• Title/Summary/Keyword: Cohort Study

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Association of Interleukin 10 Haplotype with Low Bone Mineral Density in Korean Postmenopausal Women

  • Park, Byung-Lae;Han, In-Kwon;Lee, Ho-Sa;Kim, Lyoung-Hyo;Kim, Sa-Jin;Shin, Joon-Shik;Kim, Shin-Yoon;Shin, Hyoung-Doo
    • BMB Reports
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    • v.37 no.6
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    • pp.691-699
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    • 2004
  • Osteoporosis is a disease characterized by exaggerated loss of bone mass, with as much as 50 to 85% of the variation in bone mineral density (BMD) commonly accepted as being genetically determined. Although intensive studies have attempted to elucidate the genetic effects of polymorphisms on BMD and/or osteoporosis in several genes, the genes involved are still largely unknown. The possible associations of genetic variants in five-candidate genes (IL10, CCR3, MCP1, MCP2 and GC) with spinal BMD were investigated in Korean postmenopausal women (n = 370). Fourteen SNPs in five candidate genes were genotyped, and the haplotypes of each gene constructed. The associations of adjusted spinal BMD by age, year since menopause (YSM) and body mass index (BMI), with genetic polymorphisms, were analyzed using multiple regression models. Genetic association analysis of Korean postmenopausal women revealed that IL10 -592A > C and/or IL10 ht2 were associated with decreased bone mass, whereas no significant associations were observed with all polymorphisms in other genes. The levels of spinal BMD in individuals bearing the IL10 -592CC genotype were lower ($0.78{\pm}0.16$) than those in others ($0.85{\pm}0.17$) (P = 0.02), and the BMD of IL10 ht2 bearing individuals were also lower ($0.82{\pm}0.15$) than those in others ($0.85{\pm}0.17$) (P = 0.04). Our results suggest that variants of IL10 might play a role in the decreased BMD, although additional study might need to be followed-up in a more powerful cohort.

Advances of Hospice Palliative Care in Taiwan

  • Cheng, Shao-Yi;Chen, Ching-Yu;Chiu, Tai-Yuan
    • Journal of Hospice and Palliative Care
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    • v.19 no.4
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    • pp.292-295
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    • 2016
  • Hospice and palliative care in Taiwan has been growing continuously. The 2015 Quality of Death index, as rated by the Economist Intelligence Unit, ranked Taiwan first among Asian countries and sixth in the world. In this review article, we highlight three particular areas that might have contributed to this success; the laws and regulations, spiritual care and research network. Finally, we discuss the future challenges and prospects for Taiwanese encounters. A systemic review was conducted with the keywords "hospice palliative care Taiwan" using PubMed. The passing of the "Natural Death Act" in 2000 set the example and established a landmark for patient autonomy in Asia; it guarantees the patient's right to request that medical staff do not resuscitate (DNR) them and to reject other futile medical treatments at the end of their life, thus reflecting the importance of palliative care from the policy perspective. In 2015, Taiwan passed another pioneering law entitled the "Patient Autonomy Act". This law states that a patient may decline medical treatment according to his/her own will. Taiwanese indigenous spiritual care was launched in 2000. It requires a Buddhist Chaplain to successfully complete a training program consisting of lectures, as well as bedside practicum before applying Buddhist practices to end-of-life care. The Japan-Korea-Taiwan research network was established for the purpose of enabling collaborative research for the East-Asian collaborative cross-cultural Study to Elucidate the Dying process (EASED) cohort. With consensus from the government and society to make it a priority, hospice and palliative medicine in Taiwan has been growing steadily.

