• Tuberculosis and Respiratory Diseases
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• v.81 no.4
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• pp.311-318
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• 2018

Background: The aim of this study was to examine the influence of body mass index (BMI) on the development of acute kidney injury (AKI) in critically ill patients in intensive care unit (ICU). Methods: Data of patients admitted to medical ICU from December 2011 to May 2014 were retrospectively analyzed. Patients were classified into three groups according to their BMI: underweight (< $18.5kg/m^2$), normal ($18.5-24.9kg/m^2$), and overweight (${\geq}25kg/m^2$). The incidence of AKI was compared among these groups and factors associated with the development of AKI were analyzed. AKI was defined according to the Risk, Injury, Failure, Loss of kidney function, and End-stage (RIFLE) kidney disease criteria. Results: A total of 468 patients were analyzed. Their mean BMI was $21.5{\pm}3.9kg/m^2$, including 102 (21.8%) underweight, 286 (61.1%) normal-weight, and 80 (17.1%) overweight patients. Overall, AKI occurred in 82 (17.5%) patients. The overweight group had significantly (p<0.001) higher incidence of AKI (36.3%) than the underweight (9.8%) or normal group (15.0%). In addition, BMI was significantly higher in patients with AKI than that in those without AKI ($23.4{\pm}4.2$ vs. $21.1{\pm}3.7$, p<0.001). Multivariate analysis showed that BMI was significantly associated with the development of AKI (odds ratio, 1.893; 95% confidence interval, 1.224-2.927). Conclusion: BMI may be associated with the development of AKI in critically ill patients.

• Korean Journal of Psychosomatic Medicine
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• v.27 no.1
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• pp.69-76
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• 2019

Objectives : The purpose of this study was to examine the prevalence and clinical characteristics of nonsuicidal self-injury (NSSI), and its association with suicide attempts among clinically depressed adolescents in Korea. Methods : In total, 113 depressed adolescents aged 12-18 years in South Korea were enrolled in this study. We assessed sociodemographic and clinical characteristics including suicidality and non-suicidal self-injury (NSSI) using various self-reported scales and semi-structured interview for diagnosis of psychiatric disorders. Demographic and clinical characteristics of the subjects were compared between NSSI and non-NSSI groups. We examined significant predictors of suicide attempts using logistic regression analysis. Results : Among 113 depressed participants, 48 (42.1%) adolescents were classified into the NSSI group. In the NSSI group, there were significantly more females, showed higher depression, higher state-anxiety, and more suicide ideation. The most predictive factors of suicide attempts were history of NSSI, observed suicide/NSSI behaviors of their family or friends, and total state anxiety score. Conclusions : NSSI is more common problem among clinically depressed adolescents and history of NSSI is a significant predictor of present suicide attempts. To include the assessment of NSSI for clinically depressed adolescent may be crucial for intervention programs for high risk adolescents of suicide in Korea.

• Journal of Korean Medicine Rehabilitation
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• v.32 no.3
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• pp.131-140
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• 2022

Objectives This study aimed to investigate whether the concurrent use of conventional and herbal medications affects liver and kidney function, by examining blood test data. Methods We retrospectively reviewed the electronic medical records of 590 inpatients with musculoskeletal diseases between 2013 and 2017. We investigated cases of drug-induced liver injury (DILI) according to the Roussel Uclaf Causality Assessment Method criteria and cases of drug-induced kidney injury (DIKI) based on the Kidney Disease Improving Global Outcomes definition. Results One case (0.17%) of DILI and one case (0.17%) of DIKI were identified. Significant improvements in serum laboratory data were observed after the concurrent use of both types of medications (p<0.05). The kappa coefficients ranged from 0.26 to 0.72, indicating that the values after the concurrent use of conventional and herbal medications showed a fair similarity to the baseline values of the patients. The linear regression test showed that female sex and high body mass index (BMI) were risk factors for an increase in the serum blood levels of liver function parameters. Conclusions The concurrent use of conventional and herbal medications for musculoskeletal disorders is relatively safe; however, clinicians should exercise caution when prescribing these medications to female patients and patients with a high BMI because of their potential effect on hepatic function.

• Journal of Korean Neurosurgical Society
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• v.55 no.1
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• pp.26-31
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• 2014

Objective : Early decompressive craniectomy (DC) has been used as the first stage treatment to prevent secondary injuries in cases of severe traumatic brain injury (TBI). Postoperative management is the major factor that influences outcome. The aim of this study is to investigate the effect of postoperative management, using intracranial pressure (ICP) monitoring and including consecutive DC on the other side, on the two-week mortality in severe TBI patients treated with early DC. Methods : Seventy-eight patients with severe TBI [Glasgow Coma Scale (GCS) score <9] underwent early DC were retrospectively investigated. Among 78 patients with early DC, 53 patients were managed by conventional medical treatments and the other, 25 patients were treated under the guidance of ICP monitoring, placed during early DC. In the ICP monitoring group, consecutive DC on the other side were performed on 11 patients due to a high ICP of greater than 30 mm Hg and failure to respond to any other medical treatments. Results : The two-week mortality rate was significantly different between two groups [50.9% (27 patients) and 24% (6 patients), respectively, p=0.025]. After adjusting for confounding factors, including sex, low GCS score, and pupillary abnormalities, ICP monitoring was associated with a 78% lower likelihood of 2-week mortality (p=0.021). Conclusion : ICP monitoring in conjunction with postoperative treatment, after early DC, is associated with a significantly reduced risk of death.

