• Korean Journal of Clinical Pharmacy
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• v.32 no.2
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• pp.125-132
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• 2022

Background: Fixed-dose combinations have the advantage of improving patient compliance, but may increase the risk of duplicate prescriptions. As the use of fixed-dose combination antihypertensives increases, it is necessary to investigate the current status of class duplication prescriptions (CDP) in patients taking fixed-dose combination antihypertensives in Korea and to identify factors associated with CDP. Methods: We conducted a retrospective observational study using nationally representative claim data. Hypertensive patients aged 20 years or older taking fixed-dose combination antihypertensives were extracted. Among these patients, patients with CDP were identified. A chi-square test was applied to determine the differences between patients with CDP and non-CDP. The associated factors of CDP were identified through multiple logistic regression. Results: Of the 74,165 patients who were prescribed fixed-dose combination antihypertensives, 426 patients (0.6%) with CDP were identified. The most common antihypertensive class associated with CDP was calcium channel blockers (194 patients, 45.5%), followed by angiotensin II receptor blockers (136 patients, 31.9%). Patients aged 75 years or older (odds ratio [OR] 1.83, 95% confidence interval [CI] 1.02-3.52), chronic kidney disease (OR 4.45, 95% CI 2.15-8.25), chronic heart failure (OR 2.71, 95% CI 1.93-3.72), coronary artery disease (OR 2.22, 95% CI 1.60-3.03) and Medical Aid/Patriots and Veterans Insurance (OR 1.49, 95% CI 1.04-2.07) were significantly associated with increased CDP. Conclusions: The factors associated with CDP were the elderly, comorbidities, and low socioeconomic status. Since CDP can result in negative clinical outcomes, active intervention by the pharmacist is warranted.

• Korean Journal of Clinical Pharmacy
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• v.32 no.1
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• pp.13-19
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• 2022

Background: The use of combination therapy and fixed-dose combination therapy is increasing for the treatment of type 2 diabetes. Sodium glucose cotransporter-2 inhibitor (SGLT2i) is a drug class used in combination with metformin. Methods: Type 2 diabetes patients on SGLT2i/metformin combination therapy were extracted from the 2019 Health Insurance Review & Assessment Service-National Patients Sample. On July 1, 2019, SGLT2i and metformin fixed-dose combination (SGLT2i/metformin FDC) and two-pill combination (TPC) groups were identified, and a chi-square test and multiple logistic regression were performed. Results: Of total 2,992 patients, 1,077 (36%) were prescribed SGLT2i/metformin FDC and 1,915 (64%) were prescribed TPC. We found that the most common comorbidities were in the order of dyslipidemia, gastrointestinal disease, and hypertension. Multiple logistic regression analysis showed that the use of SGLT2i/metformin FDC was lower than TPC in patients with diabetic neuropathy (OR=0.76, p=0.008). Clinic (OR=2.09, p<0.001) and general hospital (OR=1.40, p=0.019) showed higher tendency to prescribe SGLT2i/metformin FDC compared to tertiary hospital. The tendency of prescribing SGLT2i/metformin FDC was lower in Kyeonggi (OR=0.79, p=0.037), Gyeongsang (OR=0.77, p=0.025) and Chungcheong (OR=0.68, p=0.007) than Seoul. Conclusion: Factors related to the use of SGLT2i/metformin FDC in patients with type 2 diabetes were complication, medical institution and region. The tendency to prescribe SGLT2i/metformin FDC was relatively higher in clinics than in tertiary general hospitals and in Seoul than in other regions.

• Journal of Korean Society of Occupational and Environmental Hygiene
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• v.33 no.2
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• pp.206-214
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• 2023

Objectives: To determine the effect of the various type and number of shift work on sociopsychological stress in the university hospital nurses in Seoul, South Korea. Methods: Data was collected through a self-administered questionnaire that included general characteristics, the type and number of shift work in the past 4 weeks and the an sociopsychological stress based on PWI-SF. Logistic regression analysis was conducted to analyze the effect of shift work by types on sociopsychological stress of university hospital nurses using SAS 9.4 and it adjusted general characteristics by the additional models. Results: When the number of night shift work 3 or 4 compared to 0, sociopsychological stress was significantly high(OR=2.16, 95% CI=1.29-3.65). When 5 or more, it was higher(OR=2.39, 95% CI=1.55-3.72). Two continuous night shift work compared to 0 increased sociopsychological stress(OR=2.37, 95% CI=1.49-3.81) and 3 or more even more(OR=2.70, 95% CI=1.72-4.27). If the shift work type changes 14 or 15 times compare to below 11, sociopsychological stress is increased and even higher when 15 or more times but it's not significant after adjusting for covariates. Conclusions: It suggests that workplace with nurse expose to shift work should be on lookout for more than three night shift work, more than two continuous night shift work and more than 14 shift work change which can lead to burnout, absenteeism, depression and decreased productivity.

