A Preliminary Study on the Effectiveness of the Peer Relationship Enhancement Program in Adolescents at Risk for Internet and Smartphone Addiction

OBJECTIVES: The purpose of this study is to evaluate the preliminary effects of the Peer Relationship Enhancement Program in adolescents deemed to be in an at-risk group for Internet and smartphone addiction. METHODS: The study group consisted of 33 adolescent participants (24 boys and 9 girls) at risk of Internet and smartphone addiction in small and medium-sized cities. The subjects participated in 8 consecutive sessions of the Peer Relationship Enhancement Program. The Korean Internet Addiction Proneness Scale, the Korean Smartphone Addiction Proneness Scale, the Real-Ideal Self Discrepancy Scale, the UCLA Loneliness Scale, the Peer Intimacy Scale, and the Escaping from the Self Scale were evaluated before the initial and after the final session. A paired t-test was performed to statistically analyze the data. RESULTS: The Peer Relationship Enhancement Program led to a significant decrease (p < 0.05) in self-reported measures of The Korean Internet Addiction Proneness Scale, the Korean Smartphone Addiction Proneness Scale, and the Real-Ideal Self Discrepancy Scale. CONCLUSION: The Peer Relationship Enhancement Program reduces the risk of Internet and smartphone addiction and effectively prevents the associated problems.

Prevalence of Gallbladder Polyp in Adults in Korea / 가정의학회지

BACKGROUND: Incidentally discovered gallbladder polyp in a health check-up has been increasing in numbers due to the extended use of ultrasonography. Past research has reported on the relationship between body mass index and gallbladder (GB) polyp. As there has been a recent rise in the prevalence of obesity, this research attempted to study GB polyp prevalence and the trend according to time elapse in Korea. METHODS: Retrospective cross sectional research was carried out from the data of Korean Association of Health Promotion, between January 2, 2003 to August 3, 2007 in the subjects who received abdominal ultrasonography. The subjectrs excluded were those below 20 years of age, non-Asian and those who have received cholecystectomy. The number of eligible subjects were 137,135, where 69,493 were males and 67,642 were females. RESULTS: Out of 137,135 subjects, the number of subjects with GB polyp were 5,278, where 3,163 were males and 2,115 were females. According to 2005 census, the age adjusted prevalence was 3.7% (3,656 per 100,000). The prevalence for males was 4,403 per 100,000 (4.4%) and for females 2,943 per 100,000 (2.9%). The prevalence has been increasing for the past five years. CONCLUSION: The prevalence of GB polyp in Korea was found to be higher than the pre-existing reports and the prevalence was higher in males than females. The prevalence is on the increase and there is a need to be more attentive to this issue in the future.

Clinical Implication of Plasma Uric Acid Level / 가정의학회지

The debate over the clinical meaning of plasma uric acid level is still a very hot issue. As the interest in health grows larger in the general public, the number of having a regular health check-up is increasing rapidly. Most of the health care centers routinely check the plasma uric acid level but it is not simple to interpret and explain the appropriate meaning of that. Over the past decade, there have been several studies on clinical implication of plasma uric acid level but the question still remains. However the clinical significance of the results might be different according to the severity of cardiovascular risk among subjects studied, and the findings for correlation with the established risks have enough proof to be applied to clinical practice. Additionally, the uric acid-lowering agents should not be used in general population even though it has reason to be prescribed in a specific high risk patient. Thus, this review seeks to be helpful in clinical practice by examining the preexisting related studies in a different perspective.

