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Effectiveness of statin treatment for recurrent stroke according to stroke subtypes (뇌졸중 재발에 대한 스타틴 치료의 뇌졸중 아형에 따른 효과성)

  • Min-Surk Kye;Do Yeon Kim;Dong-Wan Kang;Baik Kyun Kim;Jung Hyun Park;Hyung Seok Guk;Nakhoon Kim;Sang-Won Choi;Dongje Lee;Yoona Ko;Jun Yup Kim;Jihoon Kang;Beom Joon Kim;Moon-Ku Han;Hee-Joon Bae
    • Journal of Medicine and Life Science
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    • v.21 no.2
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    • pp.40-48
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    • 2024
  • Understanding the effectiveness of statin treatment is essential for developing tailored stroke prevention strategies. We aimed to evaluate the efficacy of statin treatment in preventing recurrent stroke among patients with various ischemic stroke subtypes. Using data from the Clinical Research Collaboration for Stroke-Korea-National Institute for Health (CRCS-K-NIH) registry, we included patients with acute ischemic stroke admitted between January 2011 and July 2020. To evaluate the differential effects of statin treatment based on the ischemic stroke subtype, we analyzed patients with large artery atherosclerosis (LAA), cardio-embolism (CE), and small vessel occlusion (SVO). The primary outcomes were recurrent ischemic stroke and recurrent stroke events. The hazard ratio for outcomes between statin users and nonusers was compared using a Cox proportional hazards model adjusted for covariates. A total of 46,630 patients who met the inclusion criteria were analyzed. Statins were prescribed to 92%, 93%, and 78% of patients with LAA, SVO, and CE subtypes, respectively. The hazards of recurrent ischemic stroke and recurrent stroke in statin users were reduced to 0.79 (95% confidence interval [CI], 0.63-0.99) and 0.77 (95% CI, 0.62-0.95) in the LAA subtype and 0.63 (95% CI, 0.52-0.76) and 0.63 (95% CI, 0.53-0.75) in CE subtype compared to nonusers. However, the hazards of these outcomes did not significantly decrease in the SVO subtype. The effectiveness of statin treatment in reducing the risk of recurrent stroke in patients with LAA and CE subtypes has been suggested. Nonetheless, no significant effect was observed in the SVO subtype, suggesting a differential effect of statins on different stroke subtypes.

Comparative Analysis of Ginsenoside Content in Processed Red Ginseng Foods Based on Food Type and Formulation (홍삼가공식품의 식품유형별 및 제형별 진세노사이드 함량 비교)

  • Yun-Jeong Yi;Min-Su Chang;In-Sook Lee;Hyun-Jeong Kim;Hyun-Jeong Jang;In-Sook Hwang
    • Journal of Food Hygiene and Safety
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    • v.39 no.2
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    • pp.163-170
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    • 2024
  • Red ginseng is manufactured as a health-functional food and is also present in various food types and in different product forms. However, there is currently no standardized regulation of ginsenoside content in foods containing red ginseng. In the present study, we analyzed the ginsenoside content of 66 red ginseng-containing foods and 35 health-functional foods collected online and directly from the market. The ginsenoside content was assessed using liquid chromatography (LC) and liquid chromatography-tandem mass spectrometry (LC-MS/MS) methods. The ginsenoside content of the various food types ranged 0.0 (not detected)-71.567 mg per daily intake of foods containing red ginseng. Sugar-preserved foods had the highest ginsenoside content, followed by solid teas, liquid teas, and red ginseng beverages. For health-functional foods, the ginsenoside content ranged 3.4-58.5 mg per daily intake, with levels ranging 83-607% of the indicated amounts. All values met the established standards. Upon comparing red ginseng health-functional foods and red ginseng-containing foods, the average ginsenoside content was determined to be 18.21 and 8.79 mg, respectively, thus being nearly twice as high in health-functional foods. However, there was a minimal difference between the ginsenoside content of red and black ginseng, with values of 11.84 and 12.63 mg, respectively. These findings provide insights on the variations in ginsenoside content of red and black ginseng in various food forms. This information is expected to be valuable for future regulations and consumer choice of products containing red ginseng.

