• Journal of Preventive Medicine and Public Health
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• v.51 no.2
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• pp.71-82
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• 2018

Objectives: Areca nut is widely consumed in many parts of the world, especially in South and Southeast Asia, where cardiovascular disease (CVD) is also a huge burden. Among the forms of CVD, acute coronary syndrome (ACS) is a major cause of mortality and morbidity. Research has shown areca nut chewing to be associated with diabetes, hypertension, oropharyngeal and esophageal cancers, and CVD, but little is known about mortality and re-hospitalization secondary to ACS among areca nut users and non-users. Methods: A prospective cohort was studied to quantify the effect of areca nut chewing on patients with newly diagnosed ACS by categorizing the study population into exposed and non-exposed groups according to baseline chewing status. Cox proportional hazards models were used to examine the associations of areca nut chewing with the risk of re-hospitalization and 30-day mortality secondary to ACS. Results: Of the 384 ACS patients, 49.5% (n=190) were areca users. During 1-month of follow-up, 20.3% (n=78) deaths and 25.1% (n=96) re-hospitalizations occurred. A higher risk of re-hospitalization was found (adjusted hazard ratio [aHR], 2.05; 95% confidence interval [CI], 1.29 to 3.27; p=0.002) in areca users than in non-users. Moreover, patients with severe disease were at a significantly higher risk of 30-day mortality (aHR, 2.77; 95% CI, 1.67 to 4.59; p<0.001) and re-hospitalization (aHR, 2.72; 95% CI, 1.73 to 4.26; p<0.001). Conclusions: The 30-day re-hospitalization rate among ACS patients was found to be significantly higher in areca users and individuals with severe disease. These findings suggest that screening for a history of areca nut chewing may help to identify patients at a high risk for re-hospitalization due to secondary events.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.21 no.3
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• pp.196-202
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• 2018

Purpose: Treatment of chronic constipation and fecal impaction is usually outpatient and requires high or frequent doses of laxatives. However, there are children who fail outpatient treatments, sometimes repeatedly, and are ultimately hospitalized. We sought to compare the characteristics of the children who failed outpatient treatment and needed inpatient treatment vs those who achieved success with outpatient treatment, in an effort to identify attributes that might be associated with a higher likelihood towards hospitalization. Methods: In this retrospective cohort study, we reviewed the medical records of all patients aged 0 to 21 years, with chronic functional constipation and fecal impaction seen in the pediatric gastroenterology clinic over a period of 2 years. Results: Total of 188 patients met inclusion criteria. While 69.2% were successfully treated outpatient (referred to as the outpatient group), 30.9% failed outpatient treatment and were hospitalized (referred to as the inpatient group). The characteristics of the inpatient group including age at onset of $3.6{\pm}3.6years$ (p=0.02); black ethnicity (odds ratio [OR] 4.31, 95% confidence interval [95% CI] 2.04-9.09); p<0.001); prematurity (OR 2.39, 95% CI 1.09-5.26; p=0.02]; developmental delay (OR 2.20, 95% CI 1.12-4.33; p=0.02); overflow incontinence (OR 2.26, 95% CI 1.12-4.53, p=0.02); picky eating habits (OR 2.02, 95% CI 1.00-4.08; p=0.04); number of ROME III criteria met: median 4, interquartile range 3-5 (p=0.04) and $13{\pm}13.7$ constipation related prior encounters (p=0.001), were significantly different from the outpatient group. Conclusion: Identification of these characteristics may be helpful in anticipating challenges and potential barriers to effective outpatient treatment.

• BMB Reports
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• v.37 no.5
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• pp.522-526
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• 2004

Prader-Willi (PWS) and Angelman (AS) are syndromes of developmental impairment that result from the loss of expression of imprinted genes in the paternal (PWS) or maternal (AS) 15q11-q13 chromosome. Diagnosis on a clinical basis is difficult in newborns and young infants; thus, a suitable molecular test capable of revealing chromosomal abnormalities is required. We used a variety of cytogenetic and molecular approaches, such as, chromosome G banding, fluorescent in situ hybridization, a DNA methylation test, and a set of chromosome 15 DNA polymorphisms to characterize a cohort of 27 PWS patients and 24 suspected AS patients. Molecular analysis enabled the reliable diagnosis of 14 PWS and 7 AS patients, and their classification into four groups: (A) 6 of these 14 PWS subjects (44%) had deletions of paternal 15q11-q13; (B) 4 of the 7 AS patients had deletions of maternal 15q11-q13; (C) one PWS patient (8%) had a maternal uniparental disomy (UPD) of chromosome 15; (D) the remaining reliably diagnoses of 7 PWS and 3 AS cases showed abnormal methylation patterns of 15q11-q13 chromosome, but none of the alterations shown by the above groups, although they may have harbored deletions undetected by the markers used. This study highlights the importance of using a combination of cytogenetic and molecular tests for a reliable diagnosis of PWS or AS, and for the identification of genetic alterations.

