• 제목/요약/키워드: high risk population

검색결과 838건 처리시간 0.025초

혈액투석환자에서 영양상태와 필수아미노산 섭취의 관련성 연구 (Association of the Nutritional Status and Essential Amino Acids Intake in Hemodialysis Patients)

  • 김혜진;김수안;손정민
    • Journal of Nutrition and Health
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    • 제39권7호
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    • pp.617-623
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    • 2006
  • The mortality and morbidity rate of hemodialysis patients (HD) remain high. Among many factors, protein and calorie malnutrition has been shown to be a major risk factor for increased mortality in the HD patients population. Malnutrition can be caused by insufficient amino acid intake, nutrient losses in dialysate, oxidant stress and muscle catabolism. In this study, we evaluated the association of markers of nutritional status and essential amino acids intake in HD patients. We investigated nutritional status of 41 HD patients (mean age: $64.2\;{\pm}\;11.5\;y$, men: 24, women: 27) by measuring anthropometric, biochemical parameters and food intakes by using 24 hr recall methods. Subject's total energy intake and total protein intake were $1,648.0\;{\pm}\;397.31\;kcal/day,\;79.2\;{\pm}\;27.2\;g/day$:, respectively. The animal protein intake was $42.7\;{\pm}\;22.1\;g/day$, essential amino acids intake was $23.4\;{\pm}\;9.92\;g/day$, and the ratio of essential amino acids to total protein intake was $29.6\;{\pm}\;5.42%$. There were significantly positive correlation between muscle mass and lean body mass with serum creatinine level (r=0.435, p<0.01; r=0.435, p<0,01). There were also significant positive correlation in muscle mass and lean body mass with pre hemodialysis blood urea nitrogen (preHD BUN) (r=0.329, p<0.05; r=0.329, p<0.05). There were no significant correlation in total energy intake and total protein intake per kg ideal body weight (IBW) to muscle mass and lean body mass. However, there were significantly positive correlation between the ratio of essential amino acids and muscle mass and lean body mass (r=0.368, p<0.05; r=0.405, p<0.01). And serum hematocrit concentration was positively correlated with the ratio of essential amino acids (r=0.032, p<0.05). The results of this study indicate that strong associations exist in essential amino acid intakes with malnutrition than total protein intakes in HD patient. In conclusion, specialized nutrition education should be necessary to efficiently improve the quality of protein intakes.

Overexpression of Phospholipase A2 Group IIA in Esophageal Squamous Cell Carcinoma and Association with Cyclooxygenase-2 Expression

  • Zhai, Yan-Chun;Dong, Bin;Wei, Wen-Qiang;He, Yan;Li, Xin-Qing;Cormier, Robert T.;Wang, Wei;Liu, Fen
    • Asian Pacific Journal of Cancer Prevention
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    • 제15권21호
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    • pp.9417-9421
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    • 2014
  • Background: Esophageal cancer is one of the most frequently occurring malignancies and the seventh leading cause of cancer-related deaths in the world. The esophageal squamous cell carcinoma (ESCC) is the most common histological type of esophageal cancer worldwide. Materials and Methods: Our goal in this study was to detect phospholipase A2 Group IIA (PLA2G2A) and cyclooxygenase-2 (COX-2) immuno-expression in ESCC in a high-risk population in China. Results: Positive expression of PLA2G2A protein was observed in 57.2% (166/290) of the cases, while COX-2 was found in 257 of 290 samples (88.6%), both PLA2G2A and COX-2 being expressed in 153 cases (52.8%), with a significant agreement (Kappa=0.091, p=0.031).Overexpression of PLA2G2A was significantly correlated with the depth of invasion (p=0.001). Co-expression of PLA2G2A and COX-2 not only significantly correlated with the depth of invasion (p=0.004) but also with TNM stage (p=0.04). Conclusions: Our results showed that in patients with ESCC, PLA2G2A overexpression and PLA2G2A co-expression with COX-2 is significantly correlated with advanced stage. The biological role and pathophysiologic regulation of PLA2G2A and COX-2 overexpression in ESCC deserve further investigation.

