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Analysis of Factors Related to the Use of Both Korean and Western Medicine Treatment in Patients with Overweight and Obesity: Based on the Korea Health Panel Annual Data 2019 (과체중 및 비만 환자에서 한·양방 의료 이용과 관련된 요인분석: 제2기 한국의료패널 자료를 중심으로)

  • Chan-Young Kwon
    • Journal of Korean Medicine for Obesity Research
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    • v.24 no.1
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    • pp.41-53
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    • 2024
  • Objectives: We used the Korea Health Panel Annual Data 2019 to analyze factors related to visits to both Korean medicine and Western medicine (WM) outpatient clinics among patients with overweight and obesity. Methods: The inclusion criteria for this study are as follows: 1) adults over 18 years of age, 2) overweight or obese with a body mass index of 25.0 or more, 3) visited WM outpatient clinics at least once during 2019. Total 2,963 individuals were included in WM group or integrative medicine (IM) group. Using the Andersen healthcare utilization model, factors related to healthcare utilization of the participants were classified. Binomial logistic regression analysis was used to analyze factors associated with IM use. Results: Among the participants, 80.49% (n=2,385) were assigned to WM group and 19.51% (n=578) to IM group. As a result of the regression analysis, factors significantly related to the use of IM included the elderly over 65 years of age, sex (men), college or higher education level, residential area (Gwangju/Jeolla/Jeju), presence of cancer, and presence of musculoskeletal disease. The main diagnosis associated with both WM and IM use was most frequently musculoskeletal conditions. Also, IM group received WM treatment for musculoskeletal conditions more frequently compared to WM group. Conclusions: This study is the first to analyze healthcare utilization patterns among overweight or obese patients in Korea. The current findings suggest that the presence of musculoskeletal conditions, especially in this population, may be strongly associated with concurrent use of IM services.

The analysis of medical use characteristics of elderly patients and the factors influencing them depending on whether or not the manpower of long-term care hospital is secured (요양병원 인력확보 여부에 따른 고령환자의 의료이용 특성과 영향을 미치는 요인 분석)

  • Yun-Jeong Chang
    • Journal of the Health Care and Life Science
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    • v.10 no.2
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    • pp.265-274
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    • 2022
  • In this paper, the 2018 elderly patient data sets among the patient sample data of the Health Insurance Review & Assessment Service and the 260,425 statements of patients admitted to the long-term care hospitals were together used. Accordingly, the characteristics of each hospital type were analyzed by classifying the addition type of long-term care hospitals according to whether or not to secure the required manpower and whether or no to secure more than two-thirds of required nurses. However, in evaluating whether or not to secure more than 2/3 of necessary nurses and whether or not to secure the necessary manpower, the relative value points were not considered, and the same amounts of value has been maintained for 13 years, so the relevant value needs to be revised.

Relationships of hepatic histopathological findings and bile microbiological aspects with bile duct injury repair surgical outcomes: A historical cohort

  • Guilherme Hoverter, Callejas;Rodolfo Araujo Marques;Martinho Antonio Gestic;Murillo Pimentel Utrini;Felipe David Mendonca Chaim;Elinton Adami Chaim;Francisco Callejas-Neto;Everton Cazzo
    • Annals of Hepato-Biliary-Pancreatic Surgery
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    • v.26 no.4
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    • pp.325-332
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    • 2022
  • Backgrounds/Aims: To analyze relationships of hepatic histopathological findings and bile microbiological profiles with perioperative outcomes and risk of late biliary stricture in individuals undergoing surgical bile duct injury (BDI) repair. Methods: A historical cohort study was carried out at a tertiary university hospital. Fifty-six individuals who underwent surgical BDI repair from 2014-2018 with a minimal follow-up of 24 months were enrolled. Liver biopsies were performed to analyze histopathology. Bile samples were collected during repair procedures. Hepatic histopathological findings and bile microbiological profiles were then correlated with perioperative and late outcomes through uni- and multi-variate analyses. Results: Forty-three individuals (76.8%) were females and average age was 47.2 ± 13.2 years; mean follow-up was 38.1 ± 18.6 months. The commonest histopathological finding was hepatic fibrosis (87.5%). Bile cultures were positive in 53.5%. The main surgical technique was Roux-en-Y hepaticojejunostomy (96.4%). Overall morbidity was 35.7%. In univariate analysis, liver fibrosis correlated with the duration of the operation (R = 0.3; p = 0.02). In multivariate analysis, fibrosis (R = 0.36; p = 0.02) and cholestasis (R = 0.34; p = 0.02) independently correlated with operative time. Strasberg classification independently correlated with estimated bleeding (R = 0.31; p = 0.049). The time elapsed between primary cholecystectomy and BDI repair correlated with hepatic fibrosis (R = 0.4; p = 0.01). Conclusions: Bacterial contamination of bile was observed in most cases. The degree of fibrosis and cholestasis correlated with operative time. The waiting time for definitive repair correlated with the severity of liver fibrosis.

