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1.
Journal of Korean Academy of Nursing ; : 554-570, 2020.
Article | WPRIM | ID: wpr-834496

ABSTRACT

Purpose@#This study aimed to develop and test a structural equation model of health-related quality of life among older women following bilateral total knee replacement based on a literature review and Wilson and Cleary’s model of health-related quality of life. @*Methods@#One hundred ninety three women who were diagnosed with osteoarthritis, were older than 65 years, and were between 13 weeks and 12 months of having a bilateral total knee replacement were recruited from an outpatient clinic. Data were collected from July 2017 to April 2018 using a structured questionnaire and medical records. Data were analyzed using SPSS/WIN 22.0, AMOS 22.0, and Smart PLS 3.2.4. @*Results@#The fitness of the hypothetical model was good, with coefficients of determination (R2 ) ranging between .28 and .75 and predictive relevance (Q2 ) between .26 and .73. The standardized root mean square residual of the model fit indices for the hypothetical model was .04; which explained 64.2% of physical and 62.5% of mental health-related quality of life. Self-efficacy, symptom status, functional status, and general health perceptions had a significant direct effect on physical health-related quality of life, while social support, symptom status, and general health perceptions had a significant direct effect on participants’ mental-health-related quality of life. @*Conclusion@#To improve the physical and mental quality of life of older women who receive bilateral knee replacement, nursing-based intervention strategies that reduce symptoms, improve functional status, and increase health perceptions, self-efficacy, and social support are needed. The most important factor is the symptom status.

2.
Journal of Dental Hygiene Science ; (6): 271-278, 2019.
Article in English | WPRIM | ID: wpr-785946

ABSTRACT

BACKGROUND: This study aimed to examine the factors that influence clinical performance of dental hygiene students to provide useful data for developing strategies to improve clinical competence.METHODS: The effects of variables on clinical competence by quantile level were analyzed using quantile regression analysis in 247 dental hygiene students. Quantile regression and multiple regression analyses were conducted using the Stata 11.0 program to analyze predictors of clinical competence.RESULTS: The clinical competence score of dental hygiene students was 42.69±5.90, the satisfaction of clinical practice was 49.90±7.44, the clinical practice stress was 50.62±7.37, and the professional self-concept was 31.68±4.41. Empathy was the highest at 50.87±4.93. Multiple regression analysis showed that school year, stress from clinical training, satisfaction with clinical training, professional self-concept, and empathy had significant impact on clinical competence. Quantile regression analysis showed that the effects varied depending on the clinical competence level. School year and professional self-concept had a significant positive effect, regardless of the clinical competence level, while empathy had a significant positive effect at the top 10% (Q90) of the clinical competence level. Satisfaction with clinical practice affected clinical competence at Q25, Q50, and Q90. Stress from clinical practice had significant effects at Q25, Q50, and Q90 (p<0.05).CONCLUSION: According to the study results, different factors affected clinical competence according to the quantile of clinical competence. This study provides valuable implications for designing clinical competence enhancement programs and strategies. In addition, objective indicators for considering factors that may affect the clinical competence, such as academic competence and satisfaction of practice hospitals, are expected to require detailed analysis and measures.


Subject(s)
Humans , Clinical Competence , Empathy , Mental Competency , Oral Hygiene
3.
Clinical Pediatric Hematology-Oncology ; : 102-107, 2018.
Article in English | WPRIM | ID: wpr-717647

ABSTRACT

BACKGROUND: Few studies of high dose dexamethasone (HD-DXM) therapy in children with immune thrombocytopenic purpura (ITP) have been reported. The purpose of this study is to investigate efficacy and safety of repeated HD-DXM therapy as second-line treatment of ITP in childhood. METHODS: We retrospectively analyzed the medical records of patients < 18 years of age with primary ITP who received more than 2 cycles of HD-DXM therapy from May 2004 to January 2018. HD-DXM was given orally in 4-day pulses every 28 days as a 20–40 mg/1.73 m² daily dose. RESULTS: A total of 26 patients (male, 19; female, 7) were enrolled and their median age was 6 years (range, 1–15). All patients had received previous treatment for ITP. A median 6 cycles (range, 2–19) of HD-DXM was given. On the beginning of HD-DXM therapy, three patients satisfied the criteria for newly diagnosed ITP, 16 for persistent ITP and 7 for chronic ITP. Relapse-free survival (RFS) of responders (n=9) after the last HD-DXM cycle was estimated to be 38.1±17.2%, lasting for a median 9.1 months (range, 5.6–46.2). According to response after the 2nd cycle, RFS of responders (n=13) was significantly higher than non-responders (23.1±11.7% vs. 7.7%±7.4%, P=0.001). The most common adverse event was irritability (30.8%), followed by fatigue (19.2%). CONCLUSION: HD-DXM therapy in children was relatively tolerated and response after therapy was acceptable. More courses of HD-DXM may be feasible in responders after two cycles of HD-DXM.


