• Korean Journal of Radiology
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• v.24 no.4
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• pp.274-283
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• 2023

Objective: To compare the outcomes of digital breast tomosynthesis (DBT) screening combined with ultrasound (US) with those of digital mammography (DM) combined with US in women with dense breasts. Materials and Methods: A retrospective database search identified consecutive asymptomatic women with dense breasts who underwent breast cancer screening with DBT or DM and whole-breast US simultaneously between June 2016 and July 2019. Women who underwent DBT + US (DBT cohort) and DM + US (DM cohort) were matched using 1:2 ratio according to mammographic density, age, menopausal status, hormone replacement therapy, and a family history of breast cancer. The cancer detection rate (CDR) per 1000 screening examinations, abnormal interpretation rate (AIR), sensitivity, and specificity were compared. Results: A total of 863 women in the DBT cohort were matched with 1726 women in the DM cohort (median age, 53 years; interquartile range, 40-78 years) and 26 breast cancers (9 in the DBT cohort and 17 in the DM cohort) were identified. The DBT and DM cohorts showed comparable CDR (10.4 [9 of 863; 95% confidence interval {CI}: 4.8-19.7] vs. 9.8 [17 of 1726; 95% CI: 5.7-15.7] per 1000 examinations, respectively; P = 0.889). DBT cohort showed a higher AIR than the DM cohort (31.6% [273 of 863; 95% CI: 28.5%-34.9%] vs. 22.4% [387 of 1726; 95% CI: 20.5%-24.5%]; P < 0.001). The sensitivity for both cohorts was 100%. In women with negative findings on DBT or DM, supplemental US yielded similar CDRs in both DBT and DM cohorts (4.0 vs. 3.3 per 1000 examinations, respectively; P = 0.803) and higher AIR in the DBT cohort (24.8% [188 of 758; 95% CI: 21.8%-28.0%] vs. 16.9% [257 of 1516; 95% CI: 15.1%-18.9%; P < 0.001). Conclusion: DBT screening combined with US showed comparable CDR but lower specificity than DM screening combined with US in women with dense breasts.

• Journal of Bone Metabolism
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• v.25 no.4
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• pp.267-274
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• 2018

Background: This prospective cohort study used nationwide claims data to investigate the incidence of fall and fragility fractures in association with urinary incontinence (UI) in the elderly, and to compare mortality after fragility fractures in elderly patients with or without incontinence. Methods: A total of 39,854 Korean adults (age, 66-80 years) who participated in health examinations between 2007 and 2012 and were followed up until 2015 were analyzed. Patient and comparison groups were classified according to the presence or absence of UI. The cumulative incidence of osteoporotic fragility fractures and falls in the 2 groups was assessed and compared. Hazard ratios for fragility fractures were calculated for the risk of UI in association with falls using a Cox proportional hazards model. Results: Of 39,854 elderly participants, 5,703 were classified in the UI group, while 34,151 were placed in the comparison group. Fall rates were significantly higher (20.8%) in the incontinence group than in the comparison group (4.7%) (P<0.001). Women in the incontinence group (13.9%) showed a significantly higher incidence of all types of fragility fractures than those in the comparison group (11.8%) (P=0.005). After adjustment for confounders, UI was not a significant risk factor for fragility fractures in men (P=0.878) or women (P=0.324). Conclusions: This study demonstrated that elderly women with UI have a significantly higher incidence of osteoporotic fragility fractures. In addition, elderly women are at higher risk for falls.

• Journal of the Korean Society of Food Culture
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• v.34 no.4
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• pp.389-400
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• 2019

In this study we compared the cognitive function (Mini-Mental State Examination for Dementia Screening: MMSE-DS) and nutrient intake of elderly women with dementia in a long-term care facility (EW-LCF) and a day-time care facility (EW-DCF). This survey was conducted from July 2015 to May 2017 on 73 elderly women with dementia (47 women in LCF and 26 women in DCF) in the city of Incheon. The data obtained from interviews with the subjects and caregivers were analyzed using the SPSS 20.0. The total score of the MMSE-DS and intakes of most nutrients in the EW-LCF were significantly lower compared to the EW-DCF (p<0.05). The nutrient adequacy ratios (NAR) of protein, vitamin A, C, $B_6$, $B_{12}$, thiamin, riboflavin, niacin, folic acid, calcium and phosphorus in the EW-LCF were significantly lower compared to the EW-DCF (p<0.05). However, the indexes of nutritional quality (INQ) of vitamin C, $B_6$, thiamine, niacin, calcium, magnesium, and iron in the EW-LCF were significantly higher compared to the EW-DCF (p<0.05). As a result, the subjects showed an unbalanced and insufficient nutrition intake status regardless of the type of care facility. Most nutrient intakes of the EW-LCF with lower cognitive function were very significantly lower compared to the EW-DCF (p<0.001). Therefore, it is necessary to assess the cognitive function and nutritional status regularly at care facilities for the elderly women suffering with dementia and to provide specialized individual nutritional management.

