Body Mass Index as a Predictor of Acute Kidney Injury in Critically Ill Patients: A Retrospective Single-Center Study

( Sunmi Ju ),( Tae Won Lee ),( Jung-wan Yoo ),( Seung Jun Lee ),( Yu Ji Cho ),( Yi Yeong Jeong ),( Jong Deog Lee ),( Ju-young Kim ),( Gi Dong Lee ),( Ho Cheol Kim ) 대한결핵 및 호흡기학회 2018 Tuberculosis and Respiratory Diseases Vol.81 No.4

Background: The aim of this study was to examine the influence of body mass index (BMI) on the development of acute kidney injury (AKI) in critically ill patients in intensive care unit (ICU). Methods: Data of patients admitted to medical ICU from December 2011 to May 2014 were retrospectively analyzed. Patients were classified into three groups according to their BMI: underweight (<18.5 kg/m²), normal (18.5-24.9 kg/m²), and overweight (≥25 kg/m²). The incidence of AKI was compared among these groups and factors associated with the development of AKI were analyzed. AKI was defined according to the Risk, Injury, Failure, Loss of kidney function, and End-stage (RIFLE) kidney disease criteria. Results: A total of 468 patients were analyzed. Their mean BMI was 21.5±3.9 kg/m², including 102 (21.8%) underweight, 286 (61.1%) normal-weight, and 80 (17.1%) overweight patients. Overall, AKI occurred in 82 (17.5%) patients. The overweight group had significantly (p<0.001) higher incidence of AKI (36.3%) than the underweight (9.8%) or normal group (15.0%). In addition, BMI was significantly higher in patients with AKI than that in those without AKI (23.4±4.2 vs. 21.1±3.7, p<0.001). Multivariate analysis showed that BMI was significantly associated with the development of AKI (odds ratio, 1.893; 95% confidence interval, 1.224-2.927). Conclusion: BMI may be associated with the development of AKI in critically ill patients.

Slide Session : OS-105 ; Critical Care : Body Mass Index as a Predictor of Acute Kidney Injury in Critically 3 Patients

( Sunmi Ju ),( Tae Won Lee ),( Wan Chul Kim ),( Seung Hun Lee ),( Seung Jun Lee ),( Yu Ji Cho ),( Yi Yeong Jeong ),( Jong Deog Lee ),( Young Sil Hwang ),( Ho Cheol Kim ) 대한내과학회 2014 대한내과학회 추계학술대회 Vol.2014 No.1

Background: Some studies suggest the existence of an “obesity paradox” in the intensive care unit (ICU). However, reports relating renal function and body mass index (BMI) are limited and controversial. This study aimed to examine the infiuence of BMI on acute kidney injury (AKI) in critically ill patients. Methods: We retrospectively analyzed the prospectively collected data from patients admitted to the ICU at Gyeongsang National University Hospital in Korea from December 2011 to May 2014. Patients were stratified to three classes according to their BMI (“underweight” <18.5 kg/m2, “normal” 18.5-24.9 kg/m2, and “overweight” =25 kg/m2). The occurrence of AKI was defined by Risk, Injury, Failure, Loss of kidney function, and End-stage kidney disease criteria, and the impact of BMI on AKI was analyzed. Results: A total 468 patients in the ICU were analyzed, and AKI occurred in 82 (17.5%) patients. The mean BMI was 21.5 ± 4.0 kg/m2; 102 patients (21.8%) were classified as “underweight,” 286 patients (61.1%) were classified as “normal,” and 80 patients (17.1%) were classified as “overweight.” The adjusted analysis showed significantly higher risk of AKI in the overweight group compared to the underweight group (odds ratio, 3.95; 95% confidence interval, 1.74-9). Additional risk factors for AKI in critically ill patients included comorbid liver cirrhosis, septic shock, and acute respiratory distress syndrome. Conclusions: BMI is a possible predictor of AKI in ICU patients, as this study indicated that AKI occurs more frequently in overweight patients than in underweight patients.

