• Title/Summary/Keyword: cohort

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Clinical Features, Diagnosis, Management, and Outcomes of Idiopathic Pulmonary Fibrosis in Korea: Analysis of the Korea IPF Cohort (KICO) Registry

  • Jegal, Yangjin;Park, Jong Sun;Kim, Song Yee;Yoo, Hongseok;Jeong, Sung Hwan;Song, Jin Woo;Lee, Jae Ha;Lee, Hong Lyeol;Choi, Sun Mi;Kim, Young Whan;Kim, Yong Hyun;Choi, Hye Sook;Lee, Jongmin;Uh, Soo-Taek;Kim, Tae-Hyung;Kim, Sang-Heon;Lee, Won-Yeon;Kim, Yee Hyung;Lee, Hyun-kyung;Lee, Eun Joo;Heo, Eun Young;Yang, Sei Hoon;Kang, Hyung Koo;Chung, Man Pyo;Korea ILD Study Group,
    • Tuberculosis and Respiratory Diseases
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    • v.85 no.2
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    • pp.185-194
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    • 2022
  • Background: The Korea Interstitial Lung Disease Study Group has made a new nationwide idiopathic pulmonary fibrosis (IPF) registry because the routine clinical practice has changed due to new guidelines and newly developed antifibrotic agents in the recent decade. The aim of this study was to describe recent clinical characteristics of Korean IPF patients. Methods: Both newly diagnosed and following IPF patients diagnosed after the previous registry in 2008 were enrolled. Survival analysis was only conducted for patients diagnosed with IPF after 2016 because antifibrotic agents started to be covered by medical insurance of Korea in October 2015. Results: A total of 2,139 patients were analyzed. Their mean age at diagnosis was 67.4±9.3 years. Of these patients, 76.1% were males, 71.0% were ever-smokers, 14.4% were asymptomatic at the time of diagnosis, and 56.9% were at gender-age-physiology stage I. Occupational toxic material exposure was reported in 534 patients. The mean forced vital capacity was 74.6% and the diffusing capacity for carbon monoxide was 63.6%. Treatment with pirfenidone was increased over time: 62.4% of IPF patients were treated with pirfenidone initially. And 79.2% of patients were treated with antifiboritics for more than three months during the course of the disease since 2016. Old age, acute exacerbation, treatment without antifibrotics, and exposure to wood and stone dust were associated with higher mortality. Conclusion: In the recent Korean IPF registry, the percentage of IPF patients treated with antifibrotics was increased compared to that in the previous IPF registry. Old age, acute exacerbation, treatment without antifibrotics, and exposure to wood and stone dust were associated with higher mortality.

Qualitative Study on Experiences of Responding to COVID-19 of Therapists in Long-term Care Hospitals (요양병원 치료사의 코로나19 대응 경험에 대한 질적 연구)

  • Bae, Won-Jin;Park, Ju-Young
    • Journal of Korea Entertainment Industry Association
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    • v.15 no.4
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    • pp.337-347
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    • 2021
  • This study is a qualitative study conducted to provide basic data for therapists working in long-term care hospitals to improve their countermeasure strategies for new infectious diseases and improvement of the treatment room infection management system, and to help therapists understand their infection management work. Colaizzi's phenomenological research method was applied as the research method. Telephone interviews were conducted with nine occupational therapists and physical therapists working in nursing hospitals. The contents of the interview were recorded with the consent of the study subjects, and additional confirmation was received by email. The recorded content was analyzed after transcription, and the meaning and nature of the experience coping with COVID-19 were described. The content was organized into 6 themes, 17 main meaning and 49 meaning units. In accordance with the COVID-19 situation, the infection control system has been strengthened by reinforcing infection control education in nursing hospitals, practicing infection control, and supervising infection control outside business hours. It was found that the treatment environment was changed due to the restriction of treatment activities by practicing distancing in the treatment room, adjusting rest and meal times during working hours, and strengthening infection control. In addition, the therapist's role has been expanded and the paradigm of treatment has changed, such as considering the untact intervention, and they have experienced cohort quarantine, pre-tested for COVID-19, vaccinations, and side effects from COVID-19. However, due to the infection work, the therapist's work burden is increased, and the person is experiencing fear, depression, and work stress from the spread of COVID-19. They were also aware of the need for nursing hospital care personnel support, such as guaranteeing rest after vaccination and providing infection control tools and equipment. The results of this study are expected to be used as basic data for human and physical support for the development of infectious disease response strategy programs in nursing hospital treatment rooms and for infection control in nursing hospitals.

