• Clinical and Experimental Pediatrics
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• v.64 no.7
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• pp.355-363
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• 2021

Background: Nephrotic syndrome (NS) is a common renal disorder in children attributed to podocyte injury. However, children with the same diagnosis have markedly variable treatment responses, clinical courses, and outcomes, suggesting molecular heterogeneity. Purpose: This study aimed to explore the molecular responses of podocytes to nephrotic plasma to identify specific genes and signaling pathways differentiating various clinical NS groups as well as biological processes that drive injury in normal podocytes. Methods: Transcriptome profiles from immortalized human podocyte cell line exposed to the plasma of 8 subjects (steroid-sensitive nephrotic syndrome [SSNS], n=4; steroid-resistant nephrotic syndrome [SRNS], n=2; and healthy adult individuals [control], n=2) were generated using microarray analysis. Results: Unsupervised hierarchical clustering of global gene expression data was broadly correlated with the clinical classification of NS. Differential gene expression (DGE) analysis of diseased groups (SSNS or SRNS) versus healthy controls identified 105 genes (58 up-regulated, 47 down-regulated) in SSNS and 139 genes (78 up-regulated, 61 down-regulated) in SRNS with 55 common to SSNS and SRNS, while the rest were unique (50 in SSNS, 84 genes in SRNS). Pathway analysis of the significant (P≤0.05, -1≤ log2 FC ≥1) differentially expressed genes identified the transforming growth factor-β and Janus kinase-signal transducer and activator of transcription pathways to be involved in both SSNS and SRNS. DGE analysis of SSNS versus SRNS identified 2,350 genes with values of P≤0.05, and a heatmap of corresponding expression values of these genes in each subject showed clear differences in SSNS and SRNS. Conclusion: Our study observations indicate that, although podocyte injury follows similar pathways in different clinical subgroups, the pathways are modulated differently as evidenced by the heatmap. Such transcriptome profiling with a larger cohort can stratify patients into intrinsic subtypes and provide insight into the molecular mechanisms of podocyte injury.

• The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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• v.34 no.2
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• pp.53-69
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• 2021

Objectives : The purpose of this study is to analyze the effects of treatment between Western medicine and Korean medicine on Allergic rhinitis patients using national population-based claim data from the Health Insurance Review and Assessment Service. Methods : The subjects of the study were 30,024 patients in the Korean medicine group and 30,024 in the Western medicine group who were diagnosed with Allergic rhinitis from September 1, 2018 to December 31, 2018. Propensity score analysis was used for matching age, sex, etc. at a ratio of 1:1. Cox regression and subgroup analysis were used to estimate the adjusted hazard ratio of recurrence, Asthma, and Atopic dermatitis in Korean medicine group and Western medicine group. In addition, the total treatment period, total treatment cost, and average cost per day of visit were compared and analyzed. Results : Compared to Korean medicine, Western medicine had a significantly higher risk of recurrence at 1.701 times, Asthma occurrence risk at 1.609 times and Atopic dermatitis occurrence risk at 1.098 times. Compared to Western medicine, the total treatment period of Korean medicine was 14.27 days longer, the total treatment cost was 53,591 won more, and the average cost per day was 7,539 won more. Conclusions : This study is a retrospective cohort study using the propensity score matching in Korea to compare the outcomes of Allergic rhinitis between Western medicine and Korean medicine. Further research is needed by considering patients characteristics, and linking with additional data.

• Journal of The Korean Society of Integrative Medicine
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• v.11 no.3
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• pp.49-57
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• 2023

