• Asian Pacific Journal of Cancer Prevention
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• v.16 no.9
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• pp.3931-3936
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• 2015

Fatty liver disease (FLD) can be a precondition for other liver pathology including cholangiocarcinoma (CCA). Diabetes mellitus (DM) has been suggested in some studies to be a risk factor for FLD as well as cancers, including cholangiocellular carcinoma; however, there are currently very few studies on FLD in DM subjects, although the rate of FLD continues to increase annually. To determine the association between DM and FLD ultrasonographic data were analyzed from the Cholangiocarcinoma Screening and Care Program (CASCAP), in northeast Thailand. DM was reported by the subjects based on the CASCAP health questionnaire. Factors that were associated with FLD were determined by prevalence, odds ratio (ORs) and its 95% confidence intervals (CIs) using multiple logistic regression. There were 45,263 subjects with a mean age of 53.46 (${\pm}9.25$) years. FLD was found in 36.3% of DM subjects but only in 20.7% of non-DM subjects. The association between DM and FLD was adjusted for all other factors including gender, age, education level, relatives diagnosed with CCA, smoking, alcohol consumption, and hepatitis B and C. The risk of DM in subjects having FLD was highly significant compared with the non-DM subjects (OR 2.13; 95%CI: 1.92 to 2.35; p-value < 0.001). Thus DM is significantly associated with FLD which in turn may facilitate the development of several diseases including CCA. DM should be taken into consideration in future ultrasonic investigations of FLD and CCA.

• Asian Pacific Journal of Cancer Prevention
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• v.14 no.11
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• pp.6955-6959
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• 2013

The incidence of hepatocellular carcinoma (HCC) is relatively high in Southeast Asia. Globally, HCC has a high fatality rate and short survival. The objectives of this retrospective cohort study were to review the epidemiology and survival of HCC patients at a tertiary centre in north-east of Peninsular Malaysia. Subjects were adult HCC patients diagnosed by histopathology or radio-imaging. Secondary liver carcinoma was excluded. Kaplan Meier and multiple Cox proportional hazard survival analyses were used. Only 210 HCC cases from years 1987-2008, were included in the final analysis. The number of cases was increasing annually. The mean age was 55.0 (SD 13.9) years with male:female ratio of 3.7:1. Approximately 57.6% had positive hepatitis B virus, 2.4% hepatitis C virus, 20% liver cirrhosis and 8.1% chronic liver disease. Only 2.9% had family history and 9.0% had frequently consumed alcohol. Most patients presented with abdominal pain or discomfort and had hepatomegaly, 47.9% had an elevated ${\alpha}$-fetoprotein level of 800 IU/ml or more, 51.9% had multiple tumors and 44.8% involved multiple liver lobes. Approximately 63.3% were in stage 3 and 23.4% in stage 4, and 82.9% did not receive any treatment. The overall median survival time was 1.9 months (95% confidence interval (CI): 1.5, 2.3). The 1-month, 6-month, 1-year and 2-year survival rates were 71.8%, 23.3%, 13.0% and 7.3% respectively. Significant prognostic factors were Malay ethnicity [Adjusted hazard ratio (AHR) 1.6; 95%CI: 1.0, 2.5; p=0.030], no chemotherapy [AHR 1.7; 95%CI: 1.1, 2.5; p=0.017] and Child-Pugh class C [AHR 2.6; 95%CI: 1.4, 4.9; p=0.002]. HCC in our study affected a wide age range, mostly male, in advanced stage of disease, with no treatment and very low survival rates. Primary prevention should be advocated in view of late presentation and difficulty of treatment. Vaccination of hepatitis virus and avoidance of liver toxins are to be encouraged.

