• Title/Summary/Keyword: Risk Adjustment

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CCDC26 Gene Polymorphism and Glioblastoma Risk in the Han Chinese Population

  • Wei, Xiao-Bing;Jin, Tian-Bo;Li, Gang;Geng, Ting-Ting;Zhang, Jia-Yi;Chen, Cui-Ping;Gao, Guo-Dong;Chen, Chao;Gong, Yong-Kuan
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.8
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    • pp.3629-3633
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    • 2014
  • Background: Glioblastoma (GBM) is an immunosuppressive tumor whose median survival time is only 12-15 months, and patients with GBM have a uniformly poor prognosis. It is known that heredity contributes to formation of glioma, but there are few genetic studies concerning GBM. Materials and Methods: We genotyped six tagging SNPs (tSNP) in Han Chinese GBM and control patients. We used Microsoft Excel and SPSS 16.0 statistical package for statistical analysis and SNP Stats to test for associations between certain tSNPs and risk of GBM in five different models. ORs and 95%CIs were calculated for unconditional logistic-regression analysis with adjustment for age and gender. The SHEsis software platform was applied for analysis of linkage disequilibrium, haplotype construction, and genetic associations at polymorphism loci. Results: We found rs891835 in CCDC26 to be associated with GBM susceptibility at a level of p=0.009. The following genotypes of rs891835 were found to be associated with GBM risk in four different models of gene action: i) genotype GT (OR=2.26; 95%CI, 1.29-3.97; p=0.019) or GG (OR=1.33; 95%CI, 0.23-7.81; p=0.019) in the codominant model; ii) genotypes GT and GG (OR=2.18; 95%CI, 1.26-3.78; p=0.0061) in the dominant model; iii) GT (OR=2.24; 95%CI, 1.28-3.92; p=0.0053) in the overdominant model; iv) the allele G of rs891835 (OR=1.85; 95%CI, 1.14-3.00; p=0.015) in the additive model. In addition, "CG" and "CGGAG" were found by haplotype analysis to be associated with increased GBM risk. In contrast, genotype GG of CCDC26 rs6470745 was associated with decreased GBM risk (OR=0.34; 95%CI, 0.12-1.01; p=0.029) in the recessive model. Conclusions: Our results, combined with those from previous studies, suggest a potential genetic contribution of CCDC26 to GBM progression among Han Chinese.

Association of Total Sugar Intakes and Metabolic Syndrome from Korean National Health and Nutrition Examination Survey 2001-2002 (한국 성인의 총당류 섭취와 대사증후군과의 관계 -2001년과 2002년도 국민건강영양조사자료를 이용하여-)

  • Chung, Chin-Eun
    • Journal of Nutrition and Health
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    • v.40 no.sup
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    • pp.29-38
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    • 2007
  • The purpose of this study was to establish an association between the percent of energy from total sugar and disease prevalence of obesity, hypertension, dyslipidemia, insulin resistance, and metabolic syndrome with the context of the current population dietary practice in Korea. The Korean National Health and Nutrition Survey, 2001 and 2002 dataset were used as the source of data for this research. Usual nutritional intakes for over 20 years old people were calculated from the two non-consecutive dietary intake data from KNHANES 2001 and 2002 dataset. SAS and SUDAAN were used for statistical analyses. Sample weighted means, standard errors, and population percentages were calculated, and multiple logistic regression model with adjustment for covariates were used to determine the odds ratios(ORs) and 95% confidence intervals. Subjects were categorized as 3 ways and compared the LS means and ORs for heath factors. First, subjects excluding pregnant women, were categorized according to percent of energy from the usual total sugar intakes as ${\leq}10%$, 11-15%, 16-20%, 21-25%, >25%. Risk of LDL cholesterol showed a tendency to increase in the '>25%' group compared to the '<10%' group. The risks of the other health effects did not show any significant differences. Second, the subjects were categorized considering both Acceptable Macronutrient Distribution Range(AMDR) from carbohydrate and %Energy from total sugar as 'CHO<55% & Total sugar ${\leq}10%$', 'CHO 55-70% & Total sugar 11-25%', and '$CHO{\geq}70%$ & Total sugar ${\geq}25%$'. The risk of obesity tended to increase in the '$CHO{\geq}70%$ & Total sugar ${\geq}25%$' group compared to the 'CHO<55% & Total sugar ${\leq}10%$'. Third, the subjects were categorized as 'CHO<55% & Total sugar ${\leq}10%$', 'CHO 55-70% & Total sugar 11-20%', and '$CHO{\geq}70%$ & Total sugar ${\geq}20%$'. The risk of obesity also tended to increase in the '$CHO{\geq}70%$ & Total sugar ${\geq}20%$' group compared to the 'CHO<55% & Total sugar ${\geq}20%$' group. In conclusion, risk of LDL cholesterol showed a tendency to increase in the over 25% total sugar intake group, and the risk of obesity tended to increase in the 20-25% total sugar intake and high carbohydrate intake group. The risks of hypertension, hyperlipidemia, insulin resistance, and metabolic syndrome were not associated with total sugar intakes. More research to elucidate the association for Korean between the intakes of total sugar, added sugar, glucose, fructose, and sweeteners and diseases prevalences shoud be excuted in the future.