Actual Experience of the Oracle of the I Ching-Death, God and Love: In Front of My Father's Spirit (주역 점(占)의 실제 체험-죽음, 신 그리고 사랑: 아버지의 영전(靈前)에서)

  • Ju Hyun Lee;Bou-Yong Rhi
    • Sim-seong Yeon-gu
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    • v.37 no.2
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    • pp.149-183
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    • 2022
  • The oracle of the I Ching, divination can be understood as 'synchronicity phenomenon' in analytic psychology. In order to experience divination actually, it requires a religious attitude that asks questions with a serious mind when a person is in trouble that consciousness reaches its limit. It is not just a passive attitude, but a modest, active attitude to ask what I can do now. The experience of the oracle of the I Ching connected to supra-consciousness is similar to 'active imagination'-talking with the archetype of collective unconsciousness-and is 'the process of finding the rhythm of Self-archetype, the absolute wisdom of unconsciousness.' One month before my father's death, I took care of him who couldn't communicate verbally and I divination with a question 'What can I do for my father and me now?' The I Ching's answer was hexagram 19 Lin 臨, nine at the beginning. It's message was '咸臨貞吉 joint approach. perseverance brings good fortune.' 志行正也 we must adhere perseveringly to what is right.' Through this phrase, I learned the attitude of waiting for life after death as if 'joyful obedient' to the providence of nature that spring comes after winter. And I found that keeping the touching emotion of meeting infinity (in analytical psychological terms, 'Self') with perseveration is to do the true meaning of life beyond popular money-mindedness. And six months before my father's death, I had a dream about the afterlife. In the process of interpreting that dream, I learned not only from the shock of the direct message that 'it is a truth that there is something after death,' but also the regeneration of the mind through introversion from the similarity between the closed ward and '黃泉'-chinese underworld through amplification. And I learned the importance of an open attitude to accept new things through the 'window to eternity' symbolized by the white iron gate. In my father's catholic funeral ritual, I had hope that the catholic doctrine 'Communio Sanctorum'-A spiral cycle in which the living and the dead help each other may be real as well as a symbol of the individuation process in which consciousness and unconsciousness interact in our minds. Through the consolation received through the funeral visit of many people I met in my life, I found the answer that the path to contact with infinity begins with loving the beings in front of me. I tried to understand this continuous experience by the perspective of analytical psychology.

Current Status of Informed Consent Form for Acupotomy in Korean Medicine Hospitals and Development of a Standard Informed Consent Form Using Delphi Method (한방병원의 침도 시술 동의서의 현황 조사와 델파이 기법을 활용한 표준 시술 동의서 개발)

  • Jihun Kim;Bonhyuk Goo;Hyongjun Kim;Kyoungsuk Seo;Myungjin Oh;Myungseok Ryu;Sang-Hoon Yoon;Kwang Ho Lee;Hyun-Jong Lee;Jungtae Leem;Hyungsun Jun;Jeong Ihn Sook;Sung Woon Choi;Tae Wook Lee;Yeonhak Kim;Yoona Oh;Kunhyung Kim;Gi Young Yang;Eunseok Kim
    • The Journal of Korean Medicine
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    • v.45 no.1
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    • pp.182-201
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    • 2024
  • Objectives: This study was conducted to develop a standard acupotomy consent form that takes into account the unique characteristics of Korean Medicine. The study was motivated by the increasing importance of patient autonomy and the growing number of legal disputes related to medical malpractice in the clinical field of Korean Medicine. Methods: The analysis phase of the study involved a survey of the current status of acupotomy consent forms in Korean Medicine hospitals nationwide. The items of each form were analyzed based on the contents of the Medical law and the standard contract for medical procedures of the Fair Trade Commission (FTC). In the development and evaluation phase, the items and contents of the acupotomy consent form were evaluated using a 5-point Likert scale and content validity was assessed through two rounds of Delphi surveys. In the improvement phase, the contents of the consent form were revised based on the results of a survey of inpatient and outpatient patients in the Department of Acupuncture and Moxibustion at Pusan National University Korean Medicine Hospital, and real-time online meeting. The final version of the standard acupotomy consent form was completed after undergoing proofreading and corrections by a linguistics expert. Results: Only 30% of Korean Medicine hospitals have implemented acupotomy consent forms. The items of the consent forms did not fully include the items presented in the Medical act and the standard contract for medical procedures of the FTC. To address this issue, two rounds of Delphi surveys and a real-time discussion were conducted with a panel of 12 experts on 27 preliminary items of consent forms. The items and contents that met the criteria for content validity ratio, convergence, and consensus were derived. Based on the derived items and content, a standard acupotomy consent form was developed. Conclusions: The standard consent form for acupotomy is anticipated to ensure patient autonomy and enhance transparency and liability in acupotomy. Furthermore, it is expected to serve as evidence in case of medical disputes related to acupotomy and contribute as a reference document for the development of standard consents forms for various procedures of Korean Medicine. However, the limitations of the study include that the survey of consent forms was limited to only training hospitals of Korean Medicine, and the standard consent form is only applicable to adults in Korea. Future studies are needed to address these limitations.

