• Journal of Chest Surgery
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• v.47 no.3
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• pp.233-239
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• 2014

Background: As hypertrophied myocardium predisposes the patient to decreased tolerance to ischemia and increased reperfusion injury, myocardial protection is of utmost importance in patients undergoing aortic valve replacement (AVR) for severe aortic valve stenosis (AS). Methods: Consecutive 314 patients (mean age, $62.5{\pm}10.8$ years; 143 females) with severe AS undergoing isolated AVR were included. Postoperative myocardial injury (PMI) was defined as 1) maximum postoperative creatinine kinase isoenzyme MB or troponin-I levels ${\geq}10$ times of reference, 2) postoperative low cardiac output syndrome or episodes of ventricular arrhythmia, or 3) left ventricular ejection fraction of less than 55% and decrease in left ventricle (LV) ejection fraction of more than 20% of the baseline value. Results: There were 90 patients (28.7%) who developed PMI. There were five cases of early death (1.6%), all of whom had PMI. On multivariable analysis, the use of histidine-tryptophan-ketoglutarate (HTK) solution instead of blood cardioplegia (odds ratio [OR], 3.06; 95% confidence interval [CI], 1.63 to 5.77; p=0.001), greater LV mass (OR, 1.04; 95% CI, 1.01 to 1.07; p=0.007), and increased cardiac ischemic time (OR, 1.13; 95% CI, 1.05 to 1.22; p<0.001) were independent predictors for PMI. Patients who had PMI showed significantly inferior long-term survival than those without PMI (p=0.049). Conclusion: PMI occurred in a considerable proportion of patients undergoing AVR for severe AS and was associated with poor long-term survival. HTK cardioplegia, higher LV mass, and longer cardiac ischemic duration were suggested as predictors of myocardial injury.

• Parasites, Hosts and Diseases
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• v.54 no.5
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• pp.645-652
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• 2016

Toxocara vitulorum has been rarely reported in yaks at high altitudes and remote areas of Sichuan Province of Tibetan Plateau of China. The current study was designed to investigate the prevalence, associated risk factors, and phylogenetic characteristics of T. vitulorum in yak calves on the Qinghai Tibetan plateau. Fecal samples were collected from 891 yak calves and were examined for the presence of T. vitulorum eggs by the McMaster technique. A multivariable logistic regression model was employed to explore variables potentially associated with exposure to T. vitulorum infection. T. vitulorum specimens were collected from the feces of yaks in Hongyuan of Sichuan Province, China. DNA was extracted from ascaris. After PCR amplification, the sequencing of ND1 gene was carried out and phylogenetic analyses was performed by MEGA 6.0 software. The results showed that 64 (20.1%; 95% CI 15.8-24.9%), 75 (17.2; 13.8-21.1), 29 (40.9; 29.3-53.2), and 5 (7.6; 2.5-16.8) yak calves were detected out to excrete T. vitulorum eggs in yak calve feces in Qinghai, Tibet, Sichuan, and Gansu, respectively. The present study revealed that high infection and mortality by T. vitulorum is wildly spread on the Qinghai Tibetan plateau, China by fecal examination. Geographical origin, ages, and fecal consistencies are the risk factors associated with T. vitulorum prevalence by logistic regression analysis. Molecular detection and phylogenetic analysis of ND1 gene of T. vitulorum indicated that T. vitulorum in the yak calves on the Qinghai Tibetan plateau are homologous to preveiously studies reported.

• Journal of Preventive Medicine and Public Health
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• v.39 no.4
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• pp.353-358
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• 2006

