• Title/Summary/Keyword: medical practice

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Fatty liver associated with metabolic derangement in patients with chronic kidney disease: A controlled attenuation parameter study

  • Yoon, Chang-Yun;Lee, Misol;Kim, Seung Up;Lim, Hyunsun;Chang, Tae Ik;Kee, Youn Kyung;Han, Seung Gyu;Han, In Mee;Kwon, Young Eun;Park, Kyoung Sook;Lee, Mi Jung;Park, Jung Tak;Han, Seung Hyeok;Ahn, Sang Hoon;Kang, Shin-Wook;Yoo, Tae-Hyun
    • Kidney Research and Clinical Practice
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    • v.36 no.1
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    • pp.48-57
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    • 2017
  • Background: Hepatic steatosis measured with controlled attenuation parameter (CAP) using transient elastography predicts metabolic syndrome in the general population. We investigated whether CAP predicted metabolic syndrome in chronic kidney disease patients. Methods: CAP was measured with transient elastography in 465 predialysis chronic kidney disease patients (mean age, 57.5 years). Results: The median CAP value was 239 (202-274) dB/m. In 195 (41.9%) patients with metabolic syndrome, diabetes mellitus was more prevalent (105 [53.8%] vs. 71 [26.3%], P < 0.001), with significantly increased urine albumin-to-creatinine ratio (184 [38-706] vs. 56 [16-408] mg/g Cr, P = 0.003), high sensitivity C-reactive protein levels (5.4 [1.4-28.2] vs. 1.7 [0.6-9.9] mg/L, P < 0.001), and CAP (248 [210-302] vs. 226 [196-259] dB/m, P < 0.001). In multiple linear regression analysis, CAP was independently related to body mass index (${\beta}=0.742$, P < 0.001), triglyceride levels (${\beta}=2.034$, P < 0.001), estimated glomerular filtration rate (${\beta}=0.316$, P = 0.001), serum albumin (${\beta}=1.386$, P < 0.001), alanine aminotransferase (${\beta}=0.064$, P = 0.029), and total bilirubin (${\beta}=-0.881$, P = 0.009). In multiple logistic regression analysis, increased CAP was independently associated with increased metabolic syndrome risk (per 10 dB/m increase; odds ratio, 1.093; 95% confidence interval, 1.009-1.183; P = 0.029) even after adjusting for multiple confounding factors. Conclusion: Increased CAP measured with transient elastography significantly correlated with and could predict increased metabolic syndrome risk in chronic kidney disease patients.

A Study on the Experience of Hands-on Workers' Case Management in the Organization for Preventing Prostitution (성매매방지기관 실무자의 사례관리 경험에 대한 연구)

  • Yuk, Hea-Ryeon;Nam, Mi-Ae
    • Korean Journal of Social Welfare Studies
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    • v.47 no.1
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    • pp.233-259
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    • 2016
  • The purpose of this study is to investigate the problems brought about by applying the case management of prostitution in practice, considering its special characteristics. The study is based on the actual experience and understanding of the hands-on workers toward its case management, who are working at the organization for preventing prostitution. To do this, data collected for the research is analyzed by an inductive approache. Participants are selected in the Counseling Centers for Prostitution, General Supporting Facilities, Supporting Centers for Self-help, and Youth Facilities. Three organizations in each type of the centers or facilities are respectively chosen. Twelve participants are composed of six hands-on workers in charge of the case management and six managers supervising it(called the director of the Center in some Centers). According to the analysis, the main issues of their case management experiences are divided into 5 topics and then sub-divided into 12 ones in 3 areas. Each theme of the topics is 'Steady & ordinary, not special tasks', 'Co-existence of a burden & thrilling', 'Sad, but pretending to be serene', 'Know-hows through practical experiences', 'Nevertheless, fill my future with hopes'. On the basis of the result, some policies and instructions necessary to actively revitalize the case management are suggested: expanding professional training centers based on the field, preparing government level customized-services in medical treatments and laws, creating jobs & intensifying job training, setting up various cooperative systems with local organizations via active networking, establishing super-vision systems, and so on.

