Acute kidney injury (AKI) is common in advanced cirrhosis. Prerenal azotemia, hepatorenal syndrome, and acute tubular necrosis are the main causes of AKI in patients with cirrhosis. Evaluation of renal function and differentiation between functional and structural kidney injury are important issues in the management of cirrhosis. However, AKI in cirrhosis exists as a complex clinical spectrum rather than concrete clinical entity. Based on current evidence, changes in serum creatinine (Cr) levels remain the most appropriate standard for defining AKI in cirrhosis. However, serum Cr has a limited role in assessing renal function in this population. This review examines previous studies that investigated the ability of recent biomarkers for AKI in cirrhosis from the perspective of earlier and accurate diagnosis, classification of AKI phenotype, and prediction of clinical outcomes. Serum cystatin C and urine neutrophil gelatinase-associated lipocalin have been extensively studied in cirrhosis, and have facilitated improved diagnosis and prognosis prediction in patients with AKI. In addition, urine N-acetyl-β-D-glucosaminidase, interleukin 18, and kidney injury molecule 1 are other promising biomarkers for advanced cirrhosis. However, the clinical significance of these markers remains unclear because there are no cut-off values defining the normal range and differentiating phenotypes of AKI. In addition, AKI has been defined in terms of serum Cr, and renal biopsy—the gold standard—has not been carried out in most studies. Further discovery of innovate biomarkers and incorporation of various markers could improve the diagnosis and prognosis prediction of AKI, and will translate into meaningful improvements in patient outcomes.

BACKGROUND: The risk for a hand injury was increased according to industrial structure and lifestyle change. This study investigated the post traumatic stress (PTS) and related factors in some hand replantation patients. METHODS: Total 150 hand replantation patients in one hospital were selected using convenience sampling methods. General characteristics of patients, characteristics of injured hand, self-esteem and PTS were collected using self-reported questionnaires. And clinical characteristics of injured hand were obtained from a review of medical records. Descriptive analysis, t-test, ANOVA and multiple regression analysis were performed to determine the associated factors with the score of PTS. RESULTS: Among 150 patients, 80% were male and 94% had a job. The mean score of PTS was 22.2±16.9. In simple analysis, PTS score were associated with smoking status, injury day of the week, pain score and self-esteem. Finally, the subjects who injured in weekdays had significantly higher PTS score compared to subjects who injured in weekend (β=0.185, P=0.021) and pain score was positively associated with PTS score (β=0.181, P=0.027) in multiple regression analysis. CONCLUSIONS: Injury day of the week and pain score were associated with PTS score in some hand replantation patients. Considering these results will help to management and improve quality of life of hand replantation patients.
Amputation ; Hand Injuries ; Hand* ; Humans ; Life Style ; Male ; Medical Records ; Quality of Life ; Replantation* ; Risk Factors ; Smoke ; Smoking

Short (< or = 6 hr) and long (> or = 9 hr) sleep durations are both associated with risk factors for cardiovascular diseases and diabetes, depression, learning problems, accidents and excess mortality. However, little is known about factors associated with sleep duration in Korean adults. This study examined sleep patterns in Korean adults and identified factors associated with short and long sleep durations. This study analyzed cross-sectional data collected from 4,411 Korean adults aged 19 yr and older who participated in a community health survey conducted in Gwangju, Korea. Multinomial logistic regression analysis was used to identify associations between socio-demographic and health-related factors and short or long sleep durations. Of the population, 37.2% and 4.0% reported short and long sleep, respectively. Short sleep was associated with older age, lower levels of income, night or shift work, heavy smoking, and depression or anxiety; long sleep was associated with younger age, being divorced or widowed, heavy smoking, underweight, depression or anxiety, and poorer self-reported health. In conclusion, a relatively high prevalence of short sleep duration is identified in this population of Korean adults. Factors associated with short or long sleep may act as potential confounders of the relationship between sleep duration and health outcomes.
Adult ; Age Factors ; Aged ; Anxiety ; Cross-Sectional Studies ; Depression ; Female ; Health Status ; Health Surveys ; Humans ; Logistic Models ; Male ; Middle Aged ; Odds Ratio ; Republic of Korea ; Sleep/*physiology ; Sleep Deprivation/epidemiology/*etiology ; Smoking ; Socioeconomic Factors ; Time Factors

Objectives: This study examined the current status of depression and related factors among children using community child center. Methods: A cross-sectional study selected children in grades 4-6 who used the Gwangju and Jeollanamdo community child center (n=224) using a convenience sampling method. General characteristics, family characteristics, children's emotional characteristics, children's school life environment and depression status were assessed using a self-reported questionnaire. Results: The average score of depression among children using community child center was 15.31±7.70 out of a total of 27. Fifty-eight (25.9%) children had depression above 22 points. Variables related to children's depression were shown as grade, subjective economic level awareness, after-school activities excluding local children's centers, presence of family members after school, and family structure. Conclusions The depression prevalence of children using community child center was higher. Policy support such as children's psychological support programs would be needed to reduce children's depression, and community child centers are expected to be effective in reducing children's depression if continuous child psychological support services are developed for children's mental health.

