• Title/Summary/Keyword: risk stratification

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Association of dietary calcium, magnesium, sodium, and potassium intake and hypertension: a study on an 8-year dietary intake data from the National Health and Nutrition Examination Survey

  • Wabo, Therese Martin Cheteu;Wu, Xiaoyan;Sun, Changhao;Boah, Michael;Nkondjock, Victorine Raissa Ngo;Cheruiyot, Janet Kosgey;Adjei, Daniel Amporfro;Shah, Imranulllah
    • Nutrition Research and Practice
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    • v.16 no.1
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    • pp.74-93
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    • 2022
  • BACKGROUND/OBJECTIVES: There has been an increased interest in determining calcium magnesium, sodium, and potassium's distinct effects on hypertension over the past decade, yet they simultaneously regulate blood pressure. We aimed at examining the association of dietary calcium, magnesium, sodium, and potassium independently and jointly with hypertension using National Health and Nutrition Examination Survey data from 2007 to 2014. MATERIALS/METHODS: The associations were examined on a large cross-sectional study involving 16684 US adults aged>20 years, using multivariate analyses with logistical models. RESULTS: Sodium and calcium quartiles assessed alone were not associated with hypertension. Potassium was negatively associated with hypertension in the highest quartile, 0.64 (95% confidence interval [CI], 0.48-0.87). When jointly assessed using the high and low cut-off points, low sodium and corresponding high calcium, magnesium, and potassium intake somewhat reduced the odds of hypertension 0.39 (95% CI, 0.20-0.76). The sodium-to-potassium ratio was positively associated with hypertension in the highest quartile1.50 (95% CI, 1.11-2.02). When potassium was adjusted for sodium intake and sodium-to-potassium ratio assessed among women, increased odds of hypertension were reported in the highest quartile as 2.02 (95% CI, 1.18-3.34) and 1.69 (95% CI, 1.12-2.57), respectively. The association of combined minerals on hypertension using dietary goals established that men meeting the reference intakes for calcium and exceeding for magnesium had reduced odds of hypertension 0.51 (95% CI, 0.30-0.89). Women exceeding the recommendations for both calcium and magnesium had the lower reduced odds of 0.30 (95% CI, 0.10-0.69). CONCLUSIONS: Our results suggest that the studied minerals' association on hypertension is stronger when jointly assessed, mostly after gender stratification. As compared to men, women increased their risk of hypertension even with a low sodium intake. Women would also reasonably reduce their risk of developing hypertension by increasing calcium and magnesium intake. In comparison, men would somewhat be protected from developing hypertension with calcium intake meeting the dietary goals and magnesium exceeding the nutritional goals.

A Numerical Study on Ventilation Characteristics of Factors Affecting Leakages in Hydrogen Ventilation (누출 수소 환기에 영향을 미치는 요인별 환기 특성에 관한 수치해석적 연구)

  • Lee, Chang-Yong;Cho, Dae-Hwan
    • Journal of the Korean Society of Marine Environment & Safety
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    • v.28 no.4
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    • pp.610-619
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    • 2022
  • Hydrogen is emerging as an alternative fuel for eco-friendly ships because it reacts with oxygen to produce electrical energy and only water as a by-product. However, unlike regular fossil fuels, hydrogen has a material with a high risk of explosion due to its low ignition point and high flammability range. In order to safely use hydrogen in ships, it is an essential task to study the flow characteristics of hydrogen leakage and diffusion need to be studied. In this study, a numerical analysis was performed on the effect of leakage, ventilation, etc. on ventilation performance when hydrogen leaks in an enclosed space such as inside a ship. ANSYS CFX ver 18.1, a commercial CFD software, was used for numerical analysis. The leakage rate was changed to 1 q, 2 q, and 3 q at 1 q = 1 g/s, the ventilation rate was changed to 1 Q, 2 Q and 3 Q at 1 Q = 0.91 m/s, and the ventilation method was changed to type I, type II, type III to analyze the ventilation performance was analyzed. As the amount of leakage increased from 1 q to 3 q, the HMF in the storage room was about 2.4 to 3.0 times higher. Furthermore, the amount of ventilation to reduce the risk of explosion should be at least 2 Q, and it was established that type III was the most suitable method for the formation of negative pressure inside the hydrogen tank storage room.

