• Asian Pacific Journal of Cancer Prevention
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• v.13 no.1
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• pp.211-216
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• 2012

Background: Patients' demographics, presenting clinical and histopathological features for colo-rectal cancer (CRC) are important factors for patients' outcome and disease prognosis. This study aimed to describe the pattern of CRC in terms of patients' demographics, main presenting symptoms and histopathological features in Al Hassa region of Saudi Arabia. Subjects and Methods: A retrospective hospital records-based study which included reviewing of patients' records diagnosed with CRC at three general hospitals in Al Hassa region, Saudi Arabia. A compilation form was designed to collect information regarding socio-demographics, age at diagnosis; referral sites and the main presentations at CRC diagnosis. sites and the main presentations at CRC diagnosis. Histopathological reports were reviewed to delineate the main cytopathologic features, prominent cytological characteristics, the presence of predisposing pathology, and disease stage. Results: Of the 142 cases with CRC, 15.5% and 33.1% were affected before 40 and 50 years of age respectively. Emergency rooms were main referral sites for CRC cases (31.0%). Right colon was affected in 16.9% while left colonic lesions accounted for 62.7%. Intestinal obstruction was the main presentations (41.5%), and 26.1% presented with symptoms indicating distant metastastic lesions. Adenocarcinoma was the predominant pathological lesions (86.6%). Metastastic CRC was diagnosed in 62.7%. Duke's staging showed that 22.5% and 40.1% of lesions were classified into C and D categories respectively. Conclusion: Saudi patients with CRC present late with distant metastasis, and advanced disease stage. A sizeable proportion of patients developed the lesions at relatively young age. Screening recommendations should be enacted and revised in response to current change with younger age of affection.

• Korean Journal of Clinical Pharmacy
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• v.25 no.4
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• pp.273-279
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• 2015

Objective: Codeine may result in death or respiratory depression in children, particularly who are rapid metabolizer of CYP2D6, therefore it should be used cautiously among children under 12 years of age. This study was to investigate the prescribing pattern of codeine among children according to the age group, prescribed diagnosis, type of medical service and medical specialties. Method: We used Korea Health Insurance Review and Assessment Service-National Patient Sample (HIRA-NPS) database. Study subjects included inpatients or outpatients, who were prescribed codeine between January, 1, 2011 and December, 31, 2011. Contraindicated use of codeine was defined as the use of codeine at least one times under aged 12. Age groups were subclassified according to the <2 years, 2-4 years, 5-8 years, and 9-11 years. Frequently prescribed diagnosis (ICD-10), type of medical service, and medical specialties were also described among codeine users under aged 12. Results: Codeine users were 6,411 inpatients (9,958 prescriptions), and 3,397 outpatients (6,258 prescriptions), respectively. Codeine prescription under 12 years of age were 2.1% (210 prescriptions) among inpatients, and 12.3% (776 prescriptions) among outpatients (p-value<0.05). Outpatient prescriptions of codeine under 12 aged were issued mostly from primary care clinics and frequent diagnosis were unspecified bronchopneumonia (51.6%), and vasomotor rhinitis (23.7%). Conclusion: This study found prescribing of codeine under 12 aged is common in outpatient and primary clinics. Nationwide and community-based efforts should be needed to reduce inappropriate prescribing among children.

• Health Policy and Management
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• v.23 no.1
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• pp.44-51
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• 2013

Background: This study designed to evaluate the homogeneity of Korean diagnosis related group (KDRG) version 3.4 classification system. Methods: The total 5,921,873 claims data submitted to the Health Insurance Review and Assessment Service during 2010 were used. Both coefficient of variation (CV) and reduction in variance of cost were measured for evaluation. This analysis was divided into before and after trimming outliers at the level of adjacent DRG (ADRG), aged ADRG (AADRG) split by age, and DRG split by complication and comorbidity. Results: At the each three level of ADRG, AADRG, and DRG, there were 38.9%, 38.7%, and 30.0% of which had a CV > 100% in the untrimmed data and there were 1.4%, 1.4%, and 1.9% in the trimmed one. Before trimming outliers, ADRGs explained 52.5% of the variability in resource use, AADRGs did 53.1% and DRGs did 57.1%. The additional explanatory power by age and comorbidity and complication (CC) split were 0.6%p and 4.6%p for each, which were statistically significant. After trimming outliers, ADRGs explained 75.2% of the variability in resource use, AADRGs did 75.6%, and DRGs did 77.1%. The additional explanatory power were 0.4%p and 2.0%p for each, which were statistically significant too. Conclusion: The results demonstrated that KDRG showed high homogeneity within groups and performance after trimming outliers. But there were DRGs CV > 100% after age or CC split and the most contributing factor to high performance of KDRG was the ADRG rather than age or CC split. Therefore, it is recommended that the efforts for improving clinical homogeneity of KDRG such as review of the hierarchical structure of classification systems and classification variables.