Effect of a Needle Aspiration in Patients with Lymphedema / 한국호스피스완화의료학회지

PURPOSE: Lymphedemas are tissue fluid swellings, usually on the arms or legs, and occur as a result of impaired lymphatic drainage. Presently, the most effective treatment available is complete decongestive physiotherapy (CDP). However, this therapy is ineffective in some patients and surgery may be indicated. Herein, we examined the efficacy of minimally invasive needle aspiration of the most enlarged areas in hypodermic adipose tissues, of patients who had failed CDP. METHODS: We included 21 patients who were diagnosed with lymphedema stage II-III in the upper or lower extremities and visited the lymphedema clinic at a university hospital from September 1, 2003 to February 28, 2004. All patients had been treated with CDP at least once, but had failed to respond to the therapy for more than one year. Nine patients had breast cancer and 12 had cervical cancer. We identified the area with the most severe edema by using MRI and performed a 16-gauge angio-needle aspiration on the area. The patients were followed up for 3 months. Effectiveness of the treatment was evaluated by comparing the volume of edema before and after the treatment using Wilcoxon signed rank-test. RESULTS: The mean reduction ratio of the volume of edema comparison normal volume was 41.1+/-35.3% (P=0.001). There were no major or minor operative complications except localized hemorrhage. CONCLUSION: We conclude that a needle aspiration prior to other surgical treatments is relatively safe and effective for those patients who are unresponsive to CDP.

Rapidly progressive glomerulonephritis associated with infective endocarditis: a dramatically improved case after plasmapheresis / 대한내과학회지

A 28-year-old woman was admitted due to fever, dyspnea, hematuria and acute renal insufficiency. 1 months ago, she had been diagnosed as having ventricular septal defect with mild dyspnea and chronic cough. Infective endocarditis (IE) was diagnosed by clinical findings including vegetation in echocardiography. A blood culture drawn during the hospitalization grew streptococcus sanguis. A renal biopsy showed IE-induced crescentic glomerulonephritis (GN). Antibiotic treatment alone was effective for fever, but not for gross hematuria and renal insufficiency. After the initiation of plasmapheresis, gross hematuria and acute renal insufficiency was dramatically improved. After clinical stability was achieved, closure of the ventricular septal defect was performed. This result suggests that plasmapheresis may be beneficial in the treatment infective endocarditis-induced crescent GN.

The Role of Renin-Angiotensin System in Experimental Unilateral Ureteral Obstruction / 대한신장학회잡지

In order to evaluate the renal expression of renin, TGF-beta, TNF-alpha, IL-6, MCP-1, endothelin-1, osteopontin, and the role of renin-angiotensin system(RAS) in renal injury mechanism of experimental unilateral ureteral obstruction(UUO), 44 male Sprague-Dawley rats weighing 260-280g underwent sham operation(n= 8), UUO without treatment(n=12), UUO with angiotensin converting enzyme inhibitor(ACEI, enalapril 100 mg/kg body weight in drinking water, n=12) and UUO with angiotensin II AT1 receptor antagonist(AT1 RA, losartan 300mg/Kg body weight in drinking water, n= 12) under thiopental sodium anesthesia(50mg/kg, body weight, I.P.). Half number of each group was sacrificed at 3 and 7 days after surgery. With standard point count method, we evaluated the magnitude of tubulointerstitial mononuclear cell infiltration and relative volume of interstitium by light microscopic examination (PAS stain and immunohistochemistry for ED-1). Competitive RT-PCR was performed for the estimation of renin, TGF-beta, TNF-alpha, IL-6, MCP-1, endothelin-1, osteopontin and beta-actin gene expression levels of the kidneys. Renal gene expressions of renin, TGF-beta, MCP-1, TNF-alpha, IL-6, endothelin-1, and osteopontin of untreated control UUO rats were significantly increased compared to sham operated rats at 3 and 7 days after surgery. The level of TGF-beta, TNF-alpha, IL-6 and endothelin-1 gene expressions of ACEI treated UUO rats was significantly lower than those of untreated control UUO rats. AT1 RA treated UUO rats also showed significantly lower level of TGF-beta and osteopontin gene expression than those of control UUO group. Untreated control UUO rats showed significantly increased mononuclear cell infiltration of tubulointerstitium and relative volume of interstitium of the kidney compared to sham operated rats. ACEI or AT1 RA treated UUO rats showed significantly less relative volume of interstitium and mononuclear cell infiltration than those of untreated UUO rats(p<0.05, p<0.05). With the above result, we speculate that the upregulation of renin, TGF-beta, MCP-1, TNF-alpha, IL-6, osteopontin and endothelin-1 genes is closely related to the progressive renal injury process in this model and at least in part, the early activation of renin angiotensin system of the kidney is involved in this mechanism.

