• 병원약사회지
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• 제35권4호
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• pp.453-462
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• 2018

Background : The prevalence of chronic hepatitis C virus (HCV) tends to be higher in the elderly. Pegylated interferon and ribavirin therapy (Peg-IFN/RBV) was recommended as the first-line treatment in the past decades, but this regimen showed unsatisfactory results in terms of safety and efficacy especially in elderly patients. Recently, it was demonstrated that dual therapy with daclatasvir and asunaprevir was well tolerated and led to high sustained virological response (SVR) rates, irrespective of age. We conducted a study to evaluate the efficacy and safety of daclatasvir plus asunaprevir by involving elderly patients aged above 65 years. Methods : We retrospectively analyzed clinical data from chronic hepatitis C virus (HCV) genotype 1b patients treated with daclatasvir plus asunaprevir from September 2015 to December 2016 at Seoul St. Mary's hospital. The patients were divided into two groups as elderly patients (older than 65 years) and non-elderly patients (younger than 65 years) and compared the efficacy and safety. Results : A total of 112 patients were treated with daclatasvir plus asunaprevir for chronic hepatitis C. Among them, 101 patients completed the whole treatment, and in 88 patients the amount of HCV RNA was measured after 12 weeks of treatment. There was no significant difference in SVR at 12 weeks between both the groups (p=0.68). Typically, 91.4%(32/35) of elderly patients and 94.3%(50/53) of non-elderly patients achieved SVR12. Common adverse events included elevation in transaminase level, headache, and gastrointestinal disorders. There was no statistical difference in the symptoms between the two groups. Conclusions : The combination therapy with daclatasvir plus asunaprevir exhibited similar rates of SVR12 in HCV elderly patients without leading to further adverse events compared to non-elderly patients. Therefore, it is proposed that daclatasvir plus asunaprevir therapy could be considered as an effective and safe treatment, even in patients aged over 65 years.

• 한국산학기술학회논문지
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• 제22권1호
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• pp.94-103
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• 2021

본 연구의 목적은 가임기 여성의 규칙적 운동 및 운동의 종류에 따른 대사증후군 간의 관련성을 파악하여 효과적인 대사증후군 예방 및 관리 중재 개발을 위한 기초자료를 제공하고자 한다. 본 연구는 제7기 3차년도 국민건강영양조사 원시자료(KNHANES VII-3, 2018년)를 이용하여 만 19세 이상 가임기 여성 4172명을 대상으로 시행하였으며, 규칙적 운동의 종류에 따른 대사증후군 구성요소의 차이는 복합표본 t검정으로, 규칙적 운동의 종류가 영향을 미치는 대사증후군의 유병 위험은 복합표본 다중 로지스틱 회귀분석으로 분석하였다. 가임기 여성의 대사증후군 유병률은 3.1%(128명)이었으며 가임기 여성 중 규칙적 운동 실천군은 1979명(46.5%)이었다. 가임기 여성의 규칙적 운동 실천군은 미실천군과 비교하여 다섯 가지 대사증후군 구성요소 중 수축기 혈압(p =.002), 허리둘레(p <.001)와 공복혈당(p =.007)가 상대적으로 낮았으며 고밀도콜레스테롤(p <.001)는 상대적으로 높았다. 규칙적 운동 중 규칙적 근력운동 실천군은 규칙적 근력운동 미실천군과 비교하여 수축기 혈압(p <.001), 이완기 혈압(p =.005), 허리둘레(p <.001), 공복혈당(p <.001)과 중성지방(p =.015) 모두 상대적으로 낮았고 고밀도콜레스테롤(p <.001)은 상대적으로 높았다. 대사증후군에 영향을 미치는 혼란 변수들을 통제한 후, 규칙적 운동 실천군(유병교차비 0.59, 95% 신뢰구간 0.35-0.98, p =.040)과 규칙적 근력운동 실천군(유병교차비 0.34, 95% 신뢰구간 0.14-0.80, p =.013)은 각각 미실천군과 비교하여 대사증후군 유병위험이 낮게 나타났다. 그러므로 규칙적 운동은 가임기 여성의 대사증후군 유병 위험을 낮추는 중요한 변수임을 알 수 있으며, 가임기 여성의 대사증후군 예방 및 관리를 위한 운동 중재 개발 시 근력운동을 포함할 필요가 있음을 제언한다.

