• Title/Summary/Keyword: New Risk Classification

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Behavioural and Metabolic Risk Factors for Mortality from Colon and Rectum Cancer: Analysis of Data from the Asia-Pacific Cohort Studies Collaboration

  • Morrison, David Stewart;Parr, Christine Louise;Lam, Tai Hing;Ueshima, Hirotsugu;Kim, Hyeon Chang;Jee, Sun Ha;Murakami, Yoshitaka;Giles, Graham;Fang, Xianghua;Barzi, Federica;Batty, George David;Huxley, Rachel Rita;Woodward, Mark
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.2
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    • pp.1083-1087
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    • 2013
  • Background: Colorectal cancer has several modifiable behavioural risk factors but their relationship to the risk of colon and rectum cancer separately and between countries with high and low incidence is not clear. Methods: Data from participants in the Asia Pacific Cohort Studies Collaboration (APCSC) were used to estimate mortality from colon (International Classification of Diseases, revision 9 (ICD-9) 153, ICD-10 C18) and rectum (ICD-9 154, ICD-10 C19-20) cancers. Data on age, body mass index (BMI), serum cholesterol, height, smoking, physical activity, alcohol and diabetes mellitus were entered into Cox proportional hazards models. Results: 600,427 adults contributed 4,281,239 person-years follow-up. The mean ages (SD) for Asian and Australia/New Zealand cohorts were 44.0 (9.5) and 53.4 (14.5) years, respectively. 455 colon and 158 rectum cancer deaths were observed. Increasing age, BMI and attained adult height were associated with increased hazards of death from colorectal cancer, and physical activity was associated with a reduced hazard. After multiple adjustment, any physical activity was associated with a 28% lower hazard of colon cancer mortality (HR 0.72, 95%CI 0.53-0.96) and lower rectum cancer mortality (HR 0.75, 95%CI 0.45-1.27). A 2cm increase in height increased colon and all colorectal cancer mortality by 7% and 6% respectively. Conclusions: Physical inactivity and greater BMI are modifiable risk factors for colon cancer in both Western and Asian populations. Further efforts are needed to promote physical activity and reduce obesity while biological research is needed to understand the mechanisms by which they act to cause cancer mortality.

Sacral Insufficiency Fractures : How to Classify?

  • Bakker, Gesa;Hattingen, Joerg;Stuetzer, Hartmut;Isenberg, Joerg
    • Journal of Korean Neurosurgical Society
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    • v.61 no.2
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    • pp.258-266
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    • 2018
  • Objective : The diagnosis of insufficiency fractures of the sacrum in an elder population increases annually. Fractures show very different morphology. We aimed to classify sacral insufficiency fractures according to the position of cortical break and possible need for intervention. Methods : Between January 1, 2008 and December 31, 2014, all patients with a proven fracture of the sacrum following a low-energy or an even unnoticed trauma were prospectively registered : 117 females and 13 males. All patients had a computer tomography of the pelvic ring, two patients had a magnetic resonance imaging additionally : localization and involvement of the fracture lines into the sacroiliac joint, neural foramina or the spinal canal were identified. Results : Patients were aged between 46 and 98 years (mean, 79.8 years). Seventy-seven patients had an unilateral fracture of the sacral ala, 41 bilateral ala fractures and 12 patients showed a fracture of the sacral corpus : a total of 171 fractures were analyzed. The first group A included fractures of the sacral ala which were assessed to have no or less mechanical importance (n=53) : fractures with no cortical disruption ("bone bruise") (A1; n=2), cortical deformation of the anterior cortical bone (A2; n=4), and fracture of the anterolateral rim of ala (A3; n=47). Complete fractures of the sacral ala (B; n=106) : parallel to the sacroiliac joint (B1; n=63), into the sacroiliac joint (B2; n=19), and involvement of the sacral foramina respectively the spinal canal (B3; n=24). Central fractures involving the sacral corpus (C; n=12) : fracture limited to the corpus or finishing into one ala (C1; n=3), unidirectional including the neural foramina or the spinal canal or both (C2; n=2), and horizontal fractures of the corpus with bilateral sagittal completion (C3; n=8). Sixty-eight fractures proceeded into the sacroiliac joint, 34 fractures showed an injury of foramina or canal. Conclusion : The new classification allowes the differentiation of fractures of less mechanical importance and a risk assessment for possible polymethyl methacrylate leaks during sacroplasty in the direction of the neurological structures. In addition, identification of instable fractures in need for laminectomy and surgical stabilization is possible.

