• Title/Summary/Keyword: 95% confidence interval

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Des-Gamma-Carboxyprothrombin for Early Identification and Prognosis of Hepatocellular Carcinoma - A Case Control Study from Western Nepal

  • Mittal, Ankush;Gupta, Satrudhan Pd;Sathian, Brijesh;Sreedharan, Jayadevan;Poudel, Bibek;Yadav, Shambhu Kumar;Pandeya, Dipendra Raj
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.11
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    • pp.5773-5775
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    • 2012
  • Objective: To assess the diagnostic and prognostic value of AFP and des-gamma-carboxyprothrombin (DCP) in combination and alone for hepatocellular carcinoma. Materials and Methods: A case control study carried out in the Department of Biochemistry of Manipal College of Medical Sciences, Pokhara, Nepal between $1^{st}$ January 2010 and $31^{st}$ December 2011. The variables collected were age, gender, BMI, total proteins, albumin, AST, ALT, total bilirubin, DCP, AFP. Approval for the study was obtained from the institutional research ethical committee. Estimation of AFP was performed by ELISA reader for all cases. Analysis was done using descriptive statistics and confidence interval (CI). The data was analyzed using Excel 2003, R 2.8.0 Statistical Package for the Social Sciences (SPSS) for Windows Version 16.0 (SPSS Inc; Chicago, IL, USA) and the EPI Info 3.5.1 Windows Version. Results:The mean age of HCC cases was $53.6{\pm}14.93$ yrs. The percentage of females was less than males in both cases (23%) and controls (29%). The specificity of DCP reached 100% when its values was equal or greater than 150 (MAU/ml) for 0, 3, 6, 9, 12 months preceding the diagnosis of HCC. Similarly, the specificity for AFP was also nearly 100% when its value was equal or greater than 200 ng/ml 0, 3, 6, 9, 12 months earlier to the finding of HCC. The specificity of DCP (${\geq}40MAU/mL$) and AFP(${\geq}20$ ng/mL) in combination was 93%, 97%, 95%, 96%, 97% in respect to 0, 3, 6, 9, 12 months prior to the diagnosis of HCC. Conclusion: The combination of both DCP and AFP will improve the finding of initial HCC and the sensitivity of these markers was utmost at the time of HCC identification and noticeably lesser at former time points.

CYP1A1 (Ile462Val), CYP1B1 (Ala119Ser and Val432Leu), GSTM1 (null), and GSTT1 (null) Polymorphisms and Bladder Cancer Risk in a Turkish Population

  • Berber, Ufuk;Yilmaz, Ismail;Yilmaz, Omer;Haholu, Aptullah;Kucukodaci, Zafer;Ates, Ferhat;Demirel, Dilaver
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.6
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    • pp.3925-3929
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    • 2013
  • We aimed to investigate bladder cancer risk with reference to polymorphic variants of cytochrome p450 (CYP) 1A1, CYP1B1, glutathione S-transferase (GST) M1, and GSTT1 genes in a case control study. Polymorphisms were examined in 114 bladder cancer patients and 114 age and sex-matched cancer-free subjects. Genotypes were determined using allele specific PCR for CYP1A1 and CYP1B1 genes, and by multiplex PCR and melting curve analysis for GSTM1 and GSTT1 genes. Our results revealed a statistically significant increased bladder cancer risk for GSTT1 null genotype carriers with an odds ratio of 3.06 (95% confidence interval=1.39-6.74, p=0.006). Differences of CYP1A1, CYP1B1 and GSTM1 genotype frequencies were not statistically significant between patients and controls. However, the specific combination of GSTM1 null, GSTT1 null, and CYP1B1 codon 119 risk allele carriers and specific combination of GSTM1 present, GSTT1 null, and CYP1B1 432 risk allele carriers exhibited increased cancer risk in the combined analysis. We did not observe any association between different genotype groups and prognostic tumor characteristics of bladder cancer. Our results indicate that inherited absence of GSTT1 gene may be associated with bladder cancer susceptibility, and specific combinations of GSTM1, GSTT1 and CYP1B1 gene polymorphisms may modify bladder cancer risk in the Turkish population, without any association being observed for CYP1A1 gene polymorphism and bladder cancer risk.