Behavioural and Metabolic Risk Factors for Mortality from Colon and Rectum Cancer: Analysis of Data from the Asia-Pacific Cohort Studies Collaboration

  • Morrison, David Stewart;Parr, Christine Louise;Lam, Tai Hing;Ueshima, Hirotsugu;Kim, Hyeon Chang;Jee, Sun Ha;Murakami, Yoshitaka;Giles, Graham;Fang, Xianghua;Barzi, Federica;Batty, George David;Huxley, Rachel Rita;Woodward, Mark
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.2
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    • pp.1083-1087
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    • 2013
  • Background: Colorectal cancer has several modifiable behavioural risk factors but their relationship to the risk of colon and rectum cancer separately and between countries with high and low incidence is not clear. Methods: Data from participants in the Asia Pacific Cohort Studies Collaboration (APCSC) were used to estimate mortality from colon (International Classification of Diseases, revision 9 (ICD-9) 153, ICD-10 C18) and rectum (ICD-9 154, ICD-10 C19-20) cancers. Data on age, body mass index (BMI), serum cholesterol, height, smoking, physical activity, alcohol and diabetes mellitus were entered into Cox proportional hazards models. Results: 600,427 adults contributed 4,281,239 person-years follow-up. The mean ages (SD) for Asian and Australia/New Zealand cohorts were 44.0 (9.5) and 53.4 (14.5) years, respectively. 455 colon and 158 rectum cancer deaths were observed. Increasing age, BMI and attained adult height were associated with increased hazards of death from colorectal cancer, and physical activity was associated with a reduced hazard. After multiple adjustment, any physical activity was associated with a 28% lower hazard of colon cancer mortality (HR 0.72, 95%CI 0.53-0.96) and lower rectum cancer mortality (HR 0.75, 95%CI 0.45-1.27). A 2cm increase in height increased colon and all colorectal cancer mortality by 7% and 6% respectively. Conclusions: Physical inactivity and greater BMI are modifiable risk factors for colon cancer in both Western and Asian populations. Further efforts are needed to promote physical activity and reduce obesity while biological research is needed to understand the mechanisms by which they act to cause cancer mortality.

A Study on Dieting Behaviors and Related Factors among Normal or Low-weight Middle School Girls in Seoul (서울시내 정상 또는 저체중 여중생의 다이어트 행위 실태와 관련요인 분석)

