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End-stage Renal Disease and Risk of Active Tuberculosis: a Nationwide Population-Based Cohort Study

  • Min, Jinsoo;Kwon, Soon Kil;Jeong, Hye Won;Han, Joung-Ho;Kim, Yeonkook Joseph;Kang, Minseok;Kang, Gilwon
    • Journal of Korean Medical Science
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    • v.33 no.53
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    • pp.341.1-341.11
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    • 2018
  • Background: The converging epidemics of tuberculosis (TB) and end-stage renal disease (ESRD) have generated a significant public health burden, however, previous studies have been limited to a small number of patients. This nationwide cohort study aimed to assess the rate of developing active TB among patients receiving dialysis for ESRD. Methods: The Korean national health insurance database was used to identify patients receiving dialysis for new-onset ESRD during 2004-2013, who were propensity score matched to an equivalent number of non-dialysis subjects from the general population. The incidences of active TB in the ESRD and control cohorts were calculated for 2004-2013, and multivariable Cox proportional hazards model was used to evaluate the ESRD-related risk of active TB. Results: During 2004-2013, 59,584 patients received dialysis for newly diagnosed ESRD. In the dialysis and control cohorts, 457 (0.8%) and 125 (0.2%) cases of active TB were detected, respectively. Patients with ESRD were associated with a significantly higher risk of active TB compared to the controls (incidence rate ratio, 4.80). The ESRD cohort had an independently elevated risk of active TB (adjusted hazard ratio, 4.39; 95% confidence interval, 3.60-5.37). Conclusion: We found that patients receiving dialysis for ESRD had an elevated risk of active TB. These results highlight the need for detailed and well-organised guidelines for active TB screening among patients with ESRD.

Network Analysis of Herbs that are Frequently Prescribed for Osteoporosis with a Focus on Oasis Platform Research (골다공증 다빈도 처방과 구성 약물의 네트워크 분석 - 오아시스 검색을 중심으로)

  • Shin, Seon-mi;Ko, Heung
    • The Journal of Internal Korean Medicine
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    • v.42 no.4
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    • pp.628-644
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    • 2021
  • Objectives: This study analyzed, through network analysis and data mining analysis, the relationship between herbs used in osteoporosis prescriptions, diversified the analysis of osteoporosis-related prescriptions, and analyzed the combination of herbs used in osteoporosis-related prescriptions. Methods: The prescriptions used in osteoporosis treatment and experiments were established by conducting a full survey of the papers published by the OASIS site. A database for osteoporosis-related prescriptions was established, herbs were extracted, and the frequency of frequent herbs and prescriptions were investigated using Excel (MS offices ver. 2013). Using the freeware R version 4.0.3 (2020-10-10), igraph, and arules package, network analysis was performed in the first second of prescription composition. Results: Among the osteoporosis-related prescriptions, the most studied prescriptions are as follows.: Yukmijihwang-tang (六味地黃湯) and Samul-tang (四物湯). In the osteoporosis prescription network, herbs with connection centrality, proximity centrality, mediation centrality, and eigenvector centrality appeared in the order of Rehmanniae Radix Preparata, Angelicae Gigantis Radix, Poria Sclerotium, Paeoniae Radix, and Glycyrrhizae Radix et Rhizoma. After extracting the herbal combination network, including the corresponding herbs, and clustering it, it can be divided into drugs of the Yukmijihwang-tang (六味地黃湯) series and the Samul-tang (四物湯). Conclusions: This study could assist researchers in diversifyingy formula analysis in future studies. Moreover, the herbal combination used in osteoporosis prescriptions could be used to search for osteoporosis prescriptions in other databases or to create a new prescription.

Bibliometric Analysis of the Effect of Acupuncture on Cancer Pain in the Last 20 Years (최근 20년간 침의 암성통증에 대한 효과 연구의 계량서지학적 분석)

  • Park, Han-song;Lee, Do-eun;Ha, Ji-su;Seo, Ho-seok;Kim, Jin-won
    • The Journal of Internal Korean Medicine
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    • v.42 no.3
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    • pp.279-292
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    • 2021
  • Objectives: Analyze papers on the effect of acupuncture on cancer pain from a macroscopic point of view, suggesting global trends and future research directions to promote acupuncture treatment for cancer pain. Methods: By filtering the papers searched for (acupuncture) AND (cancer pain) in the Web of Science database, 351 papers were selected and analyzed by year, field, journal, institution, author, and keyword. Results: Most papers were published in 2020, and research was active in the field of complementary and alternative medicine. Research on the effects of acupuncture in cancer pain has been active in cancer centers and university hospitals, research has been active in various countries. The most frequently mentioned keywords in the titles and abstracts were acupuncture, pain, and quality of life. The latest top 5 keywords were inhibitor-induced arthralgia, acupuncture therapy, risk factors, opioids, and recovery. Conclusions: Acupuncture treatment has the potential to reduce pain and improve quality of life in cancer patients, and it should be actively studied in the future.

