• Journal of Korean Neurosurgical Society
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• v.64 no.2
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• pp.189-197
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• 2021

Objective : This study aims to investigate the relationship between aneurysm wall enhancement and clinical rupture risks based on the magnetic resonance vessel wall imaging (MR-VWI) quantitative methods. Methods : One hundred and eight patients with 127 unruptured aneurysms were prospectively enrolled from Feburary 2016 to October 2017. Aneurysms were divided into high risk (≥10) and intermediate-low risk group (<10) according to the PHASES (Population, Hypertension, Age, Size of aneurysm, Earlier SAH history from another aneurysm, Site of aneurysm) scores. Clinical risk factors, aneurysm morphology, and wall enhancement index (WEI) calculated using 3D MR-VWI were analyzed and compared. Results : In comparison of high-risk and intermediated-low risk groups, univariate analysis showed that neck width (4.5±3.3 mm vs. 3.4±1.7 mm, p=0.002), the presence of wall enhancement (100.0% vs. 62.9%, p<0.001), and WEI (1.6±0.6 vs. 0.8±0.8, p<0.001) were significantly associated with high rupture risk. Multivariate regression analysis revealed that WEI was the most important factor in predicting high rupture risk (odds ratio, 2.6; 95% confidence interval, 1.4-4.9; p=0.002). The receiver operating characteristic (ROC) curve analysis can efficiently differentiate higher risk aneurysms (area under the curve, 0.780; p<0.001) which have a reliable WEI cutoff value (1.04; sensitivity, 0.833; specificity, 0.67) predictive of high rupture risk. Conclusion : Aneurysms with higher rupture risk based on PHASES score demonstrate increased neck width, wall enhancement, and the enhancement intensity. Higher WEI in unruptured aneurysms has a predictive value for increased rupture risk.

• Nutrition Research and Practice
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• v.16 no.3
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• pp.392-404
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• 2022

BACKGROUND/OBJECTIVES: Numerous studies have examined the relationship between drinking behaviors and metabolic syndrome (MetS) for adults, but these include very few studies for young adults. This study therefore undertook to investigate the association between drinking behaviors and components of MetS among adult drinkers aged 20-30 years. SUBJECTS/METHODS: Using the 2016-2018 Korea National Health and Nutrition Examination Survey data, drinking behaviors of adults in the age group 20-30 years were divided into 4 groups: 1) group A, good drinking habits; 2) group B, frequent binge drinking but not frequent drinking; 3) group C, frequent drinking but not frequent binge drinking; 4) group D, frequent drinking and binge drinking. The association between MetS components and drinking behaviors was analyzed by applying multiple logistic regression analysis. RESULTS: We determined the prevalence risk compared to group A. In men, the prevalence risk of high triglyceride (TG) increased 2.051-fold in group C and 1.965-fold in group D. Moreover, in group D, the prevalence risk of low high density lipoprotein cholesterol (HDL-C) increased 0.668-fold, high blood pressure (BP) increased 2.147-fold, and MetS increased 1.567-fold. In women, there was an increased prevalence risk of low HDL-C (0.353-fold) and MetS (3.438-fold) in group C, whereas group D showed increased prevalence risk of abdominal obesity (2.959-fold), high TG (1.824-fold, and low HDL-C (0.424-fold). CONCLUSIONS: Our study indicates that frequent drinking increases the risk of high TG, whereas frequent and binge drinking increases the risk of high TG, low HDL-C, high BP, and prevalence of MetS in men. In women, frequent drinking without binge drinking increases the risk of low HDL-C and MetS, whereas frequent and binge drinking increases the risk of abdominal obesity, high TG, and low HDL-C. We propose that improvements in the drinking behaviors can reduce the prevalence of MetS.