• Safety and Health at Work
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• v.15 no.1
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• pp.53-58
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• 2024

Background: As social distancing persists and interest in work-life balance grows, more companies are adopting flexible work policies. While there have been studies on sleep disorders associated with different types of work, such as shift work, research exploring the relationship between flexible work schedules and sleep disorders is still limited, particularly among Korean workers. Methods: We performed a secondary analysis of the 6th Korean Working Conditions Survey, focusing on 31,243 paid workers out of a total of 50,538 participants. We defined flexible workers as those who set their own working hours. Sleep disorders were divided into three categories: 'difficulty falling asleep,' 'frequent waking during sleep,' and 'waking up feeling exhausted and fatigued.' Using scores derived from three specific symptoms, the Minimal Insomnia Symptoms Scale (MISS) was calculated to assess the prevalence of insomnia. We used chi-square tests to analyze demographic and job-related differences. A multivariate logistic regression analysis was employed to identify any relationship between flexible work schedules and sleep disorders. Results: Significant differences were found between flexible and non-flexible workers regarding age, income level, education level, and job type. Flexible workers reported sleep-related symptoms significantly more often. The odds ratio for insomnia was 1.40 (95% CI 1.21-1.61). For males, the odds ratio was 1.68 (1.36-2.08). Conclusion: This study establishes a correlation between flexible work schedules and sleep disorders among Korean salaried workers. Potential causes could include changes in circadian rhythm, increased work demands, and extended working hours. To precisely determine causality and associated diseases, further research is required.

• Journal of Cardiovascular Imaging
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• v.31 no.1
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• pp.41-48
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• 2023

BACKGROUND: The function of left atrium (LA) is difficult to assess because of its ventricle-dependent, dynamic movement. The aim of this study was to assess LA function using velocity vector imaging (VVI) and compare LA function in patients with hypertrophic cardiomyopathy (HCMP) and left ventricular hypertrophy (LVH) with normal controls. METHODS: Fourteen patients with HCMP (72% male, mean age of 52.6 ± 9.8), 15 hypertensive patients with LVH (88% male, mean age of 54.0 ± 15.3), and 10 age-matched controls (83% male, mean age of 50.0 ± 4.6) were prospectively studied. Echocardiographic images of the LA were analyzed with VVI, and strain rate (SR) was compared among the 3 groups. RESULTS: The e' velocity (7.7 ± 1.1; 5.1 ± 0.8; 4.5 ± 1.3 cm/sec, p = 0.013), E/e' (6.8 ± 1.6; 12.4 ± 3.3; 14.7 ± 4.2, p = 0.035), and late diastolic SR at mid LA (-1.65 ± 0.51; -0.97 ± 0.55; -0.82 ± 0.32, p = 0.002) were significantly different among the groups (normal; LVH; HCMP, respectively). The e' velocity, E/e', and late diastolic SR at mid LA were significantly different between normal and LVH (p = 0.001; 0.022; 0.018), whereas LA size was similar between normal and LVH (p = 0.592). The mean late diastolic peak SR of mid LA was significantly correlated with indices of diastolic function (E/e', e', and LA size). CONCLUSIONS: The SR is a useful tool for detailed evaluation of LA function, especially early dysfunction of LA in groups with normal LA size.

• Journal of Cardiovascular Imaging
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• v.31 no.2
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• pp.98-104
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• 2023

BACKGROUND: We aimed to investigate left ventricular (LV) global longitudinal strain (GLS) in end-stage renal disease patients and its change after kidney transplantation (KT). METHODS: We retrospectively reviewed patients who underwent KT between 2007 and 2018 at two tertiary centers. We analyzed 488 patients (median age, 53 years; 58% male) who had obtained echocardiography both before and within 3 years after KT. Conventional echocardiography and LV GLS assessed by two-dimensional speckle-tracking echocardiography were comprehensively analyzed. Patients were classified into three groups according to the absolute value of pre-KT LV GLS (|LV GLS|). We compared longitudinal changes of cardiac structure and function according to pre-KT |LV GLS|. RESULTS: Correlation between pre-KT LV EF and |LV GLS| were statistically significant, but the constant was not high (r = 0.292, p < 0.001). |LV GLS| was widely distributed at corresponding LV EF, especially when the LV EF was > 50%. Patients with severely impaired pre-KT |LV GLS| had significantly larger LV dimension, LV mass index, left atrial volume index, and E/e' and lower LV EF, compared to mildly and moderately reduced pre-KT |LV GLS|. After KT, the LV EF, LV mass index, and |LV GLS| were significantly improved in three groups. Patients with severely impaired pre-KT |LV GLS| showed the most prominent improvement of LV EF and |LV GLS| after KT, compared to other groups. CONCLUSIONS: Improvements in LV structure and function after KT were observed in patients throughout the full spectrum of pre-KT |LV GLS|.