  • Park, Sunhee
    • Journal of the Korean Society of School Health
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    • v.14 no.1
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    • pp.115-130
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    • 2001
  • Dieting behaviors prevail among most women and are highly increasing among female adolescents who don't have to lose weight. The dieting behaviors of normal or low weight groups are highly related to the negative impact of health risk behaviors. We need a strategy for intervening in the dieting behaviors of relevant groups. With this background, a study was conducted to examine the current situation of dieting behaviors and related factors in middle school girls, and to provide guidelines for the relevant dieting group. This survey was carried out by self-questionnaires passed out to 901 middle school girls from 3 middle schools in Seoul. Data were collected from April 10th, 2000 to April 17th, 2000 and 794 respondents' data were finally selected for analysis. The instruments of this study were Shin's scale for effects of mass-media, Birleson's depression self-rating scale translated by shim, Rosenberg's self-esteem scale, Smilkstein's Family APGAR score translated by Yoon, Kim's school-related adjustment scale. The credibility of instruments was 0.41~0.83 in the pilot study and 0.70~0.86 in the main study. The summary of results was as follows: 1. The general characteristics of respondents were analyzed. In comparison of grade and dieting behaviors, the subjects of the group perceived that their body image was obeser than their real body image and their ideal body image was slenderer than their current body image. A dieter's body image was seriously distorted. 2. The dieting behaviors were analyzed. The Subjects' BMI was within the normal to low range -- they didn't have to lose weight. But actually 47.3% of the respondents were dieters. Their main dieting methods were exercise(71.8%), computer games(64.9%) such as DDR and pump, and intake reduction(64.1%). Most dieters were using desirable methods such as exercise and intake control. But unhealthy methods such as saunax, smoking and harmful drug-use were also used by a few dieters. The main reason for dieting was attractiveness. The chief resources of dieting methods were mass-media(67.8%), friends(64.3%), and parents & relatives(35.1%). Only a few subjects obtained the information from health professionals. While they were trying to lose weight, 42.1% of the subjects experienced side effects such as dizziness(45.0%), apathy(20.5%), appetite loss(18.5%), amenorrhea and the irregularity of the menstrual cycle(16.6%). 3. The relationship between dieting behaviors and factors was analyzed. Dieting behaviors were significantly related to the experience of menarche, the experience of dating with heterosexuals, perceived body image, self-esteem, depression, family's relationship, school instruction-related adjustment, school life-related adjustment, and the effect of mass-media. After that, the multiple logistic regression was used. The analysis revealed that dating, perceived body image, the experience of menarche and the effect of mass media were significant factors. In conclusion, strategies for preventing irrelevant dieting behaviors are urgently required to enhance female adolescents' ability to choose the right information from countless others and to recognize their optimum body image.

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Determination of Practical Dosing of Warfarin in Korean Outpatients with Mechanical Heart Valves (인공심장판막 치환환자의 Warfarin 용량결정)

  • Lee Ju Yeun;Jeong Young Mi;Lee Myung Koo;Kim Ki-bong;Ahn Hyuk;Lee Byung Koo
    • Journal of Chest Surgery
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    • v.38 no.11 s.256
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    • pp.761-772
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    • 2005
  • Background: Following the implantation of heart valve prostheses, it is important to maintain therapeutic INR to reduce the risk of thromboembolism. The objective of this study was to suggest a practical dosing guideline for Korean outpatients with prosthetic heart valves managed by a pharmacist-run anticoagulation service (ACS). Material and Method: A retrospective chart review was completed for all patients enrolled in the ACS at Seoul National University Hospital from March, 1997 to September, 2000. Patients who were at least 6 months post-valve replacement and had nontherapeutic INR value (less than 2.0 or greater than 3.0) were included. The data on 688 patients (1,782 visits) requiring dosing adjustment without any known drug or food interaction with warfarin were analyzed. The amount of adjusted dose and INR changes based on the INR at the time of the event were calculated. Aortic valve replacements (AVR) patients and mitral or double valve replacement (MVR/DVR) patients were evaluated separately. Result: Two methods for the warfarin dosage adjustment were suggested: Guideline I (mg-based total weekly dose (TWD) adjustment), Guideline II (percentage-based TWD adjustment). The effectiveness of Guideline 1 was superior to Guideline II overall in patients with both AVR and MVR/DVR. Conclusion: The guideline suggested in this study could be useful when the dosage adjustment of wafarin is necessary in outpatients with mechanical heart valves.

