• 제목/요약/키워드: Low risk

검색결과 4,533건 처리시간 0.04초

미확정 편평상피세포와 인체 유두종바이러스와의 비교 (Comparison of ASCUS and Human Papilloma Virus)

  • 박미순;장병수
    • 한국콘텐츠학회논문지
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    • 제13권8호
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    • pp.308-313
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    • 2013
  • 세포선별검사에서 ASCUS로 진단된 검체 중 F-UP이 진행되지 않은 검체 179건을 대상으로 HPV high risk factor, low risk factor를 확인하기 위해서 Hybrid Capture II Test를 하였다. 시험 결과 high risk factor 양성 및 low risk factor 양성은 전체 179 cases 중 26 cases로 나타났으며, 전체 검체 중 약 15%에 해당되었다. 또한 전체 15%의 양성검체 중 high risk factor 양성은 96%에 해당되는 것을 확인하였다. 결론적으로 효과적인 검진 체계를 갖춘 나라에서도 자궁경부암의 예방이 완전히 해결되지 않고 있는 문제점이 있는 여건을 고려해 볼 때 추적 관찰이 용이하지 않은 경우를 대비해 자궁경부암으로 진행될 수 있는 precancerous lesion의 원인 인자인 HPV 존재 유무를 세포선별검사와 HPV Hybrid Capture II Test를 동시에 시행하는 것이 효과적이라고 사료된다.

Treatment results of the second-line chemotherapy regimen for patients with low-risk gestational trophoblastic neoplasia treated with 5-day methotrexate and 5-day etoposide

  • Kanno, Toshiyuki;Matsui, Hideo;Akizawa, Yoshika;Usui, Hirokazu;Shozu, Makio
    • Journal of Gynecologic Oncology
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    • 제29권6호
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    • pp.89.1-89.8
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    • 2018
  • Objective: Highly effective chemotherapy for patients with low-risk gestational trophoblastic neoplasia (GTN) is associated with almost a 100% cure rate. However, 20%-30% of patients treated with chemotherapy need to change their regimens due to severe adverse events (SAEs) or drug resistance. We examined the treatment outcomes of second-line chemotherapy for patients with low-risk GTN. Methods: Between 1980 and 2015, 281 patients with low-risk GTN were treated. Of these 281 patients, 178 patients were primarily treated with 5-day intramuscular methotrexate (MTX; n=114) or 5-day drip infusion etoposide (ETP; n=64). We examined the remission rates, the drug change rates, and the outcomes of second-line chemotherapy. Results: The primary remission rates and drug resistant rates of 5-day ETP were significantly higher (p<0.001) and significantly lower (p=0.002) than those of 5-day MTX, respectively. Forty-seven patients (26.4%) required a change in their chemotherapy regimen due to the SAEs (n=16) and drug resistance (n=31), respectively. Of these 47 patients failed the first-line regimen, 39 patients (39/47, 82.9%) were re-treated with single-agent chemotherapy, and 35 patients (35/39, 89.7%) achieved remission. Four patients failed second-line, single-agent chemotherapy and eight patients (17.0%) who failed first-line regimens were treated with combined or multi-agent chemotherapy and achieved remission. Conclusions: Patients with low-risk GTN were usually treated with single-agent chemotherapy, while 20%-30% patients had to change their chemotherapy regimen due to SAEs or drug resistance. The second-line regimens of single-agent chemotherapy were effective; however, there were several patients who needed multiple agents and combined chemotherapy to achieve remission.

