• Tuberculosis and Respiratory Diseases
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• 제75권1호
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• pp.18-24
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• 2013

Background: We investigated the prevalence of latent tuberculosis infection (LTBI) among the health care workers (HCWs) and analyzed its risk factors in South Korea. Methods: A standard questionnaire regarding the baseline demographics and risk factors for LTBI was given to each participant and tuberculin skin test (TST), QuantiFERON-TB GOLD In-Tube (QFT-GIT) assay, and chest radiography were performed. Results: A total of 493 participants, 152 (30.8%) doctors and 341 (69.2%) nurses were enrolled in eight tertiary referral hospitals. The mean age of the subjects was 30.6 years old, and 383 (77.7%) were female. Of the 152 doctors, 63 (41.4%) and 36 (23.7%) were positive by TST and by QTF-GIT, respectively, and among the 341 nurses, 119 (34.9%) and 49 (14.4%) had positive TST and QFT-GIT results, respectively. Overall, the agreement between the two tests was 0.22 by the chance corrected proportional agreement rate (kappa coefficient) in 493 subjects. Experience of working in tuberculosis (TB)-related departments was significantly associated with positive LTBI test results by QFT-GIT assay, not by TST. In multivariate analysis, only age was independently associated with increased risk of a positive TST result, while age and experience of working in TB-related departments (odds ratio, 2.29; 95% confidence interval, 1.01-5.12) were independently associated with increased risk of a positive QFT-GIT result. Conclusion: A high prevalence of LTBI was found among South Korean HCWs. Considering the association between the experience of working in TB-related departments and high risk of LTBI, QFT-GIT may be a better diagnostic test for LTBI than TST in HCWs.

• Tuberculosis and Respiratory Diseases
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• 제81권4호
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• pp.311-318
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• 2018

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.

• 대한한의학회지
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• 제27권3호
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• pp.241-250
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• 2006

Backgrounds: Blood stasis is hon as an important pathologic factor for vascular disorder in Oriental medicine. Despite its clinical importance there have been few objective tests for diagnosing blood stasis. Objectives: This study was designed to examine the relationship between blood stasis and arterial stiffness measured by cardio-ankle vascular index (CAVI). Methods: The subjects were 104 ischemic stroke patients with onset after 14 days. Their general characteristics, lipid profiles and uric acid were recorded. The degree of arterial stiffness was assessed by CAVI, and blood stasis was evaluated by diagnostic criteria. The data were analyze4 by chi-square test, student t-test, spearman correlation analysis, and pearson correlation analysis. Then, stepwise multiple logistic regression analysis was applied in order to exclude the interactions among several factors. Results: There were significant differences in right, left and higher CAVI between the blood stasis group and the non blood stasis group (p-value<0.01). Age, systolic blood pressure, triglyceride and CAVI had relationships with blood static scores. In multiple logistic regression analysis, the adjusted odds ratio of blood stasis for arterial stiffness with CAVI above 9 were 7.091 (95% confidence interval, $1.641\sim30.638$). Conclusions: The results demonstrated the relationship between blood stasis and arterial stiffness measured by CAVI. Therefore, we suggest that CAVI should be one of the objective tests for diagnosing blood stasis.

• 대한한방내과학회지
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• 제37권1호
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• pp.47-64
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• 2016

Objectives: In the present study, a genetic analysis was conducted to investigate the association of the expression of SNPs of EDN1 gene polymorphism with the clinical phenotype in bronchial asthma patients with either excess or deficiency syndrome.Methods: Ninety-four healthy control subjects and 52 asthma patients were included in this study. The asthma patients were divided into two groups: those with deficiency syndrome and those with excess syndrome. We searched the exonic and promoter areas of the EDN1 gene in the NCBI website SNPs with <0.01 minor allele frequency (MAF) and <0.01 heterozygosity. Pro programs were performed to obtain the odds ratio, 95% confidence interval, and p-value. Multiple logistic regression models were conducted to analyze the genetic data.Results: In our genotype and allele analyses, there were significant differences in the codominant 2 model of the rs3087459 SNP genotype and also in the CGG haplotype between the control group and the asthma group. Genotype and allele analyses were conducted between the deficiency and excess syndrome group. There were significant differences in the dominant and log-additive model and also in the frequency of C-alleles of rs3087459 SNP genotype. There were significant differences in codominant 1, dominant and log-additive model and T-allele of rs5370 SNP genotype. The AGG haplotype also revealed significant differences.Conclusions: EDN1 SNPs (rs3087459, rs5370) showed a significant association with symptomatic excess syndrome in Korean asthmatic patients.

