• Journal of Korean Neurosurgical Society
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• v.57 no.3
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• pp.185-191
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• 2015

Objective : In order to provide normal values of the pediatric sub-axial cervical spinal canal and vertebral body growth pattern using computed tomographic scans, a total of 318 patients less than 10 years old were included. Methods : The growth of the vertebral body and canal space was investigated using four different age groups. The Torg ratio (TR) was calculated and all patients were classified into a low TR group and a high TR group according to a cutoff value of 1.0. To account for spinal curvature, the C3-7 angle was measured. Results : Very little axial expansion and growth in height were observed (2.9 mm and 3.4 mm, respectively), and the spinal canal increments (1.8 mm) were much smaller than the dimensions of the vertebral body. The mean TR values were $1.03{\pm}0.14$ at the C3 vertebral level, $1.02{\pm}0.13$ at C4, $1.05{\pm}0.13$ at C5, $1.04{\pm}0.13$ at C6, and $1.02{\pm}0.12$ at C7 in all patients. The mean sub-axial angle (C3-7) was $7.9{\pm}10.6^{\circ}$ (range: $-17-47^{\circ}$). Conclusion : The upper sub-axial spinal canal continuously increased in size compared to the lower sub-axial spine after 8 years of age. Considerable decrements in the TR was found after late childhood compared to younger ages. Generally, there were no significant differences between boys and girls in vertical length of the cervical vertebrae. However, the axial dimension of the vertebral body and the spinal canal space varied according to gender.

• Journal of Korean Biological Nursing Science
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• v.20 no.2
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• pp.103-113
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• 2018

Purpose: This study was performed to assess problems associated with sleep (short and long sleep duration) and to identify risky subgroups with sleep problems among adult cancer survivors. The study is based on the Korea National Health and Nutrition Examination Survey (KNHANES VI and VII) from 2013 to 2016. Methods: The sociodemographic and clinical data of 504 Korean cancer survivors aged 20-64 years was extracted from the KNHANES VI and VII database. Descriptive statistics for complex samples was used, and decision-tree analyses were performed using the SPSS WIN 24.0 program. Results: The mean age for survivors was approximately 51 years. The mean sleep duration was 6.97 hours; 36.2% of participants had short (< 7 hours) and 9.9% had long (> 8 hours) sleep duration. From the decision-trees analyses, the characteristics of the adult cancer survivors related to sleep problems were presented with six different pathways. Sleep problems were analyzed according to the survivors' sociodemographic information (age, education, living status, and occupation), clinical characteristics (body mass index, hypercholesterolemia, and anemia) and health-related quality of life (HRQoL). The HRQoL (${\leq}0.5$ or > 0.5 cutoff point) was a significant predictor of the participants' sleep problems because all six pathways were started from this predictor in the model. Conclusion: Health care professionals could use the decision-tree model for screening adult cancer survivors with sleep problems in clinical or community settings. Nursing interventions considering these specific individual characteristics and HRQoL level should be developed to have adequate sleep duration for Korean adult cancer survivors.

• Journal of Korean Neurosurgical Society
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• v.60 no.5
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• pp.567-576
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• 2017

