• Korean Circulation Journal
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• v.48 no.11
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• pp.1002-1011
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• 2018

Background and Objectives: The prognostic impact of left axis deviation (LAD) on clinical outcomes in acute heart failure syndrome (AHFS) with left bundle branch block (LBBB) is unknown. The aim of this study was to determine the prognostic significance of axis deviation in acute heart failure patients with LBBB. Methods: Between March 2011 and February 2014, 292 consecutive AHFS patients with LBBB were recruited from 10 tertiary university hospitals. They were divided into groups with no LAD (n=189) or with LAD (n=103) groups according to QRS axis <-30 degree. The primary outcome was all-cause mortality. Results: The median follow-up duration was 24 months. On multivariate analysis, the rate of all-cause death did not significantly differ between the normal axis and LAD groups (39.7% vs. 46.6%, adjusted hazard ratio, 1.01; 95% confidence interval, 0.66, 1.53; p=0.97). However, on the multiple linear regression analysis to evaluate the predictors of the left ventricular ejection fraction (LVEF), presence of LAD significantly predicted a worse LVEF (adjusted beta, -3.25; 95% confidence interval, -5.82, -0.67; p=0.01). Right ventricle (RV) dilatation was defined as at least 2 of 3 electrocardiographic criteria (late R in lead aVR, low voltages in limb leads, and R/S ratio <1 in lead V5) and was more frequent in the LAD group than in the normal axis group (p<0.001). Conclusions: Among the AHFS with LBBB patients, LAD did not predict mortality, but it could be used as a significant predictor of worse LVEF and RV dilatation (Trial registry at KorAHF registry, ClinicalTrial.gov, NCT01389843).

• Journal of Korean Neurosurgical Society
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• v.66 no.6
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• pp.716-725
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• 2023

Objective : Anterior cervical spine surgery (ACSS) is a common surgical procedure used to treat cervical spinal degenerative diseases. One of the complications associated with ACSS is prevertebral soft tissue swelling (PSTS), which can result in airway obstruction, dysphagia, and other adverse outcomes. This study aims to investigate the correlation between various cervical sagittal parameters and PSTS following single-level ACSS, as well as to identify independent risk factors for PSTS. Methods : A retrospective study conducted at a single institution. The study population included all patients who underwent single-level ACSS between January 2014 and December 2022. Patients with a history of cervical spine surgery or trauma were excluded from the study. The presence and severity of PSTS was assessed by reviewing pre- and postoperative imaging studies. The potential risk factors for PSTS that were examined include patient age, sex, body mass index, tobacco use, comorbidities, serum albumin levels, operative time, implant type, implanted level, and various cervical spine sagittal parameters. Multivariate linear regression analysis was performed to identify the independent risk factors for PSTS. Results : A total of 62 consecutive patients who underwent single-level ACSS over a 8-year period at a single institution were enrolled in this study. Only preoperative segmental angle showed positive correlation with PSTS among various cervical spine sagittal parameters (r=0.36, p=0.005). Artificial disc replacement showed a negative correlation with PSTS (β=-0.38, p=0.002), whereas the use of demineralized bone matrix (DBM) had a positive impact on PSTS (β=0.33, p=0.009). We found that male sex, lower preoperative serum albumin, and implantation of upper cervical level (above C5) were independent predictors for PSTS after single-level ACSS (β=1.21; 95% confidence interval [CI], 0.27 to 2.15; p=0.012; β=-1.63; 95% CI, -2.91 to -0.34; p=0.014; β=1.44; 95% CI, 0.38 to 2.49; p=0.008, respectively). Conclusion : Our study identified male sex, lower preoperative serum albumin levels, and upper cervical level involvement as independent risk factors for PSTS after single-level ACSS. These findings can help clinicians monitor high-risk patients and take preventive measures to reduce complications. Further research with larger sample sizes and prospective designs is needed to validate these findings.

• Geomechanics and Engineering
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• v.35 no.2
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• pp.121-133
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• 2023

