• 대한한방내과학회지
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• 제41권3호
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• pp.293-305
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• 2020

Purpose: This study aimed to develop a questionnaire for the diagnosis of chronic fatigue syndrome (CFS) designed based on the systematic exertion intolerance disorder (SEID) criteria, and to validate the reliability of the questionnaire. Methods: A literature search on questionnaires for CFS diagnosis was conducted to develop a SEID questionnaire (SEID-Q27), followed by a pilot survey to identify the reliability of the questionnaire. Adults (Daejeon university personnel) with a Chalder fatigue scale (CFQ) score ≥15 were invited for the survey. We commenced the survey in November 2019 with a two weeks of interval for the test and retest method. The reliability of the questionnaire was investigated in three angles: 1. Cronbach's α, 2. correlations (r) of the questions, numerical rating scale (NRS), and visual analog scale (VAS), and 3. kappa (k) analysis. Results: Among the total 275 adults registered, 55 (20%) participants with a CFQ score ≥15 were invited, and 31 (11%) [15 male, 16 female] completed the questionnaire. The total Cronbach's α was 0.944 for the test and 0.949 for the retest. The reliability (r) of questions by CFQ score (≥15, ≥18, ≥20) ranged from 0.533-0.928 (p <0.05), and the r score of the NRS and VAS were the highest in CFQ scores ≥20, at 0.933 (p<0.001). The agreement rate of the SEID-Q27 between the test and retest was 87% (kappa k=0.743). Conclusions: The SEID-Q27 seems to be reliable. Further studies are needed to measure the validity of the tool and the cutoff point.

• Journal of Korean Medical Science
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• 제33권48호
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• pp.305.1-305.5
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• 2018

Background: In 1997 the Korean Association of Medical Journal Editors (KAMJE) instituted a program to evaluate member journals. Journals that passed the initial evaluation were indexed in the KoreaMed. Here, we report changes in measures of quality of the KAMJE member journals during the last 20 years. Methods: Quality measures used in the study comprised 3 assessment categories; self-assessment by journal editors, assessment of the journals by KAMJE reviewers, and by Korean health science librarians. Each used detailed criteria to score the journals on a scale of 0 to 5 or 6 in multiple dimensions. We compared scores at baseline evaluation and those after 7 years for 129 journals and compared improvements in journals indexed vs. not-indexed by the Web of Science (Science Citation Index Expanded; SCIE). Results: Among 251 KAMJE member journals at the end of 2015, 227 passed evaluation criteria and 129 (56%) had both baseline and 7-year follow-up assessment data. The journals showed improvement overall (increase in median [interquartile range; IQR] score from baseline, 0.47 [0.64]; 95% confidence interval [CI], 0.44-0.61; P < 0.001) and within each category (median [IQR] increase by editor's assessment, 0.17 [0.83]; 95% CI, 0.04-0.26; P = 0.007; by reviewer's, 0.45 [1.00]; 95% CI, 0.29-0.57; P < 0.001; by librarian's, 1.75 [1.08]; 95% CI, 1.77-2.18, P < 0.001). Before the foundation of KAMJE in 1996, there were only 5 Korean medical journals indexed in the MEDLINE and none in SCIE, but 24 journals in the MEDLINE and 34 journals in SCIE were indexed by 2016. Conclusion: The KAMJE journal evaluation program successfully contributes improving the quality of the member journals.

• 대한물리의학회지
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• 제14권1호
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• pp.63-73
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• 2019

PURPOSE: This study examined the effects of cardiopulmonary physiotherapy on the cardiopulmonary function, metabolism, inflammatory markers, and quality of life in patients with coronary artery disease who underwent percutaneous coronary intervention (PCI). METHODS: Electronic bibliographic databases of a regional information sharing system (RISS) and PubMed were searched to identify studies with randomized and non-randomized controlled trials. As the final outcome, 320 publications were identified and 18 studies met the inclusion and exclusion criteria. All studies were assessed for the quality of study using Cochrane's risk of bias. RESULTS: Sixteen studies met the inclusion criteria, in which meta-analysis had been conducted to examine the effectiveness of cardiopulmonary physiotherapy on the cardiopulmonary function, metabolism, inflammatory markers, and quality of life in patients undergoing PCI. Meta-analysis based on a random effect model showed that the cardiopulmonary physiotherapy was beneficial in improving the cardiopulmonary function, metabolism, inflammatory markers, and quality of life. In particular, there was a significant effect on the peak oxygen uptake (effect size 5.30%; 95% confidence interval 3.62~6.97). Cardiopulmonary physiotherapy for a during period of 6 weeks or more was effective in significantly improving the cardiopulmonary function and metabolism function in a subgroup analysis, but cardiopulmonary physiotherapy for less than 6 weeks was not effective. CONCLUSION: Cardiopulmonary physiotherapy has positive effects on the cardiopulmonary function, metabolism, inflammatory markers, and quality of life in patients undergoing PCI.