Sarcopenia and Sarcopenic Obesity and Their Association with Cardiovascular Disease Risk in Postmenopausal Women : Results for the 2008-2011 Korea National Health and Nutrition Examination Survey (폐경 여성의 근감소증 및 근감소성비만과 심혈관질환 위험도와의 관련성 연구: 국민건강영양조사(2008-2011) 자료를 활용하여)

  • Kim, Misung;Sohn, Cheongmin
    • Korean Journal of Community Nutrition
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    • v.21 no.4
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    • pp.378-385
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    • 2016
  • Objectives: This study was conducted to investigate the association between sarcopenia and sarcopenic obesity and cardiovascular disease risk in Korean postmenopausal women. Methods: We analyzed data of 2,019 postmenopausal women aged 50-64 years who participated in the Korea National Health and Nutrition Examination Survey in 2008-2011 and were free of cardiovascular disease history. Blood pressure, height, and weight were measured. We analyzed the serum concentrations of glucose, total cholesterol, high density lipoprotein cholesterol, low density lipoprotein cholesterol and triglyceride levels. Waist circumference was used to measure obesity. Appendicular skeletal muscle mass was measured by dual-energy X-ray absorptiometry. Sarcopenia was defined as the appendicular skeletal muscle mass/body weight<1 standard deviation below the gender-specific means for healthy young adults. The estimated 10-year risk of cardiovascular disease risk was calculated by Pooled Cohort Equation. Subjects were classified as non-sarcopenia, sarcopenia, or sarcopenic obesity based on status of waist circumference and appendicular skeletal muscle mass. Results: The prevalence of sarcopenia and sarcopenic obesity was 16.3% (n=317) and 18.3% (n=369), respectively. The 10-year risk of cardiovascular disease risk in the sarcopenic obesity group was higher ($3.82{\pm}0.22%$) than the normal group ($2.73{\pm}0.09%$) and sarcopenia group ($3.17{\pm}0.22%$) (p < 0.000). The odd ratios (ORs) for the ${\geq}7.5%$ 10-year risk of cardiovascular disease risk were significantly higher in the sarcopenic obesity group (OR 3.609, 95% CI: 2.030-6.417) compared to the sarcopenia group (OR 2.799, 95% CI: 1.463-5.352) (p for trend < 0.000) after adjusting for independent variables (i.e., exercise, period of menopausal, alcohol use disorders identification test (AUDIT) score, income, education level, calorie intake, %fat intake and hormonal replacement therapy). Conclusions: Sarcopenia and sarcopenic obesity appear to be associated with higher risk factors predicting the 10-year risks of cardiovascular disease risk in postmenopausal women. These findings imply that maintaining normal weight and muscle mass may be important for cardiovascular disease risk prevention in postmenopausal women.

Maturation and growth of Trachysalambria curvirostris in the coastal water of Geomundo, Korea (한국 거문도 인근해역의 꽃새우, Trachysalambria curvirostris의 성숙과 성장)

  • 오택윤;최정화;차형기;김주일;고정락;이주희
    • Journal of the Korean Society of Fisheries and Ocean Technology
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    • v.39 no.2
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    • pp.120-127
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    • 2003
  • In Korea, Trachysalambria curvirostris occurs widely along the south and west coasts with a range extending from Kanghwado in the northwest down to Sarangdo in the southeast. Sex ratio showed seasonal variations, with a mean value of 48.6% for the females. T. curvirostris produces one cohort a year, with the ovaries ripening from July to August. Insemination appeared to take place from June to August, as more than half of the females sampled in the study of over 19 mm carapace length were inseminated. The mean gonado somatic index (GSI) reached a maximum between July and August. The smallest mature female found was a 18 mm carapace length (CL). Size at 50% sexual maturity (CL$_(50)$), determined from both mature females and inseminated females was 18.89 mm and 19.91 mm CL, respectively. The life span of females appeared to be 14-15 months according to size frequency distributions, while that of the male was 13-14 months. Population growth was estimated by the modified von Bertalanffy growth function incorporating seasonal variation in growth. Based on the growth parameters (K = 1.40 yr$_(-1)$ and L$L\infty$ = 29.54 mm CL for females, and K = 2.00yr$_(-1)$ and L$L\infty$ = 18.95 mm CL for males) growth curves showed that females grew faster and reached a larger size than males.