Association between Systemic Health Conditions and Self-Reported Oral Health in Korean Elderly (한국노인의 전신건강상태와 주관적 구강건강 관련성)

  • Choi, Eun Sil;Lyu, Jiyoung;Patton, Lauren L.;Kim, Hae-Young
    • Journal of dental hygiene science
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    • v.17 no.1
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    • pp.56-64
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    • 2017
  • Systemic health conditions increase with advancing age, and may be linked to poor self-reported oral health. The purpose of this study was to evaluate the association between systemic health conditions and poor self-reported oral health among Korean elderly. The study used a nationally representative sample of Koreans (2012 Korea National Health and Nutrition Examination Survey) aged 65~98 years (n=1,595). Systemic health conditions in this population were assessed by the presence of one or more of the following conditions: obesity, hypertension, diabetes, and hypercholesterolemia. The relative risk of poor self-reported oral health according to the occurrence of systemic health conditions was estimated by multivariate logistic regression after controlling for several potential confounders (i.e., socio-demographic factors, oral health behaviors, health behaviors, and psychological factors). After adjustment for these confounders, the relative risk of having poor self-reported oral health was greater among the elderly with one or more systemic health conditions than in those without a systemic health condition. The odds ratio of having poor self-reported oral health according to the occurrence of systemic health conditions was 1.51 (95% confidence interval, 1.08~2.12). Among the Korean elderly, perception of poor oral health was associated with the presence of one or more systemic health conditions. Future studies are needed to examine the detailed causal relation between systemic health conditions and poor oral health longitudinally.

The Association of High Sensitivity C-reactive Protein(hsCRP) with Hypertension in Some Rural Residents (일부 농촌지역 주민의 High Sensitivity C-reactive Protein(hsCRP)과 고혈압의 관련성)

  • Lee, Young-Seon;Park, Jong;Kang, Myeong-Guen;Kim, Ki-Soon;Ryu, So-Yeon
    • Journal of Preventive Medicine and Public Health
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    • v.38 no.3
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    • pp.325-329
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    • 2005
  • Objectives : This study was performed to assess the association between high sensitivity C-Reactive Protein (hsCRP) and hypertension. Methods : We evaluated the relationship between hsCRP with hypertension and other cardiovascular risk factors, using a cross-sectional survey of 202 people over the age of 50, living in a rural area. A logistic regression analysis was used to study the association between hsCRP and hypertension. The hsCRP levels were divided in quartiles, and the odds ratios (OR), with 95% confidence intervals (95% CI), calculated, using the lowest quartile as a reference. Results : The subjects consisted of 37.1% men and 62.9% women, with a mean (SD) hsCRP level of $1.9({\pm}3.0mg/{\ell})$ . The overall prevalence of hypertension was 61.4%. The prevalence of hypertension according to the hsCRP quartile was not statistically significant. After adjustment for confounding variables, the prevalence of hypertension according to the subjects in the 2nd, 3rd and 4th hsCRP quartiles were 1.418 (95% CI=0.554-3.628), 1.124 (95% CI=0.392-3.214) and 0.892 (95% CI=0.312-2.547) times higher, respectively, compared to those in the 1st quartile. Conclusions : The results showed that the level of hsCRP was not a risk factor for hypertension among adults aged over 50 years, living in a rural area. A further study should be performed to find the association between hsCRP and hypertension.

Risk Assessment of Strong Wind over Industrial Facilities in Shipyards (조선소 시설물의 강풍 위험 평가)

  • Lee, Sung-Su;Kim, Hak-Sun;Lee, Young-Kyu;Shim, Kyu-Cheoul
    • Journal of the Korean Society of Hazard Mitigation
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    • v.9 no.4
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    • pp.21-28
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    • 2009
  • Most of domestic shipyards are located at coastal regions which are affected by typhoons nearly every year. For effectiveness of shipbuilding, shipyards contain many facilities which are light-weighted and affected dominantly by wind. In the present paper, we analyze various wind fields over a shipyard including surrounding topology and structures to evaluate the structural safety of the facilities posed in the strong wind. Extreme wind speed for a study region was estimated by typhoon Monte Carlo simulation and then used for inlet wind speed for CFD analysis for wind load on the facilities. Considering geometrical wind effects, we assess the surface pressure of the elements as the pressure factor, the ratio of surface pressure to dynamic pressure. The results show that the simulated wind speed is greater than the design wind speed for the some facilities because of the shipyard's geometry. It also shows that surrounding topography in coastal area is needed to be considered and adjustment for design wind speed at wind load standard application is necessary for mooring ship and industry facilities.

