• Journal of Nutrition and Health
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• v.49 no.5
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• pp.304-312
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• 2016

Purpose: The purpose of the study was to investigate the association between food intakes and cardiovascular disease (CVD) risk factors in Korean women with type 2 diabetes mellitus (T2DM). Methods: The data were collected from the 2007~2012 Korea National Health and Nutrition Examination Survey (KNHANES). In this study, subjects were divided into two groups, the normal fasting glucose (NFG) group (n = 7,738) and the T2DM group (n = 225). Dietary intake was derived from the nutrition survey, which was collected by trained dietitians using 24-hour dietary recall through the face-to-face interview method in the sample person's home. Results: After adjustment for confounding factors, mean fruit (p = 0.0265), fruit and vegetable without kimchi (p = 0.0295), and fish (p = 0.0112) intakes were significantly lower in the T2DM group than in the NFG group. In the multiple logistic regression analysis, odds ratio (OR) for risk of high systolic blood pressure (${\geq}140mmHg$) was lower in the over the median compared to under the median for fruit intakes (OR; 0.657, 95% CI; 0.523~0.824). The OR for the risk of hypertriglyceridemia was lower in the over the median compared to under the median for fruit and vegetable without kimchi (OR; 0.828, 95% CI; 0.7111~0.963) and fish (OR; 0.783, 95% CI; 0.673~0.910) intakes. Conclusion: These results show that intakes of fruits, fish, and fruits and vegetables without kimchi have beneficial effects on CVD in Korean women with T2DM.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.6
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• pp.2431-2440
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• 2015

Background: Registry data from four major public hospitals indicate trends in clinical care and survival from colorectal cancer over three decades, from 1980 to 2010. Materials and Methods: Kaplan-Meier productlimit estimates and Cox proportional hazards models were used to investigate disease-specific survival and multiple logistic regression analyses to explore first-round treatment trends. Results: Five-year survivals increased from 48% for 1980-1986 to 63% for 2005-2010 diagnoses. Survival increases applied to each ACPS stage (Australian Clinico-Pathological Stage), and particularly stage C (an increase from 38% to 68%). Risk of death from colorectal cancer halved (hazards ratio: 0.50 (0.45, 0.56)) over the study period after adjusting for age, sex, stage, differentiation, primary sub-site, health administrative region, and measures of socioeconomic status and geographic remoteness. Decreases in stage were not observed. Survivals did not vary by sex or place of residence, suggesting reasonable equity in service access and outcomes. Of staged cases, 91% were treated surgically with lower surgical rates for older ages and more advanced stage. Proportions of surgical cases having adjuvant therapy during primary courses of treatment increased for all stages and were highest for stage C (an increase from 5% in 1980-1986 to 63% for 2005-2010). Radiotherapy was more common for rectal than colonic cases. Proportions of rectal cases receiving radiotherapy increased, particularly for stage C where the increase was from 8% in 1980-1986 to 60% in 2005-2010. The percentage of stage C colorectal cases less than 70 years of age having systemic therapy as part of their first treatment round increased from 3% in 1980-1986 to 81% by 1995-2010. Based on survey data on uptake of adjuvant therapy among those offered this care, it is likely that all these younger patients were offered systemic treatment. Conclusions: We conclude that pronounced increases in survivals from colorectal cancer have occurred at major public hospitals in South Australia due to increases in stage-specific survivals. Use of adjuvant therapies has increased and the patterns of change accord with clinical guideline recommendations. Reasons for sub-optimal use of radiotherapy for rectal cases warrant further investigation, including the potential for limited rural access to impede uptake of treatments at metropolitan-based radiotherapy centres.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.16
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• pp.6811-6817
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• 2014