• 대한신경집중치료학회지
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• 제11권2호
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• pp.102-109
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• 2018

Background: A sians were known to have a relatively lower incidence of venous thromboembolism (VTE), and there is insufficient evidence to suggest a specific D-dimer threshold level for screening VTE in patients with acute stroke. Methods: We prospectively enrolled patients with acute ischemic stroke admitted to Jeju National University Hospital. The inclusion criteria were: 1) aged ${\geq}18$ years, 2) admission within seven days of symptom onset, and 3) an initial National Institute of Health Stroke Scale (NIHSS) score >1 for the affected lower limb. Ultrasound scans of the lower limbs and plasma D-dimer assays were performed on days 7-14 and 15-28 after stroke onset. Results: Of 285 patients admitted during the study period, 52 patients met inclusion criteria (mean age 74.5, male 40.4%, median initial NIHSS score 12, and unable to walk unassisted at discharge 76.9%). During 7-14 days, 23 of 52 patients (44.2%) had a D-dimer level above 1.57 mg/L, and 9.6% had a level above 5.50 mg/L. Proximal deep vein thrombosis (DVT) was detected in 3 patients (5.8%, 95% confidence Interval 1.2-16.0%) on ultrasound examination. All DVTs were found in elderly female patients with severe leg weakness. No patient was diagnosed with pulmonary embolism during the study period. Conclusion: The incidence of VTE seems to be very low among Korean patients with acute ischemic stroke. Advanced age, female sex, and severe leg weakness were important risk factors for developing DVT in this study.

• Journal of Gastric Cancer
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• 제21권1호
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• pp.16-29
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• 2021

Purpose: Incidence, risk factors, and clinical consequences of pancreatic fistula (POPF) after D1+/D2 radical gastrectomy have not been well investigated in Western patients, particularly those from Eastern Europe. Materials and Methods: A total of 358 D1+/D2 radical gastrectomies were performed by surgeons with high caseloads in a single surgical center from 2002 to 2017. A retrospective analysis of data that were prospectively gathered in an electronic database was performed. POPF was defined and graded according to the International Study Group for Pancreatic Surgery (ISGPS) criteria. Uni- and multivariate analyses were performed to identify potential predictors of POPF. Additionally, the impact of POPF on early complications and long-term outcomes were investigated. Results: POPF was observed in 20 patients (5.6%), according to the updated ISGPS grading system. Cardiovascular comorbidities emerged as the single independent predictor of POPF formation (risk ratio, 3.051; 95% confidence interval, 1.161-8.019; P=0.024). POPF occurrence was associated with statistically significant increased rates of postoperative hemorrhage requiring re-laparotomy (P=0.029), anastomotic leak (P=0.002), 90-day mortality (P=0.036), and prolonged hospital stay (P<0.001). The long-term survival of patients with gastric adenocarcinoma was not affected by POPF (P=0.661). Conclusions: In this large series of Eastern European patients, the clinically relevant rate of POPF after D1+/D2 radical gastrectomy was low. The presence of co-existing cardiovascular disease favored the occurrence of POPF and was associated with an increased risk of postoperative bleeding, anastomotic leak, 90-day mortality, and prolonged hospital stay. POPF was not found to affect the long-term survival of patients with gastric adenocarcinoma.