Objective : Preoperative parameters including the T1 slope (T1S) and C2-C7 sagittal vertical axis (SVA) have been recognized as predictors of kyphosis after laminoplasty, which is accompanied by posterior neck muscle damage. The importance of preoperative parameters has been under-estimated in anterior cervical discectomy and fusion (ACDF) because there is no posterior neck muscle damage. We aimed to determine whether postoperative subsidence and pseudarthrosis could be predicted according to specific parameters on preoperative plain radiographs. Methods : We retrospectively analyzed 41 consecutive patients (male : female, 22 : 19; mean age, $51.15{\pm}9.25years$) who underwent ACDF with a stand-alone polyether-ether-ketone (PEEK) cage (>1 year follow-up). Parameters including SVA, T1S, segmental angle and range of motion (ROM), C2-C7 cervical angle and ROM, and segmental inter-spinous distance were measured on preoperative plain radiographs. Risk factors of subsidence and pseudarthrosis were determined using multivariate logistic regression. Results : Fifty-five segments (27 single-segment and 14 two-segment fusions) were included. The subsidence and pseudarthrosis rates based on the number of segments were 36.4% and 29.1%, respectively. Demographic data and fusion level were unrelated to subsidence. A greater T1S was associated with a lower risk of subsidence (p=0.017, odds ratio=0.206). A cutoff value of T1S<$28^{\circ}$ significantly predicted subsidence (sensitivity : 70%, specificity : 68.6%). There were no preoperative predictors of pseudarthrosis except old age. Conclusion : A lower T1S (T1S<$28^{\circ}$) could be a risk factor of subsidence following ACDF. Surgeons need to be aware of this risk factor and should consider various supportive procedures to reduce the subsidence rates for such cases.

• Journal of Korean Biological Nursing Science
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• v.21 no.1
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• pp.85-97
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• 2019

Purpose: This study was performed to analyze the levels of blood pressure and to identify good or poor blood pressure control (BPC) groups among hypertension patients. The study was based on the Korea National Health and Nutrition Examination Survey (KNHANES VI and VII) conducted from 2013 to 2016. Methods: The sociodemographic and clinical data of 4,151 Korean hypertension patients aged 20-79 years and who were taking antihypertensive medications was extracted from the KNHANES VI and VII database. Descriptive statistics for complex samples and a decision-tree analysis were performed using the SPSS WIN 24.0 program. Results: The mean age was $62.46{\pm}0.21years$. The mean systolic blood pressure (SBP) was $128.07{\pm}0.28mmHg$, and the diastolic blood pressure (DBP) was $76.99{\pm}0.21mmHg$. 71.9% of participants showed normal blood pressure (SBP < 140mmHg and DBP < 90mmHg). From the decisiontrees analysis, the characteristics of participants related to good BPC group were presented with 9 different pathways same as those from the poor BPC group. Good or poor BPC groups were classified according to the patients' characteristics such as age, living status, occupation, education, hypertension diagnosis period, numbers of comorbidity, perceived health status, total cholesterol, high density lipoprotein-cholesterol, alcohol drinking per month, and depressive mood. Total cholesterol level (< 201mg/dL or ${\geq}201mg/dL$ cutoff point) was the most significant predictor of the participants' BPC group. Conclusion: This decision-tree model with the 18 different pathways can form a basis for the screening of hypertension patients with good or poor BPC in either clinical or community settings.

• Journal of Convergence for Information Technology
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• v.10 no.12
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• pp.146-155
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• 2020

This study was to evaluate the usefulness of gamma glutamyl transferase (GGT) as a surrogate marker predicting metabolic syndrome. 7,155 non obese men over the age of 20 were studied as subjects. The criteria for diagnosing MetS were the National Cholesterol Education Program - Third Adult Treatment Panel (NCEP-ATP III). The risk of developing MetS according to GGT was conducted logistic regression analysis, and the ROC (receiver operating characteristic) curve was obtained to confirm GGT ability to predict the risk of MetS. Regardless of age and body mass index, MetS had a 7.09 times higher risk of onset in the fourth quartile than in the first quartile of GGT (p<0.001). The AUC (area under the curve) of GGT for the diagnosis of MetS was 0.715, and the cutoff value of GGT was 40.0 U/L, the sensitivity was 65.0%, and the specificity was 70.2%. Therefore, GGT is considered to be a useful diagnostic index for diagnosing MetS.