Objectives: An increase in the serum gamma-glutamyltransferase (GGT) concentration has been regarded as a marker of alcohol drinking or liver disease. Some reports, however, have suggested that the serum GGT may be a sensitive and early biomarker for the development of prediabetes and diabetes. In this study we investigated whether serum GGT is a reliable predictor of the incident impaired fasting glucose (IFG), including diabetes. Methods: We performed a prospective study for two years (2002-2004). We analyzed the periodic health examination data from a total of 4,711 men. The examinations were done in the years 2002 and 2004. The analyzed data included a self-questionnaire, a physical examination and the laboratory results. Both IFG and diabetes were defined as a serum fasting glucose concentration of more than 100 mg/dL and 126 mg/dL, respectively. Results: A total of 738 cases (15.7%) of incident IFG and 13 cases (0.3%) of diabetes occurred. The mean serum GGT concentrations were quite different between the normal (38.0 IU) and incident IFG groups (50.3 IU), and the incident diabetes group (66.0 IU) (p<0.001). After multivariable adjustment, the relative risks for incident IFG or diabetes across the baseline GGT categories (<10th, 10th-20th, 30th-40th, 50th-60th, 70th-80th and >90th percentile) were 1.0, 1.172 (0.769-1.785), 1.107 (0.725-1.689), 1.444 (0.934-2.232), 2.061 (1.401-3.031) and 2.545 (1.784-3.631) (p-value for trend: <0.001). The risks significantly increased with increasing levels of GGT for 2 years; when comparing the increased groups (<10%, 10-20%, >20%) versus the decreased over 20% group of GGT, the risks for IFG or diabetes were 1.334 (1.002-1.776), 1.613 (1.183-2.199) and 1.399 (1.092-1.794). Conclusions: Our findings suggest that serum GGT concentrations within its normal range may be an early predictor of the development of IFG and diabetes. As serum GGT is a relatively inexpensive test and a reliable marker, it might have important implications in public health promotion.

• Korean Journal of Organic Agriculture
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• v.7 no.2
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• pp.89-97
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• 1999

Through manifestation of the principles of commodity production spatial sharing of labour can be observed in the agriculture as well as in cattle production. Better adjustment of the production structure to the environment factors brings higher yields and more effective production. In being able to maximize the profit the entrepreneurs opt for producing output that closely matches to their featuring conditions. In contrary to the relatively high "mobility" of crop production animal husbandry and within this cattle production - as known - is strictly chained to forage production. On the basis of our economic research and as a result of multivariable analysis(factor analysis) it can be concluded that two variable groups(factors) are highly dominant in organizing profitable cattle production. First of them is the crop site factor (indicated by gold crown value), the second is the forage production feature(forage and grassland area and the yield of them). During recent years the weight of environmental factors suffered from devaluation. As a result of the central economic administration differentiating effects were suppressed and the chances of equalizing concepts strengthened. The outcome can be observed even today. In the regions, for example, being predominantly suitable for grass and forage cropping the milk and slaughter cattle production decreased. The same is ture for com and pig production regions. Unexploitment of local environmental features can be observed mainly in grassland management. Branches being potential user of grasslands hardly take them into consideration. Main method of rational use of grasslands is pasturing. Presence of pastures and the usage of them through cattle production is highly important not only for profitable production but also for maintaining ecological stability.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.31 no.1
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• pp.19-26
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• 2020

Background and Objective Endoscopic airway dilation is the primary treatment for pediatric subglottic stenosis (SGS) due to its feasibility and non-invasiveness. The aim of this study is to evaluate the risk factors for the failure of endoscopic airway dilation in pediatric patients with SGS. Materials and Methods This study reviewed medical records of 38 pediatric patients had endoscopic dilation from a single and tertiary referral center, retrospectively. The success of the endoscopic dilation procedure was defined as no dyspneic symptom without tracheostomy or laryngotracheal reconstruction. Demographic profiles, underlying disease, and Myer-Cotton SGS severity grade were recorded. Success rates and risk factors for the failure of treatment were analyzed. Results The SGS patients with severity grade I was most common. After mean 1.8 numbers of procedures, there were 23 patients (60.5%) in the success group and 15 patients (39.5%) in the failure group. Age, sex, underlying diseases, and SGS severity grade were not significantly different between two groups. In patients who had multiple endoscopic procedures, the failure group showed SGS deteriorated after procedures in 66.7%, compared to 11.1% of the success group. In multivariable analysis, a long-term intubation (≥1 month) was identified as an independent risk factor for failure of endoscopic dilation procedure. Conclusion Although endoscopic dilation procedure is safe and effective for the management, repetitive endoscopic dilation may not give clinical benefit in patient with long-term intubation. Other airway procedures must be considered in those group of patients.

