• Title/Summary/Keyword: Risk management factors

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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.

Rectal Bleeding and Its Management after Irradiation for Cervix Cancer (자궁경부암 환자에서 방사선치료 후에 발생한 직장출혈과 치료)

  • Chun Mison;Kang Seunghee;Kil Hoon-Jong;Oh Young-Taek;Sohn Jeong-Hye;Jung Hye-Young;Ryu Hee Suk;Lee Kwang-Jae
    • Radiation Oncology Journal
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    • v.20 no.4
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    • pp.343-352
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    • 2002
  • Purpose : Radiotherapy is the main treatment modality for uterine cervix cancer. Since the rectum is in the radiation target volume, rectal bleeding is a common late side effect. This study evaluates the risk factors of radiation induced rectal bleeding and discusses its optimal management. Materials and Methods : total of 213 patients who completed external beam radiation therapy (EBRT) and intracavitary radiation (ICR) between September 1994 and December 1999 were included in this study. No patient had undergone concurrent chemo-radiotherapy. Ninety patients received radiotherapy according to a modified hyperfractionated schedule. A midline block was placed at a pelvic dose of between 30.6 Gy to 39.6 Gy. The total parametrial dose from the EBRT was 51 to 59 Gy depending on the extent of their disease. The Point A dose from the HDR brachytherapy was 28 Gy to 30 Gy $(4\;Gy\times7,\;or\;5\;Gy\times6)$. The rectal point dose was calculated either by the ICRU 38 guideline, or by anterior rectal wall point seen on radiographs, with barium contrast. Rectal bleeding was scored by the LENT/SOMA criteria. For the management of rectal bleeding, we opted for observation, sucralfate enema or coagulation based on the frequency or amount of bleeding. The median follow-up period was 39 months $(12\~86\;months)$. Results : The incidence of rectal bleeding was $12.7\%$ (27/213); graded as 1 in 9 patients, grade 2 in 16 and grade 3 in 2. The overall moderate and severe rectal complication rate was $8.5\%$. Most complications $(92.6\%)$ developed within 2 years following completion of radiotherapy (median 16 months). No patient progressed to rectal fistula or obstruction during the follow-up period. In the univariate analysis, three factors correlated with a high incidence of bleeding an icruCRBED greater than 100 Gy $(19.7\%\;vs.\;4.2\%)$, an EBRT dose to the parametrium over 55 Gy $(22.1\%\;vs.\;5.1\%)$ and higher stages of III and IV $(31.8\%\;vs.\;10.5\%)$. In the multivariate analysis, the icruCRBED was the only significant factor (p>0.0432). The total parametrial dose from the EBRT had borderline significance (p=0.0546). Grade 1 bleeding was controlled without further management (3 patients), or with sucralfate enema 1 to 2 months after treatment. For grade 2 bleeding, sucralfate enema for 1 to 2 months reduced the frequency or amount of bleeding but for residual bleeding, additional coagulation was peformed, where immediate cessation of bleeding was achieved (symptom duration of 3 to 10 months). Grade 3 bleeding lasted for 1 year even with multiple transfusions and coagulations. Conclusion : Moderate and several rectal bleeding occurred in $8.5\%$ of patients, which is comparable with other reports. The most significant risk factor for rectal bleeding was the accumulated dose to the rectum (icruCRBED), which corrected with consideration to biological equivalence. Prompt management of rectal bleeding, with a combination of sucralfate enema and coagulation, reduced the duration of the symptom, and minimized the anxiety/discomfort of patients.

The influence of internet addiction on health behavior, sexual behavior and mental health of college student (대학생의 인터넷 중독이 건강행동, 성행동, 정신건강에 미치는 요인)

