BACKGROUND: Bilirubin has been suggested as a antioxidant which protect oxidation of lipids and lipoproteins. Given that oxidized lipids and lipoproteins are known to be atherogenic, low serum concentrations of bilirubin could be associated with the high risk of coronary artery disease (CAD). But few studies have been performed for confirmation of this hypothesis. In this study, we evaluated the relationship between serum concentrations of billrubln and the angiographically documented CAD. METHODS: Eighty five CAD patients and 56 non-CAD patients, classified according to the maximum stenosis of coronary artery at angiography, were enrolled in this study. The degree of the coronary arterial stenosis were subclassified into <10% (non-CAD), 10-49% (mildly stenotic CAD) and > or =50% (severely stenotic CAD). We retro-spectively reviewed serum concentrations of total and direct bilrubin at the time of angiography, compared tine mean concentrations of bilirubin between two groups and evaluated it in relation to the severity of CAD by statistical analysis. RESULTS: The mean concentration of total bilrubin was significant1y lower in CAD group 4han non-CAD group (12.8 micromol/L vs. 15.2 micromol/L, p value=0.04) The mean concentration of direct bilirubin was lower in CAD group than non-CAD group but not statistically significant (3.3 micromol/L vs. 4.2 micromol/L, p value=0.07). Although not significant, the concentration of total bilirubin in severely stenotic group (12.8 CAD group 12.8+/-4.3 micromol/L) was lower than mildly stenotic group (13.5+/-3.8 micromol/L) and non CAD group (15.2+/-7.4 micromol/L ) (p=0.07). CONCLUSIONS: This study showed that low serum concentrations of total bilirubin were associated with the high risk of CAD and supports the hypothesis that serum bilirubin could act as an antiatherosclerotic factor. Further prospective studies are required to confirm the relationship between bilirubin and CAD and to elucidate the most associated fraction of bilirubin and pathogenic mechanism.
Angiography ; Bilirubin* ; Constriction, Pathologic ; Coronary Artery Disease* ; Coronary Vessels* ; Humans ; Lipoproteins

PURPOSE: This study examined the health status among elderly in community. METHOD: This is a survey using cross-sectional design. The subjects were 531 elders who were 65 and over in Pusan, Korea. Data were collected by 17 trained interviewers from April 10 to August 26, 2000. Functional status for physical health status, depression, loneliness, self-esteem for psychological health status, and social support for social health status were measured. RESULT: About forty three percent of the subjects were found as the elderly who need support in physical status. About fifty six percent of the subjects were depressed. The mean score on the Loneliness scale was 40.4, which means relatively higher. For self-esteem, its score was lower than that of elderly who were examined in other studies. The subjects were living in the state of lower social support. The risk factors for vulnerable health status were being female, becoming older, lower income and education, and living alone. CONCLUSION: This finding indicates that the elderly subjects in Korean community were in poor health status in physical, psychological and social aspects.

BACKGROUND: Peripheral T cell lymphoma (PTCL), a prevalent form of non Hodgkin lymphomas in East Asia, can manifest fever, hepatomegaly, lymphadenopathy, pancytopenia and hemophagocytic histiocytosis (HPH). Similar clinicopathologic findings are also frequently encountered in reactive hemophagocytic syndrome (HPS) and malignant histiocytosis (MH) , thus diagnoses could be confused among them. With recent advancement of immunohistochemlal techniques, diagnostic accuracies have been improved and most cases of MH could have been reclassified as PTCL. In this study, we intended to delineate the lineage of atypical malignant cells in bone marrow of subjects which were previously diagnosed as MH or HPS with immunohlstochemical analysis and characterize clinlcophathologic findings of PTCL associated with HPH in the bone marrow. METHODS: Five cases dignosed as HPS, 3 as MH, 3 as presumed MH, and 7 as PTCL on bone marrow examination were enrolled in this study. We performed immunohistochemical stain for CD45, CD3, CD43, CD2O and CD68, then revised the diagnoses and summarized the clinical and morphologic features of PTCL associated with HPH. RESULTS: Eleven out of 18 cases were confirmed as PTCL which were previously diagnosed as MH(1), presumed MH(3) and PTCL(7). Eight cases of 11 PTCL showed HPH mimicking MH with infiltration of the atypical malignant cells, even if the proportion of atypical malignant cells was small on bone marrow aspirates. They manifested fever and hepatomegaly but didn't have lymphadenopathy at the early stage of disease. Subtypes of PTCL with HPH were PTCL, unspecifed (3), angioimmunoblastic T cell lymphoma (1) and undetermined (4). They showed poorer outcome in 3-month survival rate (25%) than in those with PTCL without HPH(100%). CONCLUSION: These results suggest that PTCL associated with HPH should be excluded from MH by immunohistochemical analysis. Considering that prognosis of PTCL with HPH is very poor, accurate and rapid diagnosis is needed for prompt treatment.
Bone Marrow ; Bone Marrow Examination ; Diagnosis ; Far East ; Fever ; Hepatomegaly ; Histiocytic Sarcoma* ; Histiocytosis* ; Lymphatic Diseases ; Lymphohistiocytosis, Hemophagocytic ; Lymphoma, Non-Hodgkin ; Lymphoma, T-Cell ; Lymphoma, T-Cell, Peripheral* ; Pancytopenia ; Prognosis ; Survival Rate

