Kang, Il Ku;Kim, Kwangsoon;Bae, Ja Seong;Kim, Jeong Soo
Korean Journal of Head & Neck Oncology
/
v.37
no.2
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pp.25-31
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2021
Background/Objectives: Although thyroid lobectomy recently is considered as sufficient for low-risk papillary thyroid carcinoma (PTC), completion thyroidectomy is required due to the insufficiency of the preoperative evaluation. The aim of this study was to investigate recurrence rate and disease free survival depending on the gross extrathyroidal extension (gETE) or the number of metastatic lymph node identified in patients with PTC. Materials & Methods: We assessed 3373 patients with PTC who underwent lobectomy at Seoul St. Mary's Hospital (Seoul, Korea) between January 2009 and December 2014. Clinicopathological characteristics and long-term surgical outcomes were retrospectively analyzed through complete chart reviews. The mean follow-up duration was 97.1 ± 21.4 months. Results: The rate of recurrence was higher in gETE group (1.8% vs. 6.0%, p=0.004), leading to decreased disease free survival in Kaplan-Meier analysis (log-rank p<0.001). N1 group (n=1389) was analyzed into two groups whether the number of positive nodes is more than 5 or less. For the group of the more metastatic nodes, the recurrence rate higher compared to the other group (3.0% vs. 9.3%, p<0.001). DFS was longer in the group that had lesser metastatic nodes (log-rank p<0.001). However, in terms of N1 group over 1cm (n=492), No statistical difference was observed according to the number of positive lymph nodes (4.5% vs. 9.1%, p=0.092) Conclusion: When it comes to node positive PTC, Despite the number of positive lymph nodes was over 5, follow-up with no further surgery can be an option.
In this study, sub-indicators, and thematic mid-indexes to evaluate the water use characteristics were selected through historical data analysis and factor analysis, and consisted of the subject approach framework. And the integrated index was developed to evaluate water use characteristics of the watershed. Using developed index, the water use characteristics were assessed for 812 standard basins with the exception for North Korea using data of 1990 to 2007 from the relevant agencies. A sensitivity analysis is conducted for this study to determine the proper way through various normalization and weighting methods. To increase the objectivity of developed index, the history of the damage indicators are excluded in the analysis. In addition, in order to ensure its reliability, results from index with and without consideration of the damage history were compared. Also, the index is also applied to real data for 2008 Gangwon region to verify its field applicability. Through the validation process this index confirmed the adequacy for the indicators selection and calculation method. The results of this study were analyzed based on the spatial and time vulnerability of the basin's water use, which can be applied to various parts such as priority decision-making for water business or policy, mitigations for the vulnerable components of the basin, and supporting measures to establishment by providing relevant information about it.
Jong Chan Choi;Min Jun Ji;Kyung Jun Ser;Do Young Kwon;Jae Eun Yang;Ji Hyang Gu;Eun Jung Lee;Min Seok Oh
Journal of Korean Medicine Rehabilitation
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v.34
no.2
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pp.101-134
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2024
Objectives The purpose of this study is to observe the effectiveness of acupotomy treatment for lateral epicondylitis by comparing it with various control groups. Methods We searched 11 domestic and international databases for systematic reviews and meta-analysis. The subjects were studies published from January 1, 2017 to September 1, 2023, and only randomised controlled trials were included. Results 208 studies were searched, of which 21 studies were finally selected. Among the studies published after 2017, the largest number of studies was published in 2019. The average number of participants per study was 72.28±20.26 and the average age was in the 40s. The most frequent intervention in the study was acupotomy alone, and the treatment most often mentioned as a control group was local nerve block. The most used evaluation tool is efficiency. Acupotomy+manipulation had statistically better effect than that of local nerve block in terms of pain (standard mean difference -1.87, 95% confidence interval, -2.18 to -1.57, p<0.00001) and elbow joint function (standard mean difference 2.25, 95% confidence interval, 1.65 to 2.86, p<0.00001). Conclusions As a result of the meta-analysis, the effect of acupotomy added manual therapy treatment was statistically significant compared to the local nerve block frequently used for lateral epicondylitis. Based on these results, it appears that more research on combination treatments other than acupotomy treatment will be needed. Also, it appears that more large-scale randomized controlled studies that strictly adhere to the standards for reporting interventions in controlled trials of acupuncture, risk of bias 2 criteria will be needed.
