• Asian Pacific Journal of Cancer Prevention
• /
• 제15권23호
• /
• pp.10209-10215
• /
• 2015

To assess the contribution of tumor necrosis factor $(TNF){\beta}$ +252 polymorphisms to risk and prognosis of hepatocellular carcinoma (HCC), we enrolled 150 pairs of sex- and age-matched patients with HCC, patients with cirrhosis alone, and unrelated healthy controls. $TNF{\beta}$ +252 genotypes were determined by polymerase chain reaction with restriction fragment length polymorphism. Multivariate analysis indicated that $TNF{\beta}$ G/G genotype [odds ratio (OR), 3.64; 95%CI, 1.49-8.91], hepatitis B surface antigen (OR, 16.38; 95%CI, 8.30-32.33), and antibodies to hepatitis C virus (HCV) (OR, 39.11; 95%CI, 14.83-103.14) were independent risk factors for HCC. There was an additive interaction between $TNF{\beta}$ G/G genotype and chronic hepatitis B virus (HBV)/HCV infection (synergy index=1.15). Multivariate analysis indicated that factors associated with $TNF{\beta}$ G/G genotype included cirrhosis with Child-Pugh C (OR, 4.06; 95%CI, 1.34-12.29), thrombocytopenia (OR, 6.55; 95%CI, 1.46-29.43), and higher serum ${\alpha}$-fetoprotein concentration (OR, 2.53; 95%CI, 1.14-5.62). Patients with $TNF{\beta}$ G/G genotype had poor cumulative survival (p=0.005). Cox proportional hazard model indicated that $TNF{\beta}$ G/G genotype was a biomarker for poor HCC survival (hazard ratio, 1.70; 95%CI, 1.07-2.69). In conclusion, there are independent and additive effects between $TNF{\beta}$ G/G genotype and chronic HBV/HCV infection on risk for HCC. It is a biomarker for poor HCC survival. Carriage of this genotype correlates with disease severity and advanced hepatic fibrosis, which may contribute to a higher risk and poor survival of HCC. Chronic HBV/HCV infected subjects with this genotype should receive more intensive surveillance for early detection of HCC.

• Journal of Korean Medical Science
• /
• 제33권48호
• /
• pp.312.1-312.10
• /
• 2018

Background: Obesity is related to several comorbidities and mortality, but its relationship with acute kidney injury (AKI) and long-term mortality remain undetermined in patients undergoing coronary artery bypass grafting. Methods: Data from 3,018 patients (age ${\geq}18$ years) who underwent coronary artery bypass graft surgery from two tertiary referral centers were retrospectively reviewed between 2004 and 2015. Obesity was defined using the body mass index, according to the World Health Organization's recommendation. The odds and hazard ratios in post-surgical, AKI, and all-cause mortality were calculated after adjustment for multiple covariates. Patients were followed for $90{\pm}40.9$ months (maximum: 13 years). Results: Among the cohort, 37.4%, 2.4%, 21.1%, 35.1%, and 4.0% of patients were classified as normal weight, underweight, overweight-at-risk, obese I, and obese II, respectively. Post-surgical AKI developed in 799 patients (26.5%). Patients in the obese groups (overweight-at-risk to obese II) had a higher risk of AKI than did those in the normal-weight group. During the follow-up period, 787 patients (26.1%) died. Underweight patients had a higher risk of mortality than did normal-weight patients, whereas overweight-at-risk, obese I, and obese II patients showed better survival rates. Conclusion: After coronary artery bypass graft surgery, obese patients encountered a high risk of AKI, and underweight patients exhibited a low chance of survival. Awareness of both obese and underweight statuses should be raised in these patients.

