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Lim J.-Y.,Seoul National University | Jang S.-N.,Chung - Ang University | Park W.-B.,Incheon Sarang Hospital | Oh M.K.,Gyeongsang National University | And 2 more authors.
Archives of Physical Medicine and Rehabilitation | Year: 2011

Objective: To investigate the association between habitual exercise and fear of falling in an older Korean population. Design: Cross-sectional study conducted in a population-based sample of an urban city. Setting: Urban city in South Korea. Participants: Randomly sampled older Korean people (N=828; aged ≥65y) living in a typical urban city located in South Korea. Intervention: Standardized telephone interview. Main Outcome Measures: Data on exercise habits, history of falls during the previous year, and fear of falling were obtained using a random digit dialing telephone survey method. Multiple linear regression and multiple logistic regression analyses were used to examine the association between exercise habits and the fear of falling. Results: The incidence of falls in the study cohort was 13%, and the prevalence of the fear of falling was 67.4% (47.6% in men and 80.8% in women). About 30% of those that expressed a fear of falling stated that this was the cause of their limited activity. Older men and women who exercised regularly showed a similar level of fear of falling, but they were less likely to experience fear-related activity restriction than nonexercisers. Conclusions: A regular exercise habit was found to be inversely associated with fear-related activity restriction regardless of fall experience among older Korean men and women. © 2011 by the American Congress of Rehabilitation Medicine.

Park J.,Incheon Sarang Hospital | Kwak Y.H.,Seoul National University | Kim D.K.,Seoul National University | Jung J.Y.,Seoul National University | And 4 more authors.
Resuscitation | Year: 2012

Objectives: The objective of this study was to develop and validate a new age-based formula for estimating body weights of Korean children. Methods: We obtained body weight and age data from a survey conducted in 2005 by the Korean Pediatric Society that was performed to establish normative values for Korean children. Children aged 0-14 were enrolled, and they were divided into three groups according to age: infants (<12 months), preschool-aged (1-4 years) and school-aged children (5-14 years). Seventy-five percent of all subjects were randomly selected to make a derivation set. Regression analysis was performed in order to produce equations that predict the weight from the age for each group. The linear equations derived from this analysis were simplified to create a weight estimating formula for Korean children. This formula was then validated using the remaining 25% of the study subjects with mean percentage error and absolute error. To determine whether a new formula accurately predicts actual weights of Korean children, we also compared this new formula to other weight estimation methods (APLS, Shann formula, Leffler formula, Nelson formula and Broselow tape). Results: A total of 124,095 children's data were enrolled, and 19,854 (16.0%), 40,612 (32.7%) and 63,629 (51.3%) were classified as infants, preschool-aged and school-aged groups, respectively. Three equations, (age in months + 9)/2, 2 × (age in years) + 9 and 4 × (age in years) - 1 were derived for infants, pre-school and school-aged groups, respectively. When these equations were applied to the validation set, the actual average weight of those children was 0.4. kg heavier than our estimated weight (95% CI = 0.37-0.43, p< 0.001). The mean percentage error of our model (+0.9%) was lower than APLS (-11.5%), Shann formula (-8.6%), Leffler formula (-1.7%), Nelson formula (-10.0%), Best Guess formula (+5.0%) and Broselow tape (-4.8%) for all age groups. Conclusion: We developed and validated a simple formula to estimate body weight from the age of Korean children and found that this new formula was more accurate than other weight estimating methods. However, care should be taken when applying this formula to older children because of a large standard deviation of estimated weight. © 2012 Elsevier Ireland Ltd.

PubMed | Soonchunhyang University, Incheon Sarang Hospital and Eulji University
Type: Journal Article | Journal: Wounds : a compendium of clinical research and practice | Year: 2015