Association of Low Hand Grip Strength with Protein Intake in Korean Female Elderly: based on the Seventh Korea National Health and Nutrition Examination Survey (KNHANES VII), 2016-2018 (한국인 여성 노인의 단백질 섭취 수준과 근력의 상관성 연구: 국민건강영양조사 제 7기(2016-2018년) 자료를 이용하여)

  • Jang, Won;Ryu, Ho Kyung
    • Korean Journal of Community Nutrition
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    • v.25 no.3
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    • pp.226-235
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    • 2020
  • Objectives: Decreasing muscle strength in old age has become a significant health problem because it increases the risk of falls or fractures and transfers to other diseases. The precise role of dietary protein intake in preventing or reducing muscle weakness is unclear. This study examined the relationship between handgrip strength and protein intake in Korean female elderly. Methods: This was a cross-sectional study that used data from the Seventh Korean National Health and Nutrition Examination Surveys (KNHANES) on female subjects aged 65 years and older. Low handgrip strength (LHGS) was defined as a handgrip strength below than 18 kg. Dietary intake data were obtained using the 1-day 24-hour recall method. Multiple regression was performed to test whether there is an independent relationship between the grip strength and protein intake, and the association between protein intake and LHGS was confirmed through multiple logistic regression. Results: The mean age of the 2,083 elderly females was 73.3 ± 0.1 years, and the prevalence of LHGS was 35% (n=734). Elderly women with an LHGS consumed less energy, total protein, and animal-based protein than those in the normal group. A multiple regression analysis after adjusting for covariate revealed a significant positive association between the handgrip strength and energy, protein, and animal-based protein intake. Multiple logistic regression analysis showed that the odds ratio (OR) of LHGS in female elderly with the highest quartiles of consumption of energy [OR, 0.65; 95% confidence interval (CI), 0.43-0.82; P for trend=0.004], and animal-based protein [OR, 0.59; CI, 0.40-0.87; P for trend=0.037] were significantly lower than those in the lowest quartiles. Conclusions: The energy intake and animal-based protein intake were negatively associated with the LHGS. These results suggest that adequate energy intake and protein intake, particularly those from animal-based sources, for elderly women in Korea are beneficial in lowering the risk of LHGS.

Mechanical versus Tissue Aortic Prosthesis in Sexagenarians: Comparison of Hemodynamic and Clinical Outcomes

  • Son, Jongbae;Cho, Yang Hyun;Jeong, Dong Seop;Sung, Kiick;Kim, Wook Sung;Lee, Young Tak;Park, Pyo Won
    • Journal of Chest Surgery
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    • v.51 no.2
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    • pp.100-108
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    • 2018
  • Background: The question of which type of prosthetic aortic valve leads to the best outcomes in patients in their 60s remains controversial. We examined the hemodynamic and clinical outcomes of aortic valve replacement in sexagenarians according to the type of prosthesis. Methods: We retrospectively reviewed 270 patients in their 60s who underwent first-time aortic valve replacement from 1995 to 2011. Early and late mortality, major adverse valve-related events, anticoagulation-related events, and hemodynamic outcomes were assessed. The mean follow-up duration was $58.7{\pm}44.0$ months. Results: Of the 270 patients, 93 had a mechanical prosthesis (mechanical group), and 177 had a bioprosthesis (tissue group). The tissue group had a higher mean age and prevalence of preoperative stroke than the mechanical group. The groups had no differences in the aortic valve mean pressure gradient (AVMPG) or the left ventricular mass index (LVMI) at 5 years after surgery. In a sub-analysis limited to prostheses in the supra-annular position, the AVMPG was higher in the tissue group, but the LVMI was still not significantly different. There was no early mortality. The 10-year survival rate was 83% in the mechanical group and 90% in the tissue group. The type of aortic prosthesis did not influence overall mortality, cardiac mortality, or major adverse valve-related events. Anticoagulation-related events were more common in the mechanical group than in the tissue group (p=0.034; hazard ratio, 4.100; 95% confidence interval, 1.111-15.132). Conclusion: The type of aortic prosthesis was not associated with hemodynamic or clinical outcomes, except for anticoagulation-related events.