Characteristics Associated with Citation Rates of the Journal of Korean Orthopaedic Association (An Analysis of Articles between 2001-2015) (대한정형외과학회지에 발표된 논문들의 피인용 횟수와 연관된 특성(2001년부터 2015년까지의 논문 분석))

  • Bae, Jung Yun;Kwak, Sang Ho;Kang, Sang Woo;Woo, Seung Hun;Ahn, Tae Young;Lee, Sang Hyun
    • Journal of the Korean Orthopaedic Association
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    • v.55 no.6
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    • pp.487-494
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    • 2020
  • Purpose: No attempt has been made to identify the relationship between the study characteristics and citation rates of articles published in the Journal of the Korean Orthopaedic Association (JKOA). This study classified the study characteristics of articles in the JKOA and analyzed the relationship between the study characteristics and citation rates. Materials and Methods: A cohort study was conducted on all articles published from February 2001 to December 2015. Three independent reviewers classified the articles according to the article type, material, time of the study, design, clinical categories, number of authors, and number of cases. The citation numbers of each article by other journals were taken in January 2020. Univariate analyses were conducted to assess the effect of each characteristic, and multivariate linear regression analysis was performed to analyze the overall relationship between the characteristics and the citation rates. Results: A total of 1,640 articles were published from 2001 to 2015, and 724 articles were cited more than once. The articles published in 2009 had the highest average number of citations. Original articles had the highest citation rates, followed in descending order by surgical techniques and reviews, instructional course lectures, and case reports (p<0.001). Among the case reports, articles dealing with general trauma scored significantly higher average citations (mean=1.5, p=0.006). Among the original articles, articles on general orthopedics had the highest citation rates, followed in order by clinical articles and experimental articles. Among the clinical articles, epidemiologic studies (mean=5.0, p<0.001) and studies on the spine (mean=1.7, p<0.001) recorded significantly higher citation rates than the others. Conclusion: Of all the articles published in the JKOA from 2001 to 2015, articles dealing with general trauma had the highest citation rates among case reports. Among the original articles, epidemiologic studies and studies concerning the spine were cited significantly more than others.

Periprosthetic Fracture around Tumor Prosthesis, Comparison of Results with or without Cortical Strut Onlay Allograft (종양인공관절 주위 골절의 피질골 지주 중첩 동종골 이식술 유무에 따른 결과 비교)

  • Kim, Yongsung;Cho, Wan Hyeong;Song, Won Seok;Lee, Kyupyung;Jeon, Dae-Geun
    • Journal of the Korean Orthopaedic Association
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    • v.56 no.1
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    • pp.42-50
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    • 2021
  • Purpose: Periprosthetic fractures of a tumor prosthesis are rare but have difficulties in achieving sound fixation because of the poor bone quality, which increases the risk of loosening or re-fracture, even after bone union. A cortical strut onlay allograft was adopted for peri-prosthetic fractures after hip arthroplasty into the periprosthetic fracture of a tumor prosthesis, assuming that it would assist in firm fixation, shorten the time to union, and increase the bone stock, thereby, lower the chance of loosening and re-fracture. Materials and Methods: This study reviewed 27 patients (30 cases) of periprosthetic fracture of tumor prosthesis. Sixteen cases (allograft group) had augmentation with an onlay allograft, while 14 cases (conventional group) had internal fixation or conservative treatment. The following were assessed; mode of periprosthetic fracture, difference in the time to union between a strut cortical onlay allograft and without it, and survival of prosthesis, complication, and functional outcome between the two groups. Results: According to the unified classification system (UCS), 21 cases were type B (70.0%; B1, 14; B2, 1; B3, 6) and 9 cases were type C. The five-, 10-year survival of the 30 reconstructions by Kaplan-Meier plot was 84.5%±4.18% and 42.2%±7.83%, respectively. The average time to bone union of the entire cohort was 5.1 months (range, 2.0-11.2 months). The allograft group (3.5 months) showed a shorter period for union than the conventional group (7.2 months) (p<0.0001). All four cases of major complications occurred in the conventional group. Two cases with loosening and anterior angulation were treated with a change of prosthesis, and another with infection underwent amputation. The remaining case with loosening had conservative management. At the final follow-up, the average Musculosketal Tumor Society score of the allograft group (26.1) was better than that of the conventional group (20.9). Conclusion: Bone union in periprosthetic fractures of a tumor prosthesis can be achieved, but the minimization of complications is important. An onlay allograft facilitates firm fixation and increases the bone stock with a shortened time to union. This simple method can minimize the risk of loosening, joint contracture, and re-fracture.