• Journal of Medicine and Life Science
• /
• 제19권2호
• /
• pp.46-56
• /
• 2022

The incidence of fever complicating percutaneous coronary intervention (PCI) is rare. However, little is known regarding the cause of fever after PCI. Therefore, this study aimed to determine the clinical characteristics of patients with acute myocardial infarction (AMI), with or without fever, after PCI. We enrolled a total of 926 AMI patients who underwent PCI. Body temperature (BT) was measured every 4 hours or 8 hours for 5 days after PCI. Patients were divided into two groups according to BT as follows: BT<37.7℃ (no-fever group) and BT ≥37.7℃ (fever group). The 2 years clinical outcomes were compared subsequently. Fever after PCI was associated with higher incidence of major adverse cardiac events (MACE) (hazard ratio [HR], 1.56; 95% confidence interval [CI], 1.07-2.28; P=0.021), all-cause death (HR, 2.32; 95% CI, 1.18-4.45; P=0.014), cardiac death (CD) (HR, 2.57; 95% CI, 1.02-6.76; P=0.049), and any revascularization (HR, 1.69; 95% CI, 1.02-2.81; P=0.044) than without fever. In women, prior chronic kidney disease, lower left ventricular (LV) ejection fraction, higher LV wall motion score index, white blood cell count, peak creatine kinase-myocardial band level, and longer PCI duration were associated with fever after PCI. Procedures such as an intra-aortic balloon pump, extracorporeal membrane oxygenation, continuous renal replacement therapy, central and arterial line insertion, and cardiopulmonary resuscitation were related to fever after PCI. Fever after PCI in patients with AMI was associated with a higher incidence of MACE, all-cause death, CD, and any revascularization at the 2 years mark than in those without fever.

• Journal of Hospice and Palliative Care
• /
• 제24권4호
• /
• pp.254-260
• /
• 2021

Continuous deep sedation (CDS) is an extreme form of palliative sedation to relieve refractory symptoms at the end of life. In this study, we shared our experiences with CDS and examined the clinical characteristics associated with survival in patients with terminal cancer who received CDS. We conducted a chart audit of 106 consecutive patients with terminal cancer who received CDS at a single hospice care unit between January 2014 and December 2016. Survival was defined as the first day of admission to the date of death. The associations between clinical characteristics and survival were presented as hazard ratios and 95% confidence intervals using a Cox proportional hazard model. The mean age of participants was 65.2 years, and 33.0% (n=35) were women. Diazepam was the most commonly administered drug, and haloperidol or lorazepam were also used if needed. One sedative was enough for a majority of the patients. Stepwise multivariate analysis identified poor functioning, a high Palliative Prognostic Index score, hyperbilirubinemia, high serum ferritin levels, and a low number of sedatives as independent poor prognostic factors. Our experiences and findings are expected to be helpful for shared decision-making and further research on palliative sedation.

• Tuberculosis and Respiratory Diseases
• /
• 제86권2호
• /
• pp.133-141
• /
• 2023

Background: The present study evaluated the association between participation in a rehabilitation program during a hospital stay and 1-year survival of patients requiring at least 21 days of mechanical ventilation (prolonged mechanical ventilation [PMV]) with various respiratory diseases as their main diagnoses that led to mechanical ventilation. Methods: Retrospective data of 105 patients (71.4% male, mean age 70.1±11.3 years) who received PMV in the past 5 years were analyzed. Rehabilitation included physiotherapy, physical rehabilitation, and dysphagia treatment program that was individually provided by physiatrists. Results: The main diagnosis leading to mechanical ventilation was pneumonia (n=101, 96.2%) and the 1-year survival rate was 33.3% (n=35). One-year survivors had lower Acute Physiology and Chronic Health Evaluation (APACHE) II score (20.2±5.8 vs. 24.2±7.5, p=0.006) and Sequential Organ Failure Assessment score (6.7±5.6 vs. 8.5±2.7, p=0.001) on the day of intubation than non-survivors. More survivors participated in a rehabilitation program during their hospital stays (88.6% vs. 57.1%, p=0.001). The rehabilitation program was an independent factor for 1-year survival based on the Cox proportional hazard model (hazard ratio, 3.513; 95% confidence interval, 1.785 to 6.930; p<0.001) in patients with APACHE II scores ≤23 (a cutoff value based on Youden's index). Conclusion: Our study showed that participation in a rehabilitation program during hospital stay was associated with an improvement of 1-year survival of PMV patients who had less severe illness on the day of intubation.