Safety and Efficacy of Hypothermia (34℃) after Hemicraniectomy for Malignant MCA Infarction

  • Park, Hyun-Seok;Choi, Jae-Hyung
    • Journal of Korean Neurosurgical Society
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    • v.61 no.2
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    • pp.267-276
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    • 2018
  • Objective : The beneficial effect of hypothermia after hemicraniectomy in malignant middle cerebral artery (MCA) infarction has been controversial. We aim to investigate the safety and clinical efficacy of hypothermia after hemicraniectomy in malignant MCA infarction. Methods : From October 2012 to February 2016, 20 patients underwent hypothermia (Blanketrol III, Cincinnati Sub-Zero, Cincinnati, OH, USA) at $34^{\circ}C$ after hemicraniectomy in malignant MCA infarction (hypothermia group). The indication of hypothermia included acute cerebral infarction >2/3 of MCA territory and a Glasgow coma scale (GCS) score <11 with a midline shift >10 mm or transtentorial herniation sign (a fixed and dilated pupil). We retrospectively collected 27 patients, as the control group, who had undergone hemicraniectomy alone and simultaneously met the inclusion criteria of hypothermia between January 2010 and September 2012, before hypothermia was implemented as a treatment strategy in Dong-A University Hospital. We compared the mortality rate between the two groups and investigated hypothermia-related complications, such as postoperative bleeding, pneumonia, sepsis and arrhythmia. Results : The age, preoperative infarct volume, GCS score, National institutes of Health Stroke Scale score, and degree of midline shift were not significantly different between the two groups. Of the 20 patients in the hypothermia group, 11 patients were induced with hypothermia immediately after hemicraniectomy and hypothermia was initiated in 9 patients after the decision of hypothermia during postoperative care. The duration of hypothermia was $4{\pm}2days$ (range, 1 to 7 days). The side effects of hypothermia included two patients with arrhythmia, one with sepsis, one with pneumonia, and one with hypotension. Three cases of hypothermia were discontinued due to these side effects (one sepsis, one hypotension, and one bradycardia). The mortality rate of the hypothermia group was 15.0% and that of the control group was 40.7% (p=0.056). On the basis of the logistic regression analysis, hypothermia was considered to contribute to the decrease in mortality rate (odds ratio, 6.21; 95% confidence interval, 1.04 to 37.05; p=0.045). Conclusion : This study suggests that hypothermia after hemicraniectomy is a viable option when the progression of patients with malignant MCA infarction indicate poor prognosis.

Intake of fruits and vegetables may modify the risk of cataract in Korean males: data from Korean National Health and Nutrition Examination Survey 2012 (채소 및 과일의 섭취가 백내장 유병율에 미치는 영향 : 2012년 국민건강영양조사 자료를 이용하여)

  • Lee, Eunkyung;Choi, Jeong-Hwa;Heo, Young-Ran
    • Journal of Nutrition and Health
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    • v.51 no.5
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    • pp.423-432
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    • 2018
  • Purpose: Cataract is a major cause of a loss of eye sight, and is a critical health issue in an aging society. The oxidative stresses to the lens due to various exterior/interior stimuli leads to degenerative changes of the visual system, resulting in cataract. Therefore, reducing the level of oxidative damage is critical in the prevention of the disease. This study examined the association between the risk of cataract and intake of fruits and vegetables, the major dietary source of antioxidants. Methods: Using the data of Korean National Health and Nutrition Examination Survey 2012, the intake of fruits and vegetables of 1,332 males (222 cases) and 2,012 females (377 cases) were analyzed, taking into account the cataract phenotype. Their dietary intake was categorized in 6 groups: TV (total vegetables), F (fruits), TVF (TV+F), SV (salted vegetables), NSV (Non-SV), and NSVF (NSV+F). The level of intakes were evaluated referring to the recommendation level of various dietary guidelines. Results: The presence of cataract was associated with some type of fruit and vegetable intake. In males, the controls had more TVF (p < 0.001), TV (p = 0.001), SV (p = 0.012), NSV (p = 0.007), and NSVF (p < 0.001) intake than the cases, and the lower intake of TVF (< 500g), TV (300g), NSV (< 100g), and NSVF (< 400g) increased the risk of cataract by up to 1.7 fold [95% confidence interval: 1.06-2.71]. In females, the controls also had a higher intake of TVF (p < 0.001), TV (p = 0.042), and NSVF (p < 0.001), but the intake of such fruits and vegetables did not predict the meaningful risk of cataract. The intake of SV and F was not associated with the cataract phenotype in either males or females. Conclusion: The intake of fruits and vegetables can modify the risk of cataract in Korean males and a sufficient intake of those could be effective in the prevention of cataract.

