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The Relationship between the Cognitive Impairment and Mortality in the Rural Elderly (농촌지역 노인들의 인지기능 장애와 사망과의 관련성)

  • Sun, Byeong-Hwan;Park, Kyeong-Soo;Na, Baeg-Ju;Park, Yo-Seop;Nam, Hae-Sung;Shin, Jun-Ho;Sohn, Seok-Joon;Rhee, Jung-Ae
    • Journal of Preventive Medicine and Public Health
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    • v.30 no.3 s.58
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    • pp.630-642
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    • 1997
  • The purpose of this study was to examine the mortality risk associated with cognitive impairment among the rural elderly. The subjective of study was 558 of 'A Study on the Depression and Cognitive Impairment in the Rural Elderly' of Jung Ae Rhee and Hyang Gyun Jung's study(1993). Cognitive impairment and other social and health factors were assessed in 558 elderly rural community residents. For this study, a Korean version of the Mini-Mental State Examination(MMSEK) was used as a global indicator of cognitive functioning. And mortality risk factors for each cognitive impairment subgroup were identified by univariate and multivariate Cox regression analysis. At baseline 22.6% of the sample were mildly impaired and 14.2% were severely impaired. As the age increased, the cognitive function was more impaired. Sexual difference was existed in the cognitive function level. Also the variables such as smoking habits, physical disorders had the significant relationship with cognitive function impairment. Across a 3-year observation period the mortality rate was 8.5% for the cognitively unimpaired, 11.1% for the mildly impaired, and 16.5% for the severly impaired respendents. And the survival probability was .92 for the cognitively unimpaired, .90 for the mildly impaired, and .86 for the severly impaired respondents. Compared to survival curve for the cognitively unimpaired group, each survival curve for the mildly and the severely impaired group was not significantly different. When adjustments models were not made for the effects of other health and social covariates, each hazard ratio of death of mildly and severely impaired persons was not significantly different as compared with the cognitively unimpaired. But, as MMSEK score increased, significantly hazard ratio of death decreased. Employing Cox univariate proportional hazards model, statistically other significant variables were age, monthly income, smoking habits, physical disorders. Also when adjustments were made for the effects of other health and social covariates, there was no difference in hazard ratio of death between those with severe or mild impairment and unimpaired persons. And as MMSEK score increased, significantly hazard ratio of death did not decrease. Employing Cox multivariate proportional hazards model, statistically other significant variables were age, monthly income, physical disorders. Employing Cox multivariate proportional hazards model by sex, at men and women statistically significant variable was only age. For both men and women, also cognitive impairment was not a significant risk factor. Other investigators have found that cognitive impairment is a significant predictor of mortality. But we didn't find that it is a significant predictor of mortality. Even though the conclusions of our study were not related to cognitive impairment and mortality, early detection of impaired cognition and attention to associated health problems could improve the quality of life of these older adults and perhaps extend their survival.

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Determination of Representative Renal Depth for Accurate Attenuation Correction in Measurement of Glomerular Filtration Rate in Transplanted Kidney (이식 신의 사구체 여과율 측정에서 정확한 감쇄 보정을 위한 신장 깊이 대표값 설정)

  • Oh, Soon-Nam;Kim, Sung-Hoon;Rha, Sung-Eun;Chung, Yong-An;Yoo, Ie-Ryung;Sohn, Hyung-Sun;Lee, Sung-Young;Chung, Soo-Kyo
    • The Korean Journal of Nuclear Medicine
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    • v.36 no.4
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    • pp.271-276
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    • 2002
  • Purpose: To measure reliable glomerular filtration rate by using the representative values of transplanted renal depths, which are measured with ultrasonography. Materials and Methods: We included 54 patients (26 men, 28 women), with having both renal scintigraphy and ultrasonography after renal transplantation. We measured GFR with Gates' method using the renal depth measured by ultrasonography, and median and mean ones in each patient. We compared GFR derived from ultrasonography-measured renal depth with GFR derived from median and mean renal depths. The correlation coefficients were obtained among GFR derived from ultrasonography-measured renal depths, median and mean renal depths under linear regression analysis. We determined whether GFR derived from median or mean renal depth could substitute GFR derived from ultrasonography-measured renal depth with Bland-Altman method. We analyze the expected errors of the GFR using representative renal depth in terms of age, sex, weight, height, creatinine value, and body surface. Results: The transplanted renal depths range from 3.20 cm to 5.96 cm. The mean value and standard deviation of renal depths measured by ultrasonography are $4.09{\pm}0.65cm$ in men, and $4.24{\pm}0.78cm$ in women. The median value of renal depths measured by ultrasonography is 4.36 cm in men and 4.14 cm in women. The GFR derived from median renal depth is more consistent with GFR derived from ultrasonography-measured renal depth than GFR derived from mean renal depth. Differences of GFR derived from median and ultrasonography-measured renal depth are not significantly different in the groups classified with creatinine value, age, sex, height, weight and body surface. Conclusion: When median value is adapted as a representative renal depth, we could obtain reliable GFR in transplanted kidney simply.