• Journal of Labour Economics
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• v.39 no.3
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• pp.1-32
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• 2016

The purpose of this article is to examine the change of employment expectation using the wave 7-11 (2010-2014) of Korea Education and Employment Panel(KEEP). The three main variables are the reservation wage, which has been studied by labor economists for a long time, the convenient working environment factor, the desired job factor. Last two of which are extracted from the 15 survey questions about employment expectation using the factor analysis. Our estimates suggest that male have a higher reservation wage than female while female have a higher level of expectation overall. Women attach more importance to working environment especially. Also, university students have a higher reservation wage and set a higher value on the desired job than employees and job seekers.

• Journal of Nutrition and Health
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• v.38 no.4
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• pp.313-319
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• 2005

Adequate vitamin $B_2$, vitamin $B_6$, folate and vitamin $B_{12}$ intakes are known to be important for the growth and development in infants. The purpose of this study was to evaluate concentrations of vitamin $B_2$, vitamin $B_6$, folate and vitamin $B_{12}$ in human milk and to investigate the relationship between vitamin B levels in human milk and dietary habits and other health-related behaviors. Milk samples were obtained from 38 healthy lactating women (aged 29.0 $\pm$ 3.2 years) who are participating in the cohort study on pregnant women. Vitamin $B_2$ concentrations in human milk were positively correlated with maternal vitamin $B_2$ intakes in lactating mothers. Vitamin $B_6$, folate and vitamin $B_{12}$ concentrations in human milk were not correlated with maternal B vitamin intakes. Vitamin $B_6$ concentrations in human milk were negatively correlated with the amount of postpartum weight loss. The vitamin B concentrations in human milk were not associated with maternal age, height, weight and parity. Mothers who were exposed to indirect smoking had lower vitamin $B_2$ concentrations, and those who reported to consume health foods had higher vitamin $B_2$ concentrations in their milk. In conclusion, lactating women need to consume more vitamin B intakes for the growth and development in infants. Further researches are needed to find other diet and health-related factors which influence on B vitamin concentrations in human milk.

• Journal of Nutrition and Health
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• v.49 no.4
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• pp.213-222
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• 2016

Purpose: Coffee is the most frequently consumed food item in South Korea after rice and cabbage. Coffee contains various substances, including caffeine, cafestol, kahweol, chlorogenic acid, and many other known and unknown ingredients with some health benefits. Especially, cumulative evidence has shown that regular coffee use is associated with lower risk of type 2 diabetes, although limited and inconsistent data are available regarding metabolic syndrome. Methods: This study reviewed all available scientific and epidemiologic evidence on coffee consumption, metabolic syndrome, and the association between them. Most epidemiologic research regarding this association was of a cross-sectional design, and a few case-control and cohort studies were available. We conducted meta-analysis with 11 observational studies investigated in Europe, America, and Asia. Summary odds ratios (OR) were calculated using a random-effects model. Results: The overall OR of metabolic syndrome was 0.90 (95% Confidence Interval (CI), 0.81-0.99) for the highest category of coffee intake compared with the lowest intake category. These associations were stronger in populations of US and Europe (OR 0.84, 95% CI 0.76-0.94), whereas no association was observed in the Asian population (OR 1.00, 95% CI 0.81-1.23). Conclusion: The review results indicate that frequent coffee consumption may be beneficial to metabolic syndrome, but the association between coffee consumption and metabolic syndrome may differ by nations or continents.

• Nutrition Research and Practice
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• v.1 no.3
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• pp.231-236
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• 2007

Underreporting patterns by the level of obesity have not been fully assessed yet. The purpose of this study was to examine the differential underreporting patterns on cardiovascular risk factor, macronutrient, and food group intakes by the level of Body Mass Index (BMI). We analyzed cross-sectional baseline nutritional survey data from the population-based longitudinal study, the Healthy Women Study (HWS) cohort. Study subjects included 538 healthy premenopausal women participating in the HWS. Nutrient and food group intakes were assessed by the one-day 24-hour dietary recall and a semi-quantitative food frequency questionnaire, respectively. The ratio of reported energy intake (EI) to estimated basal metabolic rate (BMR) was used as a measure of relative energy reporting status and categorized into tertiles. Overweight group ($BMI{\geq}25kg/m^2$) had a higher ratio of EI to BMR (EI/BMR) than normal weight group ($BMI<25kg/m^2$). Normal weight and overweight groups showed similar patterns in cardiovascular risk factors, nutrient intake, and food group intake by the EI/BMR. Fat and saturated fat intakes as a nutrient density were positively associated with the EI/BMR. Proportion of women who reported higher consumption (${\geq}4\;times/wk$) of sugar/candy, cream and red meat groups was greater in higher tertiles of the EI/BMR in both BMI groups. Our findings suggest similar patterns of underreporting of cardiovascular risk factors, and macronutrient and food group intakes in both normal and overweight women.

