1.Identification of differentially expressed miRNAs associated with chronic kidney disease-mineral bone disorder
Kim Im KYUNG ; Jeong SOHYUN ; Han NAYOUNG ; Oh Mi JUNG ; Oh KOOK-HWAN ; Kim IN-WHA
Frontiers of Medicine 2017;11(3):378-385
The purpose of this study is to characterize a meta-signature of differentially expressed mRNA in chronic kidney disease (CKD) to predict putative microRNA (miRNA) in CKD-mineral bone disorder (CKD-MBD) and confirm the changes in these genes and miRNA expression under uremic conditions by using a cell culture system.PubMed searches using MeSH terms and keywords related to CKD,uremia,and mRNA arrays were conducted.Through a computational analysis,a meta-signature that characterizes the significant intersection of differentially expressed mRNA and expected miRNAs associated with CKD-MBD was determined.Additionally,changes in gene and miRNA expressions under uremic conditions were confirmed with human Saos-2 osteoblast-like cells.A statistically significant mRNA meta-signature of upregulated and downregulated mRNA levels was identified.Furthermore,miRNA expression profiles were inferred,and computational analyses were performed with the imputed microRNA regulation based on weighted ranked expression and putative microRNA targets (IMRE) method to identify miRNAs associated with CKD occurrence.TLR4 and miR-146b levels were significantly associated with CKD-MBD.TLR4 levels were significantly downregulated,whereas pri-miR-146b and miR-146b were upregulated in the presence of uremic toxins in human Saos-2 osteoblast-like cells.Differentially expressed miRNAs associated with CKD-MBD were identified through a computational analysis,and changes in gene and miRNA expressions were confirmed with an in vitro cell culture system.
2.Delayed Traumatic Subarachnoid Hemorrhage in a Polytraumatized Patient with Disseminated Intravascular Coagulation.
Jiwoong OH ; Wonyeon LEE ; Ji Young JANG ; Pilyoung JUNG ; Sohyun KIM ; Jongyeon KIM ; Jinsu PYEN ; Kum WHANG ; Sungmin CHO
Korean Journal of Critical Care Medicine 2015;30(4):336-342
The precise mechanism involved in DIC and delayed traumatic subarachnoid hemorrhage (DT-SAH) remains unclear in multiple-trauma patients. Hereby, we describe a polytraumatized patient with DIC who died due to DT-SAH. A 75-year-old female patient was admitted to our Emergency Department complaining of abdominal pain and drowsiness after a pedestrian accident. Her initial brain computerized tomography (CT) finding was negative for intracranial injury. However, her abdominal CT scan revealed a collection of retroperitoneal hematomas from internal iliac artery bleeding after a compressive pelvic fracture. This event eventually resulted in shock and DIC. An immediate angiographic embolization of the bleeding artery was performed along with transfusion and anti-thrombin III. Her vital signs were stabilized without neurological change. Fourteen hours after admission, she suddenly became comatose, and her follow-up brain CT scan revealed a dense DT-SAH along the basal cisterns with acute hydrocephalus. This event rapidly prompted brain CT angiography and digital subtraction angiography, which both confirmed the absence of any cerebrovascular abnormality. Despite emergency extraventricular drainage to reverse the hydrocephalus, the patient died three days after the trauma. This paper presents an unusual case of DT-SAH in a polytraumatized patient with DIC.
Abdominal Pain
;
Aged
;
Angiography
;
Angiography, Digital Subtraction
;
Arteries
;
Brain
;
Coma
;
Dacarbazine
;
Disseminated Intravascular Coagulation*
;
Drainage
;
Emergencies
;
Emergency Service, Hospital
;
Female
;
Follow-Up Studies
;
Hematoma
;
Hemorrhage
;
Humans
;
Hydrocephalus
;
Iliac Artery
;
Multiple Trauma
;
Shock
;
Sleep Stages
;
Subarachnoid Hemorrhage, Traumatic*
;
Tomography, X-Ray Computed
;
Vital Signs
3.Survival, Prognosis, and Clinical Feature of Refractory Myasthenia Gravis: a 15-year Nationwide Cohort Study
Sohyun JEONG ; Yunha NOH ; In-Sun OH ; Yoon-Ho HONG ; Ju-Young SHIN
Journal of Korean Medical Science 2021;36(39):e242-
Background:
Myasthenia gravis (MG) is a rare classic autoimmune disease where immunosuppressant therapies have been successful to reduce MG attributable mortality fairly well. However, patients with refractory MG (rMG) among the actively treated MG (aMG) are nonresponsive to conventional therapy and display high disease severity, which calls for further research. We aimed to determine survival, prognosis, and clinical feature of patients with rMG compared to non-rMG.
