• Title/Summary/Keyword: high risk groups

Search Result 1,485, Processing Time 0.043 seconds

Prognostic Factors of Malignant Pleural Effusion in Non-small Cell Lung Cancer (비소세포폐암에 발생한 악성 흉수의 예후 인자)

  • Lim, Chang-Young;Lee, Gun;Lee, Hyeon-Jae
    • Journal of Chest Surgery
    • /
    • v.40 no.2 s.271
    • /
    • pp.109-113
    • /
    • 2007
  • Background: In non-small cell lung cancer (NSCLC), malignant pleural effusion is a frequently observed com-plication, and is an important negative prognostic factor. Although many studies concerned to diagnosis and treatment of malignant pleural effusion have been performed, prognostic factors of malignant pleural effusion have rarely been investigated. This study was performed to determine the prognostic factors of malignant pleural effusion n non-small cell lung cancer. Material and Method: We evaluated 33 NSCLC patients with malignant effusion treated between January 2002 and December 2003. We analyzed possible factors: gender, age, TNM Stage, fluid analysis (pH, CEA, LDH, glucose, albumin) and treatment modality. Median survival time of each factor was calculated by Kaplan-Meier method and difference of median survival time between groups of factor compared by log-rank test. The Cox proportional hazards regression model was used to confirm the significance of prognostic factor. Results: Of the 33 patients, 23 (69.7%) patients were adenocarcinoma. The median interval of the diagnosis of lung cancer and malignant effusion was 7.3 months ($25^{th}{\sim}75^{th}:\;3.9{\sim}11.8$), and the median survival time was 3.6 months (95% Confidence Interval: $1.14{\sim}5.99$). In the univariate analysis, using the log-rank test, those with an adenocarcinoma showed a relatively longer median survival time than those of a non-adenocarcinoma (4.067 vs. 1.867 months, p=0.067) without statistical significance. In the multivariate analysis, using the Cox regression, those with a non-adenocarcinoma showed a trend of high risk of cancer death than those with an adenocarcinoma without statistical significance (Relative risk; 2.754, 95% Cl: $0.988{\sim}7.672$, p=0.053). Conclusion: We could not find an independent prognostic factor of malignant pleural effusion in NSCLC. As there was a trend of high risk of cancer death according to histology, further study will be needed.

The Effects of 8-weeks Jeol Meditation Program on Stress, Depression and Cardiovascular Risk Factors in Women (8주간의 절명상 프로그램이 여성의 스트레스, 우울 및 심혈관 위험인자에 미치는 효과)

  • Jung, HwanSug;Kang, YuneSik
    • Journal of agricultural medicine and community health
    • /
    • v.38 no.3
    • /
    • pp.163-173
    • /
    • 2013
  • Objectives: There has been an increase in the use of mind-body therapies to control cardiovascular risk factors recently. This trial was designed to determine whether the 'jeol'(Korean Buddhists' prostration) meditation program, as a new mind-body intervention, was effective in managing stress, depression and controlling cardiovascular risk factors in women working at a geriatric hospital. Methods: We conducted a randomized controlled trial to determine whether the 'jeol' meditation program could improve stress, anxiety, depression, and cardiovascular risk factors in women. We randomly assigned 57 participants to the intervention(29 participants) or control(28 participants) group. The subjects in the intervention group participated in a group Jeol meditation program once weekly, and practiced at home. The following variables were assessed: stress(Psychosocial Wellbeing Index), depression(Beck's Depression Inventory), body mass index(BMI), waist circumference, hemoglobin A1c(HbA1c), homeostasis model assessment(HOMA), low-density lipoprotein(LDL) cholesterol, high-density lipoprotein(HDL) cholesterol, and triglyceride were assessed. Results: After the 8-week program, 2 participants from the intervention group and 1 from the control group dropped out. The subjects in the intervention group exhibited decreased scores for stress(t=5.102, p<0.01), depression(t=5.259, p<0.01), BMI(t=2.942, p=0.007), and waist circumference(t=2.582, p=0.016); however these scores did not demonstrate a significant decrease in participants of the control group. The other variables showed no significant difference between the groups. Conclusion: The 'jeol' meditation program evidently reduced stress, anxiety, depression, body weight, and waist circumference in women, which suggests that this program could be employed as a mind-body therapies.