The Cause of Cervical Lymph Node Recurrence after the Initial Surgery of Papillary Thyroid Carcinoma (갑상선 유두암의 일차 수술 후 경부 림프절 재발의 원인)

  • Kim, Hyeung Kyoo;Ha, Eun Ju;Lee, Inhwa;Lee, Jeonghun;Soh, Euy Young
    • Korean Journal of Head & Neck Oncology
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    • v.35 no.2
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    • pp.11-17
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    • 2019
  • Background/Objectives: Papillary thyroid carcinoma (PTC) has generally an indolent character with a good prognosis. However, recurrence remains a major concern for the patients during their lifetime. Despite the slowly progressing character of PTC, recurrence can occur within a short period after initial surgery. This study aimed to determine the clinical findings and cause of recurrence in patients who underwent re-operative surgery due to neck node recurrence by reviewing the CT (computed tomographic) scan imaging of the recurrence of PTC retrospectively. Materials & Methods: We reviewed the medical records of patients referred to Ajou University Hospital from January 2002 to January 2018. All patients had re-operative surgery due to neck node recurrence and CT scan results of preoperative evaluation and postoperative follow up. Over this period, 110 patients who underwent re-operation due to neck node recurrence with a CT scan were included in our cohort, resulting in a total of 220 re-operations. Results: The time from initial operation to first re-operation was examined in 110 patients. The median time to re-operation was 28 months, with a range of 4 months to 186 months. Most re-operations (82.7%) occurred within the first five years, 43.6% were in the first two years from the initial surgery. The result of the retrospective CT review showed newly developed cases (21,19.1%), missed diagnosis cases (42,38.2%), real recur cases after surgery (33,30.0%), and remnant lymph nodes (LNs) cases (14,12.7%). We further sub-analyzed 14 cases with remnant LNs. Reasons for remnant LNs included insufficient operation (N=5) and beyond general surgical extent. (N=9). Conclusion: Re-operation due to cervical lymph node recurrence is mostly a persistent disease. They included a missed diagnosis and incomplete operation. These finding may reduce the reoperation of cervical lymph node recurrence by accurate preoperative evaluation and complete surgical resection at the initial surgery.

Evaluation of changes in random blood glucose and body mass index during and after completion of chemotherapy in children with acute lymphoblastic leukemia

  • Bang, Kyong-Won;Seo, Soo-Young;Lee, Jae-Wook;Jang, Pil-Sang;Jung, Min-Ho;Chung, Nack-Gyun;Cho, Bin;Jeong, Dae-Chul;Suh, Byung-Kyu;Kim, Hack-Ki
    • Clinical and Experimental Pediatrics
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    • v.55 no.4
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    • pp.121-127
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    • 2012
  • Purpose: Improved survival of patients with childhood acute lymphoblastic leukemia (ALL) has drawn attention to the potential for late consequences of previous treatments among survivors, including metabolic syndrome. In this study, we evaluated changes in 3 parameters, namely, random blood glucose, body mass index (BMI), and Z score for BMI (Z-BMI), in children with ALL during chemotherapy and after completion of treatment. Methods: Patients newly diagnosed with ALL from January, 2005 to December, 2008 at Saint Mary's Hospital, The Catholic University of Korea, who completed treatment with chemotherapy only were included (n=107). Random glucose, BMI, and Z-BMI were recorded at 5 intervals: at diagnosis, before maintenance treatment, at completion of maintenance treatment, and 6 and 12 months after completion of maintenance treatment. Similar analyses were conducted on 2 subcohorts based on ALL risk groups. Results: For random glucose, a paired comparison showed significantly lower levels at 12 months post-treatment compared to those at initial diagnosis ($P$ <0.001) and before maintenance ($P$ <0.001). The Z-BMI score was significantly higher before maintenance than at diagnosis ($P$ <0.001), but decreased significantly at the end of treatment ($P$ <0.001) and remained low at 6 months ($P$ <0.001) and 12 months ($P$ <0.001) post-treatment. Similar results were obtained upon analysis of risk group-based subcohorts. Conclusion: For a cohort of ALL patients treated without allogeneic transplantation or cranial irradiation, decrease in random glucose and Z-BMI after completion of chemotherapy does not indicate future glucose intolerance or obesity.

