Koo, Bo Kyung;Oh, Sohee;Kim, Yoon Ji;Moon, Min Kyong
Journal of Lipid and Atherosclerosis
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v.7
no.2
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pp.110-121
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2018
Objective: We developed a new equation for predicting coronary heart disease (CHD) risk in Korean diabetic patients using a hospital-based cohort and compared it with a UK Prospective Diabetes Study (UKPDS) risk engine. Methods: By considering patients with type 2 diabetes aged ${\geq}30years$ visiting the diabetic center in Boramae hospital in 2006, we developed a multivariable equation for predicting CHD events using the Cox proportional hazard model. Those with CHD were excluded. The predictability of CHD events over 6 years was evaluated using area under the receiver operating characteristic (AUROC) curves, which were compared using the DeLong test. Results: A total of 732 participants (304 males and 428 females; mean age, $60{\pm}10years$; mean duration of diabetes, $10{\pm}7years$) were followed up for 76 months (range, 1-99 month). During the study period, 48 patients (6.6%) experienced CHD events. The AUROC of the proposed equation for predicting 6-year CHD events was 0.721 (95% confidence interval [CI], 0.641-0.800), which is significantly larger than that of the UKPDS risk engine (0.578; 95% CI, 0.482-0.675; p from DeLong test=0.001). Among the subjects with <5% of risk based on the proposed equation, 30.6% (121 out of 396) were classified as ${\geq}10%$ of risk based on the UKPDS risk engine, and their event rate was only 3.3% over 6 years. Conclusion: The UKPDS risk engine overestimated CHD risk in type 2 diabetic patients in this cohort, and the proposed equation has superior predictability for CHD risk compared to the UKPDS risk engine.
Purpose: Previous studies have demonstrated the usefulness of the controlling nutritional status (CONUT) score in nutritional assessment and survival prediction of patients with various malignancies. However, its value in advanced gastric cancer (GC) treated with neoadjuvant chemotherapy and curative gastrectomy remains unclear. Materials and Methods: The CONUT score at different time points (pretreatment, preoperative, and postoperative) of 272 patients with advanced GC were retrospectively calculated from August 2004 to October 2015. The χ2 test or Mann-Whitney U test was used to estimate the relationships between the CONUT score and clinical characteristics as well as short-term outcomes, while the Cox proportional hazard model was used to estimate long-term outcomes. Survival curves were estimated by using the Kaplan-Meier method and log-rank test. Results: The proportion of moderate or severe malnutrition among all patients was not significantly changed from pretreatment (13.5%) to pre-operation (11.7%) but increased dramatically postoperatively (47.5%). The pretreatment CONUT-high score (≥4) was significantly associated with older age (P=0.010), deeper tumor invasion (P=0.025), and lower pathological complete response rate (CONUT-high vs. CONUT-low: 1.2% vs. 6.6%, P=0.107). Pretreatment CONUT-high score patients had worse progression-free survival (P=0.032) and overall survival (OS) (P=0.026). Adjusted for pathologic node status, the pretreatment CONUT-high score was strongly associated with worse OS in pathologic node-positive patients (P=0.039). Conclusions: The pretreatment CONUT score might be a straightforward index for immune-nutritional status assessment, while being a reliable prognostic indicator in patients with advanced GC receiving neoadjuvant chemotherapy and curative gastrectomy. Moreover, lower pretreatment CONUT scores might indicate better chemotherapy responses.
To characterize the dynamic properties of Gimhae Plains sediments, we calculated natural frequencies using microtremor horizontal-to-vertical spectral ratios and derived shear wave velocity profiles by inversion of Rayleigh-wave dispersion curves obtained by the high frequency-wavenumber and modified spatial autocorrelation methods. Our results suggest that in this region, strong amplification of ground motion is expected in the vibration frequency (f ≥ 1 Hz). Additionally, obtained velocity profiles show that shear wave velocities are ~200 and 400 m/s for the shallow marine and old fluvial sediments, respectively. Bedrock is possibly encountered at depths of 60-100 m at most sites. We developed a simplified shear wave velocity model of shallow sediments based on the obtained profiles. Our results suggest that a large area in the Gimhae Plains could be categorized as an S6 site based on the Korean seismic design code (KDS 17 10 00).
