• Title/Summary/Keyword: Cohort effect

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Real-World Efficacy and Safety of Everolimus with Low Dose Tacrolimus in Liver Transplantation Recipients (실제 임상현장에서의 간이식 환자 대상 Everolimus와 저용량 Tacrolimus 병용요법의 유효성 및 안전성 평가)

  • Jang, Seoyoun;Kim, Boram;Jeon, Sujeong;Choi, Kyung Suk;Lee, Eunsook;Lee, Ju-Yeun;Lee, Euni;Han, Ho-Seong;Cho, Jai Young
    • Korean Journal of Clinical Pharmacy
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    • v.31 no.1
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    • pp.44-52
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    • 2021
  • Background: Post-transplant immunosuppression with calcineurin inhibitors (CNIs) is associated with kidney function impairment while mammalian target of rapamycin (mTOR) inhibitors, such as everolimus, can be used for its renal-sparing effects. In this study, we compared the efficacy and safety of everolimus with low dose tacrolimus (EVR+Low TAC) and conventional dose tacrolimus (TAC) in liver transplantation recipients. Methods: Medical records of recipients who received liver transplantation at Seoul National University Bundang Hospital from January 1st 2009 to December 31st 2018 were retrospectively reviewed. Cohort entry date was defined as the day everolimus was initiated and tacrolimus dosage was reduced. All patients were followed up for 1 year. Indicator of efficacy was the incidence of rejection and safety was evaluated by incidence of drug adverse events including renal function. Results: Among 118 patients, there were 40 patients (33.9%) in EVR+Low TAC group. Incidence of rejection, including both biopsy proven acute rejection and clinical rejection, was similar in two groups [7.5% (n=3) vs. 6.4% (n=5), p=1.000]. Renal dysfunction was less frequent in EVR+Low TAC [17.5% (n=7) vs. 35.9% (n=28), p=0.038]. However, incidence rates of dyslipidemia, oral ulcer were more frequent in EVR+Low TAC [45.0% (n=18) vs. 21.8% (n=17), p=0.009; 15.0% (n=6) vs. 1.3% (n=1), p=0.006]. Conclusions: In terms of prevention of rejection, EVR+Low TAC was as effective as TAC and had renal-sparing effect but was associated with increased risk of dyslipidemia and oral ulcer. This study demonstrates that EVR+Low TAC could be an alternative to liver transplant recipients with nephrotoxicity after administration of conventional dose tacrolimus.

The Moderating Effect of Gender in the Relationship between Physical Education and Adolescents' Internalizing and Externalizing Problem Behaviors: Using Multi-level Growth Modeling (체육시간과 청소년의 외현화·내재화 문제와의 관계에서 성별의 조절효과: 다층성장모형의 적용)

  • Taekho Lee;Seokyoung Lee;Yoonsun Han
    • Korean Journal of Culture and Social Issue
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    • v.21 no.2
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    • pp.131-158
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    • 2015
  • This study examined the relationship between physical education and externalizing(aggression) and internalizing(depression, social withdrawal) problem behaviors among adolescents. The moderating role of gender and time in the association between physical education and problem behavior was also identified. This study used data from the second, third, and fourth waves of the middle school student cohort (N=2,133, N=2,151, N=1,979) of the Korean Children-Youth Panel Survey(KCYPS). Main analyses involved multilevel growth model with interaction terms. The dependent variables were aggression, depression, and social withdrawal. The independent variables were gender and physical education (exercise hours) at school. The control variables were abuse, school-adjustment, annual household income and parents' highest level of education. The major longitudinal findings of this study are as follows: First, there was significant change according to the passage of time only in aggression among externalizing and internalizing problems. Second, gender differences exist in aggression and depression. Third, exercise hours of physical education had a negative relationship with internalizing problems. Fourth, there were no gender differences over time in both externalizing and internalizing problems. Fifth, the interaction between exercise hours of physical education and time was statistically significant for social withdrawal. Sixth, the interaction between exercise hours of physical education and gender was statistically significant for depression. The results of this study may become an academic basis for suggesting policy directions that promote increased exercise hours in physical education classes at school.

