• 제목/요약/키워드: Hazard ratio

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간 효소(AST, ALT)와 전체원인사망 위험의 관련성: 한국인유전체역학조사 자료 활용 (Association Between Liver Enzyme and Risk of All-Cause Mortality: Use of Korean Genome and Epidemiology Study (KoGES) Data)

  • 이태용;류효선;박창수
    • 한국산학기술학회논문지
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    • 제17권11호
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    • pp.94-103
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    • 2016
  • 간 효소(ALT와 AST)는 주로 간기능을 검사하는데 활용되지만, 간 효소와 심혈관질환 사망과의 관련성에 대한 연구들이 보고되고 있다. 본 연구는 간 효소와 전체사망원인의 관련성을 확인하고자 하였다. 연구자료는 2005년 8월과 2006년 12월에 한국농촌코호트(5개 지역) 연구에 참여한 40세 이상의 성인 10,110명의 건강검진 및 설문조사 자료와 2012년 12월 통계청의 사망자료를 병합하여 사용하였다. 분석방법은 5개 범주로 구분한 간 효소에 의한 사망위험비는 Cox의 비례위험모델을 이용하여 다른 위험요인들을 보정하여 분석하였다. 연구결과 지금까지 사망의 중요 위험요인들의 사망위험비는 65세 이상이 3.5배, 남자가 3.8배, 흡연 3.2배, WHR이 높을수록, 운동 안함 1.6배, 지질성분 및 PP2가 높을수록 높았으며, 이런 변수들을 보정한 상태에서 AST가 50 IU/L 이상일 때 사망위험비가 2.198배(95% CI: 1.217-3.971)였고, ALT도 증가하는 경향을 보였다. 이런 결과는 높은 값의 AST는 사망 위험을 높이는데 영향을 미치며, ALT도 사망을 예측하는데 유용한 도구가 될 수 있다는 것을 제시한다.

Prognostic Value of Tumor Regression Grade on MR in Rectal Cancer: A Large-Scale, Single-Center Experience

  • Heera Yoen;Hye Eun Park;Se Hyung Kim;Jeong Hee Yoon;Bo Yun Hur;Jae Seok Bae;Jung Ho Kim;Hyeon Jeong Oh;Joon Koo Han
    • Korean Journal of Radiology
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    • 제21권9호
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    • pp.1065-1076
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    • 2020
  • Objective: To determine the prognostic value of MRI-based tumor regression grading (mrTRG) in rectal cancer compared with pathological tumor regression grading (pTRG), and to assess the effect of diffusion-weighted imaging (DWI) on interobserver agreement for evaluating mrTRG. Materials and Methods: Between 2007 and 2016, we retrospectively enrolled 321 patients (male:female = 208:113; mean age, 60.2 years) with rectal cancer who underwent both pre-chemoradiotherapy (CRT) and post-CRT MRI. Two radiologists independently determined mrTRG using a 5-point grading system with and without DWI in a one-month interval. Two pathologists graded pTRG using a 5-point grading system in consensus. Kaplan-Meier estimation and Cox-proportional hazard models were used for survival analysis. Cohen's kappa analysis was used to determine interobserver agreement. Results: According to mrTRG on MRI with DWI, there were 6 mrTRG 1, 48 mrTRG 2, 109 mrTRG 3, 152 mrTRG 4, and 6 mrTRG 5. By pTRG, there were 7 pTRG 1, 59 pTRG 2, 180 pTRG 3, 73 pTRG 4, and 2 pTRG 5. A 5-year overall survival (OS) was significantly different according to the 5-point grading mrTRG (p = 0.024) and pTRG (p = 0.038). The 5-year disease-free survival (DFS) was significantly different among the five mrTRG groups (p = 0.039), but not among the five pTRG groups (p = 0.072). OS and DFS were significantly different according to post-CRT MR variables: extramural venous invasion after CRT (hazard ratio = 2.259 for OS, hazard ratio = 5.011 for DFS) and extramesorectal lymph node (hazard ratio = 2.610 for DFS). For mrTRG, k value between the two radiologists was 0.309 (fair agreement) without DWI and slightly improved to 0.376 with DWI. Conclusion: mrTRG may predict OS and DFS comparably or even better compared to pTRG. The addition of DWI on T2-weighted MRI may improve interobserver agreement on mrTRG.