• Korean Journal of Radiology
• /
• 제24권7호
• /
• pp.626-639
• /
• 2023

Objective: To investigate the association of clinical, pathologic, and magnetic resonance imaging (MRI) variables with progressive disease (PD) during neoadjuvant chemotherapy (NAC) and distant metastasis-free survival (DMFS) in patients with triple-negative breast cancer (TNBC). Materials and Methods: This single-center retrospective study included 252 women with TNBC who underwent NAC between 2010 and 2019. Clinical, pathologic, and treatment data were collected. Two radiologists analyzed the pre-NAC MRI. After random allocation to the development and validation sets in a 2:1 ratio, we developed models to predict PD and DMFS using logistic regression and Cox proportional hazard regression, respectively, and validated them. Results: Among the 252 patients (age, 48.3 ± 10.7 years; 168 in the development set; 84 in the validation set), PD was occurred in 17 patients and 9 patients in the development and validation sets, respectively. In the clinical-pathologic-MRI model, the metaplastic histology (odds ratio [OR], 8.0; P = 0.032), Ki-67 index (OR, 1.02; P = 0.044), and subcutaneous edema (OR, 30.6; P = 0.004) were independently associated with PD in the development set. The clinical-pathologic-MRI model showed a higher area under the receiver-operating characteristic curve (AUC) than the clinical-pathologic model (AUC: 0.69 vs. 0.54; P = 0.017) for predicting PD in the validation set. Distant metastases occurred in 49 patients and 18 patients in the development and validation sets, respectively. Residual disease in both the breast and lymph nodes (hazard ratio [HR], 6.0; P = 0.005) and the presence of lymphovascular invasion (HR, 3.3; P < 0.001) were independently associated with DMFS. The model consisting of these pathologic variables showed a Harrell's C-index of 0.86 in the validation set. Conclusion: The clinical-pathologic-MRI model, which considered subcutaneous edema observed using MRI, performed better than the clinical-pathologic model for predicting PD. However, MRI did not independently contribute to the prediction of DMFS.

• Gut and Liver
• /
• 제12권6호
• /
• pp.674-681
• /
• 2018

Background/Aims: The cumulative surgery rate and postoperative relapse of intestinal Behçet's disease (BD) have been reported to be high. This study aimed to establish a scoring system based on follow-up endoscopic findings that can predict intestinal BD recurrence after surgery. Methods: Fifty-four patients with intestinal BD who underwent surgery due to bowel complications and underwent follow-up colonoscopy were retrospectively investigated. Their clinical data, including colonoscopic findings, were retrieved. Classification and regression tree analysis was used to develop an appropriate endoscopic classification model that can explain the postsurgical recurrence of intestinal BD most accurately based on the following classification: e0, no lesions; e1, solitary ulcer <20 mm in size; e2, solitary ulcer ${\geq}20mm$ in size; and e3, multiple ulcers regardless of size. Results: Clinical relapse occurred in 37 patients (68.5%). Among 38 patients with colonoscopic recurrence, only 29 patients had clinically relapsed. Multivariate analysis identified higher disease activity index for intestinal BD at colonoscopy (hazard ratio [HR], 1.013; 95% confidence interval [CI], 1.005 to 1.021; p=0.002) and colonoscopic recurrence (HR, 2.829; 95% CI, 1.223 to 6.545; p=0.015) as independent risk factors for clinical relapse of intestinal BD. Endoscopic findings were classified into four groups, and multivariate analysis showed that the endoscopic score was an independent risk factor of clinical relapse (p=0.012). The risk of clinical relapse was higher in the e3 group compared to the e0 group (HR, 6.284; 95% CI, 2.036 to 19.391; p=0.001). Conclusions: This new endoscopic scoring system could predict clinical relapse in patients after surgical resection of intestinal BD.

