• Title/Summary/Keyword: risk categories

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Reappraisal of Anatomic Outcome Scales of Coiled Intracranial Aneurysms in the Prediction of Recanalization

  • Lee, Jong Young;Kwon, Bae Ju;Cho, Young Dae;Kang, Hyun-Seung;Han, Moon Hee
    • Journal of Korean Neurosurgical Society
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    • v.53 no.6
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    • pp.342-348
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    • 2013
  • Objective : Several scales are currently used to assess occlusion rates of coiled cerebral aneurysms. This study compared these scales as predictors of recanalization. Methods : Clinical data of 827 patients harboring 901 aneurysms treated by coiling were retrospectively reviewed. Occlusion rates were assessed using angiographic grading scale (AGS), two-dimensional percent occlusion (2DPO), and volumetric packing density (vPD). Every scale had 3 categories. Followed patients were dichotomized into either presence or absence of recanalization. Kaplan-Meier analysis was conducted, and Cox proportional hazards analysis was performed to identify surviving probabilities of recanalization. Lastly, the predictive accuracies of three different scales were measured via Harrell's C index. Results : The cumulative risk of recanalization was 7% at 12-month, 10% at 24-month, and 13% at 36-month of postembolization, and significantly higher for the second and third categories of every scale (p<0.001). Multivariate-adjusted hazard ratios (HRs) of the second and third categories as compared with the first category of AGS (HR : 3.95 and 4.15, p=0.004 and 0.001) and 2DPO (HR : 4.87 and 3.12, p<0.001 and 0.01) were similar. For vPD, there was no association between occlusion rates and recanalization. The validated and optimism-adjusted C-indices were 0.50 [confidence (CI) : -1.09-2.09], 0.47 (CI : -1.10-2.09) and 0.44 (CI : -1.10-2.08) for AGS, 2DPO, and vPD, respectively. Conclusion : Total occlusion should be reasonably tried in coiling to maximize the benefit of the treatment. AGS may be the best to predict recanalization, whereas vPD should not be used alone.

A Strategy for the Risk Assessment of Abandoned Mine Filler Materials (비산재가 포함된 폐광산 채움재의 위해성 평가 전략)

  • Ji, Sangwoo;Jo, Hwanju;Shin, Hee-young;Lee, Sang-hun;Ahn, Ji-Whan
    • Resources Recycling
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    • v.28 no.4
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    • pp.59-64
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    • 2019
  • This study suggests a conceptual strategy and methodology for the risk assessment of the domestic abandoned mine fillers with fly ash. The fillers are composed of coal fly ash and solidification materials, and contain little toxic substances such as carbonates but also some heavy metals; therefore, those requires a risk assessment. The risk assessment should primarily focus on estimation of the effects to human health both on carcinogen and non-carcinogen aspects. The significant data such as toxicity and partition coefficients can be obtained from the national soil or mine environmental risk assessment guidelines. Accurate risk assessment of heavy metal contamination in the fillers may consume lots of time and efforts through site survey and instrumental analyses, etc. Moreover, it is inefficient to explore all of the factors as concentrations and categories in every heavy metal in the fillers, due to a high variety and complexity. Therefore, implementation of a preliminary risk assessment is suggested by using the literature data and the basic characteristics of the filler samples prior to the detailed risk assessment. Certainly, this presumes a thorough understanding of reliable sample analysis methods, exposure pathways, and relevant physicochemical and biological mechanisms.

Risk factors for postoperative nausea and vomiting in patients of orthognathic surgery according to the initial onset time: a cross-sectional study