초등학교 아동의 스트레스 생활사건과 대처방식, 건강문제에 관한 연구 (A Study of Stress, Stress Coping Style and Health Symptoms in 6th Grade Elementary School Children)

  • 조남진;박인숙
    • Child Health Nursing Research
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    • 제4권2호
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    • pp.193-206
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    • 1998
  • The purpose of this study was to examine the stressors and stress coping styles of 6th grade el ementary school children and to explore the relationship between stressful life events and health symptoms and the effects of coping style which is theoretically considered to mediate the relationship between stress and health symptoms. The study subjects consisted of 329 in 6th grade elementary school children in Cheong-Ju city. Of the 329 subjects, 171 were boys and 158 were girls. For this study, three kinds of questionnaires were adopted as follows ; 1) Feel Bad Scale (FBS) by Lewis et al., 2) lazarus-Folkman's Way of coping questionnaire 3) Hee Sun Shin's Health Symptom questionnaire (HSQ) The researcher visited the school and collected data in the class using the questionnaire method after an explanation of the purpose and procedures was given to the children. Data collection was done for 10 days (from 5th to 15th of July 1997) . The data were analyzed by descriptive statistics, correlation analysis, multiple regression analysis using the SAS statistical program. The results of this study were as follows : 1. The mean score for the FBS was 211.37(range : 77-427), The most severe stressors perceived by children were parental divorce and other's smash or steal of my things. The most frequently experienced stressful life events were conflict with siblings and being scolded for other's fault. 2. The most frequently used stress coping style was the active coping (M=17.85), followed by passive (M=13.64) and magical one (M=13.42). 3. The mean score for the HSQ was 23.30(range : 0-72) The most frequently complained health symptoms were headache and having much worry about everything. 4. There was a significant relationship between stressful life events and health symptoms (r=.60, p<.001). Also, stressful life events were positively related with passive coping(r=.27, p<.001) and magical coping (r=.38, p<.001). Health symptoms were positively correlated with passive coping(r=.33, p<.001) and magical coping (r=.41, p<.001). 5. Stepwise multiple regression analysis revealed that the most powerful predictor was the variable of stressful life events. Health concerns, magical coping style, passive coping style and active coping style accounted for 49.15% of the variance in health symptoms. This study revealed that stressful life events correlated with health symptoms in 6th grade elementary school children and passive coping and magical coping had mediating effects on this relationship. The implication for nursing is that there is a need to develop supportive interventions for high risk population to decrease health problems due to stress.

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P53 and MDM2 Over-expression and Five-year Survival of Kidney Cancer Patients Undergoing Radical Nephrectomy - Iranian Experience

  • Abolhasani, Maryam;Salarinejad, Sareh;Asgari, Mojgan
    • Asian Pacific Journal of Cancer Prevention
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    • 제16권12호
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    • pp.5043-5047
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    • 2015
  • Background: Relatively little is known with certainty about the status and role of p53 or MDM2 in predicting prognosis and survival of renal cell carcinoma. The present study aimed to determine the value of P53 and MDM2 over-expression, alone and simultaneously, to predict five-year survival of patients with kidney cancer in Iran. Materials and Methods: Patients with kidney cancer referred to Hasheminejad Kidney Center between 2007 and 2009, underwent radical nephrectomy and had pathology reports of clear cell, papillary or chromophobe renal cell carcinoma were included in our cohort study. Other histological types of renal cell carcinoma were not included. The patients with missed, incomplete or poor quality paraffin blocks were also excluded. Overall ninety one patients met the inclusion and exclusion criteria. To assess the histopathological features of the tumor, immunohistochemical (IHC) staining of formalin fixed, paraffin-embedded tumor samples were performed. The five-year survival was determined by the patients' medical files and telephone following-up. Results: In total, 1.1% of all samples were revealed to be positive for P53. Also, 20.8% of all samples were revealed to be positive for MDM2.The patients were all followed for 5 years. In this regard, 5-year mortality was 30.5% and thus 5-year survival was 85.3%. According to the Cox proportional hazard analysis, positive P53 marker was only predictor for patients' 5-year survival that the presence of positive p53 increased the risk for long-term mortality up to 2.8 times (HR=2.798, 95%CI: 1.176-6.660, P=0.020). However, the presence of MDM2 could not predict long-term mortality. In this regard, analysis by the ROC curve showed a limited role for predicting long-term survival by confirming P53 positivity (AUC=0.610, 95%CI: 0.471-.750, P=0.106). The best cutoff point for P53 to predict mortality was 0.5 yielding a low sensitivity (32.0%) but a high specificity (97.9%). In similar analysis, measurement of MDM2 positivity could not predict mortality (AUC=0.449, 95%CI: 0.316-.583, P=0.455). Conclusions: The simultaneous presence of both P53 and MDM2 markers in our population is a rare phenomenon and the presence of these markers may not predict long-term survival in patients who undergoing radical nephrectomy.