• 한국식품영양학회지
• /
• 제26권1호
• /
• pp.44-50
• /
• 2013

Quantitative analyses of naturally occurring methanol were performed for the alcoholic beverages commonly consumed in Jecheon, Chungbuk province, South Korea. The headspace analysis method was optimized for the low and high alcoholic beverages. The external standard method was applied due to the overlapping of 2-propanol and 2-butanol (the internal standard candidates) with target sample matrix peaks. The target samples were selected based on the retail sales amounts of alcoholic beverages in the largest retailer food-mart chain, Jecheon, Chungbuk province, South Korea. There was no sample containing methanol over 0.5 $mg/m{\ell}$, the Korean maximum level of methanol in alcoholic beverages (1.0 $mg/m{\ell}$ for fruit originated liquor etc). The total exposure amount of methanol via alcoholic beverages was estimated based on the daily alcohol consumption of 40 g. The hazard indices calculated by methanol RfD 0.5 mg/kg bw day (US EPA) and ADI 20 mg/kg bw day (proposed by Lachenmeier etc.) were 0.301 and 0.008, respectively. As with the hazard index, aggregate exposures below a HI of 1.0 will likely not result in adverse noncancer health effects over a lifetime of exposure. Then the methanol exposure via the alcoholic liquours might not hazard to Jecheon citizen.

• 한국수자원학회논문집
• /
• 제39권1호
• /
• pp.23-33
• /
• 2006

본 연구에서는 국내에서 발생했던 산사태에 대한 사례연구를 통하여 GIS 기반의 산사태 예측모형 SINMAP의 적용성을 검토하였다. 사례연구의 대상지역은 서울에서 남쪽으로 78km 정도 떨어진 곳에 위치한 용인시 이동면 덕성리 소재 달봉산으로 1991년 집중호우기간 동안에 많은 산사태가 발생하였다. 이 지역에 대하여 SINMAP을 적용하여 당시 산사태지도와 비교 분석한 결과 대부분의 산사태를 성공적으로 예측하였다. 또한 본 연구에서는 SINMAP 모형의 적용에 필요한 3가지 매개변수인 흙의 내부마찰각, 점착력, T/R 산사태 예측에 미치는 영향과 적정범위에 대하여 검토하였다 본 연구를 통하여 SINMAP은 사면 경사가 급하고 토층의 두께가 얕은 국내산지의 산사태 위험도를 예비적으로 평가하는 유용한 도구가 될 수 있는 것으로 보인다.

• Nuclear Engineering and Technology
• /
• 제55권7호
• /
• pp.2388-2394
• /
• 2023

The radioactivity concentration of environmental radionuclides was analyzed for soil and sand at eight locations within a radius of 255 m centered on the Dongnam Institute of Radiological & Medical Science (DIRAMS), Korea. The average activity concentrations of ⁴⁰K, ¹³⁷Cs, ²²⁶Ra, and ²³²Th were 661.1 Bq/kg-dry, 0.9 Bq/kg-dry, 21.9 Bq/kg-dry, and 11.1 Bq/kg-dry, respectively. The activity of ⁴⁰K and ¹³⁷Cs was lower than the 3-year (2017-2019) average reported by the Korea Institute of Nuclear Safety, respectively. Due to the nature of granite-rich soil, the radioactivity of ⁴⁰K was 0.6-fold higher than in other countries, while ¹³⁷Cs was in the normal fluctuation range (15-30 Bq/kg-dry) of the concentration of radioactive fallout from nuclear tests. The activity of ²²⁶Ra and ²³²Th was lower than in Korean soils reported by the United Nations Scientific Committee on the Effects of Atomic Radiation (UNSCEAR). The average activity concentrations of ²³²Th and ⁴⁰K for the soil and sand samples from DIRAMS were within the range specified by UNSCEAR in 2000. The radium equivalent activity and internal and external hazard index values were below the recommended limits (1 mSv/y). These radionuclide concentration (²²⁶Ra, ²³²Th, ⁴⁰K, and ¹³⁷Cs) data can be used for regional environmental monitoring and ecological impact assessments of nuclear power plant accidents.