• Title/Summary/Keyword: Low risk criteria

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Assessment of Risk Factors for Developmental Defects of the Enamel in Preterm (조산아의 발육성 법랑질 결함의 위험 요인 평가)

  • Shang-yon Park;Jaeho Lee;Hyung-Jun Choi;Chung-Min Kang
    • Journal of the korean academy of Pediatric Dentistry
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    • v.50 no.2
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    • pp.192-204
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    • 2023
  • This study aimed to determine the criteria for quantifying developmental defects of enamel in primary teeth in premature babies and to investigate the severity of developmental defects according to the gestational age, birth weight, systemic complications, and treatments received after preterm birth. Birth information, a history of complications, the duration of parenteral nutrition, and endotracheal intubation were investigated by retrospectively reviewing the admission and discharge records of premature babies in the neonatal intensive care unit. The Preterm Developmental Defects of Enamel (PDDE) index was designed by modifying the existing developmental defects of enamel index. Based on PDDE index, the evaluator scored developmental defects of enamel by classifying them as enamel hypomineralization and hypoplasia. The PDDE scores in the extremely preterm and extremely low birth weight groups were significantly higher than those in other groups. Furthermore, PDDE scores of premature babies with bronchopulmonary dysplasia, rickets, intraventricular hemorrhage, or necrotizing colitis were significantly higher than those in the control group. In addition, more than 50 days of endotracheal intubation and more than 20 days of parenteral nutrition were associated with significantly higher PDDE scores than those in the control group and were risk factors for developmental defects of enamel. This study provides basic information for identifying risk factors for developmental defects of enamel in premature babies.

Prevalence and Management of Dyslipidemia, Hypertension, Diabetes Among Adults in Gangwon-do, Korea: the 2013-2014 KNHSP (강원도 성인의 이상지질혈증, 고혈압, 당뇨병의 유병률과 관리: 국가건강검진(2013-2014) 자료의 분석결과와 시사점)

  • Jang, Sungok;Lee, Jongseok
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.18 no.1
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    • pp.625-636
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    • 2017
  • Dyslipidemia, hypertension, and diabetes are well-established risk factors for cardio-cerebrovascular disease (CVD). Although the prevalence of dyslipidemia among Korean adults is very high, its management is known to be poor. The aim of this study was to assess the prevalence, awareness, treatment, and control rates of dyslipidemia among adults aged 30 years and older in Gangwon-do, Korea. Analysis included 58,121 adults (29,123 males and 28,998 females) participating in the 2013-2014 Korea National Health Screening Program (KNHSP). Dyslipidemia was defined according to the treatment criteria rather than the diagnostic criteria in Korea. Therefore, high-low-density lipoprotein cholesterol (LDL)-cholesterolemia was deemed present in individuals with LDL-cholesterol levels that exceeded the appropriate risk-based threshold. The age-standardized prevalence was highest in dyslipidemia (32.5%), followed by hypertension (25.1%), and diabetes (9.4%). The awareness rate was 76.7% for hypertension and 74.7% for diabetes, but only 10.6% for dyslipidemia. The lowest patient treatment was found for dyslipidemia (9.4%). The control rate among those undergoing treatment was highest for hypertension (75.8), followed by dyslipidemia (63.3%), and diabetes (43.9%). The higher CVD-risk categories showed lower control rates of hyper-LDL-cholesterolemia. The prevalence of dyslipidemia was higher than hypertension and diabetes, but awareness and treatment rates were lower. Our findings indicate there is a wide gap between the prevalence of dyslipidemia and subsequent treatment, which suggests that effective strategies are required to improve dyslipidemia management. It would be worthwhile to strengthen the follow-up management of patients with dyslipidemia in the KNHSP, especially for the high risk group of CVD.

2021 Korean Thyroid Imaging Reporting and Data System and Imaging-Based Management of Thyroid Nodules: Korean Society of Thyroid Radiology Consensus Statement and Recommendations

