• Journal of the Korea Academia-Industrial cooperation Society
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• v.20 no.7
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• pp.36-44
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• 2019

Swallowing impairment is a frequent complication following stroke. The characteristics of swallowing impairment with stork patient can facilitate identification of individuals at risk of dysphagia would be of great helpful. The present study examined oropharyngeal swallowing impairment with subacute stroke patients using the Modified Barium Swallowing Impairment Profile(MBSImP). The 49 consecutive patients with the supratentorial stroke met inclusion criteria for the present study. A retrospective review was performed of patients who underwent the videofluoroscopic swallowing study(VFSS). Of Stroke patients, 95.9% exhibited abnormal function of lip closure. 98% and 57.1 % shown abnormal tongue function and lingual motion, respectively. Oral residue was present in 51% and delayed pharyngeal response was present in 89.9%. In addition, abnormal laryngeal and hyoid excursion was seen in 42.9% and 87.8%, respectively. Abnormal function of soft palate elevation was present in 18.4% and abnormal epiglottic movement was seen in 4.1%. 30.6% of 30.6% of these patients exhibited abnormal laryngeal closure. All of the stroke patients(100%) in this study exhibited abnormal pharyngeal stripping wave and pharyngoesophageal segment opening. Abnormal tongue base retraction and oral reside were present 91.8%, respectively. The results suggest that stroke patient is more likely to exhibit reduced swallowing functions including lip closure, tongue control, initiation of pharyngeal swallow, anterior hyoid motion, tongue base retraction, pharyngeal residue and pharyngoesophageal contraction. Therefore, these data could provide valid and precise information regarding physiological evidence to delineate symptoms of dysphagia in this stroke cohort. Future studies should explore the bolus effect in the swallowing impairment.

• Korean Journal of Community Nutrition
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• v.26 no.4
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• pp.280-295
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• 2021

Objectives: This study aimed to examine the characteristics of patients according to their nutritional status as assessed by five nutritional screening tools: Patient-Generated Subjective Global Assessment (PG-SGA), NUTRISCORE, Nutritional Risk Index (NRI), Prognostic Nutritional Index (PNI), and Controlling Nutritional Status (CONUT) and to compare the agreement, sensitivity, and specificity of these tools. Methods: A total of 952 gastric cancer patients who underwent gastrectomy and chemotherapy from January 2009 to December 2012 at the Samsung Medical Center were included. We categorized patients into malnourished and normal according to the five nutritional screening tools 1 month after surgery and compared their characteristics. We also calculated the Spearman partial correlation, Cohen's Kappa coefficient, the area under the curve (AUC), sensitivity, and specificity of each pair of screening tools. Results: We observed 86.24% malnutrition based on the PG-SGA and 85.82% based on the NUTRISCORE among gastric cancer patients in our study. When we applied NRI or CONUT, however, the malnutrition levels were less than 30%. Patients with malnutrition as assessed by the PG-SGA, NUTRISCORE, or NRI had lower intakes of energy and protein compared to normal patients. When NRI, PNI, or CONUT were used to identify malnutrition, lower levels of albumin, hemoglobin, total lymphocyte count, total cholesterol, and longer postoperative hospital stays were observed among patients with malnutrition compared to those without malnutrition. We found relatively high agreement between PG-SGA and NUTRISCORE; sensitivity was 90.86% and AUC was 0.78. When we compared NRI and PNI, sensitivity was 99.64% and AUC was 0.97. AUC ranged from 0.50 to 0.67 for comparisons between CONUT and each of the other nutritional screening tools. Conclusions: Our study suggests that PG-SGA and NRI have a relatively high agreement with the NUTRISCORE and PNI, respectively. Further cohort studies are needed to examine whether the nutritional status assessed by PG-SGA, NUTRISCORE, NRI, PNI, and CONUT predicts the gastric cancer prognosis.