• Journal of Microbiology and Biotechnology
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• v.34 no.4
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• pp.949-957
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• 2024

There has been a growing interest in skin beauty and antimelanogenic products. Melanogenesis is the process of melanin synthesis whereby melanocytes are activated by UV light or hormone stimulation to produce melanin. Melanogenesis is mediated by several enzymes, such as tyrosinase (TYR), microphthalmia-associated transcription factor (MITF), tyrosinase-related protein-1 (TRP-1), and TRP-2. In this study, we investigated the effect of Tuber himalayense extract on melanin synthesis in α-melanocyte-stimulating hormone (α-MSH)-treated B16F10 melanoma cells. We confirmed that T. himalayense extract was not toxic to α-MSH-treated B16F10 melanoma cells and exhibited a significant inhibitory effect on melanin synthesis at concentrations of 25, 50, and 100 ㎍/ml. Additionally, the T. himalayense extract inhibited melanin, TRP-1, TRP-2, tyrosinase, and MITF, which are enzymes involved in melanin synthesis, in a concentration-dependent manner. Furthermore, T. himalayense extract inhibited the mitogen-activated protein kinase (MAPK) pathways, such as extracellular signal-regulated kinase-1/2 (ERK), c-Jun N-terminal kinase (JNK), and p38. Therefore, we hypothesized that various components of T. himalayense extract affect multiple factors involved in melanogenesis in B16F10 cells. Our results indicate that T. himalayense extract could potentially be used as a new material for preparing whitening cosmetics.

• Journal of the Daesoon Academy of Sciences
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• v.41
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• pp.1-25
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• 2022

This paper examines whether the dynamic and practical nature of Daoism has a significant relationship with the messianic figure Kang Jeungsan (姜甑山) via Honam (湖南) Daoism's Jinindaemangron (眞人待望論, discourse on awaiting an immortal). To this end, the historical implementation of Daoism's social transformation of consciousness in China and Korea is explored, and then the circumstances of Honam Daoism, in particular, are considered. Following that, analysis turns to the 'Jinindaemangron' in the late Joseon Dynasty that developed in Honam. As a result of the discussion, Daoism's social transformation of consciousness was expressed in China through the anti-establishment activities of the early Daoist groups such as Wudoumidao (五斗米道) and Taipingdao (太平道), movements that sought to build utopias. Throughout this process, the term, zhenren (眞人, 'jinin' in Korean), that originally meant 'master,' was transformed into the idea of a future savior. In the case of Korea, the dynamic and practical nature of Daoism can be found in the preface of Nanrang tombstone (鸞郎碑序) written by Choi Chi-won (崔致遠) which was later inherited by the Danhak sect (丹學派) practitioners who struggled against Buddhist monastics. Additionally, examined is the Docham theory of geomancy (圖讖說) that rose after Goryeo, the prophecy of 'Mokjadeuksul (木子得國說 a Lee clansman shall attain the kingdom)' that appeared thereafter, and the Prophecies of Jeong Gam (鄭鑑錄)'s 'Jinindaemangron' in the Joseon Dynasty. Next, the circumstances of Honam Daoism can be considered with regards ti Choi Chi-won and Doseon (道詵) in ancient times, and it can be confirmed that Nam Gung-du (南宮斗) and Kwon Geuk-jung (權克中) were entangled behind Kang Jeungsan. The close relationship among the Daoist Jeong family of Onyang (溫陽鄭氏), the Koh family of Jangheung (長興 高氏), and Kwon Geuk-jung was also confirmed in this study. Finally, in dealing with the 'Jinindaemangron' of Honam in the late Joseon Dynasty and the birth of Kang Jeungsan, Honam Daoism's intense consciousness of social transformation receives first focus, and this is expressed through Prophecies of Jeong Gam, and the religious ideologies of Donghak (東學) and Namhak (南學). These expressions are analyzed through Song of Gungeul (弓乙歌), composed by Jeongryeom (鄭磏), and through Daesoon Jinrihoe's The Canonical Scripture (典經). As a result, it can be confirmed that the messianic significance of the Kang Jeungsan's advent lay on the basis of the people's desire for an ideal future, which is a notion that had been ripening for several centuries.