Objectives The purpose of this research is to evaluate the effectiveness of moxibustion theraphy for frozen shoulder through systematic review and meta-analysis. Methods The effect of moxibustion for frozen shoulder was constructed as a key question to search randomized controlled trials (RCTs) in 16 databases without type of publication restriction. Results A total of 790 studies were searched and 22 RCTs were finally selected through primary and secondary selection/exclusion process. In most of the evaluation indexes used in each study, moxibustion treatment for shoulder pain was statistically significant compared with other treatments. A meta-analysis of effective rate in 10 studies comparing moxibustion with acupuncture and acupuncture showed a statistically significant effect of moxibustion treatment. And there was a significant effect on the improvement of the shoulder mobility, but the effect size of shoulder pain was no significant effect for shoulder pain reduction. In addition in the result of meta-analysis of 4 studies' effective rate comparing moxibustion with electronic acupuncture, the effect of moxibustion was significantly higher than that of electronic acupuncture in frozen shoulder. Conclusions Moxibustion therapy was effective in symptoms in patients with frozen shoulder. However because of the high risk of bias in the quality of the included studies, the applicability of this study seems to be limited. It is thought that future randomized controlled trials will need to be designed and performed by reviewing ways to minimize bias.
Purpose : To identify variable prognostic factors and analyse failure patterns in the uterine cervix cancer after radical operation and adjuvant radio-therapy, a retrospective analysis was undertaken. Materals and Methods : I analysed one hundred and twenty four patients with uterine cervix cancer, FIGO stage IB, IIA and IIB, treated with radical hysterectomy and pelvic lymph node dissection followed by adjuvant radio-therapy between May 1985 and May 1994. Minimum follow up period was 24 months. All of them were treated with full dose external radiotherapy with linear accelerator and/or high dese rate intracavitary radiation. Results : Overall 5 year survival rate and relapse free survival rate were $75.4\%,\;73.5\%$, respectively. Significant prognostic factors by relapse free survival were wall involvement thickness, lymph node location and number, parametrium involvement, tumor size, stage, uterine body involvement, vaginal resection margin involvement. By multivariate analysis, lymph node matastasis. tumor size and vaginal resection margin involvement were significant prognostic factos. Treatment related failure were 33 cases. Locoregional failure were more likely in the stage IIB, lymph node positive or vaginal resection margin positive patients whereas distant failures were relatively more frequent in stage IB, IIA and lymph node, vaginal resection negative patients. In stage IIB, 5 year relapse free survival rate was only $56\%$ and nine of twenty two patients recurred. Conculsion : Postoperative radiotherapy results are good for patients with relatively low risk factor. But the results are poor for patients with multiple, high risk factors or stage IIB. To control recurrence for patients with high risk factors, postoperative adjuvant radiotherapy is not sufficient treatment method. To raise control rate adding other methods such as radiosensitizing agent or chemotherapy is necessary and prospectively randomized study is needed for evaluation of postoperative radiotherapy efficacy and /or other methods. And it is reasonable to treat primary radical radiotherapy for patients with stage IIB cervical cancer instead of radical operation and adjuvant radiotherapy and/or chemotherapy regimen.
A stochastic numerical analysis for predicting the groundswater fluctuations in hillside slopes is performed in this paper to account for the uncertainties associated with the rainfall and site characteristics. The effect of spatial variabilities of aquifer parameters and the effect of temporal variability of recharge on the groundwater fluctuations are studied in depth. The Kriging is used to account for the spatial tariabilities of aquifer parameters. This technique prolevides the best linear unbiased estimator of a parameter and its minimum variance from a litsitem number of measured data. A stochastic one-dimensional numerical model is delreloped b) combining the groundwater flow model, the Kriging, and the first-order second-moment analysis. In addition, a two dimensional detelministic groundwater model is developed to study the change of ground water surfas in the transverse direction as well as in the downslope direction. It is revealed that the undulations of the impervious bedrock in addition to the permeability and the specific yield have an important influence on the fluctuations of the groundwater surface. It is also found that th'e groundwater changes significantly in the transverse direction as well as in the downslope direction. The results obtained in this analysis may be used for evaluation of landslide risks due to high porewater pressure.
Background: Colposcopy is the gold standard procedure for evaluating cervical cytological abnormalities. Although it is essentially a minimally invasive intervention, referral for colposcopy may cause significant distress on patients. In this study, we aimed to determine if pre-procedural anxiety levels have a significant association with procedure related pain and discomfort in women undergoing colposcopy for evaluation of abnormal cervical cytology. We also assessed the impact of various clinical factors on anxiety, pain and discomfort in these patients. Materials and Methods: This prospective study was performed at the gynecologic oncology department of Zekai Tahir Burak Women's Health Education and Research Hospital in Ankara, Turkey between January and June 2013. After taking informed consent, State-Trait Anxiety Inventory (STAI) form and a 14-item questionnaire were filled for women who were admitted to our outpatient colposcopy unit for evaluation of abnormal cervical cytology. STAI scores were calculated for each participant. Immediately after the procedure, visual analog scale (VAS) scores for procedure-related pain and discomfort were obtained. Associations between STAI and VAS scores were investigated using correlation analyses. The effect of various contributing factors on anxiety, pain and discomfort were evaluated with linear regression analysis. The p values less than 0.05 were considered statistically significant. Results: A total of 222 women met the inclusion criteria within the study period. Mean patient age was $38.5{\pm}9.6$. Median state and trait anxiety scores were 47 and 46, respectively. Median VAS scores for pain and discomfort were 4 for both variables. State anxiety had a significant correlation with procedure related discomfort (p=0.02). Colposcopy related pain VAS scores were significantly affected by state anxiety level, marital status and prior gynecological examination (p<0.05). Colposcopy related discomfort VAS scores were significantly affected by state anxiety level, marital status, prior gynecological examination and educational status. Conclusions: Additional measures should be implemented in women that carry higher risk for experiencing pain and discomfort. Social, cultural and lifestyle issues may also affect women's experiences during colposcopy, therefore further studies are needed to define specific determining factors in various populations.
