• Title/Summary/Keyword: Healthcare 3.0

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Comparison of clinical outcomes between in vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI) in IVF-ICSI split insemination cycles

  • Lee, Sun Hee;Lee, Jae Hyun;Park, Yong-Seog;Yang, Kwang Moon;Lim, Chun Kyu
    • Clinical and Experimental Reproductive Medicine
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    • v.44 no.2
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    • pp.96-104
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    • 2017
  • Objective: This study aimed to compare the clinical outcomes between in vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI) in sibling oocytes. Additionally, we evaluated whether the implementation of split insemination contributed to an increase in the number of ICSI procedures. Methods: A total of 571 cycles in 555 couples undergoing split insemination cycles were included in this study. Among them, 512 cycles (89.7%) were a couple's first IVF cycle. The patients were under 40 years of age and at least 10 oocytes were retrieved in all cycles. Sibling oocytes were randomly allocated to IVF or ICSI. Results: Total fertilization failure was significantly more common in IVF cycles than in ICSI cycles (4.0% vs. 1.4%, p<0.05), but the low fertilization rate among retrieved oocytes (as defined by fertilization rates greater than 0% but < 30%) was significantly higher in ICSI cycles than in IVF cycles (17.2% vs. 11.4%, p<0.05). The fertilization rate of ICSI among injected oocytes was significantly higher than for IVF ($72.3%{\pm}24.3%$ vs. $59.2%{\pm}25.9%$, p<0.001), but the fertilization rate among retrieved oocytes was significantly higher in IVF than in ICSI ($59.2%{\pm}25.9%$ vs. $52.1%{\pm}22.5%$, p<0.001). Embryo quality before embryo transfer was not different between IVF and ICSI. Although the sperm parameters were not different between the first cycle and the second cycle, split insemination or ICSI was performed in 18 of the 95 cycles in which a second IVF cycle was performed. Conclusion: The clinical outcomes did not differ between IVF and ICSI in split insemination cycles. Split insemination can decrease the risk of total fertilization failure. However, unnecessary ICSI is carried out in most split insemination cycles and the use of split insemination might make ICSI more common.

Digital Breast Tomosynthesis Plus Ultrasound Versus Digital Mammography Plus Ultrasound for Screening Breast Cancer in Women With Dense Breasts

  • Su Min Ha;Ann Yi;Dahae Yim;Myoung-jin Jang;Bo Ra Kwon;Sung Ui Shin;Eun Jae Lee;Soo Hyun Lee;Woo Kyung Moon;Jung Min Chang
    • 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.

Efficacy of Coculture System in the Patients with Poor Prognoses on Human IVF-ET Program (사람의 체외수정 시술시 저적응 예후를 보이는 환자에서 공동배양술의 효용성에 관한 연구)

  • Byun, Hye-Kyung;Youm, Hye-Won;Koong, Mi-Kyung;Son, Il-Pyo;Kang, Inn-Soo;Lee, Ho-Joon
    • Clinical and Experimental Reproductive Medicine
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    • v.24 no.2
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    • pp.211-216
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    • 1997
  • The present study was carried out to evaluate whether the coculture system of human embryos with Vero cells can improve the quality of embryo or overcome the repetitive implantation failures in order to obtain pregnancy. From January to December 1996, a total 202 cases which patients with the problems of repetitive implantation failures (group I) or those with the poor embryonic quality in their previous cycles (group II) was analysed. The quality of cocultured embryo, pregnancy, on-going and implantation rates between coculture and control groups were compared. Of 93 cases in group I, coculture was performed in 34 cases and conventional IVF for the rest. Of 109 cases in group II, 36 for coculture and 73 for conventional IVF. In group I, pregnancy, on-going and implantation rates in coculture group (14/34 (41.2%), 9/34 (26.5%), 16/81 (19.8%), respectively) were higher than those of control (11/59 (18.6%), 8/59 (13.6%), 12/152 (7.9%), respectively). There is significance in the pregnancy and implantation rates (p=0.028 and p=0.015). In group II, pregnancy, on-going and implantation rates in coculture group (8/36 (22.2%), 5/36 (13.9%), 8/87 (9.2%), respectively) were higher than those of control (5/73 (6.8%), 3/73 (4.1%), 3/158 (1.9%), respectively). Like the result of group I, there is significance in the pregnancy and implantation rates (p=0.028 and p=0.022). Coculture system with Vero cells works well in the groups of the two indications. Although the case of 3 day-coculture was small as 15 cases in group II, 3 day-coculture improved pregnancy rate (4/15 (26.7%)). Therefore, 3 day-coculture with assisted hatching is recommended to the patients with poor embryonic quality. In conclusion, coculture system with Vero cells can be suggested as an effective method which improves pregnancy rate in those who have repetitive implantation failures or whose embryonic quality was poor in their previous cycles.