Systematic Review of Efficacy of Electroacupuncture for Spasticity because of Stroke (중풍 환자의 경직에 있어서 전침 치료 효과에 대한 체계적 고찰)

  • Go, Ho-Yeon;Kong, Kyung-Hwan;Shin, Mi-ran;Jang, Myung-Woong;Park, Sun-Ju;Park, Jung-Su;Jang, Bo-Hyung;Lee, Ju-A;Ko, Seong-Gyu;Jeon, Chan-Yong
    • The Journal of the Society of Stroke on Korean Medicine
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    • v.12 no.1
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    • pp.61-67
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    • 2011
  • Background : Prevalence of spasticity because of stroke are 40% patients after 12 month. Spasticity caused decrease of range of motor, motor function, and active daily living. Electroacupuncture widely used stroke. But it is been studied by systematic review between spasticity and electroacupuncture. This study is aimed to efficacy of electroacupuncture for spasticity because of stroke. Methods : We had used pubmed(www.pubmed.com) and cochrane library(www.thecochranelibrary.com) database. Limits are'human','randomized controlled trial'and'all adult 19+ years'in pubmed. The period was until 15, september, 2011. We used MeSH(Medical Subject Headings terms. The search words were'stroke'[mesh],'muscle spasticity'[mesh and 'electroacupuncture'[mesh]. In cochrane library, we used spasticity and electroacupuncture in cochrane library. We found 19 studies. But only 3 studies were included for inclusion criteria. Results : The appropriate 3 studies were different from subject, acupoint, duration of treatment, endpoint and etc. But these studies were effective for spasticity because of stroke. Conclusion : These studies were not meta analysis because of heterogeneity. But the above results might explain the electroacupuncture were effective for spasticity and further study needed to verify and standard electroacupuncture study for spasticity.

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Scientific Publications on Thyroid Ultrasound between 2001 and 2020: Differences in Research Characteristics by Disciplines

  • Won Chul Shin;Chae Woon Lee;Jiyeon Ha;Kyoung Ja Lim;Young Lan Seo;Eun Joo Yun;Dae Young Yoon
    • Korean Journal of Radiology
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    • v.23 no.8
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    • pp.835-845
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    • 2022
  • Objective: To analyze the characteristics and trends of scientific publications on thyroid ultrasound (US) from 2001 to 2020, specifically examining the differences among disciplines. Materials and Methods: The MEDLINE database was searched for scientific articles on thyroid US published between 2001 and 2020 using the PubMed online service. The evaluated parameters included year of publication, type of document, topic, funding, first author's specialty, journal name, subject category, impact factor, and quartile ranking of the publishing journal, country, and language. Relationships between the first author's specialty (radiology, internal medicine, surgery, otorhinolaryngology, and miscellaneous) and other parameters were analyzed. Results: A total of 2917 thyroid US publications were published between 2001 and 2020, which followed an exponential growth pattern, with an annual growth rate of 11.6%. Radiology produced the most publications (n = 1290, 44.2%), followed by internal medicine (n = 716, 24.5%), surgery (n = 409, 14.0%), and otorhinolaryngology (n = 171, 5.9%). Otorhinolaryngology and internal medicine published significantly more case reports than radiology (p < 0.001, each). Radiology published a significantly higher proportion of publications on imaging diagnosis (p < 0.001 for all) and a significantly lower proportion of publications on biopsy (p < 0.001 for all) than the other disciplines. Publications produced by radiology authors were less frequently published in Q1 journals than those from other disciplines (p < 0.005 for internal medicine and miscellaneous disciplines and < 0.01 for surgery and otorhinolaryngology). China contributed the greatest number of publications (n = 622, 21.3%), followed by South Korea (n = 478, 16.4%) and the United States (n = 468, 16.0%). Conclusion: Radiology produced the most publications for thyroid US than any other discipline. Radiology authors published more notably on imaging diagnosis compared to other topics and in journals with lower impact factors compared to authors in other disciplines.

