• Journal of Preventive Medicine and Public Health
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• v.30 no.3 s.58
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• pp.630-642
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• 1997

The purpose of this study was to examine the mortality risk associated with cognitive impairment among the rural elderly. The subjective of study was 558 of 'A Study on the Depression and Cognitive Impairment in the Rural Elderly' of Jung Ae Rhee and Hyang Gyun Jung's study(1993). Cognitive impairment and other social and health factors were assessed in 558 elderly rural community residents. For this study, a Korean version of the Mini-Mental State Examination(MMSEK) was used as a global indicator of cognitive functioning. And mortality risk factors for each cognitive impairment subgroup were identified by univariate and multivariate Cox regression analysis. At baseline 22.6% of the sample were mildly impaired and 14.2% were severely impaired. As the age increased, the cognitive function was more impaired. Sexual difference was existed in the cognitive function level. Also the variables such as smoking habits, physical disorders had the significant relationship with cognitive function impairment. Across a 3-year observation period the mortality rate was 8.5% for the cognitively unimpaired, 11.1% for the mildly impaired, and 16.5% for the severly impaired respendents. And the survival probability was .92 for the cognitively unimpaired, .90 for the mildly impaired, and .86 for the severly impaired respondents. Compared to survival curve for the cognitively unimpaired group, each survival curve for the mildly and the severely impaired group was not significantly different. When adjustments models were not made for the effects of other health and social covariates, each hazard ratio of death of mildly and severely impaired persons was not significantly different as compared with the cognitively unimpaired. But, as MMSEK score increased, significantly hazard ratio of death decreased. Employing Cox univariate proportional hazards model, statistically other significant variables were age, monthly income, smoking habits, physical disorders. Also when adjustments were made for the effects of other health and social covariates, there was no difference in hazard ratio of death between those with severe or mild impairment and unimpaired persons. And as MMSEK score increased, significantly hazard ratio of death did not decrease. Employing Cox multivariate proportional hazards model, statistically other significant variables were age, monthly income, physical disorders. Employing Cox multivariate proportional hazards model by sex, at men and women statistically significant variable was only age. For both men and women, also cognitive impairment was not a significant risk factor. Other investigators have found that cognitive impairment is a significant predictor of mortality. But we didn't find that it is a significant predictor of mortality. Even though the conclusions of our study were not related to cognitive impairment and mortality, early detection of impaired cognition and attention to associated health problems could improve the quality of life of these older adults and perhaps extend their survival.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.13 no.11
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• pp.5238-5246
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• 2012

This study was done to identify the evaluation of CPSCS for neurocritical patients and provide effective nursing interventions for these patients. Data were collected from medical records of 203 neurocritical patients over 18 years of age who were admitted to the ICU of C University Hospital during the period from January 2008 to May 2009 and from October 2011 to December 2011. Collected data were analyzed through t-test, ANOVA test, Person's correlation analysis, trend analysis, stepwise multiple regression. The average CPSCS score was $112.09{\pm}18.91$ and there was a significant trendency for higher severity to lead to higher CPSCS's scores(survival: J-T:9.795, die: J-T:5.415, p=<.001). The scores of the respective areas follows measurement of vital sign($3.74{\pm}2.15$), monitoring($28.97{\pm}4.31$), activity daily living ($34.99{\pm}3.66$), feeding($.19{\pm}.98$), intravenous infusion ($18.20{\pm}8.27$), treatment/procedure ($16.93{\pm}4.90$), respiratory therapy($8.61{\pm}7.07$). By means of stepwise multiple regression analysis, the intravenous therapy & medication, respiratory therapy, activities of daily living, and monitoring area that contains the model showed a significant (F=2073.963, p<.001), and they explained 98.1% of CPSCS. These findings provide information that is relevant in designing interventions to enhance CPSCS among neurocritical patients in hospital.

• IMMUNE NETWORK
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• v.3 no.3
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• pp.188-200
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• 2003