Effect of Thermal Method on the Activation of Brown Adipose Tissue (온열 요법이 갈색지방세포 활성화에 미치는 영향)

  • You, Yeon Wook;Lee, Chung Wun;Seon, Ahn Jeong;Lee, Dong Eun;Moon, Jong Wun;Kim, Yun Cheol;Park, So Hyeon;Kim, Tae-Sung
    • The Korean Journal of Nuclear Medicine Technology
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    • v.25 no.2
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    • pp.48-54
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    • 2021
  • Purpose In 18F-FDG PET/CT, the absorption of 18F-FDG due to the activation of Brown Adipose Tissue (BAT) greatly interferes with the discrimination of lymph node malignant metastasis. Warming the patient's body temperature before and after injection of 18F-FDG to prevent FDG absorption by BAT is a safe and non-pharmacological approach. The purpose of this study was to identify and select patients with a high potential for BAT activation in advance, and to investigate whether BAT can inhibit FDG absorption when the body temperature is raised for a short time by directly applying heat to the target patient. Materials and Methods Among the patients who underwent 18F-FDG PET/CT at the National Cancer Center from January 2020 to December 2020, 825 female patients (415 in the thermal group, 410 in the non-thermal group) under 50 years old were included. The thermal group was administered heat for 10 minutes before injection of 18F-FDG. For statistical analysis, the Z test comparing the ratios between the two groups was used, and logistic regression analysis was performed to correct for important variables (BMI, outdoor temperature, blood sugar) according to the results of the previous retrospective study. Results Among 825 patients, 19 patients with BAT activated (Thermal group: 5(1.2%), Non-thermal group: 14(3.41%)) accounted for 2.3% of the total. As a result of performing the Z test to compare the ratios between the two groups, the activation of BAT in the thermal group was significantly decreased (P=0.034). In the univariate logistic regression analysis, the activation of BAT was also decreased in the thermal group (OR: 0.34, P<0.05). In the multivariate results, BAT activation increased in patients younger than 45 years old (OR: 4.46, P<0.05) and outdoor temperature less than 13.2 degrees (OR: 9.97, P<0.05). BAT activation tended to decrease in the thermal group, but there was no significant difference (OR: 0.37, P=0.066). Conclusion We confirmed that the activation of BAT tends to decrease by 62.5% in the group subjected to the thermal method, and it will be of great help in preventing FDG absorption of BAT more effectively in the future.

Relationships between inbreeding coefficient and economic traits in inbred line of Duroc pigs (두록 계통조성 집단의 근교수준이 경제형질에 미치는 영향)

  • song, Na-Rae;Kim, Yong-Min;Kim, Doo-Wan;Sa, Soo-Jin;Kim, Ki-Hyun;Kim, Young-Hwa;Cho, Kyu-Ho;Do, Chang-hee;Hong, Joon-Ki
    • Korean Journal of Agricultural Science
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    • v.42 no.2
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    • pp.141-149
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    • 2015
  • The data of Duroc swine species that were born from 2000 to 2014 excluding missing ones collected by Korea National Institute of Animal Science were used in the present study. After removing missing data we used 9756 of productions data and 1728 of reproductive reference of breeding research to study the level of inbreeding and to investigate the impact on the reproductive traits, production traits. The correlation of reproductive traits and inbreeding coefficient are -0.07, -0.08 for total number pigs born, number of pigs born alive respectively and birth weight per litter is -0.10, number of pigs born alive per litter to 21days is -0.06 and body weight per litter to 21days is -0.09. The correlation coefficients of the inbreeding coefficients of reproductive traits are shown within 10% with negative correlation (P < 0.05). Days of 90kg and Backfat in the correlation coefficient and inbreeding coefficient production traits were not observed significant correlations, Average daily gain was investigated by the positive correlation of 0.05. According to the above results, the inbreeding level gave a negative effect on the improvement of the breed traits, investigating a relatively high compared to a negative effect on other traits. But overall correlation degree is less than 10% was observed. This inbreeding coefficient has not been clearly observed due to degeneration of the average inbreeding coefficients of these generations was maintained within 10% of the population. The scale of the experimental group was about 150 degree pig husbandry is very small compared to the advanced countries. However, the level of inbreeding in the population group with the appropriate mating combinations is maintained below 10% of population is thought to be small and can minimize the effects of inbreeding degeneration. further testing utilizing this selection is constantly considered to be necessary.