Improving the Nutritional Value of Tenebrio molitor Larvae by Feeding Them a Soymilk Residue-added Food Source (두유박 첨가 먹이원 급이에 따른 갈색거저리 유충의 영양성 증진 효과)

  • So-Yun Kim;Min Ji Park;Jeong-Hun Song;Sangmin Ji;Gyu-Dong Chang;Sun Young Kim
    • Journal of Life Science
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    • v.34 no.3
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    • pp.191-198
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    • 2024
  • To verify the nutritional value and safety of larvae fed with a soymilk residue-added food source, we compared and analyzed the nutritional components of and harmful substances in Tenebrio molitor larvae reared on wheat bran. Crude protein content based on dry weight was 1.2 times higher in the 10% soymilk residue-fed group (SR) (54.0%) than in the wheat bran-fed group (WB) (43.5%). Dietary fiber also tended to be 1.9 times more in the SR (4.9%) than the WB (2.5%). Among unsaturated fatty acids, the linoleic acid content was found to be 1.1-fold higher in the SR (32.9%) than in the WB (29.0%). Potassium, which was the most abundant among the macro minerals, was 1.1-fold more abundant in the WB (1,074.5 mg/100 g) than in the SR (1,014.0 mg/100 g). Among the micro minerals, zinc content was 1.2-fold higher in the SR (14.5 mg/100 g) than in the WB (11.9 mg/100 g). The results of the analysis of hazardous substances in the WB and SR revealed that the amount of heavy metals met the standards for heavy metals in edible insects, and food poisoning-inducing bacteria such as Escherichia coli and Salmonella spp. were not detected in all groups. These results indicate that mealworm larvae fed with 10% soymilk residue have abundant nutrients and are safe for intake. Thus, food sources with added soymilk residue has the potential to be used as feed ingredients.

A Psychological Interpretation of Fairly Tale Mokdoryung, Son of Tree (한국민담 '목(木)도령'의 분석심리학적 해석)

  • Jin-Sook Kim
    • Sim-seong Yeon-gu
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    • v.25 no.2
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    • pp.224-264
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    • 2010
  • A brief story of the tale follows : Mokdoryung was a son of an arbor tree and a fairly. When the boy was 7-8 years old, mother-fairy returned to the sky. By using father-tree, Mokdoryung survived from the flood where he saved ants, mosquitos, and a boy with the same age. They arrived on top of the highest mountain, met an old woman with two daughters, worked as servants. With help of insects, Mokdoryung passed the trials, married to a wise daughter and 2 couples became the ancestor of the mankind. Interpretation of the tale starts with amplification of tree which symbolizes Self and Libido. As the son of the tree-spirit and a fairly from the sky, Mokdoryung is a kind of 'divine child' which represents a psychic possibility to understand archetypal nature of unconscious. Adversities of early childhood due to mother's absence regarded as necessary condition for 'divine child' to attain highest good. Flood can be compensation of absence of feminine as well as to bring a new life. The notion of father·tree becomes a kind of life-boat has to do with union of opposite(vertical phallic tree and horizontal feminine boat). Ants and mosquitoes represent upper and lower level of unconsciousness, they mediate divine power. Therefore respecting insects means respecting unconscious, and reward of insects means salvation come from unconscious. The boy saved from the flood presents emergence of psychic energy in its latent unconscious condition to create mental dynamism. The old woman is Great Mother or anima, the controller or guider of unconscious. Working as servants can be an active service for the divine marriage. Trials of separating millet from sand, and finding right direction relate to separatio, means one needs to be separated from unconscious before conunctio, union of opposite. Two sets of couple becoming ancestor of man-kind has to do with number 4 (quaternity) as well as regeneration. Although the tale includes both positive couple (Mokdoryung, wise daugther in east room). and negative couple(shadow side of Mokdoryung, step daughter in west room)as ancestors of mankind, "Good" seems to be more valued than "evil".

