Purpose: The aims of this study are to evaluate psychological impact and quality of life according to the cancer diagnosis and mutation status in Korean families with BRCA mutations. Materials and Methods: Seventeen affected carriers (AC), 16 unaffected carriers (UC) and 13 healthy non carriers (NC) from 13 BRCA mutation families were included in the study. Outcomes were compared with regard to depression (Beck Depression Inventory), anxiety (State-Trait Anxiety Inventory, STAI), optimism (Reevaluation of the Life Orientation test, LOT-R), knowledge of hereditary ovarian cancer, and quality of life (QoL) (SF-36v2 Health Survey, physical component score [PCS], mental component score [MCS]) among three groups. Result: Level of depression, optimism, and PCS were similar in AC, UC, and NC. Anxiety score was elevated in all three groups. MCS was significantly low in AC than in UC and NC (P=0.009, P=0.017). Knowledge of hereditary breast and ovarian cancer was high in AC than NC (P=0.001). MCS was significantly related to whether patient was affected by cancer (P=0.043) and has occupation (P=0.008) or not in multivariable analysis. Conclusion: From this cross sectional study, psychological adverse effect was not related to the carrier status of BRCA mutation. Elevated anxiety in BRCA family members was observed but, independent to affection and the type of genetic mutation. AC showed low mental QoL. Further effort to understand psychological impact and QoL of genetic testing in BRCA family members is required for follow-up in clinical aspects.
Purpose: Several studies have shown that magnesium plays an important role in modulating N-methyl-D-aspartate (NMDA)-related seizures by blocking NMDA ion channel receptors. Clinicians usually measure total serum magnesium levels instead of biologically active ionized magnesium levels. We compared the serum ionized magnesium ($iMg^{2+}$) level between epileptic children with and without a history of fever-triggered seizure (FTS). Methods: All epileptic children who visited the outpatient clinic or pediatric emergency department at Korea University Guro Hospital between January 2015 and July 2017 were included. Only epileptic children aged 1-8 years who were newly diagnosed within 2 years were included. Results: There were 12 children with FTS and 16 without FTS. Median serum $iMg^{2+}$ level was 0.93 (0.85-1.14, quartile) mEq/L. Serum $iMg^{2+}$ level was significantly lower in epileptic children with FTS (0.86 mEq/L) compared to those without FTS (1.10 mEq/L) (P=0.005). No difference was noted in clinical variables between the two groups. Lower serum $iMg^{2+}$ level significantly increased the risk of having FTS in epileptic children based on multivariable logistic regression analysis (odds ratio [OR]=0.028). Conclusion: Serum $iMg^{2+}$ level was significantly lower in epileptic children with FTS than in those without FTS. Measurement of biologically active serum $iMg^{2+}$ level could be considered in epileptic children with recurrent FTS. A large-scale prospective study is warranted.
Purpose: We evaluate the influence of the types of coffee beverage on obesity and abdominal obesity in Korean adults who were aged 19 years or over by using the 2013 ~ 2016 Korea National Health and Nutrition Examination Survey (KNHANES). Methods: Specific questions were asked about frequency of coffee intake, the type of coffee beverage, the addition of milk and/or sugar to coffee by using the food frequency questionnaire of the 2013 ~ 2016 KNHANES. Results: We found that coffee intake increased the prevalence of obesity and abdominal obesity. After multivariable adjustment, coffee consumption increased the risk of obesity by 1.30 (95% CI: 1.08 ~ 1.57) in the group that drank coffee twice a day, and 1.33 (95% CI: 1.11 ~ 1.60) in the people who drank coffee ${\geq}3$ times a day as compared to that of the non-coffee intake group. The risk of abdominal obesity increased to 1.27 (95% CI: 1.02 ~ 1.57) in the < 1 time/day coffee drinking group, 1.34 (95% CI: 1.08 ~ 1.66) in the 1 time/day coffee drinking group, 1.35 (95% CI: 1.09 ~ 1.67) in the 2 times/day coffee drinking group, and 1.40 (95% CI: 1.14 ~ 1.72) in the ${\geq}3$ times/day coffee drinking group as compared to that of the non-coffee drinking group. The influence of black coffee intake was different according to gender: males showed a high prevalence of abdominal obesity and females showed a high prevalence of obesity. Mixed coffee consumption increased the risk of obesity and abdominal obesity by more than 34% in men who consumed coffee more than 3 times a day and in women who consumed coffee more than 2 times per day. Conclusions: We found that coffee intake, regardless of the type of coffee, increased the prevalence of obesity and abdominal obesity. It is necessary to refrain from drinking coffee to prevent obesity.