Methods:
Retrospective nationwide cohort study using Korea's healthcare database between 2002 and 2017 was conducted. Patients with rMG (n = 47) and non-rMG (n = 4,251) who were aged > 18 years, followed-up for ≥ 1 year, and prescribed immunosuppressants within 2 years after incident MG diagnosis were included. Patients with rMG were defined as administered plasma exchange or intravenous immunoglobulin at least 3 times per year after receiving ≥ 2 immunosuppressants. All-cause mortality, myasthenic crisis, hospitalization, pneumonia/ sepsis, and emergency department (ED) visits were measured using Cox proportional hazard models and pharmacotherapy patterns for rMG were assessed.
Results:
The rMG cohort included a preponderance of younger patients and women. The adjusted hazard ratio was 2.49 (95% confidence interval, 1.26–4.94) for mortality, 3.14 (2.25–4.38) for myasthenic crisis, 1.54 (1.15–2.06) for hospitalization, 2.69 (1.74–4.15) for pneumonia/sepsis, and 1.81 (1.28–2.56) for ED visits for rMG versus non-rMG. The immunosuppressant prescriptions were more prevalent in patients with rMG, while the difference was more remarkable before rMG onset rather than after rMG onset.
Conclusion
Despite the severe prognosis of rMG, the strategies for pharmacotherapeutic regimens were similar in those two groups, suggesting that intensive monitoring and introduction of timely treatment options in the early phase of MG are required.
4.Survival, Prognosis, and Clinical Feature of Refractory Myasthenia Gravis: a 15-year Nationwide Cohort Study
Sohyun JEONG ; Yunha NOH ; In-Sun OH ; Yoon-Ho HONG ; Ju-Young SHIN
Journal of Korean Medical Science 2021;36(39):e242-
Background:
Myasthenia gravis (MG) is a rare classic autoimmune disease where immunosuppressant therapies have been successful to reduce MG attributable mortality fairly well. However, patients with refractory MG (rMG) among the actively treated MG (aMG) are nonresponsive to conventional therapy and display high disease severity, which calls for further research. We aimed to determine survival, prognosis, and clinical feature of patients with rMG compared to non-rMG.
Methods:
Retrospective nationwide cohort study using Korea's healthcare database between 2002 and 2017 was conducted. Patients with rMG (n = 47) and non-rMG (n = 4,251) who were aged > 18 years, followed-up for ≥ 1 year, and prescribed immunosuppressants within 2 years after incident MG diagnosis were included. Patients with rMG were defined as administered plasma exchange or intravenous immunoglobulin at least 3 times per year after receiving ≥ 2 immunosuppressants. All-cause mortality, myasthenic crisis, hospitalization, pneumonia/ sepsis, and emergency department (ED) visits were measured using Cox proportional hazard models and pharmacotherapy patterns for rMG were assessed.
Results:
The rMG cohort included a preponderance of younger patients and women. The adjusted hazard ratio was 2.49 (95% confidence interval, 1.26–4.94) for mortality, 3.14 (2.25–4.38) for myasthenic crisis, 1.54 (1.15–2.06) for hospitalization, 2.69 (1.74–4.15) for pneumonia/sepsis, and 1.81 (1.28–2.56) for ED visits for rMG versus non-rMG. The immunosuppressant prescriptions were more prevalent in patients with rMG, while the difference was more remarkable before rMG onset rather than after rMG onset.
Conclusion
Despite the severe prognosis of rMG, the strategies for pharmacotherapeutic regimens were similar in those two groups, suggesting that intensive monitoring and introduction of timely treatment options in the early phase of MG are required.