Effect of cordycepin-enriched Cordyceps militaris L. extract powder on alcohol degradation and hepatoprotection in mice alcohol model

  • Ju-Hye Kim;Heejin Park;Mun-Hyoung Bae;Youngha Seo;Eun-Young Gu;Taek-Keun Oh;Byoung-Seok Lee
    • Korean Journal of Agricultural Science
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    • v.51 no.2
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    • pp.169-178
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    • 2024
  • Cordyceps militaris L. (C. militaris) has been traditionally used as tonic medicine for metabolic syndrome. Cordycepin, has been reported with immunomodulatory, antitumor, and hepatoprotective effect, is the main extract from C. militaris. This study was conducted to evaluate the alcohol degradation and hepatoprotective effect of cordycepin-enriched C. militaris extract (CM) powder in chronic and binge ethanol (ethanol Lieber-DeCarli diet)-fed male C57BL/6 Mice. Cordycepin-enriched C. militaris extract powder was orally administered once daily at dose levels of 0, 125, 250, and 500 mg·kg-1·day-1 for 16 days. For evaluating alcohol degradation, ethanol concentration and alcohol dehydrogenase (ADH) and aldehyde dehydrogenase (ALDH) activity were measured in serum. Serum ethanol (EtOH) concentration was decreased at CM treated groups, and the activities of ADH and ALDH were increased dose-dependently at CM treated groups compare to EtOH model group. In clinical chemistry, the values of aspartate aminotransferase (AST) and alanine aminotransferase (ALT) were lower in CM treated groups than those in EtOH model group. Additionally, absolute and relative (to body weight) liver weights were statistically decreased in the CM treated groups compared to the EtOH model group. In conclusion, our study showed that cordycepin-enriched C. militaris extract powder exhibits hepatoprotective effect by upregulating the ADH and ALDH enzyme in an alcoholic liver disease model.

Evaluating the knowledge, attitude, perception, and readiness of caregivers of under 5-year-old children to accept malaria vaccine in Nigeria

  • Blessing Nkechi Emmanuel;Abubakar Nuhu Ishaq;Olisaemeka Zikora Akunne;Umar Faruk Saidu
    • Clinical and Experimental Vaccine Research
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    • v.13 no.2
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    • pp.121-131
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    • 2024
  • Purpose: The global burden of disease and mortality is greatly influenced by malaria, particularly in children. Nigeria alone accounts for about 25% of global malaria cases and fatalities. Despite efforts to control and eliminate malaria, conventional treatments have limitations, prompting the need for a vaccine. However, while efforts have focused on researching and developing malaria vaccines, less attention has been given to public acceptance and preparedness for vaccination. Materials and Methods: The study employed a cross-sectional approach to assess the knowledge, perceptions, and readiness of caregivers towards the malaria vaccine. Data were collected through a physical and online survey among a representative sample of caregivers across the six geopolitical regions of Nigeria. The data was analyzed using principal component analysis and percentages. Results: Out of 347 respondents, 180 (51%) men, 165 (46.6%) women, 2 (0.5%) transgender, 156 (45%) rural settlers, and 191 (55%) urban settlers were identified in this study. The study reported an overall acceptance rate of 78.4% and 21.6% resistance rate. The age group between 21-30 years recorded the highest 207 (59.6%). A significant number of participants, 252 (59.6%), held at least a higher or post-secondary certificate, out of which 193 (55.6%) demonstrated strong readiness to accept the malaria vaccine. The study showed that fear of adverse effects was the main reason for malaria vaccine resistance among caregivers. Conclusion: This study's findings offer valuable insights into caregivers' knowledge about the malaria vaccine, highlighting the factors that impact the acceptance of the malaria vaccine.

Clinical Characteristics, Risk Factors, and Outcomes of Acute Pulmonary Embolism in Thailand: 6-Year Retrospective Study

