, 'long term' morbidity rate and hospital days didn't increase.
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