• 대한청각학회지
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• 제24권1호
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• pp.24-28
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• 2020

Background and Objectives: Systemic steroid therapy (SST) and intratympanic steroid injection (ISI) have been the treatment of choice for sudden sensorineural hearing loss (SSNHL). We studied the effect of ISI administered at different intervals on hearing outcomes in patients with SSNHL. Subjects and Methods: We performed a retrospective study of 427 patients diagnosed with SSNHL at Bundang Jesaeng Hospital, of whom 51 patients with SSNHL who received SST and four ISIs were included in this study. Patients were treated with four ISIs either every day for 4 days (group 1) or at intervals (mean duration of interval: 2.21 days) (group 2). Hearing outcomes were evaluated using the pure-tone test before the injection and 14 days, 1 month, and 3 months after the final injection. Recovery rates were classified based on Siegel's criteria. Results: The amount of improvement was 27.67 dB (±20.45) in group 1 and 32.79 dB (±21.42) in group 2. However, there were no significant differences between the two groups (p= 0.714). The recovery rates based on Siegel's criteria were 18/27 (66.7%) and 16/24 (66.7%) in groups 1 and 2, respectively, with no significant difference (p=1.000). Considering only complete recoveries in hearing recovery, the recovery rates were 15/27 (55.6%) and 14/24 (58.3%) in groups 1 and 2, respectively, with no significant difference (p=0.842). Conclusions: There were no significant differences in hearing outcomes or recovery rates after ISI administration every day or at intervals of 2-3 days.

• Journal of Audiology & Otology
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• 제24권1호
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• pp.24-28
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• 2020

Background and Objectives: Systemic steroid therapy (SST) and intratympanic steroid injection (ISI) have been the treatment of choice for sudden sensorineural hearing loss (SSNHL). We studied the effect of ISI administered at different intervals on hearing outcomes in patients with SSNHL. Subjects and Methods: We performed a retrospective study of 427 patients diagnosed with SSNHL at Bundang Jesaeng Hospital, of whom 51 patients with SSNHL who received SST and four ISIs were included in this study. Patients were treated with four ISIs either every day for 4 days (group 1) or at intervals (mean duration of interval: 2.21 days) (group 2). Hearing outcomes were evaluated using the pure-tone test before the injection and 14 days, 1 month, and 3 months after the final injection. Recovery rates were classified based on Siegel's criteria. Results: The amount of improvement was 27.67 dB (±20.45) in group 1 and 32.79 dB (±21.42) in group 2. However, there were no significant differences between the two groups (p= 0.714). The recovery rates based on Siegel's criteria were 18/27 (66.7%) and 16/24 (66.7%) in groups 1 and 2, respectively, with no significant difference (p=1.000). Considering only complete recoveries in hearing recovery, the recovery rates were 15/27 (55.6%) and 14/24 (58.3%) in groups 1 and 2, respectively, with no significant difference (p=0.842). Conclusions: There were no significant differences in hearing outcomes or recovery rates after ISI administration every day or at intervals of 2-3 days.

• Journal of Gastric Cancer
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• 제22권4호
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• pp.339-347
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• 2022

Purpose: Lymphovascular invasion is a criterion for non-curative resection in patients who have undergone endoscopic submucosal dissection (ESD) for early gastric cancer (EGC). We aimed to determine the rate of extragastric metastasis (EGM) and identify the predictors of EGM in patients with negative resection margins (R0 resection) and lymphovascular invasion in post-ESD pathology. Materials and Methods: A total of 2,983 patients underwent ESD for EGC. Among them, 110 had a pathology of R0 resection and positive lymphovascular invasion. Patients underwent additional gastrectomy (n=63) or further follow-up without gastrectomy (n=47). Results: The 110 patients were assigned to one of the 3 groups according to ESD indications based on post-ESD pathology. The first group satisfied the absolute indication for ESD (n=18), the second group satisfied the expanded indications for ESD (n=34), and the last group satisfied the beyond indication (n=58). The number of occurrences of EGM in each group was 1 (5.6%), 3 (8.8%), and 3 (5.2%), respectively. The logistic regression analysis adjusted for age, sex, tumor size, and indication for ESD, showed that larger tumor size was associated with EGM (odds ratio, 1.76; 95% confidence interval, 1.00-3.10; P=0.048). In contrast, ESD indication criteria did not affect EGM (P=0.349). Conclusions: Tumor size was the only predictive indicator for EGM in patients who underwent R0 resection and lymphovascular invasion on post-ESD pathology. Even patients with pathology corresponding to the absolute indication criteria of ESD had lymphovascular invasion, which means that they require additional gastrectomy due to the risk of EGM.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제26권2호
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• pp.116-126
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• 2023