Characteristics and Recurrence Risk Factors of Urinary Tract Infection in Early Infancy (6개월 미만 영아 요로 감염의 특성과 재발의 위험 인자)

  • Kang Hee-Gyung;Kim Nam-Hee;Kang Ju-Hyung;Ha Il-Soo;Cheong Hae-Il;Choi Yong
    • Childhood Kidney Diseases
    • /
    • v.8 no.2
    • /
    • pp.223-228
    • /
    • 2004
  • Purpose and Methods: Urinary tract infection(UTI) is one of the most important diseases of childhood, especially for young infants. To characterize the patients diagnosed with febrile UTI in their first 6 months of life and to explore the risk factors of recurrent UTI, a retrospective study was performed. Results: Among the 90 patients studied, 77 were boys(86%). First episodes of UTI were diagnosed at the age of $2.5{\pm}1.4$ months. These patients underwent ultrasonographic evaluation of urinary tract(n=90) and voiding cystourethrography(n=81) where 53 and 35 studies showed abnormal findings respectively, and a total of 45 cases of urinary tract anomaly including vesicoureteral reflux(VUR, n=35) were diagnosed. Normal findings on ultrasonography indicated decreased risk of VUR in boys of 1-3 months of age(n=30). 53 patients were followed up more than 6 months and 45 episodes of subsequent UTI developed in 29 patients during the first 6-month period. Patients with relapse were older than patients without relapse at the diagnosis of first UTI, but other clinical parameters including abnormal findings on the imaging studies and prophylactic antibiotics prescription were not different between the two groups. Conclusion: UTI in early infancy occurred mainly in male infants and half of the patients had structural anomalies. USG was of clinical value in detecting anomalies requiring surgical intervention, and to rule out high grade VUR in 1-3 months old boys. Results of the imaging study or prophylactic antibiotics could not modify the risk of recurrent UTI. (J Korean Soc Pediatr Nephrol 2004;8:223-228)

  • PDF

Intrauterine Intraventricular Hemorrhage in Premature Infants (태아기 신생아 뇌실내 출혈)

  • Jin, Hyun-Seung;Park, Kyeng-Ah;Goo, Hyun-Woo;Yoon, Jong-Hyun;Kim, Ai-Rhan;Kim, Ki-Soo;Pi, Su-Young
    • Clinical and Experimental Pediatrics
    • /
    • v.48 no.1
    • /
    • pp.27-33
    • /
    • 2005
  • Purpose : To determine incidence, characteristics and risk factors associated with intrauterine intraventricular hemorrhage(IU-IVH) among premature infants. Methods : The medical records of infants with intraventricular hemorrhage(IVH) admitted to the neonatal intensive care unit of Asan Medical Center from January 1999 to June 2003 were reviewed retrospectively. Infants whose IVH with cystic change were detected within five days of life were defined as the IU-IVH group. The control group included those without any IVH. Various maternal and neonatal factors were evaluated between the IU-IVH and control groups, and risk factors for IU-IVH were identified using multiple logistic regression analysis. Results : The incidence of IU-IVH was 49/1024(15.9%). Mothers who are younger, primiparous, use less antenatal steroid, and neonates with greater incidence of neonatal respiratory distress syndrome, had higher incidences of IU-IVH compared to neonates with normal neurosonography. Risk factors associated with IU-IVH included neonatal respiratory distress syndrome and placenta infarct by placenta biopsy. Most infants with IU-IVH were ${\geq}1,501g$, ${\geq}34$ weeks gestational age and had low grade IVH. The size of the cysts associated with IU-IVH remained the same or disappeared in 96 %. IU-IVH does not seem to affect short-term neurodevelopmental outcome although a longer period of follow-up is needed. Conculusion : IU-IVH occurred mostly in ${\geq}1,501g$, ${\geq}34$ weeks infants with grade I IVH without developmental delays. However, the high incidence of total IVH merits more attention in terms of awareness of its existence as an unusual IVH among premature infants.