The demand for cement and limestone crushed materials has increased many folds due to the tremendous increase in construction activities in Pakistan during the past few decades. The number of cement production industries has increased correspondingly, and so the rock-blasting operations at the limestone quarry sites. However, the safety procedures warranted at these sites for the blast-induced ground vibrations (BIGV) have not been adequately developed and/or implemented. Proper prediction and monitoring of BIGV are necessary to ensure the safety of structures in the vicinity of these quarry sites. In this paper, an attempt has been made to predict BIGV using artificial neural network (ANN) at three selected limestone quarries of Pakistan. The ANN has been developed in Python using Keras with sequential model and dense layers. The hyper parameters and neurons in each of the activation layers has been optimized using randomized and grid search method. The input parameters for the model include distance, a maximum charge per delay (MCPD), depth of hole, burden, spacing, and number of blast holes, whereas, peak particle velocity (PPV) is taken as the only output parameter. A total of 110 blast vibrations datasets were recorded from three different limestone quarries. The dataset has been divided into 85% for neural network training, and 15% for testing of the network. A five-layer ANN is trained with Rectified Linear Unit (ReLU) activation function, Adam optimization algorithm with a learning rate of 0.001, and batch size of 32 with the topology of 6-32-32-256-1. The blast datasets were utilized to compare the performance of ANN, multivariate regression analysis (MVRA), and empirical predictors. The performance was evaluated using the coefficient of determination (R²), mean absolute error (MAE), mean squared error (MSE), mean absolute percentage error (MAPE), and root mean squared error (RMSE)for predicted and measured PPV. To determine the relative influence of each parameter on the PPV, sensitivity analyses were performed for all input parameters. The analyses reveal that ANN performs superior than MVRA and other empirical predictors, andthat83% PPV is affected by distance and MCPD while hole depth, number of blast holes, burden and spacing contribute for the remaining 17%. This research provides valuable insights into improving safety measures and ensuring the structural integrity of buildings near limestone quarry sites.

• Korean Journal of Radiology
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• v.22 no.3
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• pp.464-475
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• 2021

Objective: This study aimed to evaluate the tumor doubling time of invasive lung adenocarcinoma according to the International Association of the Study for Lung Cancer (IASLC)/American Thoracic Society (ATS)/European Respiratory Society (ERS) histologic classification. Materials and Methods: Among the 2905 patients with surgically resected lung adenocarcinoma, we retrospectively included 172 patients (mean age, 65.6 ± 9.0 years) who had paired thin-section non-contrast chest computed tomography (CT) scans at least 84 days apart with the same CT parameters, along with 10 patients with squamous cell carcinoma (mean age, 70.9 ± 7.4 years) for comparison. Three-dimensional semiautomatic segmentation of nodules was performed to calculate the volume doubling time (VDT), mass doubling time (MDT), and specific growth rate (SGR) of volume and mass. Multivariate linear regression, one-way analysis of variance, and receiver operating characteristic curve analyses were performed. Results: The median VDT and MDT of lung cancers were as follows: acinar, 603.2 and 639.5 days; lepidic, 1140.6 and 970.1 days; solid/micropapillary, 232.7 and 221.8 days; papillary, 599.0 and 624.3 days; invasive mucinous, 440.7 and 438.2 days; and squamous cell carcinoma, 149.1 and 146.1 days, respectively. The adjusted SGR of volume and mass of the solid-/micropapillary-predominant subtypes were significantly shorter than those of the acinar-, lepidic-, and papillary-predominant subtypes. The histologic subtype was independently associated with tumor doubling time. A VDT of 465.2 days and an MDT of 437.5 days yielded areas under the curve of 0.791 and 0.795, respectively, for distinguishing solid-/micropapillary-predominant subtypes from other subtypes of lung adenocarcinoma. Conclusion: The tumor doubling time of invasive lung adenocarcinoma differed according to the IASCL/ATS/ERS histologic classification.

• The Korean Journal of Nuclear Medicine
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• v.34 no.1
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• pp.30-38
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• 2000

Purpose: We investigated the role of myocardial perfusion SPECT in prediction of ventricular dilatation and the role of revascularization including thrombolytic therapy and PTCA in prevention of ventricular dilatation after an acute myocardial infarction (AMI). Materials and Methods: We performed dipyridamole stress, 4 hour redistribution, and 24 hour reinjection Tl-201 SPECT in 16 patients with AMI two to nine days after attack. Perfusion and wall motion abnormalities were quantified by perfusion index (PI) and wall motion index (WMI). Left ventricular ejection fraction (LVEF), WMI and ventricular volume were measured within 1 week of AMI and after average of 6 months. According to serial changes of left ventricular end-diastolic volume (LVEDV), patients were divided into two groups. We compared WMI, PI and LVEF between the two groups. Relationships among degree of volume, stress-rest PI, WMI, CKMB, Q wave, LVEF and revascularization were analysed using multivariate analysis. Results: Only initial rest perfusion index was significantly different between the two groups (p<0.05). While initial LVEF, stress PI, CKMB, trial of revascularization procedure, presence of Q wave and WMI were not significantly different between the two groups. Eight of 16 patients (50%) showed LV dilatation on follow-up echocardiography. Three of 3 patients (100%) who did not undergo revascualrization procedure documented LV dilatation. And only 5 (38%) of the remaining 13 patients who underwent revascularization revealed LV dilatation. There was no difference in infarct location between the two groups. By multivariate linear regression analysis in patients only undergoing revascularization, rest perfusion index was the only significant factor. Conclusion: Myocardial perfusion SPECT performed prior to revascularization was useful in prediction of LV dilatation after an AMI. Rest perfusion index on myocardial perfusion plays as a significant predictor of left ventricular dilatation after AMI. And revascularization appears to be a valuable procedure in alleviating LV dilatation after AMI with or without viable myocardium in a limited number of patients studied retrospectively.