• Journal of Nutrition and Health
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• v.52 no.6
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• pp.552-558
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• 2019

Purpose: Although vitamin D deficiency is common among Korean adolescent girls and young women, few studies have explored the potential health effects of vitamin D deficiency in this vulnerable population. This study examined the association between vitamin D deficiency and anemia in Korean adolescent girls and young women. Methods: The data from the Korea National Health and Nutrition Examination Survey 2008 ~ 2014 were used. A total of 3,643 girls and adult women aged 12 to 29 who provided all the information (including serum 25-hydroxy vitamin D, hemoglobin, and/or serum ferritin) needed for the analysis were included in the analysis. Demographic, lifestyle, and health data were obtained through survey questionnaires. Anemia and iron deficiency anemia were defined according to the World Health Organization cut-offs. Multivariable logistic regression, and restricted cubic spline regression were used in the analysis. Results: In fully adjusted logistic regression models, the vitamin D deficiency was significantly associated with higher prevalences of anemia (odds ratio (OR): 1.61, 95% confidence interval (CI): 1.04 ~ 2.49) and iron deficiency anemia (OR: 1.43, 95% CI: 1.01 ~ 2.03). In a cubic spline regression model, we observed a dose-response relationship between serum 25(OH)D concentration and anemia, and this linear relationship was also clearly observed between serum 25(OH)D concentration and iron deficiency anemia. Conclusion: Vitamin D deficiency may be associated with a higher prevalence of iron deficiency anemia and anemia in adolescent girls and young women. Alternatively, vitamin D deficiency may be a concurrent event for patients with anemia, which we cannot distinguish in this cross-sectional study. Further studies are needed to verify the causality in this population of low vitamin D levels.

• Journal of Nutrition and Health
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• v.50 no.3
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• pp.257-269
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• 2017

Purpose: This study was conducted to evaluate the risk of metabolic factors in adults consuming 3-in-1 coffee from the 2012~2015 Korea National Health and Nutrition Examination Survey (KNHANES). Methods: A total of 5,872 subjects (male = 2,253, female = 3,619) aged 19~64 yrs were presented with food frequency questionnaires, and they were classified according to coffee consumption level and types of coffee consumed (black coffee, ${\leq}1$ time/day of 3-in-1 coffee, > 1 and ${\leq}2$ times/day of 3-in-1 coffee, > 2 times/day of 3-in-1 coffee). Analysis was conducted by gender for age-stratified groups: 19~39 (male = 968 and female = 1,285) and 40~64 (male = 1,468, female = 2,151) yrs old. Results: Black coffee consumption was associated with a significantly higher education level and household income compared to 3-in-1 coffee consumption in both males and females. The > 2 times/day group had significantly more smokers compared to other patterns of coffee consumption in both males and females. In the 40~64 yrs age group, males and females in the > 2 times/day group had significantly lower density of micronutrients such as fiber, niacin, vitamin C, calcium, phosphorus, and potassium compared with black coffee consumption. In the 40~64 yrs age group, males (OR: 2.03, 95% CI: 1.13~3.64) in the > 2 times/day group were at a higher risk of metabolic syndrome compared with black coffee consumption after multivariable adjustment. Conclusion: We found that frequency of 3-in-1 coffee consumption may be associated with prevalence of metabolic syndrome in males aged 40~64 yrs.

• Diabetes and Metabolism Journal
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• v.42 no.6
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• pp.496-512
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• 2018