Comparison of Thermal Ablation and Surgery for Low-Risk Papillary Thyroid Microcarcinoma: A Systematic Review and Meta-Analysis

  • Hyun Jin Kim;Se Jin Cho;Jung Hwan Baek
    • Korean Journal of Radiology
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    • 제22권10호
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    • pp.1730-1741
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    • 2021
  • Objective: Although thermal ablation is effective in treating low-risk papillary thyroid microcarcinomas (PTMCs), comparison of treatment outcomes between thermal ablation and surgery has not yet been systematically evaluated. This study aimed to compare the efficacy and safety of thermal ablation and surgery for the treatment of low-risk PTMCs. Materials and Methods: Ovid-MEDLINE and EMBASE databases were searched for studies reporting comparisons of treatment results between thermal ablation and surgery for patients with low-risk PTMC published up to April 6, 2020. The analysis evaluated the efficacy (local tumor recurrence, occurrence of new tumor, metastasis, and rescue surgery) and safety (complication rate) of thermal ablation and surgery. Results: This systematic review included four studies with a total of 339 PTMCs in 339 patients who underwent thermal ablation and 320 PTMCs in 314 patients who underwent surgery. There was no local tumor recurrence or distant metastasis in either group. There was no significant difference in the pooled proportion of lymph node metastasis (2.6% with thermal ablation vs. 3.3% with surgery, p = 0.65), occurrence of new tumors (1.4% with thermal ablation vs. 1.3% with surgery, p = 0.85), or rescue surgery (2.6% with thermal ablation vs. 1.6% with surgery, p = 0.62). However, the pooled complication rate was significantly higher in the surgery group than in the ablation group (3.3% with thermal ablation vs. 7.8% with surgery, p = 0.03). Conclusion: Both thermal ablation and surgery are effective and safe options for the management of low-risk PTMCs, with thermal ablation achieving a lower complication rate. Therefore, thermal ablation may be considered as an alternative treatment option for low-risk PTMC in patients who refuse surgery and active surveillance or are ineligible for surgery.

A prediction model of low back pain risk: a population based cohort study in Korea

  • Mukasa, David;Sung, Joohon
    • The Korean Journal of Pain
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    • 제33권2호
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    • pp.153-165
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    • 2020
  • Background: Well-validated risk prediction models help to identify individuals at high risk of diseases and suggest preventive measures. A recent systematic review reported lack of validated prediction models for low back pain (LBP). We aimed to develop prediction models to estimate the 8-year risk of developing LBP and its recurrence. Methods: A population based prospective cohort study using data from 435,968 participants in the National Health Insurance Service-National Sample Cohort enrolled from 2002 to 2010. We used Cox proportional hazards models. Results: During median follow-up period of 8.4 years, there were 143,396 (32.9%) first onset LBP cases. The prediction model of first onset consisted of age, sex, income grade, alcohol consumption, physical exercise, body mass index (BMI), total cholesterol, blood pressure, and medical history of diseases. The model of 5-year recurrence risk was comprised of age, sex, income grade, BMI, length of prescription, and medical history of diseases. The Harrell's C-statistic was 0.812 (95% confidence interval [CI], 0.804-0.820) and 0.916 (95% CI, 0.907-0.924) in validation cohorts of LBP onset and recurrence models, respectively. Age, disc degeneration, and sex conferred the highest risk points for onset, whereas age, spondylolisthesis, and disc degeneration conferred the highest risk for recurrence. Conclusions: LBP risk prediction models and simplified risk scores have been developed and validated using data from general medical practice. This study also offers an opportunity for external validation and updating of the models by incorporating other risk predictors in other settings, especially in this era of precision medicine.

관여도에 따른 와인 소비자의 인지된 구매 위험에 관한 연구 (A Study on the Wine Consumers' Perceived Risk of Purchasing by Involvement)

  • 김맹진
    • 한국조리학회지
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    • 제14권4호
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    • pp.232-243
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    • 2008
  • The purpose of this study is to investigate Korean wine consumers' perceived risk dimensions affecting wine purchasing behavior and identify the differences in the dimensions by wine involvement. Questionnaires were collected from the wine purchasers of wine retailer shops in Seoul. 230 data were analysed using SPSS package(v. 12.0). Findings were as follows: (1) There were 5 dimensions in the perceived risk of wine purchasing: functional, social, physical, psychological, financial. Social dimension was the most serious risk for wine consumers, then come psychological, functional, financial, and physical ones. (2) There were significant differences in the perceived risk dimensions by involvement level except the financial dimension. The perception level of wine purchasing risk was relatively low in the high involvement group while high in the middle and low involvement groups.