Purpose: Management of the metabolic risk factors in diabetes patients is essential for preventing or delaying diabetic complications. This study compared the levels of the metabolic risk factors in diabetes patients according to the income levels, and examined the secular trends in recent decades. Methods: The data from the Korea National Health and Nutrition Examination Survey 1998 ~ 2014 were used. The diabetes patients were divided into three groups based on their household income levels. General information was obtained through self-administered questionnaires, and the blood biomarkers and blood pressure data were obtained from a health examination. Multivariable linear regression models were used to compare the metabolic biomarker levels according to the household income levels, adjusting for potential confounding factors. Results: The fasting blood glucose, hemoglobin A1c, and blood lipid (total cholesterol, high-density lipoprotein (HDL) cholesterol, low-density lipoprotein (LDL) cholesterol, and triglyceride) levels were similar in the three groups. During the survey period of 16 years, the blood pressure showed a significant decreasing trend with time in all groups (p < 0.001). In contrast, the fasting blood glucose (p = 0.004), total cholesterol (p < 0.001), and LDL-cholesterol levels (p = 0.007) decreased significantly, and the HDL-cholesterol level (p < 0.001) increased significantly in the highest-income groups. In the lowest-income group, the fasting blood glucose (p = 0.02), total cholesterol (p < 0.001), and triglyceride (p = 0.003) levels showed a significant decreasing trend over time. On the other hand, the middle-income group showed no significant change in any of the metabolic risk factors except for blood pressure. Conclusion: The level of management of metabolic risk factors according to the income level of Korean diabetes patients was similar. On the other hand, the highest- and lowest-income groups showed positive trends of management of these factors during 16 years of observation, whereas the middle-income group did not show any improvement.
Kim, Min Gyun;Shin, Tae Gun;Jo, Ik Joon;Kim, Won Young;Ryoo, Seung Mok;Chung, Sung Phil;Beom, Jin Ho;Choi, Sung-Hyuk;Kim, Kyuseok;Jo, You Hwan;Kang, Gu Hyun;Suh, Gil Joon;Shin, Jonghwan;Lim, Tae Ho;Han, Kap Su;Hwang, Sung Yeon;Korean Shock Society (KoSS)
Journal of The Korean Society of Emergency Medicine
/
v.29
no.5
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pp.465-473
/
2018
Objective: We evaluated the clinical characteristics and prognoses of patients with septic shock who transferred to the emergency department (ED) in a tertiary referral center. Methods: This study was performed using a prospective, multi-center registry of septic shock, with the participation of 11 tertiary referral centers in the Korean Shock Society between October 2015 and February 2017. We classified the patients as a transferred group who transferred from other hospitals after meeting the inclusion criteria upon ED arrival and a non-transferred group who presented directly to the ED. Primary outcome was hospital mortality. We conducted multiple logistic regression analysis to assess variables related to in-hospital mortality. Results: A total of 2,098 patients were included, and we assigned 717 patients to the transferred group and 1,381 patients to the non-transferred group. The initial Sequential Organ Failure Assessment score was higher in the transferred group than the non-transferred group (6; interquartile range [IQR], 4-9 vs. 6; IQR, 4-8; P<0.001). Mechanical ventilator (29% vs. 21%, P<0.001) and renal replacement therapy (12% vs. 9%, P=0.034) within 24 hours after ED arrival were more frequently applied in the transferred group than the non-transferred group. Overall hospital mortality was 22% and there was no significant difference between transferred and non-transferred groups (23% vs. 22%, P=0.820). Multivariable analysis showed an odds ratio for in-hospital mortality of 1.00 (95% confidence interval, 0.78-1.28; P=0.999) for the transferred group compared with the non-transferred group. Conclusion: The transferred group showed higher severity and needed more organ support procedures than the non-transferred group. However, inter-hospital transfer did not affect in-hospital mortality.