Sensitive and Noninvasive Detection of Aberrant SFRP2 and MGMT-B Methylation in Iranian Patients with Colon Polyps

  • Naini, M Alizade;Mokarram, P;Kavousipour, S;Zare, N;Atapour, A;Zarin, M Hassan;Mehrabani, G;Borji, M
    • Asian Pacific Journal of Cancer Prevention
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    • 제17권4호
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    • pp.2185-2193
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    • 2016
  • Background: The pathogenesis of sporadic colorectal cancer (CRC) is influenced by the patient genetic background and environmental factors. Based on prior understanding, these are classified in two major pathways of genetic instability. Microsatellite instability (MSI) and CPG island methylator phenotype (CIMP) are categorized as features of the hypermethylated prototype, and chromosomal instability (CIN) is known to be indicative of the non-hypermethylated category. Secreted frizzled related protein 2 (SFRP2), APC1A in WNT signaling pathway and the DNA repair gene, O6-methylguanine-DNA methyltransferase (MGMT), are frequently hypermethylated in colorectal cancer. Detection of methylated DNA as a biomarker by easy and inexpensive methods might improve the quality of life of patients with CRC via early detection of cancer or a precancerous condition. Aim: To evaluate the rate of SFRP2 and MGMT hypermethylation in both polyp tissue and serum of patients in south Iran as compared with matched control normal population corresponding samples. Materials and Methods: Methylation-specific PCR was used to detect hypermethylation in DNA extracted from 48 polypoid tissue samples and 25 healthy individuals. Results: Of total polyp samples, 89.5% had at least one promoter gene hypermethylation. The most frequent methylated locus was SFRP2 followed by MGMT-B (81.2 and 66.6 percent respectively). Serologic detection of hypermethylation was 95% sensitive as compared with polyp tissue. No hypermethylation was detected in normal tissue and serum and its detection in patients with polyps, especially of serrated type, was specific. Conclusions: Serologic investigation for detection of MGMT-B, SFRP2 hypermethylation could facilitate prioritization of high risk patients for colonoscopic polyp detection and excision.

Plasma Nuclear Factor Kappa B and Serum Peroxiredoxin 3 in Early Diagnosis of Hepatocellular Carcinoma

  • Ismail, Saber;Mayah, Wael;Battia, Hassan El;Gaballah, Hanaa;Jiman-Fatani, Asif;Hamouda, Hala;Afifi, Mohamed A.;Elmashad, Nehal;Saadany, Sherif El
    • Asian Pacific Journal of Cancer Prevention
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    • 제16권4호
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    • pp.1657-1663
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    • 2015
  • Background: Early diagnosis of hepatocellular carcinoma (HCC) is the most important step in successful treatment. However, it is usually rare due to the lack of a highly sensitive specific biomarker so that the HCC is usually fatal within few months after diagnosis. The aim of this work was to study the role of plasma nuclear factor kappa B (NF-${\kappa}B$) and serum peroxiredoxin 3 (PRDX3) as diagnostic biomarkers for early detection of HCC in a high-risk population. Materials and Methods: Plasma nuclear factor kappa B level (NF-${\kappa}B$) and serum peroxiredoxin 3 (PRDX3) levels were measured using enzyme linked immunosorbent assay (ELISA), in addition to alpha-fetoprotein (AFP) in 72 cirrhotic patients, 64 patients with HCC and 29 healthy controls. Results: NF-${\kappa}B$ and PRDX3 were significantly elevated in the HCC group in relation to the others. Higher area under curve (AUC) of 0.854 (for PRDX3) and 0.825 (for NF-${\kappa}B$) with sensitivity of 86.3% and 84.4% and specificity of 75.8% and 75.4% respectively, were found compared to AUC of alpha-fetoprotein (AFP) (0.65) with sensitivity of 72.4% and specificity of 64.3%. Conclusions: NF-${\kappa}B$ and PRDX3 may serve as early and sensitive biomarkers for early detection of HCC facilitating improved management. The role of nuclear factor kappa B (NF-${\kappa}B$) as a target for treatment of liver fibrosis and HCC must be widely evaluated.