Body Mass Index as a Predictor of Acute Kidney Injury in Critically Ill Patients: A Retrospective Single-Center Study

Ju, Sunmi,Lee, Tae Won,Yoo, Jung-Wan,Lee, Seung Jun,Cho, Yu Ji,Jeong, Yi Yeong,Lee, Jong Deog,Kim, Ju-young,Lee, Gi Dong,Kim, Ho Cheol The Korean Academy of Tuberculosis and Respiratory 2018 Tuberculosis and Respiratory Diseases Vol.81 No.4

Background: The aim of this study was to examine the influence of body mass index (BMI) on the development of acute kidney injury (AKI) in critically ill patients in intensive care unit (ICU). Methods: Data of patients admitted to medical ICU from December 2011 to May 2014 were retrospectively analyzed. Patients were classified into three groups according to their BMI: underweight (< $18.5kg/m^2$), normal ($18.5-24.9kg/m^2$), and overweight (${\geq}25kg/m^2$). The incidence of AKI was compared among these groups and factors associated with the development of AKI were analyzed. AKI was defined according to the Risk, Injury, Failure, Loss of kidney function, and End-stage (RIFLE) kidney disease criteria. Results: A total of 468 patients were analyzed. Their mean BMI was $21.5{\pm}3.9kg/m^2$, including 102 (21.8%) underweight, 286 (61.1%) normal-weight, and 80 (17.1%) overweight patients. Overall, AKI occurred in 82 (17.5%) patients. The overweight group had significantly (p<0.001) higher incidence of AKI (36.3%) than the underweight (9.8%) or normal group (15.0%). In addition, BMI was significantly higher in patients with AKI than that in those without AKI ($23.4{\pm}4.2$ vs. $21.1{\pm}3.7$, p<0.001). Multivariate analysis showed that BMI was significantly associated with the development of AKI (odds ratio, 1.893; 95% confidence interval, 1.224-2.927). Conclusion: BMI may be associated with the development of AKI in critically ill patients.

The impact of muscle loss on outcomes of cirrhotic patients in medical intensive care unit

( Sunmi Ju ),( Sun Mi Choi ),( Young Sik Park ),( Chang Hoon Lee ),( Sang Min Lee ),( Jae Joon Yim ),( Chul Gyu Yoo ),( Sung Koo Han ),( Jinwoo Lee ) 대한결핵 및 호흡기학회 2015 대한결핵 및 호흡기학회 추계학술대회 초록집 Vol.120 No.-

Objective: To assess the impact of muscle loss on clinical outcomes of cirrhotic patients admitted to the medical ICU. Methods: Cirrhotic patients with at least two or more recent CT scans before admission to the MICU from 2006 to 2015 at Seoul National University Hospital were included for analysis. Muscle cross-sectional area at the level of the third lumbar vertebrae was quantified using the Osirix software. The rate of muscle mass change and skeletal muscle index were also calculated. We used multivariable Cox proportional hazard regression to evaluate the association between muscle loss and ICU/in-hospital mortality. Results: Among 125 patients, 113 patients (90.4%) were classified as sarcopenia. The mean BMI was 22.6 ± 3.9 kg/m2. Thirty-nine patients (31.2%) were within the normal range of muscle mass change while 86 patients (68.8%) had accelerated decline of muscle mass before admission to the MICU. Patients with accelerated muscle loss showed high ICU mortality (59.3%) and in-hospital mortality (77.9%). By multivariate Cox analysis, ICU mortality was associated independently with chronic kidney disease, Acute Physiology and Chronic Health Evaluation (APACHE) II score, Model for End-Stage Liver Disease (MELD) score, whole body muscle index, and accelerated muscle loss. And in-hospital mortality was associated malignancy, APACHE II score, MELD score and accelerated muscle loss. Conclusion: Accelerated muscle loss is correlated with increased ICU mortality and in-hospital mortality in critically ill cirrhotic patients.

한국제조업에서 기술변화와 자본축적이 비교우위변화에 미친 효과

朱炅垣,張善美 한국국제경제학회 2003 국제경제연구 Vol.9 No.2

본 연구는 1970~1999년 기간동안 기술변화와 자본집약도의 변화가 한국제조업의 비교우위에 미친 영향을 분석하고 있다. 분석결과 한국제조업에서 1990년대 중반이후 기술집약적 산업의 비교우위가 높아졌음을 알 수 있다. 1970년대에는 노동집약적인 산업에 비교우위가 있었으나 1990년대에는 자본집약적인 산업으로 비교우위가 변화하였으며, 1990년대 후반기에는 중기술산업에서 비교우위 지수가 가장 높다. 다음으로 1970~1996년 기간동안 총요소 생산성 성장률과 생산에 대한 생산성의 기여율은 기술집약적 산업에서 보다 높다. 마지막으로 회귀분석결과 총요소생산성 증가가 비교우위 변화의 중요한 요인이며, 자본축적으로 인한 자본집약도의 증가도 기술집약적 산업의 비교우위를 증가시키는 데 기여하였음을 보여준다. This study analyzed the effect of total factor productivity and capital accumulation on the change in comparative advantage In Korean manufacturing for the period 1970∼1999. Twenty-nine industries were classified into three groups according to their technology levels. The empirical results were as follows. First, the comparative advantage of Korean manufacturing changed compared to that in 1970, as the RCA from low-tech industries to high-and mid-tech industries during the period 1970∼1999. Second, the growth rate of total factor productivity (TFP) and its relative contribution to output was higher in high-tech industries than in mid-or low-tech industries. Third, the growth of TFP played an important role in the change of comparative advantage for the period 1970∼1996, and its influence on comparative advantage has increased recently. In addition, the comparative advantage of capital-intensive industries strengthened steadily in the 1990s.

