• Title/Summary/Keyword: $L_{eq}$

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The Significance of the Strong Ion Gap in Predicting Acute Kidney Injury and In-hospital Mortality in Critically Ill Patients with Acute Poisoning (중증 급성 중독 환자에서 급성 신장 손상과 병원 내 사망률을 예측하기 위한 강이온차(Strong Ion Gap)의 중요성)

  • Sim, Tae Jin;Cho, Jae Wan;Lee, Mi Jin;Jung, Haewon;Park, Jungbae;Seo, Kang Suk
    • Journal of The Korean Society of Clinical Toxicology
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    • v.19 no.2
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    • pp.72-82
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    • 2021
  • Purpose: A high anion gap (AG) is known to be a significant risk factor for serious acid-base imbalances and death in acute poisoning cases. The strong ion difference (SID), or strong ion gap (SIG), has recently been used to predict in-hospital mortality or acute kidney injury (AKI) in patients with systemic inflammatory response syndrome. This study presents a comprehensive acid-base analysis in order to identify the predictive value of the SIG for disease severity in severe poisoning. Methods: A cross-sectional observational study was conducted on acute poisoning patients treated in the emergency intensive care unit (ICU) between December 2015 and November 2020. Initial serum electrolytes, base deficit (BD), AG, SIG, and laboratory parameters were concurrently measured upon hospital arrival and were subsequently used along with Stewart's approach to acid-base analysis to predict AKI development and in-hospital death. The area under the receiver operating characteristic curve (AUC) and logistic regression analysis were used as statistical tests. Results: Overall, 343 patients who were treated in the intensive care unit were enrolled. The initial levels of lactate, AG, and BD were significantly higher in the AKI group (n=62). Both effective SID [SIDe] (20.3 vs. 26.4 mEq/L, p<0.001) and SIG (20.2 vs. 16.5 mEq/L, p<0.001) were significantly higher in the AKI group; however, the AUC of serum SIDe was 0.842 (95% confidence interval [CI]=0.799-0.879). Serum SIDe had a higher predictive capacity for AKI than initial creatinine (AUC=0.796, 95% CI=0.749-0.837), BD (AUC=0.761, 95% CI=0.712-0.805), and AG (AUC=0.660, 95% CI=0.607-0.711). Multivariate logistic regression analyses revealed that diabetes, lactic acidosis, high SIG, and low SIDe were significant risk factors for in-hospital mortality. Conclusion: Initial SIDe and SIG were identified as useful predictors of AKI and in-hospital mortality in intoxicated patients who were critically ill. Further research is necessary to evaluate the physiological nature of the toxicant or unmeasured anions in such patients.

Recovery and Associated Factors of Cognitive Function in Patients with Hemorrhagic Stroke (출혈성 뇌졸중 환자의 인지기능 변화 및 연관 요인에 대한 추적조사)

  • Park, Minsu;Min, Ji Hong;Ko, Sung Hwa;Lee, Sang Won;Ko, Hyun-Yoon;Shin, Yong-Il
    • 재활복지
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    • v.21 no.2
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    • pp.247-259
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    • 2017
  • We investigated the improvement of cognitive functions, activity of daily living (ADL), and quality of life (QoL) after hemorrhagic stroke and identified associated factors. For this research, twenty-five patients with a hemorrhagic stroke were enrolled. We measured cognitive function, activity of daily living (ADL), and quality of life (QoL) from 7 days to 12 months after onset of stroke. Then we analyzed the correlation between cognitive function and other risk factors. According to results, cognitive functions improved during 12 months with statistically significant differences. Other functions were similar to cognitive functions. Improvement of cognitive functions were correlated with age, the type of hemorrhagic stroke and Glasgow coma scale at 7 days after stroke. Overall, cognitive function in patients with hemorrhagic stroke recovered from acute to 12 months after onset of stroke. And, improvement of cognitive function at this phase were associated with age, the type of hemorrhagic stroke and GCS score at 7 days. These results would provide us an information to plan cognitive rehabilitation in patients with hemorrhagic stroke.