Update of Head and Neck Cancer Staging in the 8th Edition Cancer Staging Manual of the American Joint Committee on Cancer (두경부암 병기 설정의 최신 변화: AJCC 암 병기설정 매뉴얼8판)

  • Hong, Hyun Jun
    • Korean Journal of Head & Neck Oncology
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    • v.33 no.2
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    • pp.9-15
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    • 2017
  • The recently released the $8^{th}$ edition of the American Joint Committee on Cancer (AJCC) Staging Manual introduces significant modifications from the prior $7^{th}$ edition. In this paper, the contents of the new changes in the decision of cancer of the head and neck is summarized except changes in staging of skin and thyroid cancer. In addition to the 8th edition, 1) Addition of extracapsular involvement in metastatic lymph nodes (N category) 2) Oral cancer T classification change, 3) Staging of the pharyngeal cancer was divided into 3 chapters: high-risk human papilloma virus (HR-HPV) associated oropharyngeal cancer (OPC), non HR-HPV associated OPC and hypopharynx cancer (HPC), and nasopharynx cancer (NPC) 4) Changes in T and N classification in NPC, 5) In the case of cancer of unknown primary, P16-positive case is defined as HR-HPV related OPC, and EBV-positive case is defined as NPC. The process that led to these changes highlights the need to collect high-fidelity cancer registry-level data that can be used to confirm prognostic observations identified in institutional data sets. Clinicians will continue to use the latest information for patient care, including scientific content of the 8th Edition Manual. All newly diagnosed cases through December $31^{st}$ 2017 should be staged with the 7th edition. The time extension will allow all partners to develop and update protocols and guidelines and for software vendors to develop, test, and deploy their products in time for the data collection and implementation of the 8th edition in 2018. The 8th edition strikes a balance between a personalized, complex system and a more general, simpler one that maintains the user-friendliness and worldwide acceptability of the traditional TNM staging paradigm.

Susceptibility for ischemic stroke in Sasang constitutional classification is associated with the interleukin-1 receptor antagonist polymorphism

  • Lee, Byung-Cheol;Ahn, Young-Min;Ahn, Se-Young;Doo, Ho-Kyung
    • Advances in Traditional Medicine
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    • v.6 no.1
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    • pp.27-33
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    • 2006
  • The Sasang constitutional medicine classifies the mankind into four constitutional types according to the individual psychological and physical traits. Differences in the Sasang constitutional medicine may be explained by the genetic factors. In order to determine the association of Sasang constitutional classification and interleukin-1 receptor antagonist (IL-1Ra) in genetic susceptibility to ischemic stroke, we classified the four constitutional types in ischemic stroke patients (n = 125) and the healthy control subjects (n = 107), and genotyped for IL-1Ra polymorphism by polymerase chain reaction (PCR) methods. The distribution of the $IL1RN^*1/IL1RN^*2$ genotype in the ischemic stroke patients was significantly different from the healthy controls (OR = 6.09; P =0.0134). And the prevalence of $IL1RN^*1/IL1RN^*2$ genotype was increased in Taeum-in ischemic stroke patients, as compared to Taeum-in healthy controls (OR = 14.71; P = 0.0144). These results suggest that $IL1RN^*1/IL1RN^*2$ genotype in Taeum-in might be associated with the increasing risk for ischemic stroke. Furthermore, this relationship could provide the basis for a new approach in the investigation of the etiology of ischemic stroke.