Background: Breast cancer risk prediction models are widely used in clinical practice. They should be useful in identifying high risk women for screening in limited-resource countries. However, previous models showed poor performance in derived and validated settings. Therefore, we aimed to develop and validate a breast cancer risk prediction model for Thai women. Materials and Methods: This cross-sectional study consisted of derived and validation phases. Data collected at Ramathibodi and other two hospitals were used for deriving and externally validating models, respectively. Multiple logistic regression was applied to construct the model. Calibration and discrimination performances were assessed using the observed/expected ratio and concordance statistic (C-statistic), respectively. A bootstrap with 200 repetitions was applied for internal validation. Results: Age, menopausal status, body mass index, and use of oral contraceptives were significantly associated with breast cancer and were included in the model. Observed/expected ratio and C-statistic were 1.00 (95% CI: 0.82, 1.21) and 0.651 (95% CI: 0.595, 0.707), respectively. Internal validation showed good performance with a bias of 0.010 (95% CI: 0.002, 0.018) and C-statistic of 0.646(95% CI: 0.642, 0.650). The observed/expected ratio and C-statistic from external validation were 0.97 (95% CI: 0.68, 1.35) and 0.609 (95% CI: 0.511, 0.706), respectively. Risk scores were created and was stratified as low (0-0.86), low-intermediate (0.87-1.14), intermediate-high (1.15-1.52), and high-risk (1.53-3.40) groups. Conclusions: A Thai breast cancer risk prediction model was created with good calibration and fair discrimination performance. Risk stratification should aid to prioritize high risk women to receive an organized breast cancer screening program in Thailand and other limited-resource countries.

• Asian Pacific Journal of Cancer Prevention
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• v.14 no.12
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• pp.7127-7131
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• 2013

The primary aim of this study was to evaluate the relationship of single nucleotide polymorphisms (SNPs) in ribosomal protein SA (RPSA) gene with colorectal cancer (CRC). A case-control study including 388 controls and 387 patients with CRC was conducted in a Chinese population. Information about socio-demography and living behavior factors was collected by a structured questionnaire. Three SNPs (rs2133579, rs2269349, rs7641291) in RPSA gene were genotyped by Illumina SnapShot method. Multiple logistic regression models were used for assessing the joint effects between tea consumption and SNPs on CRC. The subjects with rs2269349 CC genotype had a decreased risk for CRC (OR=0.60; 95%CI = 0.37-0.99), compared with TT/CT genotype after adjustment for covariates. A similar association of rs2269349 with rectal cancer was observed (OR=0.49; 95%CI=0.24-1.00). Further analyses indicated that this SNP could modify the protective effect of tea drinking on CRC. Among the subjects with rs2269349 TT/CT or rs2133579 AA/GA, there was a marginal significantly lower risk of CRC (OR and 95%CI: 0.63 and 0.39-1.01 for rs2269349; 0.64 and 0.40-1.02 for rs2133579) in tea-drinking subjects in comparison to non-tea-drinking subjects. Mutants in the RPSA gene might be associated with genetic susceptibility to CRC and influence the protective effect of tea consumption in the Chinese population.

• Korean Journal of Psychosomatic Medicine
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• v.20 no.2
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• pp.91-97
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• 2012

Objectives : With the increase in cancer prevalence, the health behavior of cancer survivors has become an important issue. This study was conducted to examine the psychosocial correlates of behavior changes after cancer diagnosis. Methods : 95 patients completed questionnaires assessing depression, anxiety, insomnia, posttraumatic stress symptoms, social constraints, personal beliefs about cancer cause and health-related behavior changes after cancer diagnosis. Results : In the multiple logistic regression analysis, insomnia was the only significant predictor of positive change in physical behavior : normal sleep group(Odds ratio=9.462, 95% CI 1.738-51.509) and subthreshold insomnia group(Odds ratio=10.529, 95% CI 1.701-65.161) showed a larger increase compared to the insomnia group. In psychosocial behavior, low age, religion and causal belief in hormonal factors were independent factors that predicted increase in positive change. Conclusions : This study showed a difference between predictors of physical and psychosocial health behavior change after breast cancer diagnosis. Multi-faceted approaches are required to promote positive change in health behavior in cancer patients.

• The Korean Journal of Physiology and Pharmacology
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• v.12 no.2
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• pp.83-87
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• 2008