  • Nam, Mun-Hee;Kim, Jeoung-Mi
    • Journal of Digital Convergence
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    • v.12 no.4
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    • pp.367-378
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    • 2014
  • The purpose of this study was to explore the factors related to internet addiction in college student of Korea. Methods: From November 19, 2012 until December 14, 2012, 300 college students from one of the universities located at K city were surveyed. This study is a cross-sectional survey of college students in K city, and data was collected through self-report questionnaires. Data was analyzed by Fisher's exact test, independent t-test to identify different according to addiction group, and logistic regression analysis in order to factors related to on health behavior, sexual behavior and mental health of among college students. According to results, factors related to risk of addiction were lower frequency of exercise (p<0.05), no eat breakfast for 2 day (p<0.05), porno magazine/porno video contact pornography (p<0.05), subjective happiness index (p<0.05), and suicidal Ideation (p<0.05). This study suggest that exercise, regular diet, important of reproductive health, subjective happiness index and Suicidal Ideation are associated with internet addiction in College student. It is necessary to develop some preventive programs for those of internet addiction.

Analysis of Association with Risk Factors of Cardiovascular Disease and Heart Rate Variability (심박동수 변이에 따른 심혈관질환 위험 인자와의 관련성에 미치는 영향 분석)

  • Lim, Bo-Hee;Seok, Jong-Min;Jeon, Woo-Jin;Ko, Eun-Ju;Lee, Jin
    • Journal of the Korean Society of Radiology
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    • v.12 no.3
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    • pp.321-328
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    • 2018
  • The purpose of this study was to investigate factors affecting the heart rate, to analyze the relevance and to use it as a management index of factors of increase in heart rate. A total of 204 adults from November, 2016 to March, 2017 who responded to a personal questionnaire among the adults who underwent coronary computed tomography scans for health screening, were the target of the investigation. In the study, there was a statistically significant difference (p <.05) between the heart rate and the gender, CACS, Stenosis and the forces affecting cardiovascular disease. CACS, Stenosis had a statistically significant difference (p <.05) compared with the other groups in the group with a heart rate of 80 bpm or more, the ability to influence cardiovascular disease was different from that of other groups There was a meaning difference in the heart rate below 60 bpm group compared (p <.05). In conclusion, it is important and desirable to maintain heart rate below 60 bpm in order to prevent having cardiovascular disease history, and below 80 bpm to prevent CACS and stenosis.

Factors Influencing Treatment Result in Inpatients with Tuberculosis (결핵입원환자의 치료결과에 영향을 미치는 요인)

  • Lee, Hyun-Sook;Hwang, Seul-Ki;Kim, Sang-Mi
    • The Journal of the Korea Contents Association
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    • v.16 no.10
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    • pp.196-205
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    • 2016
  • The purpose of this study is to identify factors influencing treatment result in patients with Tuberculosis by patient characteristic, admission and disease characteristic, and hospital characteristic from 2006 to 2012. Survey data was using Korean national hospital discharge in-depth survey data produced by KCDC(Korea Center for Disease Control and Prevention). Study subjects were 8,305 inpatients with TB(A15.0~A19.9) and analyzed frequency, chi-square test, and logistic regression by using SPSS 20(Statistical Package for the Science). The results of this study show that influencing factors of treatment result were ages (20-39, 40-64, and over 65 years), type of insurance(medical aid), disease code (A16, A17, A18, A19), LOS (31-90, and 91-180 days), beds of hospital (300-499, 500-999, over 1,000 beds) and hospital district (non-metropolitan). These findings implied that it is necessary to support successful prevention and management for high risk TB groups and to build middle and long-term policies as well as short -term policy.

Diversity of the Gastric Microbiota in Thoroughbred Racehorses Having Gastric Ulcer

