• Title/Summary/Keyword: covariates

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Associations of Non Alcoholic Fatty Liver with the Metabolic Syndrome and Serum Carotenoids (비알코올성 지방간과 대사증후군 및 혈청 카로테노이드와의 관련성)

  • Park, Sun-Kyun;Lee, Hyun-Jung;Lee, Duk-Hee;Lee, Sung-Kook;Chun, Byung-Yeol;Kim, Sung-Ae;Lee, Hye-Sung;Son, Hyo-Kyung;Kim, Sung-Hi
    • Journal of Preventive Medicine and Public Health
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    • v.41 no.1
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    • pp.39-44
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    • 2008
  • Objectives : This study was conducted to investigate the associations of non alcoholic fatty liver with metabolic syndrome and the serum carotenoids. Methods : This study was conducted in a general hospital in South Korea from November, 2004 to August, 2005. The study subjects were 350 sampled persons who were aged from 40 years and older (males : 180, females : 170). They were grouped into the normal, mild and severe groups according to fat accumulation in their livers, as determined by ultrasonography. We analyzed the association between non alcoholic fatty liver and metabolic syndrome by multiple logistic regression analysis and we analyzed the association between non alcoholic fatty liver and the serum carotenoids by a general linear model(ANCOVA). Results : After adjustment for the effect of potential covariates, the prevalence of metabolic syndrome was associated with fat accumulation in the liver (p trend <0.001). If the odds ratio of normal group is 1.00, then that of the mild group is 2.80 (95% C.I=1.17-6.71) and that of the severe group is 7.29 (95% C.I=2.76-19.30). The prevalence of metabolic alterations fitting the criteria of metabolic syndrome, according to the class of fat accumulation in the liver, was significantly increased, except for criteria of high blood pressure, a large waist circumference and low HDL (high density lipoprotein) cholesterol level (p trend <0.001). The level of serum ${\beta}$-carotene was decreased according to the class of fat accumulation in the liver (p trend=0.036), but the levels of serum ${\alpha}$-carotene, lycopene, ${\beta}$-cryptoxanthin and lutein were not decreased. Conclusions : This study shows that non alcoholic fatty liver was associated with metabolic syndrome and with the serum ${\beta}$-carotene level.

Analysis of Factors Affecting Nontherapeutic INRs in Korean Outpatients with Mechanical Heart Valves (인공심장판막 치환환자의 치료범위를 벗어난 INR 원인분석)

  • Lee Ju Yeun;Jeong Young Mi;Lee Myung Koo;Kim Ki-bong;Ahn Hyuk;Lee Byung Koo
    • Journal of Chest Surgery
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    • v.38 no.11 s.256
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    • pp.746-760
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    • 2005
  • Background: Following the implantation of heart valve prostheses, it is important to maintain therapeutic INR to reduce the risk of thromboembolism. The objectives of this study were to determine the causes of nontherapeutic INRs, and to identify the factors associated with nonadherences to warfarin therapy in Korean outpatients with prosthetic heart valves managed by a pharmacist-run anticoagulation service (ACS). Material and Method: A retrospective chart review was completed for all patients enrolled in the ACS at Seoul National University Hospital from March, 1997b to September, 2000. The data on 868 patients (5,304 visits) who were at least 6 months post-valve replacement were included. All possible causes of nontherapeutic INRs were documented for each patient visit. The association of covariates to noncompliance was investigated by univariate analysis. Result: The reasons for nontherapeutic INRs were identified as follows: inadequate dosage adjustment $(21\%)$, nonadherences to dosing regimen $(13\%)$, drug/herbal interactions $(12\%)$, changes in diet $(7\%)$, and indeterminate cause $(42\%)$. Younger age, shorter duration of ACS and longer duration of warfarin therapy were associated with nonadherence. Conclusion: In this study, nonadherence and interactions between diet and medications were found to be important factors influencing nontherapeutic INRs. Longer duration of enrollment in the ACS affected the adherence to warfarin therapy Positively whereas younger age and longer duration of warfarin therapy affected negatively.