Epidemiologic Study of Human Epidermal Growth Factor Receptor 2 Expression in Advanced/Metastatic Gastric Cancer: an Assessment of Human Epidermal Growth Factor Receptor 2 Status in Tumor Tissue Samples of Gastric and Gastro-Esophageal Junction Cancer

  • Seo, Kyung Won;Jeon, Taeyong;Kim, Sewon;Kim, Sung Soo;Kim, Kwanghee;Suh, Byoung-Jo;Hwang, Sunhwi;Choi, SeongHee;Ryu, Seungwan;Min, Jae Seok;Lee, Young-Joon;Jee, Ye Seob;Chae, Hyeondong;Yang, Doo Hyun;Lee, Sang Ho
    • Journal of Gastric Cancer
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    • v.17 no.1
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    • pp.52-62
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    • 2017
  • Purpose: The Trastuzumab for gastric cancer (GC) trial identified human epidermal growth factor receptor 2 (HER2) as a predictor of successful treatment with trastuzumab (HER2 receptor targeting agent) among patients with advanced/metastatic GC. To date, the prevalence of HER2 overexpression in the Korean population is unknown. The present study aimed to assess the incidence of HER2 positivity among GC and gastroesophageal (GE) junction cancer samples and the relationship between HER2 overexpression and clinicopathological characteristics in Korean patients. Materials and Methods: Tumor samples collected from 1,695 patients with histologically proven GC or GE junction enrolled at 14 different hospitals in Korea were examined. After gathering clinicopathological data of all patients, HER2 status was assessed by immunohistochemistry (IHC) at each hospital, and IHC 2+ cases were subjected to silver-enhanced in situ hybridization at 3 central laboratories. Results: A total of 182 specimens tested positive for HER2, whereas 1,505 tested negative. Therefore, the overall HER2-positive rate in this study was 10.8% (95% confidence interval=9.3%-12.3%). The HER2-positive rate was higher among intestinal-type cases (17.6%) than among other types, and was higher among patients older than 70 years and 50 years of age, compared to other age groups. Conclusions: Our evaluation of the HER2 positivity rate (10.8%) among Korean patients with GC and GE junction indicated the necessity of epidemiological data when conducting studies related to HER2 expression in GC and GE junction.

A Pediatric Fall-Risk Assessment Tool for Hospitalized Children (입원 아동의 낙상 위험 예측 도구)

  • Shin, Hyeon Ju;Kim, Young Nam;Kim, Ju Hee;Son, In Sook;Bang, Kyung-Sook
    • Child Health Nursing Research
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    • v.20 no.3
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    • pp.215-224
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    • 2014
  • Purpose: This study was conducted to identify risk factors in hospitalized children, and to develop and validate a fall-risk assessment tool for hospitalized children. Methods: A retrospective chart review was performed at one university children's hospital, and an analysis was done of the characteristics of all patients who fell during a 44-month period (n=48). These patients were compared with another 149 hospitalized children who did not fall. Results: Significant predictors of falls as identified in a multivariate logistic regression analyses were age of less than 3 years old, neurological diagnosis including epilepsy, children's dependency of ADL, physical developmental delay, multiple usage of fall-risk-increasing drugs. The respective odds ratios ranged from 2.4 to 7.1 with 95% confidence interval (p<0.05). Accordingly, defining patients with either 5 risk factors as fall-prone hospitalized children provided a sensitivity of 93.6% and specificity of 16.2%. Conclusion: The results show that this tool has an acceptable level of sensitivity to assess the risk factors of fall in hospitalized children even though the specificity was low, suggesting that this tool may enable nurses to predict the risk level of childhood falls, and develop preventive strategies against pediatric falls in children's units.

