• Tuberculosis and Respiratory Diseases
• /
• v.45 no.6
• /
• pp.1154-1166
• /
• 1998

Background : In the management of patients whose primary chemotherapy has failed, careful assessment is essential. It is important to find out as accurate a chemotherapy history as possible. Preferably it should contain the drugs which has never used before. The purpose of present study is establishment of retreatment regimen for pulmonary tuberculosis. The present report concerns the results of retreatment of pulmonary tuberculosis patients treated at National Masan Tuberculosis Hospital. Methods : Retrospective cohort study was made of 104 drug-resistant pulmonary tuberculosis patients who were treated by five regimens between Jan. 1994 and Nov. 1996. All the patients taken medicine for second anti-tuberculosis regimens for the first time. We separated the patients by three groups(Group I ; OFX+PTA+CS+PAS+Aminoglycoside, Group II : PZA+PTA+CS+PAS+Aminoglycoside, Group III : PZA+OFX+PTA+PAS+Aminoglycoside). Results : The age distribution was most frequent in fourth decade(36patients, 34.6%) and the mean age was 42.6 year. The sex distribution was more frequent in the males(81 patients, 85.7%). There was 31 patients(29.8%) with combined diseaes, 18 patients with complication and 24 patients(27.9%) with family history. Primary chemotherapy regimens were HERZ(S or K) in 48 patients (46.2%), HER(S or K) in 41 patients(39.4%) and others in 15 patients(14.4%). Result of drug sensitivity test showed that the resistance to INH and RFP is in 68 patients(65.4%), RFP is 12 patients(11.5%), INH is in 3 patients(2.9%) and all sensitive to INH and RFP is 3 patients(2.9%). The clinical symptoms on admission were coughing(89.4%), sputum(69.2%), dyspnea on exertion(37.5%), weight loss(33.7%) blood tinged sputum(15.4%) and others. The extent of disease on the radiograph was far-advanced in 73 patients(70.2%), moderate in 28 patients(26.9%) and minimal in 3 patients(2.9%). The side effects for drugs were gastrointestinal troubles in 31 patients(29.8%), arthralgia in 22 patients(21.2%), skin rash in 12 patients(11.5%) and others. The negative conversion rate on sputum AFB smear was 85.6%(87.5% in Group I, 80.0% in Group II and 90.5% in Group III). The average negative conversion time on sputum was 4 month(4.0 month in Group I, 4.6 month in Group II and 3.0 month in Group III). Conclusion : In the retreatment of pulmonary tuberculosis, ofloxacin is useful drug for the patients who are not available to use PZA and combination of PZA and OFX can be use effectively substituting for CS.

• Journal of Preventive Medicine and Public Health
• /
• v.28 no.4 s.51
• /
• pp.845-862
• /
• 1995

We followed prospectively some hospital-delivered mothers to identify characteristics of those not initiated breast-feeding and predictors of breast-feeding discontinuation in monthly telephone interviews. Recruits were composed of 482 mothers who delivered their babies at one university hospital and one OB/GYN clinic in September to November 1991. Breast-feeding discontinuation was defined as switch to 100% formula lasting more than one week regardless of solid foods. Average age of the study subjects was 27.3 years of age(standard deviation 3.2). Multiple logistic regression analysis indicated native place, occupation, method of delivery and method of feeding considered to be better for maternal health were statistically significant(p<0.1) between initiators and non-initiators of breast feeding. In starting cohort(N=242) of those initiated breast-feeding, that median of breast-feeding discontinuation were 5 months and 25th and 75th percentiles were 3 and 9 months respectively. In Cox's proportional hazard model, mothers with $10\sim13$ years of education were 2.63 times (95% confidence interval, CI $1.50\sim4.60$) more likely to discontinue than those with less than 9 years of education and those with more than 13 years of education were 3.55 time (95% CI $1.99\sim6.33$). Compared with house wife, mothers with part-time jobs were 1.99 times (95% CI $0.86\sim4.57$) more likely to discontinue and those with employed full-time were 1.55 times (95% CI $0.96\sim2.51$). These results suggest that the predictors of initiation and discontinuation of breast-feeding may be different and different target populations should be selected to promote initiation and to prevent discontinuation of breast-feeding according to the period after birth.