Fully Automatic Coronary Calcium Score Software Empowered by Artificial Intelligence Technology: Validation Study Using Three CT Cohorts

  • June-Goo Lee;HeeSoo Kim;Heejun Kang;Hyun Jung Koo;Joon-Won Kang;Young-Hak Kim;Dong Hyun Yang
    • Korean Journal of Radiology
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    • v.22 no.11
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    • pp.1764-1776
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    • 2021
  • Objective: This study aimed to validate a deep learning-based fully automatic calcium scoring (coronary artery calcium [CAC]_auto) system using previously published cardiac computed tomography (CT) cohort data with the manually segmented coronary calcium scoring (CAC_hand) system as the reference standard. Materials and Methods: We developed the CAC_auto system using 100 co-registered, non-enhanced and contrast-enhanced CT scans. For the validation of the CAC_auto system, three previously published CT cohorts (n = 2985) were chosen to represent different clinical scenarios (i.e., 2647 asymptomatic, 220 symptomatic, 118 valve disease) and four CT models. The performance of the CAC_auto system in detecting coronary calcium was determined. The reliability of the system in measuring the Agatston score as compared with CAC_hand was also evaluated per vessel and per patient using intraclass correlation coefficients (ICCs) and Bland-Altman analysis. The agreement between CAC_auto and CAC_hand based on the cardiovascular risk stratification categories (Agatston score: 0, 1-10, 11-100, 101-400, > 400) was evaluated. Results: In 2985 patients, 6218 coronary calcium lesions were identified using CAC_hand. The per-lesion sensitivity and false-positive rate of the CAC_auto system in detecting coronary calcium were 93.3% (5800 of 6218) and 0.11 false-positive lesions per patient, respectively. The CAC_auto system, in measuring the Agatston score, yielded ICCs of 0.99 for all the vessels (left main 0.91, left anterior descending 0.99, left circumflex 0.96, right coronary 0.99). The limits of agreement between CAC_auto and CAC_hand were 1.6 ± 52.2. The linearly weighted kappa value for the Agatston score categorization was 0.94. The main causes of false-positive results were image noise (29.1%, 97/333 lesions), aortic wall calcification (25.5%, 85/333 lesions), and pericardial calcification (24.3%, 81/333 lesions). Conclusion: The atlas-based CAC_auto empowered by deep learning provided accurate calcium score measurement as compared with manual method and risk category classification, which could potentially streamline CAC imaging workflows.

The Clinical Outcomes of Marginal Donor Hearts: A Single Center Experience

  • Soo Yong Lee;Seok Hyun Kim;Min Ho Ju;Mi Hee Lim;Chee-hoon Lee;Hyung Gon Je;Ji Hoon Lim;Ga Yun Kim;Ji Soo Oh;Jin Hee Choi;Min Ku Chon;Sang Hyun Lee;Ki Won Hwang;Jeong Su Kim;Yong Hyun Park;June Hong Kim;Kook Jin Chun
    • Korean Circulation Journal
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    • v.53 no.4
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    • pp.254-267
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    • 2023
  • Background and Objectives: Although the shortage of donor is a common problem worldwide, a significant portion of unutilized hearts are classified as marginal donor (MD) hearts. However, research on the correlation between the MD and the prognosis of heart transplantation (HTx) is lacking. This study was conducted to investigate the clinical impact of MD in HTx. Methods: Consecutive 73 HTxs during 2014 and 2021 in a tertiary hospital were analyzed. MD was defined as follows; a donor age >55 years, left ventricular ejection fraction <50%, cold ischemic time >240 minutes, or significant cardiac structural problems. Preoperative characteristics and postoperative hemodynamic data, primary graft dysfunction (PGD), and the survival rate were analyzed. Risk stratification by Index for Mortality Prediction after Cardiac Transplantation (IMPACT) score was performed to examine the outcomes according to the recipient state. Each group was sub-divided into 2 risk groups according to the IMPACT score (low <10 vs. high ≥10). Results: A total of 32 (43.8%) patients received an organ from MDs. Extracorporeal membrane oxygenation was more frequent in the non-MD group (34.4% vs. 70.7, p=0.007) There was no significant difference in PGD, 30-day mortality and long-term survival between groups. In the subgroup analysis, early outcomes did not differ between low- and high-risk groups. However, the long-term survival was better in the low-risk group (p=0.01). Conclusions: The outcomes of MD group were not significantly different from non-MD group. Particularly, in low-risk recipient, the MD group showed excellent early and long-term outcomes. These results suggest the usability of selected MD hearts without increasing adverse events.