• 보건행정학회지
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• 제30권4호
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• pp.479-492
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• 2020

Background: As the prevalence of hypertension is increasing in Korea, the government is seeking policy actions to manage patients with hypertension more efficiently. In this paper, we aimed to identify factors associated with the use of medical care at hospitals among outpatients with hypertension. Methods: We analyzed a total of 15,040 cases of 3,877 outpatients with hypertension obtained from the Korea Medical Panel database from 2010 to 2016. The dependent variable was whether a patient with hypertension visited a hospital or not; and independent variables were the patient's various socio-demographic, health-related, and heath-status characteristics. We conducted a generalized linear mixed model analysis with logit link for all the cases and then conducted it stratified by gender. Results: As a result of a multivariable analysis, women were less likely than to visit at a hospital (odds ratio [OR], 0.44; 95% confidence interval [CI], 0.32-0.61) and people aged 65 years and older than those aged less than 65 years (OR, 0.71; 95% CI, 0.57-0.89). Residents in Busan, Ulsan, and Gyeongnam were more likely than those in than Seoul, Gyeonggi, Incheon, and Jeju to visit a hospital (OR, 1.40; 95% CI, 1.05-1.86). The likelihood of visiting a hospital was high in people belonging to a group of: the highest level of annual household income (OR, 1.73; 95% CI, 1.30-2.29); Medical care aid recipients (OR, 1.94; 95% CI, 1.34-2.83); people having three or more complex chronic diseases (OR, 1.59; 95% CI, 1.19-2.11); people having diabetes (OR, 1.81; 95% CI, 1.41-2.32); or people having ischemic heart disease or cerebrovascular disease (OR, 6.80; 95% CI, 5.28-8.76). Also, we found that factors associated with the use of medical care at hospitals among outpatients with hypertension differed between genders. Conclusion: A variety of factors seem to be associated with the use of medical care at hospitals among outpatients with hypertension. Future research needs to find a way to help patients with hypertension visit an appropriate medical institution between clinics and hospitals.

• 대한임상검사과학회지
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• 제53권1호
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• pp.41-48
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• 2021

Essential thrombocythemia (ET) is a clonal bone marrow stem cell disorder, primarily involving the megakaryocytic lineage. The WHO 2016 guidelines include the molecular detection of JAK2, MPL, and CALR mutations as a major diagnostic criterion for ET. This study aimed to determine the frequency of JAK2 V617F, MPL W515L, and CALR mutations in Iraqi Kurdish patients afflicted with ET, and to analyze their clinical and hematological features. A total of 73 Iraqi Kurdish patients with ET were enrolled as subjects, and analysis was achieved utilizing real-time PCR. The frequency of JAK2 V617F, CALR, and MPL W515L mutations was determined to be 50.7%, 22%, and 16.4%, respectively. No statistically significant difference was obtained when considering the age and gender among different genotypes. The JAK2 V617F mutated patients had significantly higher white blood cell counts and hemoglobin levels than the CALR-positive patients (P-value=0.000, 0.007, respectively), MPL W515L-positive patients (P-value=0.000, 0.000, respectively), and triple negative patients (P-value=0.000, 0.000, respectively). Also, the JAK2 V617F mutated patients showed higher platelet count as compared to the MPL W515L-positive patients (P-value=0.02) and triple negative patients (P-value=0.04). Furthermore, significantly lower white blood cell count and hemoglobin levels were associated with CALR positivity (P-value=0.000, 0.01, respectively), MPL W515L-positivity (P-value=0.001, 0.000, respectively), and triple negativity (P-value=0.000, 0.000, respectively), as compared to patients with combined mutations. In conclusion, apart from a relatively high frequency of MPL W515L mutation, our data is comparable to earlier reports, and highlights the importance of genotyping the JAK2 V617F, MPL W515L, and CALR mutations for accurate diagnosis of patients with ET.