  • Eun Ju Ha;Sae Rom Chung;Dong Gyu Na;Hye Shin Ahn;Jin Chung;Ji Ye Lee;Jeong Seon Park;Roh-Eul Yoo;Jung Hwan Baek;Sun Mi Baek;Seong Whi Cho;Yoon Jung Choi;Soo Yeon Hahn;So Lyung Jung;Ji-hoon Kim;Seul Kee Kim;Soo Jin Kim;Chang Yoon Lee;Ho Kyu Lee;Jeong Hyun Lee;Young Hen Lee;Hyun Kyung Lim;Jung Hee Shin;Jung Suk Sim;Jin Young Sung;Jung Hyun Yoon;Miyoung Choi
    • Korean Journal of Radiology
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    • v.22 no.12
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    • pp.2094-2123
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    • 2021
  • Incidental thyroid nodules are commonly detected on ultrasonography (US). This has contributed to the rapidly rising incidence of low-risk papillary thyroid carcinoma over the last 20 years. The appropriate diagnosis and management of these patients is based on the risk factors related to the patients as well as the thyroid nodules. The Korean Society of Thyroid Radiology (KSThR) published consensus recommendations for US-based management of thyroid nodules in 2011 and revised them in 2016. These guidelines have been used as the standard guidelines in Korea. However, recent advances in the diagnosis and management of thyroid nodules have necessitated the revision of the original recommendations. The task force of the KSThR has revised the Korean Thyroid Imaging Reporting and Data System and recommendations for US lexicon, biopsy criteria, US criteria of extrathyroidal extension, optimal thyroid computed tomography protocol, and US follow-up of thyroid nodules before and after biopsy. The biopsy criteria were revised to reduce unnecessary biopsies for benign nodules while maintaining an appropriate sensitivity for the detection of malignant tumors in small (1-2 cm) thyroid nodules. The goal of these recommendations is to provide the optimal scientific evidence and expert opinion consensus regarding US-based diagnosis and management of thyroid nodules.

A Review on Treatment of Somatization Disorder in Traditional Chinese Medicine (신체화 장애에 대한 중의학 연구동향)

  • Kim, Hyo-seop;Bae, Jin-soo;Lee, Seung-Hwan;Lim, Jung-Hwa;Seong, Woo-Yong
    • Journal of Oriental Neuropsychiatry
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    • v.28 no.3
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    • pp.217-230
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    • 2017
  • Objectives: This study was conducted to review studies on somatization disorder in traditional Chinese medicine. Methods: We reviewed studies in the China National Knowledge Infrastructure (CNKI) to 2017. Keywords were 軀體化障碍, Somatization disorder, somatic symptom disorder. We included Randomized Controlled Trial (RCT), and excluded non-Randomized Controlled Trial (nRCT), non-related somatization disorder or traditional Chinese medicine, non-clinical trials, dissertations for degrees. Jadad scale and Cochrane Library's Risk of Bias (RoB) were used for assessment of the quality of studies. Results: Twelve studies were selected. The Chinese Classification of Mental Disorders-3 (CCMD-3) was most frequently used as diagnostic criteria for somatization disorder. As for outcome measurement, Hamilton Rating Scale for Depression (HAMD) was used most commonly. Meta-analysis of 10 studies revealed effective rate of Chinese Herbal Medicine groups (CHM) was significantly higher than Western Medicine groups (WM) (RR: 1.14, 95% CI: 1.02 to 1.27, p=0.02, $I^2=40%$). There was no significant difference in effective rate of CHM+WM and WM (RR: 1.12, 95% CI: 0.84 to 1.49, p=0.46, $I^2=83%$). And also, effective rate of Acupuncture group (Acu) revealed no significant difference compared to that of WM (RR: 1.17, 95% CI: 0.95 to 1.44, p=0.13, $I^2=84%$). For HAMD, there was significant difference in CHM vs, WM group and Acu vs. WM group. Quality of selected 12 RCTs was low. Conclusions: Therapies practiced in traditional Chinese medicine may be effective options for somatization disorder. treatment. For further clinical studies in Korean medicine, this study could be groundwork for development of diagnosis and treatment on somatization disorder.

Operative Treatment for Midshaft Clavicle Fractures in Adults: A 10-Year Study Conducted in a Korean Metropolitan Hospital

  • Baek, Jeong Kook;Lee, Young Ho;Kim, Min Bom;Baek, Goo Hyun
    • Journal of Trauma and Injury
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    • v.29 no.4
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    • pp.105-115
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    • 2016
  • Purpose: While all midshaft clavicle fractures have traditionally been treated with conservative measures, recent operative treatment of displaced, communited midshaft clavicle fractures has become more common. Though a recent increase in operative treatment for midshaft clavicle fractures, we have done the operative methods in limited cases. The aim of this study is to present indications, operative techniques and outcomes of the experienced cases that have applied to this limited group over the previous 10 years. Methods: This study consists of a retrospective review of radiological and clinical data from January of 2005 to July of 2015. Operative criteria for midshaft clavicle fractures having considerable risk of bone healing process were 4 groups - a floating shoulder, an open fracture, an associated neurovascular injury, and a nonunion case after previous treatment. Results: The study consisted of 18 patients who had operative treatment for midshaft clavicle fractures in adults. The most common surgical indication was a floating shoulder (10 cases, 55.6%), followed by nonunion (5 cases, 27.8%), an associated neurovascular injury (4 cases, 22.2%), and open fracture (3 cases, 16.7%). All cases were treated by open reduction and internal fixation in anterosuperior position with reconstruction plate or locking compression plate. Bone union was achieved in all cases except 1 case which was done bone resection due to infected nonunion. Mean bone union period was 19.5 weeks. There were no postoperative complications, but still sequelae in 4 cases of brachial plexus injury. Conclusion: We have conducted an open reduction and internal fixation by anterosuperior position for midshaft clavicle fractures in very limited surgical indications for last 10 years. Our treatment strategy for midshaft clavicle fractures showed favorable radiological results and low postoperative complications.