AI Advisor for Response of Disaster Safety in Risk Society (위험사회 재난 안전 분야 대응을 위한 AI 조력자)

  • Lee, Yong-Hak;Kang, Yunhee;Lee, Min-Ho;Park, Seong-Ho;Kang, Myung-Ju
    • Journal of Platform Technology
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    • v.8 no.3
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    • pp.22-29
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    • 2020
  • The 4th industrial revolution is progressing by country as a mega trend that leads various technological convergence directions in the social and economic fields from the initial simple manufacturing innovation. The epidemic of infectious diseases such as COVID-19 is shifting digital-centered non-face-to-face business from economic operation, and the use of AI and big data technology for personalized services is essential to spread online. In this paper, we analyze cases focusing on the application of artificial intelligence technology, which is a key technology for the effective implementation of the digital new deal promoted by the government, as well as the major technological characteristics of the 4th industrial revolution and describe the use cases in the field of disaster response. As a disaster response use case, AI assistants suggest appropriate countermeasures according to the status of the reporter in an emergency call. To this end, AI assistants provide speech recognition data-based analysis and disaster classification of converted text for adaptive response.

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Case Report : The Hypoglycemic Effect of Gamiyookmigihwang-tang on A Mild Diabetes Mellitus patient with Impaired Glucose Tolerance & Impaired Fasting Glucose (가미육미지황탕(加味六味地黃湯)이 공복혈당장애와 내당능장애를 가진 경증 당뇨병환자의 혈당조절에 미치는 영향 1례)

  • Kim, In Soo;Kim, Myeong Sin;Lee, Young Su
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.27 no.5
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    • pp.677-682
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    • 2013
  • Impaired glucose tolerance(IGT) & Impaired fasting glucose(IFG) were standardized in 1979 by the National Diabetes Data Group and the World Health Organization as a risk factor for type 2 diabetes. The main clinical significance of IGT & IFG shows some risk factors on type 2 diabetes, cardiovascular disease and component of the metabolic syndrome. In 1997, the American Diabetes Association(ADA) proposed the new classification and diagnostic criteria for diabetes, which wss striction on the diagnostic baseline of Diabetes from 140 mg/dl to 126 mg/dl. This is because that the early diagnosis and treatments can prevent chronic complications. In the oriental medicine, Gamiyookmigihwang-tang has been using for the treatments of Diabetes including IGT & IFG; however, there have not been enough studies about the effect of the glycemic control objectively. So clinical studies have been performed on a mild DM(Diabetes Mellitus) patient with IGT and IFG in order to investigate whether there is hypoglycemic effect of Gamiyookmigihwang-tang. Prior to the study, for two weeks fasting blood sugar(FBS) and postprandial 2hrs(PP2hrs) glucose were checked. in addition ECG, T-cholesterol, TG, HbA1c levels were measured; then, Gamiyookmigihwang-tang has administrated for 4 weeks. and FBS, PP2hrs, T-cholesterol, TG, HbA1c were measured again after the herb medicine treatment. FBS, PP2hrs glucose levels and other measuring levels (T-cholesterol, TG, HbA1c) were decreased by the administration of Gamiyookmigihwang-tang. Gamiyookmigihwang-tang has hypoglycemic effects on a mild DM patient with IGT and IFG.

Principal Components Regression in Logistic Model (로지스틱모형에서의 주성분회귀)

  • Kim, Bu-Yong;Kahng, Myung-Wook
    • The Korean Journal of Applied Statistics
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    • v.21 no.4
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    • pp.571-580
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    • 2008
  • The logistic regression analysis is widely used in the area of customer relationship management and credit risk management. It is well known that the maximum likelihood estimation is not appropriate when multicollinearity exists among the regressors. Thus we propose the logistic principal components regression to deal with the multicollinearity problem. In particular, new method is suggested to select proper principal components. The selection method is based on the condition index instead of the eigenvalue. When a condition index is larger than the upper limit of cutoff value, principal component corresponding to the index is removed from the estimation. And hypothesis test is sequentially employed to eliminate the principal component when a condition index is between the upper limit and the lower limit. The limits are obtained by a linear model which is constructed on the basis of the conjoint analysis. The proposed method is evaluated by means of the variance of the estimates and the correct classification rate. The results indicate that the proposed method is superior to the existing method in terms of efficiency and goodness of fit.