Literature review and future tasks necessary to establish of Korean Dietary Reference Intake for choline (콜린의 한국인 영양소 섭취기준 제정 검토를 위한 문헌 고찰 및 향후 과제)

  • Shim, Eugene;Park, Jae-Hee;Lee, Yunjung;Park, Eunju
    • Journal of Nutrition and Health
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    • v.55 no.2
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    • pp.211-226
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    • 2022
  • Choline, an essential nutrient for humans, is required for the structural integrity of the cell membranes, methyl-group metabolism, synthesis of the neurotransmitter acetylcholine, synthesis of the membrane phospholipid components of the cell membranes, and the transport of lipids and cholesterol. Choline can be synthesized in the body, but it is insufficient to meet the daily requirements and hence it must be obtained through the diet. In the United States/Canada, Australia/New Zealand, Europe, China, and Taiwan, the adequate intake (AI) and tolerable upper intake level (UL) of choline have been established, while the establishment of the 2020 Dietary Reference Intakes for Koreans (KDRI) for choline was postponed due to the lack of a choline database for Korean foods and studies on the choline intake of Koreans. However, as part of the preparation work for the 2020 DRI revision and finalization, choline intake and the possibility of disease occurrence were verified through analysis of published data. The groundwork for the subsequent establishment of a choline DRI was laid through a literature search, evaluation, and review of the literature reported from 1949 up to 2019. This can be regarded as the culmination of this project. According to the results of randomized controlled trials (RCTs), cohort studies, case-control studies, and cross-sectional observational studies in humans, approximately 400-500 mg/day of choline intake was effective in preventing liver function damage (fatty liver), neural tube damage, cardiovascular disease, breast cancer, and cognitive function improvement. The same amount of choline intake, however, also correlated with the risk of prostate and colorectal cancer. At present, there is limited information available on choline intake and health outcomes, particularly for the Korean population. More human studies, including clinical trials on the requirements and the physiological benefits associated with dietary intake, are needed to establish the KDRI for choline.

Surgical Management of Comminuted Midshaft Clavicle Fractures Using Reconstruction Plate and Circumferential Wiring: Does the Circumferential Wiring Interfere with the Bone Union? (쇄골 간부 복합 골절에서 재건 금속판 및 환 강선을 이용한 수술적 치료: 환 강선이 골 유합을 방해하는가?)

  • Kim, Kyung-Tae;Shin, Chung-Shik;Park, Young-Chul;Kim, Dong-hyun;Kim, Min-Woo
    • Journal of the Korean Orthopaedic Association
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    • v.56 no.3
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    • pp.245-252
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    • 2021
  • Purpose: This study examined the radiological and clinical outcomes of internal fixation using a reconstruction plate and 21G circumferential wire in comminuted midshaft clavicular fractures. Materials and Methods: A retrospective cohort study was performed on 51 patients between 2005 and 2019. Thirty-two patients underwent internal fixation with a reconstruction plate and a 21G circumferential wire with minimal soft tissue detachment, and 19 patients underwent surgery without a wire. The patients were assessed with the radiographic parameters, the University of California at Los Angeles (UCLA) score, and the visual analogue scale (VAS) pain score. Based on this, patients who operated without a circumferential wire were set as the control group, and the differences in bone union between the two groups were compared. Results: Thirty-two patients were followed-up for an average of 65 weeks, and 19 patients in the control group were followed-up for an average of 56 weeks. The radiological evaluation confirmed the anatomical reduction and bone union in all 32 patients. No case of nonunion was present. The UCLA score was 32.38 on average and 33.11 in the control group (p=0.395). The VAS score was 1.00 on average and 0.84 in the control group (p=0.668). A significant difference in the bony union time was observed between the group who underwent internal fixation with a reconstruction plate and a 21G circumferential wire with minimal soft tissue detachment, and the control group (p=0.015). On the other hand, there was no statistical significance when other variables were controlled (p=0.107). Conclusion: For displaced midshaft clavicular fractures, internal fixation using a reconstruction plate and 21G circumferential wire maintained accurate anatomical reduction. The satisfactory clinical and radiological results mean that internal fixation using a reconstruction plate and 21G circumferential wire may be a good option for surgical treatment.

