• Asian Pacific Journal of Cancer Prevention
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• v.15 no.2
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• pp.925-928
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• 2014

Background: Gestational trophoblastic neoplasia (GTN) is a spectrum of disease with abnormal trophoblastic proliferation. Treatment is based on FIGO stage and WHO risk factor scores. Patients whose score is 12 or more are considered as at extremely high risk with a high likelihood of resistance to first line treatment. Optimal therapy is therefore controversial. Objective: This study was conducted in order to summarize the regimen used for extremely high risk or resistant GTN patients in our institution the in past 10 years. Materials and Methods: All the charts of GTN patients classified as extremely high risk, recurrent or resistant during 1 January 2002 to 31 December 2011 were reviewed. Criteria for diagnosis of GTN were also assessed to confirm the diagnosis. FIGO stage and WHO risk prognostic score were also re-calculated to ensure the accuracy of the information. Patient characteristics were reviewed in the aspects of age, weight, height, BMI, presenting symptoms, metastatic area, lesions, FIGO stage, WHO risk factor score, serum hCG level, treatment regimen, adjuvant treatments, side effects and response to treatment, including disease free survival. Results: Eight patients meeting the criteria of extremely high risk or resistant GTN were included in this review. Mean age was 33.6 years (SD=13.5, range 17-53). Of the total, 3 were stage III (37.5%) and 5 were stage IV (62.5%). Mean duration from previous pregnancies to GTN was 17.6 months (SD 9.9). Mean serum hCG level was 864,589 mIU/ml (SD 98,151). Presenting symptoms of the patients were various such as hemoptysis, abdominal pain, headache, heavy vaginal bleeding and stroke. The most commonly used first line chemotherapeutic regimen in our institution was the VAC regimen which was given to 4 of 8 patients in this study. The most common second line chemotherapy was EMACO. Adjuvant radiation was given to most of the patients who had brain metastasis. Most of the patients have to delay chemotherapy for 1-2 weeks due to grade 2-3 leukopenia and require G-CSF to rescue from neutropenia. Five form 8 patients were still survived. Mean of disease free survival was 20.4 months. Two patients died of the disease, while another one patient died from sepsis of pressure sore wound. None of surviving patients developed recurrence of disease after complete treatment. Conclusions: In extremely high risk GTN patients, main treatment is multi-agent chemotherapy. In our institution, we usually use VAC as a first line treatment of high risk GTN, but since resistance is quite common, this may not suitable for extremely high risk GTN patients. The most commonly used second line multi-agent chemotherapy in our institution is EMA-CO. Adjuvant brain radiation was administered to most of the patients with brain metastasis in our institution. The survival rate is comparable to previous reviews. Our treatment demonstrated differences from other institutions but the survival is comparable. The limitation of this review is the number of cases is small due to rarity of the disease. Further trials or multicenter analyses may be considered.

• Tuberculosis and Respiratory Diseases
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• v.87 no.3
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• pp.357-367
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• 2024

Background: Obstructive sleep apnea (OSA) is a prevalent sleep disorder associated with various health issues. Although some studies have suggested an association between reduced lung function and OSA, this association remains unclear. Our study aimed to explore this relationship using data from a nationally representative population-based survey. Methods: We performed an analysis of data from the 2019 Korea National Health and Nutrition Examination Survey. Our study encompassed 3,675 participants aged 40 years and older. Risk of OSA was assessed using the STOP-Bang (Snoring, Tiredness during daytime, Observed apnea, and high blood Pressure-Body mass index, Age, Neck circumference, Gender) questionnaire and lung function tests were performed using a portable spirometer. Logistic regression analysis was applied to identify the risk factors associated with a high-risk of OSA, defined as a STOP-Bang score of ≥3. Results: Of 3,675 participants, 600 (16.3%) were classified into high-risk OSA group. Participants in the high-risk OSA group were older, had a higher body mass index, and a higher proportion of males and ever-smokers. They also reported lower lung function and quality of life index in various domains along with increased respiratory symptoms. Univariate logistic regression analysis indicated a significant association between impaired lung function and a high-risk of OSA. However, in the multivariable analysis, only chronic cough (odds ratio [OR], 2.413; 95% confidence interval [CI], 1.383 to 4.213) and sputum production (OR, 1.868; 95% CI, 1.166 to 2.992) remained significantly associated with a high OSA risk. Conclusion: Our study suggested that, rather than baseline lung function, chronic cough, and sputum production are more significantly associated with OSA risk.

