• Clinical and Experimental Pediatrics
• /
• v.59 no.2
• /
• pp.80-90
• /
• 2016

Purpose: Studies have been conducted to identify predictive factors of resistance to intravenous immunoglobulin (IVIG) for Kawasaki disease (KD). However, the results are conflicting. This study aimed to identify laboratory factors predictive of resistance to high-dose IVIG for KD by performing meta-analysis of available studies using statistical techniques. Methods: All relevant scientific publications from 2006 to 2014 were identified through PubMed searches. For studies in English on KD and IVIG resistance, predictive factors were included. A meta-analysis was performed that calculated the effect size of various laboratory parameters as predictive factors for IVIG-resistant KD. Results: Twelve studies comprising 2,745 patients were included. Meta-analysis demonstrated significant effect sizes for several laboratory parameters: polymorphonuclear leukocytes (PMNs) 0.698 (95% confidence interval [CI], 0.469-0.926), C-reactive protein (CRP) 0.375 (95% CI, 0.086-0.663), pro-brain natriuretic peptide (pro-BNP) 0.561 (95% CI, 0.261-0.861), total bilirubin 0.859 (95% CI, 0.582-1.136), alanine aminotransferase (AST) 0.503 (95% CI, 0.313-0.693), aspartate aminotransferase (ALT) 0.436 (95% CI, 0.275-0.597), albumin 0.427 (95% CI, -0.657 to -0.198), and sodium 0.604 (95% CI, -0.839 to -0.370). Particularly, total bilirubin, PMN, sodium, pro-BNP, and AST, in descending numerical order, demonstrated more than a medium effect size. Conclusion: Based on the results of this study, laboratory predictive factors for IVIG-resistant KD included higher total bilirubin, PMN, pro-BNP, AST, ALT, and CRP, and lower sodium and albumin. The presence of several of these predictive factors should alert clinicians to the increased likelihood that the patient may not respond adequately to initial IVIG therapy.

• Journal of Physiology & Pathology in Korean Medicine
• /
• v.23 no.4
• /
• pp.751-760
• /
• 2009

Yoon Gil-Young(1911-1987) was a frontier of the field of Traditional Korean Medical Physiology(TKMP) who was academically active since mid 1950s until early 1970s. He wrote several important papers and books. Among his writings, "A Study on the Methodology of Traditional Korean Medical Physiology", which was published serially in the "Korean Oriental Medical Journal" from June 1966 until March 1967, played an important role in establishing the contemporary TKMP and showed his academic stance on Traditional Korean Medicine(TKM). This review will evaluate this paper's contribution to the establishment of TKMP in historical context, summarize the unique characteristics of his understanding of TKMP by analyzing the text, and then based on those information, examine his view on TKMP and TKM. Historically, this paper was written in transition period from the traditional TKM knowledge system to the modernized one. Aim of this paper was to provide a methodology for establishing TKMP as a scientific knowledge system like that of the western medicine. Based on his study of Yin-Yang theory and theory of five circuits and six qi in Huangdi's Internal Classics, he suggested those theories as methods to observing life phenomena and systematizing the observations. And he regarded these methods as of great value in determining the unique characteristics of TKM compared to those of western medicine. Through re-reading this paper, it was found that he had pride and confidence in the methodology of TKM, and also that he thought in scientizing and modernizing TKM it was very important to understand and efficiently put in use the methodology of TKM. It was also found that his view on TKMP and TKM was pro modernization.