• 한국융합학회논문지
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• 제13권3호
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• pp.125-131
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• 2022

최근에는 COVID-19 인해 의료기관에서 원격으로 관리되는 환자케어 시스템의 보급이 증가되고 있다. 특히 수액 모니터링인 경우 환자의 안전과 간호사의 업무를 줄일 수 있는 시스템으로 병원에서 도입을 고려하고 있다. 현재 개발되어 있는 제품은 무게를 측정하는 로드셀 방식과 적외선 센싱으로 수액 방울을 검출하는 방식의 두 가지 제품이 있다. 각 제품은 동작원리, 센서의 종류, 크기, 사용법, 가격등의 차이가 있지만, 의료기관에서는 획득되는 데이터의 정확도에 관심이 높다. 본 연구에서는 센서 방식이 다른 두 가지 시제품을 제작하여 수액모니터링 장치의 핵심인 정확도를 실험하기 위해 시간당 총 수액량을 측정하였다. 또 외부의 움직임이 있을 경우 수액 측정값의 변화를 실험하여 측정방식에 따른 정확도를 평가하였다. 실험 결과 두 장치의 측정값 오차는 5% 미만의 차이가 있었고, 로드셀 방식은 저용량 측정값에서 적외선 방식은 고용량 측정값에서 차이를 보였다. 본 연구결과 수액모니터링장치의 센서방식에 따른 정확도 차이는 거의 없었고, 향후 의료기관에서 사용할 경우 정확도의 문제는 없을 것으로 사료된다.

• Nutrition Research and Practice
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• 제15권sup1호
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• pp.32-40
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• 2021

BACKGROUND/OBJECTIVES: Considering the high number of deaths from coronavirus disease 2019 (COVID-19) in Latin American countries, together with multiple factors that increase the prevalence of vitamin D deficiency, we aimed to determine 25-hydroxyvitamin D (25[OH]D) levels and its association with mortality in patients with critical COVID-19. SUBJECTS/METHODS: This was a prospective observational study including adult patients with critical COVID-19. Data, including clinical characteristics and 25(OH)D levels measured at the time of intensive care unit admission, were collected. All patients were followed until hospital discharge or in-hospital death. The patients were divided into those surviving and deceased patient groups, and univariate and multivariate logistic regression analyses were performed to determine independent predictors of in hospital mortality. RESULTS: The entire cohort comprised 94 patients with critical COVID-19 (males, 59.6%; median age, 61.5 years). The median 25(OH)D level was 12.7 ng/mL, and 15 (16%) and 79 (84%) patients had vitamin D insufficiency and vitamin D deficiency, respectively. The median serum 25(OH)D level was significantly lower in deceased patients compared with surviving (12.1 vs. 18.7 ng/mL, P < 0.001). Vitamin D deficiency was present in 100% of the deceased patients. Multivariate logistic regression analysis revealed that age, body mass index, other risk factors, and 25(OH)D level were independent predictors of mortality. CONCLUSIONS: Vitamin D deficiency was present in 84% of critical COVID-19 patients. Serum 25(OH)D was independently associated with mortality in critical patients with COVID-19.

• Fisheries and Aquatic Sciences
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• 제25권5호
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• pp.287-297
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• 2022

The objective of this study was to evaluate the probability of norovirus foodborne illness by raw oyster consumption. One hundred fifty-six oyster samples were collected to examine the norovirus prevalence. The oyster samples were inoculated with murine norovirus and stored at 4℃-25℃. A plaque assay determined norovirus titers. The norovirus titers were fitted with the Baranyi model to calculate shoulder period (h) and death rate (Log PFU/g/h). These kinetic parameters were fitted to a polynomial model as a function of temperature. Distribution temperature and time were surveyed, and consumption data were surveyed. A dose-response model was also searched through literature. The simulation model was prepared with these data in @RISK to estimate the probability of norovirus foodborne. One sample of 156 samples was norovirus positive. Thus, the initial contamination level was estimated by the Beta distribution (2, 156), and the level was -5.3 Log PFU/g. The developed predictive models showed that the norovirus titers decreased in oysters under the storage conditions simulated with the Uniform distribution (0.325, 1.643) for time and the Pert distribution (10, 18, 25) for temperature. Consumption ratio of raw oyster was 0.98%, and average consumption amount was 1.82 g, calculated by the Pert distribution [Pert {1.8200, 1.8200, 335.30, Truncate (0, 236.8)}]. ₁F₁ hypergeometric dose-response model [1 - (1 + 2.55 × 10^-3 × dose)^-0.086] was appropriate to evaluate dose-response. The simulation showed that the probability of norovirus foodborne illness by raw oyster consumption was 5.90 × 10^-10 per person per day. The annual socioeconomic cost of consuming raw oysters contaminated with norovirus was not very high.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제25권3호
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• pp.163-179
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• 2022