• The Journal of Korean Academic Society of Nursing Education
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• v.18 no.1
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• pp.95-101
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• 2012

Purpose: This study aimed to analyze the impact of advanced maternal and paternal age on perinatal outcome in Korea. Methods: We conducted a retrospective study involving 1,622 Korean women who delivered at M Woman Hospital from January to December 2010 and their spouses were included. We obtained obstetrics database which included demographic characteristics, medical and obstetrics history, course of the current pregnancy and advised perinatal outcome. Multivariable logistic regression was used to adjust for potential confounding variables. Results: Women giving birth age 35 or older were statistically significant in paternal age, gravidity, spontaneous abortion experience, method of conception, method of delivery, and multiple gestation compared to women aged <34 years. After adjusting for the confounding effects of maternal characteristics, women aged 35 or older were at increased risk for cesarean section delivery (adjusted OR 1.6, 95% CI 1.22-2.13) and preterm birth (adjusted OR 2.2, 95% CI 1.03-4.63). Conclusion: In this population of Korean women, advance maternal and paternal age is independently associated with specific adverse perinatal outcome, especially preterm birth and cesarean section delivery.

• Journal of Korean society of Dental Hygiene
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• v.7 no.2
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• pp.123-133
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• 2007

This document is about immigrant worker who use counseling office for human rights in the Daegu Gumin Church. We researched their oral health state so that we can understand their situation and support them properly. General characteristics of study subjects, habits related to oral health, the oral examination and treatment clinic, participated in oral heath education program were studied by designed administered questionaire. And decay, filling(treatment teeth), missing tooth(lost teeth by dental-caries)was counted by oral examination, and calculated DMFT-index. This study was done from the July, 9, 2006 to Aug. 8, 2006. In a total of 289 immigrant worker, 77.9% of them were men and 22.1% of them were women. 55.7% of their salary was from 1,000,000 won to 1,500,000 won and most of them were working for a fiber industry. Many of them are living in korea for more then three years. DMFT index for men was 2.77 and for women was 4.06 so average of DMFT index was 3.06. 46.7% of them said that they are healthy in oral health state. The question for having difficulty using dental clinic in korea, 65.1% of them said "it is difficult". First reason was a communication problem and second was time. Most of them didn't have a oral health education but 85.1% of them said that they are looking forward to attending oral health education. Immigrant worker had better DMFT index then that of korean blue color worker. But still it is quite difficult for them using dental clinic in korea also cost. It is necessary to support them properly that medical insurance system, medical facilities of quality, medical insurance subscriber beside, made by their language, manual for them. At once, medical service improvement a policy is necessary for immigrant worker in korea.

• The Journal of Korean Obstetrics and Gynecology
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• v.26 no.2
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• pp.33-45
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• 2013

Objectives: The purpose of this study was to identify the tendency toward depression and fatigue in early postpartum women and to determine the relationship between the symptoms of these conditions, according to the women's Sasang constitutions. Methods: In this study, 73 healthy postpartum women were analyzed according to Sasang constitution: 33 Taeeumin, 22 Soyangin, and 18 Soeumin. Symptoms of depression and fatigue were assessed using the Edinburgh Postnatal Depression Scale-K(EPDS-K) and the Fatigue Continuum Form(FCF), respectively, on the fourth(time 1), seventh(time 2), and fifteenth(time 3) days postpartum. Sasang constitutional types were determined by a medical specialist, using results from the Two Step Questionnaire for Sasang Constitution Diagnosis(TS-QSCD). Results: 1. The overall depressive symptoms and fatigue scores decreased significantly over time in early postpartum women. 2. The mean scores for the EPDS and FCF were higher in the Soeumin group than in other groups. The scores for EPDS and FCF dropped sharply in comparison to a former level in the Soyangin group. And the mean EPDS score was lower in the Soyangin group than in other groups. The EPDS and FCF scores in the Taeeumin group changed slightly over time. However, these results were not statistically significant according to Sasang constitution. 3. The relationship between postpartum depression and fatigue showed a significant positive correlation. Conclusions: These results suggest that, in early postpartum women, depressive symptoms and fatigue differ according to Sasang constitution.