Breast Cancer in Young Women from a Low Risk Population in Nepal

  • Thapa, Bibhusal;Singh, Yogendra;Sayami, Prakash;Shrestha, Uttam Krishna;Sapkota, Ranjan;Sayami, Gita
    • Asian Pacific Journal of Cancer Prevention
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    • 제14권9호
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    • pp.5095-5099
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    • 2013
  • Background: The overall incidence of breast cancer in South Asian countries, including Nepal, is low compared to Western countries. However, the incidence of breast cancer among young women is relatively high. Breast cancer in such cases is characterized by a relatively unfavorable prognosis and unusual pathological features. The aim of this study was to investigate clinico-pathological and biological characteristics in younger breast cancer patients (<40 years) and compare these with their older counterparts. Materials and Methods: Nine hundred and forty four consecutive female breast cancer patients, admitted to the Department of Surgery, Tribhuvan University Teaching Hospital, Kathmandu, Nepal between November 1997 and October 2012, were retrospectively analyzed. Results: Out of the 944 female breast cancer patients, 263 (27.9%) were <40 years. The mean age was $34.6{\pm}5.0$ years among younger patients compared to $54.1{\pm}9.9$ for those ${\geq}40$ years. The mean age at menarche was also significantly lower ($13.5{\pm}1.5$ vs $14.2{\pm}1.5$ years p=0.001) while the mean duration of symptoms was significantly longer (7.6 vs 6.5 months p=0.004). Family history of breast cancer was evident in 3.0% of the young women versus 0.3% in the older one. Mammography was performed less frequently in younger patients (59.7%), compared to older (74.4%), and was of diagnostic benefit in only 20% of younger patients compared to 85% of older ones. At diagnosis, the mean tumor diameter was significantly larger in young women ($5.0{\pm}2.5$ vs $4.5{\pm}2.4cm$, p=0.005). Axillary lymph nodes were positive in 73% of younger patients and 59% of older patients. In the younger group, the proportion of stage III or IV disease was higher (55.1% vs 47.1%, $p{\leq}0.05$). The proportion of breast conserving surgery was higher in young patients (25.1% vs 8.7%) and a higher proportion of younger patients receive neoadjuvant chemotherapy (9.9% vs 2.8%). The most common histological type was ductal carcinoma (93.1% vs 86%). The proportion of histological grade II or III was higher in younger patients (55.9% vs 24.5%). Similarly, in the younger group, lymphatic and vascular invasion was more common (63.2% vs 34.3% and 39.8% vs 25.4%, respectively). Patients in the younger age group exhibited lower estrogen and/or progesterone receptor positivity (34.7% vs 49.8%). Although statistically not significant, the proportion of triple negative tumors in younger age group was higher (22.4% vs 13.6%). Conclusions: Breast cancer in young Nepalese women represents over one quarter of all female breast cancers, many being diagnosed at an advanced stage. Tumors in young women exhibit more aggressive biological features. Hence, breast cancer in young women is worth special attention for earlier detection.

건강검진 수진자에서 담낭용종과 생화학적검사, 대사증후군 및 생활습관의 관련성 (The Relation of Biochemical Examination, Metabolic Syndrome and Life Style of the Gallbladder Polyp in Health Examination Examinees)

  • 박연화;강재선;이혜남
    • 한국산학기술학회논문지
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    • 제17권2호
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    • pp.386-393
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    • 2016
  • 최근, 복부초음파로 인해 담낭용종의 발견률이 높아지고 있다. 담낭용종의 위험인자에 대한 다양한 연구가 보고 되었지만 생화학검사, 생활습관을 포함한 대사증후군과 담낭용종의 관계에 대한 연구가 미흡한 실정이다. 본 연구의 목적은 생활습관, 생화학적 혈액검사를 포함한 대사증후군과 담낭용종과의 관련성을 알아보는데 있다. 2013년 1월부터 2013년 12월까지 건강검진 수진자 중 복부초음파검사를 시행 받아 담낭용종의 진단을 받은 596명을 대상으로 나이, 성별, 흡연, 음주, 운동의 일반적인 특성과 신장, 체중, 혈압, 허리둘레, 체질량 지수 등의 신체 계측을 하였으며, 동시에 채혈을 통한 공복 시 혈당과 여러 가지 혈액검사 및 대사증후군 여부를 분석하여 담낭용종과의 관계를 알아보았다. 그 결과 남성, 흡연자, 비음주자에서 유의하게 높았으며, 체질량지수가 높을수록, 대사증후군이 있는 집단이, HBsAg 양성군에서 높았고, 위험도는 남성이 여성보다 1.8배, 대사증후군이 있는 군이 없는 군보다 2.3배, HBsAg이 양성인 군에서 2.6배 높게 나타났다.