• Asian Pacific Journal of Cancer Prevention
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• v.13 no.8
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• pp.3809-3813
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• 2012

Background and Objectives: Colorectal cancer (CRC) is a major health problem in the Kingdom of Saudi Arabia (KSA). Our aim was to characterize the epidemiology of CRC in the Saudi population. Design and Setting: Retrospective analysis of all cases of CRC recorded in the Saudi Cancer Registry (SCR) between January 2001 and December 2006 amongst Saudi citizens in KSA. Patients and Methods: Data were retrieved from the database of the SCR. Descriptive statistics was performed using SPSS. Results: A total of 4,201 cases of CRC were registered in the SCR. The incidence of CRC increased between 2001 and 2006. The mean age of patients at the time of diagnosis was 58 years; most patients were above 45 years of age (n=3322; 79.1%). At the time of diagnosis, 977 patients (23.0%) presented with localized disease and 1,018 (24.0%) had distant metastasis. The most frequent pathological variant was adenocarcinoma (73%), with grade 2 (moderately differentiated) being the most common grade among all variants (61%). For all cancer grades, the frequency of CRC was significantly higher among patients >45 years (P=0.004), who presented with more advanced disease (stages III and IV) (P=0.012). Based on logistic regression, age >45 years was associated with advanced regional presentation (P=0.001). Tumor grade was associated with advanced regional presentation and metastasis. Conclusions: There was an increase in the incidence of CRC between 2001 and 2006. The age at the time of diagnosis was low when compared with reports from developed countries. A nationwide approach is needed to encourage and illustrate the importance of screening programs.

• Journal of information and communication convergence engineering
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• v.21 no.4
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• pp.281-286
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• 2023

Diagnosing reading disorders involves complex procedures to evaluate complex cognitive processes. For an accurate diagnosis, a series of tests and evaluations by human experts are required. In this study, we propose a quantitative tool to diagnose reading disorders based on natural reading behaviors using minimal human input. The eye movements of the third- and fourth-grade students were recorded while they read a text at their own pace. Seven machine learning models were used to evaluate the gaze patterns of the words in the presented text and classify the students as normal or having a reading disorder. The accuracy of the machine learning-based diagnosis was measured using the diagnosis by human experts as the ground truth. The highest accuracy of 0.8 was achieved by the support vector machine and random forest classifiers. This result demonstrated that machine learning-based automated diagnosis could substitute for the traditional diagnosis of reading disorders and enable large-scale screening for students at an early age.

• Journal of the Korean society of biological therapies in psychiatry
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• v.24 no.3
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• pp.202-208
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• 2018

Objectives : The purpose of this study was to investigate the differences in forensic demographic characteristics, interpersonal problems and personality disorder between early and late onset criminal patients with schizophrenia. Methods : The participants included 187 inpatients with schizophrenia who had committed crimes. They filled out the Korean Inventory of Interpersonal Problem Personality Disorder Scales and Psychopathic Personality Inventory-Revised. They were divided into early onset group and late onset group according to onset age of schizophrenia at 26 years old(under 26 versus 26 and older) and forensic demographic characteristics, interpersonal problem and personality disorders including psychopathy were compared between two groups. Results : There were no differences in gender, education years and family history between the two groups. Early onset group was associated with lower age, earlier onset of age and earlier age at the time of the crime. Duration from onset to diagnosis was not different between the two groups. Duration from onset to crime and after diagnosis to crime was shorter in late onset group. There were no differences between the two groups in the interpersonal problems, personality disorder and psychopathic personality evaluation. Conclusion : These results suggested that there may be forensic demographic differences related to crime between early and later onset schizophrenia. Psychiatrists should consider the age at onset of schizophrenia when assessing the risk of violence in patients with schizophrenia. In the future. it will be needed other study of age classification such as admixture analysis.