Mobi-kids: A Case-control Study Protocol on Electromagnetic Field Radiation Exposure from Telecommunication and Brain Tumors in Children and Adolescents (모비키즈: 통신전자파 노출과 어린이청소년의 뇌종양에 관한 환자 -대조군 연구 프로토콜)

  • Choi, Kyung-Hwa;Kim, Dong-Seok;Lee, Jung-il;Ra, Young-Shin;Phi, Ji Hoon;Ahn, Young Hwan;Kwon, Jong Hwa;Lee, Ae-Kyoung;Choi, Hyung-Do;Ha, Mina
    • Journal of Environmental Health Sciences
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    • v.41 no.3
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    • pp.182-190
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    • 2015
  • Objectives: To introduce a protocol of Mobi-kids study which was aimed to examine an association between radiofrequency (RF) radiation exposure by mobile phone use and brain tumor risk in children and adolescents. Methods: The Mobi-kids study was a multinational matched case control study using a standardized protocol with the number of subjects targeted about 1,000 cases and 2,000 controls aged 10 to 24. In Mobi-Kids Korea, the source population was restricted to Seoul, Incheon, and Gyeonggi-do province. Eligible cases of primary brain tumor (glioma, meningioma, and others) were diagnosed from January 2012 to June 2015. Eligible controls were appendicitis patients operated during the study period. Two controls were matched on age, gender, and study region for 1 case. Information about pattern and history of mobile phone use and other covariates were obtained by face to face interview by trained interviewer. The Mobi-kids study has been involved in Mobi-expo as a validation study about mobile phone use, XGridmaster to localize tumor in the brain for RF energy calculation, and histological review for validation of diagnosis. Results: The Mobi-kids was the first and largest study in children and adolescents to estimate risk of brain tumor in association with the RF energy absorption in the brain estimated by mobile phone use. Forty-six-cases and 54 controls were collected as of September 2014 in Korea. Conclusions: The meaningful results of the study were expected because of the largest sample size, high validity of EMF exposure assessment as well as the susceptible study populationof children and adolescents.

The Effect of Computer-Assisted Instruction Using Molecular-Level Animation in Middle School Science Class (중학교 과학수업에서 입자수준의 애니메이션을 이용한 컴퓨터 보조수업의 효과)

  • Noh, Tae-Hee;Cha, Jeong-Ho;Kim, Chang-Min;Choi, Yong-Nam
    • Journal of The Korean Association For Science Education
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    • v.18 no.2
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    • pp.161-171
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    • 1998
  • The effects of computer-assisted instruction (CAl) using molecular-level animation upon students' conceptions, attitudes toward science instruction, and learning motivation were investigated. Treatment and control groups (2 classes) were selected from a girls middle school in Seoul, and taught about the motion of molecule for 5 class hours. Before instruction, the short-version Group Assessment of Logical Thinking (GALT) and the Patterns of Adaptive Survey were administered, and the grade for the previous science course was obtained. The GALT score was used as a blocking variable, and the others as covariates. After the instructions, the researcher-made conceptions test, the test of attitudes toward science instruction, and the motivation questionnaire were administered. The perception questionnaire of CAl was also administered to the treatment group. Although more students in the CAl group had sound understanding about the motion of molecule, the scores of the conceptions test for the two groups were not significantly different at .05 level of significance. The students in the CAl group, however, were found to have more positive attitudes toward science instruction and learning motivation. In the perception questionnaire of CAl, most students in the treatment group exhibited positive attitudes toward the CAl. However, some students mentioned that they were disturbed by noisy environments, and that they could not understand some content presented. Educational implications are discussed.

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The Sleep Characteristics of Chronic Schizophrenia Patients with Insomnia in Community-based Mental Health Services (지역사회 정신보건 서비스를 이용하는 불면증을 동반한 만성 조현병 환자의 수면의 특징)