Jang, Se Young;Kim, Jihun;Kim, Seonhwa;Lee, Eun Sun;Choi, Eun Jeong
Journal of Korean Academy of Nursing
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v.54
no.1
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pp.18-31
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2024
Purpose: This study aimed to investigate the impact of anthropometric indices of obesity (body mass index [BMI], waist circumference, waist hip ratio, and body fat percentage) on the incidence of hypertension in adults with prehypertension. Methods: A longitudinal study design using secondary data form the Korean Genome and Epidemiology Study was employed. The study included 1,838 adults with prehypertension tracked every two years from 2001 to 2018. Statistical analyses, including frequency assessments, number of cases per 1,000 person-years, log-rank tests, Kaplan-Meier curves, and Cox's proportional hazards regression, were conducted using SPSS version 25. Results: Over the observation period (15,783.6 person-years), 1,136 individuals developed hypertension. The incidence of hypertension was significantly higher in the obesity groups defined by BMI (hazard ratio [HR] = 1.33), waist circumference (HR = 1.34), waist hip ratio (HR = 1.29), and body fat percentage (HR = 1.31) compared to the non-obese group. These findings indicate an increased risk of hypertension associated with obesity as measured by these indices. Conclusion: The study underscores the importance of avoiding obesity to prevent hypertension in individuals with prehypertension. Specifically, BMI, waist circumference, waist hip circumference, and body fat percentage were identified as significant risk factors for hypertension. The results suggest the need for individualized weight control interventions, emphasizing the role of health professionals in addressing the heightened hypertension risk in this population.
Background: Hypoxia-inducible factor $1{\alpha}$ (HIF-$1{\alpha}$) plays an important role in regulating cell survival and angiogenesis, which are critical for tumor growth and metastasis. Genetic variations of HIF1A have been shown to influence the susceptibility to many kinds of human tumors. Increased expression of HIF-$1{\alpha}$ has also been demonstrated to be involved in tumor progression. However, the prognostic value of single nucleotide polymorphisms (SNPs) inthe HIF1A gene remains to be determined in most cancer types, including colorectal cancer (CRC). In this study, we sought to investigate the predictive role of HIF1A SNPs in prognosis of CRC patients and efficacy of chemotherapy. Materials and Methods: We genotyped two functional SNPs in HIF1A gene using the Sequenom iPLEX genotyping system and then assessed their associations with clinicopathological parameters and clinical outcomes of 697 CRC patients receiving radical surgery using Cox logistic regression model and Kaplan Meier curves. Results: Generally, no significant association was found between these 2 SNPs and clinical outcomes of CRC. In stratified analysis of subgroup without adjuvant chemotherapy, patients carrying CT/TT genotypes of rs2057482 exhibited a borderline significant association with better overall survival when compared with those carrying CC genotype [Hazard ratio (HR), 0.47; 95% confidence interval (95% CI): 0.29-0.76; P < 0.01]. Moreover, significant protective effects on CRC outcomes conferred by adjuvant chemotherapy were exclusively observed in patients carrying CC genotype of rs2057482 and in those carrying AC/CC genotype of rs2301113. Conclusions: Genetic variations in HIF1A gene may modulate the efficacy of adjuvant chemotherapy after surgery in CRC patients.