• Journal of Nutrition and Health
• /
• v.52 no.6
• /
• pp.569-580
• /
• 2019

Purpose: This study examined the associations of Korean fermented cabbage kimchi consumption with the incidence risk of metabolic syndrome and its components in Korean adults. Methods: We used the community-based cohort data from the 2001 ~ 2012 Korean Genome and Epidemiology Study (KoGES). General characteristics, food group frequencies and nutrient intakes at baseline from 3,560 healthy individuals aged 40 ~ 69 years and the incidence of metabolic syndrome and its component from 2,259 participants, after excluding the data with incomplete anthropometric and blood test, during 10-year follow-up were analyzed. The participants were classified into three groups according to their daily consumption frequency of Korean fermented cabbage kimchi: 'less than once (< 1/day)', 'once or twice (1 ~ 2/day)', and 'three times (3/day)'. Results: After controlling for potential confounders such as age, education, income, residence area, alcohol drinking and energy intake, the consumption frequencies of rice and legumes were significantly higher, and the consumption frequency of meat was significantly lower in the 3/day group compared to that of the other two groups in men and women. The average intakes of energy and most nutrients, except fat and cholesterol, were higher in the 3/day group compared to those of the other two groups in men and women. Frequent consumption of kimchi was associated with a lower incidence of metabolic syndrome in all the models (unadjusted, age-adjusted, and multivariable-adjusted models) in women. When examining the multivariable-adjusted model, the hazard ratio for metabolic syndrome was 0.63 (95% CI: 0.47 ~ 0.86) for the 3/day group compared to that of the < 1/day group in women. However, there was no significant association between kimchi consumption and the incidence of metabolic syndrome in men. Conclusion: Our results show that consumption of kimchi at every meal was significantly associated with a lower incidence of metabolic syndrome in women.

• Journal of Nutrition and Health
• /
• v.52 no.5
• /
• pp.449-464
• /
• 2019

Purpose: North Koreans could be at higher risk for their bone health because of previous periods of severe famine and the continuing low availability of food. This study determined the bone mineral density (BMD) status and its relationship with dietary behaviors and nutrient intake of North Korean refugees (NKR) in South Korea (SK). Methods: This cross-sectional study analyzed 110 female NKR from a NORNS cohort of a non-probability sample of adult NKR in Seoul. BMD examined by DEXA was used to divide participants into the normal group (NG) and the non-normal group (NNG) according to the WHO guideline. A self-administered questionnaire included questions on age, the socioeconomic situation in North Korea (NK) and SK, the food security in NK and SK, and the health behaviors, dietary behaviors, and food frequency questionnaire administered in SK. A one-day 24-hr recall was conducted and the results were analyzed by using CanPro. SPSS was used to analyze whether BMD and related dietary behaviors and nutrient intakes differed according to the groups. Results: NG (62.7%) was significantly younger and had a lower abdominal obesity score than NNG (p < 0.001). While 14.5% of NG reported experiencing menopause, all of NNG reported experiencing menopause. The NG more frequently consumed the dairy group of foods (9.6 times a week) than did the NNG (4.8 times a week) after the statistics were adjusted for age (p < 0.007). The NG consumed significantly more animal protein and animal calcium than did the NNG (p = 0.01, p = 0.009, respectively). Calcium intake was low with 49.3% of NG, and 78.0% of the NNG reported consuming calcium lower than the estimated average requirement. Only calcium showed an index of nutrient quality lower than one in both groups. Conclusion: These results showed that NKR women and possibly all North Korean women are at high risk for bone health and they consumed low levels of bone-related nutrients, and this should be considered for the nutrition policy for NKR and North Korea.