With the aim of an intelligent world in the age of individual customization through decentralization of information and technology, sharing/opening, and connection, we often see a tendency to cross expectations and concerns in the technological discourse and interest in artificial intelligence more than ever. Recently, it is easy to find claims by futurists that AI singularity will appear before and after 2045. Now, as part of preparations to create a paradigm of coexistence that coexists and prosper with AI in the coming age of artificial intelligence, a standard framework for setting up more correct AI ethics and regulations is required. This is because excluding the risk of omission of setting major guidelines and methods for evaluating reasonable and more reasonable guideline items and evaluation standards are increasingly becoming major research issues. In order to solve these research problems and at the same time to develop continuous experiences and learning effects on AI ethics and regulation setting, we collect guideline data on AI ethics and regulation of international organizations / countries / companies, and research and suggest ways to set up a standard framework (SF: Standard Framework) through a setting research model and text mining exploratory analysis. The results of this study can be contributed as basic prior research data for more advanced AI ethics and regulatory guidelines item setting and evaluation methods in the future.
The quality of the management of sanitation in food service establishments (school lunch programs, hospital patient food services, and commercial catering food services) in Korea was reviewed and evaluated, and ten strategies fur future improvement were suggested. They were: (1) An increase of qualified manpower and improvement of the professional training of the staff; (2) Obtaining special facilities exclusively for food service; (3) Improvement of facilities especially the kitchens; (4) Improvement of policy fur procuring raw materials and being assured of their quality by designing some standards and specifications for the raw materials to be purchased; (5) Production and use accurate and reliable kitchen apparatus and instruments; (6) An increase of the laboratory apparatus and instruments for inspection and evaluation of the sanitary level of raw materials and food service environments; (7) Enforced improvement of personal hygiene of the staff; (8) Use of a variety of methods in sanitary education and training; (9) Actively inspect the quality of imported foods; (10) Strengthening the research and accumulation of background data regarding sanitation management. There is a long process from the production of food to eating. The cooking process is the ultimate end of preparation of food before eating. This process sometimes increases the occurrence of food-borne diseases if we mishandle the food, even we obtained safe food. The process can also remove health hazards and reduce the risk from the hazards if we handle the food well although we have unsafe foods. This means the cooking process is a major key to preventing food-borne diseases. The concepts of hazard analysis critical control point (HACCP) should be applied and practiced in food service establishments in Korea as soon as possible.
Purpose We designed this study for the purpose of determining the relationship between periodontal disease activity and PLBW, using the evaluation of probing pocket depth, loss of attachment, gingival index, gingival crevicular fluid amount and subgingival microflora. Methods A total of 100 volunteer mothers(mean age 30.44) at the Department of Obstetrics and Gynecology Seoul National University Hospital were selected for this study.Pregnancy outcomes were categorized into cases and controls in two ways. our definition was based on the following; Group 1 : Any PLBW cases Vs. All NBW controls Group 2 : PLBW cases Vs. NBW controls A periodontal exam was performed on the Ramfjord( #16, 21, 24, 36, 41, 44) teeth and Clinical evaluation consisted of probing pocket depth, loss of attachment, gingival index and gingival crevicular fluid amount. Subgingival plaque samples were collected by three sterile #35 paper points. The total number of anaerobic colonies and aerobic bacteria were enumerated after incubation. Antisera to P. gingivalis, P. intermedia, A. actinomycetemcomitans were produced in white rabbits with live whole cells suspensions. The specific fluorescent bacteria obtained by immunofluorescence and total cell counts obtained by dark-field microscopy were counted on four fields. The percent of each specific microorganism in the total cell count was determined. Results Any PLBW and PLBW cases showed significantly greater probing depth and attachment loss than all NBW and NBW controls. Cases group had significantly increased anaerobic bacterial counts compared with control group and no differences in the other microbes. This study confirmed that periodontal disease is a statistically significant risk factor for PLBW by investigating clinical parameters and subgingival plaque analysis.
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