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CT-Based Leiden Score Outperforms Confirm Score in Predicting Major Adverse Cardiovascular Events for Diabetic Patients with Suspected Coronary Artery Disease

  • Zinuan Liu;Yipu Ding;Guanhua Dou;Xi Wang;Dongkai Shan;Bai He;Jing Jing;Yundai Chen;Junjie Yang
    • Korean Journal of Radiology
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    • v.23 no.10
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    • pp.939-948
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    • 2022
  • Objective: Evidence supports the efficacy of coronary computed tomography angiography (CCTA)-based risk scores in cardiovascular risk stratification of patients with suspected coronary artery disease (CAD). We aimed to compare two CCTA-based risk score algorithms, Leiden and Confirm scores, in patients with diabetes mellitus (DM) and suspected CAD. Materials and Methods: This single-center prospective cohort study consecutively included 1241 DM patients (54.1% male, 60.2 ± 10.4 years) referred for CCTA for suspected CAD in 2015-2017. Leiden and Confirm scores were calculated and stratified as < 5 (reference), 5-20, and > 20 for Leiden and < 14.3 (reference), 14.3-19.5, and > 19.5 for Confirm. Major adverse cardiovascular events (MACE) were defined as the composite outcomes of cardiovascular death, nonfatal myocardial infarction (MI), stroke, and unstable angina requiring hospitalization. The Cox model and Kaplan-Meier method were used to evaluate the effect size of the risk scores on MACE. The area under the curve (AUC) at the median follow-up time was also compared between score algorithms. Results: During a median follow-up of 31 months (interquartile range, 27.6-37.3 months), 131 of MACE were recorded, including 17 cardiovascular deaths, 28 nonfatal MIs, 64 unstable anginas requiring hospitalization, and 22 strokes. An incremental incidence of MACE was observed in both Leiden and Confirm scores, with an increase in the scores (log-rank p < 0.001). In the multivariable analysis, compared with Leiden score < 5, the hazard ratios for Leiden scores of 5-20 and > 20 were 2.37 (95% confidence interval [CI]: 1.53-3.69; p < 0.001) and 4.39 (95% CI: 2.40-8.01; p < 0.001), respectively, while the Confirm score did not demonstrate a statistically significant association with the risk of MACE. The Leiden score showed a greater AUC of 0.840 compared to 0.777 for the Confirm score (p < 0.001). Conclusion: CCTA-based risk score algorithms could be used as reliable cardiovascular risk predictors in patients with DM and suspected CAD, among which the Leiden score outperformed the Confirm score in predicting MACE.

Cone-beam computed tomographic evaluation of mandibular incisor alveolar bone changes for the intrusion arch technique: A retrospective cohort research

  • Lin Lu;Jiaping Si;Zhikang Wang;Xiaoyan Chen
    • The korean journal of orthodontics
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    • v.54 no.2
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    • pp.79-88
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    • 2024
  • Objective: Alveolar bone loss is a common adverse effect of intrusion treatment. Mandibular incisors are prone to dehiscence and fenestrations as they suffer from thinner alveolar bone thickness. Methods: Thirty skeletal class II patients treated with mandibular intrusion arch therapy were included in this study. Lateral cephalograms and cone-beam computed tomography images were taken before treatment (T1) and immediately after intrusion arch removal (T2) to evaluate the tooth displacement and the alveolar bone changes. Pearson's and Spearman's correlation was used to identify risk factors of alveolar bone loss during the intrusion treatment. Results: Deep overbite was successfully corrected (P < 0.05), accompanied by mandibular incisor proclination (P < 0.05). There were no statistically significant change in the true incisor intrusion (P > 0.05). The labial and lingual vertical alveolar bone levels showed a significant decrease (P < 0.05). The alveolar bone is thinning in the labial crestal area and lingual apical area (P < 0.05); accompanied by thickening in the labial apical area (P < 0.05). Proclined incisors, non-extraction treatment, and increased A point-nasion-B point (ANB) degree were positively correlated with alveolar bone loss. Conclusions: While the mandibular intrusion arch effectively corrected the deep overbite, it did cause some unwanted incisor labial tipping/flaring. During the intrusion treatment, the alveolar bone underwent corresponding changes, which was thinning in the labial crestal area and thickening in the labial apical area vice versa. And increased axis change of incisors, non-extraction treatment, and increased ANB were identified as risk factors for alveolar bone loss in patients with mandibular intrusion therapy.