• Imaging Science in Dentistry
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• v.46 no.3
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• pp.167-171
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• 2016

Purpose: Obstructive sleep apnea (OSA) is a common medical disorder with serious complications if untreated. Dentists play a vital role in the early diagnosis of this condition, thereby improving patients' prognoses. The purpose of this study was to identify patients with a high risk of OSA using simple cephalometric measurements in patients receiving routine dental care. Materials and Methods: The present study was conducted on 206 patients divided into a high-risk group and a control group after answering the Berlin questionnaire. Cephalometric analysis of a digital cephalogram was performed to measure the upper airway diameter (UAD) and mandibular-to-hyoid bone distance (MP-H) by 2 observers at 2 different times. Results: Among 206 patients, 93 (45%) were included in the high-risk group and 113 (55%) were in the control group. No significant difference was present between the groups with regard to gender, and the patients ranged in age from 18 to 65 years. The UAD measurements in the high-risk group were significantly lower than in the control group, and the MP-H measurements were significantly higher in the high-risk group than in the control group. The UAD was lower in middle-aged patients in both groups. Conclusion: Our study found that the UAD was lower in individuals with a high risk of OSA. Also, we found that middle-aged individuals of both genders were more likely to develop OSA. Dentists play a vital role in diagnosing patients at a high risk for OSA via thorough clinical examinations, risk factor analyses, and simple cephalometric analyses.

• Journal of the Society of Disaster Information
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• v.9 no.2
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• pp.178-187
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• 2013

This paper studied the potential risk of high-rise apartment by analysis of the loss ratio of housing fire insurance, statistics related high-rise apartment fire, and the insured amount of housing fire insurance, and, found that it is so high and need the improvement of risk management measures for high-rise apartment. Accordingly, the study recommend the composit risk management measures including preventing of fire expanding for higher stories, a shelter for people of hire-rise apartment, and sprinkler protection, etc. Also as risk transfer measures, the composit risk measures for high-rise apartment includes the full insurance of housing fire insurance, third party property liability insurance, and development of endorsement for special risk such as a typhoon, liability etc.

• Parasites, Hosts and Diseases
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• v.53 no.5
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• pp.605-610
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• 2015

Toxoplasmosis is considered as an important risk factor for bad obstetric history (BOH) and one of the major causes of congenitally acquired infections. The present study aimed to estimate the seropositivity of T. gondii infection and associated risk factors among the attendees of high risk pregnancy and low risk antenatal care clinic of Minia Maternity and Pediatric University Hospital, Minia, Egypt. The study was carried out from April 2013 to April 2014 through 2 phases, the first phase was case-control study, and the second phase was follow-up with intervention. A total of 120 high risk pregnant and 120 normal pregnant females were submitted to clinical examinations, serological screening for anti-Toxoplasma IgM and IgG antibodies by ELISA, and an interview questionnaire. Seropositive cases were subjected to spiramycin course treatment. The results showed that the seroprevalence of toxoplasmosis in high-risk pregnancy group was 50.8%, which was significantly different from that of normal pregnancy group (P<0.05). Analysis of seropositive women in relation to BOH showed that abortion was the commonest form of the pregnancy wastage (56.5%). The high prevalence of T. gondii seropositive cases was observed in the age group of 21-30 years. Post-delivery adverse outcome was observed in 80.3% of high-risk pregnancy group compared to 20% of normal pregnancy group. There was a statistically significant relationship between seropositivity and living in rural area, low socioeconomic level, and undercooked meat consumption (P<0.05). Serological screening for anti-Toxoplasma antibodies should be routine tests especially among high-risk pregnant women.

• Korean Journal of Construction Engineering and Management
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• v.16 no.2
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• pp.38-45
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• 2015

The risk analysis phase of construction risk management process is subdivided into the qualitative risk analysis that plays a major role, and the quantitative risk analysis acting as a supportive role. The traditional calculation method for quantifying a risk value that has been applied so far is an equation to multiply a probability by an impact simply, but its result shows the low risk value biased distribution. Although another equation that shows the high risk biased distribution as an alternative of traditional method was proposed, both of the low or high risk biased equations do not match with the statistical general knowledge that most natural phenomenons are close to the normal distribution. This study proposes a new risk value calculation method that is concentrated to the moderate risk value. Because the risk value distribution by a new method shows a normal shape similar to natural phenomenon, it helps to choose a middle level not biased to the low or high levels when choosing the level of risk response. Furthermore, it could contribute to improve the flexibility and rationality of risk analysis method by providing additional options for the risk value calculation.