Background: Immunization of dendritic cells (DCs) pulsed with tumor antigen can activate tumor-specific cytotoxic T lymphocytes (CTL) that are responsible for protection and regression. In this study, we examined whether the uptake of necrotic tumor cells could modulate DC phenotypes and whether the immunization of necrotic tumor cell-loaded DCs could elicit efficient tumor specific immune responses followed by a regression of established tumor burdens. Methods: We prepared necrotic tumor cell-pulsed DCs for the therapeutic vaccination and investigated their phenotypic characteristics, the immune responses induced by these DCs, and therapeutic vaccine efficacy against colon carcinoma in vivo. Several parameters including phagocytosis of tumor cells, surface antigen expression, chemokine receptor expression, IL-12 production, and NK as well as CTL activation were assessed to characterize the immune response. Results: DCs derived from mouse bone marrow efficiently phagocytosed necrotic tumor cells and after the uptake, they produced remarkably increased levels of IL-12. A decreased CCR1 and increased CCR7 expression on DCs was also observed after the tumor uptake, suggesting that antigen uptake could induce DC maturation. Furthermore, co-culturing of DCs with NK cells in vitro enhanced IL-12 production in DCs and IFN-${\gamma}$ production in NK cells, which was significantly dependent on IL-12 production and cell-to-cell contact. Immunization of necrotic tumor cell-loaded DCs induced cytotoxic T lymphocytes as well as NK activation, and protected mice against subsequent tumor challenge. In addition, intratumoral or contra-lateral immunization of these DCs not only inhibited the growth of established tumors, but also eradicated tumors in more than 60% of tumor-bearing mice. Conclusion: Our data indicate that production of IL-12, chemokine receptor expression and NK as well as CTL activation may serve as major parameters in assessing the effect of tumor cell-pulsed DC vaccine. Therefore, DCs loaded with necrotic tumor cells offer a rational strategy to treat tumors and eventually lead to prolonged survival.

• Journal of Gastric Cancer
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• v.5 no.2
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• pp.113-119
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• 2005

Purpose: Some controversies exist over the prognostic values of lymphatic, venous, and neural invasion in patients with gastric cancer. This study was conducted to confirm the prognostic values of these histopathologic factors in gastric cancer patients who received a gastrectomy. Materials and Methods: Data for clinicopathologic factors and clinical outcomes were collected retrospectively from the medical records of 1,018 gastric cancer patients who received a gastrectomy at Yeungnam University Medical Center between January 1995 and December 1999. A statistical analysis was done using the SPSS program for Windows (Version 10.0, SPSS Inc., USA). The Kaplan-Meier method was used for the survival analysis. Prognostic factors were analyzed by using a multivariate analysis with Cox proportional hazard regression model. Results: Ages ranged from 21 to 79 (median age, 56). A univariate analysis revealed that age, tumor size, location, gross type, depth of invasion, extent of gastrectomy or lymph node dissection, lymph node metastasis, distant metastasis, lymphatic invasion, venous invasion, neural invasion, pathologic stage, histologic type, and curability of surgery had statistical significance. Among these factors, lymph node metastasis, curability of surgery, neural invasion, lymphatic invasion, and depth of invasion were found to be independent prognostic factors by using a multivariate analysis. Venous invasion showed no prognostic value in the multivariate analysis. Conclusion: Neural invasion and lymphatic invasion are useful parameters in determining a prognosis for gastric cancer patients.

• Knowledge Management Research
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• v.21 no.3
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• pp.67-87
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• 2020

Maintaining active users who repeatedly share high-quality knowledge is critical for the success of online Q&A sites. This study suggests two paths that lead to active users' continuous knowledge sharing: 1) elaborated decision process, represented by continuance intention, and 2) automated cognitive process, represented by past behavior. The direct and moderating effects of continuance intention and past behavior were verified by analyzing subjective intention data and objective behavior data of 333 active users of Naver Knowledge-iN. Using Cox proportional hazards regression and negative binomial regression, the influences of continuance intention and past behavior on two types of continuous knowledge sharing were examined. The results showed that only past behavior was significantly influential on knowledge sharing continuance and as to the frequency of knowledge sharing, both continuance intention and past behavior's influences were significant. It was also confirmed that past behavior negatively moderates continuance intention's effect on the frequency of knowledge sharing. In order to maintain active users' continuous knowledge sharing, it is important to habituate knowledge sharing through repetitive knowledge sharing behavior. And in order to increase the frequency of knowledge sharing, in addition to the habituation, appropriate benefits that can increase the continuance intention should be provided.