The Interpretation of German Fairy Tale "Three Dogs" from the Aspect of Analytical Psychology (독일민담 '세 마리 개 Die drei Hunde'(Ludwig Bechstein)의 분석심리학적 관점에서의 이해)

  • Kwang Ja Lee
    • Sim-seong Yeon-gu
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    • v.25 no.2
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    • pp.194-223
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    • 2010
  • I tried here to interpret german fairy tale "Three Dogs" from the aspect of analytical psychology. A poor young shepherd will be 'hero'accidently while wandering the world to find good luck. When he was exhausted and frustrated in wandering life, a stranger appeared before him. A stranger offered barter. So he exchanged three sheep with three black dogs which a stranger had. One dog can bring the food. Another dog can tear everything. The last one can break even steel and iron. After that, shepherd led a satisfactory wandering life. On the way, he met a sad princess who should sacrifice herself for the piece of the country to the dragon which swallows a young girl yearly. But the strong black dog which tears everything, killed the dragon and saved the princess from the sacrifice. After that, a young shepherd promised princess to come back to her after three years of wandering life. In the meanwhile a horse driver played hero false. But the princess couldn't reveal the truth because of the threat of horse driver. Three years later, the young shepherd appeared in the castle. But the true hero was caught in the prison and finally cried out the strongest dog and succeeded in escaping from the prison. And with help of another dog which bring food to him, he could meet the princess and finally married her. So they lived happy life for a long time. But he remembered the poor younger sister. So he wanted to live together with her. After that, three dogs left him with saying, they stayed to see whether he shares his good fortune with his younger sister. Then they turned into birds and disappeared in the air. In this fairy tale can we find many important symbols. With the amplification of symbols and the interpretation of this fairy tale in terms of Jung's analytical psychology, I tried to find the meaning of individuation process in this fairy tale. Hero kills the dragon which could symbolize negative mother archetype. After overcoming the negative mother complex, he could get princess which could be expressive of Anima. This marriage could symbolize coniunctio oppositorum, an important process in individuation. Each fairy tale tells us the individuation process in a different way. And the fairy tale works always in our mind with plain, simple, pure, crystal like nature. Through it can we take precious treasure like wisdom for life.

Effect of the Ayres Sensory Integration Intervention on the Motor Skills and Occupation Participation of Preschool Children with Attention-Deficit/Hyperactivity Disorder (Ayres의 감각통합중재가 학령전기 주의력결핍 과잉행동장애(ADHD) 성향 아동의 운동기능 및 작업참여에 미치는 영향)

  • Jung, Yun-Jin;Kang, Je-wook;Chang, Moon-young;Kim, Kyeong-Mi
    • The Journal of Korean Academy of Sensory Integration
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    • v.22 no.1
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    • pp.1-14
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    • 2024
  • Objective : This study aimed to investigate the impact of Ayres' sensory integration (ASI) intervention on motor skills and occupational participation of preschool children with attention-deficit/hyperactivity disorder (ADHD). Method : Children with ADHD aged between 4 and 6 years who met the inclusion and exclusion criteria were randomly recruited through screening tests. The subjects were divided into an experimental group (10 subjects) and a control group (8 subjects). The instruments used were the Bruininks-Oseretsky test of motor proficiency-2 (BOT-2), Pediatric Evaluation of Disability Inventory (PEDI), and Goal Attainment Scale (GAS) to evaluate occupational participation. The subjects in the experimental group underwent individual sensory integration therapy according to the ASI principles for 40 minutes twice a week in a total of 16 sessions over eight weeks. The control group did not receive the ASI intervention. Data analysis was performed using the Mann-Whitney U test, chi-squared test, Wilcoxon signed-rank test, and Cohen's d test in SPSS 20.0. Results : The ASI experimental group had significantly higher scores in total motor composite, manual coordination, body coordination, strength, and agility in motor function than the control group (p<.05). The two groups did not differ significantly in terms of occupational participation (PEDI), but GAS scores for individual target activities were significantly higher in the experimental group than in the control group (p<.05). Conclusion : This study shows that the ASI intervention has positive effects on motor skills and occupation participation among preschool children with ADHD.

Development and Validation of Career Barrier Scale for Career Interruption Women (경력단절여성 진로장벽 척도 개발 및 타당화)