Purpose : This study aimed to systematically review the correlation between hand dexterity and cognitive function in the elderly, and summarize various evaluation tests and results analysis methods for manual dexterity tests applied to this population. Methods : We searched published studies in the Korean Studies Information Service System and PubMed databases from January 2013 to March 2023. The main keywords used were "dexterity," "fine motor," "elderly," "cognitive function," and "correlation." A total of 10 studies were selected for analysis from the 1,524 searched articles. The included studies consisted of a cohort study, a longitudinal study, and eight cross-sectional studies which were analyzed for patients, intervention, comparison, and outcomes. Results : Analyzing the qualitative level of 10 studies, 8 articles (80%) were non-randomized two-group studies that provided level II evidence whereas the remaining 2 studies (20%) were non-randomized single-group studies (level III evidence). Therefore, these results indicated that the level of evidence in this field is generally high. The Purdue pegboard test was the most commonly used evaluation test for manual dexterity, and velocity speed was the most frequently employed analysis method. Results indicated that there were significant differences in manual dexterity test between the normal elderly, those with mild cognitive impairment, or dementia. Conclusions : These results can be used as a basis for selecting dexterity test evaluation items and methods to analyze it in the elderly while screening for cognitive impairment. In addition, this study highlights potential areas for future research on the development of manual dexterity evaluation tools and techniques for analysis and the need for more reliable and valid methods for assessing cognitive function in the elderly.

• Restorative Dentistry and Endodontics
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• v.47 no.3
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• pp.27.1-27.14
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• 2022

Objectives: This systematic review and meta-analysis aimed to assess the association of cigarette smoking with the prevalence of post-endodontic apical periodontitis in humans. Materials and Methods: We searched through PubMed/Medline, Web of Science, and Scopus from inception to December 2020. Risk of bias was performed by using the Newcastle-Ottawa Scale for cross-sectional, cohort, and case-control studies. We performed the statistical analysis in Review Manager 5.3 (RevMan 5.3). Results: 6 studies met the inclusion criteria for qualitative and quantitative synthesis. Statistical analysis of these studies suggests that there were no differences in the prevalence of post endodontic apical periodontitis (AP) when comparing non-smokers vs smoker subjects regarding patients (odds ratio [OR], 0.68; 95% confidence interval [CI], 0.31-1.49; I2 = 58%) and teeth (OR, 1.71; 95% CI, 0.99-2.93; I2 = 72%). Conclusions: Our findings suggest that there was no association between cigarette smoking and post-endodontic apical periodontitis, as we did not find statistical differences in the prevalence of post-endodontic AP when comparing non-smokers vs smoker subjects. Therefore, smoking should not be considered a risk factor associated with endodontic failure.

• Annals of Hepato-Biliary-Pancreatic Surgery
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• v.27 no.1
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• pp.28-39
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• 2023

We aimed to compare resection and survival outcomes of neoadjuvant chemoradiotherapy (CRT) and immediate surgery in patients with resectable pancreatic cancer (RPC) or borderline resectable pancreatic cancer (BRPC). In compliance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement standards, a systematic review of randomized controlled trials (RCTs) was conducted. Random effects modeling was applied to calculate pooled outcome data. Likelihood of type 1 or 2 errors in the meta-analysis model was assessed by trial sequential analysis. A total of 400 patients from four RCTs were included. When RPC and BRPC were analyzed together, neoadjuvant CRT resulted in a higher R0 resection rate (risk ratio [RR]: 1.55, p = 0.004), longer overall survival (mean difference [MD]: 3.75 years, p = 0.009) but lower overall resection rate (RR: 0.83, p = 0.008) compared with immediate surgery. When RPC and BRPC were analyzed separately, neoadjuvant CRT improved R0 resection rate (RR: 3.72, p = 0.004) and overall survival (MD: 6.64, p = 0.004) of patients with BRPC. However, it did not improve R0 resection rate (RR: 1.18, p = 0.13) or overall survival (MD: 0.94, p = 0.57) of patients with RPC. Neoadjuvant CRT might be beneficial for patients with BRPC, but not for patients with RPC. Nevertheless, the best available evidence does not include contemporary chemotherapy regimens. Patients with RPC and those with BRPC should not be combined in the same cohort in future studies.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.16
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• pp.7295-7302
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• 2015