Effects of the interaction between seaweed consumption and the polygenic risk score on inflammation in Korean adults (한국 성인의 해조류 섭취와 다유전자 위험 점수 간의 상호작용이 염증에 미치는 영향)

  • Gayeon Hong;Dayeon Shin
    • Journal of Nutrition and Health
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    • v.57 no.2
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    • pp.211-227
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    • 2024
  • Introduction: Seaweed is a sustainable and underexplored source of bioactive compounds with potent anti-inflammatory activities. However, studies on the interaction between seaweed and genes on inflammation are limited. Purpose: We aimed to evaluate the relationships between seaweed consumption and the polygenic risk scores (PRS) and their interactions with high-sensitivity C-reactive protein (hs-CRP) levels. Methods: Information on seaweed consumption was collected using a food frequency questionnaire, which included laver, kelp, and sea mustard among the items consumed. A total of 31 hs-CRP-related single nucleotide polymorphisms (SNPs) were selected using genome-wide association studies and clumping analysis, and the individual PRS were calculated by weighting the effect size of each allele in the selected SNPs of 39,369 middle-aged (≥40 years) Koreans using the Korean Genome and Epidemiology Study (KoGES)-Health Examinees (HEXA) cohort data. To investigate the interaction between seaweed intake and the PRS on hs-CRP levels >1 mg/L, hazard ratios (HRs) and 95% confidence intervals (CIs) were assessed using multivariable Cox proportional hazards models. Results: During a mean follow-up period of 4.8 years, we recorded 436 patients with elevated hs-CRP levels. Women in the highest tertile of the PRS with the lowest quartile of seaweed intake had an increased incidence of elevated hs-CRP levels compared with women in the lowest tertile of the PRS with the lowest seaweed intake quartile (HR 2.34, 95% CI 1.23-4.45). No significant association was observed among the men. Conclusion: In conclusion, we identified a new interaction between the PRS, seaweed intake, and inflammation in Korean women, and this study suggests that the interaction between the identification of genetic predisposition and dietary seaweed intake may have an impact on determining the risk of developing hyperinflammation in the future.

Effects of Sodium/Glucose Cotransporter 2 (SGLT2) Inhibitors on Cardiac Imaging Parameters: A Systematic Review and Meta-analysis of Randomized Controlled Trials

  • Caitlin Fern Wee;Yao Hao Teo;Yao Neng Teo;Nicholas LX Syn;Ray Meng See;Shariel Leong;Alicia Swee Yan Yip;Zhi Xian Ong;Chi-Hang Lee;Mark Yan-Yee Chan;Kian-Keong Poh;Ching-Ching Ong;Lynette LS Teo;Devinder Singh;Benjamin YQ Tan;Leonard LL Yeo;William KF Kong;Tiong-Cheng Yeo;Raymond CC Wong;Ping Chai;Ching-Hui Sia
    • Journal of Cardiovascular Imaging
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    • v.30 no.3
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    • pp.153-168
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    • 2022
  • Recent studies have shown that sodium/glucose cotransporter 2 (SGLT2) inhibitors might exert favourable changes on cardiac parameters as observed on cardiovascular imaging. We conducted a systematic review and meta-analysis to determine the effects of SGLT2 inhibitors on cardiac imaging parameters. Four electronic databases (PubMed, Embase, Cochrane, Scopus) were searched for studies in which the effects of SGLT2 inhibitors on cardiac imaging parameters were examined. Studies in which a population was administered SGLT2 inhibitors and analysed by echocardiography and/or cardiac magnetic resonance (CMR) imaging were included. Random-effects pair-wise meta-analysis models were utilized to summarize the studies. A total of 11 randomized controlled trials was included with a combined cohort of 910 patients. Comparing patients receiving SGLT2 inhibitors with subjects receiving placebo, the mean change in CMR-measured left ventricular mass (LVM) was -3.87 g (95% confidence interval [CI], -7.77 to 0.04), that in left ventricular end-systolic volume (LVESV) was -5.96 mL (95% CI, -10.52 to -1.41) for combined LVESV outcomes, that in left atrial volume index (LAVi) was -1.78 mL/m2 (95% CI, -3.01 to -0.55) for combined LAVi outcomes, and that in echocardiography-measured E/e' was -0.73 (95% CI, -1.43 to -0.03). Between-group differences were not observed in LVM and LVESV after indexation. The only between-group difference that persisted was for LAVi. Treatment with SGLT2 inhibitors resulted in reduction in LAVi and E/e' on imaging, indicating they might have an effect on outcomes associated with LV diastolic function.