Survival analysis of extrahepatic cholangiocarcinoma based on surveillance, epidemiology, and end results database

  • Hassam Ali;Joshua Zweigle;Pratik Patel;Brandon Tedder;Rafeh Khan;Saurabh Agrawal
    • Annals of Hepato-Biliary-Pancreatic Surgery
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    • v.27 no.2
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    • pp.151-157
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    • 2023
  • Backgrounds/Aims: Cholangiocarcinoma (CCA) can be classified as intrahepatic CCA or extrahepatic CCA (eCCA). We intended to analyze and reports the survival outcomes for eCCA. Methods: Surveillance, epidemiology, and end results (SEER) registry, site recode C24.0, was used to select cases of eCCA from 2000 to 2018. Patients with incomplete data or ages <18 years were excluded. Results: Male (52.69%) and White race (77.99%) predominated. Compared with 2000-2006, survival increased in 2013 (adjusted hazard ratio [HRadj]: 0.68, 95% confidence interval [CI] 0.58-0.70; p < 0.01). Surgery with chemoradiotherapy (HRadj: 0.69, 95% CI 0.60-0.7; p < 0.01) and surgery with chemotherapy (HRadj: 0.72, 95% CI 0.62-0.83; p < 0.01) improved survival over surgery alone. Compared with surgery without lymph node (LN) removal, surgery of four or more regional LN reduced the risk of death by 58% (HRadj: 0.42, 95% CI 0.36-0.51; p < 0.01). Compared with patients without surgery, patients who underwent bile duct excision (HRadj: 0.82, 95% CI 0.72-0.94; p < 0.01), simple or extended lobectomy (HRadj: 0.85, 95% CI 0.75-0.95; p = 0.009), and hepatectomy (HRadj: 0.80, 95% CI 0.72-0.88; p < 0.01) significantly improved survival. Patients with distal CCA had a 17% higher survival than perihilar CCA (HRadj: 0.83, 95% CI 0.74-0.92; p < 0.01) and LN dissection was equally beneficial for both subgroups (p < 0.01). Conclusions: Surgery with chemoradiotherapy has a proven increase in the 5-year survival of the eCCA. LN resection, bile duct excision, lobectomy, and hepatectomy have better outcomes.

Identifying Atrial Fibrillation With Sinus Rhythm Electrocardiogram in Embolic Stroke of Undetermined Source: A Validation Study With Insertable Cardiac Monitors

  • Ki-Hyun Jeon;Jong-Hwan Jang;Sora Kang;Hak Seung Lee;Min Sung Lee;Jeong Min Son;Yong-Yeon Jo;Tae Jun Park;Il-Young Oh;Joon-myoung Kwon;Ji Hyun Lee
    • Korean Circulation Journal
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    • v.53 no.11
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    • pp.758-771
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    • 2023
  • Background and Objectives: Paroxysmal atrial fibrillation (AF) is a major potential cause of embolic stroke of undetermined source (ESUS). However, identifying AF remains challenging because it occurs sporadically. Deep learning could be used to identify hidden AF based on the sinus rhythm (SR) electrocardiogram (ECG). We combined known AF risk factors and developed a deep learning algorithm (DLA) for predicting AF to optimize diagnostic performance in ESUS patients. Methods: A DLA was developed to identify AF using SR 12-lead ECG with the database consisting of AF patients and non-AF patients. The accuracy of the DLA was validated in 221 ESUS patients who underwent insertable cardiac monitor (ICM) insertion to identify AF. Results: A total of 44,085 ECGs from 12,666 patient were used for developing the DLA. The internal validation of the DLA revealed 0.862 (95% confidence interval, 0.850-0.873) area under the curve (AUC) in the receiver operating curve analysis. In external validation data from 221 ESUS patients, the diagnostic accuracy of DLA and AUC were 0.811 and 0.827, respectively, and DLA outperformed conventional predictive models, including CHARGE-AF, C2HEST, and HATCH. The combined model, comprising atrial ectopic burden, left atrial diameter and the DLA, showed excellent performance in AF prediction with AUC of 0.906. Conclusions: The DLA accurately identified paroxysmal AF using 12-lead SR ECG in patients with ESUS and outperformed the conventional models. The DLA model along with the traditional AF risk factors could be a useful tool to identify paroxysmal AF in ESUS patients.