BACKGROUND: Lumbar stabilization exercise was used to improve spinal mobilization and stabilization. This research was conducted to investigate the effects of lumbar stabilization exercise programs on shoulder pain and range of motion among a group of elderly individuals. METHODS: The study subjects were 28 elderly patients from C hospital, Gochang, Jeollabukdo. They were randomly divided into 3 groups: lumbar stability exercise group, passive upper arm exercise group, and conservative therapy group. The therapies were conducted for 4 weeks. Shoulder pain and range of motion were measured both before and after therapies. The homogeneity of study subjects was analyzed using the chi-square and Kruskal-Wallis tests. For the pre-/post-status comparison, the Wilcoxon's signed-ranks tests and Kruskal-Wallis tests were conducted. RESULTS: General characteristics including age, sex, and disease history of the 3 groups were comparable. After 4 weeks of exercise, shoulder pain was significantly reduced in the lumbar stability exercise group (6.4+/-2.9 vs. 3.6+/-3.1, P=.026) and range of motion was significantly increased in the same group. More specifically, right flexion (121.1+/-12.0degrees vs. 137.9+/-11.9degrees, P=.008), right abduction (96.6+/-21.8degrees vs. 129.7+/-50.7degrees, P=.008), and left abduction (92.0+/-21.8degrees vs. 110.3+/-21.2degrees, P=.038) increased significantly. CONCLUSIONS: Shoulder pain and range of motion improved significantly in the lumbar stability exercise group. Further study is needed to look into the longer effects of this exercise program using more subjects.
Aged ; Arm ; Humans ; Range of Motion, Articular* ; Shoulder Pain ; Shoulder*

OBJECTIVES: This study was conducted to examine the association of serum Vitamin D with insulin resistance and β-cell function in Korean health checkup examinees. METHODS: This study subjects were 374 healthy adults (199 males, 175 females) over the age of 20, who visited a general hospital medical center located in Haenam-gun, Jeollanam-do. To find the association of Vitamin D with HOMA-IR and HOMA-β, the used statistical analysis were ANOVA and ANCOVA. RESULTS: Of the study subjects, the level of serum Vitamin D defined by deficient group, insufficient group and sufficient group was 38.5%, 48.1% and 13.4%, respectively. According to the level of serum Vitamin D, the mean values of HOMA-IR were 1.92±1.08 in sufficient group, 1.99±1.04 in the insufficient group and 2.91±1.05 in deficient group and there were statistically significant different(p<0.001). The mean values of HOMA-β were 84.69±1.07 in sufficient group, 78.41±1.04 in the insufficient group and 80.48±1.04 in deficient group, and there were not significant. As a result of ANCOVA, adjusted mean of HOMA-IR were statistically significant different (p<0.001), but those of HOMA-β were not statistically significant according to the level of serum Vitamin D. CONCLUSIONS: The insufficient level of serum Vitamin D was relatively high in healthy adults who live in rural area, and it was found that HOMA-IR significantly increased when Vitamin D was deficient. To prevent insulin resistance or diabetes, it is necessary to provide sufficient information related to sufficient production of Vitamin D such as Vitamin D supplement, sun exposure, food intake and etc.
Adult ; Eating ; Hospitals, General ; Humans ; Insulin Resistance* ; Insulin* ; Jeollanam-do ; Male ; Solar System ; Vitamin D* ; Vitamins*

BACKGROUND: The “Tuberculosis Relief Belt Supporting Project (Tuberculosis Patient Management Project for Poverty Groups)” is a national program for socioeconomically vulnerable tuberculosis (TB) patients. We sought to evaluate the clinical and socioeconomic characteristics of poverty-stricken TB patients, and determined the need for relief. METHODS: We examined in-patients with TB, who were supported by this project at the National Medical Center from 2014 to 2015. We retrospectively investigated the patients' socioeconomic status, clinical characteristics, and project expenditures. RESULTS: Fifty-eight patients were enrolled. Among 55 patients with known income status, 24 (43.6%) had no income. Most patients (80%) lived alone. A total of 48 patients (82.8%) had more than one underlying disease. More than half of the enrolled patients (30 patients, 51.7%) had smear-positive TB. Cavitary disease was found in 38 patients (65.5%). Among the 38 patients with known resistance status, 19 (50%) had drug-resistant TB. In terms of disease severity, 96.6% of the cases had moderate-to-severe disease. A total of 14 patients (26.4%) died during treatment. Nursing expenses were supported for 12 patients (20.7%), with patient transportation costs reimbursed for 35 patients (60%). In terms of treatment expenses for 31 people (53.4%), 93.5% of them were supported by uninsured benefits. CONCLUSION: Underlying disease, infectivity, drug resistance, severity, and death occurred frequently in socioeconomically vulnerable patients with TB. Many uninsured treatment costs were not supported by the current government TB programs, and the “Tuberculosis Relief Belt Supporting Project” compensated for these limitations.
Drug Resistance ; Health Care Costs ; Health Expenditures ; Humans ; Medically Uninsured ; Nursing ; Poverty* ; Retrospective Studies ; Social Class ; Transportation ; Tuberculosis*