Subject(s)
Child , Female , Humans , Dexamethasone , Fatigue , Medical Records , Purpura, Thrombocytopenic, Idiopathic , Retrospective Studies
4.
Journal of Dental Hygiene Science ; (6): 234-240, 2018.
Article in Korean | WPRIM | ID: wpr-716175

ABSTRACT

The purpose of this study was to provide basic data on counseling, education, and treatment related to orthodontic practices through an understanding of the relationships between orthodontic treatment, oral health-related quality of life, and happiness of high school students. The subjects in this study were 500 students in Grades 1~3 of a high school in Jeollabuk-do. We conducted a survey targeting this group; the results revealed the following: in the social support item, peer support showed significant differences in the matter of orthodontic treatment (p < 0.05). In oral health-related quality of life, the students without orthodontic treatment showed 14.09 scores that were higher than the students with treatment (p < 0.05). Regarding happiness, the students with orthodontic treatment showed higher scores which were significantly different from the those of the non-orthodontic treatment group (p < 0.05). Additionally, upon examining the correlations between self-esteem, social support, oral health-related quality of life, and happiness, oral health-related quality of life, peer support, and happiness showed the negative (−) correlations while the rest of the variables showed the positive correlations (p < 0.05). The factors having effects on oral health-related quality of life included the stress, matter of orthodontic treatment, and teachers support (p < 0.05). The factors having effects on happiness included self-esteem, peer support, and family support (p < 0.05). Based on the above results, even though dental orthodontic treatment had negative effects on oral health-related quality of life, it had positive effects on happiness. Consequently, it would seem necessary to seek active methods to increase oral health-related quality of life. This improvement could be achieved by minimizing inconveniences, such as mastication, in the process of dental orthodontic treatment, and developing programs that could enhance happiness.


Subject(s)
Humans , Counseling , Education , Happiness , Mastication , Oral Health , Orthodontics , Quality of Life
5.
Journal of the Korean Child Neurology Society ; : 133-138, 2017.
Article in Korean | WPRIM | ID: wpr-159141

ABSTRACT

PURPOSE: Benign childhood epilepsy with centrotemporal spikes (BECTS) is one of the most common and benign focal epilepsy syndromes during childhood. In this study, we analyzed the clinical features and electroencephalogram (EEG) of BECT patients to determine if there were any predictive factors for seizures or abnormal EEG findings lasting longer than the average. METHODS: We studied 49 patients who were diagnosed with BECTS at the Department of Pediatrics, Chonnam National University Hospital and were 18 years of age or older at the time of the study. Differences in clinical course according to EEG features, treatment duration, abnormal EEG duration, seizure development period, and time to achieving the first normal EEG were analyzed. RESULTS: Average onset age was 8.3±1.9 years and follow-up duration was 4.2±2.4 years. The average seizure-free age was 9.5±2.0 years, and abnormal EEG-free age was 11.6±2.1 years. Younger-onset patients had a longer duration of medication (P=0.04). Patients who needed shorter time to achieving the first normal EEG had a shorter seizure development period (P=0.02). Patients who did not show typical EEG findings consistent with BECTS had a significantly longer duration of medication (P<0.01) and seizure development period (P=0.02), and abnormal EEG duration (P= 0.01). The ratio of abnormal findings in the first three EEGs was significantly correlated with the seizure development period, abnormal EEG duration, and duration of medication (P<0.01). CONCLUSION: Although BECTS is known to take a benign course, the actual clinical course varied from patient to patient, and these variations may be predicted by analyzing clinical factors or EEGs.


