• 제목/요약/키워드: Matched case-control

검색결과 247건 처리시간 0.027초

Should asymptomatic young men with iron deficiency anemia necessarily undergo endoscopy?

  • Kim, Nam Hee;Park, Jung Ho;Park, Dong Il;Sohn, Chong Il;Choi, Kyuyong;Jung, Yoon Suk
    • The Korean journal of internal medicine
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    • 제33권6호
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    • pp.1084-1092
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    • 2018
  • Background/Aims: There has been no evidence for the necessity of endoscopy in asymptomatic young men with iron deficiency anemia (IDA). To determine whether endoscopy should be recommended in asymptomatic young men with IDA, we compared the prevalence of gastrointestinal (GI) lesions between young men (< 50 years) with IDA and those without IDA. Methods: We conducted a case-control study on asymptomatic young men aged < 50 years who underwent both esophagogastroduodenoscopy (EGD) and colonoscopy as part of a health checkup between 2010 and 2014. Results: Of 77,864 participants, 128 (0.16%) had IDA and 512 subjects without IDA were matched for several variables including age. Young men with IDA had a significantly higher proportion of colorectal cancer (CRC) (0.8% vs. 0.0%, p = 0.045), villous adenoma (0.8% vs. 0.0%, p = 0.045), and inflammatory bowel disease (IBD; 2.3% vs. 0.4%, p = 0.025) than those without IDA. Additionally, the prevalence of advanced colorectal neoplasia (ACRN) tended to be higher in subjects with IDA than in those without IDA (3.1% vs. 1.0%, p = 0.084). The prevalence of significant lower GI lesions including ACRN and IBD was higher in subjects with IDA than in those without IDA (5.5% vs. 1.4%, p = 0.011). Regarding upper GI lesions, a positive association with IDA was observed only for gastric ulcer (4.7% vs. 1.0%, p = 0.011). Conclusions: GI lesions including CRC, villous adenoma, IBD, and gastric ulcer were more common in asymptomatic young men with IDA. Our results suggest that EGD and particularly colonoscopy should be recommended even in asymptomatic young men with IDA.

Factors Associated with Worsening Oxygenation in Patients with Non-severe COVID-19 Pneumonia

  • Hahm, Cho Rom;Lee, Young Kyung;Oh, Dong Hyun;Ahn, Mi Young;Choi, Jae-Phil;Kang, Na Ree;Oh, Jungkyun;Choi, Hanzo;Kim, Suhyun
    • Tuberculosis and Respiratory Diseases
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    • 제84권2호
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    • pp.115-124
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    • 2021
  • Background: This study aimed to determine the parameters for worsening oxygenation in non-severe coronavirus disease 2019 (COVID-19) pneumonia. Methods: This retrospective cohort study included cases of confirmed COVID-19 pneumonia in a public hospital in South Korea. The worsening oxygenation group was defined as that with SpO2 ≤94% or received oxygen or mechanical ventilation (MV) throughout the clinical course versus the non-worsening oxygenation group that did not experience any respiratory event. Parameters were compared, and the extent of viral pneumonia from an initial chest computed tomography (CT) was calculated using artificial intelligence (AI) and measured visually by a radiologist. Results: We included 136 patients, with 32 (23.5%) patients in the worsening oxygenation group; of whom, two needed MV and one died. Initial vital signs and duration of symptoms showed no difference between the two groups; however, univariate logistic regression analysis revealed that a variety of parameters on admission were associated with an increased risk of a desaturation event. A subset of patients was studied to eliminate potential bias, that ferritin ≥280 ㎍/L (p=0.029), lactate dehydrogenase ≥240 U/L (p=0.029), pneumonia volume (p=0.021), and extent (p=0.030) by AI, and visual severity scores (p=0.042) were the predictive parameters for worsening oxygenation in a sex-, age-, and comorbid illness-matched case-control study using propensity score (n=52). Conclusion: Our study suggests that initial CT evaluated by AI or visual severity scoring as well as serum markers of inflammation on admission are significantly associated with worsening oxygenation in this COVID-19 pneumonia cohort.

Why do Sovereign Wealth Funds Invest in Asia?