• Korean Journal of Veterinary Research
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• v.34 no.3
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• pp.537-547
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• 1994

Ninety seven cases of histopathologically diagnosed spontaneous canine parvovirus enteritis(CPE) were studied gross pathologically, histopathologically, immunohistochemically, to investigate histopathological types of small intestinal lesions, and antigen distributions in each pattern related to the infected age. And also, reliability of histopathological method in diagnosis of CPE was inspected with immunohistochemistry. The results were as follows : 1. Age-related occurring ratio in histopathologically diagnosed CPE was 53.6% in 4-8 weeks, 26.8% in 9-15 weeks, 8.25 in 16-19 weeks and 11.3% in 20-45 weeks of the clog age. 2. In histopathologic classification based on patterns of villi/crypts lesions of small intestine(jejunum), the ratio of A type (initial phase of necrosis of crypt epithelia, desquamated epithelial cells in the dilated lumen of the crypt) was 20.6%; the ratio of B type(middle phase of atrophy and fission of the villi, collapse of the mucosa, loss of normal crypt structure) was 62.9%, and C type(regenerative phase of the crypt architecture) was 16.5%. 3. The ratio of A, B, C type in 4-8 weeks old, respectively, was 23.5%, 61.5%, 15.4%; in 9-15 weeks old was 19.2%, 65.4%, 15.3% in 16-19 weeks old was 25.0%, 75.0%, 0.0%; and in 20-45 weeks old was 9.0%, 54.5%, 36.4%. 4. The antigen distribution in the nuclei of the crypt epithelial cells was higher than of the cytoplasm and numerous desquamated epithelial cells in dialated crypts in A type; The antigen cytoplasm and numerous desquamated epithelial cells in dialated crypts in A type; The antigen distribution in the nuclei of the collapsed crypt epithelial cells was not higher than that of the cytoplasm, crypts were lined by and filled with released viral antigens from the destructed epithelial cells in B type; and its distribution was also higher than in the epithelial cells adjacent to the tips of the villi, but it was not reacted in the regenerative crypt epithelial cells in C type. 5. Immunohistochemically detected antigen ratio in the small intestine of histopathologically diagnosed CPE was 94.6%, and this result indicates that histopathological diagnosis is very reliable method in diagnosis of CPE.

• Health Policy and Management
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• v.3 no.2
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• pp.100-129
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• 1993

This study is designed to find out some intra-clinic factors affecting the content of practice provided by primary care physicians in Korea, and proposed factors in this study are characteristcs of each private clinc --- physician-related variables(age, sex, specialty), bfed-related variables for inpatient care, laboratory-related variables for precise diagnosis. We have tried to estimate the difference of disease entities cared by each primary care physician according to above factors by analyzin gdisease data claimed during one month(April, 1992) to National Federation of Medical Insurance. The diagnosis codes by ICD-9 in the research disease data were reclassified to 'diagnosis clusters' by virtue of clinical similarities for effective analyses. We have converted frequent-tsing ICD-9 codes to 86 diagnosis clusters, which incorporated 97.4 percents of all ambulatory visits to private clinics. This result means proposed diagnosis-cluster method is effective tool for analysis of the content of ambulatory medical care carried out by primary care physicians. Comparisons and analyses of multiple diagnosis-clusters made on the basis of presented factors were done and the results were as follows; - Major factors affecting the difference between diagnosis-cluster pattern by each variables were phyusician's age, sex, specialty and bed counts of each private clinic for inpatient care and the size of laboratories of each clinic. - Middle aged(30th to 40th) group physicians are providing more comprehensive care than 20th or above 50th aged groups. Male physicians are more adequate for comprehensive care than female physicians, because woman-doctors are providing narrow-spectrum care. The content of practice of obstetricians and gynecologists shows much difference from primary medical practice, and they cannot be included in primary care physician, this study suggested. Pediatricians are also providing short-spectum acre, and nearly all visits to pediatricians were incorporated only 2-3 diagnosis-clusters. General surgeons' practices are very similar to general practioners' or family physicians' practices, the means they are providing primary care rather than special surgical care. And small number of beds(under 5 beds) and only basic(2-3 sorts of)diagnostic apparatuses are sufficient for primary physicians' clinic to carry out primary care. In conclusion, to reinforce primary care department in Korea, there must be support with health policy to expand office-based primary care practice-- with small number of beds for inpatient care and only basic laboratories-- provided by general practitioner of family physician.