Treatment outcome and risk analysis for cataract after radiotherapy of localized ocular adnexal mucosa-associated lymphoid tissue (MALT) lymphoma

  • Park, Hee Hyun;Lee, Sea-Won;Sung, Soo Yoon;Choi, Byung Ock
    • Radiation Oncology Journal
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    • 제35권3호
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    • pp.249-256
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    • 2017
  • Purpose: We retrospectively reviewed the results of radiotherapy for localized ocular adnexal MALT lymphoma (OAML) to investigate the risk factors of cataract. Methods: Sixty-seven patients with stage IE OAML treated with radiotherapy at Seoul St. Mary's Hospital from 2001 to 2016 were included. Median treatment dose was 30 Gy. Lens protection was done in 52 (76%) patients. Radiation therapy (RT) extent was as follows: superficial (82.1%), tumor mass (4.5%), and entire orbital socket (13.4%). The risk factors for symptomatic cataract were analyzed using the Cox proportional hazard model. Results: Median follow-up time was 50.9 months (range, 1.9 to 149.4 months). All patients were alive at the time of analysis. There were 7 recurrences and there was no local recurrence. Median time to recurrence was 40.4 months. There were 14 cases of symptomatic cataract. Dose >30 Gy had hazard ratio of 3.47 for cataract (p = 0.026). Omitting lens protection showed hazard ratio of 4.10 (p = 0.008). Conclusions: RT achieves excellent local control of ocular MALT lymphoma. Consideration of RT-related factors such as lens protection and radiation dose at the stage of RT planning may reduce the risk of RT-induced cataract after radiotherapy.

Immunoregulatory Function of HLA-G in Gastric Cancer

  • Tuncel, Tolga;Karagoz, Bulent;Haholu, Aptullah;Ozgun, Alpaslan;Emirzeoglu, Levent;Bilgi, Oguz;Kandemir, Emin Gokhan
    • Asian Pacific Journal of Cancer Prevention
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    • 제14권12호
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    • pp.7681-7684
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    • 2013
  • Background: Human leukocyte antigen (HLA)-G-positive gastric cancers are associated with poor survival, but links with tumor escape mechanisms remain to be determined. Materials and Methods: We used immunohistochemistry to investigate HLA-G expression, tumor infiltrating CD8+ T lymphocytes, and Treg cells in 52 gastric cancer patients. Results: There were 29 cancer-related deaths during the follow-up period. Kaplan-Meier analysis indicated that patients with HLA-G-positive (n=16) primary tumors had a significantly poorer prognosis than patients with HLA-G-negative tumors (n=36, p=0.008). The median survival time was 14 months and 47 months, respectively. Patients with high numbers of Tregs and low numbers of CD8+T lymphocytes in the primary tumor had a poorer prognosis than those with low numbers of Tregs and high numbers of CD8+T lymphocytes (p=0.034, p=0.043). Multivariate Cox proportional hazard regression analysis showed that HLA-G expression (hazard ratio: 2.662; 95% confidence interval: 1.242-5.723; p=0.012) and stage (hazard ratio: 2.012;95% confidence interval: 1.112-3.715; p=0.041) were independent unfavorable factors for patient survival. Conclusions: We found a significant positive correlation between HLA-G expression and the number of tumor infiltrating Tregs (p=0.01) and a negative correlation with the number of CD8+T lymphocytes (p=0.041). HLA-G may protect gastric cancer cells from cytolysis by inducing Foxp3+Treg lymphocytes and suppressing CD8+T lymphocytes.