  • Zhang, Hongxia;Kim, Heeho
    • Journal of Korea Trade
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    • 제25권1호
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    • pp.65-88
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    • 2021
  • Purpose - This paper aims to examine the determinants of SWFs' investment in Asian countries and to identify consistent investment patterns of SWFs in specific target firms from Asia, particularly China and South Korea. Design/methodology - This study extends the Tobin's Q model to examine the relationship between SWF investments in target firms and their returns with other firm-level control variables. We collect consistent data on SWF investments and the matched firm-level data on target firms, which of observation is 1,512 firms (333 in South Korea and 1,179 in China) targeted by 20 SWF sources during 1997-2017. The panel random effect model is used to estimate the extended Tobin's Q model. The robustness of the estimations is tested by the simultaneous equation models and the panel GEE model. Findings - The evidence shows that sovereign wealth funds are more inclined to invest in the financial sector with a monopoly position and in large firms with higher growth opportunity and superior cash asset ratios in China. In contrast to their investments in China, sovereign wealth funds in South Korea prefer to invest in strategic sectors, such as energy and information technology, and in large firms with high performance and low leverage. Sovereign wealth funds' investments tend to significantly improve the target firm's performance measured by sales growth and returns in both Korea and China. Originality/value - The existing literature focuses on examining the determination of SWFs investment in the developed countries, such as Europe and the United States. Our paper contributes to the literature in three ways; first, we analyzes case studies of SWF investments in Asian markets, which are less developed and riskier. Second, we examine whether the determination of SWF investment in Asian target firms depends on the different time periods, on types of sources of SWFs, and on acquiring countries. Third, our research uses vast sample data on target firms in longer time periods (1997-2017) than other previous studies on the SWFs for Asian markets.

Surveillance Evaluation of the National Cancer Registry in Sabah, Malaysia

  • Jeffree, Saffree Mohammad;Mihat, Omar;Lukman, Khamisah Awang;Ibrahim, Mohd Yusof;Kamaludin, Fadzilah;Hassan, Mohd Rohaizat;Kaur, Nirmal;Myint, Than
    • Asian Pacific Journal of Cancer Prevention
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    • 제17권7호
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    • pp.3123-3129
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    • 2016
  • Background: Cancer is the fourth leading cause of death in Sabah Malaysia with a reported age-standardized incidence rate was 104.9 per 100,000 in 2007. The incidence rate depends on non-mandatory notification in the registry. Under-reporting will provide the false picture of cancer control program effectiveness. The present study was to evaluate the performance of the cancer registry system in terms of representativeness, data quality, simplicity, acceptability and timeliness and provision of recommendations for improvement. Materials and Methods: The evaluation was conducted among key informants in the National Cancer Registry (NCR) and reporting facilities from Feb-May 2012 and was based on US CDC guidelines. Representativeness was assessed by matching cancer case in the Health Information System (HIS) and state pathology records with those in NCR. Data quality was measured through case finding and re-abstracting of medical records by independent auditors. The re-abstracting portion comprised 15 data items. Self-administered questionnaires were used to assess simplicity and acceptability. Timeliness was measured from date of diagnosis to date of notification received and data dissemination. Results: Of 4613 cancer cases reported in HIS, 83.3% were matched with cancer registry. In the state pathology centre, 99.8% was notified to registry. Duplication of notification was 3%. Data completeness calculated for 104 samples was 63.4%. Registrars perceived simplicity in coding diagnosis as moderate. Notification process was moderately acceptable. Median duration of interval 1 was 5.7 months. Conclusions: The performances of registry's attributes are fairly positive in terms of simplicity, case reporting sensitivity, and predictive value positive. It is moderately acceptable, data completeness and inflexible. The usefulness of registry is the area of concern to achieve registry objectives. Timeliness of reporting is within international standard, whereas timeliness to data dissemination was longer up to 4 years. Integration between existing HIS and national registration department will improve data quality.