• Childhood Kidney Diseases
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• v.26 no.1
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• pp.46-51
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• 2022

Purpose: Delta neutrophil index (DNI) indicates immature granulocytes in peripheral blood and has been confirmed to be effective as a prognostic factor for neonatal sepsis. Also, it has been reported to have diagnostic value in acute pyelonephritis and in predicting vesicoureteral reflux (VUR) in the infant. We conducted the study to verify whether DNI is also helpful in the entire pediatric age group with febrile urinary tract infection (UTI). Methods: Medical records of children hospitalized for febrile UTIs were analyzed retrospectively. All subjects underwent kidney ultrasound and voiding cystourethrography. In the group with and without VUR, we compared sex and age, and the following laboratory values: the white blood cell count, neutrophil, polymorphonuclear leucocyte, eosinophil, hemoglobin, platelet count, C-reactive protein, DNI value, and the finding of ultrasound. Results: A total of 315 patients (163 males and 152 females; range, 0-127 months) were eligible, and 41 patients (13%) had VUR. As a result of univariate analysis, the white blood cell count, neutrophil, DNI, and ultrasonic abnormalities were high in the reflux group, and the hemoglobin and lymphocyte fraction values were low. The value of DNI and the abnormal ultrasound were significantly higher in the reflux group on the multivariate analysis. The area under the curve value of the receiver operating curve was higher in DNI (0.640; 95% confidence interval, 0.536-0.744; P=0.004), and the DNI cutoff value for VUR prediction was 1.85%. Conclusions: We identified that ultrasound findings and DNI values were helpful predictors of VUR in pediatric febrile UTIs.

• Clinical and Experimental Pediatrics
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• v.62 no.12
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• pp.450-455
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• 2019

Background: Lipid accumulation product (LAP) is associated with the presence and severity of nonalcoholic fatty liver disease (NAFLD) in adults. Purpose: Here we evaluated the ability of LAP to predict NAFLD in obese children. Methods: Eighty obese children (38 girls; age 6-18 years) were included. Anthropometric measurements and biochemical values were obtained from the patients' medical records. LAP was calculated as [waist circumference (WC) (cm) - 58]×triglycerides (mmol/L) in girls; [WC (cm) - 65]×triglycerides (mmol/L) in boys. The minLAP and adjLAP were described (3% and 50% of WC values, respectively) and the total/high-density lipoprotein cholesterol index (TC/HDL-C) was calculated. NAFLD was observed on ultrasound, and patients were divided into 3 groups by steatosis grade (normal, grade 0; mild, grade 1; moderate-severe, grade 2-3). The area under the curve (AUC) and appropriate index cutoff points were calculated by receiver operator characteristic analysis. Results: LAP was positively correlated with puberty stage (rho=0.409; P<0.001), fasting insulin (rho= 0.507; P<0.001), homeostasis model assessment of insulin resistance (rho=0.470; P<0.001), uric acid (rho=0.522; P<0.001), and TC/HDL-C (rho=0.494; P<0.001) and negatively correlated with HDL-C (rho=-3.833; P<0.001). LAP values could be used to diagnose hepatosteatosis (AUC=0.698; P=0.002). The LAP, adjLAP, and minLAP cutoff values were 42.7 (P=0.002), 40.05 (P=0.003), and 53.47 (P= 0.08), respectively. For LAP, the differences between the normal and mild groups (P=0.035) and the normal and moderate-severe groups were statistically significant (P=0.037), whereas the difference between the mild and moderate-severe groups was not (P>0.005). There was a statistically significant difference between the normal and mild groups for adjLAP (P=0.043) but not between the other groups (P>0.005). There was no significant intergroup difference in minLAP (P>0.005). Conclusion: LAP is a powerful and easy tool to predict NAFLD in childhood. If LAP is ≥42.7, NAFLD should be suspected. This is the first study to assess LAP diagnostic accuracy for childhood obesity.