The influencing Factors of Quality of Life in Hemodialysis Patients / 대한신장학회잡지

This study was performed to evaluate the factors influencing the Quality of Life(QOL) in hemodialysis patients. Authors surveyed and analyzed the questionnaires about social characteristics, symptom, social support, satisfaction with life and quality of life. With these questionnaires, authors compared the hemodialysis patients(N=240, >6 month with hemodialysis) with the control group(N=240). Additionally authors eva- luated the anemia state, nutritional state and dialysis effect, and then analyzed the correlation between these laboratory findings and quality of life in hemodialysis patients. The results were as follows ; 1) The mean age of control group was 33.4 +/- 8.2 yrs, and the patients group was 48.812yrs. 2) Of 294 patients, 73 had the religion(75.2%), 173 had studied above high school(58.8%), 211 were married(71.8%), and 94 were homemaker(3296). Economically, 130 of 294 patients(44.2M) were the middle classes. The patients without occupation were 121 of 294 patients(41.2M), while those with occupation were 77(26.1%) and remainder were housemaker. The patients with medical insurance were 59.9%, those with 1st Medicaid were 22.4%, and those with 2nd Medicaid were 17%. 3) The causes of ESRD were CGN(29.5%), DM (22.3%), etc. Total duration of hemodialysis was 51.4 43.8 months in average, and weekly hemodialysis time was 11.541.98 hours in average. Average BMI was 20.6 +/- 2.79, and in 236 of 294 patients(80.1%), EPO was injected. Of all the complication, 96(32.9%) was cardiovascular problem. Iron storage state was relatively good in all the patients, and the mean level of PTH-i was 174.3 +/- 307.9pg/dl, hemoglobin 8.5 +/- 1.3g/dl, cholesterol 161.536.6mg/dl, total protein 6.60.5g/dl, albumin 3.960.4g/dl. The URR was 65.36.9%, and KtV was 1.3 +/- 0.3. The comparison about laboratory finding between male and female was as followed; Hb. and albumin level was signifi- cantly higher in male compared with female patients, and cholesterol, URR and Kt/V was significantly higher in female than in male. 4) The result of statistic analysis about several variables and Questionnaires. (1) The subjective and objective instrument about QOL showed positive correlation, and the QOL was correlated positively to symptom, physical health state and social support. (2) Of social characteristics, the direct influencing factors for QOL were occupation, economic state, marriage state, and educational state, whereas in- direct factors were a fee for medical treatment and social support. In clinical and laboratory characteristics, the significant factors were age, DM, symptoms, albumin, pre-dialytic creatinine, sodium and calcium. The effect of dialysis did not correlate with QOL. In conclusion, to increase QOL in dialysis pa- tients, all of the community, family, and medical team should make an effort. Firsty, the concern and the support of the community about the dialysis patients should be promoted in social welfare and the opportunity of employment. Secondly, the patients should promote the self-reliance and self- efficacy to take a share of their role in the community and a family by their own efforts. Lastly, the medical team should make an effort to decrease the symptom, to correct the anemia and malnutrition, to treat the complication, and to promote the physical activity. Through these efforts, the health of patients will be elevated. Elevation of the patient's health will increase the possibility of employment and self-reliance, and subsequently will increase the economics. If so, the burden of a fee for the medical treatment will be reduced. Additionally, if social and familial support increase, the QOL of the dialysis patients will be better.

Multivariate Analysis of Factors Associated with Serum Lipoprotein(a) Level in Continuous Ambulatory Peritoneal Dialysis Patients / 대한신장학회잡지