Effects of Psychoeducational Intervention for Cancer Survivors: A Systematic Review and Meta-Analysis (암생존자를 위한 심리교육중재의 효과에 대한 체계적 고찰 및 메타분석)

  • Park, Jin-Hee;Bae, Sun Hyoung
    • Journal of Korean Academy of Nursing
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    • v.47 no.2
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    • pp.143-163
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    • 2017
  • Purpose: This study was a systematic review and meta-analysis designed to investigate effects of psychoeducational intervention for cancer survivors. Methods: Ten databases were searched. Two reviewers independently performed the selection of the studies, data extraction and assessment. The risk of bias was assessed using Cochrane Collaboration's tool. To estimate the effect size, meta-analysis of the studies was performed using Comprehensive Meta-Analysis and RevMan programs. Results: Of 18,781 publications identified, 35 met inclusion criteria, and 25 studies were used to estimate effect size of psychoeducational intervention. Effect sizes (standardized mean difference [SMD]) were heterogeneous and random effects models were used in the analyses. Psychoeducational intervention was effective for quality of life (n=2,410, ES=0.23; 95% CI: 0.09~0.37), coping and self-efficacy (n=179, ES=0.68; 95% CI: 0.26~1.11), anxiety (n=1,786, ES=-0.26; 95% CI: -0.37~-0.15), depression (n=1,910, ES=-0.28; 95% CI: -0.37~-0.18), and psychological distress (n=2,242, ES=-0.31; 95% CI: -0.46~-0.17). Subgroup analysis showed that counseling was the most effective intervention for quality of life, and behavioral therapy was an effective intervention for all positive and negative outcomes. Publication bias was not detected except for psychological distress. Conclusion: Psychoeducational intervention appears to be effective in improving quality of life and coping and self-efficacy, and it is effective in reducing psychological symptoms in cancer survivors. Behavioral therapy, especially, is commonly effective in improving psychosocial outcomes. However, low-quality evidence, variability in the designs of existing studies, and publication bias suggest that additional high-quality trials should be conducted in the future.

Clinical Effectiveness of Traditional Herbal Medicine in the Treatment of Chemotherapy-induced Leukopenia: A Systematic Review and Meta-analysis of Randomized Clinical Trials (항암화학요법 유발 백혈구감소증에 대한 한약치료의 효과 : 체계적 고찰 및 메타분석(2007-2017))

  • Kim, Min-serh;Jung, Yu-jin;Hong, Sang-hoon
    • The Journal of Internal Korean Medicine
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    • v.39 no.4
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    • pp.520-549
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    • 2018
  • Objectives: We performed a systematic review and meta-analysis to explore the recent clinical research trends regarding the effects of traditional herbal medicine (THM) on chemotherapy-induced leukopenia. Methods: Randomized controlled trials that verified effects of herbal medicine treating chemotherapy induced leukopenia were included in the study. A literature search was performed in the English, Chinese, and Korean databases for papers published from January 1, 2007, to September 1, 2017. The selected literature was assessed by Cochrane's Risk of Bias (RoB). Results: Forty-two of 232 randomized controlled trials met the inclusion criteria. The most commonly used herbal prescriptions called '升白湯 (shengbai decoction)' which means elevating the numbers of White blood cells (WBCs). And the mostly included herbs such as Astragali Radix, Angelicae Gigantis Radix, Atractylodis Rhizoma Alba, Codonopsis Pilosulae, Glycyrrhizae Radix, Ligustri Lucidi Fructus are commonly used to elevate qi, blood and yin. The count of WBC in peripheral blood, the level of leukopenia presented in WHO (World Health Organization), and clinical symptoms were used to evaluate the treatments. The effective rate was 68.6-98.18% and the effectiveness was significantly higher in the intervention group than in the control group in 38 articles (p<0.05). No serious adverse events were reported. Only five articles (5/42, 11.9%) were rated as having adequate methodological quality with a low level of bias. Conclusion: Some traditional herbal medicines may be effective as therapeutic treatments for chemotherapy-induced leukopenia, but the majority of reviewed studies were of poor quality. The present findings need to be confirmed by rigorously conducted high-quality trials, including pharmacokinetic studies, to confirm the absence of interactions between traditional herbal medicine agents and chemotherapy.