  • Dong, Hee-Jin;Ho, Hungwui;Hwang, Hyeshin;Kim, Yongbaek;Han, Janet;Lee, Inhyung;Cho, Seongbeom
    • Journal of Microbiology and Biotechnology
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    • v.26 no.4
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    • pp.763-774
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    • 2016
  • Equine gastric ulcer syndrome is one of the most frequently reported diseases in thoroughbred racehorses. Although several risk factors for the development of gastric ulcers have been widely studied, investigation of microbiological factors has been limited. In this study, the presence of Helicobacter spp. and the gastric microbial communities of thoroughbred racehorses having mild to severe gastric ulcers were investigated. Although Helicobacter spp. were not detected using culture and PCR techniques from 52 gastric biopsies and 52 fecal samples, the genomic sequences of H. pylori and H. ganmani were detected using nextgeneration sequencing techniques from 2 out of 10 representative gastric samples. The gastric microbiota of horses was mainly composed of Firmicutes (50.0%), Proteobacteria (18.7%), Bacteroidetes (14.4%), and Actinobacteria (9.7%), but the proportion of each phylum varied among samples. There was no major difference in microbial composition among samples having mild to severe gastric ulcers. Using phylogenetic analysis, three distinct clusters were observed, and one cluster differed from the other two clusters in the frequency of feeding, amount of water consumption, and type of bedding. To the best of our knowledge, this is the first study to investigate the gastric microbiota of thoroughbred racehorses having gastric ulcer and to evaluate the microbial diversity in relation to the severity of gastric ulcer and management factors. This study is important for further exploration of the gastric microbiota in racehorses and is ultimately applicable to improving animal and human health.

Clinical Characteristics and Prognosis of Lung Cancer Patients Admitted to the Medical Intensive Care Unit at a University Hospital (한 대학병원 내과계 중환자실로 입원한 폐암 환자들의 임상 특성 및 예후)

  • Moon, Kyoung Min;Han, Min Soo;Lee, Sung Kyu;Jeon, Ho Seok;Lee, Yang Deok;Cho, Yong Seon;Na, Dong Jib
    • Tuberculosis and Respiratory Diseases
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    • v.66 no.1
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    • pp.27-32
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    • 2009
  • Background: The management of patients with lung cancer has improved recently, and many of them will require admission to the medical intensive care unit (MICU). The aim of this study was to examine the clinical characteristics and to identify risk factors for mortality in patients with lung cancer admitted to the MICU. Methods: We conducted retrospective analysis on 88 patients with lung cancer admitted to the MICU between April 2004 and March 2008. Results: Of the 88 patients (mean age, 66 years), 71 patients (80.7%) had non-small cell lung cancer and 17 patients (19.3%) had small cell lung cancer. Distant metastasis were present in 79 patients (89.8%). The main reasons for MICU admission were acute respiratory failure (77.3%), sepsis (11.4%), and central nervous system dysfunction (4.5%). Mechanical ventilation was used in 54 patients (61.4%). Acute Physiology and Chronic Health Evaluation (APACHE) II score, length of MICU stay, need for mechanical ventilation, source of MICU admission were correlated with MICU mortality. The type of lung cancer and metastasis were not predictive factors of death in MICU. Conclusion: Most common reason for ICU admission was acute respiratory failure. Mortality rate of lung cancer patients admitted to the MICU was 65.9%. APACHE II score, length of ICU stay, need for mechanical ventilation, source of MICU admission were predicted factors of death in the MICU.

Genetic and Non-genetic Factors Affecting Mortality in Lori-Bakhtiari Lambs

  • Vatankhah, M.;Talebi, M.A.
    • Asian-Australasian Journal of Animal Sciences
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    • v.22 no.4
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    • pp.459-464
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    • 2009
  • Data and pedigree information for Lori-Bakhtiari sheep used in this study were 6,239 records of lamb mortality from 246 sires and 1,721 dams, collected from 1989 through 2007 from a Lori-Bakhtiari flock at Shooli station in Shahrekord. The traits investigated were cumulative lamb mortality from birth up to 7 days, up to 14 days, up to 21 days, and up to 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11 and 12 months of age. The models included fixed factors that had significant effects and random direct genetic, maternal genetic and maternal permanent environmental effects. Variance components were estimated using the restricted maximum likelihood procedure applying three animal models with and without maternal and common environmental effects. The overall mean of cumulative lamb mortality rate was 22.95% from birth to 1 year of age, while the overall mortality rate up to 3 and from 3 to 6 months of age was 6.14% and 12.76%, respectively. The mortality rate after 6 months of age declined as the lambs grew older. The age of dam had no important effect on lamb mortality. The type of birth was more important during the preweaning period than at later ages, and lamb mortality rate was higher in twins. The year of birth, month of birth and sex of lamb significantly (p${\leq}$0.01) affected the cumulative lamb mortality rate at all ages. The least square mean of mortality during the final one-third of the lambing period was higher than the first and middle onethird of the lambing period. Male lambs were found to be at a higher risk of mortality than females. Birth weight of the lamb had a highly significant (p${\leq}$0.01) effect on lamb mortality at all ages as a quadratic regression. Direct and maternal heritability estimates of lamb mortality ranged from 0.01 to 0.13 and 0.01 to 0.05, respectively. Direct heritability increased with age of lamb, while maternal effects (genetic and common environmental) were important in the preweaning period. These results indicate that lamb mortality can be reduced first through farm management practices and secondly by genetic selection. Both animal and maternal effects should be considered in breeding programmes for reducing lamb mortality at preweaning.

