Background: Components of the systemic inflammatory response, combined to form inflammation-based prognostic scores (mGPS, NLR, PLR, PI, PNI) have been associated with overall survival. The aim of the present study was to compare various prognostic factors including many previously established parameters and such systemic inflammation-based prognostic scores in a series of incurable stage IV colorectal cancer (CRC) patients. Materials and Methods: Patients (n=167) with stage IV CRC undergoing surgical procedures between 2005 and 2013 were enrolled. Preoperatively (7-30 days before surgery), routine laboratory examinations were performed on the same day. We calculated scores using these data and analyzed the association with cancer specific survival (CSS) statistically. Results: Univariate analysis revealed significant associations between CSS and WBC, albumin, CRP, CEA values, mGPS, PNI, and PI values among preoperative factors. On multivariate analysis, high mGPS and high CEA independently predicted shorter CSS (p=0.001 and p=0.018). A new scoring system was constructed using mGPS and CEA. When patients were separated into three categorized using this system, the new score accurately predicted CSS (p < 0.001). Conclusions: The present study indicates that a new scoring system, consisting of mGPS and CEA, is a simple and useful tool in predicting the survival of patients with incurable stage IV CRC, and should be included in the routine assessment of these patients for decision making of appropriate treatment.
BACKGROUND/OBJECTIVES: The current study examined trends in adherence to dietary recommendations and compared the levels of adherence between diagnosed and undiagnosed subjects with type 2 diabetes mellitus (T2DM) in Korea over the past 14 years. SUBJECTS/METHODS: Data were collected from the 1998-2012 Korea National Health and Nutrition Examination Surveys (KNHANES). Diagnosed diabetes was defined as giving a positive response to questions about awareness of the disease, a physician's diagnosis of diabetes, or medical treatment for diabetes, whereas undiagnosed diabetes was defined as having a fasting glucose level ${\geq}126mg/dl$. Assessment of adherence level was based on 6 components of dietary guidelines, considering meal patterns and intake levels of calories, carbohydrates, vegetable/seaweed, sodium, and alcohol. The participants received 1 point if they met the criteria for each of the 6 components, and the total possible score ranged from 0 to 6 points. Multivariate generalized linear regression was performed, taking into account the complex survey design. RESULTS: Among all diabetic patients aged 30 years or older, the proportion of diagnosed diabetes increased dramatically, from 40.9% in 1998 to 75.9% in 2012 (P for trend < 0.001). The overall adherence levels to dietary recommendations were low and did not significantly differ between diagnosed and undiagnosed subjects with T2DM for all survey years. Several improvements were observed, including increased adherence to maintaining sufficient vegetable/seaweed consumption (increased from 0.12 to 0.16 points) and limiting sodium intake (increased from 0.12-0.13 points to 0.19-0.24 points; P for trend < 0.001), while adherence to maintaining moderate alcohol consumption decreased. CONCLUSIONS: Analysis of data collected by the KNHANES indicates that Korean T2DM patients have poor adherence to dietary recommendations and maintenance of a healthy lifestyle, regardless of disease awareness. This finding suggests that development of practical, evidence-based guidelines is necessary and that provision and expansion of educational programs for T2DM patients is critical after diagnosis.