• Journal of Preventive Medicine and Public Health
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• v.24 no.2 s.34
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• pp.161-170
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• 1991

The purpose of this study is to find the tracking of blood pressure in primary school-age children. A follow-up study was conducted from 1986 to 1990 on 330 first grade children attending primary schools in Kangwha County, Kyungki-Do. Basically we employed a linear regression model with random coefficients to figure out the relation between blood pressure changes and initial blood pressure. We obtained the following results ; 1. The mean blood pressures were increased grade went up in both sexs and were generally higher in female than male except for the systolic blood pressure at first grade. The size of difference was about 0.8 mmHg in mean systolic blood pressure and 1.5 mmHg in mean diastolic blood pressure. 2. The average annual increasing rates of systolic blood pressure were 2.5 mmHg in male and 3.1 mmHg in female respectively. For the diastolic blood pressure IV the average annual increasing rates were observed to be 3.0 mmHg in male and 2.9 mmHg in female respectively. Increasing rate of systolic blood pressure was significantly higher in female than male. 3. The adjusted regression coefficient of systolic blood pressure change on initial value was -0.11 in male and -0.13 in female and that coefficient of diastolic blood pressure change on initial value was -0.01 in male and -0.11 in female. This result shows that children with higher initial blood pressure do not pick up their blood pressure faster than others with lower initial blood pressure. There is no evidence of tracking of blood pressure in children. It is essential to find the earliest age having the tracking of blood pressure and we leave it for the further study.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.3
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• pp.1069-1072
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• 2015

Background: Colorectal cancer (CRC) is an important cause of mortality and morbidity in many communities worldwide. This population based study was conducted to assess determinants of colorectal mortality in Iranian patients. Materials and Methods: A cohort of 1,127 cases of confirmed colorectal cancer registered in a population based registry covering 10 referral hospital in Tehran, Iran, were followed for five years. Information about tumor characteristics, smoking status and family history were collected at base line and survival status were followed every six months by contacting patient or next of kin (if patients died during the follow-up). The cause of death for each case was validated by verbal autopsy and referring to patient medical records at the time of death. The data were analyzed by Stata software using univariate and multivariate analysis (Cox regression). In building the model a p value of less than 5% was considered as significant. Results: The age at diagnosis was $53.5{\pm}14$ years. Sixty one percent were male. Colorectal mortality among the patients was 96.9 person-years among men and 83 person-years among women. Seventy five percent of patients lived for 2.72 years, 50% for 5.83, and 25% for 13 years after the diagnosis of colorectal cancer. The age at diagnosis was significantly different between men and women (p<0.03). Higher tumor grade predicted higher death rate; the adjusted hazard ratios were 1.79 (95%CI, 0.88-3.61), 2.16 (95%CI, 1.07-4.37), and 3.1 (95%CI, 1.51-6.34) for grades II, III, and IV respectively when they were compared with grade I as reference. Ethnicity, marital status, family history of cancer, and smoking were related to survival with different degrees of magnitude. Conclusions: Among many factors related to survival among the colorectal patients, tumor grade and smoking showed the highest magnitudes of association.

• Journal of Yeungnam Medical Science
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• v.40 no.2
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• pp.187-192
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• 2023

Background: This study aimed to present the short- and midterm outcomes after complete atrioventricular canal defect (CAVC) repair using a single-patch technique. Methods: This study included 30 children who underwent surgical correction of the CAVC using a single-patch technique. Results: The median age of the patients was 5.7 months (interquartile range [IQR], 5.0-7.5 months), and 23 patients (76.7%) had type A CAVC. Fourteen patients (46.7%) were female and 17 (56.7%) had been diagnosed with Down syndrome. The in-hospital mortality rate was 0%. No deaths were observed during a median follow-up of 4 years (IQR, 3.5-5.0 years). Patients without Down syndrome were associated with late moderate mitral regurgitation (MR) (p=0.02). Late MR less than moderate degree was observed in 96.6%, 78.5%, and 50% of patients after 2, 4, and 5 years of follow-up, respectively, while late tricuspid valve regurgitation less than moderate degree was observed in 96.7%, 85.9%, and 59.0% of patients after 2, 4, and 6 years of follow-up, respectively. After a median follow-up of 4 years, only one patient had required surgical repair of a left ventricular outflow tract obstruction, which occurred 26 months after the first operation. Multivariable logistic regression analysis adjusted for the type of CAVC, sex, Down syndrome, age, and weight revealed that the absence of Down syndrome was a risk factor for late moderate MR (MR-2) (odds ratio, 0.05; 95% confidence interval, 0.006-0.50; p=0.01). Conclusion: A single-patch technique for CAVC surgical repair is a safe method with acceptable short- and midterm results.