The Clinical Outcome of Dedifferentiated Chondrosarcoma (역분화 연골육종의 임상 결과)

  • Kong, Chang-Bae;Lee, Seung Yong;Song, Won-Seok;Cho, Wan-Hyeong;Koh, Jae-Soo;Jeon, Dae-Geun
    • Journal of the Korean Orthopaedic Association
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    • v.54 no.2
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    • pp.164-171
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    • 2019
  • Purpose: A dedifferentiated chondrosarcoma is a rare lethal tumor characterized by a low grade chondrosarcoma juxtaposed with a high grade dedifferentiated sarcoma, such as osteosarcoma, fibrosarcoma. The aim of our study was to document the clinical manifestation and oncologic outcomes of a dedifferentiated chondrosarcoma. Materials and Methods: This study identified 11 patients who were diagnosed and treated for dedifferentiated chondrosarcoma between January 2007 and December 2016. The identified cohort was then reviewed regarding age, sex, symptom onset, tumor location, magnetic resonance imagings (MRIs), surgical margin, and pathologic diagnosis. The time to local recurrence and/or metastasis, follow-up duration, and the patients' final status were analyzed. Results: The patients were comprised of 7 males and 4 females with a mean age of 54 years (range, 33-80 years). The location of the tumor was in the femur in 6 cases, pelvis in 4 cases, and metatarsal in 1 case. The average tumor diameter was 12.7 cm (range, 6.0-26.1 cm). At the time of diagnosis, 2 patients showed pathologic fracture; 1 patient was Enecking stage IIA, 9 patients were stage IIB, and 1 patient was stage III. Eight patients were classified as a primary dedifferentiated chondrosarcoma and 3 patients were secondary. One of the primary lesions was misinterpreted initially as a low grade chondroid lesion by MRI and underwent curettage. Local recurrence occurred in 8 cases and distant metastasis occurred in 10 cases with a mean duration of 8 months (range, 2-23 months) and 7 months (range, 1-32 months), respectively. The three-year overall survival of patients with dedifferentiated chondrosarcoma was 18%, and 10 patients died due to disease progression. Conclusion: Dedifferentiated chondrosarcoma developed lung metastases in the early period of the clinical courses and the prognosis was dismal.

Concurrent Validity of the Self-Report and Proxy-Report Versions of a Health-Related Quality of Life Measure: A Focus Group Study (초등학교 아동과 보호자에게 적용한 삶의 질 평가도구의 동시타당도 연구: 표적집단 파일럿연구)

  • Choi, Bongsam
    • The Journal of Korean Academy of Sensory Integration
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    • v.21 no.2
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    • pp.45-57
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    • 2023
  • Objective : The purpose of this study was to investigate the concurrent validity of the self- and proxy-report versions of the KIDSCREEN-10 quality of life questionnaire. Methods : A total of nine children and nine parents were selected to represent a cohort registered for a school-based wellness program. Two versions of the KIDSCREEN-10 questionnaire (self- and proxy reports) were administered to the children and their parents. The Rasch rating scale model was applied to determine the dimensionality and item difficulty of the two versions of the questionnaire. Moreover, the item-person matching map and Spearman's rho were compared to confirm the concurrent validity of the two versions. Results : All items, except four items (i.e., autonomy, home life, concentration/learning, and peers/social support), fit the Rasch rating scale model of the children's self-report version of the questionnaire. With regard to the parent's proxy-report version, two items misfit the model. While the items of the self- and proxy-report versions showed similar item difficulties, the parents had a tendency to be more severe in their ratings than the children. The correlation between the two versions was relatively low (Spearman's rho = .533, p > .05). The scatterplots between the two versions showed differences in the item difficulties of the physical and psychological well-being and self-perception items. Conclusion : These findings suggest that the three identified items should be taken into consideration when measuring children's health-related quality of life using the KIDSCREEN-10 questionnaire.