  • Emi Ishikawa;Takayuki Hojo;Makiko Shibuya;Takahito Teshirogi;Keiji Hashimoto;Yukifumi Kimura;Toshiaki Fujisawa
    • Journal of Dental Anesthesia and Pain Medicine
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    • v.23 no.1
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    • pp.29-37
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    • 2023
  • Background: A high incidence (40-73%) of postoperative nausea and vomiting (PONV) has been reported following orthognathic surgery, and various risk factors have been associated with it. Identifying PONV risk factors based on initial onset time will help establish preventive measures. This study aimed to identify factors that are significantly related to PONV based on the initial onset time after orthognathic surgery. Methods: This study included 590 patients who underwent orthognathic surgery. Multivariate logistic regression analysis was performed to identify the risk factors that are significantly related to PONV. The objective variables were classified into three categories: no PONV, early PONV (initial onset time: 0-2 h after anesthesia), and late PONV (initial onset time: 2-24 h after anesthesia). The explanatory variables included relevant risk factors for PONV, as considered in previous studies. Results: Total intravenous anesthesia with propofol was a significant depressant factor for early PONV (adjusted odds ratio [aOR] = 0.340, 95% confidence interval [CI] = 0.209-0.555) and late PONV (aOR = 0.535, 95% CI = 0.352-0.814). The administration of a combination of intraoperative antiemetics (vs. no administration) significantly reduced the risk of early PONV (aOR = 0.464, 95% CI = 0.230-0.961). Female sex and young age were significant risk factors for late PONV (aOR = 1.492, 95% CI = 1.170-1.925 and unit aOR = 1.033, 95% CI = 1.010-1.057, respectively). Conclusion: We identified factors that are significantly related to PONV based on the initial onset time after orthognathic surgery. Total intravenous anesthesia with propofol significantly reduced the risk of PONV not only in the early period (0-2 h after anesthesia) but also in the late period (2-24 h after anesthesia).

A Modified eCura System to Stratify the Risk of Lymph Node Metastasis in Undifferentiated-Type Early Gastric Cancer After Endoscopic Resection

  • Hyo-Joon Yang ;Hyuk Lee;Tae Jun Kim;Da Hyun Jung;Kee Don Choi;Ji Yong Ahn;Wan Sik Lee;Seong Woo Jeon;Jie-Hyun Kim;Gwang Ha Kim;Jae Myung Park;Sang Gyun Kim;Woon Geon Shin;Young-Il Kim;Il Ju Choi
    • Journal of Gastric Cancer
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    • v.24 no.2
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    • pp.172-184
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    • 2024
  • Purpose: The original eCura system was designed to stratify the risk of lymph node metastasis (LNM) after endoscopic resection (ER) in patients with early gastric cancer (EGC). We assessed the effectiveness of a modified eCura system for reflecting the characteristics of undifferentiated-type (UD)-EGC. Materials and Methods: Six hundred thirty-four patients who underwent non-curative ER for UD-EGC and received either additional surgery (radical surgery group; n=270) or no further treatment (no additional treatment group; n=364) from 18 institutions between 2005 and 2015 were retrospectively included in this study. The eCuraU system assigned 1 point each for tumors >20 mm in size, ulceration, positive vertical margin, and submucosal invasion <500 ㎛; 2 points for submucosal invasion ≥500 ㎛; and 3 points for lymphovascular invasion. Results: LNM rates in the radical surgery group were 1.1%, 5.4%, and 13.3% for the low-(0-1 point), intermediate- (2-3 points), and high-risk (4-8 points), respectively (P-fortrend<0.001). The eCuraU system showed a significantly higher probability of identifying patients with LNM as high-risk than the eCura system (66.7% vs. 22.2%; McNemar P<0.001). In the no additional treatment group, overall survival (93.4%, 87.2%, and 67.6% at 5 years) and cancer-specific survival (99.6%, 98.9%, and 92.9% at 5 years) differed significantly among the low-, intermediate-, and high-risk categories, respectively (both P<0.001). In the high-risk category, surgery outperformed no treatment in terms of overall mortality (hazard ratio, 3.26; P=0.015). Conclusions: The eCuraU system stratified the risk of LNM in patients with UD-EGC after ER. It is strongly recommended that high-risk patients undergo additional surgery.

Overweight among Preschool Children in Seoul ; Prevalence and Associated Factors (서울 시내 일부 학령 전 아동들의 비만 유병률과 이에 영향을 주는 요인)

  • 김미경;김희정;김영옥;이진희;이원철
    • Korean Journal of Community Nutrition
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    • v.6 no.2
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    • pp.121-129
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    • 2001
  • The purpose of this study was to estimate the prevalence and to identify risk factors of overweight among preschool children in Korea. The study subjects were 750 children, aged 2-6, attending child care centers in Korea. A measurement of the height and weight of the children, as well as collection of wide range of variables including general characteristics, and potential factors related with dietary habit for children and their parents, were conducted. Overweight was defined based on more than 110% of ideal body weight. A logistic regression analysis was adopted to identify the factors associated with overweight. Subjects were classified into three categories according to the obesity index : underweight(PIBW〈90%, n=34), normal(90%$\leq$PIBW〈110%, n=577), and overweight(PIBW$\geq$110%, n=139). The overall prevalence of overweight and underweight of the subjects were 21.3% and 4.0% of the boys and 15.5% and 5.1% of the girls respectively. Parent's obesity was associated with a higher risk of overweight on girls. Subjects o the third quartile(girls) and fourth quartile(boys) of income level had a substantially higher risk of overweight than did those in the first quartile. Fast eating, overeating, and food prejudice were also associated with an increased risk of overweight. The results of a logistic regression analysis showed that the eating habits and food preferences of the children were the most influencial factors on overweight. These finding may imply the importance of early stage nutrition education on rational dietary habit to prevent prevailing obesity of preschool in Korea.