쯔쯔가무시증 환자군과 대조군의 인지도와 지식 비교 (Comparison of the Awareness and Knowledge of Scrub Typhus between Case and Control Groups)

  • 이관;박병찬;임현술;권순석;최진수;김장락;김건엽;류소연
    • 농촌의학ㆍ지역보건
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    • 제37권1호
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    • pp.1-11
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    • 2012
  • 이 연구는 지역사회 주민 중 쯔쯔가무시증 환자군과 대조군에 대하여 쯔쯔가무시증 인지도 및 지식 정도를 파악하고, 쯔쯔가무시증 발생과 인지도의 관련성 및 인지도에 영향을 미치는 요인을 파악함으로서 향후 쯔쯔가무시증 방역사업에 활용할 수 있도록 하기위해 수행하였다. 2006년 10월부터 12월까지, 시 도 단위로 다섯 지역을 선정후 각 지역별로 2곳 이상의 시 군을 지정하였다. 환자군은 지난 2주간 동안 확진된 환자 299명으로 하였고, 대조군은 환자가 실제 거주지 이웃 주민 중 최근 2년 동안 쯔쯔가무시증의 감염 병력이 없고, 성별, 연령(${\pm}5$세)이 일치하며 환자의 집에서 가까운 순으로 2명을 선정하여 598명이었다. 저자들이 전문가의 자문을 통하여 직접 개발한 설문지를 통하여 쯔쯔가무시증에 대한 인지도 및 지식정도를 조사하였다. 쯔쯔가무시증에 대한 인지도는 대조군 79.4%, 환자군 66.6%로 유의한 차이가 있었다(p<0.01). 환자군과 대조군에서 유의한 차이가 있었던 변수, 즉 인지도와 과거 감염력을 이용한 다변량 분석에서 쯔쯔가무시증은 인지도가 없을 경우 그렇지 않은 경우에 비해 1.95배 더 발생하였다. 쯔쯔가무시증에 대한 인지도가 있는 대상자 중 쯔쯔가무시증 인지 경로별 분포는 전체적으로 가족 또는 이웃이 쯔쯔가무시증을 앓은 경우가 54.9%로 가장 많았고, 텔레비전 28.3%, 과거 쯔쯔가무시증을 앓은 경우 5.5% 등의 순이었다. 쯔쯔가무시증에 관한 지식 정도는 전반적으로 대부분의 항목에서 정답률이 70% 미만이었으며, 모든 항목에서 환자군이 대조군보다 유의하게 정답률이 높았다(p<0.01). 다변량 분석 결과 쯔쯔가무시증 인지도에 영향을 미치는 요인은 환자군에서 연령(OR, 0.96; 95% CI, 0.94-0.98)이었고, 대조군에서는 여자(OR, 1.56; 95% CI, 1.03-2.36), 연령(OR, 0.98; 95% CI, 0.96-0.99), 가족력이 있는 경우(OR, 10.18; 95% CI, 1.37-75.99), 교육을 받은 경험이 있는 경우(OR, 8.47; 95% CI, 1.14-63.00) 등이었다. 쯔쯔가무시증 예방 또는 감소를 위해서는 예방교육을 통해 주민의 인지도를 향상시키고, 이를 통해 예방활동을 수행할 수 있도록 하는 것이 최선의 방법일 것이다. 낮은 인지도 향상과 쯔쯔가무시증 예방을 위해 효과적인 작업 지침 및 교육 프로그램이 개발되어야 하며, 예방에 관련된 홍보를 강화하여야 할 것이다.

영양소 섭취 수준에 따른 뇌졸중 위험도 분석 - 대구.경북지역 환자-대조군 연구 - (Analysis of Relative Risk of Stroke by Nutrient Intake Levels - Case-Control Study in Daegu.Gyeongbuk Area, Korea -)