Subject(s)
Child , Humans , Age of Onset , Electroencephalography , Epilepsies, Partial , Epilepsy , Epilepsy, Rolandic , Follow-Up Studies , Pediatrics , Seizures
6.
Journal of Korean Medical Science ; : 1423-1430, 2017.
Article in English | WPRIM | ID: wpr-200241

ABSTRACT

The purpose of this study was to examine the relationship between emotional labor and burnout, and whether the levels of self-efficacy and type A personality characteristics increase the risk of burnout in a sample of Korean female dental hygienists. Participants were 807 female dental hygienists with experience in performing customer service for one year or more in dental clinics, dental hospitals, or general hospitals in Korea. Data were collected using a structured self-administered questionnaire. A hierarchical multiple linear regression analysis was used to examine the effects of emotional labor on burnout, and to elucidate the additive effects of self-efficacy and type A personality on burnout. The results showed that “overload and conflict in customer service,”“emotional disharmony and hurt,” and “lack of a supportive and protective system in the organization” were positively associated with burnout. With reference to the relationship between personality traits and burnout, we found that personal traits such as self-efficacy and type A personality were significantly related to burnout, which confirmed the additive effects of self-efficacy and type A personality on burnout. These results indicate that engaging in excessive and prolonged emotional work in customer service roles is more likely to increase burnout. Additionally, an insufficient organizational supportive and protective system toward the negative consequences of emotional labor was found to accelerate burnout. The present findings also revealed that personality traits such as self-efficacy and type A personality are also important in understanding the relationship between emotional labor and burnout.


Subject(s)
Female , Humans , Dental Clinics , Dental Hygienists , Hospitals, General , Korea , Linear Models , Type A Personality
7.
Journal of Dental Hygiene Science ; (6): 398-404, 2017.
Article in English | WPRIM | ID: wpr-645142

ABSTRACT

The present study aimed to examine the influence of mental health factors on oral health factors using data from the Korean National Health and Nutrition Examination Survey (KNHANES). A total of 1,548 elderly individuals aged over 65 years who completed the screening and health questionnaire were selected as the final study participants. The psychological health factors related to perceived oral health status were depression and stress when the gender was controlled, and in terms of gender, both elderly male and female individuals were stressed and depressed. These results suggested that the psychological health of elderly individuals negatively affects not only perceived oral health but also the quality of life. In addition, the psychological health of the elderly individuals should be systematically managed along with oral health care and overall health care and lifestyle. If a comprehensive health management system is available for low-income groups or an elderly person living alone, it should positively affect and improve the quality of life of elderly individuals.


Subject(s)
Aged , Female , Humans , Male , Delivery of Health Care , Depression , Life Style , Mass Screening , Mental Health , Nutrition Surveys , Oral Health , Quality of Life , Suicidal Ideation
8.
Clinical Pediatric Hematology-Oncology ; : 105-115, 2016.
Article in Korean | WPRIM | ID: wpr-788586

ABSTRACT

BACKGROUND: Acute promyelocytic leukemia (APL) is rare in children, accounting for 5-7% of all acute myeloid leukemia (AML) cases. This study aimed to review clinical and laboratory characteristics of pediatric APL patients, and to analyze the therapeutic outcomes.METHODS: Twenty pediatric patients with APL, diagnosed from January 1998 to April 2016, were retrospectively reviewed. Clinical and laboratory findings were collected, and morphologic, immunophenotypic, cytogenetic and molecular characteristics were evaluated. Therapeutic outcomes and prognostic factors of patients were analyzed.RESULTS: The number of pediatric APL patients was 20, which was 18.5% of all the cases of AML. The 5-year overall survival (OS) and event-free survival (EFS) were 88.5±7.6% and 83.0±9.0%, respectively. As compared to typical APL patients, patients with microgranular variants (M3v) (n=4, 20%) showed a tendency for a younger age, low white blood cell counts, and a shorter prothrombin time (P=0.045), but their 5-year OS and EFS were not significantly different. Better survival was observed in ATRA plus chemotherapy group both for 5-year OS (100% vs. 60.0±21.9%, P=0.018), and for 5-year EFS (60.0±21.9% vs. 91.7±8.0%, P=0.080) than ATRA only group. Stem cell transplantations were given to 3 patients and they are alive without disease for 8.3-16.5 years of follow-up. One death after relapse, another death in remission and development of secondary leukemia were encountered during the study period.CONCLUSION: This study analyzed clinical characteristics of pediatric APL and demonstrated very good outcome with the combination of ATRA and chemotherapy.