• Korean Journal of Community Nutrition
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• v.27 no.3
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• pp.205-222
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• 2022

Objectives: This study examined the characteristics of patients according to nutritional status assessed by five nutritional screening tools: Patient-Generated Subjective Global Assessment (PG-SGA), NUTRISCORE, Nutritional Risk Index (NRI), Prognostic Nutritional Index (PNI), and Controlling Nutritional Status (CONUT) and to compare the agreement, sensitivity, and specificity of these tools. Methods: A total of 952 gastric cancer patients who underwent gastrectomy and chemotherapy from January 2009 to December 2012 were included. The patients were categorized into malnutrition and normal status according to five nutritional screening tools one month after surgery. The Spearman partial correlation, Cohen's Kappa coefficient, the area under the curve (AUC), sensitivity, and specificity of each two screening tools were calculated. Results: Malnutrition was observed in 86.24% of patients based on the PG-SGA and 85.82% based on the NUTRISCORE. When NRI or CONUT were applied, the proportions of malnutrition were < 30%. Patients with malnutrition had lower intakes of energy and protein than normal patients when assessed using the PG-SGA, NUTRISCORE, or NRI. Lower levels of albumin, hemoglobin, total lymphocyte count, and total cholesterol and longer postoperative hospital stays were observed among patients with malnutrition compared to normal patients when NRI, PNI, or CONUT were applied. Relatively high agreement for NUTRISCORE relative to PG-SGA was found; the sensitivity was 90.86%, and the AUC was 0.78. When NRI, PNI, and CONUT were compared, the sensitivities were 23.72% for PNI relative to NRI, 44.53% for CONUT relative to NRI, and 90.91% for CONUT relative to PNI. The AUCs were 0.95 for NRI relative to PNI and 0.91 for CONUT relative to PNI. Conclusions: NUTRISCORE had a high sensitivity compared to PG-SGA, and CONUT had a high sensitivity compared to PNI. NRI had a high specificity compared to PNI. This relatively high sensitivity and specificity resulted in 77.00% agreement between PNI and CONUT and 77.94% agreement between NRI and PNI. Further cohort studies will be needed to determine if the nutritional status assessed by PG-SGA, NUTRISCORE, NRI, PNI, and CONUT predicts the gastric cancer prognosis.

• Journal of Periodontal and Implant Science
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• v.50 no.6
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• pp.368-378
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• 2020

Purpose: Vitamin D deficiency may cause bone loss and increased inflammation, which are well-known symptoms of periodontal disease. This study investigated whether serum 25-hydroxyvitamin D (25(OH)D) levels are associated with periodontal disease status and tooth loss. Methods: Cross-sectional data from 5,405 individuals aged ≥50 years (2,253 males and 3,152 females) were obtained from the 2008-2010 Dong-gu study, a prospective cohort study of risk factors for chronic diseases. Periodontal examinations were conducted to evaluate the number of remaining teeth, the periodontal probing depth (PPD), the clinical attachment level (CAL), and bleeding on probing. The percentages of sites with PPD ≥4 mm and CAL ≥4 mm were recorded for each participant. The severity of periodontitis was classified using the Centers for Disease Control and Prevention and the American Academy of Periodontology case definitions. Serum 25(OH)D levels were classified as reflecting severe deficiency, deficiency, insufficiency, or sufficiency. Multivariate linear regression analysis was performed to assess the associations of serum 25(OH)D levels with periodontal parameters and the number of remaining teeth after adjusting for confounders including age, smoking status, alcohol consumption status, month of blood collection, and physical activity. Multivariate logistic regression was used to evaluate the association between serum vitamin D levels and severe periodontitis. An overall statistical analysis and a stratified analysis by sex were performed. Results: Overall, the rates of severe deficiency, deficiency, insufficiency, and sufficiency were 6.5%, 67.9%, 22.4%, and 3.2%, respectively. After adjustment for confounders, vitamin D levels were directly associated with the number of remaining teeth, an association that was significant in males, but not in females. Sufficient serum 25(OH)D was associated with a low frequency of severe periodontitis. Conclusions: This population-based cross-sectional study indicates that low serum 25(OH) D is significantly associated with tooth loss and severe periodontitis in Koreans aged 50 years and older.