Changing Gadolinium-Based Contrast Agents to Prevent Recurrent Acute Adverse Drug Reactions: 6-Year Cohort Study Using Propensity Score Matching

  • Min Woo Han;Chong Hyun Suh;Pyeong Hwa Kim;Seonok Kim;Ah Young Kim;Kyung-Hyun Do;Jeong Hyun Lee;Dong-Il Gwon;Ah Young Jung;Choong Wook Lee
    • Korean Journal of Radiology
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    • v.25 no.9
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    • pp.824-832
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    • 2024
  • Objective: To determine the preventive effect of changing gadolinium-based contrast agents (GBCAs) to reduce the recurrence of GBCA-associated acute adverse drug reactions (ADRs). Materials and Methods: This retrospective, observational, single-center study-conducted between January 2016 and December 2021-included 238743 consecutive GBCA-enhanced MRI examinations. We focused on a subgroup of patients who experienced acute GBCA-associated ADRs during any of these examinations and subsequently underwent follow-up GBCA-enhanced MRI examinations up until July 2023. The follow-up examinations involved either the same (non-change group) or different (change group) GBCAs compared to the ones that initially caused the acute ADR. Baseline participant characteristics, generic profile of the GBCAs, administration of premedication, history of prior ADR to iodinated contrast media, and symptoms of GBCA-associated acute ADRs were retrospectively analyzed. Multivariable logistic regression with generalized estimating equations and propensity score matching were used. Results: A total of 1042 instances of acute ADRs (0.44%; 95% confidence interval [CI]: 0.41%-0.46%) were reported. Three-hundred and seventy-three patients underwent GBCA-enhanced MRI examinations after experiencing GBCA-associated acute ADRs within the study period; 31.9% (119/373) reexperienced acute ADRs at any of the follow-up examinations. The ADR recurrence was significantly lower in the GBCA change group than in the non-change group according to multivariable logistic regression (adjusted odds ratio [OR]: 0.35; 95% CI: 0.13-0.90; P = 0.03) and analysis with propensity score matching (14.3% [6/42] vs. 36.9% [31/84], respectively; OR: 0.32, 95% CI: 0.11-0.94; P = 0.04). A history of an ADR to iodinated contrast media (OR: 1.14, 95% CI: 0.68-1.90; P = 0.62) and premedication (adjusted OR: 2.09, 95% CI: 0.93-4.68; P = 0.07) were not significantly associated with GBCA-associated acute ADR recurrence. A separate analysis for recurrent allergic-like hypersensitivity reactions demonstrated similar results (adjusted OR: 0.20, 95% CI: 0.06-0.65; P < 0.01). Conclusion: Changing GBCAs may reduce the risk of GBCA-associated acute ADR recurrence.

The Effect of Coffee Consumption on Serum Total Cholesterol Level in Healthy Middle-Aged Men (건강한 중년 남성에서 커피 음용 습관이 혈중 총 콜레스테롤 값에 미치는 영향)