The fyn-related kinase (FRK) belongs to the tyrosine kinase family of protein kinases. Recent studies have shown that Frk affects pancreatic beta cell number during embryogenesis and promotes beta cell cytotoxic signals in response to streptozotocin. To investigate the genetic association between FRK polymorphisms and the risk of obesity in Korean population, single nucleotide polymorphisms (SNPs) in the FRK gene region were selected and analyzed. The body mass index (BMI) was calculated, and biochemical data (systolic blood pressure, diastolic blood pressure, hemoglobin A1C, triglyceride, total cholesterol, high density lipoprotein, and low density lipoprotein) of blood sample from each subject were also measured. One hundred fifty five healthy control and 204 overweight/obesity subjects were recruited. Genotype frequencies of six SNPs [rs6568920 (+8391G>A), rs3756772 (+56780A>G), rs3798234 (+75687C>T), rs9384970 (+68506G>A), rs1933739 (+72978G>A), and rs9400883 (+75809A>G)] in the FRK gene were determined by Affymetrix Targeted Genotyping Chip data. According to the classification of Korean Society for the Study of Obesity, control (BMI 18 to < 23) and overweight/obesity (BMI$\geq$23) subjects were recruited. For the analysis of genetic data, EM algorithm, SNPStats, Haploview, HapAnalyzer, SNPAnalyzer, and Helixtree programs were used. Multiple logistic regression analysis (codominant, dominant, and recessive models) was performed. Age and gender as covariates were adjusted. For biochemical data, Student's t test was used. The mean value of BMI in the control and overweigh/obesity groups was 21.1${\pm}$1.2 (mean${\pm}$SD) and 25.6${\pm}$2.0, respectively. All biochemical data of the overweight/obesity group were statistically significance, compared with the control group. Among six SNPs, two linkage disequilibrium (LD) blocks were discovered. One block consisted of rs1933739 and rs9400883, and the other comprised rs3756772 and rs3798234. One SNP (rs9384970, +68506G>A) showed an association with overweight/obesity in the codominant model (p=0.03). Interestingly, the AA genotype distribution in the overweight/obesity group (n=7, 3.5%) was higher than those in the control group (n=1, 0.6%), which is not found in either Japanese or Chinese subjects. Therefore, the AA genotype of rs9384970 may be a risk factor for development of obesity in Korean population. The results suggest that FRK may be associated with overweight/obesity in Korean population.

• Quality Improvement in Health Care
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• v.10 no.2
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• pp.190-203
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• 2003

Background: Dental hygienists are at risk of acquiring infections through exposure to infectious agents. This study explores the frequency of exposure to infectious agents and infection control practices among dental hygienists. Methods: We undertook a cross-sectional survey to examine the exposure to infectious agents and infection control practices among dental hygienists through questionnaire. Data were obtained from 124 dental hygienists attending educational conferences. A multiple logistic regression analysis was conducted to determine the factors that effect infection control practices in relation to age, completion of infection control education, recognition of their own serum hepatitis Ag/Ab status, the number of one day patients, location of clinics, type of clinics, and career years. Result: Of the 124 dental hygienists, 91.7% were exposed to at least one accident such as needle stick injuries during their practices periods. The health screening coverage rate in dental hygienists was 16.5%. The number of one day patients and career years were important in relation to infection control practices among dental hygienists. The adjusted odds ratio estimates for career years were 5.049 times greater(95% Cl 1.238-20.597) for groups with over 4 career years than under 2 career years. That for the number of one day patients were 0.261(95% Cl 0.071-0.955) lower for through 20 up to 30 patients, 0.531(95% Cl 0.102-2.78) lower for through 30 up to 40 patients and 0.498(95% Cl 0.123-2.017) lower for more than 40 patients than under 20 patients. Conclusion: From these results, prevalence of infection control practices among dental hygienists is related to the number of one day patients and career years. Prevention of cross infection and reduction of future transmission should be a priority to dental hygienists for promotion of infection control and further efforts to educate newcomers on infection prevention should be made.

• Journal of Korean Neurosurgical Society
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• v.57 no.5
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• pp.342-349
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• 2015