Park, Yeong Mi;Kwock, Chang Keun;Park, Seyeon;Eicher-Miller, Heather A.;Yang, Yoon Jung
Nutrition Research and Practice
/
제12권5호
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pp.443-448
/
2018
BACKGROUND/OBJECTIVES: This study was conducted to investigate the effects of sodium-potassium ratio on insulin resistance and sensitivity in Korean adults. SUBJECTS/METHODS: Subjects were 3,722 adults (1,632 men and 2,090 women) aged 40-69 years participating in the Korean genome and epidemiology study_Ansan and Ansung study. Insulin resistance was assessed using homeostasis model assessment of insulin resistance (HoMA-IR) and fasting insulin, and insulin sensitivity was assessed by using the quantitative insulin sensitivity check index (QUICKI). The 24-h urinary sodium and potassium excretion were estimated from spot urinary samples using the Tanaka formula. The generalized linear model was applied to determine the association between urinary sodium-potassium ratio and insulin resistance. RESULTS: HoMA-IR (P-value = 0.029, P-trend = 0.008) and fasting insulin (P-value = 0.017, P-trend = 0.005) levels were positively associated with 24-h estimated urinary sodium-potassium ratio in the multivariable model. QUICKI was inversely associated with 24-h estimated urinary sodium-potassium ratio in all models (P-value = 0.0002, P-trend < 0.0001 in the multivariate model). CONCLUSION: The present study suggests that high sodium-potassium ratio is related to high insulin resistance and low insulin sensitivity. Decreasing sodium intake and increasing potassium intake are important for maintaining insulin sensitivity. Further studies are needed to confirm these findings in longitudinal studies.
In order to examine nutritional and behavioral risk factors of atopic dermatitis (AD) in Korean preschoolers, we analyzed data on 144 children aged 3-6 years with AD and their 434 healthy counterparts. The data included breast-feeding history, current weight, food behaviors assessed by the Mini Dietary Assessment (MDA), food intake by a semi-quantitative food frequency questionnaire, and behavior problems by the Preschool and Kindergarten Behavior Scale (PKBS). Multivariate logistic regression analyses were performed after controlling for preschool location and child's age, gender and total energy intake, as appropriate. There was no group difference of child and household characteristics. Breastfeeding history was related to lower AD risk (OR = 0.63, 95% Cl = 0.40-0.99), yet no statistically significant association was found with overweight status. Regarding food behaviors, AD risk was lower in children who drank milk at least one cup per day (OR = 0.52, 95% Cl = 0.35-0.78) and had regular meals (OR = 0.62, 95% Cl =0.42-0.92). Moreover, there were lower risks of AD in the second (OR =0.48, 95% Cl = 0.28-0.82) and the highest (OR = 0.55, 95% Cl = 0.32-0.94) intake quartiles as compared with the lowest quartile of kimchi intake. Similarly, AD risk was lower in the highest quartile of rice (OR = 0.51 Cl = 0.28-0.93) and the second quartile of fruit (OR =0.45, 95% Cl = 0.25-0.82) intakes. AD children had more problems in social interaction (OR = 1.97,95% Cl = 1.26-3.07) and independence (OR = 1.60, 95% Cl = 1.01 -2.54) measures than the healthy controls. Likewise, AD children tended to show more problem behaviors such as anxiety (OR = 1.63, 95% Cl = 0.99-2.69). Our results suggest that nutritional and behavioral dimensions are related to AD risk, yet the case control study design may preclude generalization of these results.
Park, Jung-Eon;Kim, Sang-Hyun;Yoon, Soo-Han;Cho, Kyung-Gi;Kim, Se-Hyuk
Journal of Korean Neurosurgical Society
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제45권2호
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pp.90-95
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2009
Objective : We aimed to identify clinico-radiological risk factors that may predict unfavorable neurological outcomes in traumatic brain injury (TBI), and to establish a guideline for patient selection in clinical trials that would improve neurological outcome during the early post TBI period. Methods : Initial clinico-radiological data of 115 TBI patients were collected prospectively. Regular neurological assessment after standard treatment divided the above patients into 2 groups after 6 months : the Favorable neurological outcome group (GOS : good & moderate disability, DRS : 0-6, LCFS : 8-10) and the Unfavorable group (GOS : severe disability-death, DRS : 7-29 and death, LCFS : 1-7 and death). Results : There was a higher incidence of age $\geq$35 years, low initial GCS score, at least unilateral pupil dilatation, and neurological deficit in the Unfavorable group. The presence of bilateral parenchymal lesions or lesions involving the midline structures in the initial brain CT was observed to be a radiological risk factor for unfavorable outcome. Multivariate analysis demonstrated that age and initial GCS score were independent risk factors. The majority of the Favorable group patients with at least one or more risk factors showed improvement of GCS scores within 2 months after TBI. Conclusion : Patients with the above mentioned clinico-radiological risk factors who received standard treatment, but did not demonstrate neurological improvement within 2 months after TBI were deemed at risk for unfavorable outcome. These patients may be eligible candidates for clinical trials that would improve functional outcome after TBI.