Association of Specific Immunoglobulin E to Staphylococcal Enterotoxin with Airway Hyperresponsiveness in Asthma Patients

  • Kim, Seong Han;Yang, Seo Yeon;You, Jihong;Lee, Sang Bae;You, Jin;Chang, Yoon Soo;Kim, Hyung Jung;Ahn, Chul Min;Byun, Min Kwang;Park, Hye Jung;Park, Jung-Won
    • Tuberculosis and Respiratory Diseases
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    • v.79 no.4
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    • pp.295-301
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    • 2016
  • Background: Specific immunoglobulin E (IgE) sensitization to staphylococcal enterotoxin (SE) has been recently considered to be related to allergic disease, including asthma. Despite studies on specific IgE (sIgE) to SE and its relationship to asthma diagnosis and severity, the association of sIgE to SE with airway hyperresponsiveness (AHR) remains unclear. Methods: We enrolled 81 asthma patients admitted to the Severance Hospital in Korea from March 1, 2013, to February 28, 2015 and retrospectively reviewed the electronic medical records of the enrolled subjects. The serum levels of sIgE to SE (A/B) of all subjects was measured using the ImmunoCAP 250 (Phadia) system with SE-sIgE positive defined as >0.10 kU/mL. Results: The SE-sIgE level was not significantly correlated with asthma severity (forced expiratory volume in 1 second [$FEV_1$], $FEV_1$/forced vital capacity, sputum eosinophils, and serum eosinophils), whereas the SE-sIgE level in patients with positive AHR ($mean{\pm}standard$ error of the mean, $0.606{\pm}0.273kU/mL$) was significantly higher than that in patients with negative AHR ($0.062{\pm}0.015kU/mL$, p=0.034). In regression analysis, SE sensitization (sIgE to SE ${\geq}0.010kU/mL$) was a significant risk factor for AHR, after adjustment for age, sex, $FEV_1$, and sputum eosinophils (odds ratio, 7.090; 95% confidence interval, 1.180-42.600; p=0.032). Prevalence of SE sensitization was higher in patients with allergic rhinitis and non-atopic asthma patients, as compared to patients without allergic rhinitis and atopic asthma patients, respectively, but without statistical significance. Conclusion: SE sensitization is significantly associated with AHR.

Correlation Between Sasang Constitution and Heart Rate Variability in Won-ju Rural Population (원주 지역 주민들의 사상체질과 심박수변이도와의 상관성)

  • Kim, Soo-Yeon;Sun, Seung-Ho;Yoo, Jun-Sang;Koh, Sang-Baek;Park, Jong-Ku
    • The Journal of Internal Korean Medicine
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    • v.30 no.3
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    • pp.510-524
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    • 2009
  • Objective : This study was designed to find the correlation between Sasang Constitution and heart rate variability(HRV). Method : There were 665 subjects (280 men and 385 women), between 39 and 72 years old. in a rural community. Sasang Constitution was diagnosed by a Sasang constitutional specialist using PSSC (Phonetic System for Sasang Constitution), face and tongue photo and checkup-list. A structured-questionnaire was used to assess the general characteristics. HRV was recorded using SA-2000 (medi-core). HRV was assessed by time domain and by frequency domain analysis. Metabolic syndrome was defined on the basis of clustering of risk factors, when three or more of the following cardiovascular risk factors were included : blood pressure, fasting blood sugar, triglyceride HDL-cholesterol, and abdominal obesity (waist). Because of the skewness of the data, logarithmic transformation was performed on the absolute units of the spectral components of HRV, and the resulting logarithmic values and normalized units were compared between the groups by a logistic regression. The 95% confidence interval (CI) of the odds ratio was used and calculated from the data laid out for a cross sectional study. Results : 1. Odds ratios of Taeeumin and Soeumin in female adults below 60 years old were significantly lower than that of Soyangin in LF norm and LF/HF ratio. Odds ratios of Taeeumin and Soeumin in female adults below 60 years old were significantly higher than that of Soyangin in HF norm. 2. There was no significant correlation between HRV and Sasang Constitution in female adults from 60 years old and over. 3. There was no significant correlation between HRV and Sasang Constitution in male adults. Conclusion : There is a statistically significant correlation between the HRV and Sasang Constitution. There is a tendency of increase in the sympathetic activity in Soyangin. There is a tendency of decrease in the parasympathetic activity in Taeeumin and Soeumin.

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