Although functional gastrointestinal disorders (FGIDs) are very common in pediatric patients, there is a scarcity of published epidemiologic data, characteristics, and management patterns from Saudi Arabia, which is the 2nd largest Arabic country in terms of area and the 6th largest Arabic country in terms of population, with 10% of its population aged <5 years. Functional constipation (FC) is an FGID that has shown a rising prevalence among Saudi infants and children in the last few years, which urges us to update our clinical practices. Nine pediatric consultants attended two advisory board meetings to discuss and address current challenges, provide solutions, and reach a Saudi national consensus for the management of pediatric constipation. The pediatric consultants agreed that pediatricians should pay attention to any alarming signs (red flags) found during history taking or physical examinations. They also agreed that the Rome IV criteria are the gold standard for the diagnosis of pediatric FC. Different therapeutic options are available for pediatric patients with FC. Dietary treatment is recommended for infants with constipation for up to six months of age. When non-pharmacological interventions fail to improve FC symptoms, pharmacological treatment with laxatives is indicated. First, the treatment is aimed at disimpaction to remove fecal masses. This is achieved by administering a high dose of oral polyethylene glycol (PEG) or lactulose for a few days. Subsequently, maintenance therapy with PEG should be initiated to prevent the re-accumulation of feces. In addition to PEG, several other options may be used, such as Mg-rich formulas or stimulant laxatives. However, rectal enemas and suppositories are usually reserved for cases that require acute pain relief. In contrast, infant formulas that contain prebiotics or probiotics have not been shown to be effective in infant constipation, while the use of partially hydrolyzed formula is inconclusive. These clinical practice recommendations are intended to be adopted by pediatricians and primary care physicians across Saudi Arabia.

• Journal of Nutrition and Health
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• 제55권5호
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• pp.558-571
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• 2022

본 연구에서는 우리나라 성인 중 AD를 앓고 있는 사람들의 식이 섭취량을 분석하여 이들의 식습관이 AD발병 위험과 관련이 있는지 분석하고자 하였다. 활용한 자료는 제7기 국민건강영양조사 (2016-2018년) 자료로서, 참가자 중 19-64세 성인 10,571명을 AD군 (n = 366)과 non-AD군 (n = 10,205)으로 나누어 영양소 섭취 현황과 식생활평가지수 점수를 비교·분석하였다. 그 결과, AD군의 1일 총 에너지섭취량은 non-AD군보다 많았고, 단백질 에너지섭취비율, 섭취에너지 1,000 kcal 당 단백질, 인, 철, 칼륨 섭취량이 AD군이 non-AD군보다 유의미하게 낮았다. 식생활평가지수 총점을 비교했을 때에는, AD군의 총 채소류, 김치 및 장아찌류를 제외한 채소류, 고기·생선·달걀·콩류 섭취점수가 non-AD군보다 낮았다. 연구대상자의 식생활평가지수와 AD 위험도와의 관계를 분석했을 때, AD 위험도는 총 채소류, 김치 및 장아찌류를 제외한 채소류, 고기·생선·달걀·콩류 섭취 점수가 증가할수록 감소하였다. 결론적으로, 성인 AD환자들은 채소류와 단백질 식품 섭취가 낮았는데, 이들 식품군의 높은 섭취는 낮은 AD 위험과 관련이 있음을 확인한 바, 추후 성인 AD 관리 및 치료 시 채소류와 단백질 식품의 충분한 섭취에 대해 강조해야 할 것이다.

• Journal of Nutrition and Health
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• 제56권1호
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• pp.24-34
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• 2023

상지 물추출물의 투여는 STZ 유도 당뇨 마우스의 공복 혈당, 혈중 총 CHO, LDL-CHO, 간 무게 및 간 조직 TG를 NC군 수준으로 감소시키고 혈장 총 CHO대비 HDL-CHO비는 NC군 수준으로 증가시켰으며, 소장 proximal region의 이당류 분해효소인 lactase, sucrase 활성을 억제하였다. 이는 상지를 차로 우려내어 음용할 경우 당뇨 예방 및 증상 개선의 가능성을 기대해 볼 수 있음을 제시한다. 상지는 국내산 뽕나무 부산물로 대량 생산될 뿐만 아니라 식품의 원료로 사용이 가능한 소재이므로 향후 상지 물추출물의 생리활성성분 분리 및 혈당조절기전 연구를 보다 깊이 수행한다면 안전하고 효과적인 고부가가치 혈당조절 기능성식품 개발의 기초자료로 활용될 수 있을 것이다.