Factors Affecting Health-Related Quality of Life in Patients with Chronic Obstructive Pulmonary Disease using Health-Related Quality of Life Instrument with 8 Items (Health-Related Quality of Life Instrument with 8 Items을 사용한 만성폐쇄성폐질환 환자의 건강관련 삶의 질 영향요인)

  • Kim, Seon-Ha;Kim, Miok
    • The Journal of the Korea Contents Association
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    • v.22 no.8
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    • pp.347-357
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    • 2022
  • This study was attempted to identify the health-related quality of life of Chronic Obstructive Pulmonary Disease (COPD) patients and factors influencing the quality of life, focusing on Health-related quality of life with 8 items (HINT-8). The subjects of this study were 451 adults aged 40 years or older who performed lung function tests and whose ratio is less than 0.7 by measuring forced respiratory volume in 1 second [FEV1] to forced vital capacity in the 2019 National Health and Nutrition Examination Survey, It was analyzed using SAS program. As a result, both the HINT-8 index and EuroQol five-dimensions 3-level version (EQ-5D-3L) index were appropriate as tools to measure the health-related quality of life in COPD patients, and the factors affecting the health-related quality of life were age, gender, income, and smoking status, comorbidities, stress, and subjective health status. Therefore, in order to improve the health-related quality of life of COPD patients, an individualized management program suitable for the characteristics of subjects such as the low-income class and the elderly, including smoking cessation education and stress management, should be developed and applied.

Impact of postoperative dietary types on nutrition and treatment prognosis in hospitalized patients undergoing oral and maxillofacial surgery: a comparative study

  • Sung Bin Youn;Se-Hui Ahn;Dong-Ho Cho;Hoon Myoung
    • Korean Journal of Community Nutrition
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    • v.29 no.2
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    • pp.129-143
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    • 2024
  • Objectives: The objective of this study is to compare a nutritionally balanced soft blend diet (SBD) with a soft fluid diet (SFD) on the health of inpatients who have undergone oral and maxillofacial (OMF) surgery, ultimately aiming to enhance care outcomes, improve health-related quality of life (QOL), and increase satisfaction with the hospital. Methods: Thirty-two patients were randomized into two groups: sixteen received SFD and sixteen received SBD. Anthropometric, laboratory evaluations were conducted upon admission and discharge. Patients filled out questionnaires on demographics, diet satisfaction, food intake amount, and health-related QOL on the day of discharge, assessed using the EuroQoL 5 Dimensions 3 Level and EuroQoL Visual Analogue Scale (EQ-VAS) instruments. Data were analyzed with descriptive statistics, χ2 tests for group differences, and paired nonparametric t-tests for within-group comparisons. The Mann-Whitney U test evaluated inter-group differences in preoperative weight and body mass index (BMI), postoperative changes, meal satisfaction, intake, health-related QOL, and self-assessed health status. P-values were set at a significance level of 0.05. Results: The SBD group had higher dietary intake (63.2% vs. 51.0%) and greater diet satisfaction (80.6 vs. 48.1, P < 0.0001) compared to SFD group. Health-related QOL, measured by EQ-VAS, was better in SBD group (70.3 vs. 58.8, P < 0.05). Postoperative weight and BMI decreased in SFD group but increased in SBD group (P < 0.01). Changes in laboratory results showed more stability in the SBD group. No postoperative infections were reported in SBD group, whereas SFD group had a 31.25% complication rate. Conclusions: While SFD is often recommended after OMF surgery to protect oral wound healing process, our study reveals that SBD not only enhances physical and psychological outcomes but also, somewhat unexpectedly, supports wound healing and reduces complications. Essentially, SBD promotes physical recovery and enhances health-related QOL than SFD by supporting both somatic and mental healing aspects.

Gender Difference in Quality of Life After Controlling for Related Factors among Korean Young-old and Old-old Elderly (한국 전·후기 노인의 삶의 질 관련요인과 성별 차이)

  • Chung, Younghae;Cho, Yoo Hyang
    • Journal of agricultural medicine and community health
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    • v.39 no.3
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    • pp.176-186
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    • 2014
  • Objectives: As a sequel to the former analysis of the quality of life (QoL) among young-old and old-old in Korea, this research was aimed to identify factors related to the quality of life and the gender difference after controlling for the related factors among Korean elderly. Methods: Selected elderly data of 1,339 subjects from the 5th Korea National Health and Nutrition Examination Survey conducted in 2010 was analyzed. In this survey, QoL was measured using Euro Quality of Life (EQ-5D) instrument. Data were analyzed using complex survey data analysis on IBM-SPSS 20.0. The related factors were identified using general linear models with backward elimination. The gender difference was tested also using general linear models. Results: The distributions of educational level, family income level, and presence of cohabitant were different between male and female elderly in both young-old and old-old age group. So were the health behaviors and perceived health, and experience of stress, depression, and suicidal thoughts. QoL and its subscales- mobility, self care, daily living, pain and discomfort, and anxiety and depression- were consistently better among male elderly regardless of age group. Among the variables considered, education, family income level, presence of cohabitant, perceived health, age group and BMI were found to be related to the QoL at p=.05, and presence of chronic diseases at p=.10. The difference in QoL between male and female elderly after controlling for the variables was statistically significant. Conclusion: Improving QoL is particularly important for the elderly. In order to improve QoL of the elderly, age- and gender- differences need to be considered when developing services and programs for the elderly.