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Electronic Risk Assessment System as an Appropriate Tool for the Prevention of Cancer: a Qualitative Study

  • Amoli, Amir hossein Javan;Maserat, Elham;Safdari, Reza;Zali, Mohammad Reza
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.18
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    • pp.8595-8598
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    • 2016
  • Background: Decision making modalities for screening for many cancer conditions and different stages have become increasingly complex. Computer-based risk assessment systems facilitate scheduling and decision making and support the delivery of cancer screening services. The aim of this article was to survey electronic risk assessment system as an appropriate tool for the prevention of cancer. Materials and Methods: A qualitative design was used involving 21 face-to-face interviews. Interviewing involved asking questions and getting answers from exclusive managers of cancer screening. Of the participants 6 were female and 15 were male, and ages ranged from 32 to 78 years. The study was based on a grounded theory approach and the tool was a semi-structured interview. Results: Researchers studied 5 dimensions, comprising electronic guideline standards of colorectal cancer screening, work flow of clinical and genetic activities, pathways of colorectal cancer screening and functionality of computer based guidelines and barriers. Electronic guideline standards of colorectal cancer screening were described in the s3 categories of content standard, telecommunications and technical standards and nomenclature and classification standards. According to the participations' views, workflow and genetic pathways of colorectal cancer screening were identified. Conclusions: The study demonstrated an effective role of computer-guided consultation for screening management. Electronic based systems facilitate real-time decision making during a clinical interaction. Electronic pathways have been applied for clinical and genetic decision support, workflow management, update recommendation and resource estimates. A suitable technical and clinical infrastructure is an integral part of clinical practice guidline of screening. As a conclusion, it is recommended to consider the necessity of architecture assessment and also integration standards.

Estimation of explosion risk potential in fuel gas supply systems for LNG fuelled ships (액화 천연 가스 연료 선박의 연료 공급 장치 폭발 잠재 위험 분석)

  • Lee, Sangick
    • Journal of Advanced Marine Engineering and Technology
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    • v.39 no.9
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    • pp.918-922
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    • 2015
  • As international environmental regulations for pollutant and greenhouse gas emissions discharged from ships are being reinforced, it is drawing attention to use LNG as ship fuel. This paper compares the explosion risk potential in the LNG fuel gas supply systems of two types used in marine LNG fuelled vessels. By selecting 8500 TEU class container ships as target, LNG storage tank was designed and pressure conditions were assumed for the use of each fuel supply type. The leak hole sizes were divided into three categories, and the leak frequencies for each category were estimated. The sizes of the representative leak holes and release rates were estimated. The release rate and the leak frequency showed an inverse relationship. The pump type fuel gas supply system showed high leak frequency, and the pressure type fuel gas supply system showed high release rate. Computational fluid dynamics simulation was applied to perform a comparative analysis of the explosion risk potential of each fuel supply system.

Association between Dietary Acid Load and Insulin Resistance: Tehran Lipid and Glucose Study

  • Moghadam, Sajjad Khalili;Bahadoran, Zahra;Mirmiran, Parvin;Tohidi, Maryam;Azizi, Fereidoun
    • Preventive Nutrition and Food Science
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    • v.21 no.2
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    • pp.104-109
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    • 2016
  • In the current study, we investigated the longitudinal association between dietary acid load and the risk of insulin resistance (IR) in the Tehranian adult population. This longitudinal study was conducted on 925 participants, aged 22~80 years old, in the framework of the third (2006~2008) and fourth (2009~2011) phases of the Tehran Lipid and Glucose Study. At baseline, the dietary intake of subjects was assessed using a validated semi-quantitative food frequency questionnaire, and the potential renal acid load (PRAL) and net endogenous acid production (NEAP) scores were calculated at baseline. Fasting serum insulin and glucose were measured at baseline and again after a 3-year of follow-up; IR was defined according to optimal cut-off values. Multiple logistic regression models were used to estimate the risk of IR according to the PRAL and NEAP quartile categories. Mean age and body mass index of the participants were 40.3 years old of $26.4kg/m^2$, respectively. Mean PRAL and NEAP scores were -11.2 and 35.6 mEq/d, respectively. After adjustment for potential confounders, compared to the lowest quartile of PRAL and NEAP, the highest quartile was accompanied with increased risk of IR [odds ratio (OR)=2.81, 95% confidence interval (CI)=1.32~5.97 and OR=2.18, 95% CI=1.03~4.61, respectively]. Our findings suggest that higher acidic dietary acid-base load, defined by higher PRAL and NEAP scores, may be a risk factor for the development of IR and related metabolic disorders.