• Asian Pacific Journal of Cancer Prevention
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• v.14 no.9
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• pp.5101-5105
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• 2013

The incidence and mortality of cervical cancer remains high in India even after sixty years of introduction of the Pap smear (cervical cytology) which is an effective means of identifying preinvasive lesions of carcinoma cervix. The morbidity and mortality due to cervical cancer has come down drastically in countries with well established screening programmes at national level. This study aims at screening women for cervical cancer opportunistically during their visit to hospital and to study various types of neoplastic and non-neoplastic lesions of the cervix by cervical smear study (Pap smear study). In the present study, a total of 350 cervical smears were studied. The age of patients ranged from 19 years to 80 years with mean age being 37.5 years. Out of 350 cases, the diagnosis of neoplasia was given in 43 cases and 258 cases were diagnosed as inflammatory smears. Forty-cases were normal and 9 cases were inadequate to evaluate. Forty-three patients who were found to have neoplastic lesions on cytology were referred for further investigations like colposcopy and biopsy to confirm the diagnosis and avail proper treatment. Limitation of the present study was small sample size as all female patients aged between 20 and 60 years visiting hospital were not included in the screening, other screening tests like VIA (visual inspection with acetic acid test) and HPV DNA (human papilloma virus) tests were not done. Until the time centrally organised screening programmes for cervical cancer are established in India, arrangements should be made for hospital based opportunistic screening for all women attending hospital. The cost effectiveness of different screening tests for cervical cancer should be evaluated.

• Journal of Dental Anesthesia and Pain Medicine
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• v.19 no.1
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• pp.21-27
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• 2019

Background: Emergencies in dentistry can be classified as medical and dental. Medical emergencies occur mainly during dental treatment in patients with a systemic disease. Dental emergency departments are largely divided into dental emergency rooms located in dental college hospitals and medical emergency rooms located in medical institutions. This study aimed to analyze the characteristics of and provide help to dental emergency patients in a dental hospital. Methods: Overall, 1806 patients admitted to a dental emergency room at Yonsei University Dental Hospital for 1 year were included. The data collection period was from October 1, 2014 to September 30, 2015. An investigator reviewed medical records from the electronic medical record (EMR) system and radiographs. Results: The patients were 1,070 men and 736 women. The sex ratio was 1.45:1. The commonest age group was of 0-9 years, including 451 (25.0%) patients, followed by 20-29 years, including 353 (19.5%) patients, and 30-39 years, including 277 (15.3%) patients. Of the 108 patients transferred to the Severance emergency department, 81 had trauma, 19 were in pain, 4 were bleeding, and 4 had other complaints. Among chief complaints, 1,079 patients (60.3%) had trauma, 564 (31.5%) had pain, and 75 (4.2%) had bleeding. Twenty-three cases (1.3%) were caused by temporomandibular disorder (TMD). Conclusion: Dentists should be able to adequately assess patients in a dental emergency room and treat trauma, pain, and bleeding.

• Journal of Korean Neurosurgical Society
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• v.58 no.3
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• pp.217-224
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• 2015

Objective : To investigate the efficacy and safety of fractionated stereotactic radiosurgery for large brain metastases (BMs). Methods : Between June 2011 and December 2013, a total of 38 large BMs >3.0 cm in 37 patients were treated with fractionated Cyberknife radiosurgery. These patients comprised 16 men (43.2%) and 21 women, with a median age of 60 years (range, 38-75 years). BMs originated from the lung (n=19, 51.4%), the gastrointestinal tract (n=10, 27.0%), the breast (n=5, 13.5%), and other tissues (n=3, 8.1%). The median tumor volume was 17.6 cc (range, 9.4-49.6 cc). For Cyberknife treatment, a median peripheral dose of 35 Gy (range, 30-41 Gy) was delivered in 3 to 5 fractions. Results : With a median follow-up of 10 months (range, 1-37 months), the crude local tumor control (LTC) rate was 86.8% and the estimated LTC rates at 12 and 24 months were 87.0% and 65.2%, respectively. The median overall survival (OS) and progression-free survival (PFS) rates were 16 and 11 months, respectively. The estimated OS and PFS rates at 6, 12, and 18 months were 81.1% and 65.5%, 56.8% and 44.9%, and 40.7% and 25.7%, respectively. Patient performance status and preoperative focal neurologic deficits improved in 20 of 35 (57.1%) and 12 of 17 patients (70.6%), respectively. Radiation necrosis with a toxicity grade of 2 or 3 occurred in 6 lesions (15.8%). Conclusion : These results suggest a promising role of fractionated stereotactic radiosurgery in treating large BMs in terms of both efficacy and safety.

• International Journal of Computer Science & Network Security
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• v.24 no.2
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• pp.150-154
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• 2024

In recent years, there are extensive researches on the applications of machine learning to the automation and decision support for medical experts during disease detection. However, the performance of machine learning still needs improvement so that machine learning model produces result that is more accurate and reliable for disease detection. Selecting the hyper-parameter that could produce the possible maximum classification accuracy on medical dataset is the most challenging task in developing decision support systems with machine learning algorithms for medical dataset classification. Moreover, selecting the features that best characterizes a disease is another challenge in developing machine-learning model with better classification accuracy. In this study, we have proposed an optimized decision tree model for heart disease classification by using heart disease dataset collected from kaggle data repository. The proposed model is evaluated and experimental test reveals that the performance of decision tree improves when an optimal number of features are used for training. Overall, the accuracy of the proposed decision tree model is 98.2% for heart disease classification.