• Fisheries and Aquatic Sciences
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• v.1 no.2
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• pp.192-200
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• 1998

This study was carried out to evaluate the effect of feeding higher protein feeds with lesser amount, but feeding the constant total protein input for all treatments, on water quality and nitrite toxicity in channel catfish ponds. There was no significant difference in survival rate among treatments $(P>0.05)$. Specific growth rate (SGR) for Treatment 1$(28\%\;protein\;and\;100\%\;of\;satiation)$ was significantly higher $(P>0.05)$ than for Treatment 3$(36\%\;protein\;and\;87.5\%\;of\;satiation)$, but not significantly higher than for Treatment 2 $(32\%\;protein\;and\;77.8\%\;of\;satiation)$ at constant digestible energy (DE), 3.08kcal/g (treatments 1, 2 and 3). At constant DE/P (treatments 4, 2 and 5), no significant difference in SGR was observed among treatments. Feed conversion ratio (FCR) slightly improved or improved as dietary protein level increased from $28\%$ to $32\%$ and feed allowance decreased by $12.5\%$, but did not improve as dietary protein level increased from $32\%$ to $36\%$ and feed allowance decreased by $22.2\%$, at constant DE and constant DE/P. There was no significant difference in water quality variables, such as total ammonia nitrogen (TAN), nitrite, chlorophyll a, soluble phosphorous concentrations among treatments, but significant difference in water quality variables over time as amount of feed fed increased $(P<0.0001)$. There was a trend toward increase in TAN and nitrite over time. A strong linear regression was observed between mean total ammonia nitrogen and nitrite for all treatments Y (Nitrite) =$0.04\times (TAN)+0.01$, $R_2=0.89$. Methemoglobin percent in the blood of catifish was not significantly different among treatments. And its mean value was $7.5\%$, which was relatively low, so that it was not serious problem in catfish production pond under these experiment conditions. There was the stronger linear regression between the percentage of Methemoglobin and the molar ratio of nitrite to chloride rather than nitrite alone: $Y\;(Methemoglobin\;\%)\;=\;58.45\;\times\;(NO^{2-}/Cl^-)\;+\;0.41,\;R^2=0.60$. These results indicate that deterioration of water quality has no strong impact on poor weight gain for $36\%$ dietary protein in this study.

• Journal of Yeungnam Medical Science
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• v.19 no.2
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• pp.126-135
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• 2002

Background: Neovascular glaucoma is common secondary glaucoma at high risk for failure of glaucoma filtering surgery. Recently, trabeculectomy with adjunctive mitomycin C trabeculectomy has been tried to improve the surgical success rate of conventional trabeculectomy. But, the long-term effects of mitomycin C trabeculectomy for neovascular glaucoma are unknown. Thus, we evaluated the long-term effects of mitomycin C trabeculectomy and its prognostic factors influencing the outcome. Materials and Methods: Medical records of 62 eyes of 55 neovascular glaucoma who had undergone mitomycin C trabeculectomy were retrospectively reviewed. Surgical success was defined as intraocular pressures of 21 mmHg or less with or without glaucoma medications and no loss of light perception. Surgical failure was defined as postoperative loss of light perception in patients with preoperative vision better than light perception, additional glaucoma surgery, or phthisis bulbi in patients with preoperative vision of no light perception. Results: Postoperative success was obtained in 37 (60%) out of 62 eyes after mean followup period of $23.9{\pm}16.2$ months. Using Kaplan-Meier survival analysis, cumulative success rate at the 6-, 12-, 24- and 36-month intervals were 85%, 71%, 57% and 52%, respectively. Success rate was greater in eyes with diabetic retinopathy than other causes(p=0.005) and in eyes with preoperative panretinal photocoagulation(PRP) than without PRP(p=0.015). However, Cox proportional hazard regression analysis revealed that preoperative PRP was not a significant risk factor for surgical failure. Conclusion: Prognosis of neovascular glaucoma caused by diabetic retinopathy was better than that caused by the other disorders following mitomycin C trabeculectomy. The author would suggest that mitomycin C trabeculectomy could be effective and relatively safe as the first procedure of choice before performing glaucoma drainage device implantation or cyclodestructive procedure.

• The Korean Journal of Applied Statistics
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• v.28 no.5
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• pp.921-932
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• 2015

This study analyzed military personnel survivability in regards to offensive operations according to the scientific military training data of a reinforced infantry battalion. Scientific battle training was conducted at the Korea Combat Training Center (KCTC) training facility and utilized scientific military training equipment that included MILES and the main exercise control system. The training audience freely engaged an OPFOR who is an expert at tactics and weapon systems. It provides a statistical analysis of data in regards to state-of-the-art military training because the scientific battle training system saves and utilizes all training zone data for analysis and after action review as well as offers training control during the training period. The methodologies used the Cox PH modeling (which does not require parametric distribution assumptions) and decision tree modeling for survival data such as CART, GUIDE, and CTREE for richer and easier interpretation. The variables that violate the PH assumption were stratified and analyzed. Since the Cox PH model result was not easy to interpret the period of service, additional interpretation was attempted through univariate local regression. CART, GUIDE, and CTREE formed different tree models which allow for various interpretations.