  • Hwang, Dong-Ki;Nam, Min;Lee, Yu-Jin G.
    • Sleep Medicine and Psychophysiology
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    • v.24 no.2
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    • pp.97-105
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    • 2017
  • Objectives: To evaluate sleep characteristics and factors associated with sleep disturbance in schizophrenia patients with concurrent active psychotic symptoms and insomnia. Methods: Schizophrenia patients with insomnia and active psychotic symptoms (n = 63) were recruited from community-based mental rehabilitative facilities. Sleep scales such as the Korean version of the Insomnia Severity Index (ISI-K) and the Korean Version of the Pittsburgh Sleep Quality Index (PSQI-K) were evaluated and those with ISI-K >15 were included in the study. Psychotic, anxiety and depressive symptoms were rated with the Brief Psychotic Rating Scale (BPRS), the Korean Version of the Anxiety Sensitivity Index (K-ASI), and the Korean Version of the Beck Depression Inventory-I (K-BDI), respectively. Pearson correlation analyses were performed between the sociodemographic data, ISI-K and PSQI-K. Multiple linear regression analysis was conducted to investigate the factors which affected the ISI-K and PSQI-K. Results: The mean ISI-K and PSQI-K scores were $18.1{\pm}2.6$ and $12.0{\pm}2.2$, respectively. Pearson correlation analysis showed a negative correlation between age of onset and ISI-K score and positive correlations between BRPS and PSQI-K scores and between K-ASI and both ISI-K and PSQI-K scores. Multiple regression analyses for both ISI-K and PSQI-K with K-ASI, age of onset, and BPRS as covariates revealed K-ASI as the only significant remaining factor. Conclusion: Our study suggests that anxiety symptoms are associated with insomnia symptoms in schizophrenia patients regardless of depressive or psychotic symptoms.

Accuracy of Combined Visual Inspection with Acetic Acid and Cervical Cytology Testing as a Primary Screening Tool for Cervical Cancer: a Systematic Review and Meta-Analysis

  • Chanthavilay, Phetsavanh;Mayxay, Mayfong;Phongsavan, Keokedthong;Marsden, Donald E;White, Lisa J;Moore, Lynne;Reinharz, Daniel
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.14
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    • pp.5889-5897
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    • 2015
  • Background: The performance of combined testing visual inspection with acetic acid (VIA) and cervical cytology tests might differ from one setting to another. The average estimate of the testing accuracy across studies is informative, but no meta-analysis has been carried out to assess this combined method. Objective: The objective of this study was to estimate the average sensitivity and specificity of the combined VIA and cervical cytology tests for the detection of cervical precancerous lesions. Materials and Methods: We conducted a systematic review and a meta-analysis, according to the Cochrane Handbook for Systematic Review of Diagnostic Test Accuracy. We considered two cases. In the either-positive result case, a positive result implies positivity in at least one of the tests. A negative result implies negativity in both tests. In the both-positive case, a positive result implies having both tests positive. Eligible studies were identified using Pubmed, Embase, Website of Science, CINHAL and COCRANE databases. True positive, false positive, false negative and true negative values were extracted. Estimates of sensitivity and specificity, positive and negative likelihood (LR) and diagnostic odds ratios (DOR) were pooled using a hierarchical random effect model. Hierarchical summary receiver operating characteristics (HSROC) were generated and heterogeneity was verified through covariates potentially influencing the diagnostic odds ratio. Findings: Nine studies fulfilled inclusion criteria and were included in the analysis. Pooled estimates of the sensitivities of the combined tests in either-positive and both-positive cases were 0.87 (95% CI: 0.83-0.90) and 0.38 (95% CI: 0.29-0.48), respectively. Corresponding specificities were 0.79 (95% CI: 0.63-0.89) and 0.98 (95% CI: 0.96-0.99) respectively. The DORs of the combined tests in either-positive or both-positive result cases were 27.7 (95% CI: 12.5-61.5) and 52 (95% CI: 22.1-122.2), respectively. When including only articles without partial verification bias and also a high-grade cervical intraepithelial neoplasia as a threshold of the disease, DOR of combined test in both-positive result cases remained the highest. However, DORs decreased to 12.1 (95% CI: 6.05-24.1) and 13.8 (95% CI: 7.92-23.9) in studies without partial verification bias for the combined tests in the either-positive and both-positive result cases, respectively. The screener, the place of study and the size of the population significantly influenced the DOR of combined tests in the both-positive result case in restriction analyses that considered only articles with CIN2+ as disease threshold. Conclusions: The combined test in the either-positive result case has a high sensitivity, but a low specificity. These results suggest that the combined test should be considered in developing countries as a primary screening test if facilities exist to confirm, through colposcopy and biopsy, a positive result.