• Asian Pacific Journal of Cancer Prevention
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• v.13 no.11
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• pp.5525-5528
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• 2012

Introduction: Breast cancer is the most common cancer in women. Improvements of early diagnosis modalities have led to longer survival rates. This study aimed to determine the 5, 10 and 15 year mortality rates of breast cancer patients compared to the normal female population. Materials and Methods: The follow up data of a cohort of 615 breast cancer patients referred to Iranian Breast Cancer Research Center (BCRC) from 1986 to 1996 was considered as reference breast cancer dataset. The dataset was divided into 5 year age groups and the 5, 10 and 15 year probability of death for each group was estimated. The annual mortality rate of Iranian women was obtained from the Death Registry system. Standardized mortality ratios (SMRs) of breast cancer patients were calculated using the ratio of the mortality rate in breast cancer patients over the general female population. Results: The mean age of breast cancer patients at diagnosis time was 45.9 (${\pm}10.5$) years ranging from 24-74. A total of 73, 32 and 2 deaths were recorded at 5, 10 and 15 years, respectively, after diagnosis. The SMRs for breast cancer patients at 5, 10 and 15 year intervals after diagnosis were 6.74 (95% CI, 5.5-8.2), 6.55 (95%CI, 5-8.1) and 1.26 (95%CI, 0.65-2.9), respectively. Conclusion: Results showed that the observed mortality rate of breast cancer patients after 15 years from diagnosis was very similar to expected rates in general female population. This finding would be useful for clinicians and health policy makers to adopt a beneficial strategy to improve breast cancer survival. Further follow-up time with larger sample size and a pooled analysis of survival rates of different centres may shed more light on mortality patterns of breast cancer.

• Journal of Preventive Medicine and Public Health
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• v.53 no.1
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• pp.37-44
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• 2020

Objectives: This study investigated the effects of comorbid sleep disorders (SD) on the incidence of cardiovascular complications among newly-diagnosed hypertension (HTN) patients. Methods: As study population, 124 057 newly-diagnosed essential HTN patients aged 30 or older, without cardiovascular complications at diagnosis with HTN, were selected from the National Health Insurance Service-National Sample Cohort. The incidence of cardiovascular complications was calculated, Cox proportional-hazards regression model was used to analyze the risk of complications, and the population attributable fraction (PAF) for cardiovascular complications of having comorbid SD at HTN diagnosis was calculated. Results: Over 10 years, 32 275 patients (26.0%) developed cardiovascular complications. In HTN patients with comorbid SD at diagnosis of HTN, the incidence of cardiovascular complications (78.3/1000 person-years; 95% confidence interval [CI], 75.8 to 80.9) was higher than in those without comorbid SD (58.6/1000 person-years; 95% CI, 57.9 to 59.3) and the risk of cardiovascular complications was 1.21 times higher (95% CI, 1.17 to 1.25), adjusting for age, gender, income, area of residence, and comorbid diabetes mellitus. The PAF of having comorbid SD at diagnosis of HTN for the incidence of cardiovascular complications was 2.07% (95% CI, 1.69 to 2.44). Conclusions: Newly-diagnosed essential HTN patients aged 30 or older who had comorbid SD at the time of their HTN diagnosis had a higher incidence of cardiovascular complications than those without comorbid SD. Age, gender, income, area of residence, and comorbid diabetes mellitus had a significant effect on the incidence of cardiovascular complications. Approximately 2% of cardiovascular complications were found to occur due to the presence of SD.