• Journal of Nutrition and Health
• /
• v.54 no.2
• /
• pp.139-151
• /
• 2021

Purpose: This study examines the correlation between fish consumption and the risk of mild cognitive impairment in the elderly living in rural areas. Methods: The Yangpyeong cohort data collected from Yangpyeong in July 2009 and August 2010 was used as the data set. Adults greater than or equal to 60 years who have completed the Korean version of the Mini-Mental State Examination (MMSE-KC) were selected for the study. After excluding participants with less than 500 kcal of energy intake (n = 2), a total of 806 adults were enrolled as the final subjects. Cognitive function was assessed using the MMSE-KC, and dietary intake was collected using the quantitative food frequency questionnaire comprising 106 foods or food groups. Results: The educational level, proportion of people who exercise, fruits and vegetable intake, and energy intake, tended to increase with fish intake among men, while increasing age resulted in decreased fish consumption. Among women, the educational level, proportion of subjects who exercise, proportion of subjects currently taking dietary supplements, fruits and vegetable intake, and energy intake, tended to increase with fish consumption, whereas increasing age showed decreasing fish consumption. Increased fish intake resulted in a higher MMSE-KC score after adjusting for the confounding variables in women (p for trend = 0.016), but no significant trend was observed between fish intake and MMSE-KC score in men. Fish intake was inversely related to the risk of mild cognitive impairment after adjusting for covariates in women (Q1 vs. Q4; odds ratio, 0.46 [0.23-0.90]; p for trend = 0.009). Conclusion: This study determined that increased fish consumption is correlated with reduced risk of mild cognitive impairment in the female elderly. Further longitudinal studies with larger samples are required to determine a causal relationship between fish intake and cognitive function.

• Journal of the Korean Orthopaedic Association
• /
• v.54 no.2
• /
• pp.164-171
• /
• 2019

Purpose: A dedifferentiated chondrosarcoma is a rare lethal tumor characterized by a low grade chondrosarcoma juxtaposed with a high grade dedifferentiated sarcoma, such as osteosarcoma, fibrosarcoma. The aim of our study was to document the clinical manifestation and oncologic outcomes of a dedifferentiated chondrosarcoma. Materials and Methods: This study identified 11 patients who were diagnosed and treated for dedifferentiated chondrosarcoma between January 2007 and December 2016. The identified cohort was then reviewed regarding age, sex, symptom onset, tumor location, magnetic resonance imagings (MRIs), surgical margin, and pathologic diagnosis. The time to local recurrence and/or metastasis, follow-up duration, and the patients' final status were analyzed. Results: The patients were comprised of 7 males and 4 females with a mean age of 54 years (range, 33-80 years). The location of the tumor was in the femur in 6 cases, pelvis in 4 cases, and metatarsal in 1 case. The average tumor diameter was 12.7 cm (range, 6.0-26.1 cm). At the time of diagnosis, 2 patients showed pathologic fracture; 1 patient was Enecking stage IIA, 9 patients were stage IIB, and 1 patient was stage III. Eight patients were classified as a primary dedifferentiated chondrosarcoma and 3 patients were secondary. One of the primary lesions was misinterpreted initially as a low grade chondroid lesion by MRI and underwent curettage. Local recurrence occurred in 8 cases and distant metastasis occurred in 10 cases with a mean duration of 8 months (range, 2-23 months) and 7 months (range, 1-32 months), respectively. The three-year overall survival of patients with dedifferentiated chondrosarcoma was 18%, and 10 patients died due to disease progression. Conclusion: Dedifferentiated chondrosarcoma developed lung metastases in the early period of the clinical courses and the prognosis was dismal.