Background/Aims: Although the incidence and mortality of tuberculosis are decreasing in South Korea, the number of applications for financial assistance with the cost of tuberculosis treatment made by individuals from vulnerable groups was 3.8 times higher in 2019 compared to 2017 (Tuberculosis Relief Belt Project, 2019). Methods: We analyzed the data of patients who received financial aid for tuberculosis treatment (in the period 2014-2018) from the Tuberculosis Relief Belt Project, which was designed to assist vulnerable groups. This study analyzed 137 subjects, and the independent variables included patient factors (age, gender, nationality, tuberculosis type, number of comorbidities, and place of residence) and treatment type (outpatient or inpatient). The dependent variable was the treatment outcome. Results: The likelihood of treatment success was significantly lower for patients with one (odds ratio [OR] 0.202), two (OR 0.147), or three or more (OR 0.070) comorbidities compared to those with no comorbidities. This was also the case for patients living alone (OR 0.097), and for those classified as homeless (OR 0.053). Korean patients (OR 8.512) had a significantly higher probability of a successful treatment outcome than foreigners. Conclusions Appropriate community-based management of individuals with tuberculosis from vulnerable groups, including foreigners, people with comorbidities, people living alone, and people with an unstable residential situation or homeless status, is important.

PURPOSE: The purpose of this study was to investigate the current status of post-traumatic stress (PTS), job satisfaction, and associated factors with job satisfaction among 119 rescue crews. METHODS: The study subjects were 507 rescue crews who worked in G Metropolitan City and J province. General characteristics, job-related characteristics, PTS, and job satisfaction were collected by self-reported questionnaires via official e-mail. Job satisfaction by subjects' characteristics was tested using t-test, ANOVA, and multiple linear regression analysis. RESULTS: Of 507 rescue crews, the overall PTS scores and job satisfaction score were 13.58+/-12.99 and 85.19+/-13.37, respectively. In multiple linear regression analyses, job satisfaction scores were significantly lower in subjects with fair (beta=-3.53, 95% CI=-5.89~-1.17) or poor (beta=-7.69, 95% CI=-11.67~-3.71) self-rated health and with longer duration of career (beta=-3.53, 95% CI=-6.62~-0.44). Regarding rescue field related characteristics, witness injury of co-workers (beta=-3.02, 95% CI=-5.61~-0.44), obvious dead treatment (beta=-3.60, 95% CI=-6.37~-0.83), and PTS (beta=-4.21, 95% CI=-7.56~-0.88) showed association with lower job satisfaction. CONCLUSION: Job satisfaction showed association with general characteristics, field related factors, and PTS. Risk reduction of rescue field and management of PTS will help to increase the job satisfaction of 119 rescue crews.
Electronic Mail ; Emergency Medical Services ; Job Satisfaction* ; Linear Models ; Risk Reduction Behavior

The purpose of this study was to identify the association between health-related behaviors including smoking, alcohol intake, and the practice of a low-salt diet using data from a Community Health Survey conducted in 2008. The study subjects were 129,151 persons (19 years and older) without cardiovascular diseases or diabetes mellitus diagnosis history. An index for evaluating low salinity was created by summing three low salinity-related questions (range: 0~3), and a low-salt diet was defined if the index of low salinity was 3. We examined the levels of smoking and alcohol intake according to the index of low salinity, and conducted multiple logistic regression analysis to examine the odds ratios of low-salt diet practice in relation to smoking and drinking behavior, adjusting for general characteristics. The smoking and drinking status significantly improved as the level of low salinity index increase. Adjusting for general characteristics, those with smoking, alcohol intake, or a combined habit of the two behaviors had significantly lower odds ratios for practice of a low-salt diet. In conclusion, smoking and drinking behavior were negatively associated with the practice of a low-salt diet. Based on these findings, it may be necessary to have comprehensive nutritional education programs that consider the multiple effects of smoking, drinking, and a low-salt diet.
Cardiovascular Diseases ; Diabetes Mellitus ; Diet, Sodium-Restricted ; Drinking ; Drinking Behavior ; Health Surveys ; Humans ; Logistic Models ; Odds Ratio ; Salinity ; Smoke ; Smoking