Jeong, Tae Seok;Lee, Sang Gu;Kim, Woo Kyung;Ahn, Yong;Son, Seong
Journal of Korean Neurosurgical Society
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제61권5호
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pp.582-591
/
2018
Objective : To evaluate the magnetic resonance (MR) imaging features that have a statistically significant association with the need for a tracheostomy in patients with cervical spinal cord injury (SCI) during the acute stage of injury. Methods : This study retrospectively reviewed the clinical data of 130 patients with cervical SCI. We analyzed the factors believed to increase the risk of requiring a tracheostomy, including the severity of SCI, the level of injury as determined by radiological assessment, three quantitative MR imaging parameters, and eleven qualitative MR imaging parameters. Results : Significant differences between the non-tracheostomy and tracheostomy groups were determined by the following five factors on multivariate analysis : complete SCI (p=0.007), the radiological level of C5 and above (p=0.038), maximum canal compromise (MCC) (p=0.010), lesion length (p=0.022), and osteophyte formation (p=0.015). For the MCC, the cut-off value was 46%, and the risk of requiring a tracheostomy was three times higher at an interval between 50-60% and ten times higher between 60-70%. For lesion length, the cut-off value was 20 mm, and the risk of requiring a tracheostomy was two times higher at an interval between 20-30 mm and fourteen times higher between 40-50 mm. Conclusion : The American Spinal Injury Association grade A, a radiological injury level of C5 and above, an MCC ${\geq}50%$, a lesion length ${\geq}20mm$, and osteophyte formation at the level of injury were considered to be predictive values for requiring tracheostomy intervention in patients with cervical SCI.
Oh, Sung-Dug;Bae, Eun Ji;Park, Soo-Yun;Lee, Bumkyu;Yun, Do Won;Suh, Sang Jae
농업과학연구
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제46권4호
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pp.827-841
/
2019
The effect of genetically engineered rice Bt-9 on the diversity and abundance of plant-dwelling insects and spiders was tested under field conditions. Genetically engineered rice Bt-9, expressing mCry1Ac1 from Bacillus thuringiensis, confers resistance to rice leaf roller (Cnaphalocrocis medinalis) and provides tolerance to the herbicide glufosinate (PPT). The study compared Bt-9 and two non-GM reference varieties, Ilmi-byeo and Dongjin-byeo, at LMO isolated fields in Gunwi (Kyungpook National University) and Jeonju (National Institute Agricultural Sciences) in Southern Korea in 2016 - 2017. A total of 40,817 individuals from 62 families and 11 orders were collected from the two living modified organism (LMO) isolated fields. From the three types of rice fields, a total of 13,982, 14,105, and 12,730 individuals from the Bt-9, Ilmi-byeo and Dongjin-byeo were collected, respectively. Throughout the study, the analysis of variance indicated no significant differences (p < 0.05). Multivariate analysis showed that the abundance and diversity of plant dwelling insects were similar. The data on insect species population densities were subjected to principal component analysis (PCA), which did not distinguish among the three varieties, Bt-9 and the non-GM, reference cultivars, during the cultivation years. However, the results of the PCA analysis were completely divided into four groups based on the yearly survey areas. Therefore, there was no evidence for a negative impact of Bt-9 on the above-ground insects and spiders.