• Journal of Korean Neurosurgical Society
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• v.64 no.6
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• pp.950-956
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• 2021

Objective : Psoas and masseter muscles are known markers of sarcopenia. However, the relative superiority of either muscle as a marker is unclear. Therefore, this study analyzed the two muscles in patients with a prognosis of traumatic brain injury (TBI). Methods : Patients with TBI visiting a regional trauma center between January 2017 and December 2018 were selected, and their medical records were reviewed. TBI patients with an abbreviated injury score (AIS) of 4 or 5 were selected. Patients with an AIS of 4 or 5 at the chest, abdomen, and extremity were excluded. Patients with a hospital stay of 1 to 2 days were excluded. Both muscle areas were measured based on the initial computed tomography. The psoas muscle index (PMI) and the masseter muscle index (MMI) were calculated by dividing both muscle areas by height in meters squared (cm²/m²). These muscle parameters along with other medical information were used to analyze mortality and the Glasgow outcome scale (GOS). Results : A total of 179 patients, including 147 males (82.1%), were analyzed statistically. The mean patient age was 58.0 years. The mortality rate was 16.8% (30 patients). The mean GOS score was 3.7. Analysis was performed to identify the parameters associated with mortality, which was a qualitative study outcome. The psoas muscle area (16.9 vs. 14.4 cm², p=0.028) and PMI (5.9 vs. 5.1 cm²/m², p=0.004) showed statistical differences between the groups. The PMI was also statistically significant as a risk factor for mortality in logistic regression analysis (p=0.023; odds ratio, 0.715; 95% confidence interval, 0.535-0.954). Quantitative analyses were performed with the GOS scores. Bivariate correlation analysis showed a statistically significant correlation between PMI and GOS scores (correlation coefficient, 0.168; p=0.003). PMI (p=0.004, variation inflation factor 1.001) was significant in multiple regression analysis. The masseter muscle area and MMI did not show significance in the study. Conclusion : Larger PMI was associated with statistically significant improved survival and GOS scores, indicating its performance as a superior prognostic marker. Further analyses involving a larger number of patients, additional parameters, and more precise settings would yield a better understanding of sarcopenia and TBI.

• Korean Journal of Radiology
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• v.24 no.5
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• pp.434-443
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• 2023

Objective: To investigate the association between pelvic bone computed tomography (CT)-derived body composition and patient outcomes in older adult patients who underwent surgery for proximal femur fractures. Materials and Methods: We retrospectively identified consecutive patients aged ≥ 65 years who underwent pelvic bone CT and subsequent surgery for proximal femur fractures between July 2018 and September 2021. Eight CT metrics were calculated from the cross-sectional area and attenuation of the subcutaneous fat and muscle, including the thigh subcutaneous fat (TSF) index, TSF attenuation, thigh muscle (TM) index, TM attenuation, gluteus maximus (GM) index, GM attenuation, gluteus medius and minimus (Gmm) index, and Gmm attenuation. The patients were dichotomized using the median value of each metric. Multivariable Cox regression and logistic regression models were used to determine the association between CT metrics with overall survival (OS) and postsurgical intensive care unit (ICU) admission, respectively. Results: A total of 372 patients (median age, 80.5 years; interquartile range, 76.0-85.0 years; 285 females) were included. TSF attenuation above the median (adjusted hazard ratio [HR], 2.39; 95% confidence interval [CI], 1.41-4.05), GM index below the median (adjusted HR, 2.63; 95% CI, 1.33-5.26), and Gmm index below the median (adjusted HR, 2.33; 95% CI, 1.12-4.55) were independently associated with shorter OS. TSF index (adjusted odds ratio [OR], 6.67; 95% CI, 3.13-14.29), GM index (adjusted OR, 3.45; 95% CI, 1.49-7.69), GM attenuation (adjusted OR, 2.33; 95% CI, 1.02-5.56), Gmm index (adjusted OR, 2.70; 95% CI, 1.22-5.88), and Gmm attenuation (adjusted OR, 2.22; 95% CI, 1.01-5.00) below the median were independently associated with ICU admission. Conclusion: In older adult patients who underwent surgery for proximal femur fracture, low muscle indices of the GM and gluteus medius/minimus obtained from their cross-sectional areas on preoperative pelvic bone CT were significant prognostic markers for predicting high mortality and postsurgical ICU admission.