• 한국임상약학회지
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• 제28권4호
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• pp.285-292
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• 2018

Background: Long-term levodopa therapy relieves the motor dysfunction associated with Parkinson's disease (PD), but has various effects on non-motor symptoms, including cognitive dysfunction, hallucinations, and affective disorders, and can exacerbate certain aspects of dementia-like cognitive dysfunction. Here, we investigated the relationship between levodopa treatment and development of dementia in patients with PD. Methods: This retrospective study analyzed 76 consecutive patients with PD who had taken levodopa between 2011 and 2015. The participants were initially free of dementia and had initial daily levodopa doses of below 600 mg. Patients who did and did not develop comorbid dementia were compared in terms of potential predictor variables, including PD onset age, sex, levodopa doses, and non-dementia comorbidities. Results: Of the 76 patients, 21 (27.6%) developed dementia, which was followed by hallucinations and insomnia. The independent predictors of incident dementia were PD onset age and second-year and third-year average levodopa doses that were higher than the first-year average levodopa dose. Patients who developed dementia had significantly higher average daily levodopa doses and levodopa dose increases over the 6-year treatment period than those who did not develop dementia. In addition, patients with higher levodopa doses were more likely to experience hallucinations. Conclusion: These results suggest that increases in levodopa doses may be associated with a greater risk of cognitive impairment in patients with PD. Therefore, motor and cognitive functions and levodopa dose increases should be evaluated regularly during long-term levodopa therapy in patients with PD.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제26권1호
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• pp.23-33
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• 2023

Purpose: The incidence and prevalence of inflammatory bowel disease (IBD) are increasing along with an increasing number of patients with comorbid conditions like psychiatric and behavioral disorders, which are independent predictors of quality of life. Methods: Non-overlapping years (2003-2016) of National Inpatient Sample and Kids Inpatient Database were analyzed to include all IBD-related hospitalizations of patients less than 21 years of age. Patients were analyzed for a concomitant diagnosis of psychiatric/ behavioral disorders and were compared with IBD patients without psychiatric/behavioral disorder diagnoses for outcome variables: IBD severity, length of stay and inflation-adjusted hospitalization charges. Results: Total of 161,294 IBD-related hospitalizations were analyzed and the overall prevalence rate of any psychiatric and behavioral disorders was 15.7%. Prevalence rate increased from 11.3% (2003) to 20.6% (2016), p<0.001. Depression, substance use, and anxiety were the predominant psychiatric disorders. Regression analysis showed patients with severe IBD (odds ratio [OR], 1.57; confidence interval [CI], 1.47-1.67; p<0.001) and intermediate IBD (OR, 1.14; CI, 1.10-1.28, p<0.001) had increased risk of associated psychiatric and behavioral disorders than patients with a low severity IBD. Multivariate analysis showed that psychiatric and behavioral disorders had 1.17 (CI, 1.07-1.28; p<0.001) mean additional days of hospitalization and incurred additional $8473 (CI, 7,520-9,425; p<0.001) of mean hospitalization charges, independent of IBD severity. Conclusion: Prevalence of psychiatric and behavioral disorders in hospitalized pediatric IBD patients has been significantly increasing over the last two decades, and these disorders were independently associated with prolonged hospital stay, and higher total hospitalization charges.

• Journal of Korean Biological Nursing Science
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• 제25권4호
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• pp.285-294
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• 2023