  • Pattarin Pirompanich;Ornnicha Sathitakorn;Teeraphan Suppakomonnun;Tunlanut Sapankaew
    • Tuberculosis and Respiratory Diseases
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    • v.87 no.3
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    • pp.349-356
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    • 2024
  • Background: Acute pulmonary embolism (APE) is a fatal disease with varying clinical characteristics and imaging. The aim of this study was to define the clinical characteristics, risk factors, and outcomes in patients with APE at a university hospital in Thailand. Methods: Patients diagnosed with APE and admitted to our institute between January 1, 2017 and December 31, 2022 were retrospectively enrolled. The clinical characteristics, investigations, and outcomes were recorded. Results: Over the 6-year study period, 369 patients were diagnosed with APE. The mean age was 65 years; 64.2% were female. The most common risk factor for APE was malignancy (46.1%). In-hospital mortality rate was 23.6%. The computed tomography pulmonary artery revealed the most proximal clots largely in segmental pulmonary artery (39.0%), followed by main pulmonary artery (36.3%). This distribution was consistent between survivors and non-survivors. Multivariate logistic regression analysis revealed that APE mortality was associated with active malignancy, higher serum creatinine, lower body mass index (BMI), and tachycardia with adjusted odds ratio (95% confidence interval [CI]) of 3.70 (1.59 to 8.58), 3.54 (1.35 to 9.25), 2.91 (1.26 to 6.75), and 2.54 (1.14 to 5.64), respectively. The prediction model was constructed with area under the curve of 0.77 (95% CI, 0.70 to 0.84). Conclusion: The overall mortality rate among APE patients was 23.6%, with APE-related death accounting for 5.1%. APE mortality was associated with active malignancy, higher serum creatinine, lower BMI, and tachycardia.

Inhibition of phosphodiesterase 4D decreases the malignant properties of DLD-1 colorectal cancer cells by repressing the AKT/mTOR/Myc signaling pathway

  • Dong Uk Kim;Jehyun Nam;Matthew D. Cha;Sang‑Woo Kim
    • Oncology Letters
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    • v.17 no.3
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    • pp.3589-3598
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    • 2019
  • Colorectal cancer (CRC) is a complex disease involving numerous genetic abnormalities. One of the major characteristics of CRC is enhanced Wnt signaling caused by loss-of-function mutations in the adenomatous polyposis coli (APC) gene. Previously, it has been demonstrated that the majority of malignant phenotypes following APC deletion in adult murine small intestines could be rescued when Myc, a downstream target of the Wnt pathway, was deleted. This indicated that Myc is a critical regulator of CRC development following APC loss. Previous studies reported that cyclic adenosine 3',5'-monophosphate (cAMP) can influence the AKT/mammalian target of rapamycin (mTOR) survival pathway in cancer and Myc is a critical downstream molecule of AKT/mTOR signaling. Phosphodiesterase 4D (PDE4D), a member of the cAMP-specific PDE4 family, has been associated with drug resistance in CRC. However, the association between PDE4D and Myc remains unclear. To investigate the potential role of PDE4D in Myc regulation in CRC, the present study evaluated the expression levels of PDE4 subtypes in DLD-1 CRC cells. Additionally, the effects of PDE4 inhibitors on Myc expression and oncogenic properties were analyzed by western blot analysis, reverse transcription-quantitative polymerase chain reaction, colony formation and soft agar assays. It was demonstrated that cAMP/PDE4D signals serve a critical role in regulating Myc expression in DLD-1 CRC cells. Furthermore, PDE4D was identified to be a main hydrolyzer of cAMP and suppression of PDE4D using selective inhibitors of PDE4 increased intracellular cAMP levels, which resulted in a marked decrease in the oncogenic properties of DLD-1 cells, including colony formation, cell proliferation and anchorage-independent growth. Notably, the current data imply that cAMP represses Myc expression via the downregulation of AKT/mTOR signaling, which was abolished by high PDE4D activities in DLD-1 cells. Additionally, a natural polyphenol resveratrol in combination with forskolin elevated the concentration of cAMP and enhanced the expression of Myc and the malignant phenotype of DLD-1 cells, reproducing the effect of known chemical inhibitors of PDE4. In conclusion, the present study identified that cAMP/PDE4D signaling is a critical regulator of Myc expression in DLD-1 and possibly other CRC cells.

A review on the gut microbiome dysbiosis in diabetic patients and the improvement effects of traditional herbal medicine treatments (당뇨병 환자의 장내미생물 변화와 한의소재에 의한 개선효과 논문고찰)

  • Hye-Min Yi;Sun-Young Hwang;Mee-Hyun Lee
    • The Korea Journal of Herbology
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    • v.39 no.5
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    • pp.39-51
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    • 2024
  • Objectives : Diabetes is a chronic disease that is rapidly increasing worldwide, and recent studies suggest that gut microbiome dysbiosis may be one of the main reasons for diabetes. Therefore, we have reviewed the relationship between diabetes and microbiome changes and their regulation by treatment of traditional herbal medicine. Methods : This review was prepared by querying in PubMed with the key words such as diabetes, microbiome and traditional herbal medicine. The search was conducted for research articles including both in vivo preclinical reports and clinical studies, up to July 22, 2024 within the past five years. Results : Gut microbiota dysbiosis is implicated in diabetes through major mechanisms, including increased endotoxin (LPS), decreased short-chain fatty acid (SCFA) production, reduced gut microbiota diversity, and impaired bile acid metabolism in mouse models and human cohorts. Traditional herbal medicines including berberine and bicalein and formulations such as Gegen Qinlian Decoction, Banxia Xiexin Decoction, and Huang-Lian-Jie-Du-Decoction improved diabetes by increasing the gut microbiota diversity and SCFA generation. Conclusion : Gut microbiota imbalance plays an important role in the onset and progression of diabetes especially type 2 diabetes which is improved by traditional herbal medicines promoting the growth of beneficial microbiome and suppressing pathogenic abundance. It may provide a promising prospect for more effective diabetes management and treatment strategies.