The Relationships Among Highly Caffeinated Beverage Intake and Depressive Symptom, Suicide in Adolescents (청소년의 고카페인 음료 섭취와 우울증상 및 자살의 관계)

  • Ahn, In-Young;Seo, Ji-Yeong;Lee, Dongyun;Lee, So-Jin;Cha, Boseok;Kim, Bong-Jo;Park, Chul-Soo;Choi, Jae-Won;Lee, Cheol-Soon
    • Korean Journal of Psychosomatic Medicine
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    • v.24 no.2
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    • pp.191-199
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    • 2016
  • Objectives : Despite the increased popularity of highly caffeinated beverages, there is little research examining psychiatric adverse effects. The purpose of this study was to investigate the relationships among pattern of highly caffeinated beverage intake and depressive symptom, suicidal ideation, suicidal plan, suicidal attempt in Korean adolescents. Methods : The data was obtained from the 2014 Korean Youth's Risk Behavior Web-based Study by Korea Centers for Disease Control & Prevention. All participants conducted web-based questionnaire survey. Chisquare test and multiple logistic regression analysis were performed to determine the association among highly caffeinated beverage intake pattern, depressive symptom, suicidal ideation, suicidal plan and suicidal attempt adjusting for differences in age, gender, academic achievement, socioeconomic status. Results : A total of 71,638 participants were enrolled in this study. Depressive symptom, suicidal ideation, suicidal plan and suicidal attempt were significantly more frequent in the group with presence of highly caffeinated beverage intake within 1 week than in non-drinker group(p<0.01). Highly caffeinated beverage intake was significantly associated with suicidal attempt(OR=1.99 ; 95% CI, 1.77-2.22). In addition, depressive symptom, suicidal ideation, suicidal plan and suicidal attempt were significantly more common in the group with heavy-drinker who exceed recommended daily intake dose of caffeine than in the group with light-drinker(p<0.01). Heavy drinking of caffeinated beverage was significantly associated with suicidal attempt(OR=4.05 ; 95% CI, 3.02-5.43). Conclusions : We found that highly caffeinated beverage intake was related to more frequent depressive symptom, suicidal ideation, plan, attempt in adolescents. Also, caffeine intake which exceed recommended daily intake dose identified the predictor of suicidal attempt. Our result suggested that clinicians need to be aware of the possible psychiatric adverse effects of highly caffeinated beverage in vulnerable population including young adolescents.

Trends in metabolic risk factors among patients with diabetes mellitus according to income levels: the Korea National Health and Nutrition Examination Surveys 1998~2014 (성인 당뇨병 환자의 소득수준에 따른 혈당, 당화혈색소, 혈압, 및 혈중지질 지표의 변화 추이 : 국민건강영양조사 1998~2014 분석 결과)