Khakimov, Elyorbek;Chung, Sang Yong;Senapathi, Venkatramanan;Elzain, Hussam Eldin;Son, JooHyeong
Journal of Soil and Groundwater Environment
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v.22
no.3
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pp.27-41
/
2017
This study dealt with the characteristics and the interrelations of hydrogeological parameters such as hydraulic conductivity, dispersivity and effective porosity of unconsolidated sediments for providing the basic data necessary for the planning of the management and preservation of groundwater quality in the Nakdong River Delta of Busan City, Korea. Groundwater quality in this area has been deteriorated due to seawater intrusion, agricultural fertilizer and pesticide, industrial wastewater, and contaminated river water. The physical properties (grain size distribution, sediment type, sorting) and aquifer parameters (hydraulic conductivity, effective porosity, longitudinal dispersivity) were determined from grain size analysis, laboratory permeability test and column tracer test. Among 36 samples, there were 18 Sand (S), 7 Gravelly Sand (gS), 5 Silty Sand (zS), 5 Muddy Sand (mS), and 1 Sandy Silt (sZ). Hydraulic conductivity was determined through a falling head test, and ranged from $9.2{\times}10^{-5}$ to $2.9{\times}10^{-2}cm/sec$ (0.08 to 25.6 m/day). From breakthrough curves, dispersivity was calculated to be 0.35~3.92 cm. Also, effective porosity and average linear velocity were obtained through the column tracer test, and their values were 0.04~0.46 and 1.06E-04~6.49E-02 cm/sec, respectively. Statistical methods were used to understand the interrelations among aquifer parameters of hydraulic conductivity, effective porosity and dispersivity. The relation between dispersivity and hydraulic conductivity or effective porosity considered the sample length, because dispersivity was affected by experimental scale. The relations between dispersivity and hydraulic conductivity or effective porosity were all in inverse proportion for all long and short samples. The reason was because dispersivity was in inverse proportion to the groundwater velocity in case of steady hydrodynamic dispersion coefficient, and groundwater velocity was in proportion to the hydraulic conductivity or effective porosity. This study also elucidated that longitudinal dispersivity was dependent on the scale of column tracer test, and all hydrogeological parameters were low to high values due to the sand quantity of sediments. It is expected that the hydrogeological parameter data of sediments will be very useful for the planning of groundwater management and preservation in the Nakdong River Delta of Busan City, Korea.
Background: Breast cancer is an important cause of death among women. One way of classifying different forms of breast cancer is by molecular features, usually in terms of the four subtypes: luminal A, luminal B, HER2-enriched, and triple negative. Objectives: This study aimed to investigate the association between molecular subtypes and survival among breast cancer patients treated with radiotherapy. Materials and Methods: A retrospective cohort study was conducted. The subjects were 272 breast cancer patients who had received treatment in the radiotherapy unit at Srinagarind Hospital, Thailand, between 1 January, 1999, and 31 May, 2009. The end of the study was 1 June, 2014. Overall survival was defined as the time elapsing between initial registration at the radiotherapy unit and death or the end of the study. Survival curves were estimated by the Kaplan-Meier method, and a multivariate analysis was performed using Cox's proportional hazard regression model. Results: The patient mean age was $47.5{\pm}10.4$ at the time of diagnosis. Of the 272 patients, 146 (53.7%) were classified as luminal A, 12 (4.4%) as luminal B, 30 (11.0%) as HER2-enriched, and 84 (30.9%) as triple negative. The overall survival rates at 1, 3 and 5 years were 87.1%, 68.4% and 59.2%, respectively. According to molecular subtypes, HER2-enriched patients had the lowest 5-year survival rate (30.0 %, 95%CI: 15.02-46.55). The median follow-up time was 8.37 years. In the Cox model analysis a higher risk of death was found for patients with HER2-enriched ($HR_{adj}=3.34$, 95%CI:1.96-5.67), triple negative ($HR_{adj}=2.17$, 95%CI: 1.44-3.27), and stage IIlB ($HR_{adj}=2.20$, 95%CI: 1.16-4.17) cancers. Conclusions: The worst survival rates were among patients classified as HER2-enriched, triple negative and at stage IIIB. Early detection and an advanced treatment modality are needed to help these patients.
