• Journal of Nutrition and Health
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• 제56권5호
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• pp.523-536
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• 2023

Purpose: This study investigated the association between sleep problems and food allergies (FAs) in Chinese preschoolers and assessed whether there is a difference in this association among children with/without siblings. Methods: A cluster-stratified sampling approach was employed to select four districts in Chongqing based on demographic considerations. A total of 16 kindergartens (n = 966 parents) participated in this study. Parents completed the Children's Sleep Habits Questionnaire (CSHQ) and a standard FAs questionnaire. Analysis of covariance and multiple logistic regression were used to assess the associations between sleep problems and FAs after adjusting for relevant confounders. Results: The study found that 16.3% of children had FAs, with eggs, shellfish, and fruit being the most common allergenic foods. The prevalence of FAs was significantly higher in single children (20.63%) than in children with siblings (13.36%). A total of 70.39% of children had CSHQ scores above the clinical cut-off for sleep disorder. Factor analysis revealed five underlying dimensions from the CSHQ. Factor scores, except for the 'difficulty morning waking' factor, were not significantly different between the two groups. Remarkably, the factor scores of 'parasomnias' and 'sleep anxiety' were significantly higher when children had both siblings and FAs. For all subjects, the odds ratios (ORs) of FAs significantly increased with the presence of sleep disorder (OR, 2.35; 95% confidence interval [CI],1.50-3.68) and 'difficulty falling asleep' (OR, 1.34; 95% CI, 1.22-1.48). The subgroup analysis showed that the probability of FAs significantly increased with the 'difficulty falling asleep' (OR, 1.32 vs. 1.38) and sleep disorder (OR, 2.48 vs. 2.14) in children with and without siblings, respectively. The 'parasomnias' was positively associated only with children with siblings. Conclusion: This study suggests that children with siblings might be more susceptible to FAs when accompanied by certain sleep problems. Further studies are warranted to address the underlying dimensions and possible mediation effects of having siblings with sleep problems.

• Journal of Cardiovascular Imaging
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• 제31권4호
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• pp.169-177
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• 2023

BACKGROUND: Acute worsening of cardiac function frequently leads to kidney dysfunction. This study aimed to identify clinical and imaging parameters associated with impaired kidney function in patients with acute decompensated heart failure with reduced ejection fraction (HFrEF). METHODS: Data from 131 patients hospitalized with acute decompensated HFrEF (left ventricular ejection fraction, < 40%) were analyzed. Patients were divided into two groups according to the glomerular filtration rate (GFR) at admission (those with preserved kidney function [GFR ≥ 60 mL/min/1.73 m²] and those with reduced kidney function [GFR < 60 mL/min/1.73 m²]). Various echocardiographic parameters and perirenal fat thicknesses were assessed by computed tomography. RESULTS: There were 71 patients with preserved kidney function and 60 patients with reduced kidney function. Increased age (odds ratio [OR], 1.07; 95% confidence interval [CI], 1.04-1.12; p = 0.005), increased log N-terminal pro b-type natriuretic peptide (OR, 1.74; 95% CI, 1.14-2.66; p = 0.010), and increased perirenal fat thickness (OR, 1.19; 95% CI, 1.10-1.29; p < 0.001) were independently associated with reduced kidney function, even after adjusting for variable clinical and echocardiographic parameters. The optimal average perirenal fat thickness cut-off value of > 12 mm had a sensitivity of 55% and specificity of 83% for kidney dysfunction prediction. CONCLUSIONS: Thick perirenal fat was independently associated with impaired kidney function in patients hospitalized for acute decompensated HFrEF. Measurement of perirenal fat thickness may be a promising imaging marker for the detection of HFrEF patients who are more susceptible to kidney dysfunction.