• Environmental and Resource Economics Review
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• v.27 no.2
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• pp.233-260
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• 2018

The West Coast is known as one of the world's three largest intertidal mudflats but the mudflat ecosystems have been constantly destroyed by various reclamation projects and industrial complexes. This study intends to estimate the economic values of major ecosystem services provided by the Seocheon intertidal flats using a choice modeling method. The benefits of the intertidal flats are categorized as four different attributes: number of migratory birds (related to biodiversity and cultural services), production of fish and shellfish (regulating services and habitats), tourism activities (cultural services), and number of fishing households in local communities (cultural services). Study results show that the general public enjoys the economic benefits of 1.777 trillion won (900 million won/hectare) as of 2015 in order to preserve 1,200ha of Seocheon mudflat. Assuming that future generations continue to enjoy these economic benefits of mudflat conservation, the annual value converted is about 64.7 billion won/year, corresponding to 53.9 million won/hectare per year. Individuals are willing to pay are expected to maintain their entire life in the 1,000 households living in the Seocheon tidal-flat fishing village, with an average of 11,000 won per person and an additional 50,000 tourist activities per year. It was estimated to have the amount of payment of 9,000 won. An individual's marginal willingness to pay was estimated to be about 11,000 won per year for supporting a total of 1,000 fishing households, 6,000 won to provide tourism activities of 50,000 visitors, and 9,000 won to provide the habitats of 90,000 migratory birds. For segmentation analysis, residents of Seocheon did not place significant values for the attributes besides migratory bird conservation. However, those of Gunsan showed relatively low margtinal willingness to pay for conservation of migratory birds and fishing villages but showed similar preferences for the maintenance of tourism activities compared to the general public. The results imply that the introduction of economic incentive system is needed to effectively manage and conserve ecosystem services of specific intertidal flats.

• The Korean Journal of Community Living Science
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• v.17 no.3
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• pp.159-174
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• 2006

The purpose of this study is to provide information searching for health promotion, nutrition improvement, and health care of the impaired elderly by ADL(Activity of Daily Living) and IADL(Instrumental Activity of Daily Living). The subjects were divided into the Assistant Needed Group and No Assistant Needed Group for living in line with the responses of ADL(10 items like dressing, washing, move etc.) and IADL(10 items like housekeeping, using transportation, shopping, Phone call etc.). Survey was made for health behavior, health risk habit, dietary management status and diet intake by 24 hr-recall and questionnaire method. 242 subjects were collected in 12 cities or Gun districts in Gyeonggi Province, S. Korea. Survey was carried out by regional home extension workers using interview method. Statistical analyses were made using SAS (Version 8.1). Chi-Square Tests and General Linear Models. The subjects of impaired ADL elderly was 26.5% and it composed 30% of the total male and 22.2% of the total female. The demographic status of the impaired ADL elderly showed no difference from that of the normal elders, elementary school educated (73.4%), with spouse (43.8%) or with adult children(37.5%), using monthly living cost of 500-1,000 thousand won(35.9%). Mean age was 74.05 years compared to 72.25 years of normal elders. However, there was no significant difference from the normal and impaired ADL group, regular exercise(60.0%), with walking (90.0%), no-smoke(54.7%) and no-drink(48.4%). Kind of disease was not different from the one in impaired and normal group, with cardiovascular disease(32.3%), with diabetes mellitus(8.1%), joint lumbago neuralgia(32.3%) and osteoporosis(9.7%). Gastrointestinal complaints of the impaired ADL group were nausea(57.8%), chronic indigestion (23.4%), constipation (14,0%) and vomiting(3.7%). Sleeping time required for the impaired was longer than that for the normal group by 10hours(4.7%) or 8-10hours(20.3%), which consisted 1.7% and 16.6% respectively. Nutrient intake of the impaired ADL group was low compared to normal range elders: Energy(1260kca1), Protein(52.75g). There was gender difference in nutrient intake; the male impaired group showed no significant difference from the normal group but it was significantly lower in female impaired group. These results suggest that low quality of life and low economic status of the impaired ADL elderly require congregate meal in village hall to cover the lack of side dishe variety. And nutrition education program including community assistance would be required for the impaired ADL elderly together with the sufficient food and exercise practice. By operating nutrition education program, the impaired ADL elderly would maintain more enhanced quality of life and ameliorate the ADL capability.