• Molecular & Cellular Toxicology
• /
• v.5 no.2
• /
• pp.160-164
• /
• 2009

Notch signaling plays a crucial role in development of the nervous system. Neurodevelopmental hypothesis on etiology of schizophrenia has been implicated. The aim of this study is to determine whether single nucleotide polymorphisms (SNPs) of Notch homolog 4 (Drosophila) (NOTCH4) gene are associated with schizophrenia. This study included 283 schizophrenia patients diagnosed according to DSM-IV and 301 normal control subjects. Control subjects without history of psychiatric disorders were recruited. Four missense SNPs [rs915894 (exon 3, Lys117Gln), rs2071282 (exon 4, Pro204Leu), rs422951 (exon 6, Thr320Ala), and rs17604492 (exon 18, Gly942Arg)] of NOTCH4 gene were genotyped by the direct sequencing method. Multiple logistic regression models (codominant, dominant, and recessive models) were employed to evaluate odds ratio, 95% confidence interval, and p value. For analysis of genetic data, SNPStats, Haploview, HapAnalyzer, SNPAnalyzer, and Helixtree programs were also used. Of 4 SNPs, rs2071282 was weekly associated with schizophrenia in two alternative models (codominant model, P=0.049; dominant, P=0.041). However, these associations were not significant after Bonferroni correction. At 4 SNPs, one linkage disequilibrium (LD) block was made. This block consisted of rs915894 and rs2071282. In haplotype analysis, AC haplotype was weakly associated with schizophrenia (dominant, P=0.04). This association was disappeared after Bonferroni correction. Our result shows possibility that some SNPs of NOTCH4 gene may be weekly associated with development of schizophrenia in Korean population. However, replication result by other population will be needed.

• Pediatric Gastroenterology, Hepatology & Nutrition
• /
• v.18 no.3
• /
• pp.168-174
• /
• 2015

Purpose: Recent studies have suggested that decreased serum potassium level may contribute to various metabolic disorders in adult patients including nonalcoholic fatty liver disease (NAFLD). We aimed to study the correlation between serum potassium levels and the histologic severity of NAFLD in children. Methods: Pediatric patients with biopsy-proven NAFLD were included in this study. Demographic, clinical, and histopathological data were obtained. Multivariable logistic regression analysis was used to assess whether potassium levels are associated with the presence of nonalcoholic steatohepatitis (NASH) or fibrosis after adjusting for possible confounders. A p-value <0.05 was considered statistically significant. Results: Among 125 biopsies, 49.6% (62) had evidence of NASH while 66.4% (83) had some degree of fibrosis (stage 1-3). Mean serum potassium was significantly lower in NASH group as compared to non-NASH group ($4.4{\pm}0.42mmoL/L$ vs. $4.8{\pm}0.21$, p<0.001). Higher potassium level had negative correlation with presence of steatosis, ballooning, lobular inflammation, fibrosis and NAFLD activity score (p<0.05). On multivariable analysis and after adjusting for the metabolic syndrome and insulin resistance, higher potassium level was significantly associated with lower likelihood of having a histological diagnosis of NASH on biopsy (odds ratio [OR], 0.12; 95% confidence interval [95% CI], 0.05-0.28; p<0.001). Similarly, the likelihood of having fibrosis decreases by 76% for every 0.5 mmoL/L increase in potassium (OR, 0.24; 95% CI, 0.11-0.54; p<0.001). Conclusion: Our study shows an inverse relationship between serum potassium levels and the presence of aggressive disease (NASH and fibrosis) in children with NAFLD.

• Journal of Preventive Medicine and Public Health
• /
• v.48 no.6
• /
• pp.287-300
• /
• 2015

Objectives: Self-rated health is a measure of perceived health widely used in epidemiological studies. Our study investigated the determinants of poor self-rated health in middle-aged Korean adults with diabetes. Methods: A cross-sectional study was conducted based on the Health Examinees Study. A total of 9759 adults aged 40 to 69 years who reported having physician-diagnosed diabetes were analyzed with regard to a range of health determinants, including sociodemographic, lifestyle, psychosocial, and physical variables, in association with self-rated health status using multivariate logistic regression models. A p-value <0.05 was considered to indicate statistical significance. Results: We found that negative psychosocial conditions, including frequent stress events and severe distress according to the psychosocial well-being index, were most strongly associated with poor self-rated health (odds ratio $[OR]_{\text{Frequent stress events}}$, 5.40; 95% confidence interval [CI], 4.63 to 6.29; $OR_{\text{Severe distress}}$, 11.08; 95% CI, 8.77 to 14.00). Moreover, younger age and being underweight or obese were shown to be associated with poor self-rated health. Physical factors relating to participants' medical history of diabetes, such as a younger age at diagnosis, a longer duration of diabetes, insulin therapy, hemoglobin A1c levels of 6.5% or more, and comorbidities, were other correlates of poor reported health. Conclusions: Our findings suggest that, in addition to medical variables, unfavorable socioeconomic factors, and adverse lifestyle behaviors, younger age, being underweight or obese, and psychosocial stress could be distinc factors in predicting negative perceived health status in Korean adults with diabetes.