• Radiation Oncology Journal
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• 제14권2호
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• pp.137-147
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• 1996

목적 : 소아 급성임파모구성 백혈병 환자에 있어 예방적 전뇌방사선조사 및 척수강내화학 요법후 중추신경계 재발율, 재발양상, 중추신경계 무병생존율, 전체무병생존율및 이에 영향을 미치는 예후인자들을 알아보고자 하였다. 대상 및 방법 : 1987년 7원부터 1992년 6월까지 예방적 전뇌 방사선조사를 받은 급성 임파구성 백혈병 환아 90예를 대상으로 후향적 분석을 시행하였다. 3명을 제외한 모든 환자들이 일일 180 cGy 씩 퐁 1800 cGy의 전뇌방사선치료를 받았고, 방사선 치료중 척수강내 화학요법이 병행되었다. 결과 : 추적관착기간 36-96 개원 (중앙값 60 개원)동안 90명의 환아중 9례에서 중추신경계 재발을 보였으나, 골수재발이 선행되었던 3례를 제외하면 중추신경계 재발율은 $6.7\%$로 나타났다. 중추신경계 재발환자의 $89\%$에서 골수재발이 동반되었으며, $11\%$에서 고환재발이 동반되었다. 골수완전관해로부터 중추신경계 재발까지의 경과기간은 16개월 (중앙값) 이었고, $78\%$의 중추신경계 재발이 관해유지요법중에 발생하였다. 2년 및 5년 중추신경계 무병생존율은 각각 $68\%$, $42\%$였고, 중앙값은 43 개월이었다. 중추신경계 무병생존율에 영향을 미치는 예후인자는 진단당시의 백혈구수 (5만 기준), FAB 분류군, CALGB 위험분류기준으로 나타났다. 2년 및 5년 전체무병생존율은 각각 $61\%$, $39\%$였고 중앙값은 34 개월이었다. 전체무병생존율에 영향을 미치는 예후인자는 진단당시의 백혈구수 (5만 기준), FAB 분류군, CALGB 및 POG 위험분류군으로 나타났다. 결론 : 본 연구에서 중추신경계 재발율은 $6.7\%$, 로 다른 연구들에서 보고하는 범위에 속하여 효과적인 중추신경계 예방요법으로 판단 되었다. 진단당시의 나이및 백혈구수를 기준으로한 위험분류기준 중 POG 및 CALGB 위험분류기준이 중추신경계 무병생존율 및 전체무병생존율에 유의한 예후인자로 나타났다. 부작용을 최소화하면서도 효과적인 중추신경계예방요법을 알아내기 위해서는 각 위험분류군에 따른 중추신경계 예방요법의 차별화에 대한 전향적인 연구및장기 생존자들에 대한 체계적인 신경 심리학적 추적 조사가 필요할 것으로 사료된다.

• Tuberculosis and Respiratory Diseases
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• 제76권5호
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• pp.218-225
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• 2014

Background: Small cell lung cancer (SCLC) is an extremely aggressive tumor with a poor clinical course. Although many efforts have been made to improve patients' survival rates, patients who survive longer than 2 years after chemotherapy are still very rare. We examined the baseline characteristics of patients with long-term survival rates in order to identify the prognostic factors for overall survivals. Methods: A total of 242 patients with cytologically or histologically diagnosed SCLC were enrolled into this study. The patients were categorized into long- and short-term survival groups by using a survival cut-off of 2 years after diagnosis. Cox's analyses were performed to identify the independent factors. Results: The mean patient age was 65.66 years, and 85.5% were males; among the patients, 61 of them (25.2%) survived longer than 2 years. In the multivariate analyses, CRP (hazard ratio [HR], 2.75; 95% confidence interval [CI], 1.25-6.06; p=0.012), TNM staging (HR, 3.29; 95% CI, 1.59-6.80; p=0.001), and progression-free survival (PFS) (HR, 11.14; 95% CI, 2.98-41.73; p<0.001) were independent prognostic markers for poor survival rates. Conclusion: In addition to other well-known prognostic factors, this study discovered relationships between the long-term survival rates and serum CRP levels, TNM staging, and PFS. In situations with unfavorable conditions, the PFS would be particularly helpful for managing SCLC patients.