• Annals of Hepato-Biliary-Pancreatic Surgery
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• v.26 no.3
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• pp.235-243
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• 2022

Backgrounds/Aims: Historically, the incidence and prognosis of patients diagnosed with intrahepatic cholangiocarcinoma (ICC) have been inadequately understood. Survival analysis in ICC has yet to be investigated in a population-based study. Methods: We conducted a retrospective cohort study using the Surveillance, Epidemiology, and End Results Program (SEER) 18 Registry. Risk ratios were estimated via Poisson regression. Hazard ratios for 5-year survival were estimated using hierarchical Cox regression models. Results: Males show a higher rate of age-adjusted ICC incidence. Blacks carried a decreased risk of ICC diagnosis than Whites, while Asians revealed a higher risk of ICC diagnosis when compared with Whites. The observed survival rates at 12, 36, and 60 months were 36.3%, 12.8%, and 8.1%, respectively. Compared with Whites, Blacks showed an increased risk of death (p < 0.01). Lymph node resection during surgery was associated with a 64.1% reduced risk of mortality (p < 0.01). A higher T stage at diagnosis was associated with poor survival (p < 0.01). Surgery combined with chemoradiotherapy, radiotherapy, or chemotherapy was associated with a reduced risk of mortality compared with nonsurgical interventions (p < 0.01). Conclusions: ICC incidence has been increasing since 2000, especially in White males. The risk of ICC rises with age. Lymph node removal is associated with better survival. In recent years, survival had worsened, and surgical intervention improved survival compared with nonsurgical management.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.13 no.10
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• pp.4686-4693
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• 2012

The present study was conducted to identify the factors related to the hypertension, and to offer the evidence of 1st prevention of hypertension. 2,230 male workers aged 30-59 years were observed the relationships between hypertension and age, BMI, glucose intolerance, smoking, alcohol drinking, regular exercise, eating habits using data from health check-ups in 2011. As a results, the incidence rate of hypertension was 18.8% of 30-39 year old group, 23.8% of 40-49 year old group, 33.0% of 40-49 year old group. The incidence rate of hypertension was significantly higher as age and BMI ascend, and it was higher in the group of abnormal glucose intolerance, regular alcohol intake, no regular exercise than their respective counterparts. The multivariable-adjusted odds ratio of hypertension increased significantly as there is an increase in age, and the group of abnormal glucose intolerance, smoking, regular alcohol intake, no regular exercise. In conclusion, obesity, glucose intolerance, alcohol intake, and physical inactivity are risk factors for hypertension, therefore we need the control of these factors for 1st prevention of hypertension.

• Journal of Preventive Medicine and Public Health
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• v.39 no.1
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• pp.39-45
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• 2006

Objectives: This study estimated the burden of disease especially caused by psychiatric disorders in Korea by using DALY, a composite indicator that was recently developed by the Global Burden of Disease study group. Methods: First, 11 of the major psychiatric disorders in Korea were selected based on the ICD-10. Second, the burden of disease due to premature death was estimated by using YLLs (years of life lost due to premature death). Third, for the calculation of the YLD (years lived with disability), the following parameters were estimated in the formula: the incidence rate, the prevalence rate and the disability weight of each psychiatric disorder. Last, we estimated the DALY of the psychiatric disorders by adding the YLLs and YLDs. Results: The burden of psychiatric disorder per 100,000 people was attributed mainly to unipolar major depression (1,278 person-years), schizophrenia (638 person-years) and alcohol use disorder (287 person-years). For males, schizophrenia (596 person-years) and alcohol use disorder (491 person-years) caused the highest burden. For females, unipolar major depression (1,749 person-years) and schizophrenia (680 person-years) cause the highest burden. As analyzed by gender and age group, alcohol use disorder causes a higher burden than schizophrenia in men aged 40 years and older. For females, unipolar major depression causes the highest burden in all age groups. Conclusions: We found that each of the psychiatric disorders that cause the highest burden is different according to gender and age group. This study's results can provide a rational basis to plan a national health policy regarding the burden of disease caused by psychiatric disorders.