• Clinical and Experimental Reproductive Medicine
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• 제42권4호
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• pp.143-148
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• 2015

Objective: The aim of the current study was to determine the predictive value of anti-$M{\ddot{u}}llerian$ hormone (AMH) levels for pregnancy outcomes in patients over 40 years of age who underwent in vitro fertilization or intracytoplasmic sperm injection-embryo transfer (IVF/ICSI-ET) cycles. Methods: We retrospectively analyzed the medical records of 188 women aged 40 to 44 years who underwent IVF/ICSI-fresh ET cycles due to unexplained infertility in the fertility center of CHA Gangnam Medical Center. Patients were divided into group A, with AMH levels <1.0 ng/mL (n=97), and group B, with AMH levels ${\geq}1.0ng/mL$ (n=91). We compared the clinical pregnancy rate (CPR) in the two groups and performed logistic regression analysis to identify factors that had a significant effect on the CPR. Results: The CPR was significantly lower in group A than group B (7.2% vs. 24.2%, p<0.001). In multivariate logistic regression analysis, AMH levels were the only factor that had a significant impact on the CPR (odds ratio, 1.510; 95% confidence interval, 1.172-1.947). The area under the receiver operating characteristic curve for AMH levels as a predictor of the CPR was 0.721. When the cut-off level of AMH was set at 1.90 ng/ mL, the CPR was 6.731-fold higher in the group with AMH levels ${\geq}1.90ng/mL$ than in the group with AMH levels <1.90 ng/mL (p<0.001). Conclusion: Our study showed that AMH levels were predictive of clinical pregnancy in infertility patients over 40 years of age. Further prospective studies should be conducted to validate the predictive capability of AMH levels for the outcome of clinical pregnancy.

• Journal of Yeungnam Medical Science
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• 제21권2호
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• pp.198-206
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• 2004

gemcitabine과 carboplatin으로 치료받은 경력이 있는 진행성 비소세포폐암 환자 25명을 대상으로 2차 화학요법으로 paclitaxel과 cisplatin을 사용하여 다음과 같은 결과를 확인하였다. 전체 25명 중 5명에서 부분반응이 관찰되었으며, 반응군의 반응지속기간은 2~11개월로 중앙값 4.3개월이었다. 전체 환자의 무진행생존 기간은 0~11개월로 중앙값 3.3개월이었으며, 생존기간은 1.3~39개월로 중앙값 7.4개월이었다. 전체 83회의 화학요법 중 WHO 3도의 혈소판감소증이 1회에서만 관찰되었으며, 비혈액학적 부작용도 감내할만 하였다. 이상의 결과 paclitaxel과 cisplatin 복합화학 요법은 진행서 비소세포폐암 환자에서 2차 요법으로 사용하였을 때 부작용이 적으며 효과적인 치료법의 하나로 판단된다.

• Asian Pacific Journal of Cancer Prevention
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• 제17권3호
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• pp.979-984
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• 2016

The incidence rate of stomach cancer in Bali, Indonesia, is estimated to be strikingly lower than that in Japan. We conducted an on-site ecological study to investigate the association between the stomach cancer incidence and Helicobacter pylori (H. pylori) infection. Recruiting 291 healthy persons (136 men and 155 women) from the general population in Bali, Indonesia, we conducted a urea breath test (UBT) to examine H. pylori infection, along with a pepsinogen test to detect chronic atrophic gastritis and urine analysis to estimate sodium and potassium excretion. UBT positivities were 9% (2-15, 95% confidence interval) for men and 7% (1-12) for women, and positive cases for H. pylori IgG antibodies were 1% (0-3) for men and 3% (0-5) for women, significantly lower than the respective values in Japan. Positive pepsinogen tests in Bali were 0% (0-0) for men and 1% (0-4) for women, also significantly lower than the Japanese figures. Computed values for daily salt excretion were $13.3{\pm}4.1g$ (mean${\pm}$SD) for men and $11.1{\pm}3.1g$ for women, as high as corresponding Japanese consumption values. Moreover, the estimated potassium excretion was $3.2{\pm}0.7g$ for men and $2.8{\pm}0.6g$ for women in Bali, significantly higher than the figures in Japan. There were no associations across genetic polymorphisms of IL-beta, TNF-alpha, and PTPN11 with UBT positivity. The low incidence of stomach cancer in Bali may thus mainly be due to the rare H. pylori infection. Namely, the bacterium infection seems to be a critical factor for gastric cancer rather than host or other environmental factors.

• Asian Pacific Journal of Cancer Prevention
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• 제15권17호
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• pp.7337-7341
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• 2014