Radiologic Findings and Patient Factors Associated with 30-Day Mortality after Surgical Evacuation of Subdural Hematoma in Patients Less Than 65 Years Old

  • Han, Myung-Hoon;Ryu, Je Il;Kim, Choong Hyun;Kim, Jae Min;Cheong, Jin Hwan;Yi, Hyeong-Joong
    • Journal of Korean Neurosurgical Society
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    • 제60권2호
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    • pp.239-249
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    • 2017
  • Objective : The purpose of this study is to evaluate the associations between 30-day mortality and various radiological and clinical factors in patients with traumatic acute subdural hematoma (SDH). During the 11-year study period, young patients who underwent surgery for SDH were followed for 30 days. Patients who died due to other medical comorbidities or other organ problems were not included in the study population. Methods : From January 1, 2004 to December 31, 2014, 318 consecutive surgically-treated traumatic acute SDH patients were registered for the study. The Kaplan-Meier method was used to analyze 30-day survival rates. We also estimated the hazard ratios of various variables in order to identify the independent predictors of 30-day mortality. Results : We observed a negative correlation between 30-day mortality and Glasgow coma scale score (per 1-point score increase) (hazard ratio [HR], 0.60; 95% confidence interval [CI], 0.52-0.70; p<0.001). In addition, use of antithrombotics (HR, 2.34; 95% CI, 1.27-4.33; p=0.008), history of diabetes mellitus (HR, 2.28; 95% CI, 1.20-4.32; p=0.015), and accompanying traumatic subarachnoid hemorrhage (hazard ratio, 2.13; 95% CI, 1.27-3.58; p=0.005) were positively associated with 30-day mortality. Conclusion : We found significant associations between short-term mortality after surgery for traumatic acute SDH and lower Glasgow Coma Scale scores, use of antithrombotics, history of diabetes mellitus, and accompanying traumatic subarachnoid hemorrhage at admission. We expect these findings to be helpful for selecting patients for surgical treatment of traumatic acute SDH, and for making accurate prognoses.

대구, 경북지역 학령전기 아동의 사고 발생 현황 (Non-Fatal Injuries among Preschool Children in Daegu and Kyungpook)

  • 허윤정;이상원;박정한;박순우
    • Journal of Preventive Medicine and Public Health
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    • 제37권3호
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    • pp.274-281
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    • 2004
  • Objectives : This study was performed to investigate the injury rates and risk factors for preschool children in Daegu city and Kyungpook province. Method : A questionnaire survey about medically attended injuries during the preschool period was performed in nine primary schools located in Daegu city, Pohang city and Goryung County. The overall injury rate was estimated using person-year. The causes and patterns of the injuries, and their risk factors were examined. Result : A total of 469 medically attended injuries were reported in 330 of the 959 study subjects during the preschool period. The overall annual injury rate was 7.5 per 100 children. The injury rate increased sharply during the period from infant (2.4) to 1 year of age (7.5), and the peak injury rate (9.2) was reported for 5 year olds. The most common causes of injuries were falling (36.0%), followed by being struck by an object (23.7%), and traffic accidents (14.1%). Among the traffic accidents, 72.8% occurred while playing on the road, riding a bicycle or roller-skating. A proportional hazard model showed that males (hazard ratio=1.49, p<0.001 compared with female) and the mother's higher education level (hazard ratio of college or higher= 1.51, p=0.013; high school=1.32, p=0.085 compared with those of middle school or lower) were significant risk factors of childhood injury. Conclusion : The results of this study suggested that efforts for children's safety should be made, especially from the toddler stage, and in male children. To develop a more specific childhood injury prevention program, a surveillance system for injuries should be established. Further study of the relationship between mother's occupation and injury rates is also needed.

Relationships between Calving Season and the Incidence of Postpartum Disorders, Milk Yield, and Reproductive Performance in Dairy Cows