  • Shin, Myung-Hee;Kim, Dong-Hyun;Bae, Jong-Myun;Lee, Hyung-Ki;Lee, Moo-Song;Noh, Joon-Yang;Ahn, Yoon-Ok
    • Journal of Preventive Medicine and Public Health
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    • v.27 no.2 s.46
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    • pp.200-216
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    • 1994
  • In present study, the authors investigated the possible effect of coffee consumption on serum cholesterol level in 1017 men between the ages of 40 and 59 years, who were randomly selected from the members of Seoul Cohort Study. Serum total cholesterol data was collected with other serologic indices (e.g. systolic blood pressure, diastolic blood pressure, hight, weight, etc.) through the program of biennial health check-up offered by Korean Medical Insurance Corporation (KMIC). The amount of coffee consumption was assessed by a self-administered questionnaire through mailing. Other confounding factors, such as age, body mass index, cigarette smoking, alcohol consumption, physical activity, and other dietary intake pattern were also determined by the questionnaire. The differences in means of serum total cholesterol in compared to non consumers were $-0.4{\pm}3.56mg/dl$ for those drinking less than 1 cup a day, $-0.6{\pm}3.60mg/dl$ for those drinking 1 cup a day, and $7.1{\pm}3.41mg/dl$ for those drinking more than 2 cups a day. Since smoking interacted the relationship between coffee consumption and serum total choleaterol, we re-analyzed those relationship in smokers and non-smokers separately Other atherogenic behaviors were well correlated with total cholesterol, so we adjusted the mean values of serum total cholesterol through multivariate model selection with age(r=0.12), total cigarette index (cigarette-years; r=0.10), Quetelet's index ($Kg/m^2$, r=0.16), daily calory expenditure (kcal/day, r=0.06), weekly meat and poultry consumption(g/week, r=0.05), weekly fish consumption (g/week, r=0.08), other caffeinated beverage intake (cups/week), and the amount of sugar and prim added to the coffee. Among those variables only age, Quetelet's index, fish consumption, and total cigarette index (in smokers) were remained in the models. After adjustment, the corresponing differences of total cholesterol in smokers were changed to $0.4{\pm}5.24mg/dl,\;-0.5{\pm}4.97mg/dl,\;and\;8.9{\pm}4.78mg/dl$, which were significantly different among themselves (P=0.011). In non-smokers, however, the differences were not statistically significant (P=0.76). Adjusted mean values of systolic blood pressure and diastolic blood pressure were also determined to evaluate the direct effect of coffee to cardiovascular system, but their means were not significantly different by coffee consumption(p=0.18 for SBP, p=0.48 for DBP). Asuming instant coffee in the most popular type of coffee in Korea, the association observed in our study between coffee and serum total cholesterol, especially in smokers, is very interesting finding for the connection between coffee and serum total cholesterol, because only 'boiled coffee' tend to show significant lipid raising effect rather than to other types of coffee, like filtered or espresso, in most of the western countries. We concluded that people who drink coffee more than 2 cups a day have significantly higher serum total cholesterol level than those who never drink coffee, especially in smokers.

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Preventive Effect of Milk Products against Diabetes Mellitus Type 2: A Review (유제품의 제2형 당뇨병 예방 효과: 총설)

  • Kim, Dong-Hyeon;Chon, Jung-Whan;Kim, Hyun-Sook;Kim, Hong-Seok;Song, Kwang-Young;Kim, Young-Ji;Kang, Il-Byung;Lee, Soo-Kyung;Jeong, Dong-Gwan;Kim, Soo-Ki;Seo, Kun-Ho
    • Journal of Dairy Science and Biotechnology
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    • v.33 no.2
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    • pp.129-137
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    • 2015
  • Diabetes mellitus type 2 is a metabolic disorder that is characterized by hyperglycemia (high blood sugar level) in the context of insulin resistance and relative lack of insulin. Recently, much scientific evidence has shown that the risk of diabetes mellitus type 2 could be reduced by dairy intake. A significantly strong relationship has been noted between this disease and dairy intake. In particular, from the different types of fat in dairy foods that were reported to have a beneficial impact, low-fat dairy foods have been found to have the best effect with respect to reducing the risk of diabetes mellitus type 2. Therefore, the role of specific components of dairy foods, such as calcium, vitamin D, dairy fat, and trans-palmitoleic acid, which could be responsible for this effect and for the positive effect of dairy foods in obesity and metabolic syndrome, needs to be identified. There is a strong and relatively consistent body of accumulating evidence indicating that dairy foods may significantly reduce the risk of diabetes mellitus type 2, likely in a dose-response manner. Dairy recommendations should be an essential part of public health guidance, and identifying strategies to increase dairy food consumption to optimal levels is of utmost importance. Hence, this review summarizes various positive effects of dairy foods with respect to reducing the risk of diabetes mellitus type 2, based on available evidence, and discusses the need for further research on preventing or decreasing the risk of diabetes mellitus type 2.

