• Journal of Gastric Cancer
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• v.21 no.3
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• pp.279-297
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• 2021

Purpose: Various changes in nutrition, metabolism, immunity, and psychological status occur through multiple mechanisms after gastrectomy. The purpose of this study was to predict disease status after gastrectomy by analyzing diseases pattern that occur or change after gastrectomy. Materials and Methods: A retrospective cohort study was conducted using nationwide claims data. Patients with gastric cancer who underwent gastrectomy or endoscopic resection were included in the study. Eighteen target diseases were selected and categorized based on their underlying mechanism. The incidence of each target disease was compared by dividing the study sample into those who underwent gastrectomy (cases) and those who underwent endoscopic resection for early gastric cancer (controls). The cases were matched with controls using propensity score matching. Thereafter, Cox proportional hazard models were used to evaluate intergroup differences in disease incidence after gastrectomy. Results: A total of 97,634 patients who underwent gastrectomy (84,830) or endoscopic resection (12,804) were included. The incidence of cholecystitis (P<0.0001), pancreatitis (P=0.034), acute kidney injury (P=0.0083), anemia (P<0.0001), and inguinal hernia (P=0.0007) were higher after gastrectomy, while incidence of dyslipidemia (P<0.0001), vascular diseases (ischemic heart disease, stroke, and atherosclerosis; P<0.0001, P<0.0001, and P=0.0005), and Parkinson's disease (P=0.0093) were lower after gastrectomy. Conclusions: This study identifies diseases that may occur after gastrectomy in patients with gastric cancer.

• Korean Journal of Head & Neck Oncology
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• v.37 no.1
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• pp.11-16
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• 2021

Background/Objectives: To analyze changes in the incidence of thyroid cancer for Korean population using big data from the National Health Insurance Service. Materials & Methods: Sample cohort database between January 2004 and December 2013 with 1,000,000 cases for each year was enrolled in this study. Thyroid cancer incidence was analyzed by sex, age and by region. Public health insurance payment was used to reflect socioeconomic status. Results: The incidence of thyroid cancer in Korea increased for 10 years annually. There are 3 times increasing in the incidence rate of thyroid cancer from 2004, 0.03% to 2013, 0.09%. The sex ratio in the incidence rate of thyroid cancer was male : female = 1:7.2 in 2004 and male : female = 1:3.6 in 2013 that suggest decreased gap between the sex ratio. Between 2004 and 2010, the incidence rates of those in their 40s were found to be the highest, whereas the incidence rates for those in their 50s were found to be highest from 2011 and thereafter. Every year the high socioeconomic status group showed a higher incidence of thyroid cancer than low socioeconomic status group. Some specific region showed continuous high incidence of thyroid cancer, not all city and state. Conclusion: The incidence rate of thyroid cancer for 10 years had special feature by sex, age, socioeconomic status and especially by region. This results will be a barometer for further epidemiologic study about the incidence of thyroid cancer for Korean population

• 재활복지
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• v.18 no.4
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• pp.207-220
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• 2014

The purpose of this study is to determine the parent-perceived effect of adaptive seating devices on the lives of infant or young children with physical and brain lesion disabilities(age 1-13y) and their families. Using the seating device for disabled parents of 42 people with disabilities who use FIATS-AS to investigate functional outcomes. All parents completed the FIATS-AS 4 times-2 times before and 2 times after their child received a new adaptive seating system. Repeated-measures analysis of variance detected significant mean differences among the FIATS-AS scores. Also to estimating the impact of the new seating intervention for the 3 age cohorts using the FIATS-AS scores. The FIATS-AS detected a significant interaction between age cohort and interview time. Providing adaptive seating devices has been found that the positive effects on guardians. The change was significant in 1~7 years of age. Environmental modification, such as seating and other assistive technology devices, may have an important role to play in the lives of young children with disabilities and their families.

• Psychiatry investigation
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• v.15 no.12
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• pp.1162-1167
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• 2018

Objective Motor, perceptual, and cognitive functions are known to affect driving competence. Subcortical ischemic changes on brain magnetic resonance imaging (MRI) can reflect reduction in cognitive and motor performance. However, few studies have reported the relationship between subcortical ischemic changes and driving competence of the elderly. Thus, the objective of this study was to investigate the association between subcortical ischemic changes on MRI and driving abilities of the elderly. Methods Participants (n=540) were drawn from a nationwide, multicenter, hospital-based, longitudinal cohort. Each participant underwent MRI scan and interview for driving capacity categorized into 'now driving' and 'driving cessation (driven before, not driving now)'. Participants were divided into three groups (mild, n=389; moderate, n=116; and severe, n=35) depending on the degree of white matter hyperintensity (WMH) on MRI at baseline. Driving status was evaluated at follow-up. Statistical analyses were conducted using ${\chi}^2$ test, analysis of variance (ANOVA), structured equation model (SEM), and generalized estimating equation (GEE). Results In SEM, greater baseline degree of WMH was directly associated with driving cessation regardless of cognitive or motor dysfunction (${\beta}=-0.110$, p<0.001). In GEE models after controlling for age, sex, education, cognitive, and motor dysfunction, more severe change in the degree of WMH was associated with faster change from 'now driving' state to 'driving cessation' state over time in the elderly (${\beta}=-0.508$, p<0.001). Conclusion In both cross-sectional and longitudinal results, the degree of subcortical ischemic change on MRI might predict driving cessation in the elderly.