Purpose: This study aimed to identify the colonization rate of carbapenem-resistant Enterobacteriaceae (CRE), the characteristics of CRE isolates, and risk factors for CRE colonization in patients transferred to the general wards of a small/medium-sized hospital. Methods: This retrospective study was conducted on patients who underwent CRE culture tests within 24 hours of admission among patients transferred to a small/medium-sized hospital. Forty-seven patients confirmed as positive for CRE were classified as belonging to the patient group. For the control group, 235 patients (five times the number of the patient group) were matched by sex, age, and diagnosis, and then selected at random. Data were analyzed using descriptive analysis and multiple logistic regression analysis. Results: The CRE colonization rate was 5% (47 out of 933 patients), and Klebsiella pneumoniae (68.0%) was the most common isolate of CRE. The positivity rate of carbapenemase-producing Enterobacteriaceae was 61.7%. The risk factors for CRE colonization included renal disease (odds ratio [OR]=4.93; 95% confidence interval [CI], 1.49-16.31), heart disease (OR=3.86; 95% CI, 1.35-11.01), indwelling urinary catheters (OR=4.43; 95% CI, 1.59-12.36), and cephalosporin antibiotic use (OR=8.57; 95% CI, 1.23-59.60). Conclusion: Having a comorbid renal or cardiac disease, an indwelling urinary catheter, or a history of exposure to cephalosporin antibiotics could be classified as risk factors for CRE colonization in patients transferred to small and medium-size hospitals. It is necessary to perform active infection control through proactive CRE culture testing of patients with risk factors.

• 성인간호학회지
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• 제12권1호
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• pp.99-111
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• 2000

The purpose of this study was to identify risk factors related to sexual function of women with coronary artery disease, and to determine the predictors of sexual function. The study design, a descriptive correlational study, was done through structural questionnaire and interview. A total of 50 subjects from C University Hospital at Kwang-ju city who have undergone coronary angiography at department of cardiology were observed and interviewed from Feb. 22, 1999 to March. 23, 1999. The number of affected vessels, the level of total serum cholesterol, and the ejection fraction of 2-D echo cardiography were analyzed to evaluate the severity of coronary artery disease. And also type A behavior pattern, health behavior, Brief Index of Sexual Functioning for Women (BISF-W) were measured. The data obtained were analyzed using percentage, mean and standard deviation, t-test, ANOVA, Pearson's correlation coefficient, and stepwise multiple regression analysis via SPSS PC+. The results of this study were as follows: 1. The mean age of the subjects were 58.1 and 72.0% of those have been married over 30 years. Seventy two percentage were unemployed and monthly family income of 56.6% was less than 1,000,000 won (approximately $ 840). Eighty percent were in their postmenopausal state, and the frequency of sexual intercourse of 84.0% were two to three times per month. 2. The scores of type A behavior pattern were from 16 to 38(mean 24.94) and health behavior ranged from 21 to 43(mean 31.2). Abstinence from smoking, alcohol, and caffeine were best compliant factors and weight control and exercise were least abided ones. The result of 2D-ECHO EF showed that the half of the subjects were abnormal, and 24% had more than 240mg/dl of total serum cholesterol. The coronary angiography showed that 64% of the subjects had more than one affected vessels. 3. The predictors to explain the factor score of 'orgasm' were number of health examination, the pre- or post-menopausal state, protestant, number of coronary vessel affected, level of serum total cholesterol, and comorbid group of hypertension and diabetes, and it's total variance accounted for 52.4%. The predictors to explain the factor score of 'sexual activity' were comorbid group of hypertension and diabetes and type A behavior pattern, which accounted for 22.4% of total variance. The predictors to explain the factor score of 'sexual satisfaction' were type A behavior pattern, no religion, exercise, level of serum total cholesterol, and pre or post menopausal state, which accounted for 52.1%. The predictors to explain the factor score of 'sexual desire' were the period of marriage, type A behavior, employment or unemployment, and weight control, which accounted for 43.2%. The predictors to explain the factor score of 'external force of sexual functioning' were physical overload and exercise, which accounted for 41.1%. The predictors to explain the factor score of 'sexual activity' were family monthly income, catholics, and exercise, and which accounted for 35.4%. Above results lead us to some consensus that sexual function of women with coronary artery disease is related to various factors including vasogenic factors such as total serum cholesterol level, number of coronary vessel affected, an endocrinal factor such as menopausal state, and type A behavior pattern as a sociopshychological factor. And also health behaviors such as fitness care, overwork, weight control, and emotional tension are contributed to sexual function.