Seasonal distribution of phytoplankton and environmental factors in the offshore waters of Dokdo: Comparison between 2018 and 2019 (독도 연안 식물플랑크톤의 계절적 분포 특성과 환경요인: 2018년과 2019년 비교)

  • Lee, Minji;Kim, Yun-Bae;Kang, Jung Hoon;Park, Chan Hong;Baek, Seung Ho
    • Korean Journal of Environmental Biology
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    • v.38 no.1
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    • pp.47-60
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    • 2020
  • To assess the characteristics of phytoplankton community structures related to environmental factors, seasonal surveys were conducted in the vicinity of Dokdo. In 2019, phytoplankton of four phyla and 69 species were observed. During winter, unidentified nanoflagellates dominated, with an average of 3.19×104 cells L-1. In spring, unidentified nanoflagellates occupied about 50% of the composition and a variety of dinoflagellates appeared. The summer phytoplankton population showed very low abundance. In autumn, various species of Chaetoceros appeared, along with diatoms, such as Bacteriastrum spp., Guinardia striata, and Pseudo-nitzschia spp. In addition, tropical species Amphisolenia sp. and Ornithocercus sp. were observed in both 2018 and 2019. The diversity was high in the summer of 2018 and the winter of 2019 and the characteristics of each index varied. Cluster analysis was divided into four groups according to species and population characteristics regardless of the season. The stratification of spring was particularly weak. In the autumn of 2018, the water mass was stabilized in the same way as in the summer, which is considered a suitable condition for phytoplankton growth. However, in 2019, the water masses were mixed, resulting in a low population. In a phytoplankton comparison, the dominant group showed seasonal differences, except for summer when the population was low, and the difference was most pronounced in autumn. Therefore, the waters surrounding Dokdo have different environmental and ecological characteristics from the East Sea, but the seasonal characteristics of each year are considered to be different depending on the topography, various currents, the island effect, and other factors.

Effects of Job Strains on Absenteeism from Work (직업성 긴장과 근로자 결근)

  • Cha, Bong-Suk;Chang, Sei-Jin;Choi, Hong-Ryul;Kim, Hyong-Sik;Koh, Sang-Baek
    • Journal of Preventive Medicine and Public Health
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    • v.32 no.4
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    • pp.505-512
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    • 1999
  • Objectives : The purpose of this study was to assess the relationship between job strains and absenteeism from work. Methods : The study design was cross-sectional, and the study subjects consisted of 1,166 workers who were employed in the small-sized industries. A self administered questionnaire was used to measure the general characteristics, job characteristics(job demand, job control), and social support(coworker support, supervisor support) at work. The Job Content Questionnaire(JCQ) was used to assess job demand(2 items) and decision lattitude(10 items). Social support at work (10 items) was measured using JCQ. Sick absence was collected using self-report and were rechecked by the attendance record of their company. Odds ratios and 95% confidence intervals for the association between job strain and sick absence were estimated. The modifying effect of social support was evaluated by stratification. Logistic regression was used to estimate the relationship between job strain and sick absence. Results : In the bivariate analysis, the variables related to sick absence were age, marital status, occupation, job demand. Four distinctly different kinds of level of job strain were generated by the combination of job demand and job control: low strain group, high strain group, active group, and passive group. The crude odds ratio of high job strain was 1.78(95% CI: 1.26-2.53), and those of active group and passive group were 1.33(95% CI: 1.07-1.66) and 1.13 (95% CI: 0.88-1.47), respectively. The odds ratio of high job strain after adjusting for age and occupation were still significant The odds ratio of high job strain in low social support was 5.96(95% CI: 2.45-14.51), but that in high social support was 0.73(95% CI: 0.26-2.01). Conclusions : Job strain was associated with increased risk of absenteeism from work, and social support at work modified the association between job strain and sick absence.