• Journal of Yeungnam Medical Science
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• 제33권1호
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• pp.8-12
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• 2016

Background: The decision to administer oral anticoagulation therapy depends on accurate assessment of stroke risk in patients with atrial fibrillation (AF). Various stroke risk stratification schemes have been developed to help inform clinical decision making. The CHADS2 and CHA2DS2-VASc scores have been used in estimating the risk of stroke in patients with AF. Recently R2CHA2DS2-VASc score was developed. The objective of the current study is to validate the usefulness of the R2CHA2DS2-VASc score and to compare the accuracy of the CHADS2, CHA2DS2-VASc, and R2CHA2DS2-VASc scores in predicting a patient's risk of stroke. Methods: Based on medical records, we conducted a retrospective study of patients hospitalized with AF from March 2011 to July 2013. A total of 448 AF patients were included in this study. The receiver operating characteristic (ROC) curve analysis in MedCalc was used for comparison with respective diagnostic values. Results: The patient characteristics showed male predominance (60.9%). Among the 448 AF patients, 131 (29.2%) patients had strokes during the study. A R2CHA2DS2-VASc score of more than 5 is the optimal cut-off value for prediction of stroke. A risk score of three, the area under the ROC curve (AUC) of R2CHA2DS2-VASc score (AUC 0.631; 95% confidence interval, 0.585-0.679) was the highest. A significant difference was observed between AUC for R2CHA2DS2-VASc, CHADS2, and CHA2DS2-VASc scores, but no meaningful difference between CHADS2 and CHA2DS2-VASc scores. Conclusion: We determined the usefulness of the R2CHA2DS2-VASc score, which showed better association with stroke than the CHADS2 and CHA2DS2-VASc scores.

• Tuberculosis and Respiratory Diseases
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• 제75권6호
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• pp.244-249
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• 2013

Background: Conventional biomarkers cannot always establish the cause of pleural effusions; thus, alternative tests permitting rapid and accurate diagnosis are required. The primary aim of this study is to assess the ability of pentraxin-3 (PTX3) in order to diagnose the cause of pleural effusion and compare its efficacy to that of other previously identified biomarkers. Methods: We studied 118 patients with pleural effusion, classified as transudates and exudates including malignant, tuberculous, and parapneumonic effusions (MPE, TPE, and PPE). The levels of PTX3, C-reactive protein (CRP), procalcitonin (PCT) and lactate in the pleural fluid were assessed. Results: The levels of pleural fluid PTX3 were significantly higher in patients with PPE than in those with MPE or TPE. PTX3 yielded the most favorable discriminating ability to predict PPE from MPE or TPE by providing the following: area under the curve, 0.74 (95% confidence interval, 0.63-0.84), sensitivity, 62.07%; and specificity, 81.08% with a cut-off point of 25.00 ng/mL. Conclusion: Our data suggests that PTX3 may allow improved differentiation of PPE from MPE or TPE compared to the previously identified biomarkers CRP and PCT.

• 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.

• 대한한방내과학회지
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• 제29권3호
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• pp.730-741
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• 2008

Objective : To examine the efficacy of CY, the improvement of atopy dermatitis(AD)-like lesions on the rostral back of the NC/Nga mice, which took CY orally and were treated with a chemical substance called DNFB, the inhibition of ear swelling, and the inhibition of inflammatory response of the ear tissue of the mice were observed and compared, and the inhibition of the serum IgE count and the IL-4 and IFN-${\gamma}$ count produced by CD4+ T cells of the lymph node were observed and compared. Materials and Methods : For measurement of ear thicknesses, 0.15% DNFB $25{\mu}l$ mixed with acetone/olive oil(3:1) was applied to the right ear and dorsal skin of the NC/Nga mice 5 times at an interval of 7 days. Ear thickness was measured every day over a five-week period after the first application of DNFB. The total serum IgE count was measured with ELISA by taking blood samples 24 hours after the fifth application of DNFB. To measure the IL-4 and IFN-${\gamma}$ count, the lymph node was cut off, and the CD4+ T cells were purified and stimulated to activate the T cells, and then the IL-4 and IFN-${\gamma}$ count was measured with ELISA. Results : Continuous oral administration of CY improved the AD-like skin lesions on the rostral back and inhibited the ear swelling in NC/Nga mice treated with DNFB and inhibited the inflammatory response in the NC/Nga mice treated with DNFB NC/Nga mice. Continuous oral administration of CY did not significantly inhibit the serum IgE count and failed to significantly reduce the IL-4 count generated after TCR stimulation in the CD4+ T cells of the NC/Nga mice treated with DNFB. Continuous oral administration of CY significantly reduced the IFN-${\gamma}$ count generated after TCR stimulation in the CD4+ T cells of the NC/Nga mice treated with DNFB.