• Journal of agricultural medicine and community health
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• v.39 no.4
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• pp.240-255
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• 2014

Objective: The purpose of this study was to identify the correlates of bone mineral density of Korean adults. Methods: This study was based on the data from the 2010-2011 Korean National Health and Nutrition Examination Survey (KNHANES, 2010~2011) V. Among 8,473 subjects of the survey, who were adults 19 years old or over with bone mineral density data, the current study excluded those whose data include a missing study variable or the response of 'I don't know', and finally analyzed the data of 5,986 subjects (2,692 males and 3,294 females). This study employed the following statistical methods of analysis: t-test, analysis of variance (ANOVA), and hierarchical multivariate linear regression analysis. Results: In multivariate analysis, in the case of men, the significant associated factors in bone mineral density were age, education level, body mass index (BMI), waist circumference, total muscle mass, exercise, and weight control; in the case of women, the significant associated factors in bone mineral density were age, education level, economic activity, BMI, total muscle mass, exercise, weight control. fat intake, uptake female hormone, menopause, and age of menarche. Conclusion: For both sexes, the strongest modifiable factor in influencing bone mineral density was total muscle mass. Therefore, to prevent osteoporosis and promote health, active health education and interventions such as regular exercise for total muscle mass increase should be implemented from an early growth period.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.20
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• pp.8607-8612
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• 2014

Background: Breast cancer patients experience a variety of altered appearance - such as loss or disfigurement of breasts, discolored skin, and hair loss - which result in psychological distress that affect their quality of life. This study aims to evaluate the impact of socioeconomic status on the altered appearance distress, body image, and quality of life among Korean breast cancer patients. Materials and Methods: A cross-sectional survey was conducted at advocacy events held at 16 different hospitals in Korea. Subjects were eligible to participate if they were 18 years of age or older, had a histologically confirmed diagnosis of breast cancer, had no evidence of recurrence or metastasis, and had no psychological problems at the time of the survey. Employment status, marital status, education, and income were assessed for patient socioeconomic status. Altered appearance distress was measured using the NCI's cancer treatment side effects scale; body image and quality of life were measured by the EORTC QLC-C30 and BR23. Means and standard deviations of each outcome were compared by socioeconomic status and multivariate linear regression models for evaluating the association between socioeconomic status and altered appearance distress, body image, and quality of life. Results: A total of 126 breast cancer patients participated in the study; the mean age of participants was 47.7 (SD=8.4). Of the total, 83.2% were married, 85.6% received more than high school education, 35.2% were employed, and 41% had more than $3000 in monthly household income. About 46% had mastectomy, and over 30% were receiving either chemotherapy or radiation therapy at the time of the survey. With fully adjusted models, the employed patients had significantly higher altered appearance distress (1.80 vs 1.48; p<0.05) and poorer body image (36.63 vs 51.69; p<0.05) compared to the patients who were unemployed. Higher education (10.58, standard error (SE)=7.63) and family income (12.88, SE=5.08) was positively associated with better body image after adjusting for age, disease stage at diagnosis, current treatment status, and breast surgery type. Similarly, patients who were married and who had higher education had better quality of life were statistically significant in the multivariate models. Conclusions: Socioeconomic status is significantly associated with altered appearance distress, body image, and quality of life in Korean women with breast cancer. Patients who suffer from altered appearance distress or lower body image are much more likely to experience psychosocial, physical, and functional problems than women who do not, therefore health care providers should be aware of the changes and distresses that these breast cancer patients go through and provide specific information and psychosocial support to socioeconomically more vulnerable patients.

• Journal of Nutrition and Health
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• v.56 no.3
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• pp.264-276
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• 2023

Purpose: Food environmental factors related to food insecurity affect household food intake in several socio-ecological aspects. This study explores the relationship between food environment factors and food insecurity in households with married immigrant women. Methods: From November 2018 to February 2020, a survey was conducted enrolling 249 married immigrant women residing in the metropolitan areas of South Korea. In the final analysis, 229 subjects were divided into 2 groups classified as food security (n = 154) and food insecurity (n = 75), as assessed by the score of food security. Three aspects of food environments were measured: built·natural, political·economic, and socio-cultural Results: Food environments were significantly different between food security and food insecurity groups, as follows: the number of foods market and their distance from the home and food status for the last week at home in the built·natural domain; monthly cost of food purchase and experience for food assistance in the political·economic domain; total score of social support, parenting, and cooking skills in the socio-cultural domain. A stepwise multivariate linear regression model showed a negative association between the food insecurity score with social support from family and food inventory status in the last week. After adjusting for confounders, a positive association was obtained between the experience of a food support program. The final regression model explains about 30% of the relationship obtained in the three food environment domains and food insecurity (p < 0.001). Conclusion: Not only economic factors, which are common determinants of household food insecurity, but socio-cultural factors such as social support also affect household food insecurity. Therefore, plans for implementing a food assistance program to improve food insecurity for households with immigrant women should consider financial support as well as other comprehensive aspects, including socio-cultural domain such as social support from family and community.