A Preliminary Study for Evaluating on Demonstration Project of Community-based Home Health Care Nursing Services by the Seoul Nurses Association (지역사회중심 가정간호 시범사업 성과평가를 위한 기초연구- 서울시 간호사회 주관 -)

  • 유호신;이소우;문희자;황나미;박성애;박정숙;최행지;정기순;한상애
    • Journal of Korean Academy of Nursing
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    • v.30 no.6
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    • pp.1488-1502
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    • 2000
  • This study, based on current home nursing services, aims at promoting measures for establishing a community-based home nursing system derived from the pilot home nursing demonstration project conducted by the Seoul Nurses Association. The study was based on an analysis of home nursing records from march 1993 to December 1999. The following is a summary analysis, based on individual characteristics of the patients, the organization, which recommended the service for their patients and personnel services. 1. The service has been used by many elderly people 60years of age or older(66.4%). and married people(60.9%). The average number of visits by service personnel for patients of city government was 23.5. This is 2.5 times as many visits by general patients. General patients(20.2%) had only one visit from service personnel, while 65.5% of patients of city government had 10 or more visits. Particularly, for government recommended patients, 72.7% of the patients were recommended by nurses, while only 21.9% where referred to the services by doctors. The main focus of a home nursing service was to maintain present health status (53.4%), and hospice(11.6%). Also to increase hospital-based home nursing services focused on recovery(55.9%) and maintain present health conditions (19.0%). 2. For general patients, 42.0% of patients were suffering from problems related to CVA, 11.3% from high blood pressure, and for patients referred from city, 21.2% from skeletal muscular disease. Results of home nursing services 29.4% of patients were able to recover or maintain their health status, but 48.9% of the patients died. Another main point of community-based home nursing services is medication(6.7%), other basic nursing services(6.1%), special treatment, instructions on how to use medical devices(5.9%), change of physical posture(4.6%), and training on changing physical positions(4.7%). As mentioned above there were some differences between the characteristics of patients who used the pilot home nursing service conducted by the Seoul Nurses Association and those hospital-based service users. The results are believed to be useful to support a community-based home nursing service model. Particularly, patients under medical supervision and patients recommended by government-run health clinics show a higher frequency and longer use of home nursing services compared to general patients or hospital-based home nursing service users. According to the study, nurses accounted for a large number of recommendations for home nursing services. Many patients with CVA, high blood pressure, skeletal muscular disease and bedsores used community-based home nursing services, while others used the service for minor treatments or maintaining their current health status. Based on the study, the researchers make several suggestions to establish a community- based home nursing service system. First, different ways of setting up a community-based home nursing system have to be mapped out based on the evaluation of the pilot home nursing service conducted by the Seoul Nurses Association. Secondly, a new, community-based, home health care nursing service model, and reimbursement payment system have to be developed. This is based on the outcome of the analysis, and implemented policy. Accordingly, efforts are needed to develop a community- based home nursing system with an intermediary role to promote the visiting nursing services of government-run health centers.

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Field research of cultivation technique for stable production of common mushroom(Agaricus bisporus) (양송이 안정생산을 위한 생산기술 현장연구)

  • Jhune, Chang-Sung;Jang, Kab-Yeul;Jeong, Jong-Cheon;Lee, Chan-Jung;Kong, Won-Sik;Yoo, Young-Bok
    • Journal of Mushroom
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    • v.8 no.3
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    • pp.122-130
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    • 2010
  • Common mushroom production per area has been decreased and are up to less than 50% of the 1980 production. To determine the main reasons for the decrement, we performed this study. Two main reasons, which are mushroom disease and the low compost quality because of mechanized compost making, were assessed. In mechanized mushroom farms, nitrogen concentration in compost was lower than recommended and total compost quantity was about 100-150 $kg/3.3m^2$, which was also lower than usual. Our study revealed that higher nitrogen concentration (about 1.5%) in compost gave better production. Also, use of large amount of compost appeared to increase the mushroom production, although more insects and disease problems were observed. The relationships between the presences of microorganisms and occurrence of diseases were assessed by monitoring the microorganism densities near the mushroom farms. Higher number of microorganisms were observed near the mushroom farm area, compared to control region, Daechon beach. Most contaminating molds were found in the circulating fans, tunnel and culture room floor. The bacterial isolates were collected from the air in mushroom culture room and killed with 0.005% Benzalkonium solution, indicating treatment of Benzalkonium are the effective methods to sanitize the mushroom culture room.

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