Lp(a) is an independent risk factor of atherosclerotic cardiovascular diseases. Marked increase in plasma lipoprotein(a)[Lp(a)] was reported in conti- nuous ambulatory peritoneal dialysis(CAPD) patients. Serum albumin, parameters of nutritional status and parameters of dialysis have been reported to be related with Lp(a) concentration. Eighty nine patients(age 52 +/- 13, M: F 61: 28) undergoing CAPD were included in this study. We measured Lp(a) concentration, apolipoprotein(a) [apo(a)] phenotype, serum albumin, parathyroid hormone (PTH), Creactive protein(CRP), fibrinogen, 24 hour peritosol protein ancl albumin, 24 hour urine protein and albumin, total albumin clearance, residual renal function(RRF), and parameters of nutritional status such as prealbumin, triceps skin fold(TSF), mid-arm muscle area(MAMA), and normalized protein cata- bolic rate(nPCR). Peritoneal equilibration test(PET) and weekly Kt/V,. were also measured to evaluate relationship of Lp(a) and the adequacy of dialysis. The median serum Lp(a) was 48.9mg/dl(29.1-73.5 mg/dl) (quartiles). Higher Lp(a) level was observed in the low molecular weight apo(a) subgroup. There was no significant difference in serum Lp(a) levels between male and female, diabetic and non-diabetic patients, smokers and non-smokers. Serum albumin was negatively correlated(r=-0.28, p<0.01), while total albumin clearance was positively correlated with Lp (a)(r=0.20, p<0.05). 4)gLp(a) was not correlated with age, duration of dialysis, prealbumin, fibrinogen, RRF, weekly Kt/V, PET, PTH, CRP, TSF, MAMA, nPCR, 24hour peritosol protein and albumin and 24hour urine protein and albumin. Multivariate analysis using apo(a) phenotype, serurn albumin, total albumin clearance as independent variables revealed that serum albumin and apo(a) phenotype were significantly related with logLp(a)(p<0.05). Apo(a) phenotype and serum albumin were the factors that were independently associated with se- rum Lp(a) concentration in CAPD patients.

Hormonal and Cytokine Regulation of ICAM-1 gene in FRTL-5 Thyroid Cells: Cloning and Analysis of 5-Regulatory Region of Rat ICAM-1 Gene / 대한내분비학회지

BACKGROUND: We have found abnormal expression of ICAM-1 in thyroid follicular cells from patients with Graves disease and Hashimoto disease. In this report, we present the hormonal regulation of ICAM-1 mRNA expression and the primary structure of 5-regulatory region which is important for transcriptional regulation of ICAM-1 gene. A I.S kb fragment of the 5-regulatory sequences are identified and linked to luciferase as a reporter. METHOD: Those reporter constructs were used to evaluate the expression in response to cytokines and hormones. Deletion analysis of 1.8 kb fragment of ICAM-1 promoter in FRTL-5 cells provide the evidence for the existence of several regulatory elements of enhancer and silencer in ICAM-1 gene transcription in thyroid cells. RESULTS: ICAM-1 mRNA is easily detected by Northern analysis using total RNA from FRTL-5 cells regardless of culture conditions. The transcripts of rat ICAM-1 showed single band of 2.6 kb in length. The FRT cells which was come from early FRTL cell culture did not show ICAM-1 mRNA with usual Northern analysis, We found differential regulation of ICAM-1 RNA level in different culture condition in FRTL-5 cells, The cells maintained at 3H (no hydrocortisone, no insulin, no TSH) condition showed the highest expression level compared to 4H, 5H, or 6H medium. Hydrocortisone markedly decreased the ICAM-1 RNA and insulin partially recovered the hydrocortisone induced repression. TSH which is important in growth and function of FRTL-5 cells could independently downregulate the ICAM-1 RNA levels. Forskolin (10 mM) could mimic the action of TSH on ICAM-1 mRNA. TNF-a and interferon-y increase ICAM-1 expression in FRTL-5 thyroid cells. TSH/forskolin inhibited maximal expression of ICAM-1 by TNF-a and interferon-r. Promoter activity of the ICAM-1 gene was positively regulated by cytokines, TNF-a and IFN-r and negatively regulated by thyroid stimulating hormone. The addition of TSH and FSK caused a 50% decrease in ICAM-1 promoter activity within 24 hour. The TSH and FSK action was mapped at 175 bp and 97 bp of the start of translation. The mutant construct pCAM-175 delGAS which has no GAS sequence showed no TSH mediated suppression of promoter activity. CONCLUSION: These findings suggested that hormones and cytokines differentially regulated the ICAM-1 gene expression and TSH downregulated ICAM-1 gene transcription by inhibiting the activation of IFN-r induced transcription factors which can bind the GAS of ICAM-1 promoter.