Objective: To investigate survival outcomes in endometrioid endometrial cancer (EEC) patients with single vs. multiple positive pelvic lymph nodes. Methods: We performed a retrospective evaluation of all consecutive patients with histologically proven International Federation of Gynecology and Obstetrics (FIGO) stage IIIC1 EEC who underwent primary surgical treatment between 2004 and 2014 at seven Italian gynecologic oncology referral centers. Patients with pre- or intra-operative evidence of extra-uterine disease (including the presence of bulky nodes) and patients with stage IIIC2 disease were excluded, in order to obtain a homogeneous population. Results: Overall 140 patients met the inclusion criteria. The presence of >1 metastatic pelvic node was significantly associated with an increased risk of recurrence and mortality, compared to only 1 metastatic node, at both univariate (recurrence: hazard ratio [HR]=2.19; 95% confidence interval [CI]=1.2-3.99; p=0.01; mortality: HR=2.8; 95% CI=1.24-6.29; p=0.01) and multivariable analysis (recurrence: HR=1.91; 95% CI=1.02-3.56; p=0.04; mortality: HR=2.62; 95% CI=1.13-6.05; p=0.02) and it was the only independent predictor of prognosis in this subset of patients. Disease-free survival (DFS) and disease-specific survival (DSS) were significantly longer in patients with only 1 metastatic node compared to those with more than 1 metastatic node (p=0.008 and 0.009, respectively). Conclusion: The presence of multiple metastatic nodes in stage IIIC1 EEC represents an independent predictor of worse survival, compared to only one positive node. Our data suggest that EEC patients may be categorized according to the number of positive nodes.
Ji Yoon Kim;Sang-Hyeon Jin;Min Jae Cho;Hyeji Choi;Kwang-Guk An
Korean Journal of Environmental Biology
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v.41
no.2
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pp.109-125
/
2023
This study was conducted to select target fish species as baseline research for accumulation analysis of major hazardous chemicals entering the aquatic ecosystem in Korea and to analyze the impact on fish community. The test bed was selected from a sewage treatment plant, which could directly confirm the impact of the inflow of harmful chemicals, and the Geum River estuary where harmful chemicals introduced into the water system were concentrated. A multivariable metric model was developed to select target candidate fish species for hazardous chemical analysis. Details consisted of seven metrics: (1) commercially useful metric, (2) top-carnivorous species metric, (3) pollution fish indicator metric, (4) tolerance fish metric, (5) common abundant metric, (6) sampling availability (collectability) metric, and (7) widely distributed fish metric. Based on seven metric models for candidate fish species, eight species were selected as target candidates. The co-occurring dominant fish with target candidates was tolerant (50%), indicating that the highest abundance of tolerant species could be used as a water pollution indicator. A multi-metric fish-based model analysis for aquatic ecosystem health evaluation showed that the ecosystem health was diagnosed as "bad conditions". Physicochemical water quality variables also influenced fish feeding and tolerance guild in the testbed. Eight water quality parameters appeared high at the T1 site, indicating a large impact of discharging water from the sewage treatment plant. T2 site showed massive algal bloom, with chlorophyll concentration about 15 times higher compared to the reference site.