• Journal of Gastric Cancer
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• v.18 no.2
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• pp.142-151
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• 2018

Purpose: The modification of the cancer classification system aimed to improve the classical anatomy-based tumor, node, metastasis (TNM) staging by considering tumor biology, which is associated with patient prognosis, because such information provides additional precision and flexibility. Materials and Methods: We previously developed an mRNA expression-based single patient classifier (SPC) algorithm that could predict the prognosis of patients with stage II/III gastric cancer. We also validated its utilization in clinical settings. The prognostic single patient classifier (pSPC) differentiates based on 3 prognostic groups (low-, intermediate-, and high-risk), and these groups were considered as independent prognostic factors along with TNM stages. We evaluated whether the modified TNM staging system based on the pSPC has a better prognostic performance than the TNM 8th edition staging system. The data of 652 patients who underwent gastrectomy with curative intent for gastric cancer between 2000 and 2004 were evaluated. Furthermore, 2 other cohorts (n=307 and 625) from a previous study were assessed. Thus, 1,584 patients were included in the analysis. To modify the TNM staging system, one-grade down-staging was applied to low-risk patients according to the pSPC in the TNM 8th edition staging system; for intermediate- and high-risk groups, the modified TNM and TNM 8th edition staging systems were identical. Results: Among the 1,584 patients, 187 (11.8%), 664 (41.9%), and 733 (46.3%) were classified into the low-, intermediate-, and high-risk groups, respectively, according to the pSPC. pSPC prognoses and survival curves of the overall population were well stratified, and the TNM stage-adjusted hazard ratios of the intermediate- and high-risk groups were 1.96 (95% confidence interval [CI], 1.41-2.72; P<0.001) and 2.54 (95% CI, 1.84-3.50; P<0.001), respectively. Using Harrell's C-index, the prognostic performance of the modified TNM system was evaluated, and the results showed that its prognostic performance was better than that of the TNM 8th edition staging system in terms of overall survival (0.635 vs. 0.620, P<0.001). Conclusions: The pSPC-modified TNM staging is an alternative staging system for stage II/III gastric cancer.

• Journal of the Korean Society of Physical Medicine
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• v.12 no.2
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• pp.9-20
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• 2017

PURPOSE: The purpose of this study is to understand the difference in the risk factors of coronary artery disease (CAD) between Korean and American CAD patients to determine the discriminant factor for each group, as well as to provide useful information to be reflected in the national concern of health. METHODS: Data were collected from 248 Korean and 107 American CAD patients who underwent either percutaneous coronary intervention or coronary artery bypass grafting. By using t-test and $X^2$-test, risk factors were compared between the Koreans and Americans. To elucidate which risk factor was the most discriminant for each group, logistic regression analysis was performed. RESULTS: All risk factors, except diastolic blood pressure, showed a significant difference between the two groups. $X^2$-test showed statistical significance with respect to the smoking rate between the female groups. Moreover, there was a statistically significant difference between the two groups regarding blood total cholesterol (TC) and triglyceride, and between the male groups, here was a statistically significant difference with respect to blood high-density lipoprotein cholesterol (HDL). Diabetes mellitus (DM) was the most discriminant factor for Korean patients while TC/HDL is the most discriminant for the Americans. CONCLUSION: The characteristics of CAD risk factors were determined to be different between Koreans and Americans in this study. TC/HDL was a discriminant factor for Americans while DM was a discriminant factor for Koreans. This result implies that DM should primarily be given attention to prevent CAD in Korean adults.

• Korean Journal of Health Education and Promotion
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• v.20 no.1
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• pp.159-172
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• 2003

Purpose : The purpose of this study was to investigated the dietary habits of students in order to identify risk groups according to their Body Mass Index (BMI), and to compare the eating behavior of students in the normal range (19${\le}$24) and those in risk groups (BMI${\le}$19, 24${\le}$27, BMI>27). Method : 1176 elementary school students, 850 middle school students and 672 high school students in Wonju City, were the participants The instrument for this study was a structured questionnaire that included demographic data as well as dietary habits, and the eating behavior instrument developed by Stunkard & Messick(1985) and revised by Kim & Kim (1997). Result : 1) As students moved up ingrade level their dietary habits became more irregular and the degree that students chewed food was reduced 2) As students moved up in grade level, a greater number of the student did not eat breakfast. The reasons given were that there were not enough time before classes started(40.4%) and a lack of appetite in the morning(10.6%) in high school students. 3) As for supper, from 67.8 to 81.9% of subjects reported having regular supper. However the rest of the subjects did not eat supper because of anorexia and fear of weight gain. 4) The results identified risk groups according to their BMI showed that for elementary school students, 55.9% were in the low weight group, 5.5% in the overweight group, and 0.9% in the obese group. For middle and high school students, 40.6% and 35.5% respectively were in the low weight group, 7.4% and 6.3% in the overweight group, and 4.1% and 2.5% the obese group. 5) Comparisons of the eating behavior of students in the normal weight group with that of those in the three risk groups showed that there significant differences in 'hunger' and cognitive restraint of eating' in elementary school students, and significant differences in 'cognitive restraint of eating' in middle and high school students. Conclusion : The results of this study show that management of diet in school health should be addressed from both the aspect of lack of nutrition and that of excess nutrition. In other words, good diet is as important for students in the low weight group as it is for those in the overweight and obese groups. The establishment of good dietary habits and eating behavior in students, by nurses and dieticians should be done by providing repeated diet education and involvement in diet counseling.