  • Jeong, Jae-Kwan;Kang, Hyun-Gu;Kim, Ill-Hwa
    • 한국임상수의학회지
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    • 제35권6호
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    • pp.251-257
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    • 2018
  • We determined the relationships between calving season and the incidence of postpartum disorders, milk yield, and reproductive performance in dairy cows. Data regarding cow parity, postpartum disorders, milk yield, and reproduction were collected from 1,478 lactations. The incidence of retained placenta was higher in spring- and summer-calving cows than in autumn- and winter-calving cows (P < 0.05). The incidence of septicemic metritis was highest in spring- and summer-calving cows, and was higher in autumn-calving cows than in winter-calving cows (P < 0.05). The incidence of metabolic disorders was higher in summer-calving cows than in autumn- and winter-calving cows (P < 0.01). The mean milk yield 1 and 2 months after calving was higher in spring-calving cows than in summer-calving cows (P < 0.05). The percentage of cows that had resumed cycling, defined by detection of a corpus luteum using ultrasonography 4 weeks after calving, was highest in autumn-calving cows, and was higher in summer- and winter-calving cows than in spring-calving cows (P < 0.05). The hazard of first insemination by 150 days after calving was higher in summer- and autumn-calving cows (hazard ratio [HR] = 1.19; P < 0.05) than in spring-calving cows. The hazard of pregnancy by 210 days after calving was also higher in summer-calving (HR = 1.24; P < 0.05) and autumn-calving (HR = 1.59; P < 0.0001) cows than in spring-calving cows. The probability of conception at the first insemination was higher (P < 0.0001) in autumn-calving (odds ratio [OR] = 1.96) and winter-calving (OR = 2.04) cows than in spring-calving cows. In conclusion, spring calving is associated with the worst, and autumn calving with the best, postpartum health and reproductive performance, whereas milk yield is higher in spring-calving cows than in summer-calving cows. Therefore, an effective strategy to support postpartum health and fertility should be instituted for spring-calving dairy cows kept in the Korean climate.

The Relationship between Parkinson's Disease and Acute Myocardial Infarction in Korea : A Nationwide Longitudinal Cohort Study

  • Sheen, Seung Hun;Hong, Je Beom;Kim, Hakyung;Kim, Jimin;Han, In-bo;Sohn, Seil
    • Journal of Korean Neurosurgical Society
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    • 제65권4호
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    • pp.507-513
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    • 2022
  • Objective : The goal of the following statewide age and gender-coordinated cohort study in Korea is to find out if there is a link between acute myocardial infarction (AMI) and Parkinson's disease (PD). Methods : Utilizing the National Health Insurance Sharing Service cohort, patient data were collected. Six thousand four hundred seventy-five individuals with PD were distinguished by utilizing the International Classification of Diseases 10 code G20 and have enrolled in the PD group. The number of participants decreased to 5259 after excluding 1039 patients who were hospitalized less than one time or who visited an outpatient clinic less than twice. Then, 26295 individuals were selected as part of the control group after case control matching was conducted through 1 : 5 age- and gender-coordinated matching. The Cox proportional hazard regression analysis and Kaplan-Meier method were utilized to analyze the likelihood of AMI in PD. Results : After controlling for age and gender, the hazard ratio of AMI in the PD group was 3.603 (95% confidence interval [CI], 2.837-4.577). After that, the following hazard ratio of AMI in the PD group was modified against for co-morbid medical disorders, resulting in 3.551 (95% CI, 2.795-4.511). According to a subgroup analysis, in males and females aged <65 and aged ≥65 and in the non-diabetes and diabetes, hypertension and non-hypertension, dyslipidemia and non-dyslipidemia subgroups, the AMI incidence rates were dramatically higher in the PD group compared to that of the control. Conclusion : Individuals with PD have a greater chance of AMI, according to this cross-national study.

보텍스 생성실 지름비가 에너지 분리에 미치는 영향 (The Effect of a Vortex Chamber Diameter Ratio on Energy Separation)

  • 유갑종;이병화;최인수
    • 설비공학논문집
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    • 제13권8호
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    • pp.667-673
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    • 2001
  • As an alternative cooling method to reduce environmental hazard, vortex tubes have been studied for energy separation into cold and hot streams. Hence, the experiments were carried out systematically to find the best ratio of vortex chamber diameter to tube diameter. Also, the work was don to investigate how inlet pressure and geometric ratios of vortex tube affected temperature differences at tow needs as ell as cooling capacity and cooling efficiency. The result showed that the maximum temperature differences at the both ends and the maximum cooling efficiency were obtained when the ratio of vortex chamber diameter was about 1.45, while the inlet pressure ws not higher than 0.7 MPa.

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