5.A study on the improvement of evaluation scheme for the installation and operation of Center for Children’s and Social Welfare Foodservice Management: utilizing interviews with center stakeholders and external experts
Jinhyun KIM ; Dahye HAN ; Jieun OH ; Hyun joo RYOU ; Ji-Yun HWANG ; Kirang KIM ; Sohyun PARK
Journal of Nutrition and Health 2024;57(6):685-698
Purpose:
This study examined the evaluation indicators and frameworks for assessing the effectiveness of the Center for Children’s and Social Welfare Foodservice Management.
Methods:
A qualitative research design was used, including focus group discussions and indepth interviews cond1ucted with 26 stakeholders, such as center staff, community nutrition experts, and performance evaluation specialists. The interviews were recorded with the participants’ consent, and the transcribed data were analyzed using framework analysis to identify key patterns.
Results:
The findings highlight several critical issues in the current evaluation framework, including over-reliance on satisfaction surveys, insufficient utilization of checklist data, and a lack of long-term outcome measures. The participants recommended improving satisfaction surveys by diversifying the respondents and refining methodologies. Systematic data management was also highlighted as essential, particularly for data collected by center nutritionists during site visits. These data are crucial for evaluating the effectiveness of overseeing and educating cooks and staff in children’s and social welfare facilities. For the long-term outcome indicators, the participants suggested integrating national health datasets to monitor the food consumption patterns, such as fruit and vegetable intake or sugar-sweetened beverage consumption among children, and tracking medical expenses or hospitalization rates for elderly daycare center users. Well-designed intervention studies were recommended to develop more robust evaluation indicators, particularly for assessing the impact of the centers on the health and quality of life of the elderly.
Conclusion
Therefore, comprehensive and standardized evaluation systems should be implemented to enhance operational efficiency and service quality. The proposed evaluation scheme can better evaluate and support the health and well-being of vulnerable populations, including children, the elderly, and individuals with disabilities, by aligning these systems with the centers’ mission of ensuring safe and nutritious food services.
6.A study on the improvement of evaluation scheme for the installation and operation of Center for Children’s and Social Welfare Foodservice Management: utilizing interviews with center stakeholders and external experts
Jinhyun KIM ; Dahye HAN ; Jieun OH ; Hyun joo RYOU ; Ji-Yun HWANG ; Kirang KIM ; Sohyun PARK
Journal of Nutrition and Health 2024;57(6):685-698
Purpose:
This study examined the evaluation indicators and frameworks for assessing the effectiveness of the Center for Children’s and Social Welfare Foodservice Management.
Methods:
A qualitative research design was used, including focus group discussions and indepth interviews cond1ucted with 26 stakeholders, such as center staff, community nutrition experts, and performance evaluation specialists. The interviews were recorded with the participants’ consent, and the transcribed data were analyzed using framework analysis to identify key patterns.
Results:
The findings highlight several critical issues in the current evaluation framework, including over-reliance on satisfaction surveys, insufficient utilization of checklist data, and a lack of long-term outcome measures. The participants recommended improving satisfaction surveys by diversifying the respondents and refining methodologies. Systematic data management was also highlighted as essential, particularly for data collected by center nutritionists during site visits. These data are crucial for evaluating the effectiveness of overseeing and educating cooks and staff in children’s and social welfare facilities. For the long-term outcome indicators, the participants suggested integrating national health datasets to monitor the food consumption patterns, such as fruit and vegetable intake or sugar-sweetened beverage consumption among children, and tracking medical expenses or hospitalization rates for elderly daycare center users. Well-designed intervention studies were recommended to develop more robust evaluation indicators, particularly for assessing the impact of the centers on the health and quality of life of the elderly.
Conclusion
Therefore, comprehensive and standardized evaluation systems should be implemented to enhance operational efficiency and service quality. The proposed evaluation scheme can better evaluate and support the health and well-being of vulnerable populations, including children, the elderly, and individuals with disabilities, by aligning these systems with the centers’ mission of ensuring safe and nutritious food services.