Anticoagulation Management after Mitral Valve Replacement with the St. Jude Medical Prosthesis (승모판치환 환자의 항응혈제 치료)

  • 김종환;김영태
    • Journal of Chest Surgery
    • /
    • v.31 no.12
    • /
    • pp.1172-1182
    • /
    • 1998
  • Background: Primary goal of anticoagulation treatment in patients with mechanical heart valve is the effective prevention of thromboembolism and safe avoidance of bleeding as well. Material and Method: Two-hundred and nine patients with the St. Jude Medical prosthesis operated on between 1984 and 1995, for mitral(MVR 122), aortic(AVR 39) and double mitral and aortic valve replacement(DVR 48) respectively, were studied on the practically achieved levels of anticoagulation and the clinical outcomes. Patients were on Coumadin and followed up by monthly visit to outpatient clinic for examination and prothrombin time measurement to adjust the International Normalized Ratios(INRs) within the low-intensity target range between 1.5 and 2.5. Result: A total anticoagulation follow-up period was 1082.0 patient- years(mean 62.1 months) and INRs of 10,205 measurements were available for evaluation. The accomplished INRs among the replacement groups were not significantly different and only 65% of INRs were within the target range. And, in individual patients, only 37% of patients had INRs included within the target range in more than 70% of tests during follow-up period. The levels of INRs in patients with atrial fibrillation, which was found in 57% of patients, were definitely higher than the ones measured in patients with regular rhythm(p<0.001). Thromboembolisms were experienced by 15 patients with the incidence of 1.265%/patient- year(MVR 1.412%, AVR 0.462% and DVR 1.531%/patient-year) and major bleeding by 4 patients with the incidence of 0.337%/patient-year(MVR 0.424%, AVR none and DVR 0.383%/patient-year). Frequent as well as prolonged missing of prothrombin time tests was the main risk factor strongly associated with the thromboembolic complications(odds ratio 1.99). The proportion of INRs within target range of less than 60% in individual patient was the highly significant risk factor of both thromboembolic and overall embolic and bleeding complications(p<0.004 and p<0.002 respectively). Conclusion: In conclusion, the low-intensity therapeutic target range of INRs was adequate in patients with AVR and in sinus rhythm. However, the patients with replacement of the mitral valve were more likely to require higher target range of INRs, especially in the presence of atrial fibrillation, to achieve the practical levels of anticoagulation enough to prevent thromboembolic complications effectively. For the higher therapeutic target range of INRs between 2.0∼3.0, further accumulation of clinical evidences are required. It is highly desirable to improve the patients' compliance under continuous instructions in visiting outpatient clinic and in taking daily Coumadin without omission and to keep INRs consistently within optimal range with tight control for minimization of chances and of periods of exposure to the risk of complications. And, particularly, patients with high risk of complications and with wide fluctuation of INRs should be better managed with frequent monitoring anticoagulation levels.

  • PDF

Selective Algicidal Effects of a Newly Developed GreenTD against Red Tide Harmful Alga (GreenTD 물질을 이용한 유해 적조 발생 종의 선택적 살조능 평가)

  • Lee, Minji;Shin, Juyong;Kim, Jin Ho;Lim, Young Kyun;Cho, Hoon;Baek, Seung Ho
    • Korean Journal of Environmental Biology
    • /
    • v.36 no.3
    • /
    • pp.359-369
    • /
    • 2018
  • Harmful algal blooms (HABs) are a serious problem for public health and fisheries industries, thus there exists a need to investigate the possible ways for effective control of HABs. In the present study, we investigated the algicidal effects of a newly developed GreenTD against the HABs (Chattonella marina, Heterosigma akashiwo, Cochlodinium polykriokides, and Heterocapsa circularisquama) and non-HABs (Chaetoceros simplex, Skeletonema sp. and Tetraselmis sp.), which is focused on the different population density and concentration gradients of algicidal substances. The time series viability of target alga was assessed based on the activity of Chl. a photosynthetic efficiency in terms of $F_v/F_m$, and in vivo fluorescence (FSU). Effective control of Raphidophyta, C. marina and H. akashiwo was achieved at a GreenTD concentration of $0.5{\mu}gL^{-1}$ and $0.2{\mu}gL^{-1}$, respectively, and regrowth of both the species was not observed even after 14 days. The inhibitory ratio of the dinoflagellate, C. polykriokides was more than 80% at $0.2{\mu}gL^{-1}$ of GreenTD. H. circularisquama was constantly affected in the presence of $0.2{\mu}gL^{-1}$ of GreenTD in the high- and low-population density experimental groups. On the other hand, diatoms, C. simplex, and Skeletonema sp. were not significantly affected even in the presence of $0.2{\mu}gL^{-1}$ of GreenTD and exhibited re-growth activity with the passage of incubation time. In particular, green alga Tetraselmis sp. remained unaffected even in the presence of the highest concentration of GreenTD ($1.0{\mu}gL^{-1}$), implying that non-HABs were not greatly influenced by the algicidal substances. As a result, the algicidal activity of GreenTD on the harmful and nonharmful algae was as follows: raphidophyte>dinoflagellates>diatoms>green alga. Consequently, our results indicate that inoculation of GreenTD substances into natural blooms at a threshold concentration ($0.2{\mu}gL^{-1}$) can maximize the algicidal activity against HABs species. If we consider the dilution and diffusion rate in the field application, it is hypothesized that GreenTD will demonstrate economic efficiency, thus leading to effective control against the target HABs in the closed bay.