Adjuvant Radiotherapy for Gastric Carcinoma: 10 years Follow-up of 244 cases from a Single Institution

  • Misirlioglu, Hasan Cem;Coskun-Breuneval, Mehtap;Kucukpilakci, Bulent;Ugur, Vahide Isil;Elgin, Yesim;Demirkasimoglu, Taciser;Kara, Sakire Pinar;Ozgen, Aytul;Sanri, Ergun;Guney, Yildiz
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.20
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    • pp.8871-8876
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    • 2014
  • Background: Postoperative chemoradiotherapy (CRT) of gastric carcinoma improves survival among high-risk patients. This study was undertaken to analyse long-term survival probability and the impact of certain covariates on the survival outcome in affected individuals. Materials and Methods: Between January 2000 and December 2005, 244 patients with gastric cancer underwent adjuvant radiotherapy (RT) in our institution. Data were retrieved retrospectively from patient files and analysed with SPSS version 21.0. Results: A total of 244 cases, with a male to female ratio of 2.2:1, were enrolled in the study. The median age of the patients was 52 years (range, 20-78 years). Surgical margin status was positive or close in 72 (33%) out of 220 patients. Postoperative adjuvant RT dose was 46 Gy. Median follow-up was 99 months (range, 79-132 months) and 23 months (range, 2-155 months) for surviving patients and all patients, respectively. Actuarial overall survival (OS) probability for 1-, 3-, 5- and 10-year was 79%, 37%, 24% and 16%, respectively. Actuarial progression free survival (PFS) probability was 69%, 34%, 23% and 16% in the same consecutive order. AJCC Stage I-II disease, subtotal gastrectomy and adjuvant CRT were significantly associated with improved OS and PFS in multivariate analyses. Surgical margin status or lymph node dissection type were not prognostic for survival. Conclusions: Postoperative CRT should be considered for all patients with high risk of recurrence after gastrectomy. Beside well-known prognostic factors such as stage, lymph node status and concurrent chemotherapy, the type of gastrectomy was an important prognostic factor in our series. With our findings we add to the discussion on the definition of required surgical margin for subtotal gastrectomy. We consider that our observations in gastric cancer patients in our clinic can be useful in the future randomised trials to point the way to improved outcomes.

rs10505474 and rs7837328 at 8q24 Cumulatively Confer Risk of Prostate Cancer in Northern Han Chinese

  • Zhang, Lin-Lin;Sun, Liang;Zhu, Xiao-Quan;Xu, Yong;Yang, Kuo;Yang, Fan;Yang, Yi-Ge;Chen, Guo-Qiang;Fu, Ji-Cheng;Zheng, Chen-Guang;Li, Ying;Mu, Xiao-Qiu;Shi, Xiao-Hong;Zhao, Fan;Wang, Fei;Yang, Ze;Wang, Bin-You
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.7
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    • pp.3129-3132
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    • 2014
  • Aims: Genome-wide association studies (GWAS) have identified several risk variants for prostate cancer (pCa) mainly in Europeans, which need to be further verified in other racial groups. We selected six previously identified variants as candidates and to define the association with PCa in Northern Han Chinese. Methods: 749 subjects from Beijing and Tianjin in Northern China were included. Six variants (rs10505474, rs7837328, rs4242384, rs7813, rs486907 and rs1058205) were genotyped by high resolution melting (HRM) assays. The individual and cumulative contribution for of the risk of PCa and clinical covariates were analyzed. Results: Among the six candidate variants, onlyrs10505474, and rs7837328, both locating at 8q24 region, were associated with PCa in our population.rs10505474 (A) was associated with PCa ($OR_{recessive}=1.56$, p=0.006); and rs7837328 (A) was associated with PCa ($OR_{dominant}=1.38$, p=0.042/$OR_{recessive}=1.99$, p=0.003). Moreover, we observed a cumulative effects between them ($p_{trend}=2.58{\times}10^{-5}$). The joint population attributable risk showed the two variants might account for 71.85% of PCa risk. In addition, we found the homozygotes of rs10505474 (A) and rs7837328 (A) were associated with PCa clinical covariants (age at onset, tumor stage, respectively) ($p_{age}=0.046$, $P_{tumorstage}=0.048$). Conclusion: rs10505474 (A) and rs7387328 (A) at 8q24 are associated with PCa and cumulatively confer risk, suggesting the two variations could determine susceptibility to PCa in the Northern Chinese Han population.