Background: Lung cancer has been a major health problem in developed countries for several decades, and has emerged recently as the leading cause of cancer death in many developing countries. The incidence of lung cancer appears to be increasing more rapidly in rural than in urban areas of China. This paper presents the trends of lung cancer incidence and survival derived from a 40-year population-based cancer monitoring program in a rural area, Qidong, China. Materials and Methods: The Qidong cancer registration data of 1972-2011 were used to calculate the crude rate, age-standardized rate by Chinese population (CASR) and by world population (WASR), birth cohort rates, and other descriptive features. Active and passive methods were used to construct the data set, with a deadline of the latest follow-up of April 30, 2012. Results: The total number of lung cancer cases was 15,340, accounting for 16.5% of all sites combined. The crude incidence rate, CASR and WASR of this cancer were 34.1, 15.7 and 25.4 per 100,000, respectively. Males had higher crude rates than females (49.7 vs 19.0). Rapidly increasing trends were found in annual percent change resulting in lung cancer being a number one cancer site after year 2010 in Qidong. Birth cohort analysis showed incidence rates have increased for all age groups over 24 years old. The 5 year observed survival rates were 3.55% in 1973-1977, 3.92 in 1983-1987, 3.69% in 1993-1997, and 6.32% in 2003-2007. Males experienced poorer survival than did females. Conclusions: Lung cancer has become a major cancer-related health problem in this rural area. The rapid increases in incidence likely result from an increased cigarette smoking rate and evolving environmental risk factors. Lung cancer survival, while showing some improvement in prognosis, still remains well below that observed in the developed areas of the world.

• The Journal of Internal Korean Medicine
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• v.30 no.3
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• pp.510-524
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• 2009

Objective : This study was designed to find the correlation between Sasang Constitution and heart rate variability(HRV). Method : There were 665 subjects (280 men and 385 women), between 39 and 72 years old. in a rural community. Sasang Constitution was diagnosed by a Sasang constitutional specialist using PSSC (Phonetic System for Sasang Constitution), face and tongue photo and checkup-list. A structured-questionnaire was used to assess the general characteristics. HRV was recorded using SA-2000 (medi-core). HRV was assessed by time domain and by frequency domain analysis. Metabolic syndrome was defined on the basis of clustering of risk factors, when three or more of the following cardiovascular risk factors were included : blood pressure, fasting blood sugar, triglyceride HDL-cholesterol, and abdominal obesity (waist). Because of the skewness of the data, logarithmic transformation was performed on the absolute units of the spectral components of HRV, and the resulting logarithmic values and normalized units were compared between the groups by a logistic regression. The 95% confidence interval (CI) of the odds ratio was used and calculated from the data laid out for a cross sectional study. Results : 1. Odds ratios of Taeeumin and Soeumin in female adults below 60 years old were significantly lower than that of Soyangin in LF norm and LF/HF ratio. Odds ratios of Taeeumin and Soeumin in female adults below 60 years old were significantly higher than that of Soyangin in HF norm. 2. There was no significant correlation between HRV and Sasang Constitution in female adults from 60 years old and over. 3. There was no significant correlation between HRV and Sasang Constitution in male adults. Conclusion : There is a statistically significant correlation between the HRV and Sasang Constitution. There is a tendency of increase in the sympathetic activity in Soyangin. There is a tendency of decrease in the parasympathetic activity in Taeeumin and Soeumin.

• Journal of Preventive Medicine and Public Health
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• v.39 no.3
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• pp.229-234
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• 2006

Objectives: Cardiovascular disease is one of the main causes of death and morbidity in Korea. In this study, the prevalence and incidence of developing hypertension in a male-workers' cohort were investigated during 3-years follow-up with a view to find the risk factors that affected the development of hypertension. Methods: Among the 5,374 people who participated in a routine health check up, 3,852 people with normal blood pressure and who had no history of hypertension were prospectively followed up for 3 years. The classification of hypertension was based on the JNC7 report (the Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure). Life style factors and underlying diseases that were related to the risk factors of hypertension were collected by using a self-report questionnaires via the internet. Results: The prevalence of hypertension was 28.3% (1,520/5,374) at the first screening (2001). It was found that the incidence in 2004 of hypertension for the follow-up subjects (3,711) who had normal blood pressure in 2001 was 7.6 per 100 person-year. Multiple logistic regression analysis of the variables related to the risk factors of hypertension was carried out. The relative risks were 1.037 (95% CI=1.022-1.053) as the age increased 1 year and 1.039 (95% CI=1.023-1.055) as the body mass index increased $1kg/m^2$. The relative risk for the prehypertensive group was 2.501 (95% CI=1.986-3.149) compared to the normotensive group. These results showed that age, body mass index and the baseline blood pressure were significantly related to the incidence of hypertension. Conclusions: The incidence of hypertension was 7.6 per 100 person-year during follow-up. It was concluded that the risk factors for developing hypertension in the short-term were age, BMI, and prehypertension; Especially, this showed that it is necessary for prehypertensives to manage their body weight and blood pressure to prevent hypertension in middle-age by modifying their life style.