• Nutrition Research and Practice
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• v.12 no.6
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• pp.459-468
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• 2018

BACKGROUND/OBJECTIVES: The Dietary Reference Intakes for Koreans (KDRIs), a set of reference intake values, have served as a basis for guiding a balanced diet that promotes health and prevents disease in the general Korean population. In the process of developing DRIs, a systematic review has played an important role in helping the DRI committees make evidence-based and transparent decisions for updating the next DRIs. Thus, the 2015 KDRI steering committee applied the systematic review framework to the revision process of the KDRIs. The purpose of this article is to summarize the revision process for the 2015 KDRIs by focusing on the systematic review framework. MATERIALS/METHODS: The methods used to develop the systematic review framework for 2015 KDRIs followed the Agency for Healthcare Research and Quality and the Tufts Evidence-based Practice Center. The framework for systematic review of the 2015 KDRIs comprised of the 3 following steps: (1) development of an analytic framework and refinement of key questions and search terms; (2) literature search and data extraction; and, (3) appraisal of the literature and summarizing the results. RESULTS: A total of 203,237 studies were retrieved through the above procedure, with 2,324 of these studies included in the analysis. General information, main results, comments of reviewers, and results of quality assessment were extracted and organized by study design. The average points of quality appraisals were 3.0 (range, 0-5) points for intervention, 6.1 (0-9) points for cohort, 6.0 (3-9) points for nested case-control, 5.4 (1-8) points for case-control, 14.6 (0-22) points for cross-sectional studies, and 7.0 (0-11) points for reviews. CONCLUSIONS: Systematic review helped to establish the 2015 KDRIs as a useful tool for evidence-based approach. Collaborative efforts to improve the framework for systematic review should be continued for future KDRIs.

• Journal of Preventive Medicine and Public Health
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• v.51 no.6
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• pp.289-297
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• 2018

Objectives: Obesity is a considerable and growing public health concern worldwide. The present study aimed to quantify socioeconomic inequalities in adult obesity in western Iran. Methods: A total of 10 086 participants, aged 35-65 years, from the Ravansar Non-communicable Disease Cohort Study (2014-2016) were included in the study to examine socioeconomic inequalities in obesity. We defined obesity as a body mass index ${\geq}30kg/m^2$. The concentration index and concentration curve were used to illustrate and measure wealth-related inequality in obesity. Additionally, we decomposed the concentration index to identify factors that explained wealth-related inequality in obesity. Results: Overall, the prevalence of obesity in the total sample was 26.7%. The concentration index of obesity was 0.04; indicating that obesity was more concentrated among the rich (p<0.001). Decomposition analysis indicated that wealth, place of residence, and marital status were the main contributors to the observed inequality in obesity. Conclusions: Socioeconomic-related inequalities in obesity among adults warrant more attention. Policies should be designed to reduce both the prevalence of obesity and inequalities in obesity by focusing on those with higher socioeconomic status, urban residents, and married individuals.

• Journal of Korean Neurosurgical Society
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• v.62 no.2
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• pp.217-224
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• 2019

Objective : We attempted to discover that Ankylosing spondylitis (AS) has a comprehensive relationship with congestive heart failure and death. Methods : We used a nationwide database managed by the Korean National Health Insurance Service from 2010 to 2014. Twelve thousand nine hundred eighty-eight patients with a diagnosis of AS and 64940 age- and sex- stratified matching subjects without AS were enrolled in the AS and control groups. Incidence probabilities of 6 years congestive heart failure and death in each group were calculated. The Cox proportional hazard regression analysis was used to estimate the hazard ratio. We divided the AS and control groups into subgroups according to sex, age, income, and comorbidities. Results : During the follow-up period, 102 patients (0.79%) in the AS group and 201 patients (0.32%) in the control group developed congestive heart failure (p<0.0001). In addition, 211 (1.62%) subjects in the AS group died during the follow-up period compared to 639 (0.98%) subjects in the control group (p<0.0001). The adjusted hazard ratio of congestive heart failure and death in the AS group was 2.28 (95% confidence interval [CI], 1.80-2.89) and 1.66 (95% CI, 1.42-1.95), respectively. The hazard ratios of congestive heart failure and death were significantly increased in all of the subgroups. Conclusion : The incidence rates of congestive heart failure and death were increased in AS patients.