7.A study on the improvement of evaluation scheme for the installation and operation of Center for Children’s and Social Welfare Foodservice Management: utilizing interviews with center stakeholders and external experts
Jinhyun KIM ; Dahye HAN ; Jieun OH ; Hyun joo RYOU ; Ji-Yun HWANG ; Kirang KIM ; Sohyun PARK
Journal of Nutrition and Health 2024;57(6):685-698
Purpose:
This study examined the evaluation indicators and frameworks for assessing the effectiveness of the Center for Children’s and Social Welfare Foodservice Management.
Methods:
A qualitative research design was used, including focus group discussions and indepth interviews cond1ucted with 26 stakeholders, such as center staff, community nutrition experts, and performance evaluation specialists. The interviews were recorded with the participants’ consent, and the transcribed data were analyzed using framework analysis to identify key patterns.
Results:
The findings highlight several critical issues in the current evaluation framework, including over-reliance on satisfaction surveys, insufficient utilization of checklist data, and a lack of long-term outcome measures. The participants recommended improving satisfaction surveys by diversifying the respondents and refining methodologies. Systematic data management was also highlighted as essential, particularly for data collected by center nutritionists during site visits. These data are crucial for evaluating the effectiveness of overseeing and educating cooks and staff in children’s and social welfare facilities. For the long-term outcome indicators, the participants suggested integrating national health datasets to monitor the food consumption patterns, such as fruit and vegetable intake or sugar-sweetened beverage consumption among children, and tracking medical expenses or hospitalization rates for elderly daycare center users. Well-designed intervention studies were recommended to develop more robust evaluation indicators, particularly for assessing the impact of the centers on the health and quality of life of the elderly.
Conclusion
Therefore, comprehensive and standardized evaluation systems should be implemented to enhance operational efficiency and service quality. The proposed evaluation scheme can better evaluate and support the health and well-being of vulnerable populations, including children, the elderly, and individuals with disabilities, by aligning these systems with the centers’ mission of ensuring safe and nutritious food services.
8.Clinical Analysis of Delayed Surgical Epidural Hematoma.
Jiin KANG ; Soonki HONG ; Chul HU ; Jinsoo PYEN ; Kum WHANG ; Sungmin CHO ; Jongyeon KIM ; Sohyun KIM ; Jiwoong OH
Korean Journal of Neurotrauma 2015;11(2):112-117
OBJECTIVE: A small epidural hematoma (EDH) that has been diagnosed to be nonsurgical by initial brain computed tomography (CT) can increase in size and need surgical removal, resulting in a poor prognosis. However, there have been few studies, which focused delayed operated EDH. Therefore, we analyzed the clinical factors to determine the predicting factors of delayed operated EDH. METHODS: Between January 2011 and January 2014, 90 patients, who were admitted due to EDH, were enrolled in this study. None of the patients were indicated for operation initially. Based on the presence of surgery, we classified the patients into a delayed-surgery group (DG) and a non-surgical group (NG). Additionally, we analyzed them according to the following: time interval between the trauma and the initial CT, gender, age, medical history, drinking, change of mean arterial pressure (MAP), volume of EDH and other traumatic brain lesion. RESULTS: Among the 90 patients, the DG was 19 patients. Compared with NG, the DG revealed increased MAP, less presence of drinking, and a short time interval (DG vs. NG: +9.684 mm Hg vs. -0.428 mm Hg, 5.26% vs. 29.58%, 1.802 hours vs. 5.707 hours, respectively, p<0.05). Analyzing the time interval with receiver operating characteristic, there was 88.2% sensitivity and 68.3% specificity at the 2.05-hour cut-off value (area under the curve=0.854). CONCLUSION: According to our results, the time interval between the trauma and the initial CT along with blood pressure change are potential predicting factors in the cases of delayed operation of EDH.
Arterial Pressure
;
Blood Pressure
;
Brain
;
Craniocerebral Trauma
;
Drinking
;
Hematoma*
;
Hematoma, Epidural, Cranial
;
Humans
;
Neurosurgery
;
Prognosis
;
ROC Curve
;
Sensitivity and Specificity
;
Tomography, X-Ray Computed
9.Educating restaurant owners and cooks to lower their own sodium intake is a potential strategy for reducing the sodium contents of restaurant foods: a small-scale pilot study in South Korea.