Journal of Korean Home Economics Education Association
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v.35
no.1
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pp.1-14
/
2023
The objective of the study was to examine the associations of dietary carbohydrate and fat intake with the prevalence of metabolic syndrome in Korean women. A cross-sectional study was employed based on data from the Korea National Health and Nutrition Examination (2007-2016). A total of 22,850 women aged 19 to 69 years were studied after excluding responses from pregnant or lactating women and those with missing metabolic values. Dietary intake data were collected with a 24-hour recall method. Dietary carbohydrate and fat intakes were divided into quintiles. After controlling for confounding variables, a multivariable logistic regression and general linear model were used. The findings indicated that HDL cholesterol levels were lower (p for trend<0.01), while triglyceride levels (p for trend=0.04), waist circumference (p for trend<0.01), and systolic blood pressure (p for trend<0.01) were higher among participants in the highest quintile of carbohydrate intake compared to those in the lowest quintile. Participants in the highest quintile of fat intake had lower waist circumference (p for trend=0.02), triglyceride level (p for trend<0.01), and systolic blood pressure (p for trend<0.01), while higher HDL cholesterol level (p for trend<0.01) compared to those in the lowest fat intake quintile. Metabolic syndrome was more likely to be present in the highest quintile of carbohydrates intake than in the lowest quintile (5th quintile vs. 1st quintile, OR: 1.32; 95% CI: 1.11 to 1.57). However, metabolic syndrome was less likely to be present in the highest quintile of fat intake than in the lowest quintile (5th quintile vs. 1st quintile, OR: 0.73; 95% CI: 0.61 to 0.86). This study revealed that high dietary carbohydrate intake and low dietary fat intake were associated with metabolic syndrome in Korean women.
Purpose: Depression is a prevalent mental health concern globally including South Korea. Given the growing interest in the relationship between diet and mental health, this study aimed to investigate the association between seafood consumption and depression among Korean adults. Methods: A cross-sectional analysis was conducted using data from the Korea National Health and Nutrition Examination Survey (KNHANES, 2014-2020). The study included 18,149 participants (7,541 men and 10,608 women) aged 19 years and older who completed the Patient Health Questionnaire (PHQ-9). Seafood intake levels were assessed using a oneday 24-hour dietary recall, and participants were categorized into three tertiles by gender. Depression status was determined using the PHQ-9 scores and the self-report of the doctor's diagnosis and treatment. Multivariable logistic regression analysis was performed to assess the association between seafood consumption and depression in both genders. Results: Participants with a higher seafood intake had a significantly lower nutritional density of total fat, while the nutritional density of omega-3 polyunsaturated fatty acids was significantly higher. The prevalence of depression was significantly lower in the highest tertile of seafood consumption compared to the lowest tertile in both men (p < 0.001) and women (p < 0.001). After adjusting for confounding factors, the highest tertile of seafood consumption demonstrated a decreased risk of depression compared to the lowest tertile in men (odds ratio [OR], 0.71; 95% confidence interval [CI], 0.51-0.99; p-trend = 0.020) and women (OR, 0.73; 95% CI, 0.59-0.91; p-trend = 0.004). Conclusion: The findings of this study suggest that consuming seafood rich in omega-3 fatty acids may potentially reduce the risk of depression in the adult population.
Ko Woon Park;Boo-Kyung Han;Sun Jung Rhee;Soo Youn Cho;Eun Young Ko;Eun Sook Ko;Ji Soo Choi
Journal of the Korean Society of Radiology
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v.83
no.3
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pp.632-644
/
2022
Purpose To determine the incidence of atypical ductal hyperplasia (ADH) in needle biopsy and the upgrade rate to carcinoma, and to evaluate difference in findings between the upgrade and non-upgrade groups. Materials and Methods Among 9660 needle biopsies performed over 48 months, we reviewed the radiologic and histopathologic findings of ADH and compared the differences in imaging findings (mammography and breast US) and biopsy methods between the upgrade and non-upgrade groups. Results The incidence of ADH was 1.7% (169/9660). Of 112 resected cases and 30 cases followed-up for over 2 years, 35 were upgraded to carcinoma (24.6%, 35/142). The upgrade rates were significantly different according to biopsy methods: US-guided core needle biopsy (USCNB) (40.7%, 22/54) vs. stereotactic-vacuum-assisted biopsy (S-VAB) (16.0%, 12/75) vs. USguided VAB (US-VAB) (7.7%, 1/13) (p = 0.002). Multivariable analysis showed that only US-CNB (odds ratio = 5.19, 95% confidence interval: 2.16-13.95, p < 0.001) was an independent predictor for pathologic upgrade. There was no upgrade when a sonographic mass was biopsied by US-VAB (n = 7) Conclusion The incidence of ADH was relatively low (1.7%) and the upgrade rate was 24.6%. Surgical excision should be considered because of the considerable upgrade rate, except in the case of US-VAB.
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