Subject(s)
Adolescent , Child , Humans , Cytogenetics , Disease-Free Survival , Drug Therapy , Follow-Up Studies , Leukemia , Leukemia, Myeloid, Acute , Leukemia, Promyelocytic, Acute , Leukocyte Count , Prothrombin Time , Recurrence , Retrospective Studies , Stem Cell Transplantation
9.
Journal of Dental Hygiene Science ; (6): 415-423, 2016.
Article in Korean | WPRIM | ID: wpr-650167

ABSTRACT

This study examined the relationship between oral health behaviors and in senior citizens to determine how to improve their happiness index. The subjects in this study were 260 senior citizens aged 65 years or older, who resided in North Jeolla Province. A survey was conducted from June 17 to 30, 2016. The happiness index of elderly people who brushed their teeth more often and had dental checkups on a regular basis was significantly higher (p<0.05). Evaluation of subfactors associated with quality of life related to oral health showed significant differences in functional disturbances according to gender, age, the presence or absence of a spouse, and the use or nonuse of dentifrice (p<0.05). Physical pain significantly varied with the presence or absence of a spouse, educational level, monthly mean allowance, and regular dental checkups (p<0.05); significant differences were found in psychological discomfort according to gender, tooth brushing frequency, and regular dental checkups (p<0.05). There were significant differences in declining physical capacity according to gender, age, educational level, and monthly mean allowance (p<0.05); waning mental capacity significantly differed with age, living alone or with another person, the presence or absence of a spouse, and regular dental checkups (p<0.05). The factors that influenced the happiness index in senior citizens were age, living alone or with another person, educational level, monthly mean allowance and the Oral Health Impact Profile score (p<0.05). The study showed that measures are needed to improve the quality of life and happiness index in elderly people, including the development of oral health programs for this population.


Subject(s)
Aged , Humans , Dentifrices , Happiness , Morinda , Oral Health , Quality of Life , Spouses , Tooth
10.
Clinical Pediatric Hematology-Oncology ; : 105-115, 2016.
Article in Korean | WPRIM | ID: wpr-30890

ABSTRACT

BACKGROUND: Acute promyelocytic leukemia (APL) is rare in children, accounting for 5-7% of all acute myeloid leukemia (AML) cases. This study aimed to review clinical and laboratory characteristics of pediatric APL patients, and to analyze the therapeutic outcomes. METHODS: Twenty pediatric patients with APL, diagnosed from January 1998 to April 2016, were retrospectively reviewed. Clinical and laboratory findings were collected, and morphologic, immunophenotypic, cytogenetic and molecular characteristics were evaluated. Therapeutic outcomes and prognostic factors of patients were analyzed. RESULTS: The number of pediatric APL patients was 20, which was 18.5% of all the cases of AML. The 5-year overall survival (OS) and event-free survival (EFS) were 88.5±7.6% and 83.0±9.0%, respectively. As compared to typical APL patients, patients with microgranular variants (M3v) (n=4, 20%) showed a tendency for a younger age, low white blood cell counts, and a shorter prothrombin time (P=0.045), but their 5-year OS and EFS were not significantly different. Better survival was observed in ATRA plus chemotherapy group both for 5-year OS (100% vs. 60.0±21.9%, P=0.018), and for 5-year EFS (60.0±21.9% vs. 91.7±8.0%, P=0.080) than ATRA only group. Stem cell transplantations were given to 3 patients and they are alive without disease for 8.3-16.5 years of follow-up. One death after relapse, another death in remission and development of secondary leukemia were encountered during the study period. CONCLUSION: This study analyzed clinical characteristics of pediatric APL and demonstrated very good outcome with the combination of ATRA and chemotherapy.