• Journal of Veterinary Clinics
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• v.39 no.6
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• pp.326-333
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• 2022

The purpose of this study was to evaluate the radiographic positioning techniques used in local animal hospitals, identify the most common positioning problem, and determine whether there were changes after teleradiology consultations. From September 2016 to April 2021, 15 local animal hospitals that requested radiographic interpretation more than 10 times and for more than six cases of thoracic radiographs were selected. Six sets of two-views of (lateral and ventrodorsal [VD] or dorsoventral [DV] views) digital thoracic radiographs from six dogs per hospital were evaluated in four categories. For the lateral view, radiographic technique scores used in ten local animal hospitals improved, one remained the same, and four became worse. For the VD/DV view, the score for eleven hospitals improved and worsened for four. The most common problem was rotation (57/90) for the lateral view, followed by an inappropriate field of view (59/90), and incorrect beam center (71/90). For the VD/DV view, an inappropriate field of view (54/90) was the most common problem, followed by asymmetry (63/90), and incorrect beam center (73/90). Every factor, except rotation in the lateral view, improved after obtaining technical consultation; however, the degrees of improvement were not remarkable. There was no significant correlation between the number of requests and the degree of improvement. According to the results, the radiographic technique used in local animal hospitals was improved by technical advice on teleradiology. These changes make it possible to provide accurate diagnoses of the requested images. There are some limitations regarding the indicators of evaluation and the number of cases; therefore, further studies that use detailed indicators in large cohort group are needed. In addition, an effective method of teaching should be developed to improve radiographic techniques in local animal hospitals.

• Journal of Korea Society of Industrial Information Systems
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• v.28 no.2
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• pp.1-9
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• 2023

Research using AI and big data is also being actively conducted in the health and medical fields such as disease diagnosis and treatment. Most of the existing research data used cohort data from research institutes or some patient data. In this paper, the difference in the prediction rate of survival and the factors affecting survival between breast cancer patients in their 40~50s and other age groups was revealed using health insurance review claim data held by the HIRA. As a result, the accuracy of predicting patients' survival was 0.93 on average in their 40~50s, higher than 0.86 in their 60~80s. In terms of that factor, the number of treatments was high for those in their 40~50s, and age was high for those in their 60~80s. Performance comparison with previous studies, the average precision was 0.90, which was higher than 0.81 of the existing paper. As a result of performance comparison by applied algorithm, the overall average precision of Decision Tree, Random Forest, and Gradient Boosting was 0.90, and the recall was 1.0, and the precision of multi-layer perceptrons was 0.89, and the recall was 1.0. I hope that more research will be conducted using machine learning automation(Auto ML) tools for non-professionals to enhance the use of the value for health insurance review claim data held by the HIRA.

• The Journal of the Society of Stroke on Korean Medicine
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• v.9 no.1
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• pp.25-32
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• 2008

Objectives : Metabolic syndrome (MetS) is associated with increasing risk of cardiovascular morbidity and mortality but the risk of stroke associated with the MetS is less well established. The objective of this study was to evaluate the prevalence of MetS in stroke patients. Methods : We analyzed the data of 806 patients with acute ischemic stroke from Hanbang Stroke Registry supported by the Ministry of Science and Technology of Korea. Subjects' enrollment was done in the oriental medical hospitals of 4 universities located in the metropolitan region from April 2007 to August 2008. We analyzed all registered data and evaluated the prevalence of MetS and specific components of MetS. Results : The prevalence of MetS in stroke patients according to American Heart Association/National Heart Lung and Blood Institute (AHA/NHLBI) criteria was 59.6%. The prevalence according to the International Diabetes Federation (IDF) criteria was 41.6%. The prevalence of female patients was higher than that of male patients (71.8% vs 51% by AHA/NHLBI criteria; 61.7% vs 27.7% by IDF criteria). The prevalence of central obesity, low HDL cholesterol and hypertension was higher in female patients. There was no significant relationship between MetS and stroke subtype. Conclusions : This work gives us the basic data on the association between MetS and risk of stroke. There should be the prospective cohort studies to evaluate MetS and the risk of stroke.