Journal of the Korean Association of Geographic Information Studies
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v.17
no.4
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pp.10-27
/
2014
HAZUS-MH is a GIS-based computer program that estimates potential losses from multi-hazard phenomena: earthquakes, floods and hurricanes. With respect to seismic disaster, characteristics of a hypothetical or actual earthquake are entered into HAZUS. Then HAZUS estimates the intensity of ground shaking and calculates the correspondent losses. In this study, HAZUS was used as a part of the preparations of the future seismic events at a coastal plant facility area. To reliably characterize the target facility area, many geotechnical characteristics data were synthesized from the existing site investigation reports. And the buildings and facilities were sorted by analyzing their material and structural characteristics. In particular, the study area was divided into 17 blocks taking into account the situation of both land development and facility distribution. The ground conditions of blocks were categorized according to the site classification scheme for earthquake-resistant design. Moreover, seismic fragility curves of a main facilities were derived based on the numerical modeling and were incorporated into the database in HAZUS. The results estimated in the study area using HAZUS showed various seismic damage and loss potentials depending on site conditions and structural categories. This case study verified the usefulness of the HAZUS for estimating earthquake losses in coastal facility areas.
Purpose: The modification of the cancer classification system aimed to improve the classical anatomy-based tumor, node, metastasis (TNM) staging by considering tumor biology, which is associated with patient prognosis, because such information provides additional precision and flexibility. Materials and Methods: We previously developed an mRNA expression-based single patient classifier (SPC) algorithm that could predict the prognosis of patients with stage II/III gastric cancer. We also validated its utilization in clinical settings. The prognostic single patient classifier (pSPC) differentiates based on 3 prognostic groups (low-, intermediate-, and high-risk), and these groups were considered as independent prognostic factors along with TNM stages. We evaluated whether the modified TNM staging system based on the pSPC has a better prognostic performance than the TNM 8th edition staging system. The data of 652 patients who underwent gastrectomy with curative intent for gastric cancer between 2000 and 2004 were evaluated. Furthermore, 2 other cohorts (n=307 and 625) from a previous study were assessed. Thus, 1,584 patients were included in the analysis. To modify the TNM staging system, one-grade down-staging was applied to low-risk patients according to the pSPC in the TNM 8th edition staging system; for intermediate- and high-risk groups, the modified TNM and TNM 8th edition staging systems were identical. Results: Among the 1,584 patients, 187 (11.8%), 664 (41.9%), and 733 (46.3%) were classified into the low-, intermediate-, and high-risk groups, respectively, according to the pSPC. pSPC prognoses and survival curves of the overall population were well stratified, and the TNM stage-adjusted hazard ratios of the intermediate- and high-risk groups were 1.96 (95% confidence interval [CI], 1.41-2.72; P<0.001) and 2.54 (95% CI, 1.84-3.50; P<0.001), respectively. Using Harrell's C-index, the prognostic performance of the modified TNM system was evaluated, and the results showed that its prognostic performance was better than that of the TNM 8th edition staging system in terms of overall survival (0.635 vs. 0.620, P<0.001). Conclusions: The pSPC-modified TNM staging is an alternative staging system for stage II/III gastric cancer.
Over-expression of de novo lipogenesis (DNL) genes is associated with the prognosis of various types of cancers. However, the effects of single nucleotide polymorphisms (SNPs) in these genes on recurrence and survival of non-small cell lung cancer (NSCLC) patients after surgery are still unknown. In this study, a total of 500 NSCLC patients who underwent surgery treatment were included. Eight SNPs in 3 genes (ACACA, FASN and ACLY) of the DNL pathway were examined using the Sequenom iPLEX genotyping system. Multivariate Cox proportional hazards regression and Kaplan-Meier curves were used to analyze the association of SNPs with patient survival and tumour recurrence. We found that two SNPs in the FASN gene were significantly associated with the recurrence of NSCLC. SNP rs4246444 had a significant association with lung cancer recurrence under additive model (hazard ratio [HR], 0.82; 95% confidence interval [95%CI], 0.67-1.00; p=0.05). Under the dominant model, rs4485435 exhibited a significant association with recurrence (HR, 0.75; 95%CI, 0.56-1.01; p=0.05). Additionally, SNP rs9912300 in ACLY gene was significantly associated with overall survival in lung cancer patients (HR, 1.41; 95%CI, 1.02-1.94, p=0.04) under the dominant model. Further cumulative effect analysis showed moderate dose-dependent effects of unfavorable SNPs on both survival and recurrence. Our data suggest that the SNPs in DNL genes may serve as independent prognostic markers for NSCLC patients after surgery.
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