• Korean Journal of Community Nutrition
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• v.19 no.6
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• pp.537-549
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• 2014

Objectives: This study was conducted to examine blood pressure and other characteristics of a high sodium intake group assessed with 24-hr urine analysis and the dietary factors related to the risk of high sodium intake among Korean adults. Methods: A cross-sectional study was conducted with adults aged 20-59 years. Subjects who completed 24-hr urine collection (N = 205) were divided into 3 groups (tertile) according to the sodium intake estimated with 24-hour urine analysis. We compared the blood pressure, BMI and dietary related factors of the 3 groups (low, medium, high sodium intake group) with General Linear Model (GLM) and Duncan's multiple range test (p < 0.05). The risk factors related to high sodium intake were assessed with odds ratio (p < 0.05). Results: The sodium intake (mg/day) of the 3 groups were $3359.8{\pm}627.9$, $4900.3{\pm}395.1$ and $6770.6{\pm}873.9$, respectively, corresponding to daily salt intake (g/day) 8.5, 12.4 and 17.2, respectively. High sodium group showed significantly elevated age, BMI and systolic/diastolic blood pressure. Being male gender was associated with significantly increased risk of sodium intake (OR = 1.972; 95%CI: 1.083-3.593). The other factors related to high sodium intake were higher BMI (${\leq}25$) (OR = 2.619; 95% CI: 1.368-5.015), current alcohol consumption (OR = 1.943; 95%CI: 1.060-3.564), and having salty soybean paste with salt percentage > 14% (OR = 3.99; 95% CI: 1.404-6.841). The dietary attitude related to increased risk of high sodium intake included 'enjoy dried fish and salted mackerel' (p < 0.001) and 'eat all broth of soup, stew or noodle' (p < 0.001). Conclusions: Because high sodium intake was associated with higher blood pressure, nutrition education should focus on alcohol consumption, emphasis on related dietary factors such as using low salt soybean paste, improvements in the habit of eating dried fish and salted mackerel or eating all broth of soup, stew or noodle.

• Nutrition Research and Practice
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• v.9 no.2
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• pp.199-206
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• 2015

BACKGROUND/OBJECTIVE: Even though the prevalence of metabolic syndrome in adolescents is increasing, little is presently known about this syndrome in adolescents. This study aimed to cluster metabolic risk factors as well as examine the associations between identified patterns and nutrient intake using data from the Korean National Health Examination and Nutritional Assessment (KNHANES). SUBJECTS/METHODS: A total of 2,958 subjects aged 10 to 18 years along with both biochemical and dietary data information were obtained from KNHANES 2007-2010. Six components of metabolic syndrome were used to identify any patterns via factor analysis. Individuals were categorized into quartile groups according to their pattern score. RESULTS: Three clustering patterns with high loadings were identified and named as follows: 1) high blood pressure, 2) dyslipidemia, and 3) glucose abnormality patterns. The high blood pressure pattern showed high loadings of systolic and diastolic blood pressures, the dyslipidemia pattern showed high loadings of triglyceride and HDL-cholesterol levels, and the glucose abnormality pattern showed high loadings of fasting blood glucose levels. Intakes of fat and riboflavin were significantly decreased, whereas those of sodium and niacin were significantly increased across the quartiles in the dyslipidemia pattern. No nutrient intake except that of thiamin was significantly associated with the high blood pressure or glucose abnormality pattern. CONCLUSION: Our findings show that metabolic syndrome risk factors in the Korean adolescent population are characterized by three distinct patterns, which are differentially associated with dietary factors. Characterizing metabolic risk factors and providing specific dietary guidelines for target groups are important.