A Review on Clinical Research Trend in Treatment of Chai-Hu-Shu-Gan-San (Sihosogan-San) for Insomnia (불면증에 대한 시호소간산 치료의 임상연구 동향)

  • Lee, Jae-Eun;Kim, Sang-Ho;Kim, Bo-Kyung;Lim, Jung-Hwa
    • Journal of Oriental Neuropsychiatry
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    • v.31 no.1
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    • pp.25-38
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    • 2020
  • Objectives: This review aimed to investigate the effectiveness of Chai-Hu-Shu-Gan-San (CHSGS) for treatment of insomnia. Methods: 9 databases were comprehensively searched from their inception dates until Jan 2020 using keywords like Insomnia, Chai-Hu-Shu-Gan-San and Sihosogan-san. We included randomized controlled trials (RCTs) using CHSGS as the main intervention for insomnia patients. We assessed the quality of RCTs using the Cochrane risk of bias tool and Jadad scale. Results: 5 RCTs were included. The Chinese classification of mental disorders -3 (CCMD-3) was the most frequently used diagnostic criteria. The effective rate was the most frequently used as outcome. All the 5 RCTs that reported CHSGS and CHSGS adjunctive therapy on insomnia were more effective compared to western medication. Only one study reported adverse effects. The methodological quality of the included RCTs were generally poor. Conclusions: This review found that CHSGS may be effective to treating insomnia. However, because of the small number, heterogeneity and very low methodological quality of included studies, we could not draw any definitive conclusions. Therefore, more rigorous randomized control studies are warranted.

Fragility reduction using passive response modification in a Consequence-Based Engineering (CBE) framework

  • Duenas-Osorio, Leonardo;Park, Joonam;Towashiraporn, Peeranan;Goodno, Barry J.;Frost, David;Craig, James I.;Bostrom, Ann
    • Structural Engineering and Mechanics
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    • v.17 no.3_4
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    • pp.527-537
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    • 2004
  • Consequence-Based Engineering (CBE) is a new paradigm proposed by the Mid-America Earthquake Center (MAE) to guide evaluation and rehabilitation of building structures and networks in areas of low probability - high consequence earthquakes such as the central region of the U.S. The principal objective of CBE is to minimize consequences by prescribing appropriate intervention procedures for a broad range of structures and systems, in consultation with key decision makers. One possible intervention option for rehabilitating unreinforced masonry (URM) buildings, widely used for essential facilities in Mid-America, is passive energy dissipation (PED). After the CBE process is described, its application in the rehabilitation of vulnerable URM building construction in Mid-America is illustrated through the use of PED devices attached to flexible timber floor diaphragms. It is shown that PED's can be applied to URM buildings in situations where floor diaphragm flexibility can be controlled to reduce both out-of-plane and in-plane wall responses and damage. Reductions as high as 48% in roof displacement and acceleration can be achieved as demonstrated in studies reported below.

Renal Cell Carcinoma is More Aggressive in Turkish Patients with the Metabolic Syndrome

  • Ozbek, Emin;Otunctemur, Alper;Sahin, Suleyman;Dursun, Murat;Besiroglu, Huseyin;Koklu, Ismail;Polat, Emre Can;Erkoc, Mustafa;Danis, Eyyup;Bozkurt, Muammer
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.12
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    • pp.7351-7354
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    • 2013
  • Background: Metabolic syndrome (MetS) is a multifactorial disease characterized by impaired glucose tolerance/diabetes, obesity, high triglyceride levels, low HDL levels, and hypertension. In this study we evaluate the relationship between tumor size and grade, and presence of the metabolic syndrome in patients with renal cell carcinoma. Materials and Methods: Between 2007-2013, radical nephrectomy was performed for 310 patients with renal tumors in our clinic and those with pathology reported renal cell carcinoma were enrolled and divided into two groups, with and without metabolic syndrome diagnosed on the basis of the National Cholesterol Education Program (NCEP) Adult Treatment Panel III (ATP III) criteria. The relationship between tumor size and grade of the two groups (Fuhrman nuclear degree) was evaluated statistically. Results: The metabolic syndrome was found in 70 patients, with a mean age of 65.5 (40-87), as compared to 58.8 (31-84) years in the non-metabolic syndrome group. Tumor size over 7 cm was found in 54% and 33%, respectively, and tumor grade over Fuhrman 3 in 56% and 32% of patients. Patients with metabolic syndrome had significantly higher tumor size and grade (p<0.05). In the presence of hypertension, diabetes and high triglyceride levels, significant assocations were again observed (p<0.05). Tumor size and degree also increased with increasing body mass index but this was not statistically significant (p>0.05). Conclusions: Renal cancer is more aggressive in patients with metabolic syndrome. Lifestyle and risk factors were revealed to be significant influences in renal cancer patients.