  • 성수정;정두교;이원기;김유정;이혜성
    • 한국식품영양과학회지
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    • 제38권8호
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    • pp.1050-1061
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    • 2009
  • 본 연구는 대구 경북지역의 뇌졸중 환자들의 에너지 및 영양소 섭취실태를 측정하고, 에너지 및 영양소 섭취수준에 따른 뇌졸중 발생의 상대위험도를 분석하고자 수행되었다. 조사대상자는 경북대학교 병원에서 뇌졸중으로 처음 진단받은 후 입원한 환자 중 의사소통이 가능한 100명을 환자군으로 하였고 동일한 지역에서 뇌졸중 병력이 없고 환자군과 연령이 비슷한 지역사회 주민 150명을 대조군으로 하였다. 조사는 반정량적 식품섭취빈도 조사지를 이용하여 조사자와 직접 면접을 통하여 2004년 7월부터 2005년 2월 사이에 이루어졌다. 본 연구의 결과를 요약하면 다음과 같다. 뇌졸중 환자군과 대조군의 1일 평균 에너지와 영양소 섭취량을 성별로 비교하면 남자의 경우 환자군이 대조군에 비해 에너지와 모든 열량 영양소, 비타민 $B_1$, $B_6$, 나이아신, 엽산, 비타민 E, 인, 칼륨, 아연, 식이섬유의 섭취량과 단백질 및 지방 에너지 섭취비율이 유의하게 높았다. 여자의 경우 환자군은 대조군에 비해 지방, 비타민 C, 엽산, 비타민 E, 철분 및 식이섬유의 섭취량이 유의하게 낮았고 탄수화물 에너지 비율이 유의하게 높았다. 에너지 및 영양소별 섭취수준과 관련된뇌졸중 발생 상대위험도를 성별로 보면, 남자는 에너지, 단백질, 탄수화물, 비타민 $B_1$과 E, 나이아신, 아연, 총지방산, 단일불포화 지방산, 다가 불포화지방산 그리고 n-6 지방산의 높은 섭취수준이 뇌졸중 발생의 상대 위험도를 유의하게 높이는 것으로 나타났다. 여자의 경우 지방, 비타민 A, 비타민 $B_2$$B_6$, 나이아신, 비타민 C와 E, 철, 나트륨과 칼륨 및 셀레늄, 모든 지방산들, 그리고 콜레스테롤, 타우린, 식이섬유의 높은 섭취수준이 뇌졸중의 발생 위험도를 유의하게 낮추는 것으로 나타났다. 영양소 중 나이아신, 비타민 E, 지방산들은 성별에 따라 위험도에 미치는 영향이 상반되게 나타났다. 본 연구는 조사대상자의 규모가 작고 특정지역에 국한 하여 조사가 이루어졌다는 제한점을 가지고 있다. 따라서 성별에 따라 상반되는 결과를 보인 영양소들에 대해서는 향후 조사지역을 광역화하고, 보다 대규모의 대상자 집단에 대해 심도 있는 조사를 통해 재확인할 필요가 있다고 본다.

양성 유방 종양과 유방암 환자의 혈청 인지질 지방산 조성 (Serum Phospholipid Fatty Acids in Benign Breast Tumor and Breast Cancer)

  • 심유진;안세현;황유정;이양자
    • Journal of Nutrition and Health
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    • 제42권3호
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    • pp.213-220
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    • 2009
  • 본 연구에서는 유방암과 유방 양성종양 환자의 혈청 인지질 지방산 조성을 대조군과 비교, 분석하였으며, 유방암군을 병기에 따라 네 개의 군으로 분류하거나 림프절 전이 여부에 따라 두 군으로 나누어 혈청 인지질 지방산 조성에 차이가 있는지를 조사하였다. 그 결과를 요약하면 아래와 같다. 1) 출산 자녀수에서 양성 유방 종양과 유방암 환자군이 대조군에 비하여 유의하게 적었다. 2) 대조군과 양성 유방 종양환자에 비해 유방암 환자에서 ${\omega}$3계 PUFA인 혈청 인지질 DGLA와 AA의 수준이 높았으며 ${\omega}$3계 PUFA인 eicosatrienoic acid는 대조군에 비하여 양성 유방종양군과 유방암군에서 낮았으며, DPA는 대조군에 비하여 유방암 환자에서 낮은 수준이었다. 3) 총 SFA의 합은 대조군과 양성 유방종양 환자에 비하여 유방암 환자에서 높은 것으로 나타났다. Palmitic acid는 대조군과 양성 유방 종양 환자군에 비하여 유방암 환자군에서 높았으나, stearic acid는 대조군에 비하여 양성 유방 종양 환자군과 유방암 환자군에서 낮은 것이 특징적이었다. 4) SI로서 C18 : 0/C18 : 1 비율은 대조군에 비하여 양성 유방 종양 환자군과 유방암 환자군에서 낮았다. 5) AA 수준은 0기에 비하여 I, II, III기에서 높았으며, 림프절 전이 음성인 군과 양성인 군을 비교했을 때 양성인군에서 높은 것으로 나타났다. Stearic acid의 수준은 네개의 군 중에서 가장 낮은 수준의 병기인 0기와 가장 높은 수준의 병기인 III기 간에 유의한 차이가 있었으며 0기에 비하여 III기에서 stearic acid가 낮은 것으로 나타났다. 이상에서와 같이 혈청 인지질의 지방산 조성은 유방암 환자군에서 변화되어 있었으며 특히 양성 유방종양 단계에서 변화가 나타난 지방산도 있었다. 또한 AA와 stearic acid 등 일부 개별 지방산들은 유방암의 진행 단계와도 관련되어 있었다. 따라서 혈청 인지질의 지방산 조성은 유방암의 예방 뿐 아니라 진행의 단계에 따라 유의 깊게 관찰해야 할 중요한 요소로 사료된다.