The Occupational Socialization of the Security Guards in the Casinos - Case of Security Science Majors - (카지노 시큐리티 종사자의 직업사회화 과정 - 경호학 전공자들을 대상으로 -)

  • Chun, Yong-Tae
    • The Journal of the Korea Contents Association
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    • v.10 no.3
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    • pp.337-346
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    • 2010
  • The purpose of this study is to explore how security science graduates in casinos are socialized into the workplace. Participants for this study were seven security guards who work for two of three casinos for foreign customers in the city of Seoul. All the participants majored in the security science in colleges. They had 1 to 5 years of work experience. Their main job responsibilities were deterrent to crimes and watch for impending danger in the casinos. A variety of qualitative data collection techniques for this study included formal and informal interviews, stimulated-recall interview, observations, and field notes. Analytic induction and constant comparison were utilized to analyze data. Triangulating and member checks were employed to enhance trustworthiness. The findings of this study were as follow: Firstly, In acculturation, sports experience and media attraction were revealed as factors. Secondly, In professional socialization, college education and senior students in the program were found. Lastly, organizational socialization, Difficulty of relationship, lack of risk management training, lack of team cohesion, pride himself as a security guard, and unclear evaluation system. In conclusion, a variety of influential factors appeared through his occupational socialization even though there were negative and positive factors.

Association of Depressive/Anxiety Symptoms with Ego Resilience and Social Conflict/Support in Patients with Diabetes Mellitus (당뇨병 환자에서 우울 및 불안증상과 자아탄력성, 사회적 갈등 및 지지 사이의 연관성)

  • Jung, Hoe-Woon;Kim, Sang Hoon;Park, Sang Hag;Kim, Seung-Gon;Kim, Jung Ho;Seo, Eun Hyun;Yoon, Hyung-Jun
    • Anxiety and mood
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    • v.16 no.1
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    • pp.9-17
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    • 2020
  • Objective : The purpose of this study was to investigate the association of depressive/anxiety symptoms with psychosocial factors including ego resilience, social conflict, and social support as well as hemoglobin A1c in patients with diabetes mellitus (DM). Methods : The subjects were 144 patients with DM. Depressive/anxiety symptoms were evaluated by the Hospital Anxiety and Depression Scale. Sociodemographic factors, hemoglobin A1c, ego resilience, social conflict, and social support were measured. Multiple regression analyses were performed to examine the impact of hemoglobin A1c, ego resilience, social conflict, and social support on depressive/anxiety symptoms. Results : A total of 32.6% and 24.3% of participants were identified with depressive and anxiety symptoms, respectively. Depressive/anxiety symptoms positively correlated with the social conflict score. Conversely, ego resilience and social support negatively correlated with depressive/anxiety symptoms. In the final model of the multiple regression analyses, ego resilience was associated with a lower level of depressive (β=-0.083, p=0.019)/anxiety (β=-0.125, p=0.001) symptoms whereas social conflict was related to a higher level of depressive (β=0.353, p=0.011)/anxiety (β=0.460, p=0.003) symptoms. Also, hemoglobin A1c positively associated with anxiety symptoms (β=0.495, p=0.012) whereas social support negatively related to depressive symptoms (β=-0.464, p=0.004). Conclusion : We found possible risk and protective psychosocial factors of underlying depressive/anxiety symptoms among patients with DM. Our findings suggest that enhancing ego resilience and social support as well as decreasing social conflict would be crucial in the prevention and management of depressive/anxiety symptoms in patients with DM.