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Modeling Brand Equity for Lifestyle Brand Extensions: A Strategic Approach into Generation Y vs. Baby Boomer (생활방식품패확장적품패자산건모(生活方式品牌扩张的品牌资产建模): 침대Y세대화영인조소비자적전략로경(针对Y世代和婴儿潮消费者的战略路径))

  • Kim, Eun-Young;Brandon, Lynn
    • Journal of Global Scholars of Marketing Science
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    • v.20 no.1
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    • pp.35-48
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    • 2010
  • Today, the fashion market challenged by a maturing retail market needs a new paradigm in the "evolution of brand" to improve their comparative advantages. An important issue in fashion marketing is lifestyle brand extension with a specific aim to meet consumers' specific needs for their changing lifestyle. For fashion brand extensions into lifestyle product categories, Gen Y and Baby Boomer are emerging as "prospects"-Baby Boomers who are renovating their lifestyle, and generation Y experiencing changes in their life stage-with demands for buying new products. Therefore, it is imperative that apparel companies pay special attention to the consumer cohort for brand extension to create and manage their brand equity in a new product category. The purposes of this study are to (a) evaluate brand equity between parent and extension brands; (b) identify consumers' perceived marketing elements for brand extension; and (c) estimate a structural equation model for examining causative relationship between marketing elements and brand equity for brand extensions in lifestyle product category including home fashion items for the selected two groups (e.g., Gen Y, and Baby boomer). For theoretical frameworks, this study focused on the traditional marketing 4P's mix to identify what marketing element is more importantly related to brand extension equity for this study. It is assumed that comparable marketing capability can be critical to establish "brand extension equity", leads to successfully entering the new categories. Drawing from the relevant literature, this study developed research hypotheses incorporating brand equity factors and marketing elements by focusing on the selected consumers (e.g., Gen Y, Baby Boomer). In the context of brand extension in the lifestyle products, constructs of brand equity consist of brand awareness/association, brand perceptions (e.g., perceived quality, emotional value) and brand resonance adapted from CBBE factors (Keller, 2001). It is postulated that the marketing elements create brand extension equity in terms of brand awareness/association, brand perceptions by the brand extension into lifestyle products, which in turn influence brand resonance. For data collection, the sample was comprised of Korean female consumers in Gen Y and Baby Boomer consumer categories who have a high demand for lifestyle products due to changing their lifecycles. A total of 651 usable questionnaires were obtained from female consumers of Gen Y (n=326) and Baby Boomer (n=325) in South Korea. Structural and measurement models using a correlation matrix was estimated using LISREL 8.8. Findings indicated that perceived marketing elements for brand extension consisted of three factors: price/store image, product, and advertising. In the model of Gen Y consumers, price/store image had a positive effect on brand equity factors (e.g., brand awareness/association, perceived quality), while product had positive effect on emotional value in the brand extensions; and the brand awareness/association was likely to increase the perceived quality and emotional value, leading to brand resonance for brand extensions in the lifestyle products. In the model of Baby Boomer consumers, price/store image had a positive effect on perceived quality, which created brand resonance of brand extension; and product had a positive effect on perceived quality and emotional value, which leads to brand resonance for brand extension in the lifestyle products. However, advertising was negatively related to brand equity for both groups. This study provides an insight for fashion marketers in developing a successful brand extension strategy, leading to a sustainable competitive advantage. This study complements and extends prior works in the brand extension through critical factors of marketing efforts that affect brand extension success. Findings support a synergy effect on leveraging of fashion brand extensions (Aaker and Keller, 1990; Tauber, 1988; Shine et al., 2007; Pitta and Katsanis, 1995) in conjunction with marketing actions for entering into the new product category. Thus, it is recommended that marketers targeting both Gen Y and Baby Boomer can reduce marketing cost for entering the new product category (e.g., home furnishings) by standardized marketing efforts; fashion marketers can (a) offer extension lines with premium ranges of price; (b) place an emphasis on upscale features of store image positioning by a retail channel (e.g., specialty department store) in Korea, and (c) combine apparel with lifestyle product assortments including innovative style and designer’s limited editions. With respect to brand equity, a key to successful brand extension is consumers’ brand awareness or association that ensures brand identity with new product category. It is imperative for marketers to have knowledge of what contributes to more concrete associations in a market entry into new product categories. For fashion brands, a second key of brand extension can be a "luxury" lifestyle approach into new product categories, in that higher price or store image had impact on perceived quality that established brand resonance. More importantly, this study increases the theoretical understanding of brand extension and suggests directions for marketers as they establish marketing program at Gen Y and Baby Boomers.