• Journal of Korea Water Resources Association
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• v.56 no.7
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• pp.451-460
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• 2023

In this study, the risk of red water and turbid water occurrence was analyzed by classifying it into detachment risk and deposition risk. First, risk factors for red water and turbid water were determined, and hydraulic analysis was conducted considering seasonal water consumption. The applied area was Cheongju City, and the risk analysis was conducted across 13 areas, and the areas with high deposition risk and high detachment risk were selected. The high risk of both detachment and deposition can be judged as an area with a very high probability of causing water quality problems. The areas with the highest deposition risk and detachment risk are the old towns of Nae deok1-dong and Yul1yang-dong, which are the oldest areas in Cheongju City with an age of more than 30 service years of pipe installation. By analyzing the risk of deposition and detachment, it will be possible to strengthen the maintenance function of the water supply network to provide the safe water to citizens and increase their confidence for tap water.

• Journal of Preventive Medicine and Public Health
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• v.49 no.3
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• pp.143-152
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• 2016

Objectives: Metabolic syndrome is a cluster of risk factors for type 2 diabetes mellitus and cardiovascular disease. Associations between metabolic syndrome and several types of cancer have recently been documented. Methods: We analyzed the sample cohort data from the Korean National Health Insurance Service from 2002, with a follow-up period extending to 2013. The cohort data included 99 565 individuals who participated in the health examination program and whose data were therefore present in the cohort database. The metabolic risk profile of each participant was assessed based on obesity, high serum glucose and total cholesterol levels, and high blood pressure. The occurrence of cancer was identified using Korean National Health Insurance claims data. Hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated using Cox proportional hazards models, adjusting for age group, smoking status, alcohol intake, and regular exercise. Results: A total of 5937 cases of cancer occurred during a mean follow-up period of 10.4 years. In men with a high-risk metabolic profile, the risk of colon cancer was elevated (HR, 1.40; 95% CI, 1.14 to 1.71). In women, a high-risk metabolic profile was associated with a significantly increased risk of gallbladder and biliary tract cancer (HR, 2.05; 95% CI, 1.24 to 3.42). Non-significantly increased risks were observed in men for pharynx, larynx, rectum, and kidney cancer, and in women for colon, liver, breast, and ovarian cancer. Conclusions: The findings of this study support the previously suggested association between metabolic syndrome and the risk of several cancers. A high-risk metabolic profile may be an important risk factor for colon cancer in Korean men and gallbladder and biliary tract cancer in Korean women.

• Korean Parent-Child Health Journal
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• v.9 no.2
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• pp.116-127
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• 2006

Purpose: Assessment of mothers' neonatal perception is important in understanding early mothering experiences and in planning future care. The purpose of this study was to identify the differences of mothers' perception and caring-confidence between normal and high-risk newborn during the early postpartum period. The ultimate goal was to contribute to healthy mother-infant relationship and development of infants. Method: The data was collected for this study at one university hospital in Daejeon from May 13, 2005 to December 20, 2005. The subjects were 53 of mothers who had normal newborn and 46 of mothers who had high-risk newborn. The instrument was the 'Neonatal Perception Inventory' by revised Ja-Hyung, Lee (1986), and the 'Caring-Confidence Scale' by revised Hyun-Joo, Oh(2000). The data were statistically analyzed by using an SPSS program and include percentage, mean, SD, t-test. Result: There were significant differences in the perception of the newborn between the mothers of normal newborn and the mothers of high-risk newborn (p<.05). There were no significant differences in the perception pattern of the newborn between the mothers of normal newborn and the mothers of high-risk newborn. There were no significant differences in the caring-confidence between the mothers of normal newborn and the mothers of high-risk newborn. Conclusion: The nursing care in the nursery have needed to various interventions for normal and high-risk newborn mothers in order to improve the interaction and caring-confidence between mother and newborn.

• Anxiety and mood
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• v.14 no.2
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• pp.106-111
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• 2018

Objective : High-risk pregnant women are exposed to the physical and emotional crisis associate with the condition of high-risk pregnancy, making these women emotionally unstable, exhibiting such conditions as depression and anxiety. The aim of this study was to examine what effects the temperament and character of high-risk pregnant women had on their depression, anxiety, and maternal-fetal attachment. Methods : A hundred and five high-risk pregnant women were recruited in the maternity ward of the Keimyung University medical center. All subjects were administered a sociodemographic and obstetric questionnaire, Temperament and Character Inventory, Beck Depression Inventory-II, State Trait Anxiety Inventory-State, and Maternal-Fetal Attachment Scale. Results : First, higher scores on the harm-avoidance scale and lower scores on the self-directedness scale were associated with higher depression scores. Second, higher scores on the harm-avoidance and reward-dependence scale were associated with higher anxiety scores. Lastly, higher scores on the cooperativeness scale were associated with higher maternal-fetal attachment scores. Conclusion : Temperament and character in high-risk pregnant women were associated with the degree of depression, anxiety, maternal-fetal attachment. Based on these findings, it is suggested that examining temperament and character in advance and screening for vulnerability in pregnant women can help to prevent emotional problems for high-risk pregnant women.