Isolation and Identification of an Antioxidant Substance from Heated Onion (Allium cepa L.) (열처리 양파로부터 항산화물질의 분리동정)

  • Hwang, In-Guk;Kim, Hyun-Young;Lee, Sang-Hoon;Hwang, Cho-Rong;Oh, Seung-Hee;Woo, Koan-Sik;Kim, Dae-Joong;Lee, Jun-Soo;Jeong, Heon-Sang
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.40 no.3
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    • pp.470-474
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    • 2011
  • The objectives of this study were to identify antioxidant substance in heated onion. The isolation of active compound was performed in three steps: silica gel column chromatography, preparative TLC, and preparative HPLC. The structure of the purified compound was determined using spectroscopic methods, i.e., ultraviolet, mass spectrometry, $^1H$-NMR, $^{13}C$-NMR, and DEPT. The antioxidant activities of isolated compound were evaluated and compared with $\alpha$-tocopherol, ascorbic acid, and butylated hydroxytoluene (BHT) using DPPH and ABTS assay. The isolated compound was identified as 2,3-dihydro-3,5-dihydroxy-6-methyl-4H-pyran-4-one(DDMP). The DPPH radical-scavenging activity ($IC_{50}$) of the DDMP was in the following order: ascorbic acid (45.3 ${\mu}g/mL$)>$\alpha$-tocopherol (69.2 ${\mu}g/mL$)>DDMP (241.6 ${\mu}g/mL$)>BHT (268.0 ${\mu}g/mL$). In addition, DDMP showed strong ABTS radical-scavenging activity of 569.0 mg AA eq/g.

Coexistence of Central Diabetes Insipidus and Prolonged Cerebral Salt Wasting Syndrome after Brain Tumor Surgery: A Case Report

  • Lee, Ji Sun;Baek, Hee Jo;Kim, Chan Jong;Yang, Eun Mi
    • Childhood Kidney Diseases
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    • v.24 no.1
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    • pp.42-46
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    • 2020
  • Disturbances in water and salt balances are relatively common in children after brain tumor surgery. However, the coexistence of different diseases of water and sodium homeostasis is challenging to diagnose and treat. The coexistence of combined central diabetes insipidus (CDI) and cerebral salt wasting syndrome (CSWS) is rare and may impede accurate diagnosis. Herein, we report the case of an 18-year-old girl who underwent surgery for a germinoma and who presented prolonged coexistence of CDI and CSWS. The patient was diagnosed with panhypopituitarism with CDI at presentation and was treated with hydrocortisone, levothyroxine, and desmopressin. Postoperatively, she developed polyuria of more than 3L/day, with a maximum daily urine output of 7.2 L/day. Her serum sodium level decreased from 148 to 131 mEq/L. Polyuria was treated with desmopressin at incremental doses, and hyponatremia was managed with fluid replacement. At 2 months after surgery, she presented with hyponatremia-induced seizure. Polyuria and hyponatremia combined with natriuresis indicated CSWS. Treatment with fludrocortisone were initiated; then, her electrolyte level gradually normalized. CSWS is self-limiting and generally resolves within 2 weeks. However, the patient in this study still required treatment with vasopressin and fludrocortisone at 16-months after surgery. Hyponatremia in a patient with CDI may be erroneously interpreted as inadequate CDI control or syndrome of inappropriate antidiuretic hormone secretion, leading to inappropriate treatment. The identification of the potential combination of CDI and CSWS is important for early diagnosis and treatment.

Severe hyponatremia and seizures after bowel preparation with low-volume polyethylene glycol plus ascorbic acid solution (저용량 polyethylene glycol 용액에 아스코르빈산을 첨가한 장정결제로 대장내시경 전처치 후 발생한 발작을 동반한 저나트륨혈증)

  • Lee, Jae Young;Jang, Byung Ik;Nam, Yoon Jeong;Song, Jay;Kim, Min Cheol;Chung, Seung Min;Jang, Jong Geol;Cho, Jae Ho
    • Journal of Yeungnam Medical Science
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    • v.32 no.1
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    • pp.55-59
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    • 2015
  • The widely used polyethylene glycol (PEG)-based solutions have been proven effective for bowel preparation when 4 L of the solution is administered before colonoscopy. However, large volumes of the solutions are generally poorly tolerated. A new PEG-based solution consisting of 2 L of PEG and a high dose of ascorbic acid has recently become available. Electrolyte abnormalities caused by PEG-based solutions have rarely been reported. We report on a case of acute severe hyponatremia with associated generalized tonic-clonic seizures after bowel preparation with a low-volume PEG plus ascorbic acid solution in a 74-year-old woman with no history of seizures. She took a beta blocker, an angiotensin-converting enzyme inhibitor, and glimepiride for hypertension and diabetes mellitus. She showed general weakness, nausea, agitation, muscle cramping, and seizures after ingestion of the PEG plus ascorbic acid solution. Her serum sodium level was 112 mEq/L. Her symptoms improved after intravenous administration of hypertonic saline. Physicians should pay attention to screening for electrolytes and development of neurological symptoms during bowel preparation.