Subject(s)
Adolescent , Child , Humans , Cytogenetics , Disease-Free Survival , Drug Therapy , Follow-Up Studies , Leukemia , Leukemia, Myeloid, Acute , Leukemia, Promyelocytic, Acute , Leukocyte Count , Prothrombin Time , Recurrence , Retrospective Studies , Stem Cell Transplantation
11.
Korean Journal of Family Medicine ; : 60-71, 2015.
Article in English | WPRIM | ID: wpr-181478

ABSTRACT

BACKGROUND: We conducted a population-based cross-sectional study of Korean adults to evaluate the association between metabolic syndrome and microalbuminuria as a marker for early-stage chronic kidney disease. METHODS: A total of 8,497 adults (3,625 men and 4,872 women) who participated in the Korea National Health and Nutrition Examination Survey between 2011 and 2012 were included. Metabolic syndrome was defined according to recommendation from a joint interim statement of international organizations published in 2009. Microalbuminuria was defined as a urinary albumin-to-creatinine ratio of 30 to 300 mg/g. The association between metabolic syndrome and microalbuminuria was evaluated using logistic regression analysis with adjustment for covariates while considering sampling weights and the complex survey design. RESULTS: The prevalence of microalbuminuriain subjects with metabolic syndrome was 11% for men and 14.4% for women, whereas the prevalence in subjects without metabolic syndrome was 3.1% for men and 6.7% for women. Metabolic syndrome was significantly associated with an increased risk of microalbuminuriain both women (odds ratio, 2.79; 95% confidence interval, 2.01 to 3.88) and men (odds ratio, 3.00; 95% confidence interval, 2.11 to 4.27). All components of the metabolic syndrome were associated with a significantly increased risk of microalbuminuria with the strongest association for high blood pressure. The risk of microalbuminuria increased in a dose-dependent manner (P-value for trend < 0.001) with the number of metabolic syndrome components observed for both sexes. CONCLUSION: These findings suggest that metabolic syndrome is a risk factor for chronic kidney disease from an early stage.


Subject(s)
Adult , Female , Humans , Male , Albuminuria , Cross-Sectional Studies , Dyslipidemias , Hypertension , Joints , Korea , Logistic Models , Nutrition Surveys , Obesity , Prevalence , Renal Insufficiency, Chronic , Risk Factors , Weights and Measures
12.
Journal of the Korean Neurological Association ; : 224-230, 2008.
Article in Korean | WPRIM | ID: wpr-113740

ABSTRACT

BACKGROUND: Alzheimer's disease (AD) is characterized by the pathology of amyloid plaques and tau-associated neurofibrillary tangles. Acetylcholine esterase (AChE) transforms the beta-amyloid monomer into an oligomer, and increases beta-amyloid aggregation in the brain. Increased beta-amyloid breaks the cytoskeleton of the brain by hyperphosphorylation of the tau protein. Previous studies support that AChE inhibitor has an inhibitory effect on toxicity of the beta-amyloid and phophorylated tau protein. The purpose of this study was to analyze the CSF beta-amyloid 1-42 (A beta 1-42) and phosphorylated tau protein in AD and determine their difference depending on whether AChE inhibitor was taken or not. METHODS: Subjects included 16 AD, 14 normal controls, and 15 disease controls. Nine of AD group had taken an AChE inhibitor while the remainder had not. The CSF A beta 1-42 and phosphorylated tau were measured by ELISA. RESULTS: The CSF A beta 1-42 levels were lower in AD patients than in other groups (p<0.01). We also found increased CSF A beta 1-42 levels in the AChE inhibitor users, compared with non-users. CONCLUSIONS: The level of CSF A beta 1-42 may have a diagnostic value in the patients with cognitive impairments. Also, we may expect the effect of AChE inhibitor on Alzheimer's pathology by measuring CSF A beta 1-42 levels. Therefore, the level of CSF A beta 1-42 may serve as a biological surrogate marker for AD treatment.


Subject(s)
Humans , Acetylcholine , Alzheimer Disease , Biomarkers , Brain , Cytoskeleton , Neurofibrillary Tangles , Plaque, Amyloid , tau Proteins
13.
Journal of the Korean Dietetic Association ; : 114-124, 2005.
Article in Korean | WPRIM | ID: wpr-205206