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Prognostic significance of minimal residual disease detected by a simplified flow cytometric assay during remission induction chemotherapy in children with acute lymphoblastic leukemia

  • Koh, Kyung-Nam;Park, Mee-Rim;Kim, Bo-Eun;Im, Ho-Joon;Park, Chan-Jeoung;Jang, Seong-Soo;Chi, Hyun-Sook;Seo, Jong-Jin
    • Clinical and Experimental Pediatrics
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    • v.53 no.11
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    • pp.957-964
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    • 2010
  • Purpose: Our study attempted to determine the prognostic significance of minimal residual disease (MRD) detected by a simplified flow cytometric assay during induction chemotherapy in children with B-cell acute lymphoblastic leukemia (B-ALL). Methods: A total of 98 patients were newly diagnosed with precursor B-ALL from June 2004 to December 2008 at the Asan Medical Center (Seoul, Korea). Of those, 37 were eligible for flow cytometric MRD study analysis on day 14 of their induction treatment. The flow cytometric MRD assay was based on the expression intensity of CD19/CD10/CD34 or aberrant expression of myeloid antigens by bone marrow nucleated cells. Results: Thirty-five patients (94.6%) had CD19-positive leukemic cells that also expressed CD10 and/or CD34, and 18 (48.6%) had leukemic cells with aberrant expression of myeloid antigens. Seven patients with ${\geq}1%$ leukemic cells on day 14 had a significantly lower relapse-free survival (RFS) compared to the 30 patients with lower levels (42.9 % [18.7%] vs. 92.0% [5.4%], $P$=0.004). Stratification into 3 MRD groups (${\geq}1%$, 0.1-1%, and <0.1%) also showed a statistically significant difference in RFS (42.9% [18.7%] vs. 86.9% [8.7%] vs. 100%, $P$=0.013). However, the MRD status had no significant influence on overall survival. Multivariate analysis demonstrated that the MRD level on day 14 was an independent prognostic factor with borderline significance. Conclusion: An MRD assay using simplified flow cytometry during induction chemotherapy may help to identify patients with B-ALL who have an excellent outcome and patients who are at higher risk for relapse.

Breast Cancer Association Studies in a Han Chinese Population using 10 European-ancestry-associated Breast Cancer Susceptibility SNPs

  • Guan, Yan-Ping;Yang, Xue-Xi;Yao, Guang-Yu;Qiu, Fei;Chen, Jun;Chen, Lu-Jia;Ye, Chang-Sheng;Li, Ming
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.1
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    • pp.85-91
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    • 2014
  • Background: Genome-wide association studies (GWAS) have identified various genetic susceptibility loci for breast cancer based mainly on European-ancestry populations. Differing linkage disequilibrium patterns exist between European and Asian populations. Methods: Ten SNPs (rs2075555 in COL1A1, rs12652447 in FBXL17, rs10941679 in 5p12/MRPS30, rs11878583 in ZNF577, rs7166081 in SMAD3, rs16917302 in ZNF365, rs311499 in 20q13.3, rs1045485 in CASP8, rs12964873 in CDH1 and rs8170 in 19p13.1) were here genotyped in 1009 Chinese females (487 patients with breast cancer and 522 control subjects) using the Sequenom MassARRAY iPLEX platform. Association analysis based on unconditional logistic regression was carried out to determine the odds ratio (OR) and 95% confidence interval (95% CI) for each SNP. Stratification analyses were carried out based on the estrogen receptor (ER) and progesterone receptor (PR) status. Results: Among the 10 SNPs, rs10941679 showed significant association with breast cancer when differences between the case and control groups in this Han Chinese population were compared (30.09% GG, 45.4% GA and 23.7% AA; P = 0.012). Four SNPs (rs311499, rs1045485, rs12964873 and rs8170) showed no polymorphisms in our study. The remaining five SNPs showed no association with breast cancer in the present population. Immunohistochemical tests showed that rs2075555 was associated with ER status; the AA genotype showed greater association with ER negative than ER positive (OR = 0.54, 95% CI, 0.29-0.99; P = 0.046). AA of rs7166081 was also associated with ER status, but showed a greater association with ER positive than negative (OR = 1.59, 95% CI = 1.04-2.44; P = 0.031). However, no significant associations were found among the SNPs and PR status. Conclusion: In this study using a Han Chinese population, rs10941679 was the only SNP associated with breast cancer risk, indicating a difference between European and Chinese populations in susceptibility loci. Therefore, confirmation studies are necessary before utilization of these loci in Chinese.