• Tuberculosis and Respiratory Diseases
• /
• v.43 no.6
• /
• pp.871-881
• /
• 1996

Objective: In the early short-term therapy of pulmonary tuberculosis, PZA is used for the first two months on 6EHRZ therapy but PZA is not effective in the case of long-tenn use PZA for retreatment in the sensitive relapse or acquired drug resistance for PZA. But in the endemic area as Korea, if we can't use PZA in the retreatment of pulmonary tuberculosis, we can't expect the success for retreatment of pulmonary tuberculosis, therefore we need new drugs substituting for PZA. In these days, 4 - fluoroquinolone derivatives were investigated and only ofloxacin and ciprofloxacin of derivatives were known to be effective but the effectiveness was also not certain because the result was experimental or combined with other bacteriocidal drugs and datas on effectiveness of pulmonary tuberculosis were so little. Therefore these drugs should be use with other two or three strong-acting drugs in the last period of retreatment of pulmonary tuberculosis. The ofloxacin or ciprofloxacin is used in some area in Korea but randomly and needed more study. We did this study for proving the effectiveness of these drugs and establishment of retreatment regimen for pulmonary tuberculosis. Methods: Retrospective cohort study of 83 drug-resistant pulmonary tuberculosis patients at National Masan Tuberculosis Hospital from Jan. 1994 to dec. 1995 was made. All the patients taken medicine for 2nd ami-tuberculosis regimens for the first lime. We separated the patients by two groups.(Group I : OFX+ PTA + CS+PAS + Injection, Group II: PZA + PTA+ CS + PAS + Injection). We compared the difference between two groups and tested the confidence limit about results after treatment by $\chi$2-test and T-test. Results : 1. The age distribution was most frequent in fourth decade(29.2% in Group I, 37.1% in Group II) and the mean age was 43.9 year in Group I, and 39.0 year in Group II, but had no significant difference between two groups. The sex distribution was more frequent in the males(68.8% in Group I, 85.7% in Group II), but had no significant difference. 2. Family history was 29.2% in Group I, 28.6% in Group II, but had no significant difference. 3. In the respect of extent of disease, far-advanced stare was 60.4% in Group I, 74.3% in Group II, but had no significant difference. 4. The side effects for drugs showed in 58.3% in Group I and 65.7% in Group II, and the gastrointestinal trouble showed 25.0% in Group and arthralgia 34.3% in Group II predominantly respectively and had the significant difference(p<0.05). 5. The negative conversion rate on sputum AFB smear was 87.5% in Group I and 80.0% in Group II, but had no significant difference. But the negative conversion rate on sputum AFB culture was 83.3% in Group I and 57.1 % in Group II and had the significant difference(p<0.05). 6. The success rate of treatment was 87.5 % in Group I and 83.3 % in Group II but had no significant difference. Conclusion : In the retreatment of pulmonary tuberculosis, ofloxacin is useful drug for the patients who are not available to use PZA and can be use effectively substituting for PZA.

• Clinical and Experimental Pediatrics
• /
• v.49 no.9
• /
• pp.966-971
• /
• 2006

Purpose : 'Programming' describes the process that stimulus at a critical period of development has lifelong effects. The fact that low birth weight links to the risk of elevated blood pressures in adult life is well known. This study aims to examine whether this link is evident in the newborn by investigating the relationship of the intrauterine growth indices and neonatal blood pressure(BP). Methods : We studied 127 neonates who were born at Ewha Womans' Hospital and their mothers enrolled our cohort study during pregnancy. Data on the mothers and details of the birth records were tracked and collected from medical charts. Neonatal BP was measured within 24 hours after birth. Results : Neonatal SBP was positively correlated to intrauterine growth indices; birth weight(BW)(r=0.4), head circumference(HC)(r=0.4), and birth height(r=0.3). However, an inverse relationship existed, between HC/BW ratio and neonatal SBP(r=-0.4). After adjusting for the baby's sex, maternal BP, and gestational age, neonatal SBP still associated with intrauterine growth indices. SBP was 7 mmHg higher in the highest BW group(${\geq}90percentiles$) compared to the lowest group(<10 percentiles). On the other hand, SBP was 17 mmHg lower in the highest HC/BW group(${\geq}90percentiles$) compared in the lowest group(<10 percentiles). Conclusion : This study could not find the evidence that intrauterine growth retardation affect on elevated neonatal BP. It suggests that the initiating events of BP programming may occur during postnatal growth period. To identify the critical starting period that intrauterine growth retardation leads to elevated BP, a study tracking BP changes from birth to childhood is required.