No abstract available.
Korea

Purpose: This study examined the definitions, diagnostic criteria, and measurements of sarcopenic obesity and identified effective exercise interventions that improve cardiometabolic outcomes in middle-aged and older adults, in whom the prevalence of sarcopenic obesity is increasing. Methods: This comprehensive review followed the principles of literature search, data extraction, and review, as described in the PRISMA 2009 guidelines. Results: The 11 articles included in this study presented different concepts of sarcopenic obesity. Exercise interventions for sarcopenic obesity varied in their effects. Resistance exercise improved muscle mass and physical function, while aerobic exercise primarily impacted obesity and cardiometabolic indicators. Combined exercise had mixed results across indicators. Conclusion This study addressed a pressing public health concern in the context of an aging population, acknowledged the unique challenges of sarcopenic obesity, and attempted to clarify definitions and assessment methods, while identifying effective exercise interventions to reduce cardiometabolic risk. Sarcopenic obesity is a multifaceted condition with varying definitions and diagnostic criteria. Its association with cardiometabolic risk underscores the need for comprehensive assessments considering both muscle and obesity indicators. While exercise interventions hold promise for managing sarcopenic obesity, further research is required to establish effective strategies.

Purpose: The purpose of this study was to identify the relationship between intrinsic motivation and learning outcomes of nursing college students who took the Fundamentals of nursing as a problem-based learning method. Methods: In this cross-sectional study, we identified the intrinsic motivations of 114 nursing students who completed problem-based learning using the Intrinsic Motivation Inventory. The t-test was conducted to identify differences according to intrinsic motivation, and correlation analysis was performed to confirm the relationship between intrinsic motivation and learning outcomes. Results: The group with higher intrinsic motivation showed higher scores in all domains of self-assessed learning outcomes than the lower group. It was the ‘Relatedness with an instructor’ that showed the highest correlation with the learning outcomes in the domains of intrinsic motivation. Conclusion Problem-based learning is an effective learning method for cultivating the competencies needed for nurses. The intrinsic motivation of students is an important factor in the performance of problem-based learning. For the efficiency of problem-based learning, efforts should be made to develop and apply autonomy-supportive interventions that can enhance intrinsic motivation.