Sohyun PARK ; Heeseung LEE ; Dong il SEO ; Kwang Hwan OH ; Taik Gun HWANG ; Bo Youl CHOI
Nutrition Research and Practice 2016;10(6):635-640
BACKGROUND/OBJECTIVES: This study was conducted to evaluate the feasibility of a sodium reduction program at local restaurants through nutrition education and examination of the health of restaurant owners and cooks. SUBJECTS/METHODS: The study was a single-arm pilot intervention using a pre-post design in one business district with densely populated restaurants in Seoul, South Korea. The intervention focused on improving nutrition behaviors and psychosocial factors through education, health examination, and counseling of restaurant personnel. Forty-eight restaurant owners and cooks completed the baseline survey and participated in the intervention. Forty participants completed the post-intervention survey. RESULTS: The overweight and obesity prevalences were 25.6% and 39.5%, respectively, and 74.4% of participants had elevated blood pressure. After health examination, counseling, and nutrition education, several nutrition behaviors related to sodium intake showed improvement. In addition, those who consumed less salt in their baseline diet (measured with urine dipsticks) were more likely to agree that providing healthy foods to their customers is necessary. This study demonstrated the potential to reduce the sodium contents of restaurant foods by improving restaurant owners' and cooks' psychological factors and their own health behaviors. CONCLUSIONS: This small pilot study demonstrated that working with restaurant owners and cooks to improve their own health and sodium intake may have an effect on participation in restaurant-based sodium reduction initiatives. Future intervention studies with a larger sample size and comparison group can focus on improving the health and perceptions of restaurant personnel in order to increase the feasibility and efficacy of restaurant-based sodium reduction programs and policies.
Blood Pressure
;
Commerce
;
Counseling
;
Diet
;
Education
;
Health Behavior
;
Health Education
;
Korea*
;
Nutrition Policy
;
Obesity
;
Overweight
;
Pilot Projects*
;
Prevalence
;
Psychology
;
Restaurants*
;
Sample Size
;
Seoul
;
Sodium*
;
Surveys and Questionnaires
10.Delayed Traumatic Subarachnoid Hemorrhage in a Polytraumatized Patient with Disseminated Intravascular Coagulation
Jiwoong OH ; Wonyeon LEE ; Ji Young JANG ; Pilyoung JUNG ; Sohyun KIM ; Jongyeon KIM ; Jinsu PYEN ; Kum WHANG ; Sungmin CHO
The Korean Journal of Critical Care Medicine 2015;30(4):336-342
The precise mechanism involved in DIC and delayed traumatic subarachnoid hemorrhage (DT-SAH) remains unclear in multiple-trauma patients. Hereby, we describe a polytraumatized patient with DIC who died due to DT-SAH. A 75-year-old female patient was admitted to our Emergency Department complaining of abdominal pain and drowsiness after a pedestrian accident. Her initial brain computerized tomography (CT) finding was negative for intracranial injury. However, her abdominal CT scan revealed a collection of retroperitoneal hematomas from internal iliac artery bleeding after a compressive pelvic fracture. This event eventually resulted in shock and DIC. An immediate angiographic embolization of the bleeding artery was performed along with transfusion and anti-thrombin III. Her vital signs were stabilized without neurological change. Fourteen hours after admission, she suddenly became comatose, and her follow-up brain CT scan revealed a dense DT-SAH along the basal cisterns with acute hydrocephalus. This event rapidly prompted brain CT angiography and digital subtraction angiography, which both confirmed the absence of any cerebrovascular abnormality. Despite emergency extraventricular drainage to reverse the hydrocephalus, the patient died three days after the trauma. This paper presents an unusual case of DT-SAH in a polytraumatized patient with DIC.
Abdominal Pain
;
Aged
;
Angiography
;
Angiography, Digital Subtraction
;
Arteries
;
Brain
;
Coma
;
Dacarbazine
;
Disseminated Intravascular Coagulation
;
Drainage
;
Emergencies
;
Emergency Service, Hospital
;
Female
;
Follow-Up Studies
;
Hematoma
;
Hemorrhage
;
Humans
;
Hydrocephalus
;
Iliac Artery
;
Multiple Trauma
;
Shock
;
Sleep Stages
;
Subarachnoid Hemorrhage, Traumatic
;
Tomography, X-Ray Computed
;
Vital Signs