• Asian Pacific Journal of Cancer Prevention
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• 제14권8호
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• pp.4571-4576
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• 2013

Background: Depression is a comorbid disabling problem and potentially affects patient likelihood of survival. The aims of this study were to recognize the characteristics of depression and investigate associated predictor factors in patients with oral cancers. Methods: A cross-sectional and correlational design was used to collect data for this study conducted in northern Taiwan. A set of questionnaires was used to measure depression, symptom distress, performance status, social support, and demographic and disease-related information. Logistic regression was conducted to determine important factors predicting depression. Results: A total of 132 oral cancer patients participated in this study. Of these, 18.2% were identified as depression cases. The patient average performance status score was 90 or higher. Patients reported mild-to-moderate levels of symptom distress. The majority of social support was from families. Religious belief, alcohol use, symptom distress, and social support from family were found to be important factors predicting depression. Patients with religious belief with alcohol use reported greater symptom distress, and those with lower levels of social support from families were significantly more likely to develop depression. Conclusions: Clinicians should assess patient emotional status and manage symptoms in a timely manner to enhance coping abilities. Supportive care provides assurance during the acute survivor phase.

• Investigative Magnetic Resonance Imaging
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• 제24권3호
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• pp.162-167
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• 2020

Disseminated peritoneal leiomyomatosis (DPL) is a very rare benign disease, characterized by multiple solid subperitoneal or peritoneal smooth muscle nodules in abdominopelvic cavity and malignant transformation is extremely rare. Also, uterine smooth muscle tumors of unknown malignant potential (STUMP) is a rare tumor, which is regarded as subclassification in uterine smooth muscle tumors between benign and malignant criteria. Pathogenesis of DPL is uncertain, but increasing evidence of iatrogenic cause including laparoscopic myomectomy has been reported. We report a case of a 28-year-old female with previous history of laparoscopic myomectomy diagnosed with DPL with atypical feature and concurrent uterine STUMP using computed tomography (CT) and magnetic resonance imaging (MRI), as well as present a review of the literature.

• 근관절건강학회지
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• 제13권2호
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• pp.130-139
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• 2006

Purpose: This study was designed to present preliminary data for the development of appropriate nursing care system for the patients with ALS by analyzing their physical function. Method: The clinical data of 36 ALS patients, who visited ALS Clinic of H University Hospital in Seoul, were collected from January, 2006 to August, 2006. To determine the physical function, Norris ALS scale and Appel ALS Rating Scale were used. The data were analyzed by frequency, percentage, mean, standard deviation, range, t-test, ANOVA, using SPSS PC program. Results: The mean score of physical activity, muscle strength, upper extremity function, lower extremity function was 18.08, 27.72, 25.94, 25.19 respectively. There were significant differences in physical activity, muscle strength, and upper extremity function according to sender and comorbid disease(diabetes). Although sites of symptom onset were not statistically significant with all physical function, patients with bulbar onset showed relatively severe physical disabilities. Conclusion: The preliminary data on physical function of patients with ALS would be helpful for the development of ALS nursing guideline system.

• IMMUNE NETWORK
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• 제21권1호
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• pp.3.1-3.16
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• 2021