Benefits of adherence to the Korea Healthy Eating Index on the risk factors and incidence of the metabolic syndrome: analysis of the 7th (2016-2018) Korea National Health and Nutrition Examination Survey (제7기 (2016-2018년) 국민건강영양조사 자료를 이용한 식생활평가지수 준수와 대사증후군 위험요소 및 대사증후군 발생 관계 연구)

  • Choi, Sun A;Chung, Sung Suk;Rho, Jeong Ok
    • Journal of Nutrition and Health
    • /
    • v.55 no.1
    • /
    • pp.120-140
    • /
    • 2022
  • Purpose: The purpose of the study was to investigate whether adherence to the Korea Healthy Eating Index (KHEI) was associated with metabolic syndrome and risk markers. Methods: The participants included 8,345 adults, aged 20-59 years, who took part in the 7th Korea National Health and Nutrition Examination Survey (KNHANES). The data were analyzed using a complex-sample t-test, the Rao Scott χ2-test, and logistic regression analysis on the SPSS v. 26.0 software. The participants were divided into four groups by quartiles of KHEI scores. Results: The average KHEI score was 61.06 points out of 100, and the women's score (62.50 points) was significantly higher than that of men (59.63 points). The KHEI quartiles status showed significant differences by age (p < 0.001), household income (p < 0.001), smoking status (p < 0.001), and food security. Specifically, the KHEI quartiles in the men showed significant differences in education (p < 0.001) and economic activity (p < 0.001) whereas those of women showed significant differences in alcohol-consumption (p < 0.001), depression (p < 0.01) and eating-out (p < 0.001). As the KHEI scores increased, the proportion of subjects with an energy intake below the estimated energy requirement (EER) was lower, and significantly better levels of intake were observed for carbohydrate, protein, vitamin C, calcium, vitamin B1, vitamin B2, and niacin. The incidence of the metabolic syndrome risk factors, hypertriglyceridemia and hyperglycemia for men and hypertension, and hyperglycemia for women showed significant differences. The KHEI scores were inversely associated with abdominal obesity, hypertriglyceridemia, low high-density lipoprotein cholesterol, hyperglycemia, hypertension, and metabolic syndrome. Conclusion: Based on these results, we conclude that higher adherence to the KHEI was associated with lower metabolic syndrome risk factors and incidence of the metabolic syndrome.

Anti-hyperlipidemic effect of Agaricus brasiliensis fruiting bodies in rats fed with high cholesterol diet (고콜레스테롤 식이의 급여에 의해 고지혈증이 유도된 흰쥐의 신령버섯 자실체의 항고지혈증 효과)