PURPOSE: The purpose of the study was to identify the optimal cutoff values of indices for cardiometabolic risk in postmenopausal Korean women. Specifically, we intended to determine the cutoffs of waist circumference, waist-to-hip ratio (WHR), serum lipid profile, and homeostatic model of assessment-insulin resistance (HOMA-IR) for detecting metabolic syndrome (MetS), and metabolic obesity (MO). METHODS: The study participants were 397 postmenopausal women. We defined MetS and MO with the International Diabetes Federation criteria except for waist circumference. A receive operating characteristic curve analysis was used to assess the accuracy of diagnostic indices for identifying MetS and MO. Cutoff values were obtained both from the point on the receive operating characteristic curve which was closest to (0,1) and from the Youden's index. RESULTS: Among the participants, 34.5% and 73% were classified as having MetS and MO. The optimal cutoff of waist circumference and WHR were 81.9 cm [area under curve (AUC): 0.687, sensitivity: 61.7%, specificity: 68.9%], 0.87 (AUC: 0.660, sensitivity: 64.7%, Specificity: 60.2%) for MetS and 77.4 cm (AUC: 0.655, sensitivity: 65.6%, specificity: 57.8%), 0.86 (AUC: 0.680, sensitivity: 67.0%, specificity: 62.7%) for MO. Triglyceride to high-density lipoprotein ratio for MetS and MO were 2.11 (AUC: 0.838, sensitivity: 71.5%, specificity: 79.6%) and 1.59 (AUC: 0.725, sensitivity: 65.9%, specificity: 68.2%) respectively. The HOMA-IR for MetS was 1.36 (AUC: 0.773, sensitivity: 73%, specificity: 71.9%) and for MO was 1.17 (AUC: 0.713, sensitivity: 64.5%, specificity: 69.2%). CONCLUSIONS: For postmenopausal women, we suggest waist circumference of 81.9 cm and WHR of 0.87 as criteria of MetS. However, women with waist circumference over 77.4 cm and WHR over 0.86 should be monitored for the future development of MetS.
Female ; Humans ; Lipoproteins ; Menopause ; Obesity ; Obesity, Abdominal ; Sensitivity and Specificity ; Triglycerides ; Waist Circumference ; Waist-Hip Ratio

No abstract available.
Chronic Disease ; Glycemic Index

BACKGROUND: Chromosomal aberration observed only in a few metaphases may cause the cytogeneticists to have difficulties in making a decision whether it is due to in vivo mosaicism/multiple clones or due to in vitro artifact. This is especially important when the chromosome of concern has been associated with a classical chromosome syndrome, malignancy or its evolution. Therefore, we aimed to establish a range for random chromosomal aberrations among cells from PHA-stimulated blood(PB) and bone marrow(BM) cultures. METHODS: Among the cells from 449 PB and 472 BM specimens referred for chromosome studies from 1997 to 1998, we analyzed the frequency of random aneuploidy, structural abnormalities, and breaks/gaps. RESULTS: The number of cells analyzed was 5,904/4,488(1997/1998) in PB and 4,211/4,124(1997/1998) in BM. The frequency of metaphases with random chromosomal aberrations of BM(32.10%) was much higher than that of PB(5.90%). The most frequent aberration was chromsome loss. Autosome losses were inversely correlated with autosome size(correlation coefficient = -0.83 and -0.72, p<0.01), smaller chromosomes being lost more frequently while autosome breaks/gaps were correlated with autosome size(correlation coefficient = 0.69 and 0.85, p<0.01), in PB and BM. Comparing the data from 1998 to the data from 1997, the frequency of chromosome losses(<0.5% in PB, <2.25% in BM), gains(<0.1% in PB and BM), breaks/gaps(<0.1% in PB, <0.25% in BM), and structural aberrations( Aneuploidy ; Artifacts ; Bone Marrow* ; Chromosome Aberrations* ; Chromosomes, Human, 4-5 ; Clone Cells ; Metaphase ; Quality Control

PURPOSE: This study examined the characteristics of fatigue and the relationship between fatigue and its related factors in Korean patients on hemodialysis. METHODS: A cross-sectional correlational study was conducted with 104 patients on hemodialysis in Seoul, Korea. FINDING: Of a total of 104 subjects, eighty-one (77.9%) complained of fatigue. Fatigue severity was measured by the self-rating Visual Analogue Scale-Fatigue (VAS-F) with a mean score of 36.5 (SD=17.49, range 2 - 81). The mean duration of fatigue was 3.8 hours (SD=5.3, range 0 - 24). Depression was most significantly correlated with fatigue (beta=.43, p<.00), with interdialytic weight gain (beta=.25, p<.05) being the second most significant correlate. CONCLUSION: This study shows that nursing interventions for patients who experience fatigue while on hemodialysis should be focused on both psychological problems, such as depression, as well as on physiological problems, such as interdialytic weight gain.
Risk Factors ; Renal Dialysis/*adverse effects ; Regression Analysis ; Multivariate Analysis ; Male ; Korea ; Humans ; Female ; Fatigue/*etiology/physiopathology/psychology ; Depression/complications ; Cross-Sectional Studies ; Adult