Detection of Deep Vein Thrombosis by Follow-up Indirect Computed Tomography Venography after Pulmonary Embolism

  • Lee, Hye Jin;Cha, Seung-Ick;Shin, Kyung-Min;Lim, Jae-Kwang;Yoo, Seung-Soo;Lee, Shin-Yup;Lee, Jaehee;Kim, Chang-Ho;Park, Jae-Yong
    • Tuberculosis and Respiratory Diseases
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    • v.81 no.1
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    • pp.49-58
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    • 2018
  • Background: Information regarding the incidence and risk factors for deep vein thrombosis (DVT) detected by follow-up computed tomographic (CT) venography after pulmonary embolism (PE) is sparse. The aim of the present study was to identify the predictors of DVT in follow-up CT images, and to elucidate their clinical significance. Methods: Patients with PE were classified into the following three cohorts based on the time of indirect CT venography follow-up: within 1 month, 1 to 3 months, and 3 to 9 months after the initial CT scan. Each cohort was subdivided into patients with or without DVT detected by follow-up CT. Clinical variables were compared between the two groups. Results: Follow-up CT revealed DVT in 61% of patients with PE within 1 month, in 15% of patients with PE at 1 to 3 months, and in 9% of patients with PE at 3 to 9 months after the initial CT scan. Right ventricular (RV) dilation on the initial CT (odds ratio [OR], 8.30; 95% confidence interval [CI], 1.89-36.40; p=0.005) and proximal DVT at the initial presentation (OR, 6.93; 95% CI, 1.90-25.20; p=0.003) were found to independently predict DVT in follow-up CT images within 1 month, proximal DVT at the initial presentation was found to independently predict DVT in follow-up CT images at 1 to 3 months (OR, 6.69; 95% CI, 1.53-29.23; p=0.012), and central PE was found to independently predict DVT in follow-up CT images at 3 to 9 months (OR, 4.25; 95% CI, 1.22-4.83; p=0.023) after the initial CT scan. Furthermore, the detection of DVT by follow-up CT independently predicted the recurrence of venous thromboembolism (VTE) (OR, 4.67; 95% CI, 2.24-9.74; p<0.001). Conclusion: Three months after PE, DVT was not detected by follow-up CT in most patients with PE. RV dilation on the initial CT, central PE, and proximal DVT at the initial presentation were found to predict DVT on follow-up CT, which might predict VTE recurrence.

Cut-off Values of Waist Circumference and Body Mass Index for Metabolic Syndrome according to Sasang Constitution (대사증후군에 대한 사상체질별 허리둘레 및 체질량지수의 절단값에 대한 연구)

  • Choi, Jae-Wan;Yu, Jun-Sang
    • Journal of Sasang Constitutional Medicine
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    • v.26 no.4
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    • pp.365-378
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    • 2014
  • Objectives This study was performed to investigate the cut-off values of abdominal circumference and Body Mass Index(BMI) according to Sasang Constitution. Methods A total of 1,773 persons, namely 440 male people and 1,333 female people, in ages from 40 to 69 years old, participated in this research. They are all included in the community based Genomic cohort in Wonju in years from 2006 to 2013. The diagnostic criteria of metabolic syndrome was used followed by the National Cholesterol Education Program in Adult Treatment Panel III (NCEP ATP III) and Asian pacific guideline for only abdominal obesity. Results The prevalence of metabolic syndrome was 34.8% for men and 37.6% for women in this research. Taeeumin was the highly significant risk type for the metabolic syndrome in both sexes. Cut-off values of abdominal circumference were 88.3 cm in men, 80.3 cm in women, and cut-off values of BMI were $24.2kg/m^2$ in men and $25.3kg/m^2$ in women. For men, cut-off values of abdominal circumference were 79.5cm in Soyangin, 88.8 cm in Taeeumin and 79.5 cm in Soeumin, and cut-off values of BMI were $23.2kg/m^2$ in Soyangin, $25.6kg/m^2$ in Taeeumin and $20.6kg/m^2$ in Soeumin. For women, cut-off values of abdominal circumference were 76.3 cm in Soyangin, 80.3 cm in Taeeumin and 76.8 cm in Soeumin, and cut-off values of BMI were $22.4kg/m^2$ in Soyangin, $24.9kg/m^2$ in Taeeumin and $21.3kg/m^2$ in Soeumin. Conclusions Although 90 cm in men, 80 cm in women as an Asian pacific guideline were regarded as quite approximate to the mean value of abdominal circumference and $25kg/m^2$ to BMI. But if the results could be allocated in terms of the Sasang constitutional method, the cut-off values for Soyangin and Soeumin should be lowered than now.