• Korean Journal of Veterinary Research
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• v.46 no.4
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• pp.315-322
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• 2006

Ethanol abuse is associated with liver injury, neurotoxicity, modulation of immune responses, and increased risk for cancer, whereas moderate ethanol consumption exerts protective effects against liver injury. However, the underlying signal transduction mechanisms of insulin-like growth factors (IGFs) which play an important regulatory role in various metabolism mechanisms are not well understood. We investigated the effects of ethanol-induced p42/44 activity on IGF-I secretion, IGF-I receptor and IGFBP-1 secretion using radioimmunoassay and western blotting in primary cultured rat hepatocytes. The p42/44 activity, IGF-I secretion and IGF-I receptor activity significantly accelerated compared to control at 10 and 30 min after 200 mM ethanol treatment, but then it became suppressed at 180 min. In contrast, IGFBP-1 secretion was inhibited compared to control at 30 min after 200 mM ethanol treatment, but increased at 180 min. The IGF-I secretion, IGF-I receptor and p42/44 activity at 30 min after 200 mM ethanol treatment accelerated with increasing ethanol concentration but IGFBP-1 secretion inhibited (p<0.05). The increased IGF-I secretion, inhibited IGFBP-1 secretion and IGF-IR activity by ethanol-induced temporal p42/44 activity at 30 min after ethanol treatment was blocked by treatment with PD98059. Alcohol dehydrogenase (ADH) inhibitor, 4-methylpyramazole blocked the changes of IGF-I secretion, IGFBP-1 secretion, and IGF-IR activity by ethanol-induced p42/44 activity at 30 and 180 min. Taken together, these results suggest that ethanol is involved in the modulation of IGF-I and IGFBP-1 secretion and IGF-IR activity by p42/44 activity in primary cultured rat hepatocytes. In addition, changing of p42/44 activity by ethanol was caused with ADH.

• Childhood Kidney Diseases
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• v.23 no.2
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• pp.105-110
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• 2019

Purpose: We sought to determine associations of urinary neutrophil gelatinase-associated lipocalin (NGAL) and liver-type fatty acid-binding protein (L-FABP), known markers of renal injury, with hematuria in children and adolescents. Methods: A total of 112 urine samples from 72 patients aged 2 to 18 years with hematuria were enrolled in this study. Urinary concentrations of NGAL and L-FABP were measured by ELISA and compared between subjects with and without proteinuria and between subjects with and without glomerulonephritis diagnosed by renal biopsy. Results: Urinary concentrations of NGAL and L-FABP/creatinine (Cr) in subjects with proteinuria were not significantly different from those in subjects without proteinuria. They were not significant different between subjects with and without glomerulonephritis either. However, both concentrations of urinary NGAL and L-FABP/Cr were positively associated with urinary protein to creatinine ratio. Their levels had a tendency to be increased when proteinuria developed at later visits in subjects with hematuria only at initial visits. Conclusion: Monitoring urinary NGAL and L-FABP levels in addition to conventional risk factors such as proteinuria and serum creatinine might improve the prediction of renal injury in pediatric patients with hematuria.

• Laboraroty Animal Research
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• v.34 no.4
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• pp.195-202
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• 2018

Hyperglycemia is one of the major risk factors for stroke. Hyperglycemia can lead to a more extensive infarct volume, aggravate neuronal damage after cerebral ischemia. ${\alpha}$-Synuclein is especially abundant in neuronal tissue, where it underlies the etiopathology of several neurodegenerative diseases. This study investigated whether hyperglycemic conditions regulate the expression of ${\alpha}$-synuclein in middle cerebral artery occlusion (MCAO)-induced cerebral ischemic injury. Male Sprague-Dawley rats were treated with streptozotocin (40 mg/kg) via intraperitoneal injection to induce hyperglycemic conditions. MCAO were performed four weeks after streptozotocin injection to induce focal cerebral ischemia, and cerebral cortex tissues were obtained 24 hours after MCAO. We confirmed that MCAO induced neurological functional deficits and cerebral infarction, and these changes were more extensive in diabetic animals compared to non-diabetic animals. Moreover, we identified a decrease in ${\alpha}$-synuclein after MCAO injury. Diabetic animals showed a more serious decrease in ${\alpha}$-synuclein than non-diabetic animals. Western blot and reverse-transcription PCR analyses confirmed more extensive decreases in ${\alpha}$-synuclein expression in MCAO-injured animals with diabetic condition than these of non-diabetic animals. It is accepted that ${\alpha}$-synuclein modulates neuronal cell death and exerts a neuroprotective effect. Thus, the results of this study suggest that hyperglycemic conditions cause more serious brain damage in ischemic brain injuries by decreasing ${\alpha}$-synuclein expression.

