Purpose: To assess the association between birth weight and the development of functional gastrointestinal disorders (FGIDs) in the first year of life. Methods: This is a secondary analysis of a prospective cohort multicenter study including neonates, consecutively enrolled at birth, and followed up for one year. At birth all infants were classified by birth weight as extremely low (ELBW), very low, or low when <1,000, <1,500, and <2,500 g, respectively, and by birth weight for gestational age as appropriate (AGA, weight in the 10-90th percentile), small (SGA, weight <10th percentile), and large (LGA, weight >90th percentile) for gestational age. FGIDs were classified according to the Rome III criteria and assessed at 1, 3, 6, and 12 months of life. Results: Among 1,152 newborns enrolled, 934 (81.1%) completed the study: 302 (32.3%) were preterm, 35 (3.7%) were ELBW, 104 (11.1%) were SGA, 782 (83.7%) were AGA, and 48 (5.1%) were LGA infants. Overall, throughout the first year of life, 718 (76.9%) reported at least one FGID. The proportion of infants presenting with at least one FGID was significantly higher in ELBW (97%) compared to LBW (74%) (p=0.01) and in LGA (85.4%) and SGA (85.6%) compared to AGA (75.2%) (p=0.0001). On multivariate analysis, SGA was significantly associated with infantile colic. Conclusion: We observed an increased risk of FGIDs in ELBW, SGA, and LGA neonates. Our results suggest that prenatal factors determining birth weight may influence the development of FGIDs in infants. Understanding the role of all potential risk factors may provide new insights and targeted approaches for FGIDs.
Oh, Jee Hye;Lee, Yong Joo;Seo, Min Seok;Yoon, Jo Hi;Kim, Chul Min;Kang, Chung
Journal of Hospice and Palliative Care
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v.20
no.4
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pp.235-241
/
2017
Purpose: The Palliative Performance Scale (PPS) is a widely used prognostic tool in patients with advanced cancer. This study examines the association between changes in PPS score and survival in patients with advanced cancer. Methods: We identified a cohort of 606 inpatients who died at a Korean university hospital's hospice/palliative care center. For each patient, the PPS score was measured twice according to a standard procedure: 1) upon admission, and 2) three days after admission (D3). "Change on D3" was defined as a difference between initial PPS and PPS on D3. We used a Cox regression modeling approach to explore the association between this score change and survival. Results: The changes in scores were associated with survival. A score change of >30% yielded a hazard ratio for death of 2.66 (95% CI 2.19~3.22), compared to a score change of ${\leq}30%$. PPS of ${\leq}30$ on D3 also independently predicted survival, with a hazard ratio of 1.67 (95% CI 1.38~2.02) compared to PPS of >30. Conclusion: A change of over 30% in PPS appears to predict survival in hospitalized patients with terminal cancer, even after adjustment for confounders. Changes in PPS may be a more sensitive indicator of impending death than a single PPS measured on the day of admission in terminal cancer patients. Further prospective study is needed to examine this important finding in other populations.
Purpose: To provide effective palliative care, it is important to predict not only patients' life expectancy but their discharge status at a time of inpatient admission to a hospice care facility. This study was aimed to identify meaningful life expectancy indicators that can be used to predict patients' discharge status on admission to the facility. Methods: Among 568 patients who were admitted to the hospice ward of P hospital from April 1, 2016 through December 31, 2017, 377 terminal cancer patients were selected. This retrospective cohort study was performed by using performance status, symptoms and signs, socioeconomic status, laboratory findings on admission. Results: Alive discharge was associated with a good performance status that was measured with the Karnofsky and Eastern Cooperative Oncology Group (ECOG) scales and the Global health and Mental status. Less anorexia, dyspnea, dysphagia and fatigue were also associated with symptoms and signs. Associated laboratory findings were close to normal Complete Blood Cell (CBC) count, Liver Function Test (LFT) and Blood Urea Nitrogen (BUN). Conclusion: Our findings suggest that Karnofsky Performance Status (KPS), ECOG, Global health, Mental status, anorexia, dyspnea, dysphagia, fatigue, CBC, LFT, BUN are meaningful indicators when predicting discharge status for inpatients. Further investigation is warranted.