FISH Karyotype Analysis of Fagopyrum tartaricum Gaerth (Tartary buckwheat) using Repetitive DNAs

Yoon-Ha Ju,Franklin Hinosa Mancia,Seyong Yoon,Heekyung Park,Soeun Yoon,Jiin Park,Sunmi Joung,Su Jeong Kim,Yul Ho Kim,Hwang Bae Sohn,Ki-Byung Lim,Hyun Hee Kim,Yoon-Jung Hwang 한국원예학회 2016 한국원예학회 학술발표요지 Vol.2016 No.10

Cardiovascular Disease Risk Factors and Obesity Levels in Korean Adults: Results from the Korea National Health and Nutrition Examination Survey, 2007–2015

Kwanjun Park,Sunmi Lim,박윤형,Woong Ju,신윤희,Hansol Yeom 질병관리본부 2018 Osong Public Health and Research Persptectives Vol.9 No.4

Objectives The increase in the obesity rate in adult males in Korea is higher than countries in the Organization for Economic Co-operation and Development and other Asian countries. We examined the trends and prevalence of major risk factors for cardiovascular disease by evaluating the weight status amongst adults from 2007 to 2015. Methods The study included 37,402 adults, who participated in the Korea National Health and Nutrition Examination Survey. The prevalence trends of cardiovascular disease risk factors were estimated for each body mass index group. Results From 2007 to 2015, significant increases in the prevalence of hypertension, diabetes, and hypercholesterolemia were observed in normal weight adults (0.03 percentage point (%p), 0.06%p, and 0.13%p, respectively). Amongst the overweight and obese adults, a significant increase in the prevalence of hypercholesterolemia was observed, During this period, the prevalence of smoking decreased amongst obese adults and no significant changes in drinking habits and physical activity were noted across all body mass index groups. Conclusion The prevalence of obesity in Korean adults is increasing, and it is necessary to implement interventions to prevent further weight gain and obesity-associated cardiovascular disease.

Characteristics and Outcomes of Patients with Pulmonary Acute Respiratory Distress Syndrome Infected with Influenza versus Other Respiratory Viruses

Yoo, Jung-Wan,Ju, Sunmi,Lee, Seung Jun,Cho, Min-Chul,Cho, Yu Ji,Jeong, Yi Yeong,Lee, Jong Deog,Kim, Ho Choel The Korean Academy of Tuberculosis and Respiratory 2019 Tuberculosis and Respiratory Diseases Vol.82 No.4

Background: Although the frequency of respiratory viral infection in patients with pulmonary acute respiratory distress syndrome (ARDS) is not uncommon, clinical significance of the condition remains to be further elucidated. The purpose of this study was to compare characteristics and outcomes of patients with pulmonary ARDS infected with influenza and other respiratory viruses. Methods: Clinical data of patients with pulmonary ARDS infected with respiratory viruses January 2014-June 2018 were reviewed. Respiratory viral infection was identified by multiplex reverse transcription-polymerase chain reaction (RT-PCR). Results: Among 126 patients who underwent multiplex RT-PCR, respiratory viral infection was identified in 46% (58/126): 28 patients with influenza and 30 patients with other respiratory viruses. There was no significant difference in baseline and clinical characteristics between patients with influenza and those with other respiratory viruses. The use of extracorporeal membrane oxygenation (ECMO) was more frequent in patients with influenza than in those with other respiratory viruses (32.1% vs 3.3%, p=0.006). Co-bacterial pathogens were more frequently isolated from respiratory samples of patients with pulmonary ARDS infected with influenza virus than those with other respiratory viruses. (53.6% vs 26.7%, p=0.036). There were no significant differences regarding clinical outcomes. In multivariate analysis, acute physiology and chronic health evaluation II was associated with 30-mortality (odds ratio, 1.158; 95% confidence interval, 1.022-1.312; p=0.022). Conclusion: Respiratory viral infection was not uncommon in patients with pulmonary ARDS. Influenza virus was most commonly identified and was associated with more co-bacterial infection and ECMO therapy.