Vascular Endothelial Growth Factor (VEGF) Gene Polymorphisms and Breast Cancer Risk in a Chinese Population

  • Luo, Ting;Chen, Long;He, Ping;Hu, Qian-Cheng;Zhong, Xiao-Rong;Sun, Yu;Yang, Yuan-Fu;Tian, Ting-Lun;Zheng, Hong
    • Asian Pacific Journal of Cancer Prevention
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    • 제14권4호
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    • pp.2433-2437
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    • 2013
  • Vascular endothelial growth factor (VEGF) is a potent regulator of angiogenesis and thereby involved in the development and progression of solid tumours. Associations between three VEGF gene polymorphisms (-634 G/C, +936 C/T, and +1612 G/A) and breast cancer risk have been extensively studied, but the currently available results are inconclusive. Our aim was to investigate associations between three VEGF gene polymorphisms and breast cancer risk in Chinese Han patients. We performed a hospital-based case-control study including 680 female incident breast cancer patients and 680 female age-matched healthy control subjects. Polymerase chain reaction restriction fragment length polymorphism (PCR-RFLP) analysis was performed to detect the three VEGF gene polymorphisms. We observed that women carriers of +936 TT genotypes [odds ratio (OR) =0.46, 95% confidence interval (CI) = 0.28, 0.76; P=0.002] or 936 T-allele (OR=0.81, 95% CI= 0.68, 0.98; P=0.03) had a protective effect concerning the disease. Our study suggested that the +1612G/A polymorphism was unlikely to be associated with breast cancer risk. The -634CC genotype was significantly associated with high tumor aggressiveness [large tumor size (OR=2.63, 95% CI=1.15, 6.02; P=0.02) and high histologic grade (OR=1.47, 95% CI= 1.06, 2.03; P=0.02)]. The genotypes were not related with other tumor characteristics such as regional or distant metastasis, stage at diagnosis, or estrogen or progesterone receptor status. Our study revealed that the VEGF -634 G/C and +936 C/T gene polymorphisms may be associated with breast cancer in Chinese Han patients.