• Journal of Korean Neurosurgical Society
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• v.62 no.2
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• pp.232-242
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• 2019

Objective : To investigate the effects of trauma center establishment on the clinical characteristics and outcomes of trauma patients with traumatic brain injury (TBI). Methods : We enrolled 322 patients with severe trauma and TBI from January 2015 to December 2016. Clinical factors, indexes, and outcomes were compared before and after trauma center establishment (September 2015). The outcome was the Glasgow outcome scale classification at 3 months post-trauma. Results : Of the 322 patients, 120 (37.3%) and 202 (62.7%) were admitted before and after trauma center establishment, respectively. The two groups were significantly different in age (p=0.038), the trauma location within the city (p=0.010), the proportion of intensive care unit (ICU) admissions (p=0.001), and the emergency room stay time (p<0.001). Mortality occurred in 37 patients (11.5%). Although the preventable death rate decreased from before to after center establishment (23.1% vs. 12.5%), the difference was not significant. None of the clinical factors, indexes, or outcomes were different from before to after center establishment for patients with severe TBI (Glasgow coma scale score ${\leq}8$). However, the proportion of inter-hospital transfers increased and the time to emergency room arrival was longer in both the entire cohort and patients with severe TBI after versus before trauma center establishment. Conclusion : We confirmed that for patients with severe trauma and TBI, establishing a trauma center increased the proportion of ICU admissions and decreased the emergency room stay time and preventable death rate. However, management strategies for handling the high proportion of inter-hospital transfers and long times to emergency room arrival will be necessary.

• Clinics in Shoulder and Elbow
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• v.22 no.3
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• pp.128-134
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• 2019

Background: Patients with rotator cuff tears are usually afflicted with shoulder pain and disability. However, it is unclear which factors are related to shoulder pain in patients with rotator cuff tears. This study was therefore undertaken to determine the factors correlated with shoulder pain in patients with painful rotator cuff tears, but without any history of trauma. Methods: We evaluated a cohort of 745 patients with painful rotator cuff tears having no trauma history, and analyzed the relationship between pain and multiple factors including demographic data, tear characteristics, and passive range of motion. Pain was analyzed with a questionnaire concerning the visual analogue scale (VAS) for pain. Tear characteristics were determined by evaluating tear size, muscle atrophy, number of torn tendons, and presence of arthritis. Multivariate linear regression analysis and chi-squared test were applied to evaluate the relationship between the VAS for pain and variable factors. Results: Shoulder pain was associated with young age (p=0.01), male sex (p=0.01) and the presence of diabetes mellitus (p<0.001). Measurements of rotator cuff tear characteristics including tear size (p=0.53), muscle atrophy (p=0.16) and the number of torn tendons (p=0.34) did not correlate with shoulder pain. Symptom duration (p=0.60) and range of motion (p>0.05) also showed no correlation with VAS for pain. Conclusions: Young age, male sex and the presence of diabetes mellitus correlated positively with preoperative shoulder pain in patients with painful rotator cuff tears without a trauma history. Combined treatment of pain management and risk factor correction could be helpful to control preoperative shoulder pain.

• Tuberculosis and Respiratory Diseases
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• v.82 no.4
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• pp.341-347
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• 2019

Background: Information about the epidemiology of venous thromboembolism (VTE) recurrence in Korea is lacking. The purpose of this study was to investigate VTE cumulative recurrence rates and identify risk factors for VTE recurrence among Korean adults. Methods: A retrospective cohort study was conducted on adult patients (${\geq}18years$) admitted to a university teaching hospital for pulmonary embolism (PE) from 2005 to 2013. The main outcome of interest was a recurrence of VTE. We used Cox proportional hazard regression analyses to calculate the relative risk of VTE recurrence. Results: Five-year cumulative incidence of recurrent VTE events was 21.5% (95% confidence interval [CI], 17.7-25.4) in all cases of PE; 17% after provoked and 27% after unprovoked PE. Multivariate analysis showed that body mass index (BMI) of ${\geq}25$ (hazard ratio [HR], 2.02; 95% CI, 1.17-3.46; p=0.01) and longer anticoagulation therapy duration (HR, 0.90; 95% CI, 0.84-0.96; p<0.01) were independently associated with risk of VTE recurrence. Risk factors not found to be statistically significant at the <0.05 level included history of VTE (HR, 1.81; 95% CI, 0.84-3.88; p=0.12), unprovoked PE (HR, 1.70; 95% CI, 0.89-3.25; p=0.10), symptomatic deep vein thrombosis (HR, 1.62; 95% CI, 0.89-2.94; p=0.10), and female sex (HR, 1.42; 95% CI, 0.78-2.55; p=0.24). We found that age, history of cancer, and other co-morbidities did not significantly affect the risk of VTE recurrence. Conclusion: Recurrence of VTE after PE is high. Patients with BMI ${\geq}25$ or reduced anticoagulation therapy duration have a higher risk of recurrent VTE.