• Asian Pacific Journal of Cancer Prevention
• /
• v.16 no.9
• /
• pp.3931-3936
• /
• 2015

Fatty liver disease (FLD) can be a precondition for other liver pathology including cholangiocarcinoma (CCA). Diabetes mellitus (DM) has been suggested in some studies to be a risk factor for FLD as well as cancers, including cholangiocellular carcinoma; however, there are currently very few studies on FLD in DM subjects, although the rate of FLD continues to increase annually. To determine the association between DM and FLD ultrasonographic data were analyzed from the Cholangiocarcinoma Screening and Care Program (CASCAP), in northeast Thailand. DM was reported by the subjects based on the CASCAP health questionnaire. Factors that were associated with FLD were determined by prevalence, odds ratio (ORs) and its 95% confidence intervals (CIs) using multiple logistic regression. There were 45,263 subjects with a mean age of 53.46 (${\pm}9.25$) years. FLD was found in 36.3% of DM subjects but only in 20.7% of non-DM subjects. The association between DM and FLD was adjusted for all other factors including gender, age, education level, relatives diagnosed with CCA, smoking, alcohol consumption, and hepatitis B and C. The risk of DM in subjects having FLD was highly significant compared with the non-DM subjects (OR 2.13; 95%CI: 1.92 to 2.35; p-value < 0.001). Thus DM is significantly associated with FLD which in turn may facilitate the development of several diseases including CCA. DM should be taken into consideration in future ultrasonic investigations of FLD and CCA.

• Asian Pacific Journal of Cancer Prevention
• /
• v.16 no.15
• /
• pp.6561-6568
• /
• 2015

Background: Smokeless tobacco (SLT) has long been realized as an important component of the fight for global tobacco control. It still remains a major problem in countries like India, Bangladesh and Nepal. The objective of this study was to estimate the trends of SLT use in three countries of the SEARO WHO office. Materials and Methods: We used data from national surveys in three countries (Bangladesh, India and Nepal) to estimate trends in prevalence of current SLT use. All available nationally representative data sources were used. Estimates were weighted, age standardized and given along with 95% confidence intervals. Significance of linear trend in prevalence over time was tested using the Cochrane-Armitage test for trend. A p value of less than 0.05 was considered statistically significant. Results: We identified three surveys for Bangladesh, three for India and four for Nepal that met the selection criteria (such as Demographic and Health Surveys, WHO-STEPwise approach to Surveillance and Global Adult Tobacco Surveys). A significantly increasing trend was noticed in the prevalence of current SLT use among Bangladeshi men (20.2% to 23%, p=0.03). In India, a similar significantly increasing trend was seen among men (27.1% to 33.4%, p<0.001) and women (10.1% to 15.7%, p<0.001). In Nepal, there was a no significant trend among both men (39.1% to 31.6%, p=0.11) and women (5.6% to 4.7%, p=0.49). Conclusions: In the study countries SLT use has remained at alarmingly high levels. Usage trends do not show any signs of decline in spite of control efforts. Tobacco control measures should focus more on controlling SLT use.