Lack of Association between Fingernail Selenium and Thyroid Cancer Risk: A Case-Control Study in French Polynesia

  • Ren, Yan;Kitahara, Cari Meinhold;de Gonzalez, Amy Berrington;Clero, Enora;Brindel, Pauline;Maillard, Stephane;Cote, Suzanne;Dewailly, Eric;Rachedi, Frederique;Boissin, Jean-Louis;Sebbag, Joseph;Shan, Larrys;Bost-Bezeaud, Frederique;Petitdidier, Patrick;Xhaard, Constance;Rubino, Carole;de Vathaire, Florent
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.13
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    • pp.5187-5194
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    • 2014
  • Background: Numerous studies have suggested that selenium deficiency may be associated with an increased risk for several types of cancer, but few have focused on thyroid cancer. Materials and Methods: We examined the association between post-diagnostic fingernail selenium levels and differentiated thyroid cancer risk in a French Polynesian matched case-control study. Conditional logistic regression models were used to estimate odds ratios and 95% confidence intervals. Results: The median selenium concentration among controls was $0.76{\mu}g/g$. Significantly, we found no association between fingernail selenium levels and thyroid cancer risk after conditioning on year of birth and sex and additionally adjusting for date of birth (highest versus lowest quartile: odds-ratio=1.12, 95% confidence interval: 0.66-1.90; p-trend=0.30). After additional adjustment for other covariates, this association remained non-significant (p-trend=0.60). When restricting the analysis to thyroid cancer of 10 mm or more, selenium in nails was non-significantly positively linked to thyroid cancer risk (p-trend=0.09). Although no significant interaction was evidenced between iodine in nails and selenium in nails effect (p=0.70), a non-significant (p-trend =0.10) positive association between selenium and thyroid cancer risk was seen in patients with less than 3 ppm of iodine in nails. The highest fingernail selenium concentration in French Polynesia was in the Marquises Islands ($M=0.87{\mu}g/g$) and in the Tuamotu-Gambier Archipelago ($M=0.86{\mu}g/g$). Conclusions: Our results do not support, among individuals with sufficient levels of selenium, that greater long-term exposure to selenium may reduce thyroid cancer risk. Because these findings are based on post-diagnostic measures, studies with prediagnostic selenium are needed for corroboration.

Pyogenic Liver Abscess as a Warning Sign for Primary Liver Cancer: A Nationwide Population-based Study

  • Huang, Wen-Kuan;Lin, Yung-Chang;Chiou, Meng-Jiun;Yang, Tsai-Sheng;Chang, John Wen-Cheng;Yu, Kuang-Hui;Kuo, Chang-Fu;See, Lai-Chu
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.8
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    • pp.4727-4731
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    • 2013
  • Background: There have been no large-scale population-based studies to estimate the subsequent risk of primary liver cancer (PLC) among patients with pyogenic liver abscess (PLA). This study aimed to provide relevant data. Materials and Methods: The Taiwan Longitudinal Health Insurance Database for the years 2000 and 2005 was used. The PLA group were adult inpatients who were newly diagnosed with PLA from 2000 to 2008. The control group was randomly selected and matched with the PLA group in terms of age, sex, and date in which medical treatment was sought other than for PLA. Results: There were 1,987 patients each in the PLA and control groups. In total, 56 had PLC, 48 (2.4%, 601.5 per 100,000 person-years) from the PLA group, and 8 from the control group. After adjusting for potential covariates, the hazard ratio of PLC for the PLA group was 3.4 times that of the control group (95% confidence interval = 1.6-7.3, p <0.001). The PLC risk for the PLA group was significantly higher within the first year after PLA diagnosis (hazard ratio: 35.4) as compared with the control group and became insignificant (hazard ratio: 2.0, 95% confidence interval = 0.8-4.9) more than one year after PLA diagnosis. Conclusions: Patients with PLA have a higher rate of PLC than matched controls, especially within the first year after the diagnosis of PLA, suggesting PLA is a warning sign for PLC.