Prognostic value of $^{18}F$-fluorodeoxyglucose positron emission tomography, computed tomography and magnetic resonance imaging in oral cavity squamous cell carcinoma with pathologically positive neck lymph node

  • Jwa, Eunjin;Lee, Sang-Wook;Kim, Jae-Seung;Park, Jin Hong;Kim, Su Ssan;Kim, Young Seok;Yoon, Sang Min;Song, Si Yeol;Kim, Jong Hoon;Choi, Eun Kyung;Ahn, Seung Do
    • Radiation Oncology Journal
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    • v.30 no.4
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    • pp.173-181
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    • 2012
  • Purpose: To evaluate the prognostic value of preoperative neck lymph node (LN) assessment with $^{18}F$-fluorodeoxyglucose positron emission tomography ($^{18}F$-FDG PET), computed tomography (CT), and magnetic resonance imaging (MRI) in oral cavity squamous cell carcinoma (OSCC) patients with pathologically positive LN. Materials and Methods: In total, 47 OSCC patients with pathologically positive LN were retrospectively reviewed with preoperative $^{18}F$-FDG PET and CT/MRI. All patients underwent surgical resection, neck dissection and postoperative adjuvant radiotherapy and/or chemotherapy between March 2002 and October 2010. Histologic correlation was performed for findings of $^{18}F$-FDG PET and CT/MRI. Results: Thirty-six (76.6%) of 47 cases were correctly diagnosed with neck LN metastasis by $^{18}F$-FDG PET and 32 (68.1%) of 47 cases were correctly diagnosed by CT/MRI. Follow-up ranged from 20 to 114 months (median, 56 months). Clinically negative nodal status evaluated by $^{18}F$-FDG PET or CT/MRI revealed a trend toward better clinical outcomes in terms of overall survival, disease-free survival, local recurrence-free survival, regional nodal recurrence-free survival, and distant metastasis-free survival rates even though the trends were not statistically significant. However, there was no impact of neck node standardized uptake value ($SUV_{max}$) on clinical outcomes. Notably, $SUV_{max}$ showed significant correlation with tumor size in LN (p < 0.01, $R^2$ = 0.62). PET and CT/MRI status of LN also had significant correlation with the size of intranodal tumor deposit (p < 0.05, $R^2$ = 0.37 and p < 0.01, $R^2$ = 0.48, respectively). Conclusion: $^{18}F$-FDG PET and CT/MRI at the neck LNs might improve risk stratification in OSCC patients with pathologically positive neck LN in this study, even without significant prognostic value of $SUV_{max}$.

Relationship and Clinical Usefulness between Preoperative Levels of Brain Natriuretic Peptide, Other Cardiac Markers and Perioperative Parameters in Patients with Coronary Artery Disease (관상동맥질환자에 있어 수술 전 brain natriuretic peptide 농도, 심장표지자, 수술전후기 변수들 간의 상관관계와 임상적 유용성)

  • Choi, Seok-Cheol;Kim, Yang-Weon;Hyun, Kyung-Yae;Hwang, Soo-Myung;Moon, Seong-Min
    • Journal of Life Science
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    • v.20 no.9
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    • pp.1299-1305
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    • 2010
  • Cardiac troponin-I (cTnI), creatine kinase-MB (CK-MB), and C-reactive protein (CRP) are routine cardiac markers for the diagnosis of cardiovascular disease. Recently, brain natriuretic peptide (BNP) has garnered attention as a marker of heart failure. This study was retrospectively designed to investigate the relationships between preoperative BNP, other cardiac markers levels and perioperative parameters in seventy-four adult patients that underwent off-pump coronary artery bypass grafting (OPCAB) and to assess its usefulness for predicting postoperative outcomes. Preoperative levels of BNP, cTnI, CK-MB, and CRP had significantly positive or negative correlations with echocadiographic parameters. There were significantly positive relationships between BNP, cTnI, CK-MB, and CRP concentration. Postoperative mechanical ventilation time had a positive correlation to preoperative levels of cTnI, CK-MB, and CRP, while ICU-staying period had a positive correlation with BNP, cTnI and CK-MB. These results reveal that a preoperative level of BNP is a good predictor and that its combination with cTnI, CK-MB, and CRP might be useful for diagnosis and comprehensive risk stratification of patients with coronary heart diseases, as well as prognosis of perioperative outcomes in OPCAB patients.