Silver plays an important part in severe wound management, mainly by reducing microbial growth within dressed wounds and wound beds. However, it is unknown how silver-coated dressing materials affect diabetic wounds. The purpose of this study is to evaluate the efficacy of silver-containing dressing materials for the treatment of methicillin-resistant Staphylococcus aureus (MRSA)-infected wounds in streptozotocininduced diabetic rats.Full-thickness skin defects were created on the backs of rats with streptozotocin (STZ)-induced diabetes (n = 108) and were infected with MRSA. The rats were assigned to 6 groups according to the wound dressing used: nanocrystalline silver (Acticoat, Smith & Nephew, Inc, London, UK), silver carboxymethylcellulose (Aquacel-Ag, ConvaTec, Skillman, NJ), silver sulfadiazine (Medifoam silver, Genewel Science Co Ltd, Seongnam, South Korea), nanocrystalline silver (Poly- Mem silver, Ferris Mfg Corp, Burr Ridge, IL), silver sulfadiazine (Ilvadon, Ildong Pharmaceuticals, Seoul, South Korea), and 10% povidone iodide (control). The wound size, histological findings, and bacterial colony count for each group was analyzed and compared to normal Sprague-Dawley rats.Wound size decreased over time in every group. On day 10, a significant difference in wound area was detected between the silver dressing groups and the control group (P = 0.0040). In the wound biopsy, on days 4, 7, and 10, the would-healing effect increased in every group. However, between days 4 (P = 0.8250) and 10 (P = 0.9912), there was no statistical difference between groups. The number of bacteria in each group decreased with time in the bacterial wound culture. The silver dressing groups were more effective on antimicrobial efficacy, but there was no statistically significant difference between the silver dressing groups and the control group.Silver-containing dressing materials are an effective method for MRSA-infected wounds, but nano silver-containing dressing materials did not have better results in a diabetic rat model compared to a normal rat model in historical review. Further investigation is necessary to determine the relative safety of these products on the healing wound. Once that is done, the relative value of the products can be determined by balancing their antimicrobial and cytotoxicity characteristics.

Lee Y.J.,Inje University | Kim D.K.,Seoul National University | Kwak Y.H.,Seoul National University | Kim H.B.,Seoul National University | And 2 more authors.
American Journal of Emergency Medicine | Year: 2012

Sedatives with a long duration are required for pediatric magnetic resonance imaging (MRI) in the emergency department. The success rate of chloral hydrate for pediatric sedation is 80% to 100% according to some studies. However, the success rate varies by age, weight, and underlying disease. To identify factors affecting the success rate, we compared the chloral hydrate sedation success rate and adverse event rate by age, weight, and underlying disease. Compared with patients in the failure group, patients in the successful group were younger (23.8 vs 36.9 months, P < .01) and weighed less (11.4 vs 14.4 kg, P < .01). No differences in neurological problems, reasons for MRI, or adverse events were observed between the 2 groups. Patients 18 months old had a success rate greater than 95%, but the success rate decreased in children older than 18 months. The adverse event rate was about 10% in patients 18 months old and increased to 20% in patients older than 36 months. Patients 24 months of age who had a neurological problem (seizure disorder or developmental delay) had a success rate greater than 95%, but the adverse event rate increased after 24 months of age. Chloral hydrate sedation was appropriate for pediatric MRI in patients younger than 18 months. Although we observed no fatal adverse events, it is necessary to monitor patients until full recovery from sedation. © 2012 Elsevier Inc. All rights reserved.

PubMed | Incheon Sarang Hospital, Sungkyunkwan University, University of Ulsan and Inje University
Type: Comparative Study | Journal: Pancreatology : official journal of the International Association of Pancreatology (IAP) ... [et al.] | Year: 2015

International consensus diagnostic criteria (ICDC) have been proposed for the diagnostic criteria and algorithm of autoimmune pancreatitis (AIP). Although endoscopy is important in the diagnosis of AIP, practical patterns of its usage vary considerably worldwide. This study aimed to compare endoscopic retrograde cholangiopancreatography (ERCP) with papillary biopsy and endoscopic ultrasound (EUS)-guided pancreatic biopsy for diagnosing AIP using ICDC.We retrospectively reviewed and classified 165 Korean patients diagnosed by Korean criteria from June 2007 to October 2013. Among them, 61 patients underwent ERCP with duodenal papillary biopsy (group A) and 62 patients underwent EUS-guided pancreatic biopsy (group B). We analyzed the diagnostic criteria and levels of each criterion, and type of AIP before and after endoscopic procedures.ERCP with papillary biopsy increased the diagnostic sensitivity from 65.6% (40/61) to 95.1% (58/61) (P < 0.01). EUS-guided pancreatic biopsy increased the diagnostic sensitivity from 50.0% (27/62) to 88.7% (55/62) (P < 0.01). The increases of diagnostic sensitivity in two endoscopic methods were not different statistically. In diagnosing definite AIP, EUS-guided pancreatic biopsy was more useful than ERCP with papilla biopsy (sensitivity; 79.0% vs. 65.6%, P < 0.01). EUS-guided pancreatic biopsy was helpful to classify type 1 and type 2 AIP in some patients. Procedure-related complication (mild pancreatitis) developed in one patient (1.6%) in group A and two patients (3.2%) in group B. ERCP with papillary biopsy was less expensive than EUS-guided pancreatic biopsy.Both ERCP with papillary biopsy and EUS-guided pancreatic biopsy are safe and play important roles in diagnosing AIP according to the ICDC.