ABSTRACT

The nutritional status of pre-school children is important for both physical growth and functional development. This study investigated the anthropometric, nutrient intakes and dietary quality of the pre-school children living in Asan for planning nutritional education program. The dietary intakes were measured by 2-day 24 hr recall recorded by children's mothers and the anthropometric data were collected by measuring children's weights, heights, and percent body fat at Asan Public Health Center. The children were 161 boys and 129 girls aged 5 and 6 years. When children's nutritional status was determined by their anthropometric status (underweight, normal weight and overweight) determined by z-score (normal range between -1.00 and 1.00), only 1.4% of the children belonged to underweight group while 55.7% and 42.9% belonged to normal and overweight groups, respectively. Significantly higher number of children belonged to overweight group for 5 year-olds. No differences were observed in nutrient intakes, nutrient adequacy ratio (NAR) and index of nutritional quality (INQ) values among nutritional status groups. Intakes of the most nutrients were adequate, but NAR and INQ of calcium and zinc were low. When nutrient intakes, NAR and INQ were compared by sex or age, all nutrient intakes were appropriate except calcium and zinc intakes of 6 year-olds. Nutrient intakes of 5 years were higher than those of 6 years. The mean of nutrient adequacy ratio (MAR) was 0.85 and mean INQ was 1.51 for all participants. The nutritional management program for pre-school children in Asan would be directed differently by age groups and education material should contain contents educating to consume moderate amount of food for 5 year-olds and to increase intake of foods with mineral nutrients such as calcium and zinc for 6 year-olds.


Subject(s)
Child , Child, Preschool , Female , Humans , Adipose Tissue , Calcium , Education , Mothers , Nutritional Status , Nutritive Value , Overweight , Public Health , Thinness , Weights and Measures , Zinc
14.
Journal of the Korean Neurological Association ; : 520-523, 2004.
Article in Korean | WPRIM | ID: wpr-186482

ABSTRACT

An 18-year-woman was referred with seizure activity and global aphasia. Diagnosis of MELAS syndrome with left temporo-parieto-occipital infarction was confirmed by gene analysis. Global aphasia was improved completely. Right temporal infarction developed after 5 months. Diagnosis of pure word deafness was made in view of impaired verbal comprehension in presence of adequate reading, writing, spontaneous speaking, and well preserved environmental sound perception. MRI findings of the patient support the hypothesis of the pathway of non-verbal hearing in previous reports.


Subject(s)
Humans , Aphasia , Comprehension , Deafness , Diagnosis , Hearing , Hearing Loss, Central , Infarction , Magnetic Resonance Imaging , MELAS Syndrome , Seizures , Writing
15.
Journal of Korean Breast Cancer Society ; : 166-173, 2004.
Article in Korean | WPRIM | ID: wpr-226513

ABSTRACT

PURPOSE: Multiple clinical, biological, and pathologic factors correlate with the outcomes in patients with invasive breast cancer. The utility of a peritumoral vascular invasion (PVI) as an additional prognostic indicator has been poorly defined. The aim of this study was to determine if the presence or absence of PVI can be used to help assess the survival and recurrence. METHODS: An invasion of the vascular space (lymphatic and/or blood vessel) by a tumor, as assessed on routine hematoxylin and eosin sections, was investigated in a 146 women with primary operable invasive breast carcinoma. The presence of PVI was compared with the established prognostic factors such as age, tumor size, axillary lymph node involvement, histological grade, hormonal receptor status, and expression of c-erb B2, Ki-67 and p53. Survival analysis was performed using Kaplan-Meier method and log-rank test. RESULTS: PVI was found in 35.6% of cases and was significantly associated with an increasing tumor size (P=0.033) and metastatic axillary lymph nodes (P=0.012). The 5 year disease free survival (DFS) and overall survival (OS) were significantly lower in the patients with PVI than without PVI (P=0.0431 and 0.0445, respectively). In multivariate analysis, the axillary lymph node status (P=0.001), the tumor size (P=0.044) and PVI (P=0.050) were significant independent prognostic factors for the DFS. In the node- negative breast cancer group and in the node-positive breast cancer group, the 5 year DFS and OS were lower in the patients with PVI than in those without, but this did not show significant difference. CONCLUSION: Cox multivariate analysis showed that PVI is a strong prognostic factor for patients with operable invasive breast cancer and an independent prognostic factor for a recurrence. A histological assessment of PVI can provide prognostic information on primary operable invasive breast carcinoma and might be helpful in making a clinical decision.