Risk of Atrial Fibrillation and Adverse Outcomes in Patients With Cardiac Implantable Electronic Devices

  • So-Ryoung Lee;Ji Hyun Lee;Eue-Keun Choi;Eun-Kyung Jung;So-Jeong You;Seil Oh;Gregory YH Lip
    • Korean Circulation Journal
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    • v.54 no.1
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    • pp.13-27
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    • 2024
  • Background and Objectives: Comprehensive epidemiological data are lacking on the incident atrial fibrillation (AF) in patients with cardiac implantable electronic devices (CIEDs). This study aimed to examine the incidence, risk factors, and AF-related adverse outcomes of patients with CIEDs. Methods: This was an observational cohort study that analyzed patients without prevalent AF who underwent CIED implantation in 2009-2018 using a Korean nationwide claims database. The subjects were divided into three groups by CIED type and indication: pacemaker (n=21,438), implantable cardioverter defibrillator (ICD)/cardiac resynchronization therapy (CRT) with heart failure (HF) (n=3,450), and ICD for secondary prevention without HF (n=2,146). The incidence of AF, AF-associated predictors, and adverse outcomes were evaluated. Results: During follow-up, the incidence of AF was 4.3, 7.3, and 5.1 per 100 person-years in the pacemaker, ICD/CRT with HF, and ICD without HF cohorts, respectively. Across the three cohorts, older age and valvular heart disease were commonly associated with incident AF. Incident AF was consistently associated with an increased risk of ischemic stroke (3.8-11.4-fold), admission for HF (2.6-10.5-fold), hospitalization for any cause (2.4-2.7-fold), all-cause death (4.1-5.0-fold), and composite outcomes (3.4-5.7-fold). Oral anticoagulation rates were suboptimal in patients with incident AF (pacemaker, 51.3%; ICD/CRT with HF, 51.7%; and ICD without HF, 33.8%, respectively). Conclusions: A substantial proportion of patients implanted CIED developed newly diagnosed AF. Incident AF was associated with a higher risk of adverse events. The importance of awareness, early detection, and appropriate management of AF in patients with CIED should be emphasized.

A Implementation of Messenger using Hybrid Cryptosystem (하이브리드 암호 시스템을 이용한 메신저 구현)

  • Han, Kun-Hee;Shin, Seung-Soo
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.11 no.10
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    • pp.3942-3949
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    • 2010
  • Since existing Nate-on Messenger application stores users' personal information in the database of its server, it is extremely venerable to internal threats, not to mention the communication data being transmitted without any safety measures. To solve such problematic areas of the existing application, we have developed a safer messenger application. The messenger application proposed in this paper discloses only the least required personal information of its users and the rest of the personal information is safely encrypted in the database using private passwords. This protective measure prevents the administrator or a third party from misusing the information since he/she will not be able access the information. In addition, users will be able to freely and safely communicate using this new messenger since transmitted data will also be encrypted.

An Experimental Investigation into the Characteristics of Sampling Module for East-Response Co2 Concentration Analyzer with NDIR (비분산 적외선 분광법을 이용한 Co2농도 고속 분석기의 Sampling Module 특성에 관한 실험적 연구)

  • Kim, Woo-Seok;Shon, Deok-Young;Park, Young-Moo;Yoo, Jae-Suk;Lee, Jong-Hwa
    • Transactions of the Korean Society of Mechanical Engineers B
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    • v.27 no.3
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    • pp.398-405
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    • 2003
  • A fast response analyzer for measuring carbon dioxide concentration has been developed for transient characteristic and researches tested on internal combustion engine. The analyzer uses the well known NDIR(Non-Dispersive Infrared) method with miniaturized detection system, giving a time constant of approximately 30 microsecond, and sampling module consists of capillary tube. Since the transit time and the time constant of the sampling system depend on the sampling conditions, it is necessary to investigate the characteristics of sampling system before applied to exhaust gas measurement in engine. A unique method was designed to study the influence of the diameter of transfer sample line and operating conditions of the FRNDIR on transit time and time constant. A database of transit time and time constant was built up for different measured and simulated pressure conditions. The database can be used for correcting eventual $CO_2$ concentration measurement.