• Asian Pacific Journal of Cancer Prevention
• /
• v.13 no.8
• /
• pp.4001-4005
• /
• 2012

Backgrouds: The hedgehog (Hh) signaling pathway is composed of patched (PTCH) and smoothened (SMO), two transmembrane proteins, and downstream glioma-associated oncogene homolog (Gli) transcription factors. Hh signaling plays a pathological role in the occurrence and development of various cancers. Methods: To investigate the expression of SMO protein in colon cancer and its association with clinicopathological parameters and postoperative liver metastasis, immunohistochemistry was performed with paraffin-embedded specimens of 96 cases. Relationships between SMO protein expression and clinicopathological parameters, postoperative liver metastasis were analyzed. Results: IHC examination showed that SMO protein expression was significantly increased in colon cancer tissues compared to normal colon tissues (P = 0.042), positively related to lymph node metastases (P = 0.018) and higher T stages (P = 0.026). Postoperative live metastasis-free survival was significantly longer in the low SMO expression group than in those with high SMO expression ($48.7{\pm}8.02$ months vs $28.0{\pm}6.86$ months, P=0.036). Multivariate analysis showed SMO expression level to be an independent prognostic factor for postoperative live metastasis-free survival (95% confidence interval [CI] =1.46-2.82, P = 0.008). Conclusions: Our results suggest that in patients with colon cancer, the SMO expression level is an independent biomarker for postoperative liver metastasis, and SMO might play an important role in colon cancer progression.

• Asian Pacific Journal of Cancer Prevention
• /
• v.14 no.7
• /
• pp.4107-4113
• /
• 2013

Objective: Matrix metalloproteinase-9(MMP-9) plays an important role in tumor cell invasion. Although it has been studied frequently in ovarian cancer, its prognostic impact is still equivocal. The aim of this study was to more precisely estimate its prognostic significance. Method:We searched Pubmed, Embase, OVID, Sciencedirect and CBM databases to identify eligible studies. Hazard ratios (HRs) or odds ratios (ORs) with 95% confidence intervals (95% CIs) were pooled across studies using fixed-effects or random-effects models. We also performed subgroup analysis. Results: 30 studies (n=2552 patients) focusing on prognosis or expression of MM-9 were included. Increased expression of MMP-9 was associated with poor prognosis in ovarian cancer patients (HR=1.68, 95%CI 1.09-2.59, p=0.02). Besides, MMP-9 expression in ovarian cancer was significantly higher than non-malignant tumors (OR=11.46, 95%CI 8.47-15.50, P<0.00001). Moreover, increased expression of MMP-9 was significantly associated with FIGO stage (OR=4.85, 95%CI 2.60-9.04, P<0.00001), grade of differentiation (OR=3.34, 95%CI 2.46-4.54, P<0.00001), lymph node metastasis (OR=5.75, 95%CI 3.71-8.92, P<0.00001) and there was no association with histological type of ovarian cancer. Conclusions: Increased expression of MMP-9 was associated with poor prognosis in ovarian cancer patients. Down-regulation of MMP-9 is an attractive therapeutic approach which might improve outcome of ovarian cancer.

• Journal of the Society of Naval Architects of Korea
• /
• v.54 no.5
• /
• pp.387-392
• /
• 2017

There is a constant demand for hull variation related to ship design. Various input variables are generally given to achieve the objective functions assigned by each variation process. When dealing with geometric shapes accompanied by nonlinear operations during the variation process, vague relationships or uncertainties among input variables are commonly observed. Therefore, it is strongly recommended to identify those uncertainty factors in advance. A method to modify the shape of a closed hull form with a new area and a centroid had been introduced as a new process of hull variation. Since uncertainty between input variables still existed in the method, however, it was not easy for the user to enter the area and the corresponding centroid. To overcome this problem, a method is presented in this paper to provide the feasible region of centroids for a given area. By utilizing the concept and techniques used in the statistics such as the number of samples, probability, margin error, and level of confidence, this method generates the distribution of possible centroids along the regression curve. The result shows that the method helps the user to choose an appropriate input value following his or her design intention.