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건축건설공사의 공종별 위험도와 직무스트레스의 상관관계 (Relationship between the Risk Level and the Job Stress Level of Work Types in Architectural Work)

  • 김정민;이종빈;장성록
    • 한국안전학회지
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    • 제32권4호
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    • pp.73-78
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    • 2017
  • In this study, the risk level of architectural works was calculated by applying work period and number of input workers based on accidents records from 2012 to 2014 and the architectural works were divided into four groups(High-High, High-Low, Low-High, Low-Low) according to risk levels of fatal accidents and loss time accidents. And then questionnaire on the job stress level of workers was performed for 670 workers working in the architectural work using Korean Occupational Stress Questionnaire Form developed by KOSHA. And then the relationship between the risk level and job stress level of four groups was analyzed. Results showed that 1) risk levels of fatal and loss time accidents applied by work period and input workers were analyzed to be different with those of previous research based on the number of fatal and loss time accidents; 2) job stress level of workers has been analyzed to have a significant relationship with the risk level of fatal and loss time accident; 3) specially, the average of job stress level of 'HH(High-High)' group was higher than those of other groups; 4) among the subfactors of job stress, interpersonal conflict, job insecurity, organizational system and lack of reward were analyzed to be key factors to affect the risk level.

한국인에서 알코올 섭취가 관상동맥질환 관련 위험요인에 미치는 영향;국민건강영양조사 제3기 (2005년) (Alcohol Consumption and the Coronary Heart Disease-Related Risk Factors in Korean Adults;the Third Korea National Health and Nutrition Examination Survey (KNHANES III), 2005)

  • 박성희;강영희;박현영
    • Journal of Nutrition and Health
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    • 제41권3호
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    • pp.232-241
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    • 2008
  • Moderate alcohol consumption has been known to be associated with reduced risk for coronary heart disease (CHD). We assessed the association between alcohol consumption and CHD-related risk factors [hypertension, diabetes mellitus (DM) , high total cholesterol, high triglyceride (TG), low HDL-cholesterol (HDL-C), and high LDL-cholesterol (LDL-C)] in Korean. After excluding those with extreme intake values, the number of final subjects included in the analysis was 4,662 Korean adults aged over 20 years (1,961 men, 2,701 women) who participate in the 2005 Korean National Health and Nutrition Examination Survey. The subjects were divided into four or five groups; none-alcohol consumption group, moderate alcohol consumption group (<15 or 15.0-29.9 g/d), heavy alcohol consumption group (30-69.9 g/d or ${\geq}$ 70 g/d in men, ${\geq}$ 30 g/d in women). Odds ratios (ORs) were estimated from logistic regression adjusting for potential covariates. Alcohol consumption was inversely associated with low HDL-C in both men and women. However, heavy alcohol intake (${\geq}$ 70 g/d) significantly increased risk for hypertension, DM, and hypertriglyceridemia in men. The frequency of alcohol intake was also associated with CHD risk. The risk for low HDLC was decreased with alcohol consumption (${\geq}$ 1 times/wk), but frequent alcohol intake (${\geq}$ 4 times/wk) increased the risk for hypertension. This study revealed that moderate alcohol consumption has protective effect on CHD-related risk factors in Korean population.