Psychogenic Dizziness for Psychiatrists in Korea (정신건강의학과 의사를 위한 심인성 어지럼)

  • Lee, Kyung-Kyu
    • Korean Journal of Psychosomatic Medicine
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    • v.24 no.1
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    • pp.9-19
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    • 2016
  • Many patients with dizziness present with a symptom pattern that does not reveal the cause by neurotologic diagnostic approaches. In such cases, the physician frequently diagnoses psychogenic dizziness. Psychogenic dizziness is not characterized by true vertigo, and occurs in combination with other psychiatric symptom cluster. One out of two to four patients with dizziness are psychogenic dizziness. But there are few concern about this including clinical practice and study in Korea. I wrote this paper to increase concerning and attending to this for psychiatrists in Korea. I reviewed etiology including biological and psychological relations between dizziness and psychiatric disorder(especially anxiety), diagnostic approaches of, characteristics of dizziness of various psychiatric disorders related to, and the treatment of psychogenic dizziness. I also briefly reviewed the central and peripheral dizziness for psychiatrists. I suggest psychiatrists and clinicians in the psychosomatic field in Korea to acknowledge, concern, and attend to psychogenic dizziness. In turn, it will be helpful to well treat the patients with psychogenic dizziness.

Study on the Piezoelectric Energy Harvesting Technology for the Energy Conversion of Vibration in Automobiles (자동차 진동 에너지 변환을 위한 압전 에너지 하베스팅에 관한 연구)

  • Lee, Hyeon Yeong;Kim, Kwangwon;Ye, Jiwon;Woo, Suhyeon;Lee, Geon;Lee, Seungah;Jeong, Seong Rok;Jeong, Seon Hye;Kim, Ho Seong;Nam, Ga Hyeon;Jo, Yun Yeong;Choi, Han Seung;Ryu, Jungho
    • Journal of the Korean Institute of Electrical and Electronic Material Engineers
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    • v.34 no.6
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    • pp.495-504
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    • 2021
  • Energy Harvesting is a technology that can convert wasted energy such as vibration, heat, light, electromagnetic energy, etc. into usable electrical energy. Among them, vibration-based piezoelectric energy harvesting (PEH) has high energy conversion efficiency with a small volume; thus, it is expected to be used in various autonomous powering devices, such as implantable medical devices, wearable devices, and energy harvesting from road or automobiles. In this study, wasted vibration energy in an automobile is converted into electrical energy by high-power piezoelectric materials, and the generated electrical energy is found to be an auxiliary power source for the operation of wireless sensor nodes, LEDs, etc. inside an automobile. In order to properly install the PEH in an automobile, vibration characteristics includes frequency and amplitude at several positions in the automobile is monitored initially and the cantilever structured PEH was designed accordingly. The harvesting properties of fabricated PEH is characterized and installed into the engine part of the automobile, where the vibration amplitude is stable and strong. The feasibility of PEH is confirmed by operating electric components (LEDs) that can be used in practice.

Korean Medication Algorithm Project for Bipolar Disorder 2018 (KMAP-BP 2018): Fourth Revision

  • Woo, Young Sup;Bahk, Won-Myong;Lee, Jung Goo;Jeong, Jong-Hyun;Kim, Moon-Doo;Sohn, InKi;Shim, Se-Hoon;Jon, Duk-In;Seo, Jeong Seok;Min, Kyung Joon;Kim, Won;Song, Hoo-Rim;Yoon, Bo-Hyun
    • Clinical Psychopharmacology and Neuroscience
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    • v.16 no.4
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    • pp.434-448
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    • 2018
  • Objective: The Korean Medication Algorithm Project for Bipolar Disorder (KMAP-BP) was first published in 2002 through an expert consensus of opinion, and updated in 2006, 2010, and 2014. This study constitutes the fourth revision of the KMAP-BP. Methods: A 50-item questionnaire was used to obtain the consensus of experts regarding pharmacological treatment strategies for various phases of adult bipolar disorder and six items for pediatric bipolar disorder. The review committee included 84 Korean psychiatrists and 43 child and adolescent psychiatry experts. Results: The preferred first-step strategies for acute mania were the combination of a mood stabilizer (MS) and an atypical antipsychotic (AAP), MS monotherapy, and AAP monotherapy. A combination of a MS and an AAP, and AAP monotherapy were preferred for psychotic mania. The first-step strategies for mild to moderate bipolar depression were monotherapy with MS, AAP, or lamotrigine (LMT), and the combination of a MS and an AAP or LMT, or a combination of an AAP and LMT. The combination of two among a MS, AAP, and LMT were preferred for non-psychotic severe depression. A combination of a MS and an AAP or the combination of an AAP with an antidepressant or LMT were the first-line options for psychotic severe depression. Conclusion: The recommendations of the KMAP-BP 2018 have changed from the previous version by reflecting recent developments in pharmacotherapy for bipolar disorder. KMAP-BP 2018 provides clinicians with a wealth of information regarding appropriate strategies for treating patients with bipolar disorder.