Relationship between Occupational Electromagnetic Field Exposure and Leukemia : A Meta-Analysis (직업성 전자장 노출과 백혈병 발생에 관한 메타분석)

  • Kim, Yoon-Shin;Song, Hae-Hiang;Hong, Seung-Cheol;Cho, Yong-Sung
    • Journal of Preventive Medicine and Public Health
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    • v.33 no.1
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    • pp.125-133
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    • 2000
  • Objectives : This study uses meta-analysis methodology to examine the statistical consistency and importance of random variation among results of epidemiologic studies of occupational electromagnetic field exposure and leukemia. Methods : Studies for this meta-analysis were identified from previous reviews and by asking researcher active in this field for recommendations. Overall, 27 studies of occupational electromagnetic field exposures and leukemia were reviewed. A variety of meta-analysis statistical methods have been used to assess combined effects, to identify heterogeneity, and to provide a single summary risk estimate based on a set of simiar epidemiologic studies. In this study, classification of exposure metircs on occupational epidemiologic studies are reported for (1) job classification (20 individual studies); (2) leukemia subtypes (13 individual studies); and (3) country (27 individual studies). Results : Results of this study, an inverse-variance weighted pooling of all the data leads to a small but significant elevation in risk of f 1% (OR=1.11, 95% CI : $1.06\sim1.16$) among 27 occupational epidemiologic studies. Publication bias was assessed by the 'fail-safe n' that may be not influence for all combined results exception a few categories, ie, 'power station operators' and 'electric utility workers' by job classification on occupational study. And ail combined odds ratio results were similar for fixed-effects models and random-effects models, with slightly higher risk estimates for the random-effects model in situations where there was significant heterogeneity, ie, Q-statistic significant (p<.05). Conclusions : We found a small elevation in risk of leukemia, but the ubiquitous nature of exposure to electromagnetic fields from workplace makes even a weak association a public health issue of substantial power to influence the present overall conclusion about relationship between electromagnetic fields exposure and leukemia.

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Development of Preliminary Assessment Methodology for Priority Listing of Soil and Groundwater Contamination Sources (토양.지하수오염원 관리우선순위 개략평가기법 개발)

  • Jeong, Seung-Woo;Kim, Young-Ju;Kim, Jae-Hoon;Hwang, Sang-Il
    • Journal of Soil and Groundwater Environment
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    • v.16 no.6
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    • pp.106-112
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    • 2011
  • This study developed preliminary assessment methodology for priority listing of soil and groundwater contamination sources, considering source characteristics, local environments and risk receptors. Source characteristics were evaluated by scoring relative risk of contamination sources. Local environments were evaluated by scoring annual rainfall, hydraulic conductivity of aquifer, and annual groundwater use. Risk receptors were evaluated by scoring local population, direct distance to surface water, direct distance to drinking-water wells. Scores of each parameter were allocated by analysing distribution of parameter values obtained from government databases. Distributed scores of source characteristics local environments: risk receptors were 12 : 12 : 12. The preliminary assessment scored 0 to 36 for each soil and groundwater sources. Inventory of soil and groundwater sources consisted of 7 categories. This study applied the preliminary assessment methodology to Manan-Gu, Anyang City, Korea. The number of car repair and washing facility was the largest in the contamination source inventory. Petroleum storage facilities showed the highest assessment score. The preliminary assessment methodology also indicated that Anyang-Dong was the priority section among Anyang-Dong, Suksu-Dong, Bakdal-Dong. This study is the first trial for relative ranking soil and groundwater contamination sources by considering source and local characteristics. Therefore, further researches and revision of the preliminary assessment methodology need to be pursued for various applications.