• Environmental Analysis Health and Toxicology
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• v.29
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• pp.12.1-12.8
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• 2014

Objectives Cohort studies of associations between air pollution and health have used exposure prediction approaches to estimate individual-level concentrations. A common prediction method used in Korean cohort studies is ordinary kriging. In this study, performance of ordinary kriging models for long-term particulate matter less than or equal to $10{\mu}m$ in diameter ($PM_{10}$) concentrations in seven major Korean cities was investigated with a focus on spatial prediction ability. Methods We obtained hourly $PM_{10}$ data for 2010 at 226 urban-ambient monitoring sites in South Korea and computed annual average $PM_{10}$ concentrations at each site. Given the annual averages, we developed ordinary kriging prediction models for each of the seven major cities and for the entire country by using an exponential covariance reference model and a maximum likelihood estimation method. For model evaluation, cross-validation was performed and mean square error and R-squared ($R^2$) statistics were computed. Results Mean annual average $PM_{10}$ concentrations in the seven major cities ranged between 45.5 and $66.0{\mu}g/m^3$ (standard deviation=2.40 and $9.51{\mu}g/m^3$, respectively). Cross-validated $R^2$ values in Seoul and Busan were 0.31 and 0.23, respectively, whereas the other five cities had $R^2$ values of zero. The national model produced a higher cross-validated $R^2$ (0.36) than those for the city-specific models. Conclusions In general, the ordinary kriging models performed poorly for the seven major cities and the entire country of South Korea, but the model performance was better in the national model. To improve model performance, future studies should examine different prediction approaches that incorporate $PM_{10}$ source characteristics.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.23
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• pp.10263-10266
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• 2015

Background: The risk of febrile neutropaenia (FN) and treatment related death (TRD) with first line palliative chemotherapy for de novo metastatic breast cancer (MBC) remains unknown outside of a clinical trial setting despite its widespread usage. This study aimed to determine rates in a large cohort of patients treated in the University of Malaya Medical Centre (UMMC). Materials and Methods: Patients who were treated with first line palliative chemotherapy for de novo MBC from 2002-2011 in UMMC were identified from the UMMC Breast Cancer Registry. Information collected included patient demographics, histopathological features, treatment received, including the different chemotherapy regimens, and presence of FN and TRD. FN was defined as an oral temperature > $38.5^{\circ}C$ or two consecutive readings of > $38.0^{\circ}C$ for 2 hours and an absolute neutrophil count < $0.5{\times}10^9/L$, or expected to fall below $0.5{\times}10^9/L$ (de Naurois et al, 2010). TRD was defined as death occurring during or within 30 days of the last chemotherapy treatment, as a consequence of the chemotherapy treatment. Statistical analysis was performed using the SPSS version 18.0 software. Survival probabilities were estimated using the Kaplan-Meier method and differences in survival compared using log-rank test. Results: Between $1^{st}$ January 2002 and $31^{st}$ December 2011, 424 patients with MBC were treated in UMMC. A total of 186 out of 221 patients with de novo MBC who received first line palliative chemotherapy were analyzed. The mean age of patients in this study was 49.5 years (range 24 to 74 years). Biologically, ER status was negative in 54.4% of patients and Her-2 status was positive in 31.1%. A 5-flourouracil, epirubicin and cyclophosphamide (FEC) chemotherapy regimen was chosen for 86.6% of the cases. Most patients had multiple metastatic sites (58.6%). The main result of this study showed a FN rate of 5.9% and TRD rate of 3.2%. The median survival (MS) for the entire cohort was 19 months. For those with multiple metastatic sites, liver only, lung only, bone only and brain only metastatic sites, the MS was 18, 24, 19, 24 and 8 months respectively (p-value= 0.319). Conclusions: In conclusion, we surmise that FEC is a safe regimen with acceptable FN and TRD rates for de novo MBC.