Purpose: This study aimed to evaluate the prevalence and risk factors of infant dyschezia as well as pediatrician awareness regarding this disease in Indonesia. Methods: This is a two-part cross-sectional study, which was divided into study A and B. Study A: Parents whose infants were under 9 months old and attended well-baby clinics were recruited at two randomly selected primary health centers. Parents also provided information on the infant's previous medical history, and socio-demographic and family details. The Rome IV criteria was translated and validated to be used for diagnosis of infant dyschezia. Study B: Randomly selected pediatricians were surveyed by using a questionnaire to evaluate their knowledge regarding infant dyschezia. Results: The prevalence of infant dyschezia based on the result of this study was 11.8%. Three risk factors had a significant relationship with infant dyschezia i.e., the number of children in the family (odds ratio [OR], 5.619; 95% confidence interval [CI], 2.194-14.390; p<0.001), complementary food diet (OR, 4.238; 95% CI, 1.902-9.443; p<0.001), and social-emotional disturbance (OR, 5.670; 95% CI, 2.550-12.609; p<0.001). The percentage of pediatricians correctly diagnosed infant dyschezia was 71.5%. Most pediatricians agreed that they did not perform any diagnostic testing (79.7%) and only provided education in cases of infant dyschezia (58.5%). Conclusion: The prevalence of infant dyschezia identified in our study was higher than that in other neighboring Asian countries, with the highest prevalence observed in infants 7-9 months old. Being an only child, receiving complementary food diet, and sociao-emotional disturbances were significant risk factors of infant dyschezia.

• Journal of Korean Neurosurgical Society
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• 제58권4호
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• pp.309-315
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• 2015

Objective : An advantage of surgical treatment over conservative treatment of spontaneous intracerebral hemorrhage (ICH) is controversial. Recent reports suggest that contrast extravasations on CT angiography (CTA) might serve as a crucial predictor of hematoma expansion and mortality. The purpose of this study was aimed at investigating the efficacy of surgical treatment in patients with spot sign positive ICH. Methods : We used our institutional medical data search system to identify all adult patients who admitted for treatment of ICH between January 1, 2007 and January 31, 2012. Patients were classified two groups into a surgical group (n=27) and a conservative treatment group (n=28). Admission criteria were the following: age 20-79 years, spontaneous supratentorial ICH, Glasgow Coma Score Ranging from 9 to 14, ICH volume ${\geq}20mL$, and treatment within 24 hours. Results : Fifty-five patients were analyzed. There was no significant difference in the ICU stay between the conservative treatment group ($7.36{\pm}3.66days$) and the surgical treatment group ($6.93{\pm}2.20days$; p=0.950). There was a significant difference in the in-hospital stay between the conservative treatment group ($13.93{\pm}8.87days$) and the surgical treatment group ($20.33{\pm}6.37days$; p=0.001). Overall mortality at day 90 after ICH was 36.4%; this included 16 of 28 patients (57.1%) in the conservative group and 4 of 27 patients (14.8%) in the surgical group. In univariate analysis, there was a positive effect of the surgical treatment in reducing mortality at 90 days (p=0.002), Glasgow Outcome Scale (GOS) at 90-day (p=0.006), and modified Rankin Scale (mRS) at 90-day (p=0.023). In multivariate logistic analysis, there was a significant difference in mortality (odds ratio, 0.211; 95% confidence interval, 0.049-0.906; p=0.036) between the groups at 90-day follow-up. However, there was no significant difference in GOS (odds ratio, 0.371; 95% confidence interval, 0.031-4.446; p=0.434) and mRS (odds ratio, 1.041; 95% confidence interval, 0.086-12.637; p=0.975) between the groups at 90-day follow-up. Conclusion : In this study of surgical treatment of supratentorial ICH in patients with spot sign positive in CTA was associated with less mortality despite of long duration of in-hospital stay. We failed to show that clinical outcome benefit of surgical treatment compared with conservative treatment in patients with spot sign positive ICH.