Trends in Obesity in a Rural Korean Adults (1990~1999) (한 농촌 지역 성인들의 10년 간 비만도 변화(1990~1999))

  • Kim, Yu-Mi;Quan, Zhen-Yu;Kim, Mi-Kyung;Choi, Bo-Youl
    • Journal of agricultural medicine and community health
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    • v.30 no.1
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    • pp.113-120
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    • 2005
  • Objectives: The worldwide epidemic of obesity is reporting but also in Korea. But there are few studies reporting with a community-based longitudinal data in Korea. This issues objects to measure the prevalence and evaluate the trends of overweight based on the repeated cross-sectional studies at a rural community adults during 10 years. Methods: With 1990~1999 Yang-Pyeong Cohort Baseline Survey Dataset, BMI is calculated and Overweight is categorized according to the classification of overweight in adult by Korean Society for the Study of Obesity. Results and Conclusions: Crude BMI means at 1990 is estimated to $22.0Kg/m^2$ and at 1999, $24.4Kg/m^2$(p for trend<0.0001). Trends of age adjusted BMI has borderline significant, but that of Age and Sex adjusted BMI is statistically significant(p for trend=0.039). In male population the change of the overweight prevalence from 1990 to 1999 is 35%, and in female population the change is 21.9%(Z=0.55). Female has more increased prevalence than male, but the change is more dominant in male than in female. At a rural community, obesity has markedly been increasing during the past decade and female in a rural community has higher prevalence of overweight.

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Effect of luteal phase support with vaginal progesterone on pregnancy outcomes in natural frozen embryo transfer cycles: A meta-analysis

  • Seol, Aeran;Shim, Yoo Jin;Kim, Sung Woo;Kim, Seul Ki;Lee, Jung Ryeol;Jee, Byung Chul;Suh, Chang Suk;Kim, Seok Hyun
    • Clinical and Experimental Reproductive Medicine
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    • v.47 no.2
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    • pp.147-152
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    • 2020
  • Objective: The purpose of this study was to determine the effect of vaginal progesterone for luteal phase support (LPS) on the clinical pregnancy rate (CPR) in natural frozen embryo transfer (FET) cycles via a meta-analysis. Methods: We performed a meta-analysis of randomized controlled trials (RCTs) and retrospective studies that met our selection criteria. Four online databases (PubMed, Embase, Medline, and the Cochrane Library) were searched between January 2017 and May 2017. Studies were selected according to predefined inclusion criteria and meta-analyzed using R software version 2.14.2. The main outcome measure was CPR. Results: A total of 18 studies were reviewed and assessed for eligibility. One RCT (n = 435) and three retrospective studies (n = 3,033) met the selection criteria. In a meta-analysis of the selected studies, we found no significant difference in the CPR (odds ratio [OR], 0.96; 95% confidence interval [CI], 0.60-1.55) between the vaginal progesterone and control groups. An analysis of the two retrospective cohort studies that reported the live birth rate (LBR) following FET showed a significantly higher LBR in the vaginal progesterone group (OR, 1.72; 95% CI, 1.21-2.46). A subgroup meta-analysis of FET conducted 5 days after injection of human chorionic gonadotropin showed no significant differences between the two groups with regard to the CPR (OR, 1.18; 95% CI, 0.90-1.55) or miscarriage rate (OR, 0.73; 95% CI, 0.36-1.47). Conclusion: The results of this meta-analysis of the currently available literature suggest that LPS with vaginal progesterone in natural FET cycles does not improve the CPR.