• Korean Journal of Radiology
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• v.21 no.6
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• pp.736-745
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• 2020

Objective: To identify the initial chest computed tomography (CT) findings and clinical characteristics associated with the course of coronavirus disease 2019 (COVID-19) pneumonia. Materials and Methods: Baseline CT scans and clinical and laboratory data of 72 patients admitted with COVID-19 pneumonia (39 men, 46.2 ± 15.9 years) were retrospectively analyzed. Baseline CT findings including lobar distribution, presence of ground glass opacities, consolidation, linear opacities, and lung severity score were evaluated. The outcome event was recovery with hospital discharge. The time from symptom onset to discharge or the end of follow-up (for those remained hospitalized) was recorded. Data were censored in events such as death or discharge without recovery. Multivariable Cox proportional hazard regression was used to explore the association between initial CT, clinical or laboratory findings, and discharge with recovery, whereby hazard ratio (HR) values < 1 indicated a lower rate of discharge at four weeks and longer time until discharge. Results: Thirty-two patients recovered and were discharged during the study period with a median length of admission of 16 days (range, 9 to 25 days), while the rest remained hospitalized at the end of this study (median, 17.5 days; range, 4 to 27 days). None died during the study period. After controlling for age, onset time, lesion characteristics, number of lung lobes affected, and bilateral involvement, the lung severity score on baseline CT (> 4 vs. ≤ 4 [reference]: adjusted HR = 0.41 [95% confidence interval, CI = 0.18-0.92], p = 0.031) and initial lymphocyte count (reduced vs. normal or elevated [reference]: adjusted HR = 0.14 [95% CI = 0.03-0.60], p = 0.008) were two significant independent factors that influenced recovery and discharge. Conclusion: Lung severity score > 4 and reduced lymphocyte count at initial evaluation were independently associated with a significantly lower rate of recovery and discharge and extended hospitalization in patients admitted for COVID-19 pneumonia.

• Journal of Korean society of Dental Hygiene
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• v.14 no.6
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• pp.805-812
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• 2014

Objectives: The purpose of the study was to examine the association between diabetes mellitus and community periodontal index in Korean adults. Methods: The study populations were recruited by the Fifth Korea National Health and Nutrition Examination Survey. Study subjects were 10,411 who were examined oral examination, blood test, and aged over 19 years. Using multiple logistic regression analyses, the variables were adjusted for gender, age, household income, family history of diabetes, body mess index, smoking habit, and frequency of tooth brushing. Periodontal tissue examination of the subjects was performed and scored by Community periodontal index(CPI). Using probe, six teeth were examined for hemorrhage, plaque, and pocket depth and classified into $CPI_0$, $CPI_1$, $CPI_2$, $CPI_3$ and $CPI_4$. Healthy periodontal groups($CPI_{0-2}$) and periodontal disease groups($CPI_{3-4}$) were divided by the periodontal disease status. The definition of diabetes mellitus(DM) was decided by the diagnosis by the doctors and fasting blood sugar level. Those who were diagnosed as DM were included in DM group. The DM variables included normal blood sugar level, increased fasting blood sugar level, and DM blood sugar level. The DM variables were compared to periodontal disease blood sugar level and analyzed. Results: The periodontitis prevalence rate was 23.2%. Those who had diabetes mellitus accounted for 5.5% of the subjects. Those who had impaired fasting glucose accounted for 17.7% and 7.9% of subjects were diabetes mellitus by blood test. In the confirmed diabetes group by doctor, the periodontitis prevalence rate was significantly higher than the non-diabetic group. Diabetic group by blood test had the highest prevalence rate of periodontitis than those who had impaired fasting glucose group or normal group. After adjusting for gender, age, household income, family history of diabetes, body mass index, smoking habit, and frequency of tooth brushing, the risk of periodontitis in diagnosed diabetes mellitus was 1.57 times(95% CI; 1.27-1.94) higher than the normal group. In impaired fasting glucose group and diabetes mellitus group by blood test, the risk of periodontitis was 1.11 times(95% CI; 0.95-1.30) and 1.45 times(95% CI; 1.45-2.12) higher, respectively. Conclusions: There was a significant relationship between diabetes mellitus and periodontitis in Korean adults. These results suggest that diabetes mellitus is a risk factor for periodontitis.