• Korean Journal of Psychosomatic Medicine
• /
• v.20 no.1
• /
• pp.59-65
• /
• 2012

Objectives : The present study takes part of the agricultural district cohort study of a certain county located in Gyeonggido and aims to investigate the difference of the heart rate variability(HRV) according to the social support level. Methods : We used data from 1727 participants of a health promotion program who are older than 40 years old. A physical examination, as well as a one-to-one interview to obtain sociodemographic characteristics, was performed with each participant. In addition, the participants completed the Medical Outcomes Study-Social Support Survey(MOS-SSS) for their the social support level to be assessed, and their HRV were measured to evaluate their autonomic function. The entire group was divided in two groups according to its MOS-SSS points to facilitate the research. Those who were evaluated as the high 25%(432 persons) were denominated as high social support (HSS) group and those who were evaluated as the low 25%(425 persons) were denominated as poor social support(PSS) group. Results : The two groups showed significant differences on the sociodemographic factor such as mean age and gender composition(p<0.05). Comparing the indices related to the HRV, the HSS group had the following values higher than the PSS group : SDNN(F=4.938, p=0.027), TP(F=8.088, p=0.005), VLF(F=6.220, p=0.013) LF (F=3.873, p=0.049). Conclusion : According to the research, the PSS group showed dysfunction on their autonomic nervous system comparing to the HSS group. The social support helps an individual overcome difficulties, helps the adaptation during the changes of circumstances and in stressful situations it serves like a buffer. Based on that, it's possible to define that a low social support level gave an impact on the autonomic function. Also, using the fact that the HRV can evaluate the autonomic function in an objective view, it was possible to visualize that it has a potential to be used as an assistant factor to evaluate the social support.

• Sleep Medicine and Psychophysiology
• /
• v.24 no.1
• /
• pp.38-45
• /
• 2017

Objectives: Sleep disturbance is a very rapidly growing disease with aging. The purpose of this study was to investigate the prevalence of sleep disturbances and its predictive factors in a three-year cohort study of people aged 60 years and over in Korea. Methods: In 2012 and 2014, we obtained data from a survey of the Korean Social Life, Health, and Aging Project. We asked participants if they had been diagnosed with stroke, myocardial infarction, angina pectoris, arthritis, pulmonary tuberculosis, asthma, cataract, glaucoma, hepatitis B, urinary incontinence, prostate hypertrophy, cancer, osteoporosis, hypertension, diabetes, hyperlipidemia, or metabolic syndrome. Cognitive function was assessed using the Mini-Mental State Examination for dementia screening in 2012, and depression was assessed using the Center for Epidemiologic Studies Depression Scale in 2012 and 2014. In 2015, a structured clinical interview for Axis I psychiatric disorders was administered to 235 people, and sleep disturbance was assessed using the Pittsburgh Sleep Quality Index. The perceived stress scale and the State-trait Anger Expression Inventory were also administered. Logistic regression analysis was used to predict sleep disturbance by gender, age, education, depression score, number of coexisting diseases in 2012 and 2014, current anger score, and perceived stress score. Results: Twenty-seven percent of the participants had sleep disturbances. Logistic regression analysis showed that the number of medical diseases three years ago, the depression score one year ago, and the current perceived stress significantly predicted sleep disturbances. Conclusion: Comorbid medical disease three years previous and depressive symptoms evaluated one year previous were predictive of current sleep disturbances. Further studies are needed to determine whether treatment of medical disease and depressive symptoms can improve sleep disturbances.