Characteristics and Outcomes of Patients with Pulmonary Acute Respiratory Distress Syndrome Infected with Influenza versus Other Respiratory Viruses

( Jung-wan Yoo ),( Sunmi Ju ),( Seung Jun Lee ),( Min-chul Cho ),( Yu Ji Cho ),( Yi Yeong Jeong ),( Jong Deog Lee ),( Ho Choel Kim ) 대한결핵 및 호흡기학회 2019 Tuberculosis and Respiratory Diseases Vol.82 No.4

Background: Although the frequency of respiratory viral infection in patients with pulmonary acute respiratory distress syndrome (ARDS) is not uncommon, clinical significance of the condition remains to be further elucidated. The purpose of this study was to compare characteristics and outcomes of patients with pulmonary ARDS infected with influenza and other respiratory viruses. Methods: Clinical data of patients with pulmonary ARDS infected with respiratory viruses January 2014-June 2018 were reviewed. Respiratory viral infection was identified by multiplex reverse transcription-polymerase chain reaction (RT-PCR). Results: Among 126 patients who underwent multiplex RT-PCR, respiratory viral infection was identified in 46% (58/126): 28 patients with influenza and 30 patients with other respiratory viruses. There was no significant difference in baseline and clinical characteristics between patients with influenza and those with other respiratory viruses. The use of extracorporeal membrane oxygenation (ECMO) was more frequent in patients with influenza than in those with other respiratory viruses (32.1% vs 3.3%, p=0.006). Co-bacterial pathogens were more frequently isolated from respiratory samples of patients with pulmonary ARDS infected with influenza virus than those with other respiratory viruses. (53.6% vs 26.7%, p=0.036). There were no significant differences regarding clinical outcomes. In multivariate analysis, acute physiology and chronic health evaluation II was associated with 30-mortality (odds ratio, 1.158; 95% confidence interval, 1.022-1.312; p=0.022). Conclusion: Respiratory viral infection was not uncommon in patients with pulmonary ARDS. Influenza virus was most commonly identified and was associated with more co-bacterial infection and ECMO therapy.

Risk Factor and Mortality in Patients with Pulmonary Embolism Combined with Infectious Disease

( Gi Dong Lee ),( Sunmi Ju ),( Ju-young Kim ),( Tae Hoon Kim ),( Jung-wan Yoo ),( Seung Jun Lee ),( Yu Ji Cho ),( Yi Yeong Jeong ),( Kyung Nyeo Jeon ),( Jong Deog Lee ),( Ho Cheol Kim ) 대한결핵 및 호흡기학회 2020 Tuberculosis and Respiratory Diseases Vol.83 No.2

Background: Infectious conditions may increase the risk of venous thromboembolism. The purpose of this study was to evaluate the risk factor for combined infectious disease and its influence on mortality in patients with pulmonary embolism (PE). Methods: Patients with PE diagnosed based on spiral computed tomography findings of the chest were retrospectively analyzed. They were classified into two groups: patients who developed PE in the setting of infectious disease or those with PE without infection based on review of their medical charts. Results: Of 258 patients with PE, 67 (25.9%) were considered as having PE combined with infectious disease. The sites of infections were the respiratory tract in 52 patients (77.6%), genitourinary tract in three patients (4.5%), and hepatobiliary tract in three patients (4.5%). Underlying lung disease (odds ratio [OR], 3.69; 95% confidence interval [CI], 1.926-7.081; p<0.001), bed-ridden state (OR, 2.84; 95% CI, 1.390-5.811; p=0.004), and malignant disease (OR, 1.867; 95% CI, 1.017-3.425; p=0.044) were associated with combined infectious disease in patients with PE. In-hospital mortality was higher in patients with PE combined with infectious disease than in those with PE without infection (24.6% vs. 11.0%, p=0.006). In the multivariate analysis, combined infectious disease (OR, 4.189; 95% CI, 1.692-10.372; p=0.002) were associated with non-survivors in patients with PE. Conclusion: A substantial portion of patients with PE has concomitant infectious disease and it may contribute a mortality in patients with PE.