Background: This study aimed to investigate the association between the presence and severity of cardiovascular autonomic neuropathy (CAN) and development of long-term glucose fluctuation in subjects with type 2 diabetes mellitus. Methods: In this retrospective cohort study, subjects with type 2 diabetes mellitus who received cardiovascular autonomic reflex tests (CARTs) at baseline and at least 4-year of follow-up with ${\geq}6$ measures of glycosylated hemoglobin (HbA1c) were included. The severity of CAN was categorized as normal, early, or severe CAN according to the CARTs score. HbA1c variability was measured as the standard deviation (SD), coefficient of variation, and adjusted SD of serial HbA1c measurements. Results: A total of 681 subjects were analyzed (294 normal, 318 early, and 69 severe CAN). The HbA1c variability index values showed a positive relationship with the severity of CAN. Multivariable logistic regression analysis showed that CAN was significantly associated with the risk of developing higher HbA1c variability (SD) after adjusting for age, sex, body mass index, diabetes duration, mean HbA1c, heart rate, glomerular filtration rate, diabetic retinopathy, coronary artery disease, insulin use, and anti-hypertensive medication (early CAN: odds ratio [OR], 1.65; 95% confidence interval [CI], 1.12 to 2.43) (severe CAN: OR, 2.86; 95% CI, 1.47 to 5.56). This association was more prominent in subjects who had a longer duration of diabetes (>10 years) and lower mean HbA1c (<7%). Conclusion: CAN is an independent risk factor for future higher HbA1c variability in subjects with type 2 diabetes mellitus. Tailored therapy for stabilizing glucose fluctuation should be emphasized in subjects with CAN.

• Journal of Korean Medical Science
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• v.33 no.51
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• pp.325.1-325.10
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• 2018

Background: To evaluate survival outcomes and prognostic factors for overall survival (OS) in patients with metastatic renal cell carcinoma (mRCC) who received sunitinib (SU) and pazopanib (PZ) as first-line therapy in real-world Korean clinical practice. Methods: Data of 554 patients with mRCC who received SU or PZ at eight institutions between 2012 and 2016 were retrospectively reviewed. Based on the targeted therapy, the patients were divided into SU (n = 293) or PZ (n = 261) groups, and the clinicopathological variables and survival rates of the two groups were compared. A multivariable Cox proportional hazard model was used to determine the prognostic factors for OS. Results: The median follow-up was 16.4 months (interquartile range, 8.3-31.3). Patients in the PZ group were older, and no significant difference was observed in the performance status (PS) between the two groups. In the SU group, the dose reduction rate was higher and the incidence of grade 3 toxicity was more frequent. The objective response rates were comparable between the two groups (SU, 32.1% vs. PZ, 36.4%). OS did not differ significantly between the two groups (SU, 36.5 months vs. PZ, 40.2 months; log-rank, P = 0.955). Body mass index, Eastern Cooperative Oncology Group PS > 2, synchronous metastasis, poor Heng risk criteria, and liver and bone metastases were associated with a shorter OS. Conclusion: Our real-world data of Korean patients with mRCC suggested that SU and PZ had similar efficacies as first-line therapy for mRCC. However, PZ was better tolerated than SU in Korean patients.

• Journal of The Korean Society of Clinical Toxicology
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• v.12 no.2
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• pp.46-53
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• 2014

Purpose: We conducted this study in order to determine clinical features and prognostic factors in adults with acute tetrodotoxin (TTX) poisoning caused by ingestion of puffer fish. Methods: In this retrospective study, 107 patients were diagnosed with TTX poisoning. The subjects were divided into two groups according to duration of treatment; Group I, patients were discharged within 48 hours (n=76, 71.0%), Group II patients were discharged after more than 48 hours (n=31, 29.0%). Group II was subsequently divided into two subgroups [IIa (n=12, 11.2%), IIb (n=19, 17.8%)] according to the need for mechanical ventilation support. Results: In multivariable logistic regression analysis, the predictors of the need for treatment over 48 hours were dizziness (odds ratio [OR], 4.72; 95% confidence intervals [CI], 1.59-12.83), time interval between onset of symptom and ingestion (OR, 0.56; 95% CI, 0.16-0.97), $PaCO_2$<35 mmHg (OR, 8.37; 95% CI, 2.37-23.59). In addition, predictors of the need for mechanical ventilation were a time interval between onset of symptoms and ingestion (OR, 0.54; 95% CI, 0.11-0.96) and $PaCO_2$<35 mmHg (OR, 5.65; 95% CI, 1.96-18.66). Conclusion: Overall, dizziness, time interval between onset of symptoms and ingestion, ${\Delta}DBP$ and $PaCO_2$<35 mmHg predict the need for treatment over 48 hours, time interval between onset of symptoms and ingestion and $PaCO_2$<35 mmHg predict the need for mechanical ventilation support after acute TTX poisoning.