• Journal of East-West Nursing Research
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• v.27 no.1
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• pp.51-60
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• 2021

Purpose: The purpose of this study was to identify factors associated with high risk drinking in adults. Methods: Multi-variate logistic regression was used to analyze the data of 15,949 adults age 19 years or older from the sixth (2013-2015) Korea National Health and Nutrition Examination Survey. Results: Factors associated with high risk drinking included education level, employment and smoking status among the age group of 19-39. In the 40-59 year age group, the associated factors were gender, employment, smoking, obesity, and depressive mood. In the over 60 year age group, related factors included gender, employment, smoking, abdominal obesity, and subjective health status. Conclusion: The result of this study suggests that early risk factor screening may be helpful to avoid the progression to high-risk drinking. An individualized approach for each age group can be used as a preventive measure.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.18 no.2
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• pp.130-137
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• 2007

Objectives: Studies investigating problematic internet use have increased rapidly and have been focused on its causes, psychopathology, prevalence, characteristics and so on. However, there are few studies concerning the correlation between problematic internet use and youth health risk behavior. Therefore, the purpose of this study was to examine the relationship between problematic internet use and youth health risk behavior. Methods: A community sample of 632 high school students in grades 10 and 11 was collected for the survey. The sample was assessed using the Youth Risk Behavior Surveillance System(YRBSS) and Young's Diagnostic Questionnaire of Internet Addiction(YDQ). The subjects were classified into two groups: normal and problematic internet use, and the problematic internet use group was further divided into at-risk use and addiction groups. Results: There were 56 subjects(8.9%) in the internet addiction group and 56 subjects(8.9%) in the at-risk internet use group. The other 507 subjects were classified as normal. The subjects in the internet addiction group kissed more frequently and ate less fruit than those in the normal group. They also showed a relatively higher tendency to watch TV, ride in a car driven by a drunk driver and to carry a weapon than those in the normal group. There were no differences in health risk behaviors between the subjects in the internet addiction group and those in the at-risk internet use group, except for the possibility of riding in a car driven by a drunk driver. Conclusion: Unlike the normal group, there was very little difference in health risk behavior between the internet addiction group and the at-risk internet use group, which indicates that the addiction group and the at-risk internet use groups are homogenous. It is important to focus on the behavior of individuals in the at-risk group, and preventive measures should be taken in order to reduce the possibility of at-risk adolescents becoming addicted.

• Childhood Kidney Diseases
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• v.21 no.2
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• pp.61-68
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• 2017

Purpose: To investigate differences in clinical features, blood/urinary findings, and prognosis in different age groups of patients with Henoch-$Sch{\ddot{o}}nlein$ purpura (HSP). Methods: A total of 469 patients with HSP were analyzed retrospectively from June 2003 to February 2016. We classified patients into child or adult groups based on their age. Results: The adult group had more patients with anemia (child vs. adult; 7.5% vs. 16.4%), and higher immunoglobulin A (IgA) (30.0% vs. 50.0%) levels, C-reactive protein (34.2% vs. 54.0%) and uric acid (3.1% vs. 12.1%) levels than the child group. The child group was highly positive for Mycoplasma pneumoniae immunoglobulin M (IgM) (34.4%). More patients in the child group presented with high levels of antistreptolysin O (24.7% vs. 2.9%) and high C4 (11.5% vs. 4.2%). Low C3 (1.1% vs. 10.2%) levels, and renal involvement with gross hematuria (8.6% vs. 21.5 %), nonnephrotic proteinuria (1.1% vs. 11.2%), and nephrotic syndrome (1.1% vs. 6.0%) were common in the adult group. Adults also had poorer renal outcomes [persistent hematuria/proteinuria (10.5% vs. 32.8%), and chronic kidney disease (0% vs. 11.2%)] than the child group. Risk factors for renal involvement such as older age and higher level of uric acid were only found in the child group. The risk factors for poor renal outcome were nephrotic syndrome in the child group and gross hematuria in the adult group. Conclusion: In this study, child and adult groups presented with different clinical manifestations of HSP. We found that risk factors for renal involvement included age and high uric acid level in the child group. Moreover, nephrotic syndrome in the child group and gross hematuria in the adult group increased the risk of poor renal outcome.