Subject(s)
Female , Humans , Breast Neoplasms , Breast , Disease-Free Survival , Eosine Yellowish-(YS) , Hematoxylin , Lymph Nodes , Multivariate Analysis , Prognosis , Recurrence
16.
Journal of the Korean Society of Pediatric Nephrology ; : 33-42, 2004.
Article in Korean | WPRIM | ID: wpr-174966

ABSTRACT

PURPOSE: Children with nephrotic syndrome(NS) are under high risk for metabolic bone disease(MBD) as a complication of long-term glucocorticoid therapy. We prospectively evaluated the effect of oral bisphosphonate(alendronate) therapy in children with NS, which has proven efficacy in adult patients with glucocorticoid induced MBD. METHODS: Among 58 children with NS, aged 5 to 8 years and having a disease duration of more than 2 years, 30(51.7%) were enrolled to meet the selection criteria, less than -1.0 Z- scores of lumbar spine bone mineral density(BMD) by dual energy X-ray absorptiometry (DEXA). These 30 children were divided into three groups and each were assigned to receive alendronate, calcitriol, and no-medication, respectively for one year. Lumbar spine BMD was followed up every 6 months and the biochemical indexes were measured before and 1 year after the treatment. There were no significant difference among groups with respect to the average age, the initial BMD, and the cumulative steroid doses. Analysis of the treatment efficacy was done by the % change of BMD and by the changes in Z-scores of lumbar spine BMD. RESULTS: Mean age and disease duration of patients at the initial lumbar spine BMD evaluation was 7.4+/-1.7 years and 2.2+/-1.2 years, respectively. Twenty-three of 30 children(76%) had osteopenia, and seven(23%) had osteoporosis. There was no difference in the biochemical values among the groups, before and 1 year after the treatment(P<0.05). Twenty two children(73.3%) with frequent relapsing or steroid dependant NS had more frequent MBD, compared to the 8 children(26.6%) with infrequent relapsing NS. The one year % changes of BMD were 8.56 in alendronate group, 5.79 in calcitriol group, and 1.9 in no-medication group. The changes in Z-score of lumbar spine BMD increased in the alendronate group and the calcitriol group, but not in the no-medication group. One year % changes of BMD were different among groups(P=0.0002). Significant differences were found between the alendronate and the no-medication group, and between the calcitriol and the no-medication group(P< 0.05). There was no difference between the alendronate and the calcitriol group. No serious adverse effect was observed in the alendronate group. CONCLUSION: Children with NS receiving high dose steroids are under the high risk of BMD and should undergo regular BMD evaluation. Z-score of lumbar spine BMD was a useful parameter in diagnosing low bone mass in children. Alendronate weekly oral therapy was effective and relatively safe in increasing the lumbar spine BMD in children with NS having steroid induced MBD.


Subject(s)
Adult , Child , Humans , Absorptiometry, Photon , Alendronate , Bone Density , Bone Diseases, Metabolic , Calcitriol , Nephrotic Syndrome , Osteoporosis , Patient Selection , Prospective Studies , Spine , Steroids , Treatment Outcome
18.
Korean Journal of Community Nutrition ; : 505-514, 1997.
Article in Korean | WPRIM | ID: wpr-62670

ABSTRACT

Concern about body weight among young females is too much, so distorted body image and restrained eating are serious problems among Korean young females. A society preoccupied with thinness give a psychological burden to women, this burden may have adverse effects on health physically and psychologically. We tried this study to investigate body image, eating problems, and dietary intakes among female college students in urban areas of Korea. We satisfactorily surveyed using their body weight, desired weight dieting, binge eating, and night eating by self- with 500 female college students. We evaluated their dietary intakes by semi-quantitative food frequency to assess their usual intakes. After removing incomplete data, we analyzed 469 data by SAS 6.10. The 469 women aged 21.1 years. Their mean height, weight, and BMI were 161.4cm, 52.5kg, and 20.2kg/m2 respectively. Though the frequency of obesity was only 2.6%, the frequency of dissatisfaction with their body weight was 84.7%. Female college students desired their hight, weight, and BMI to be 165.8cm, 48.2kg, and 17.5kg/m2, respectively. The frequency of binge eating and night eating were 20.7% and 6.8%. The odds ratios for binge eating and night eating were 10.9(95% CI : 2.6-15.1) and 6.0(95% CI : 1.8-14.8) in the group satisfied with their body weight compared with the dissatisfied group. The odds ratios for binge eating and night eating were 2.6(95% CI : 1.6-4.4) and 2.4(95% CI : 1.1-5.4) in the dieting group compared with the non-dieting group. The mean caloric intake was 1,840kacl and percent intakes of carbohydrate, protein, and fat wee 57.2%, 16.3%, and 24.0%, respectively. The dieting group showed deficient intakes of protein and calcium significantly compared with the non-dieting group showed deficient intakes of protein and calcium significantly compared with the non-dieting group. Almost all women college students in urban area had dissatisfaction with their body shape, and desired severe undrerweight. The frequency of binge eating and night eating increased according to dissatisfaction with body weight, diet, and distortion of body image. Dieting has adverse effect on the intakes of essential nutrients. Educations is needed to correct distorted body image, and bad eating habits in young females, and marked preoccupation with thinness among women should then be reduced.