Incidence of Dental Discoloration After Tetracycline Exposure in Korean Children: A Nationwide Population-Based Study

  • Ji Young Lee;Eun Hwa Kim;Myeongjee Lee;Jehee Shin;Sung Min Lim;Jee Yeon Baek;MinYoung Kim;Jong Gyun Ahn;Chung-Min Kang;Inkyung Jung;Ji-Man Kang
    • Pediatric Infection and Vaccine
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    • v.31 no.1
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    • pp.25-36
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    • 2024
  • Purpose: Tetracycline is not recommended for children under 12 by guideline due to the risk of tooth discoloration. We aimed to assess the incidence of dental discoloration in Korean children prescribed tetracyclines and investigate whether its risk was greater in tetracycline-exposed children than in the general population. Methods: This population-based cohort study using the Health Insurance Review and Assessment service database included children aged 0-12 years exposed to tetracyclines for at least 1 day between January 2008 and December 2020. The primary outcome was the incidence rate of dental discoloration ≥6 months after prescription, and the standardized incidence ratio (SIR) was evaluated as secondary outcome. Results: 56,990 children were included-1,735 and 55,255 aged <8 and 8-12 years, respectively. 61% children were prescribed tetracycline for <14 days with mostly second-generation tetracyclines, doxycycline (61%) and minocycline (35%). The 5- and 10-year cumulative incidence rates of dental discoloration were 4.1% (95% confidence interval [CI], 3.0-5.7%) and 5.7% (95% CI, 4.1% to 7.8%), respectively, in the 0-7 years age group and 0.8% (95% CI, 0.7% to 0.9%) and 1.3 (95% CI, 1.1% to 1.4%), respectively, in the 8-12 years age group. Tetracycline exposure did not increase such risk compared to that in the general population (SIR, 1.08; 95% CI, 0.69 to 1.60). Conclusions: The incidence of dental discoloration was lower than previously suggested. Relieving the age restriction for prescribing tetracyclines may be considered.

Association of Lifestyle Factors With the Risk of Frailty and Depressive Symptoms: Results From the National Survey of Older Adults (노인의 라이프스타일 요인이 허약 및 우울 위험도에 미치는 영향: 노인실태조사 자료를 바탕으로)

  • Lim, Seungju;Kim, Ah-Ram;Park, Kang-Hyun;Yang, Min-Ah;Park, Ji-Hyuk
    • Therapeutic Science for Rehabilitation
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    • v.13 no.1
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    • pp.35-47
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    • 2024
  • Objective : This study aimed to investigate the association between lifestyle factors and risk of frailty and depressive symptoms among older South Korean adults. Methods : This study included 10,072 individuals aged 65 or older from the 2017 National Survey of Older Koreans, a cohort of community-dwelling older South Koreans. The following lifestyle factors were assessed: physical activity, nutrition management (NM), and leisure/social activity participation (AP). Frailty was measured using the frail scale and depressive symptoms were measured using the Geriatric Depression Scale. Logistic regression analyses were performed to determine the odds ratios. Results : All lifestyle factors were associated with the risk of frailty and depressive symptoms in the study population. Regular exercise (≥3 times/wk, odds ratio [OR] = 0.59, 95% confidence interval [95% CI] = 0.52~0.91; OR = 0.66, 95% CI = 0.59~0.75), active NM (OR = 0.86, 95% CI = 0.80~0.91; OR = 0.81, 95% CI = 0.76~0.86), leisure AP (OR = 0.79, 95% CI = 0.74~0.84; OR = 0.71, 95% CI = 0.66~0.77) and social AP (OR = 0.92, 95% CI = 0.88~0.96; OR = 0.82, 95% CI = 0.78~0.87) were correlated with lower odds ratios of frailty and depressive symptoms. Conclusion : Adopting a healthier lifestyle characterized by regular exercise, balanced nutrition, and active engagement in various activities can effectively reduce the risk of frailty and depressive symptoms among the older population. Ultimately, this study emphasized the essential role of lifestyle choices in promoting the physical and mental well-being of older adults.