  • Cho, Sukyung;Park, Kyong
    • Journal of Nutrition and Health
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    • v.52 no.2
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    • pp.206-216
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    • 2019
  • Purpose: Management of the metabolic risk factors in diabetes patients is essential for preventing or delaying diabetic complications. This study compared the levels of the metabolic risk factors in diabetes patients according to the income levels, and examined the secular trends in recent decades. Methods: The data from the Korea National Health and Nutrition Examination Survey 1998 ~ 2014 were used. The diabetes patients were divided into three groups based on their household income levels. General information was obtained through self-administered questionnaires, and the blood biomarkers and blood pressure data were obtained from a health examination. Multivariable linear regression models were used to compare the metabolic biomarker levels according to the household income levels, adjusting for potential confounding factors. Results: The fasting blood glucose, hemoglobin A1c, and blood lipid (total cholesterol, high-density lipoprotein (HDL) cholesterol, low-density lipoprotein (LDL) cholesterol, and triglyceride) levels were similar in the three groups. During the survey period of 16 years, the blood pressure showed a significant decreasing trend with time in all groups (p < 0.001). In contrast, the fasting blood glucose (p = 0.004), total cholesterol (p < 0.001), and LDL-cholesterol levels (p = 0.007) decreased significantly, and the HDL-cholesterol level (p < 0.001) increased significantly in the highest-income groups. In the lowest-income group, the fasting blood glucose (p = 0.02), total cholesterol (p < 0.001), and triglyceride (p = 0.003) levels showed a significant decreasing trend over time. On the other hand, the middle-income group showed no significant change in any of the metabolic risk factors except for blood pressure. Conclusion: The level of management of metabolic risk factors according to the income level of Korean diabetes patients was similar. On the other hand, the highest- and lowest-income groups showed positive trends of management of these factors during 16 years of observation, whereas the middle-income group did not show any improvement.

Improvement of Mid-and Low-flow Estimation Using Variable Nonlinear Catchment Wetness Index (비선형 유역습윤지수를 이용한 평갈수기 유출모의개선)

  • Hyun, Sukhoon;Kang, Boosik;Kim, Jin-Gyeom
    • KSCE Journal of Civil and Environmental Engineering Research
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    • v.36 no.5
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    • pp.779-789
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    • 2016
  • The effective rainfall is calculated considering the soil moisture. It utilizes observed data directly in order to incorporate the soil moisture into the rainfall-runoff model, or it calculates indirectly within the model. The rainfall-runoff model, IHACRES, used in this study computes the catchment wetness index (CWI) first varying with temperature and utilize it for estimating precipitation loss. The nonlinear relationship between the CWI and the effective rainfall in the Hapcheondam watershed was derived and utilized for the long-term runoff calculation. The effects of variable and constant CWI during calibration and validation were suggested by flow regime. The results show the variable CWI is generally more effective than the constant CWI. The $R^2$ during high flow period shows relatively higher than the ones during normal or low flow period, but the difference between cases of the variable and constant CWI was insignificant. The results indicates that the high flow is relatively less sensitive to the evaporation and soil moisture associated with temperature. On the other hand, the variable CWI gives more desirable results during normal and low flow periods which means that it is crucial to incorporate evaporation and soil moisture depending on temperature into long-term continuous runoff simulation. The NSE tends to decrease during high flow period with high variability which could be natural because NSE index is largely influenced by outliers of underlying variable. Nevertheless overall NSE shows satisfactory range higher than 0.9. The utilization of variable CWI during normal and low flow period would improve the computation of long-term rainfall-runoff simulation.

Prediction of High Grade Vesicoureteral Reflux in Infants Less than 3 Months with Urinary Tract Infection (3개월 미만 요로감염 영아에서 중증 방광 요관 역류의 예측인자)

  • Yi, Dae-Yong;Kim, Na-Yeon;Cho, Hee-Yeon;Kim, Ji-Eun;Sim, So-Yeon;Son, Dong-Woo;Jeon, In-Sang;Cha, Han
    • Childhood Kidney Diseases
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    • v.12 no.2
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    • pp.178-185
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    • 2008
  • Purpose : Our aim was to investigate the predictive factors for detecting grade III-V vesicoureteral reflux(VUR) in young infants less than 3 months with urinary tract infections (UTI). Methods : Data of infants who underwent ultrasonography and VCUG between January 2004 and September 2007 were reviewed. Age, gender, incidence of bacteremia, C-reactive protein(CRP) and imaging studies were compared between group I(grade III-V VUR) and group II (normal or grade I and II VUR) retrospectively. Sensitivity, specificity, positive and negative predictive values, odds ratio, and likelihood ratio of ultrasonography for high grade VUR were evaluated. Results : Among 54 enrolled infants(41 males, 13 females), 14 infants were group I and 40 infants were group II. In the group I, CRP level was significantly higher(6.11$\pm$5.18 vs. 3.27$\pm$3.45, P=0.025), and there were more ultrasonographic abnormal findings(71.4%, vs. 22.5%, P=0.002) compared with group II. However, ultrasonography was the only significant factor after adjusting with logistic regression(P=0.002). Incidence of bacteremia and abnormal DMSA findings were not significantly different in two groups. Sensitivity, specificity, and odds ratio of ultrasonography was 71.4%, 77.5%, 6.9 respectively. Negative predictive value was 88.6% and negative likelihood ratio was 0.37. Ultrasonography had significant negative likelihood ratio for grade III-V VUR, but missed 4 infants with grade III VUR. Conclusion : We could not find any alternative predictive factors to reduce VCUG in detecting high grade VUR. Therefore, VCUG must be considered in young infants less than 3 months with UTI.