Objectives : This study was performed to evaluate the reproducibility of a questionnaire concerned with reproductive history and to ascertain which characteristics of the subjects (age, the visit-revisit intervals, education and chronic disease) are associated with good reliability in the Korean Multi-Center Cancer Cohort (KMCC) study. Materials and Methods: A total of 19,688 participants were enrolled between 1993 and 2004. Among them, we selected 386 participants who were aged 40 or more and who re-visited within 8 years after the first visit. Reliability was measured by the percent agreement according to error range for the continuous variables and the percent agreement and kappa statistics for the categorical variables. Results : The pregnancy histories were reliable (kappa=0.67) and the reasons for being menopausal among the postmenopausal women were also reliable (kappa=0.92). The percent agreement of the breast-feeding history was high (96.1%), although the kappa statistic was low. For the continuous variables, when the error range of one variable was considered to be reliable, the percent agreement of the age at menarche and the age at the first full term pregnancy was good (69.4% and 83.6%), whereas that of the age at menopause was low (51.5%). The factors associated with high reliability were a younger age, the presence of chronic disease and a short visit-revisit time interval. Conclusions : The agreements for parity, the reasons for menopause, and the breastfeeding history in the reproductive history questionnaire used in the KMCC were relatively good. The questionnaire for the menarche age and the menopausal age might have lower reliability due to the difference between Korean age and American age. To obtain reliable information, more attention should be given to the items in questionnaire-based surveys, and especially for surveying old-aged women.
This study aims to discover patterns of Korean women's life course in terms of their life time sequence of family roles and economic activity. Primary factors for the change and diversity of family-work role sequence are also examined. Data used in this study is the Fourth Survey of Korean Women's Economic Activity which was conducted by Korean Institute of Women Development (KIWD) in 2002. According to the main results, five distinctive patterns of life course are to be disentangled for ever married women: First, doing simultaneously family and work roles with no maternal leave (13.7%); second, reentry into labor market after maternal leave (M type, 18.6%); third, no reentry into labor market after maternal leave (latent M type, 26.9%); fourth, first job entry after child rearing (23.5%); and finally, no work experience (17.3%). The relative composition of the respective life course has changed over marriage cohorts. M type including latent M type became a dominant life pattern among married women since marriage cohorts of 1980 and later. The share of married women who begin to work first after maternal role or have no work experience has declined with recent marriage cohorts. It is also noted that the share of women with simultaneous family and work roles has increased among marital cohorts of 1990 and later. Marriage cohort differences being controlled, life patterns significantly differ by women's educational level, existence of role model of working mother at growth, women's own and husbands' gender role attitude, and family economy. Finally, some policy concerns for gender role division of family and work are raised.
Journal of agricultural medicine and community health
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v.40
no.2
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pp.53-61
/
2015
Objectives: An outbreak of food poisoning occurred among the baseball club students at a high school in Ulsan city in 2014. An epidemiological investigation was carried out to examine the infection source and the transmission route of pathogen, and to prevent a recurrence. Methods: A questionnaire survey was conducted for 26 male students and 2 food handlers. Rectal swabs were examined in 7 students and the 2 food handlers, and an environmental investigation was performed. A retrospective cohort study was used to evaluate the association between risk factors and disease. Results: The attack rate was 35.7% (10 persons/28 persons) from June 9 to 14, and Enterotoxigenic E. coli ST/LT was isolated from 7 among 28 persons. The study revealed that no food was a significant risk factor for the outbreak. There were no connection between environmental factors and the outbreak. Conclusions: The major risk factors for this outbreak were presumed to be the contaminated ice cube and ice making machines and eating ice cube from the machines. More strict personal and environmental hygiene need to be enforced to prevent such outbreaks.
The Journal of the Korean bone and joint tumor society
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v.13
no.2
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pp.75-80
/
2007
Purpose: To investigate the quality of training hospital based treatment, we evaluated the soft tissue sarcoma treatments afforded by general orthopedic surgeon rather than orthopedic oncologist. Materials and Methods: We reviewed the details of 25 patients with pathologically confirmed soft tissue sarcoma who registered in our hospital between July 1997 and 2006 September. We evaluated initial diagnoses, the surgical treatment (including adjuvant therapy) and the follow up method used and related these to the principles of soft tissue sarcoma treatment. Results: The study cohort comprised 16 men and 9 women of mean age of 50.2 years. A diagnostic biopsy was performed in 9(36%) cases before definitive surgical treatment. Wide excision was performed in 13(52%) cases. For the 12 cases in which the grade of sarcoma was estimated, adequate surgical treatment with adjuvant therapy was performed only in 4(33.3%) cases. In addition, an adequate follow up schedule was adopted in only 4(16%) of the 25 study subjects. Conclusion: Unexpectedly, many cases of soft tissue sarcoma were treated inadequately even in a training hospital. An intensive education program on the treatment of soft tissue sarcoma is necessary for all orthopedic surgeons.