Surgical Outcomes of Cor Triatriatum Sinister: A Single-Center Experience

  • Kim, Donghee;Kwon, Bo Sang;Kim, Dong-Hee;Choi, Eun Seok;Yun, Tae-Jin;Park, Chun Soo
    • Journal of Chest Surgery
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    • v.55 no.2
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    • pp.151-157
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    • 2022
  • Background: We investigated surgical outcomes after the surgical repair of cor triatriatum sinister (CTS). Methods: Thirty-two consecutive patients who underwent surgical repair of CTS from 1993 through 2020 were included in this study. The morphological characteristics, clinical features, and surgical outcomes were described and analyzed. Results: The median age and body weight at operation were 9 months (interquartile range [IQR], 3-238 months) and 7.5 kg (IQR, 5.8-49.6 kg), respectively. There were 16 males (50%). According to the modified Lucas classification, type IA (classical CTS) was most common (n=20, 62.5%). Atrial septal defect was associated in 22 patients (68.8%) and anomalous pulmonary venous return in 8 patients (25%). Pulmonary hypertension was preoperatively suspected with a high probability in 18 patients (56.3%). There was 1 early death (3.1%) after emergent membrane excision and hybrid palliation in a high-risk hypoplastic left heart syndrome patient. There were no late deaths. The overall survival rate was 96.9% at 15 years post-repair. No early survivors required reoperation during follow-up. Most survivors (31 of 32 patients, 96.9%) were in New York Heart Association functional class I at a median follow-up of 74 months (IQR, 39-195 months). At the latest echocardiography performed at a median of 42 months (IQR, 6-112 months) after repair, no residual lesion was observed except in 1 patient who had moderate pulmonary hypertension (mean pulmonary arterial pressure of 36 mm Hg). Conclusion: Surgical repair of cor triatriatum could be performed safely and effectively with an extremely low risk of recurrence.

Quality Attribute Classification of Service Elements in Business Incubation Center (창업보육센터의 주요 서비스 요소에 대한 품질속성 분류)

  • Kim, Soung-Hyun;Jeon, Young-Rok
    • Journal of Korean Society of Industrial and Systems Engineering
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    • v.37 no.3
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    • pp.75-81
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    • 2014
  • To establish a new creative economy, the worldwide efforts have been made to wriggle out the old economic paradigm after the financial crisis of 2008. When it comes to the limitation of the viability. the start up companies have a high risk of failure. Therefore business incubator (BI) should carry out the role to improve their viability. As for the maximization of the effect on the business incubating services as move in companies, it is important for BI to increase the level of business incubating services by the systemic and scientific measurement. This study showed that the quality of the BI center services was measured by Kano analysis and the previous research as follows. First, BI quality attribute by Timko's customer satisfaction came out into the attractive qualities on the 14 items that amount to the 70% of 20 business incubating services items. It is desirable to perform the strategy for the satisfaction. Secondly, basic business incubating services were interpreted as the one-dimensional quality like incubating spaces, parking facilities, security facilities, industry technology development funds, and incubating managers. Finally, training and educational service was recognized as indifferent quality. Futhermore, the improvement and the limitation of this study as well as the interpretation of analysis results are also provided.

The Present Status and Issues of Local Government Adaptation Plans for Climate Change: Focusing on the Health Sector (지자체 기후변화 적응대책의 현황과 과제 : 건강분야를 중심으로)

  • Lee, Jaehyung
    • Journal of Environmental Health Sciences
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    • v.43 no.2
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    • pp.111-121
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    • 2017
  • Objectives: In this study, an analysis was performed on local government adaptation plans for climate change focusing on the health sector. The limitations of past study results have been summarized and new research subjects for preparing for the advanced second period (2018-2022) of the local government adaptation plan for climate change have been suggested. Methods: First, a review of the literature related to vulnerability assessment and adaptation plans was performed. Next, a comparison among the 16 metropolitan governments' vulnerability assessment results and adaptation plans was made. Lastly, a classification of the adaptation policy and budgets to compare with their real budget amounts was performed. Results: The results show that there is a categorizing discrepancy between vulnerability assessment and adaptation policy. In addition, their adaptation budget amounts turned out to be too large in comparison with the actual budget amounts. Conclusion: The first period (2013-2017) local government adaptation plans for climate change had some limitations. This is because there was a rapid driving force for establishing adaptation plans under the green growth strategy in Korea. Now, we are confronting a risk of adaptation to climate change. By expanding this approach, the government would be able to set up a detailed policy to improve the plans during the second period.