The Relationship between Pesticide Exposure and Central Nervous System Symptoms (농약 노출과 중추신경 증상과의 관련성)

  • Kwon, Young-Jun;Kang, Tae-Sun;Kim, Kyung-Ran;Lee, Kyung-Sook;Ju, Young-Su;Song, Jae-Chul
    • Journal of agricultural medicine and community health
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    • v.29 no.2
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    • pp.265-285
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    • 2004
  • Objectives: The acute toxic effects of pesticide are well known. Concern has also been expressed that long-term exposure may result in damage to the central nervous system. This study was conducted to test the hypothesis that central nervous system symptoms might occur due to pesticide exposure. Methods: In a cross-sectional study, first, cumulative exposure index (CEI) was estimated. Neurologic symptoms (Q-16 questionnaire) for 541 farmers (exposed to pesticides) were compared with 119 non-exposed persons in spraying season nine rural areas in Korea. Results: The pesticides poisoning rates for last 3 months were 67.2% for orchard farmers, 55.3%for dry field farmers, and 20.5% for husbandry farmers, respectively, showing significant difference (p<0.001). Compared with non-exposure group, exposure groups (especially, orchard farmers) reported significantly more neurologic symptoms and had a higher overall neurological symptoms score (p<0.001). Factors related to the positive neurological symptoms (answers "yes" to six or more of Q-16 questionnaire) adjusted for age, sex, education level, smoking and alcohol drinking were type of farming (OR 3.08, 95% CI 1.50-6.30 in orchard farmers vs non-exposure group), CEI (OR 2.75, 95% CI 1.12-6.78 in Q3 vs Q1), past poisoning (OR 1.97, 95% CI 1.21-3.20 vs normal), current mild poisoning (OR 3.03, 9500 CI 1.47-6.22 vs normal) and current moderate poisoning (OR 6.34, 95% CI 3.03-13.25 vs normal), respectively. Conclusions: These results suggest that long-term exposure to pesticides appears to be associated with subtle changes in the central nervous system.

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Changes of Microbial Activity and Physicochemical Environment during Composting of Papermill Sludge in a Pilot Plant (제지슬럿지의 퇴비화 과정 중 미생물활성 및 이화학적 환경변화)

  • Chung, Young-Ryun;Chung, Man-Hoon;Han, Shin-Ho;Oh, Say-Kyun
    • Journal of the Korea Organic Resources Recycling Association
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    • v.3 no.2
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    • pp.79-89
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    • 1995
  • Changes of microbial activity and physicochemical environment during composting of papermill sludge(PMS) in the pilot plant equipped with an agitated bed reactor were monitored for establishing the efficient composting system. Microbial activity determined as the evolution of $CO_2$ increased for the first 10 days after introduction of PMS to the reactor and decreased thereafter. Population changes of microorganisms in the reactor-PMS were not typical as in windrow system. The ratio of thermophilic bacteria to mesophilic bacteria, however, increased slowly even 23 days after introduction. Temperature of PMS increased rapidly from the first day and reached $62^{\circ}C$ at 7 days after introduction and decreased slowly thereafter. The acidity of PMS was pH 6.8 initially, increased to pH 8.0 after 7 days and decreased to pH 7.4 after 23 days. Redox potential(Eh) of PMS was -320mV at the beginning of composting, but it was increased with time to reach -15mV after 23 days composting. However, Eh of PMS pre-sterilized before measurement was average 50mV, regardless of composting periods indicating the major role of microorganisms during composting process. Water content of PMS was 67% initially and decreased to about 50% after 23 days composting in the reactor. Less than 13 days-old compost inhibited growth of radish in the container mixture with bed soil. Based on statistical analysis of microbial and physicochemical parameters of PMS during composting, an equation was developed for determining compost maturity. A number of experiments using various organic wastes are required before application of the formular to the practical use.

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