Objectives We aimed to identify the neuroimaging marker for prediction of the use of atypical antipsychotics (AAP) in dementia patients. Methods From April 2010 to March 2013, 31 patients who were diagnosed as dementia at the psychiatric department of Soonchunhyang University Hospital, completed the brain magnetic resonance imaging scan and cognitive test for dementia. Ten patients were treated with AAP for the improvement of behavioral and psychological symptoms of dementia (BPSD) and the other 21patients were not. Using T1 weighted and Fluid Attenuated Inversion Recovery (FLAIR) images of brain, areas of white matter (WM), gray matter (GM), cerebrospinal fluid (CSF) and white matter hyperintensities (WMH) have been segmented and measured. Multivariate logistic regression models were applied for assessment of association between AAP use and the GM/WM ratio, the WMH/whole brain (GM + WM + CSF) ratio. Results There was a significant association between AAP use and the GM/WM ratio (odds ratio, OR = 1.18, 95% confidence interval, CI 1.01-1.38, p = 0.037), while there was no association between AAP use and the WMH/whole brain ratio (OR = 0.82, 95% CI 0.27-2.48, p = 0.73). Conclusions The GM/WM ratio could be a biological marker for the prediction of AAP use and BPSD in patients with dementia. It was more likely to increase as dementia progress since atrophy of WM was more prominent than that of GM over aging.
Purpose: The purpose of this study was to examine the frequency and the course of delirium, and identify risk factors for the development of delirium in surgical intensive care unit (SICU). Methods: Subjects older than 19 years admitted to the SICU were recruited. After informed written consent, enrolled subjects had baseline cognitive and functional assessments. Subjects were assessed daily for delirium using the Confusion Assessment Method-ICU (CAM-ICU). Results: During the study period, 110 patients were enrolled. The overall incidence of delirium was 20% (22/110). The average time to onset of delirium was 3.04(${\pm}1.25$) days. Several variables were associated with an increased risk of delirium including older age (p<.05), higher admission APACHE II score (p<.001), use of opioid and analgesics (p<.01), using physical restraints (p<.001), and intraoperative hypotension (p<.05). In a multivariate logistic regression model, using physical restraints (p<.001), intraoperative hypotension (p<.05), and older age (p<.05) remained significant predictors of the delirium development. Conclusion: Using physical restraints, intraoperative hypotension and older age was strongly associated with development of delirium in the SICU. Prevention measures need to focus on identifying patients at higher risk for delirium development.
Objectives : The aim of this study was to investigate the relationship between the contributions of macronutrients to the total energy intakes and Body Mass Indices (BMI, $kg/m^2$) of Korean women. Methods : We used dietary records data from 115 healthy Korean women, ages 20 and over, who completed four 3-day dietary records between February 2003 and March 2004. For the calculation of nutrients we used a dietary assessment program developed by the Korean Nutritional Society. Macronutrient intakes were estimated by averaging individual total daily intakes in four 3-day dietary records. Subjects were categorized into three Body Mass Index (BMI) groups : underweight (BMI < 20), normal (20 $\leq$ BMI < 25), and overweight (BMI $\geq$ 25) group. Results : The total energy intakes were not different among the three BMI groups. Similarly, other macronutrient intakes such as protein, fat, carbohydrate, vegetable protein, animal protein, saturated fatty acids, monounsaturated fatty acids, and polyunsaturated fatty acids were not different. From the multivariate nutrient density model, substituting polyunsaturated fatty acid for carbohydrate was positively associated with BMI in women aged 20 to 49 ($\beta=2.31$, p<0.01). In women aged 50 and over, substituting animal protein for carbohydrate was positively associated with BMI ($\beta=0.549$, p=0.04). Conclusions : No single macronutrient was associated with BMI when all subjects were combined. However, when stratified by age, polyunsaturated fatty acid intake in younger women, and animal protein intake in older women, were positively associated with BMI. In the future, we recommend a larger study to confirm these results.
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