• The Journal of the Society of Stroke on Korean Medicine
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• v.7 no.1
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• pp.46-53
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• 2006

Objectives : The purposes of this study were to investigate that a blepharospasm means the presymptom of stroke based on the traditional hypothesis in the oriental medicine and to compare a blepharospasm with warning signs of stroke in the western medicine. Methods : In the time period Oct. 2005 to Oct. 2006, 409 patients with a first-ever stroke admitted in the department of Internal Medicine of Kyungwon University In-cheon Oriental Medical Hospital, Kyunghee University Oriental Medical Hospital, Dongguk Il-san Oriental Medical Hospital were included. Patients were hospitalized within 14 days after the onset of stroke. Stroke patients were interviewed by residents who studied standard operation procedures in Fundamental Study for Standardization and Objectification of Differentiation and Pattern Identification of Syndrome of Oriental Medicine for Stroke. A questionnaire was completed by a question-and-answer form between patients and residents after explanation details to patients and the agreement of patients. Results : Age, care of patients or grandson, diabetes mellitus, and smoking were higher among cerebral infarction group, while smoking was higher among hemorrhage group. Female, young age, hyperlipidemia, hypertension in the family history and fat body in waist-hip ratio were higher among patients undergoing the blepharospasm before stroke onset. And the incidence of blepharospasm was lower in patients who dislike the fast food. Finally, when we compared a blepharospasm with warning signs of stroke in the western medicine, the incidence of blepharospasm in this study were the most frequent. Conclusion : In this study, the incidence of blepharospasm in patients before stroke onset was more frequent than that of warning signs in the western medicine. But more data from prospective cohort studies should be collected to be accepted that the blepharospasm is the presymptom of stroke as like warning signs in the western medicine.

• The Journal of the Korea Contents Association
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• v.22 no.8
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• pp.671-680
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• 2022

This study evaluated the consistency between the web-based and paper-based mibyeong and cold-heat pattern questionnaire, the Korean medicine-based tool for diagnosing and classifying health status. First, a web-based survey was conducted on 72 ordinary people; subsequently, a paper-based survey was conducted after a certain time interval. The equivalence between the web-based and paper-based surveys was evaluated on the basis of the consistency between scores using the Intraclass Correlation Coefficient (ICC) and Bland-Altman methodology. The mibyeong questionnaire showed high reliability for the web-based and paper-based surveys (ICC=0.95, 95% CI 0.92 - 0.97), and the cold-heat pattern questionnaire showed high reliability for both cold syndrome (ICC=0.98, 95% CI 0.96 - 0.99) and heat syndrome (ICC=0.9, 95% CI 0.83 - 0.93). The difference in average scores between the two survey methods was -0.25 for the mibyeong survey, -0.17 for the cold syndrome, and 0.11 for the heat syndrome, showing a similar pattern. Among the respondents, 84% showed positive satisfaction with the web-based survey, and 80% preferred the web-based survey. Overall, this study confirmed the reliability and feasibility of the web-based survey methods for the mibyeong and cold-heat pattern questionnaire. This could be a useful tool for the follow-up of subjects in long-term cohort studies.

• Korean Journal of Culture and Social Issue
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• v.22 no.1
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• pp.65-85
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• 2016

In this study, we examined the longitudinal change of multicultural acceptability, peer relationship, and teacher relationship using latent growth curve modeling. This study used data from the second, third, and fourth waves of the middle school student cohort (N=2,178) of the Korean Children-Youth Panel Survey (KCYPS). The dependent variable was multicultural acceptability. The independent variables were peer relationship and teacher relationship. The major longitudinal findings of this study are as follows: First, peer relationships, teacher relationships and multicultural acceptability increased with time. Second, peer relationship showed a significant effect on the multicultural acceptability over time. Finally, the teacher relationship showed a significant effect on the multicultural acceptability over time. These results show differentiation with previous cross-sectional studies of multicultural acceptability. Furthermore, it is expected that this study will provide educational implications for the cultivation of multicultural acceptability.