• Health Policy and Management
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• v.34 no.1
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• pp.48-58
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• 2024

Background: The purpose of this study was to investigate the association between external medical service use and the characteristics of Chungcheongnam-do patients. We aimed to provide evidence of external medical service use enhance the healthcare delivery system in Chungcheongnam-do. Methods: We used the Health Insurance Cohort DB 2.0 of 2016-2019, and 2,570,439 patients were included in the study. Multivariate logistic regression and multinomial logistic regression were used to identify the association between external medical service use and each patient characteristic. Generalized linear model was used to identify the association between medical costs and external medical service use area. Results: During the study period, 32.2% of inpatients and 12.5% of outpatients had external medical service use in Chungcheongnam-do. In comparison to patients living in Cheonan and Asan, the odds ratio (OR) for external medical services use was higher across all regions. Specifically, hospitalized patients from Gyeryong, Nonsan, and Geumsan (OR, 116.817) and Gongju, Buyeo, and Cheongyang (OR, 72.931) demonstrated extremely high likelihood of external medical service use in the Daejeon area. Furthermore, compared to medical expenses incurred within Chungcheongnam-do, patients with external medical service use in the capitol area (outpatient=17.01%, inpatients=22.11%) and Daejeon area (outpatient=16.63%, inpatients=15.41%) spent more on healthcare services. Conclusion: This study found the evidence of external medical service use among Chungcheongnam-do patients. Further study should be conducted taking into account variables including satisfaction of local medical services, different types of patient diseases, and others. The study's findings may serve as a foundation for policy proposals aimed at ensuring the financial stability of our health insurance system, ensuring the efficient delivery of medical care, and localization of medical care.

• Journal of Preventive Medicine and Public Health
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• v.30 no.4 s.59
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• pp.669-685
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• 1997

Previous studies, reporting the inverse relationship between osteoarthritis and osteoporosis suggest the existence of possible pathophysiologic mechanisms between them. To examinine the hypothesis that 'bone mineral densities of women with osteoarthritis are significantly higher than that of women without osteoarthritis in Korea', subjects from the health and nutritional examination survey in Kuri city were sampled. Samples were selected through multi-stage sampling frame using established clusters in Kuri city. From August 18 to September 10,1997, the survey was conducted. Among the. total number of selected sample population (1,656 people), response .ate was 52.4 percent (348 men and 519 women). 420 women who took BMD measurement, radiologic exam, and anthropometric exam were selected for the analysis. The analytic results are as follows. 1. General characteristics: Mean BMD was $0.493g/cm^2$, mean age was 43.0, mean BMI was $23.9kg/m^2$. The number of women who experienced menopause was 106, hysterectomy was 19. There were 0 case of osteoarthritis of hip, 64 cases of osteoarthritis of knee, and 2 cases of osteoarthritis of hand. 2. Univariate analysis results: Mean BMD of women with the osteoarthritis of knee was significantly lower than that of women without the osteoarthritis of knee(0.4269 vs. $0.5057g/cm^2$). But, there were too few cases of osteoarthritis of hip and hand, so comparative studies of BMD in osteoarthritis of hip and hand could not be conducted. There were significant differences of BMD among pre-menopause group(0.5204), post-menopause group(0.4206), and hysterectomy group(0.4881). Additionally, there were significant differences of BMD among diabetes group(0.4297), impaired glucose tolerance group(0.4874), and normal group(0.5057). Furthermore, age, parity, BMI, bioimpedance were significantly related with BMD. 3. Multivariate analysis results: To examinine the relationship between osteoarthritis and BMD while controlling the other variables' effects which were significant in the univariate analyses, multiple linear regression analysis was done. But, it was found that osteoarthritis of knee was not a significant variable to BMD anymore. While age and menopause had significant negative relationship with BMD. Diabetes, parity, BMI, and bioimpedance did not have significant relationships with BMD. After stratification of subjects according to menopause, multiple linear regression analyses were done to each strata. Consequently, age in post-menopause group, age and osteoarthritis of knee in hysterectomy group showed significant negative relationship with BMD. The results did not support the many results of other previous studies done with white men and women. further studies of biological plausibility to Korean women are recommended. Also it is suggested that longitudinal study to verify the relationship between osteoarthritis and BMD will be valuable.