Dietary and Lifestyle Factors and Risk of Non-Hodgkin's Lymphoma in Oman

  • Ali, Amanat;Al-Belushi, Buthaina S.;Waly, Mostafa I.;Al-Moundhri, Mansour;Burney, Ikram A.
    • Asian Pacific Journal of Cancer Prevention
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    • 제14권2호
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    • pp.841-848
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    • 2013
  • Background: The incidence of various types of cancers including the non-Hodgkin's lymphoma (NHL) has increased during the recent years. Diet and lifestyle factors have been reported to play an important role in the etiology of NHL. However, no such data are available from the Middle Eastern countries, including Oman. Materials and Methods: Forty-three histologically confirmed cases of non-Hodgkin's lymphoma (NHL) diagnosed at the Sultan Qaboos University Hospital (SQUH) and the Royal Hospital (RH), Muscat, Oman and forty-three age and gender matched controls were the subjects of this study. Frequency matching was used to select the control population. Information on social and demographic data as well as the dietary intake was collected by personal interviews, using a 117-items semi-quantitative food frequency questionnaire. Results: A non-significant increased risk of NHL was observed with higher body mass index (BMI) (OR=1.20, 95%CI: 0.45, 2.93), whereas a significantly decreased risk of NHL was associated with a higher educational level (OR=0.12, 95%CI: 0.03, 0.53). A significantly increased risk was observed for higher intake of energy (OR=2.67, 95%CI: 0.94, 7.57), protein (OR=1.49, 95%CI: 0.54, 4.10) and carbohydrates (OR=5.32, 95%CI: 1.78, 15.86). Higher consumption of daily servings from cereals (OR=3.25, 95%CI: 0.87, 12.09) and meat groups (OR=1.55, 95%CI: 0.58, 4.15) were also found to be associated with risk of NHL, whereas a significantly reduced risk was associated with higher consumption of vegetables (OR=0.24, 95%CI: 0.07, 0.82). The consumption of fruits, milk and dairy products however showed no significant association with the risk of developing NHL. Conclusion: The results suggest that obesity, high caloric intake, higher consumption of carbohydrate and protein are associated with increased risk of NHL, whereas a significantly reduced risk was observed with higher intake of vegetables.

저체중아(低體重兒) 출산 관련요인에 관한 사례-비교군 연구 (A Case-Control Study on the Risk Factors of the Low Birth Weight)

  • 맹광호;이상윤;이해천
    • Journal of Preventive Medicine and Public Health
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    • 제17권1호
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    • pp.251-257
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    • 1984
  • Low birth weight baby, defined as the baby born with less than or equal to 2,500g of body weight by WHO has been a great concern in the fold of maternal and child health since the low birth weight is a major cause of high perinatal mortality. Any measure to prevent the low birth weight baby is most desirable not only for saving the life of a baby but also for levelling up the health of the whole society. The authors attempted to figure out how some known maternal risk factors are related to the low birth weight and to measure their strengh of associations in terms of relative risk using hospital birth records. For this study, hospital birth records of 66 low birth weight cases and sex-parity matched 198 normal controls were chosen from Kangnam St. Mary's Hospital, Catholic Medical Center, and the data were analyzed in regards to several maternal factors. The risk factors studied were mother's age, mother's ABO blood type, previous histories of abortion, low birth weight baby, fetal wastage, and maternal diseases represented by anemia, hypertension, proteinuria, and glucosuria. The results obtained in this study were as follows: 1. The mean body weight of the cases and controls were 1,955g and 3,251g, respectively, and the heights were 41cm for cases and 50cm for controls. Mean gestation periods of cases and controls were 34 weeks and 39 weeks, respectively. 2. Young mother(less than or equal to 20 years of age) or old mother(more than or equal to 30 years of age) experienced more frequently the delivery of low birth weight babies than mothers in between 21 and 29 years of age. But the difference was not statistically significant. 3. Mothers whose blood type was O tended to have slighty higher frequency of low birth weight babies while B mothers have lower frequency. But the difference was not statistically significant too. 4. Those mothers who had experienced low birth weight baby in the past tended to give more births of low birth weight babies. This factor is even statistically significant and the relative risk of the prior experience of low birth weight was 6.7. 5. Mothers with experience of fetal losses and mothers of more than two pregnancies had higher frequency of low birth weight than the mothers with no fatal losses and of first pregnancy, but the difference was not statistically significant. 6. Statistically significant higher frequency of low birth weight were found in mothers with hypertension(odds ratio=4.07), anemia(odds ratio=22,33), and proteinuria(odds ratio=2.79). In summary, these study results strongly suggest that in order to prevent the low birth weight, special care should be made when the mother is too young or too old, and when the mother has experienced deliveries of low birth weight and fetal deaths. Medical control for the maternal diseases such as anemia and hypertension is also needed before or during the pregnency.

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