• Journal of the Korea Society of Computer and Information
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• v.24 no.3
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• pp.175-179
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• 2019

This study is a descriptive research of paramedic students who could be exposed to blood and body fluids during the clinical practicum to analyze the risk factors. From June 1 to June 30, 2018, 172 paramedic students who attended the University in Jeolla-do region were analyzed. The collected data were analyzed by using the SPSS WIN 21.0 program. The general characteristics of subjects, the exposure level of blood and body fluids, and etc were obtained for frequency and percentage analysis. The study found that 72.7 percent of students had experience to blood or body fluids exposure during the clinical practicum. Except for any needle injury, 70.4 percent of student were exposed to blood or body fluids. 28.8 percent of them which was the highest percentage of injection injury were exposed during the venous blood draw. 36.5 percent of exposure were related to wound dressings which was the highest percentage related to clinical procedures. 71.2 percent of students mentioned that they did not report this exposure because 68.5 percent students thought that it has no danger. According to the survey on hepatitis B, 50.6% of students had antibodies, but 31.8 percent of students did not confirm that the antibodies were formed. Even though paramedic students do practical training in a hazardous environment with repeated exposure to blood and body fluids due to the nature of job characteristics, the systemic infection control education program is insufficient. In order to prevent exposure and to protect paramedic students who do practical training with patients, it is necessary to make more systematic and active efforts in the continuous monitoring and the preventive education.

• The Korean Journal of Pain
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• v.34 no.2
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• pp.156-164
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• 2021

Several types of pain occur following spinal cord injury (SCI); however, neuropathic pain (NP) is one of the most intractable. Invasive and non-invasive brain stimulation techniques have been studied in clinical trials to treat chronic NP following SCI. The evidence for invasive stimulation including motor cortex and deep brain stimulation via the use of implanted electrodes to reduce SCI-related NP remains limited, due to the small scale of existing studies. The lower risk of complications associated with non-invasive stimulation, including transcranial direct current stimulation (tDCS) and repetitive transcranial magnetic stimulation (rTMS), provide potentially attractive alternative central neuromodulation techniques. Compared to rTMS, tDCS is technically easier to apply, more affordable, available, and potentially feasible for home use. Accordingly, several new studies have investigated the efficacy of tDCS to treat NP after SCI. In this review, articles relating to the mechanisms, clinical efficacy and safety of tDCS on SCI-related NP were searched from inception to December 2019. Six clinical trials, including five randomized placebo-controlled trials and one prospective controlled trial, were included for evidence specific to the efficacy of tDCS for treating SCI-related NP. The mechanisms of action of tDCS are complex and not fully understood. Several factors including stimulation parameters and individual patient characteristics may affect the efficacy of tDCS intervention. Current evidence to support the efficacy of utilizing tDCS for relieving chronic NP after SCI remains limited. Further strong evidence is needed to confirm the efficacy of tDCS intervention for treating SCI-related NP.

• Journal of Korean Society of Occupational and Environmental Hygiene
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• v.30 no.4
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• pp.331-341
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• 2020

Objectives: This study was conducted to evaluate perceptions of safety and risk among Korean industrial hygienists and the change between before and after the Sewol Ferry Disaster in 2014. Two surveys with questionnaires composed of 51 questions were completed by attendees of the Korea Industrial Hygiene Association(KIHA) conference. Methods: One was conducted at the 2013 KIHA Fall Conference(N=181) and the other was from the 2014 KIHA Summer Conference(N=123). Between these two surveys was the Sewol Ferry Disaster on April 14, 2014, which was believed to seriously affect safety and risk perceptions in Korea. Results: It was revealed that industrial hygienists' awareness of safety rules strengthened after the Sewol Ferry Disaster(p<0.05). It was apparent that people over the age of 30 were more sensitive to social safety. There was no significant difference in the evaluation and attitude regarding governmental safety policy between the years of 2013 and 2014. The credibility of public organizations responsible for the disaster management system decreased. The self-evaluation of respondents' safety level also decreased. This trend shows mainly in the younger generation. It was evaluated that the overall social safety level decreased and the anxiety level increased. The score on social safety on a ±5 Likert scale was 0.68 in the 2013 survey and -0.33 in the 2014 survey(p<0.05). It was reported that the most serious threat factors for accident or disaster were 'building collapse > illegalities and corruption > side effects of radiation therapy >accidents in normal activity > occupational disease,' in order. They picked 'safety ignorance > hurry-up habits and culture > focusing on short-term benefit > easy-going attitude > insufficient safety education' for the causes of low social safety levels in 2013. In 2014, they were 'safety ignorance > easy-going attitude > focusing on short-term benefit > insufficient safety education > hurry-up habits and culture'. Conclusions: This study has some limitations because it was originally not designed to survey attitudes prior to the Sewol Ferry disaster in 2013. In addition, the survey targets are industrial hygienists who are familiar with occupational disease and injury.