Background : Higher reperfusion rates have been established with endovascular treatment for acute ischemic stroke patients. There are limited data on the comparative performance of mechanical thrombectomy devices. This study aimed to analyse the efficacy and safety of the stent retriever device (Solitaire stent) by comparing procedure time, angiographic outcome, complication rate and long term clinical outcome with previous chemical thrombolysis and mechanical thrombectomy using penumbra system. Method : A retrospective single-center analysis was undertaken of all consecutive patients who underwent chemical thrombolysis and mechanical thrombectomy using Penumbra or Solitaire stent retriever from March 2009 to March 2014. Baseline characteristics, rate of successful recanalization (modified Thrombolysis in Cerebral Infarction score 2b-3), symptomatic intracerebral hemorrhage, procedure time, mortality and independent functional outcomes ($mRS{\leq}2$) at 3 month were compared across the three method. Results : Our cohort included 164 patients, mechanical thrombectomy using stent retriever device had a significant impact on recanalization rate and functional independence at 3 months. In unadjusted analysis mechanical thrombectomy using Solitaire stent retriever showed higher recanalization rate than Penumbra system and chemical thrombolysis (75% vs. 64.2% vs. 49.4%, p=0.03) and higher rate of functional independence at 3 month (53.1% vs. 37.7% vs. 35.4%, p=0.213). In view of the interrelationships between all predictors of variables associated with a good clinical outcome, when the chemical thrombolysis was used as a reference, in multiple logistic regression analysis, the use of Solitaire stent retriever showed higher odds of independent functional outcome [odds ratio (OR) 2.62, 95% confidence interval (CI) 0.96-7.17; p=0.061] in comparison with penumbra system (OR 1.57, 95% CI 0.63-3.90; p=0.331). Conclusion : Our initial data suggest that mechanical thrombectomy using stent retriever is superior to the mechanical thrombectomy using penumbra system and conventional chemical thrombolysis in achieving higher rates of reperfusion and better outcomes. Randomized clinical trials are needed to establish the actual benefit to specific patient populations.

• Nutrition Research and Practice
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• v.3 no.3
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• pp.247-252
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• 2009

The present study was to investigate the nutritional status and factors related to malnutrition in end-stage renal disease (ESRD) patients requiring hemodialysis (HD) in South Korea. Subjects were ESRD outpatients from general hospitals or HD centers in Seoul referred to the dialysis clinic for maintenance HD care. A total of 110 patients (46 men and 64 women; mean ages $58.6{\pm}1.0y$) were eligible for this study. The family history of chronic renal failure (CRF) was considered positive if a patient reported having either a first-degree or second-degree relative with CRF. Malnutrition was defined as a triceps skinfold thickness or mid-ann muscle circumference below the fifth percentile for age and sex and forty-seven of the 110 patients were malnourished. Almost all (94%) patients had anemia (hemoglobin: <13 g/dL for men and <12 g/dL for women). Energy intake was below the recommended intake levels of energy [30-35 kcal/kg ideal body weight (IBW)] and protein (1.2 g/kg IBW) in 60% of patients. The duration of HD was longer in malnourished HD patients (P=0.0095). Malnutrition was more prevalent in women (P=0.0014), those who never smoked (P=0.0007), nondiabetic patients (P=0.0113), and patients with bone diseases (P=0.0427), adequate HD (spKt/$V{\geq}1.2$) (P=0.0178), and those with a family history of CRF (P=0.0255). Multiple logistic regression was used to examine the relationship between malnutrition and potential risk factors. After adjusting for age, sex, and other putative risk factors for malnutrition, the OR for malnutrition was greater in HD patients with a family history of CRF (OR, 3.290; 95% CI, $1.003{sim}10.793$). Active nutrition monitoring is needed to improve the nutritional status of HD patients. A family history of CRF may be an independent risk factor for malnutrition in Korean HD patients. A follow-up study is needed to investigate whether there is a causal relationship between a family history of CRF and malnutrition in Korean ESRD patients.

• The Journal of the Korea Contents Association
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• v.18 no.5
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• pp.230-240
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• 2018

The objective of this study is to observe the exclusive breastfeeding(EBF) rate and to identify factors which influence EBF by postpartum period. The data were obtained from the 2015 National Fertility Survey, Family Health and Welfare in Korea, and secondary data analysis were employed for 1,839 mothers who gave birth to baby between January 2013 and February 2015. Data were analyzed using SPSS 25.0 program with descriptive statistics, chi-square test and multiple logistic regression. The EBF rate at the 1st and 6th month of postpartum were 54.0%, 9.4% respectively. The significant influencing factors on the EBF at the 1st month of postpartum were age of mother, baby's birth rank, type of delivery, breastfeeding within 1 hour after delivery. The significant influencing factors on the EBF at the 6th month of postpartum were age of mother, living area, EBF in the first month. We found that the influencing factors on EBF differed by postpartum period. In order to improving the rate of EBF, it is recommended that taioed interventions is needed considering the factors affecting the EBF by postpartum period.