Relationship between Sleep Timing and Depressive Mood in Korean Adolescents: Based on the Korea Youth Risk Behavior Web-based Survey (우리나라 청소년에서 수면시작시간과 우울감의 상관관계: 청소년 건강행태온라인조사를 바탕으로)

  • Goh, Eurah
    • Journal of the Korean Society of School Health
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    • v.29 no.2
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    • pp.90-97
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    • 2016
  • Purpose: The purpose of this study was to investigate the relationship between sleep timing and depressive mood in Korean adolescents. Methods: The study analyzed the data from the 2007~2015 Korea Youth Risk Behavior Web-based Survey. A total of 541,693 students in grades 7~12 were included in the final analysis. Multivariable logistic regression was used to examine their sleep timing and depressive mood, adjusted for sex, grade, region, socioeconomic status, academic performance, alcohol, smoking and physical activity. Sleep duration and sleep quality were also included in our model to identify whether or not the effect of sleep timing on depression is mediated by sleep duration or sleep quality. Results: The prevalence of depressive mood was 32.7% and the mean sleep timing was 12:13 AM. After adjustment for eligible covariates, the association between sleep timing and depressive mood showed a J-shaped curve. Adolescents who slept at 8 pm~10 pm were 39% more likely to be depressive (OR = 1.39, 95% CI 1.30~1.40) and at 3 am~ 4 am were 67% more likely to be depressive (OR=1.67, 95% CI 1.64~1.70) than adolescents who slept at 11 pm~12 am. These associations persisted after being adjusted for sleep duration and sleep quality. Conclusion: Sleep timing was related to depression in adolescents, independent of sleep duration and sleep quality. It appears that there is a certain sleep timing beneficial to mental health of adolescents.

Results of Protocol-based Perioperative Management in Off-Pump Coronary Artery Bypass Grafting for Patients with Non-dialysis-dependent Chronic Kidney Disease

  • Kim, Jeong-Won;Sim, Hyung Tae;Yoo, Jae Suk;Kim, Dong Jin;Cho, Kwang Ree
    • Journal of Chest Surgery
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    • v.49 no.6
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    • pp.427-434
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    • 2016
  • Background: Recent studies have demonstrated the benefits of off-pump coronary bypass grafting over the on-pump technique in patients with chronic kidney disease (CKD). To further reduce the risk of acute kidney injury and the need for renal replacement therapy, even in patients undergoing off-pump coronary artery bypass grafting, we adopted protocol-based perioperative management for patients with CKD. Methods: From December 2012 to March 2015, 265 patients underwent isolated off-pump coronary artery bypass grafting. To analyze renal function in a stable condition, we excluded 12 dialysis-dependent end stage renal failure and 10 emergency or urgent cases. Among the remaining 243 patients, 208 patients had normal kidney function (normal group), and 35 patients had CKD (CKD group). Minimizing contrast exposure, ensuring adequate hydration, using strict drug dosage adjustment, and optimizing hemodynamic status were key elements of the protocol for the CKD group. Results: The risk of acute kidney injury was about ${\times}3$ higher in the CKD group than in the normal group (p=0.01). Estimated glomerular filtration rates and serum creatinine levels deteriorated until the third postoperative day in the CKD group. However, by adopting protocol-based perioperative management, this transient renal dysfunction recovered to preoperative levels by the fifth postoperative day without requiring renal replacement therapy in all cases. Conclusion: Off-pump coronary bypass surgery combined with this protocol-based perioperative management strategy in patients with non-dialysis-dependent CKD could mostly be performed without renal replacement therapy.