• Development and Reproduction
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• v.18 no.1
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• pp.1-11
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• 2014

Early growth response 1 (Egr1) is a zinc-finger transcription factor to direct second-wave gene expression leading to cell growth, differentiation and/or apoptosis. While it is well-known that Egr1 controls transcription of an array of targets in various cell types, downstream target gene(s) whose transcription is regulated by Egr1 in the uterus has not been identified yet. Thus, we have tried to identify a list of potential target genes of Egr1 in the uterus by performing multi-step in silico promoter analyses. Analyses of mRNA microarray data provided a cohort of genes (102 genes) which were differentially expressed (DEGs) in the uterus between Egr1(+/+) and Egr1(-/-) mice. In mice, the frequency of putative EGR1 binding sites (EBS) in the promoter of DEGs is significantly higher than that of randomly selected non-DEGs, although it is not correlated with expression levels of DEGs. Furthermore, EBS are considerably enriched within -500 bp of DEG's promoters. Comparative analyses for EBS of DEGs with the promoters of other species provided power to distinguish DEGs with higher probability as EGR1 direct target genes. Eleven EBS in the promoters of 9 genes among analyzed DEGs are conserved between various species including human. In conclusion, this study provides evidence that analyses of mRNA expression profiles followed by two-step in silico analyses could provide a list of putative Egr1 direct target genes in the uterus where any known direct target genes are yet reported for further functional studies.

• Clinical and Experimental Pediatrics
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• v.60 no.11
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• pp.353-358
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• 2017

Purpose: To develop and evaluate a simple screening tool to assess hearing loss in newborns. A derived score was compared with the standard clinical practice tool. Methods: This cohort study was designed to screen the hearing of newborns using transiently evoked otoacoustic emission and auditory brain stem response, and to determine the risk factors associated with hearing loss of newborns in 3 tertiary hospitals in Northern Thailand. Data were prospectively collected from November 1, 2010 to May 31, 2012. To develop the risk score, clinical-risk indicators were measured by Poisson risk regression. The regression coefficients were transformed into item scores dividing each regression-coefficient with the smallest coefficient in the model, rounding the number to its nearest integer, and adding up to a total score. Results: Five clinical risk factors (Craniofacial anomaly, Ototoxicity, Birth weight, family history [Relative] of congenital sensorineural hearing loss, and Apgar score) were included in our COBRA score. The screening tool detected, by area under the receiver operating characteristic curve, more than 80% of existing hearing loss. The positive-likelihood ratio of hearing loss in patients with scores of 4, 6, and 8 were 25.21 (95% confidence interval [CI], 14.69-43.26), 58.52 (95% CI, 36.26-94.44), and 51.56 (95% CI, 33.74-78.82), respectively. This result was similar to the standard tool (The Joint Committee on Infant Hearing) of 26.72 (95% CI, 20.59-34.66). Conclusion: A simple screening tool of five predictors provides good prediction indices for newborn hearing loss, which may motivate parents to bring children for further appropriate testing and investigations.

• Clinical and Experimental Pediatrics
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• v.63 no.9
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• pp.361-367
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• 2020

Background: Length of stay is a significant indicator of care effectiveness and hospital performance. Owing to the limited number of healthcare centers and facilities, it is important to optimize length of stay and associated factors. Purpose: The present study aimed to investigate factors associated with neonatal length of stay in the neonatal intensive care unit (NICU) using parametric and semiparametric models and compare model fitness according to Akaike information criterion (AIC) between 2016 and 2018. Methods: This retrospective cohort study reviewed 600 medical records of infants admitted to the NICU of Bandar Abbas Hospital. Samples were identified using census sampling. Factors associated with NICU length of stay were investigated based on semiparametric Cox model and 4 parametric models including Weibull, exponential, log-logistic, and log-normal to determine the best fitted model. The data analysis was conducted using R software. The significance level was set at 0.05. Results: The study findings suggest that breastfeeding, phototherapy, acute renal failure, presence of mechanical ventilation, and availability of central venous catheter were commonly identified as factors associated with NICU length of stay in all 5 models (P<0.05). Parametric models showed better fitness than the Cox model in this study. Conclusion: Breastfeeding and availability of central venous catheter had protective effects against length of stay, whereas phototherapy, acute renal failure, and mechanical ventilation increased length of stay in NICU. Therefore, the identification of factors associated with NICU length of stay can help establish effective interventions aimed at decreasing the length of stay among infants.