Subject(s)
Female , Humans , Body Image , Body Weight , Bulimia , Calcium , Diet , Eating , Energy Intake , Korea , Obesity , Odds Ratio , Thinness , Surveys and Questionnaires
19.
Journal of the Korean Neurological Association ; : 142-158, 1987.
Article in Korean | WPRIM | ID: wpr-120238

ABSTRACT

The author studied the diagnostic usefulness of topography of flash visual evoked potential (FVEP) in evaluation of the patients with cerebrovascular diseases (CVDs) proven by brain CT scans. The patient group of 21 cases were consist of 10 cerebral infarctions and 11 intracerebral hemorrhages, that occurred at various sittes; 2 frontal lesions, 8 temporopariental lesions, 2 occipital lesions, and 8 basal ganglia lesions. As a control group, topographic studies of FVEP were done in 25 patients with no clinical eviddences of central nervous system diorders and visual symptoms. Topographic studies of FVEP with 12 recording electrodes, using Topography system 700 (San-ei), were done by binocular flashlight stimulation at the rate of 2/sec with the eyes closed. Topographic studies of FVEP were evaluated visually and the asymmetry of topography was considered as abnormal. Three types of topography were used; spatial-temporal mapping up to 300 msec of latency, latency mapping of wave II and VII (Cigenek, 1961), and amplitude mapping of wave II and VII. In both control and patient group, FVEP recorded at O1 and O2 were also obtained. The results were as follows: 1. In control group, absolute latencies and amplitudes of wave II and VII were much variable in FVEP recorded at O1and O2. Interhemispheric differences of amplitudes of wave II and VII were also much variable, but those of latencies were the least variable parameters; 1.89+1.24 msec in wave II and 2.65+3.90 msec in wave VII. Interhemispheric differences of latencies and amplitudes in patient group were interpreted as normal within the mean value plus 2 standard deviation of those of control group. 2. In patient group, abnormal FVEP recorded at O1 and O2 were observed only in 11 cases, among which 8 cases (38%) were consistent in lateralization of supratentorial lesions on brain CT scans. 3. Spatial-temporal mapping of FVEP, even in control group, was variable at each latencies, showing shifting asymimetries sidde to side and only suggested the tendency of greater amplitudes in right hemisphere and sequential transition of evoked responses. 4. In patient group, 17 cases showed abnormal latency mapping of wave II an/or wave VII, among which 13 (62%) were consistent in lateralization of supratentorial lesions. This relatively high concordance rate to brain CT findings was thought to be resulted from low variability of interhemispheric differences of latencies, and also suggested that latency mapping is more reliable method than other 2 types of topography of FVEP. 5. Amplitude mapping of wave II and/or wave VII showed 38% (8 cases) of concordance rate to brain CT findings in lateralization of supratentorial lesion. In conclusion, it is thought that topography of FVEP is a useful diagnostic test in evaluation of CVDs, and is also suggested that topography of FVEP can be used in evaluation of various supratentorial cerebral lesions functionally without such sophisticated criteria as in conventional FVEP interpretation.


Subject(s)
Humans , Basal Ganglia , Brain , Central Nervous System , Cerebral Hemorrhage , Cerebral Infarction , Diagnostic Tests, Routine , Electrodes , Evoked Potentials, Visual , Telescopes , Tomography, X-Ray Computed
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