A Research on Quality of Life and Cost of Oriental Medical Care in Adult Patients with Chronic Atopic Dermatitis in Korea (성인 만성 아토피 피부염 환자의 삶의 질과 한방 치료비용에 대한 고찰)

  • Kim, Nam-Kwen;Oh, Yong-Leol;Seo, Eun-Sung;Lee, Dong-Hyo
    • The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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    • v.23 no.1
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    • pp.215-223
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    • 2010
  • Objective : The aim of this study is to assess the impact of chronic atopic dermatitis (AD) on quality of life (QoL) as well as the economic burden associated with oriental medical treatment on adult patients with chronic AD in Korea. Methods : The EQ-5D health states, existence and duration of AD in the 2007 National Health and Nutrition Examination Survey (NHANES) were used to obtain the study subjects. A questionnaire including the questions on direct medical and direct non-medical costs associated with oriental medical treatment for adult patients with AD was specifically designed. Twenty-nine, members of the Korean Oriental Medical Ophthalmology, Otolaryngology and Dermatology Society (KOMOODS), completed the questionnaires. Results : The incidence of AD was around 3.09% in 2007 NHANES (sample survey, n=2981). Three months and above in duration of disease was 1.35%. The QoL data revealed as follows: 0.932 in non-chronic AD, 0.916 in chronic AD, and 0.908 in non-AD. We also stratified our analysis by age. The QoL data in 40's was statistically significant (P<0.023). But, no significant differences were reported in 20's, 30's, and 50's. The total direct medical costs of oriental medical treatment for AD was about 2,560,717 Won, and total direct non-medical costs was about 605,125 Won in a year. Conclusions : This study might be applied to find the evidence of economic evaluation in oriental medicine for AD. More rigorous studies are warranted.

Antioxidant Components and Antioxidant Activities of 70% Ethanol Extracts on Suweon-511 and Ilpum Rice (수원 511호와 일품쌀의 항산화성분 및 70% 에탄올 추출물의 항산화활성)

  • Woo, Koan-Sik;Jeong, Eung-Gi;Suh, Sae-Jung;Yang, Chang-Ihn;Jeong, Heon-Sang;Kim, Kee-Jong
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.37 no.10
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    • pp.1223-1230
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    • 2008
  • To evaluate the potential of a new breed, Suweon-511, antioxidant components and antioxidant activities of the 70% ethanol extracts of Suweon-511 (SWE) and Ilpum (IPE) were measured. Total polyphenol and flavonoid contents were 318.17 and 167.21 $\mu$g/g for SWE, which were higher than that of IPE (222.16 and 100.89 $\mu$g/g). Both $\alpha$- and $\gamma$-tocopherol contents were higher in SWE as well. The total tocopherol contents of SWE (1.31 mg/100 g) was higher than that of IPE (0.86 mg/100 g). The $\alpha$-, $\gamma$- and $\delta$-tocotrienol contents of SWE (0.10, 0.43, and 0.02 mg/100 g) that of IPE (0.09, 0.43, and 0.03 mg/100 g) showed little difference. For $\gamma$-oryzanol, Suweon-511, which contained 76.58 $\mu$g/g, contained ten times as much as I lpum (7.77 $\mu$g/g). The total antioxidant activity of SWE and IPE were 16.00 and 9.73 mg AA eq/g, respectively. For reducing power, at 5 mg/mL, both extracts were 0.18, but at 20 mg/mL, SWE showed 0.61 and that of IPE was 0.58. The DPPH radical, hydroxyl radical, superoxide radical and hydrogen peroxide scavenging activity of SWE were 42.00, 21.59, 23.27, and 17.13% at 5 mg/mL, and for IPE, they were 30.10, 22.37, 25.18, and 18.08%, respectively. These data, as well, did not show big difference between the two breeds. As indicated in the data above, the newly-bred Suweon-511 had higher content of antioxidant components compared to Ilpum, but similar or a little higher antioxidant activity.