Ko Y.-M.,Dongguk University | Park W.-B.,Incheon Sarang Hospital | Lim J.-Y.,Seoul National University
Spine | Year: 2010

Study Design. Validation of a translated, culturally adapted questionnaire. Objective. We developed a Korean version of the Chronic Pain Coping Inventory-42 (CPCI-42) by performing a cross-cultural adaptation, and evaluated its reliability and validity. Summary of Background Data. The CPCI is widely used and validated instruments for measuring coping strategies in chronic pain. However, no validated and culturally adapted version was available in Asian countries. Methods. We assessed 142 patients with chronic low back pain using the CPCI-42 and measures of physical disability, pain, and quality of life. Results for 93 of the 142 patients exhibited test-retest reliability. The interval time of collecting retest data varied from 2 weeks to 1 month. Criterion validity was evaluated using correlations between the CPCI-42 and the Oswestry Disability Index, the Brief Pain Inventory, and the Short Form 36-item Health Survey (version 2.0). Construct validity was computed using exploratory factor analysis. Results. The Korean version of the CPCI-42 had a high internal consistency (Cronbach's alpha >0.70) with the exception of results for task persistence and relaxation. Illness-focused coping (guarding, resting, asking for assistance) and other-focused coping (seeking social support) were most significantly correlated with Oswestry Disability Index, Brief Pain Inventory, and Short Form 36-item Health Survey, respectively. Outcomes for task persistence were contrary to other subscales in wellnessfocused coping. Construct validity by factor analysis produced similar results to the original CPCI subscale. However, several factors showed cross-loading in 8 factor solutions. Conclusion. Despite linguistic and cultural differences, the Korean version of the CPCI-42 is overall a meaningful tool, and produces results sufficiently similar to the original CPCI-42. © 2010, Lippincott Williams & Wilkins.

Yang E.J.,Seoul National University | Park W.-B.,Incheon Sarang Hospital | Shin H.-I.,Seoul National University | Lim J.-Y.,Seoul National University
American Journal of Physical Medicine and Rehabilitation | Year: 2010

Yang EJ, Park W-B, Shin H-I, Lim J-Y: The Effect of Back School Integrated with Core Strengthening in Patients with Chronic Low-Back Pain. Objective: To assess the effect of back school integrated with core-strengthening exercises on back-specific disability and pain-coping strategies and to examine how reactions to pain affect the outcomes of back school in patients with chronic low back pain. Design: A single-center prospective trial was conducted with 142 participants with chronic low-back pain (38 men and 104 women) who completed a back school program at the spine center of a university hospital. The subjects participated in a 4-wk program integrated with core-strengthening exercises. Back-specific disabilities were measured as a primary outcome before and after the program. Secondary outcomes were pain, Chronic Pain Coping Inventory, general health status assessed by the SF-36, and quantitative functional evaluations of factors, such as trunk muscle strength, endurance, and the back performance scale. A subgroup of 28 subjects (12 men and 16 women) of the total sample of 142 subjects was used to analyze the longitudinal association between coping strategies and the primary outcome in a long-term follow-up study. These participants were divided into three groups (much improved, slightly improved, and unimproved) based on changes in back-specific disability scores. Results: Participants improved significantly in terms of back-specific disability, pain, general health, and quantitative functional tests according to the short-term evaluation. They used more relaxation and exercise/stretching techniques as coping strategies. Of the groups participating in the longer-term follow-up (T3), the much-improved group showed significant improvement between T1 (before back school) and T2 (after back school) in scores for relaxation (1.6 ± 1.0 vs. 2.6 ± 1.1), task persistence (2.9 ± 1.2 vs. 3.7 ± 1.2), and exercise (3.3 ± 1.1 vs. 5.2 ± 1.9), but the coping strategies of those in the slightly improved and unimproved groups did not change significantly at T2. Conclusions: Our back school program may help patients with chronic low back pain reduce back-specific disability and pain and develop wellness-focused coping strategies such as exercise and stretching. © 2010 by Lippincott Williams & Wilkins.