분화성 갑상선암 환자에서 수술범위의 선택 (The Surgical Treatment of Choice for Patients with Differentiated Thyroid Cancer(DTC))

  • 차성재;박성준;임현묵
    • 대한두경부종양학회지
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    • 제13권2호
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    • pp.200-205
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    • 1997
  • 결론적으로 저위험군환자에서는 수술방법 및 수술후 보조적인 치료법인 방사선요드동위원소 치료 및 갑상선 흐르몬 억제 치료가 생존을 증가에 별다른 영향을 주지 않으리라 생각된다. 이러한 이유는 사실상 이들 환자에서는 사망률의 위험성이 거의 없어 생존율을 확인할 방법이 없기 때문이다. 따라서 저위험군에서는 광범위한 수술방법을 피하고 고위험군에서는 환자 개개인의 상태에 따라 수술방법이 선택되어야 하며 갑상선 전절제술은 확실한 예후의 증가나 다른 적절한 치료 방법이 없을 경우 조심해서 선택되어야 된다고 사료된다.

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심근 세포의 전기생리학적 특징을 이용한 인공 신경망 기반 약물의 심장독성 평가 (An Artificial Neural Network-Based Drug Proarrhythmia Assessment Using Electrophysiological Characteristics of Cardiomyocytes)

  • 유예담;정다운;;임기무
    • 대한의용생체공학회:의공학회지
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    • 제42권6호
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    • pp.287-294
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    • 2021
  • Cardiotoxicity assessment of all drugs has been performed according to the ICH guidelines since 2005. Non-clinical evaluation S7B has focused on the hERG assay, which has a low specificity problem. The comprehensive in vitro proarrhythmia assay (CiPA) project was initiated to correct this problem, which presented a model for classifying the Torsade de pointes (TdP)-induced risk of drugs as biomarkers calculated through an in silico ventricular model. In this study, we propose a TdP-induced risk group classifier of artificial neural network (ANN)-based. The model was trained with 12 drugs and tested with 16 drugs. The ANN model was performed according to nine features, seven features, five features as an individual ANN model input, and the model with the highest performance was selected and compared with the classification performance of the qNet input logistic regression model. When the five features model was used, the results were AUC 0.93 in the high-risk group, AUC 0.73 in the intermediate-risk group, and 0.92 in the low-risk group. The model's performance using qNet was lower than the ANN model in the high-risk group by 17.6% and in the low-risk group by 29.5%. This study was able to express performance in the three risk groups, and it is a model that solved the problem of low specificity, which is the problem of hERG assay.

Risk Stratification of Thyroid Nodules Diagnosed as Bethesda Category III by Ultrasound, Size, and Cytology

  • Hye Shin Ahn;Dong Gyu Na;Ji-Hoon Kim
    • Korean Journal of Radiology
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    • 제25권10호
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    • pp.924-933
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    • 2024
  • Objective: This study aimed to evaluate the performance of an integrated risk stratification system (RSS) based on ultrasound (US) RSSs, nodule size, and cytology subcategory for diagnosing malignancy in thyroid nodules initially identified as Bethesda category III on fine-needle aspiration. Materials and Methods: This retrospective study was conducted at two institutions and included consecutive patients with Bethesda category III nodules, and final diagnoses confirmed by repeat biopsy or surgery. A total of 320 Bethesda category III nodules (≥1 cm) from 309 patients (223 female and 86 male; mean age, 50.9 ± 12.0 years) were included. The malignancy risk of Bethesda category III nodules and predictors of malignancy were assessed according to US RSSs, nodule size, and cytology subcategory. The diagnostic performances of US-size cytology (USC) RSS and US RSS alone for malignancy were compared. Results: The intermediate or high suspicion US category independently increased the malignancy risk in all US RSSs (P ≤ 0.001). Large nodule size (≥3 cm) independently increased the malignancy risk of low- or intermediate suspicion US category nodules. Additionally, the atypia of undetermined significance cytology subcategory independently increased the malignancy risk of low suspicion US category nodules in most US RSSs. The area under the receiver operating characteristic curve of the USC RSSs was greater than that of the US RSSs alone (P < 0.048). Malignancy was not found in the very low risk category of USC RSS. Conclusion: The diagnostic performance of USC RSS for malignancy was superior to that of US RSS alone in Bethesda category III nodules. Malignancy can be ruled out in the very low-risk category of USC RSS.