Coronavirus disease 2019 caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has been spreading worldwide since its outbreak in December 2019, and World Health Organization declared it as a pandemic on March 11, 2020. SARS-CoV-2 is highly contagious and is transmitted through airway epithelial cells as the first gateway. SARS-CoV-2 is detected by nasopharyngeal or oropharyngeal swab samples, and the viral load is significantly high in the upper respiratory tract. The host cellular receptors in airway epithelial cells, including angiotensin-converting enzyme 2 and transmembrane serine protease 2, have been identified by single-cell RNA sequencing or immunostaining. The expression levels of these molecules vary by type, function, and location of airway epithelial cells, such as ciliated cells, secretory cells, olfactory epithelial cells, and alveolar epithelial cells, as well as differ from host to host depending on age, sex, or comorbid diseases. Infected airway epithelial cells by SARS-CoV-2 in ex vivo experiments produce chemokines and cytokines to recruit inflammatory cells to target organs. Same as other viral infections, IFN signaling is a critical pathway for host defense. Various studies are underway to confirm the pathophysiological mechanisms of SARS-CoV-2 infection. Herein, we review cellular entry, host-viral interactions, immune responses to SARS-CoV-2 in airway epithelial cells. We also discuss therapeutic options related to epithelial immune reactions to SARS-CoV-2.

• Annals of Clinical Neurophysiology
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• 제14권1호
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• pp.29-35
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• 2012

Background: Peripheral neuropathy is the most frequent neurological complication in human immunodeficiency virus (HIV) infection, related with diverse etiologies including inflammation, opportunistic infection and side effects of medications. The purpose of the present study was to evaluate characteristics of HIV associated neuropathy according to the stage of HIV infection. Methods: In reviewing the medical records of HIV patients who underwent electrodiagnostic studies between 1997 and 2011, total 11 patients (all males; median age, 47 years; range, 28-71 years) with comorbid neuropathy were enrolled. Stage of HIV infection was categorized according to the Centers for Disease Control and Prevention (CDC) criteria. Classification of peripheral neuropathy was based on clinical and electrophysiological features. Results: Distal symmetric polyneuropathy was observed in 8 patients (72.7%), inflammatory demyelinating polyneuropathy in 2 patients (18.1%), and polyradiculopathy in 1 patient (9.1%). Median CD4+ T cell count was $123/mm^3$ (range, $8-540/mm^3$) and 7 patients (60%) had the most advanced HIV disease stage (CDC-C3). There was no neuropathy caused by CMV infection. Conclusions: Distal symmetric polyneuropathy was the most common type of neuropathy in HIV infection, but various forms of neuropathy such as inflammatory demyelinating polyneuropathy and polyradiculopathy were also present. HIV associated neuropathy is more frequently associated with advancing immunosuppression, although it can occur in all stages of HIV infection.

• Asian Pacific Journal of Cancer Prevention
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• 제14권2호
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• pp.1111-1114
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• 2013

Background: For early detection of renal damage during the usage of cisplatin based chemotherapy, changes in renal function should be monitored carefully. In recent years, neutrophil gelatinase-associated lipocalin, a small polypeptide molecule, has shown promise as a marker of acute renal failure. The aim of this present study was to assess possible risk prediction of cisplatin-induced nephrotoxicity using serum NGAL. Materials and Methods: A total of 34 consecutive patients with documented serum creatinine at least 24 hours before every cycle of cisplatin-based chemotherapy were included in the study. Demographic and medical data including age, performance status, tumor characteristics and comorbid diseases were collected from medical charts. Renal function was evaluated at least 48 hours before the treatment and at the end of the treatment based on the Modification of Diet in Renal Disease (MDRD) formula. Before and after cisplatin infusion serum NGAL levels were measured for the first and 3rd cycles of chemotherapy. Results: The median age of the study population was 54 (32-70) years. Fifteen patients (41.1%) were treated on an adjuvant basis, whereas 19 patients (58.9%) were treated for metastatic disease. There was no correlation of serum NGAL levels with serum creatinine (r=0.20, p=0.26) and MDRD (r=-0.12, p=0.50) and creatinine clearance-Cockcroft-Gault (r=-0.22, p=0.22) after cisplatin infusion at the end of the 3rd cycle of chemotherapy. Conclusions: In our study, serum NGAL levels were not correlated with the cisplatin induced nephrotoxicity. Further prospective studies are needed to conclude that serum NGAL level is not a good surrogate marker to predict early cisplatin induced nephrotoxicity.