• 한국산림과학회지
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• 제96권6호
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• pp.652-660
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• 2007

1989년부터 2005년까지 시공된 전라북도 내의 민유임도 216개 노선의 설계도서를 대상으로 임도 설계상의 주요 공종변화를 분석하였다. 전라북도의 연평균 민유임도 시설거리는 녹색임도 정책 시행 이전단계에 비해 녹색임도 정책 시행 이후 대폭 감소하였다. 토사절취작업은 1990년부터 블도저에서 블도저와 굴삭기 혼용으로 바뀌었다. 비탈면 녹화공은 초기에는 잔디심기와 족제비싸리심기가 주종을 이루었는데, 녹색임도정책 시행단계(2단계)부터 종자뿜어붙이기와 줄파종의 혼용, Coir net 또는 볏짚거적 덮기 등으로 발전하였다. 횡단배수관의 경우, 배수관의 설치 간격은 3단계에 평균 92 m로 감소하였고, 규격은 2단계 이후에 대부분 600 mm 이상으로 확대되었으며, 재료는 모두 파형강관으로 설계되었다. 콘크리트포장은 1단계의 평균 40 m/km에서 3단계에는 240 m/km로 현저히 증가하여 임도의 안정성과 기능성이 제고되었다. 비탈안정구조물은 석축이 주종을 이루고 있지만, 1993년 이후부터 콘크리트옹벽과 돌망태옹벽 등도 많이 설계되었다. 이와 같은 분석을 바탕으로 본 연구에서는 주요 공종을 대상으로 몇 가지 개선방안을 제안하였다.

• Asian Pacific Journal of Cancer Prevention
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• 제15권14호
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• pp.5551-5556
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• 2014

Background: The prognostic value of human epidermal growth factor receptor-2 (HER-2/neu) for survival of patients with colorectal cancer (CRC) is still ambiguous. We therefore performed a meta-analysis to evaluate its prognostic significance. Materials and Methods: We searched the MEDLINE and EMBASE databases for published literature investigating associations between HER-2/neu status and overall survival of patients with CRC. A meta-analysis was performed using a DerSimonian-Laird model and publication bias was investigated by Begg's and Egger's tests. Subgroup analysis was also conducted according to the study design type, study quality score, cut-off value for HER-2/neu overexpression, publication region, patient number and publication year. Results: A total of 17 eligible studies involving 2,347 patients were identified for this meta-analysis. The combined hazard ratio (HR) was 1.31 (95% confidence interval (CI): 0.96-1.79), suggesting that HER-2/neu overexpression was not significantly associated with overall survival of patients with CRC. However, subgroup analysis revealed that HER-2/neu overexpression had an unfavorable impact on survival when the analysis was restricted to subgroups of study quality score ${\leq}5 $(HR=1.56, 95%CI: 1.17-2.10), Asian patients (HR=1.74, 95%CI: 1.22-2.49), patient number ${\leq}106$ (HR=1.57, 95%CI: 1.01-2.44), publication year before 2003 (HR=1.59, 95%CI: 1.02-2.49), and prospectively designed study (HR=3.62, 95%CI: 1.42-9.24). The effect disappeared in subgroups of study quality scores > 5 (HR=0.69, 95%CI: 0.33-1.44), non Asian patients (HR=1.14, 95%CI: 0.77-1.70), patients' number > 106 (HR=1.07, 95%CI: 0.67-1.72), publication year after 2003 (HR=1.13, 95%CI: 0.76-1.69), and retrospectively designed study (HR=1.22, 95%CI: 0.89-1.67). Conclusions: Our meta-analysis suggests that HER-2/neu overexpression might not be a significantly prognostic indicator for patients with CRC. Further studies are required to confirm these results.