Prognostic significance of non-chest pain symptoms in patients with non-ST-segment elevation myocardial infarction

  • Kim, Inna;Kim, Min Chul;Park, Keun Ho;Sim, Doo Sun;Hong, Young Joon;Kim, Ju Han;Jeong, Myung Ho;Cho, Jeong Gwan;Park, Jong Chun;Cho, Myeong Chan;Kim, Jong Jin;Kim, Young Jo;Ahn, Youngkeun
    • The Korean journal of internal medicine
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    • v.33 no.6
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    • pp.1111-1118
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    • 2018
  • Background/Aims: Chest pain is an essential symptom in the diagnosis of acute coronary syndrome (ACS). One-third of patients with ACS present atypically, which can influence their receiving timely lifesaving therapy. Methods: A total of 617 NSTEMI patients from the Korea Acute MI Registry (KAMIR) and the Korea Working Group on MI (KorMI) databases were analyzed. The study population was divided into two groups by symptoms at presentation (typical symptoms group, 128; atypical symptoms groups, 128). Results: In this study population, 23% of patients presented without chest pain. After propensity score matching, the contact-to-device time ($2,618{\pm}381minutes$ vs. $1,739{\pm}241minutes$, p = 0.050), the symptoms-to-balloon time ($3,426{\pm}389minutes$ vs. $2,366{\pm}255minutes$, p = 0.024), and the door-to-balloon time ($2,339{\pm}380minutes$ vs. $1,544{\pm}244minutes$, p = 0.002) were significantly higher in the patients with atypical symptoms than in those with typical symptoms, respectively. Atypical symptoms were an independent predictor for 1-year mortality (hazard ratio, 2.820; 95% confidence interval, 1.058 to 7.515; p = 0.038). The Kaplan-Meier estimates showed higher risk for 12-month mortality in patients with atypical symptoms (p = 0.048) and no significant difference for 12-month major adverse cardiac events (p = 0.487). Conclusions: Acute myocardial infarction patients with atypical symptoms were not rare in clinical practice and showed a high risk of delayed reperfusion therapy. After imbalance between the groups was minimized by use of propensity score matching, patients who presented atypically had a high mortality rate.

Elevation of Procalcitonin in an Adolescent Acetaminophen Intoxication (아세트아미노펜 중독 청소년에서의 프로칼시토닌 상승)

  • Kim, So Eun;Lee, Jae Baek;Jin, Young Ho;Yoon, Jae Chol;Jo, Si On;Jeong, Tae Oh
    • Journal of The Korean Society of Clinical Toxicology
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    • v.17 no.1
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    • pp.38-41
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    • 2019
  • Procalcitonin (PCT) is commonly employed in medical practice as a diagnostic biomarker of bacterial infection and also as a monitoring biomarker for antimicrobial therapy. There have been a few published reports concerning elevated PCT levels in people with acute liver injury caused by an overdose of acetaminophen. We report here on a case of PCT elevation in an adolescent with acute acetaminophen poisoning without any bacterial infection or liver injury. A 15-year-old girl had deliberately ingested 20 tablets of 650 mg acetaminophen (13 g) and she presented to our emergency department. The PCT level on admission was elevated to 65.64 ng/mL (reference range: 0-0.5 ng/mL). Her PCT level on the second day peaked up to 100 ng/mL and then it gradually decreased. There was no evidence of liver injury or infection on the computed tomography examination and other lab tests. The patient regained her good health and was discharged on the sixth day of hospitalization.

Evaluation of in vitro anti-oxidant and anti-inflammatory activities of Korean and Chinese Lonicera caerulea