부산지역 소아 및 성인의 A형 간염 바이러스 항체 양성률에 대한 역학적 조사 (An epidemiologic study on the seropositive rate of hepatitis A virus among a selected group of children and adults in Busan)

  • 권영옥;최임정;정진화;박지현
    • Clinical and Experimental Pediatrics
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    • 제50권3호
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    • pp.262-267
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    • 2007
  • 목 적 : A형 간염 유병률은 그 지역의 생활환경과 위생상태와 밀접한 관계가 있으며 시간 및 지역에 따라 다양한 양상을 보인다. 최근에 들어와 A형 간염 유병률의 변화에 대하며 많은 이들이 보고하여 왔다. 이에 본 연구는 부산 지역에 거주하는 소아과 성인을 대상으로 A형 간염 항체 유병률을 측정하였다. 방 법 : 부산시에 거주하고 2004년 10월부터 2005년 3월까지 메리놀병원에 입원한 472명을 대상으로 하였으며 전 연령층의 혈청으로부터 면역방사계수 측정법을 이용하여 항 A형 바이러스 IgG 항체 유무를 측정하였다. 결 과 : 1) A형 간염 IgG 항체 양성률은 총 472명 중 108명에서 항체가 검출되어 22.8%이었고, 2-5세가 1.7%, 6-10세가 1.7%, 11-20세가 0%, 21-30세가 40.5%, 31-40세가 82.1%, 41-50세가 94.7%, 51세 이상이 100%로 조사되었다. 2) 각 연령군 모두에서 남녀간의 항체 양성률(P=0.2)간에 유의한 차이는 없는 것으로 나타났다. 결 론 : 우리 나라에서는 최근 경제발전과 더불어 생활환경이 향상되어 A형 간염 항체 양성률이 지난 20년 전보다 현저하게 감소되었다. 현재 소아 연령에서 A형 간염 항체 보유율이 매우 낮아 이들이 성인이 되는 경우 현증 A형 간염의 유행이 초래될 가능성이 높아지고 있다. 따라서 개인위생 및 생활환경을 개선하고, 고위험군을 대상으로 수동면역 및 능동면역을 시행하여 바이러스의 전파를 막아 A형 간염의 발생을 적극적으로 예방하여야 하겠다.

Strobilurin계 살균제에 대한 잿빛곰팡이병균 Botrytis cinerea의 저항성 검정 (Monitoring for the Resistance of Strobilurin Fungicide Against Botrytis cinerea Causing Gray Mold Disease)

  • 김아형;김선보;한기돈;김흥태
    • 농약과학회지
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    • 제18권3호
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    • pp.161-167
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    • 2014
  • Strobilurin계 살균제인 azoxystrobin에 대한 잿빛곰팡이병균 Botrytis cinerea의 저항성 발현 여부를 조사하였다. B. cinerea 균주는 $1.0{\mu}g\;mL^{-1}$의 azoxystrobin에 대한 반응을 기준으로 실험 균주 중에서 46.5%가 감수성 균주로, 53.5%가 저항성 균주로 판명되었다. 병원균을 분리한 지역별로 저항성 균주의 출현 비율은 경기, 경남, 부산에서 28.6, 41.9, 36.8%이었으며, 충남에서 81.1%로 다른 지역보다 높게 나타났다. 기주별로 저항성 균주는 딸기, 오이, 토마토에서 분리한 균주에서는 각각 68.0, 40.0, 50.0%, 고추에서는 9.1%만이 나타났다. Azoxystrobin에 대해서 감수성이었던 B. cinerea 11-20은 kresoxim-methyl과 trifloxystrobin에 대해서도 감수성 반응을 보였으며, 저항성 균주인 11-74는 3종의 살균제 모두에 대해서 교차 저항성이 있음을 보여 주었다. 본 실험의 결과 실험에 사용한 B. cinerea 균주의 53.5%가 저항성 반응을 보일 정도로 높은 저항성 출현율을 보였으며, 동일 계열의 살균제에 대한 교차 저항성 반응을 보이고 있기 때문에, 포장에서 strobilurin계 살균제에 대한 철저한 관리가 요구되어진다.