  • Jin, Ga-Heon;Lee, TaeSoo
    • Journal of Mushroom
    • /
    • v.16 no.2
    • /
    • pp.118-124
    • /
    • 2018
  • In this study, we aimed to investigate the effects of dietary supplementation with fruiting body of Agaricus brasiliensis (AB) mushroom on the lipid profiles of serum and histological patterns of liver of high cholesterol-fed rats. Five-week-old, female Sprague-Dawley albino rats were divided into three groups of 8 rats each, including a normal control-diet (NC) group, a high-cholesterol diet (HC) group, and a group fed high-cholesterol diet supplemented with 5 % powder of Agaricus brasiliensis fruiting bodies (HC+AB). Total serum cholesterol, low density lipoprotein (LDL), and triglyceride (TG) concentrations in the HC+AB group were significantly reduced when compared with those in the HC group. Body weight in the HC+AB group was significantly lower than that in the HC group, whereas no adverse effects were observed on the levels of plasma albumin, creatinine, blood urea nitrogen, uric acid, glucose, and total protein. In the HC+AB group, liver enzyme activities related to liver function, such as GOT and GPT, presented values lower than those in the HC group and were very similar to the ones in the NC group. Excretion of total lipid and cholesterol in feces in the HC+AB group was significantly higher than that in the NC and HC groups, indicating that mushroom feeding inhibits the absorption of lipid cholesterol in the intestine. Liver histopathological analyses revealed that rats fed with HC diet developed fat liver disease, whereas only small amounts of fat were deposited in the livers of the HC+AB group. In conclusion, the results suggest that fruiting body powder of A. brasiliensis provides health benefits to high-cholesterol-fed rats by lowering body weight and the risk of atherogenic lipid profile.

The Effects of Functional Tea (Mori Folium, Lycii Fructus, Chrysanthemi Flos, Zizyphi Fructus, Sesamum Semen, Raphani Semen) Supplement with Medical Nutrition Therapy on the Blood Lipid Levels and Antioxidant Status in Subjects with Hyperlipidemia (고지혈증 환자에서 의학영양치료와 병행하여 섭취한 기능성차(상엽, 구기자, 국화, 대추, 참깨, 나복자)의 혈중 지질 농도 저하 및 항산화 효과)

  • Lim, Hyun-Jung;Cho, Kum-Ho;Choue, Ryowon
    • Journal of the Korean Society of Food Science and Nutrition
    • /
    • v.34 no.1
    • /
    • pp.42-56
    • /
    • 2005
  • Hyperlipidemia is one of the risk factors for coronary artery disease. Despite of epidemiological evidence that tea consumption is associated with the reduced risk of coronary heart disease, experimental studies designed to show that drinking tea affects blood lipid concentration or oxidative stress have been unsuccessful. The purpose of this study was to investigate whether functional tea (three servings/day) supplement with medical nutrition therapy (MNT) lead to a beneficial outcomes in mildly hyperlipidemic adults. From February to October, 2003, the 43 hyperlipidemic (23 men, 20 women) subjects (total cholesterol$\geq$200 mg/dL or triglyceride$\geq$150 mg/dL) admitted to K Medical Center were studied. Subjects were randomly divided into 3 groups; placebo tea (PT), half dose of functional tea (HFT), full dose of functional tea (FFT). During 12 weeks of study period, the subjects were given placebo or functional tea daily with MNT. Anthropometric measurements, blood chemical analysis including lipid levels, total superoxide dismutase (SOD) and glutathione peroxidase (GSH-Px) levels, and dietary assessment were carried out at the beginning and end of experiment. The effects of functional tea were compared with the placebo in randomized clinical trial study. The placebo was prepared to match with the functional tea in color and taste. After the 12 weeks of MNT, the subjects had regular and balanced meal pattern. Consumption of foods high in cholesterol and saturated fat, salty foods, fried foods, and instant foods decreased significantly in all three groups (p<0.05). Intake of energy and cholesterol also decreased (p<0.05). Drinking three servings per day (390 mL/day) of functional tea significantly reduced the levels of blood triglyceride (HFT, 42.5%; FFT, 29.4%), total cholesterol (HFT, 8.5%; FFT, 13.7%), and atherogenic index (HFT, 14.6%; FFT, 21.7%). Whereas no changes were found in the LDL-, HDL-cholesterollevels, and LDL/HDL ratio. Plasma homocysteine (Hcy) concentration decreased significantly (p<0.05) in functional tea groups (HFT, 14.9%; FFT, 14.1%). SOD increased significantly (p<0.05) in HFT (8.3%). GSH-Px increased significantly (p<0.05) in FFT (12.8%). In conclusion, the MNT improved the dietary habits, in addition, functional tea supplement decreased blood lipid levels and Hcy, and increased SOD and GSH-Px levels. These results indicate that functional tea consumption may decrease the risk of cardiovascular disease via improving blood lipid levels and antioxidant status.