  • Ae Ri Kim;Jin Kook Tak
    • The Korean Journal of Coaching Psychology
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    • v.8 no.1
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    • pp.1-50
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    • 2024
  • The purpose of this study is to identify career barrier factors experienced by career interruption women, develop a tool to measure career barrier, and verify their validity. To this end, preliminary questions were developed by reviewing literature, conducting one-on-one in-depth interviews with 10 women on career interruption, and conducting an open questionnaire with 100 women on career interruption. The subjects of the study were married women aged 20 to 54 who had past employment experience, wanted to be re-employed, and experienced retirement due to marriage, pregnancy, childbirth, childcare, and family care, and the period of career interruption was selected for more than one year. After that, 63 questions were selected for 7 factors. A preliminary survey was conducted on 300 women with career interruption in Korea, and as a result, 63 questions of 6 factors were derived through exploratory factor analysis. The main survey was conducted with 44 questions of 6 factors by partially modifying the questions reflecting the important concepts in each factor. In this survey of 600 people, in order to verify the validity of the constituent concept of this test, the entire sample was divided into two groups, and group 1 (G1, N=309) conducted exploratory factor analysis and group 2 (G2, N=291) conducted confirmatory factor analysis. As a result of exploratory factor analysis for Group 1, 34 questions of 6 factors were finally derived, and a confirmatory factor analysis of Group 2(G2) was conducted to confirm the model fit of the derived factors, and it was confirmed that the model fit criteria were met. In order to verify the convergence validity of the developed career barrier scale, a correlation analysis was conducted with the career barrier test for female college students, and as a result of the analysis, the career barrier scale for women with career interruption and the career barrier test for female college students showed statistically significant correlation. In order to verify the validity of the criterion, the results of a correlation analysis with variables of job preparation behavior, job stress, state anxiety, and life satisfaction were all found to be statistically significant. Finally, the academic, practical, and policy significance and limitations of this study and future research directions were presented.

A Prospective Randomized Comparative Clinical Trial Comparing the Efficacy between Ondansetron and Metoclopramide for Prevention of Nausea and Vomiting in Patients Undergoing Fractionated Radiotherapy to the Abdominal Region (복부 방사선치료를 받는 환자에서 발생하는 오심 및 구토에 대한 온단세트론과 메토클로프라미드의 효과 : 제 3상 전향적 무작위 비교임상시험)

  • Park Hee Chul;Suh Chang Ok;Seong Jinsil;Cho Jae Ho;Lim John Jihoon;Park Won;Song Jae Seok;Kim Gwi Eon
    • Radiation Oncology Journal
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    • v.19 no.2
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    • pp.127-135
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    • 2001
  • Purpose : This study is a prospective randomized clinical trial comparing the efficacy and complication of anti-emetic drugs for prevention of nausea and vomiting after radiotherapy which has moderate emetogenic potential. The aim of this study was to investigate whether the anti-emetic efficacy of ondansetron $(Zofran^{\circledR})$ 8 mg bid dose (Group O) is better than the efficacy of metoclopramide 5 mg lid dose (Group M) in patients undergoing fractionated radiotherapy to the abdominal region. Materials and Methods : Study entry was restricted to those patients who met the following eligibility criteria: histologically confirmed malignant disease; no distant metastasis; performance status of not more than ECOG grade 2; no previous chemotherapy and radiotherapy. Between March 1997 and February 1998, 60 patients enrolled in this study. All patients signed a written statement of informed consent prior to enrollment. Blinding was maintained by dosing identical number of tablets including one dose of matching placebo for Group O. The extent of nausea, appetite loss, and the number of emetic episodes were recorded everyday using diary card. The mean score of nausea, appetite loss and the mean number of emetic episodes were obtained in a weekly interval. Results : Prescription error occurred in one patient. And diary cards have not returned in 3 patients due to premature refusal of treatment. Card from one patient was excluded from the analysis because she had a history of treatment for neurosis. As a result, the analysis consisted of 55 patients. Patient characteristics and radiotherapy characteristics were similar except mean age was $52.9{\pm}11.2$ in group M, $46.5{\pm}9.5$ in group O. The difference of age was statistically significant. The mean score of nausea, appetite loss and emetic episodes in a weekly interval was higher in group M than O. In group M, the symptoms were most significant at 5th week. In a panel data analysis using mixed procedure, treatment group was only significant factor detecting the difference of weekly score for all three symptoms. Ondansetron $(Zofran^{\circledR})$ 8 mg bid dose and metoclopramide 5 mg lid dose were well tolerated without significant side effects. There were no clinically important changes In vital signs or clinical laboratory parameters with either drug. Conclusion : Concerning the fact that patients with younger age have higher emetogenic potential, there are possibilities that age difference between two treatment groups lowered the statistical power of analysis. There were significant difference favoring ondansetron group with respect to the severity of nausea, vomiting and loss of appetite. We concluded that ondansetron is more effective anti-emetic agents in the control of radiotherapy-induced nausea, vomiting, loss of appetite without significant toxicity, compared with commonly used drug, i.e., metoclopramide. However, there were patients suffering emesis despite the administration of ondansetron. The possible strategies to improve the prevention and the treatment of radiotherapy-induced emesis must be further studied.

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