Background: The physiological role of vitamin D extends beyond bone health and calcium-phosphate homeostasis to effects on cancer risk, mainly for colorectal cancer. Vitamin D may have an anticancer effect in colorectal cancer mediated by binding of the active form $1,25(OH)_2D$ to the vitamin D receptor (VDR). The Taq1 VDR gene polymorphism, a C-to-T base substitution (rs731236) in exon 9 may influence its expression and function. The aim of this study wass to determine the 25(OH)D vitamin D level and to investigate the association between circulating vitamin D level and Taq1VDR gene polymorphism among Jordanian colorectal cancer patients. Materials and Methods: This case control study enrolled ninety-three patients and one hundred and two healthy Jordanian volunteers from AL-Basheer Hospital/Amman (2012-2013). Ethical approval and signed consent forms were obtained from all participants before sample collection. 25(OH)D levels were determined by competitive immunoassay Elecsys (Roche Diagnostic, France). DNA was extracted (Promega, USA) and amplified by PCR followed by VDR Taq1 restriction enzyme digestion. The genotype distribution was evaluated by paired t-test and chi-square. Comparison between vitamin D levels among CRC and control were assessed by odds ratio with 95% confidence interval. Results: The vitamin D serum level was significantly lower among colorectal cancer patients (8.34 ng/ml) compared to the healthy control group (21.02ng/ml). Patients deficient in vitamin D (less than 10.0 ng/ml) had increased colorectal cancer risk 19.2 fold compared to control. Only 2.2% of CRC patients had optimal vitamin D compared to 23.5% among healthy control. TT, Tt and tt Taq1 genotype frequencies among CRC cases was 35.5%, 50.5% and 14% compared to 43.1%, 41.2% and 15.7% among healthy control; respectively. CRC patients had lower mean vitamin D level among TT ($8.91{\pm}4.31$) and Tt ($9.15{\pm}5.25$) genotypes compared to control ($21.3{\pm}8.31$) and ($19.3{\pm}7.68$); respectively. Conclusions: There is significant association between low 25(OH)D serum level and colorectal cancer risk. The VDRTaq1 polymorphism was associated with increased colorectal cancer risk among patient with VDRTaq1 TT and Tt genotypes. Understanding the functional mechanism of VDRTaq1 TT and Tt may provide a strategy for colorectal cancer prevention and treatment.

• Asian Pacific Journal of Cancer Prevention
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• 제14권11호
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• pp.6585-6590
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• 2013

Background: Although FOLFOX (infusional fluorouracil/leucovorin plus oxaliplatin) is established as a standard chemotherapeutic regimen, the long term efficacy of adjuvant XELOX (oral capecitabine plus intravenous oxaliplatin) in Asian colorectal cancer (CRC) patients remains anecdotal. Moreover, uncertainties persist as to whether pharmacogenetic differences in Asian populations preclude equally tolerable and effective administration of these drugs. Method: One hundred consecutive patients with resected colorectal cancer received adjuvant XELOX (oxaliplatin 130 $mg/m^2$ on day 1 plus capecitabine 900 $mg/m^2$ twice daily on day 1 to 14 every 3 weeks for 8 cycles) at Queen Mary Hospital, Hong Kong. Endpoints monitored during follow-up were disease-free survival (DFS) and disease recurrence, overall survival (OS) and adverse events (AEs). Results: The median patient age was 56 years, 56% were diagnosed with rectal cancer and 44% with colonic cancer. After a median follow-up of 4.3 years (95% confidence interval, 3.2-4.7), 24 recurrences were confirmed including 13 patients who died due to progressive disease. Four-year DFS was 81% in colon cancer patients and 67% in rectal cancer patients (p=0.06 by log-rank test). For the cohort as a whole, OS was 90% at 3 years and 84% at 5 years. Treatment-related AEs led to early withdrawal in four patients. The commonest non-hematological AEs were neuropathy (91%), hand-foot syndrome (49%) and diarrhea (46%), while the commonest grade 3/4 AEs were neutropenia (11%) and diarrhea (10%). Conclusion: These results confirm the favourable long term survival benefit with good tolerability in using adjuvant XELOX in treating East Asian colorectal cancer patients.

• 치위생과학회지
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• 제17권4호
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• pp.315-322
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• 2017

본 연구는 2014년 페루 리마 및 까야오 지역 학생 건강증진 프로그램의 기초조사 자료를 활용한 단면연구이며, 연구대상은 페루 리마북부 및 까야오 지역 내 일반 국 공립 중학교에 다니고 있는 11~19세의 청소년 959명이었다. 연구의 목적은 페루 도시 빈곤 지역 학생들의 각 건강위험행동과 칫솔질 빈도 간에 관련성을 파악하기 위해 분석되었으며, 다음과 같은 결론을 얻었다. 첫째, 페루 리마 및 까야오 지역 청소년들의 12.1% (116명)는 하루 1회 이하로 칫솔질 하였으며, 87.9% (843명)는 하루 2회 이상 칫솔질을 하였다. 하루 칫솔질 빈도의 평균은 2.42회였다. 둘째, 연구대상자들의 인구 사회학적 특성을 보정 한 후에 두 가지의 건강위험행동과 칫솔질 빈도 간에 관련성이 나타났으며, 해당 건강위험행동은 여가시간에 주로 비활동성 여가생활(TV, game, internet)을 하는 학생과 외출 후 비누를 이용하여 손을 씻지 않는 학생(never/rarely)이 하루 칫솔질을 1회 이하로 할 OR이 더 높았다. 이상의 결과를 종합하여 보면, 페루 리마 및 까야오 지역 연구대상 청소년들의 하루 칫솔질 평균치는 WHO에서 권장하는 최소 수준인 2회 정도로 파악되었으며, 건강위험행동(비활동성 여가생활, 외출 후 손씻지 않기)을 하는 학생들은 하루 칫솔질 빈도 또한 낮은 것으로 나타났다. 향후 페루 도시 빈곤 지역 청소년들을 대상으로 한 ODA 건강증진 프로그램을 개발할 때에는 본 연구에서 도출된 결과를 토대로 신체활동 프로그램과 개인위생 프로그램에 구강보건교육을 통합적으로 실시할 필요가 있다.