Perceived Weight and Health Behavior Characteristics -Normal and Overweight Middle-aged women- (도시일부 중년여성의 체중상태와 건강행위 선택 비교 연구)

  • 조현숙
    • Journal of Korean Academy of Nursing
    • /
    • v.26 no.2
    • /
    • pp.387-398
    • /
    • 1996
  • The objective of this study was to clarify whether there are any differences between normal and over-weight middle-aged(40∼59yrs)women in their perceived weight, health status, health conception and health behavior choices. The sample consisted of 39 normal weight and 55 over-weight (11% above on the Body Index Scale) women who live in Juan, Inchon. The Participants were randomly selected in each weight group considering socio-demographic factors. The findings from this study are summarized below. 1) Among the 55 overweight middle-aged women, 16 were above 20% on the Body Index Scale and 14 were above 30%. Twenty-five(45.5%) of the overweight group and 12(30.8%) of the normal weight group had one disease, and there were 12(21.8%) in the overweight group and 8(20.5%) in the normal weight group where one of the family members had a disease, but these differences were not statistically significant. The average monthly family income for the overweight group was ₩l,880,000 compared to ₩2,140, 000 for the normal weight group, but this difference was also not significant. The age range for the whole group was between 40 and 59(mean=46.8 for total, 48.6 for overweight and 45.7 for normal weight group). Again no significant difference found. Occupations were housemaker 53(56.4%), private business(13.8%), salarywoman(9.6%), and teacher (2.1%). Thirty housemaker(54.5%) from the overweight group and 23(59%) from the normal group did not constitute a statistically significant different. For the educational status, 34(61.8%) of the overweight women and 33(84.6%)of the normal weight group finished high school or more educational courses, but there was no significant statistical difference. Eleven(20.0%) of the overweight women and 5(12. 8%) of the normal weight group were single, but again no significant statistical difference was found. 2) A test for difference in health characteristics between two weight groups indicated that two groups do not show statistical differences in their perceived health status, health conception or health behavior choice. That is, the overweight group, also perceive their health status as good as the normal group, and regard ‘Health’ as a state that enables them to carry out social roles and functions rather than as the traditional concept of health as no disease or no symptoms. Moreover. the overweight group selected their health behaviors not for the prevention of diseases or maintenance of health but for promotion of health. To determine if no statistical difference might be related to the overweight group's failure of perceive themselves as overweight, the perceived and objective overweight status were compared by the chi-square analysis, and no difference was found(X/sup²=49.37, df=1, p=.000). However, 7(17.9%) of the normal group perceived themselves as being overweighted and 7(12.7%) of the overweight group thought they were of normal weight. Even though the overweight group employed in this study perceived themselves as being overweight, they regarded themselves as healthy as those in the normal weight group. It was shown that there was no statistical difference between two groups in health conception, and that they chose health behaviors to promote health status. 3) Perceived health conception was shown to be significantly related to health behavior choice (r= .28, p=.006 for whole group : r=.33, p=.014 for overweight group : and r=.12. p=.463 for normal group) .There was an indication that the more complicated the perceived health conception was, the more the trend of health behavior choice to promote health. This was especially true for the overweight group. But, the perceived health status did not related to health behavior choice statistically(r=.13, p=.202), and it was thought that reasons for selecting health behaviors were not related to their health status. That is, the overweight group perceive themselves as healthy as the normal weight group or thought that overweight itself does not incur any risk on their health. Data from two groups were combined and analyzed with multiple regression methodology, because the relationship pattern of the two groups was similar. The analysis showed that health behavior has a significant relationship with age and the perceived health conception(r/sup²=.1517, p=.05, F=8.133). It means they come to health behavior along with their health conception and their age rather than their weights, perceived weight, health status or other social characteristics. This study was intended to understand how overweight middle-aged women perceive ‘weight’ and ‘health’, and how they meet their health related needs in comparison with normal weight middle-aged women. Other factors related to the health behavior in overweight middle-aged woman need to be determined through further descriptive studies outlined in the following recommendations. a) Reseach with the study area expanded. b) Reseach with grouping more detailed : much more overweight and underweight group c) Reseach on restricted relationship between overweight and age or profession. d) Reseach on what overweight middle-aged women do to reduce their weight and what factors motivate them to do it

  • PDF