Journal of the Korean Association of Oral and Maxillofacial Surgeons
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v.43
no.3
/
pp.152-159
/
2017
Objectives: The aim of this study was to investigate the effects of advancement magnitude and changes in mandibular plane angle on the stability of mandibular advancement. Materials and Methods: This retrospective cohort study evaluated the postoperative stability of mandibular advancement in class II skeletal subjects who underwent bilateral sagittal split osteotomy. Radiographs taken preoperatively, immediately postoperatively and 1 year postoperatively were traced and analyzed using linear and angular measurements. To determine horizontal and vertical relapse, an X-Y coordinate system was established in which the X-axis was constructed by rotating S-N downward by $7^{\circ}$ (approximation of the Frankfort horizontal plane) and the Y-axis was defined as a line perpendicular to the X-axis and passing through the point Sella. For certain reference points including point A, point B, pogonion and menton, the perpendicular distance between each point and both axes was determined and cephalometric variables were recorded as X and Y coordinates. Results: Twenty-five subjects were studied. A significant correlation between the amount of mandibular advancement and relapse in the B point (vertical and horizontal) and the pogonion point was observed (vertical and horizontal, P<0.001). Evaluation of data demonstrated a positive correlation between the mandibular plane angle (SN/ML) change and vertical relapse in the B point (P<0.05). A simple regression model demonstrated that 74% of horizontal relapse and 42.3% of vertical relapse in the B point was related to the amount of mandibular advancement. The receiver operating characteristic test showed that 8.5 mm mandibular advancement is related to a relapse rate of 1 mm or more in the pogonion, vertically or horizontally. Conclusion: The magnitude of mandibular advancement is a stronger surgical predictor for horizontal rather than vertical relapse at the B point. Changes in mandibular plane angle (SN/ML) during surgery affect vertical, but not horizontal relapse at the B point.
Kim, Sung Hee;Park, Yeong Mi;Choi, Bo Youl;Kim, Mi Kyung;Roh, Sungwon;Kim, Kyunga;Yang, Yoon Jung
Nutrition Research and Practice
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v.12
no.2
/
pp.160-165
/
2018
BACKGROUND/OBJECTIVES: Korea is quickly becoming an aged society. Dementia is also becoming a vital public health problem in Korea. Cognitive impairment as a pre-stage of dementia shares most risk factors for dementia. The aim of the present study was to determine associations of serum levels of vitamins A, C, and E with the risk of cognitive impairment among elderly Koreans. SUBJECTS/METHODS: In this cross-sectional study, a total of 230 participants aged 60-79 years from Yangpyeong cohort were included. Cognitive function was assessed by the Korean version of the Mini-Mental State Examination for Dementia Screening. The logistic multivariable regression model was applied to determine the effect of serum vitamins A, C, and E on the risk of cognitive impairment. RESULTS: There was no significant association between the risk of cognitive impairment and serum levels of vitamin A and vitamin C. There was a significant odd ratio when the second tertile group of beta-gamma tocopherol level was compared to the first tertile group [odds ratio (OR) = 0.37, 95% confidence interval (CI) = 0.14-0.98, P for trend = 0.051]. In subgroup analyses, there were significant negative associations between beta-gamma tocopherol level and the risk of cognitive impairment in men (OR = 0.17, 95% CI = 0.03-0.87, P for trend = 0.028), non-drinkers or former drinkers (OR = 0.13, 95% CI = 0.02-0.66, P for trend = 0.025), and non-smokers or former smokers (OR = 0.27, 95% CI = 0.09-0.82, P for trend = 0.017). CONCLUSION: Serum beta-gamma tocopherol levels tended to be inversely associated with the risk of cognitive impairment. Further prospective large-scaled studies are needed to examine this association.
Glinka, Juan;Diaz, Federico;Alva, Augusto;Mazza, Oscar;Claria, Rodrigo Sanchez;Ardiles, Victoria;Santibanes, Eduardo de;Pekolj, Juan;Santibanes, Martin de
Radiation Oncology Journal
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v.36
no.3
/
pp.210-217
/
2018
Purpose: Pancreatic cancer (PC) has not changed overall survival in recent years despite therapeutic efforts. Surgery with curative intent has shown the best long-term oncological results. However, 80%-85% of patients with these tumors are unresectable at the time of diagnosis. In those patients, first therapeutic attempts are minimally invasive or surgical procedures to alleviate symptoms. The addition of radiotherapy (RT) to standard chemotherapy, ergo chemoradiation, in patients with locally advanced pancreatic cancer (LAPC) is still controversial. The study aims to compare outcomes in patients with a double bypass surgery due to LAPC treated or not with RT. Materials and Methods: A retrospective cohort study of patients with double bypass for LAPC were registered and divided into two groups: treated or not with postoperative RT. Baseline characteristics, postoperative complications, those related to RT and their relation to the main event (mortality) were compared. Results: Seventy-four patients were included. Surgical complications between the groups did not offer significant differences. Complications related to RT were mostly mild, and 86% of patients completed the treatment. Overall survival at 1 and 2 years for patients in the exposed group was 64% and 35% vs. 50% and 28% in the non-exposed group, respectively (p = 0.11; power 72%; hazard ratio = 0.53; 95% confidence interval, 0.24-1.18). Conclusion: We observed a tendency for survival improvement in patients with postoperative RT. However, we've not had enough power to demonstrate this difference, possibly due to the small sample size. It is indispensable to develop randomized and prospective trials to guide more specific treatment lines in this patients.
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