  • Lee, You-Suk;Cho, Il Je;Kim, Joo Wan;Lee, Sun-Kyoung;Ku, Sae Kwang;Lee, Hae-Jeung
    • Nutrition Research and Practice
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    • v.12 no.6
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    • pp.486-493
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    • 2018
  • BACKGROUND/OBJECTIVE: The honeysuckle berry (HB) contains ascorbic acid and phenolic components, especially anthocyanins, flavonoids, and low-molecular-weight phenolic acids. In order to examine the potential of HB as a hepatoprotective medicinal food, we evaluated the in vitro anti-oxidant and anti-inflammatory activities of Korean HB (HBK) and Chinese HB (HBC). MATERIALS/METHODS: Antioxidant and anti-inflammatory effects of the extracts were examined in HepG2 and RAW 264.7 cells, respectively. The anti-oxidant capacity was determined by DPPH, SOD, CAT, and ARE luciferase activities. The production of nitric oxide (NO) as an inflammatory marker was also evaluated. The Nrf2-mediated mRNA levels of heme oxygenase-1 (HO-1), NAD(P)H dehydrogenase [quinone] 1 (Nqo1), and glutamate-cysteine ligase catalytic subunit (Gclc) were measured. The concentrations of HB extracts used were 3, 10, 30, 100, and $300{\mu}g/mL$. RESULTS: The radical scavenging activity of all HB extracts increased in a concentration-dependent manner (P < 0.01 or P < 0.05). SOD (P < 0.05) and CAT (P < 0.01) activities were increased by treatment with $300{\mu}g/mL$ of each HB extract, when compared to those in the control. NO production was observed in cells pretreated with 100 or $300{\mu}g/mL$ of HBC and HBK (P < 0.01). Treatment with $300{\mu}g/mL$ of HBC significantly increased Nqo1 (P < 0.01) and Gclc (P < 0.05) mRNA levels compared to those in the control. Treatment with $300{\mu}g/mL$ of HBK (P < 0.05) and HBC (P < 0.01) also significantly increased the HO-1 mRNA level compared to that in the control. CONCLUSIONS: Thus, the Korean and Chinese HBs were found to possess favorable in vitro anti-oxidant and anti-inflammatory activities. Nrf2 and its related anti-oxidant genes were associated with both anti-oxidant and anti-inflammatory activities in HB-treated cells. Further studies are needed to confirm these in vivo effects.

Supporting plan of disabled welfare center for the Disabled in Securing the Maternity Rights (Pregnancy·Childbirth·Child Rearing) of Disabled Women from a Gender-Sensitive Perspective (성인지적 관점의 여성장애인 모성권(임신과 출산,자녀양육)보장을 위한 장애인복지관의 역할)

  • Choi, Sun-kyoung
    • Journal of Digital Convergence
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    • v.16 no.12
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    • pp.97-107
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    • 2018
  • According to the 2017 national survey of the disabled persons conducted by the Ministry of Health and Welfare, rehabilitation centers for the disabled appeared to be the service agency that disabled women use the most. This means that rehabilitation centers for the disabled hold an important role in securing the maternity rights of disabled women. However, in the practice of welfare for the disabled, programs for securing maternity rights are inadequate, and the actual condition is not being surveyed. As a result, programs related to maternity rights based on the legal basis exist, but actual support services for resolving the difficulties related to maternity rights that disabled women experience are inadequate. Thus, the study suggests that rehabilitation centers for the disabled should pay a central role in establishing the maternity rights of disabled women and provide support services such as developing a manual on basic information about pregnancy, childbirth, and child rearing, offering childbirth-related counseling, activating a self-help group, providing an individualized program for families, connecting with medical institutions, and supporting case management.

Convergence Research on Relationships among the inhibiting factors of Dying Well (웰다잉 저해 요인의 관련성에 관한 융합 연구)

  • Lee, Chong Hyung;Ahn, Sang-Yoon;Kim, Yong-Ha;Kim, Kwang-Hwan
    • Journal of the Korea Convergence Society
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    • v.10 no.8
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    • pp.37-44
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    • 2019
  • The purpose of this study is to determine the inhibiting factors of dying well for people who want to have a good death. The final respondents in this study were sampled using stratified proportional allocation using a stratified random sampling method, and 1,000 adults aged between 19 and 75 years were selected. The questionnaire used consisted of four items on general characteristics and 20 items related to the inhibiting factors of dying well scored on a 7-point Likert scale. Analysis was conducted using descriptive statistics, correlation analysis, and decision tree analysis. Results showed that, among the inhibiting factors of dying well, "degenerative diseases (such as dementia)" and "loss of control (mental / physical)" scored 5.502 and 5.268 points, respectively; the highest significant positive correlation was found between "bad marital relationship" and "bad relationship with children," followed by "did not receive death education" and "lack of medical policy promotion (dying well)" and "bad relationship with children" and "indifference of others." Considering these findings, it appears that the whole society will make efforts to improve the perception and practice of good death, and life and death education will be expanded if death education for dying well is organized and implemented.