• Journal of Chest Surgery
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• v.49 no.4
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• pp.273-279
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• 2016

Background: The use of extracorporeal life support (ECLS) in the setting of cardiopulmonary resuscitation (CPR) has shown improved outcomes compared with conventional CPR. The aim of this study was to determine factors predictive of survival in extracorporeal CPR (E-CPR). Methods: Consecutive 85 adult patients (median age, 59 years; range, 18 to 85 years; 56 males) who underwent E-CPR from May 2005 to December 2012 were evaluated. Results: Causes of arrest were cardiogenic in 62 patients (72.9%), septic in 18 patients (21.2%), and hypovolemic in 3 patients (3.5%), while the etiology was not specified in 2 patients (2.4%). The survival rate in patients with septic etiology was significantly poorer compared with those with another etiology (0% vs. 24.6%, p=0.008). Septic etiology (hazard ratio [HR], 2.84; 95% confidence interval [CI], 1.49 to 5.44; p=0.002) and the interval between arrest and ECLS initiation (HR, 1.05 by 10 minutes increment; 95% CI, 1.02 to 1.09; p=0.005) were independent risk factors for mortality. When the predictive value of the E-CPR timing for in-hospital mortality was assessed using the receiver operating characteristic curve method, the greatest accuracy was obtained at a cutoff of 60.5 minutes (area under the curve, 0.67; 95% CI, 0.54 to 0.80; p=0.032) with 47.8% sensitivity and 88.9% specificity. The survival rate was significantly different according to the cutoff of 60.5 minutes (p=0.001). Conclusion: These results indicate that efforts should be made to minimize the time between arrest and ECLS application, optimally within 60 minutes. In addition, E-CPR in patients with septic etiology showed grave outcomes, suggesting it to be of questionable benefit in these patients.

• Childhood Kidney Diseases
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• v.12 no.2
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• pp.150-156
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• 2008

Purpose : Many results have reported a correlation between the spot urine protein/creatinine ratio(P/C ratio) and 24-hour urinary protein(24UP) amount. This study was designed to evaluated correlation between 24UP amounts and P/C ratio in children and to find the factors that affect this correlation. Methods : 210 patients who visited the Department of Pediatrics in Busan Paik Hospital from september 2003 to december 2007 were included in this study. All the patients were divided into I, II, III/A, B, C group[I:24UP(mg/$m^2$/day)]<100, II: 100$\leq$24UP<1,000, III: 24UP$\geq$1,000, A: Cr excretion(mg/kg)<15, B: 15$\leq$Cr excretion<25, C: Cr excretion$\geq$25)]. Pearson correlation analysis was performed between 24UP and P/C ratio to evaluate the relationship. We defined fractional difference between 24UP and P/C ratio, and then performed multiple regression analysis. Results : There was a strong positive linear correlation between 24UP and P/C ratio in all patients, and the correlation was also good in each group. The factors affecting accurate quantitation of proteinuria using spot urine P/C ratio was creatinine excretion. Conclusion : Spot urine P/C ratio is a useful test to predict proteinuria roughly. Therefore, we expect that urine P/C ratio can be used as parameter instead of 24UP, if we set cutoff value of P/C ratio considered to creatinine excretion according to age and sex in large pediatric population.

• Journal of Gastric Cancer
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• v.9 no.1
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• pp.26-30
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• 2009

Purpose: The aim of this study was to evaluate the prognostic value of the peripheral blood lymphocyte count before surgery in those patients with gastric cancer. Materials and Methods: The study group was comprised of a series of 1,054 patients who underwent curative gastrectomy. The appropriate lymphocyte count cutoff value was determined. The prognostic factors were evaluated by univariate and multivariate analyses. Results: The lymphocyte count cutoff value was 1,500/ul. The patients were classified into two groups: Group A had a lymphocyte count $\geq$ 1,500/ul (n=765) and Group B had a lymphocyte count <1,500/ul (n=289). There were statistically significant differences between the groups according to their age (P<0.001), the tumor stage (P=0.038) and the tumor size (P<0.001). The 5- and 10-year survival rates of Group A were 80.1% and 76.6%, respectively and those of Group B were 72.4% and 63.5%, respectively (P=0.002). When multivariate analysis was performed by the Cox proportional hazards model, the lymphocyte count was not an independent prognostic factor. Conclusion: Although the prognosis of patients with a high lymphocyte count was better than that of the patients with a low lymphocyte count, our results did not support using the preoperative peripheral blood lymphocyte count as an independent prognostic factor for patients with gastric cancer.