PubMed | Incheon Sarang Hospital, National Medical Center and Seoul National University
Type: Journal Article | Journal: The Journal of surgical research | Year: 2015

Our aim was to investigate whether plasma glutathione reductase (GR) activity is well correlated with the erythrocyte-reduced glutathione (GSH)/glutathione disulfide (GSSG) ratio and is associated with the mortality of septic shock.This study was conducted on male Sprague-Dawley rats and patients admitted to the intensive care unit with septic shock. To induce endotoxemia in rats, vehicle or lipopolysaccharide (LPS) at dosages of 5 or 10mg/kg were injected into a tail vein. Animals were then euthanized 6h post-LPS. Based on the 28-d mortality, the enrolled patients were divided into the survivors and nonsurvivors. We obtained blood samples from patients at admission (0h) and 24h after admission to the intensive care unit.In endotoxemic rats, the erythrocyte GSH/GSSG ratio, erythrocyte GR activity, and plasma GR activity in the 10mg/kg of LPS group were lower than those in the sham and 5mg/kg of LPS groups. In patients with septic shock, decrease in plasma GR activity at 24h was independently associated with an increase in 28-d mortality (odds ratio, 0.828; 95% confidence interval, 0.690-0.992, P=0.041). Plasma GR activity was correlated with erythrocyte GR activity (Spearman =0.549, P<0.001) and the erythrocyte GSH/GSSG ratio (rho=0.367, P=0.009) at 24h.Plasma GR activity was well correlated with erythrocyte GR activity and the erythrocyte GSH/GSSG ratio, and a decrease in plasma GR activity was associated with an increase in the mortality of septic shock patients.

Lee J.-C.,Korea University | Hwang H.-J.,Korea University | Hwang H.-J.,Myongji Hospital | Park Y.-H.,Incheon Sarang Hospital | And 4 more authors.
Primary Care Respiratory Journal | Year: 2013

Background: Nursing home-acquired pneumonia (NHAP) is the leading cause of death among long-term care residents. Aims: To compare current scoring indices (NHAP model score, Pneumonia Severity Index (PSI), CURB-65 (confusion, urea nitrogen, respiratory rate, blood pressure, age >65 years) and SOAR (systolic blood pressure, oxygenation, age, respiratory rate)) in predicting mortality and admission to the intensive care unit (ICU) in patients with NHAP. Methods: This retrospective observational study was conducted between July 2008 and June 2011 using data from the Korean Nursing Home Networks. Two hundred and eight nursing home residents were hospitalised with pneumonia in one general hospital. The primary outcome measure was 30-day all-cause mortality. Secondary outcome measures were intensive respiratory or vasopressor support (IRVS), and severe pneumonia (ICU admission or IRVS). Results: PSI class V showed the highest Youden index (0.45), specificity (66.7%), positive predictive value (PPV, 40.0%), negative predictive value (NPV, 91.5%), and area under the curve (AUC, 0.73) for 30-day mortality. For severe pneumonia, PSI class V showed the highest Youden index (0.40), specificity (72.8%), PPV (62.2%), NPV (77.1%), and AUC (0.70). Similarly, PSI class V showed the highest Youden index (0.35), specificity (68.3%), PPV (51.1%), NPV (80.5%), and AUC (0.69) for IRVS. Conclusions: The PSI has superior discriminatory power in predicting all three clinical outcomes (30-day mortality, severe pneumonia, and IVRS) compared with the NHAP model score, CURB-65 and SOAR. © 2013 Primary Care Respiratory Society UK. All rights reserved.

Kim S.-H.,Catholic Kwandong University | Chung J.-H.,Catholic Kwandong University | Lee J.-C.,Incheon Sarang Hospital | Park Y.-H.,Incheon Sarang Hospital | And 2 more authors.
Clinica Chimica Acta | Year: 2013

Background: This study compares biomarker (including procalcitonin, pro-ANP, and copeptin) levels to pneumonia severity scores to predict 30-day mortality in NHAP (nursing home acquired pneumonia) patients. Methods: Seventy three patients aged. ≥. 65. y, admitted to general hospitals and who fulfilled the definition of NHAP were included in the study. Data collected at admission included age, gender, nursing home admission, coexisting illness, symptoms and clinical parameters (blood pressure, pulse rate, respiratory rate and status). Additional data collected included laboratory results, radiographic findings and outcome variables. Severity of pneumonia was evaluated using a prediction rule calculated by CURB-65 criteria (confusion, urea nitrogen, respiratory rate, blood pressure, age. >. 65. y). Results: After adjustment for age, sex and CURB-65, copeptin (OR. =. 5.60, 95% confidence interval (CI). =. 1.20-26.24) was associated with 30-day mortality in NHAP patients, while procalcitonin and pro-ANP were not. The areas under the receiver operating characteristic curves (AUCs) for CURB-65, in predicting mortality were 0.685 [95% CI 0.559-0.811], whereas copeptin showed slightly superior accuracy with an AUC of 0.698 (95% CI 0.568-0.827). Conclusions: Among 3 biomakers, copeptin was the strongest predictor of 30-day mortality from NHAP. The pathophysiologic and clinical implications of this finding require further investigation. © 2013 Elsevier B.V.

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