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Reproducibility and validity of semi-quantitative food frequency questionnaire measuring dietary trans-fatty acids intake among Korean adults

  • Joh, Hee-Kyung;Oh, Seung-Won;Lee, Eun
    • Nutrition Research and Practice
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    • v.9 no.1
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    • pp.99-105
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    • 2015
  • BACKGROUND/OBJECTIVES: Compelling evidence indicates that consumption of trans-fatty acids (TFA) is associated with a wide range of diseases. However, few validated tools for TFA intake assessment are available in Korea. We aimed to validate a food frequency questionnaire (FFQ) estimating usual intake of TFA in Korean adults. MATERIALS/METHODS: Eighty-two healthy adults completed an FFQ with a 3-day diet record (3DDR), and 58 completed a second FFQ at a 1-month interval. To assess the reproducibility of the FFQ, we compared estimated TFA intakes from each FFQ. To assess the validity, we compared estimates from the FFQ with those from the 3DDR. RESULTS: The FFQ was reproducible (Spearman r = 0.71) and provided modest correlations with the 3DDR (Spearman r = 0.38). After adjustment for total energy intake, the correlations increased (r = 0.45). Measurement-error correction also de-attenuated the correlations (r = 0.57). When quintiles of the FFQ and 3DDR were joint-classified, 9% on average were misclassified into extreme quintiles. CONCLUSIONS: Our findings suggest that the developed FFQ is reproducible and reasonably valid in categorizing individuals according to TFA intakes among healthy young and middle aged adults in Korea.

Pregnancy rate in women with adenomyosis undergoing fresh or frozen embryo transfer cycles following gonadotropin-releasing hormone agonist treatment

  • Park, Chan Woo;Choi, Min Hye;Yang, Kwang Moon;Song, In Ok
    • Clinical and Experimental Reproductive Medicine
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    • v.43 no.3
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    • pp.169-173
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    • 2016
  • Objective: To determine the preferred regimen for women with adenomyosis undergoing in vitro fertilization (IVF), we compared the IVF outcomes of fresh embryo transfer (ET) cycles with or without gonadotropin-releasing hormone (GnRH) agonist pretreatment and of frozenthawed embryo transfer (FET) cycles following GnRH agonist treatment. Methods: This retrospective study included 241 IVF cycles of women with adenomyosis from January 2006 to January 2012. Fresh ET cycles without (147 cycles, group A) or with (105 cycles, group B) GnRH agonist pretreatment, and FET cycles following GnRH agonist treatment (43 cycles, group C) were compared. Adenomyosis was identified by using transvaginal ultrasound at the initial workup and classified into focal and diffuse types. The IVF outcomes were also subanalyzed according to the adenomyotic region. Results: GnRH agonist pretreatment increased the stimulation duration ($11.5{\pm}2.1days$ vs. $9.9{\pm}2.0days$) and total dose of gonadotropin ($3,421{\pm}1,141IU$ vs. $2,588{\pm}1,192IU$), which resulted in a significantly higher number of retrieved oocytes ($10.0{\pm}8.2$ vs. $7.9{\pm}6.8$, p=0.013) in group B than in group A. Controlled ovarian stimulation for freezing resulted in a significantly higher number of retrieved oocytes ($14.3{\pm}9.2$ vs. $10.0{\pm}8.2$, p=0.022) with a lower dose of gonadotropin ($2,974{\pm}1,112IU$ vs. $3,421{\pm}1,141IU$, p=0.037) in group C than in group B. The clinical pregnancy rate in group C (39.5%) tended to be higher than those in groups B (30.5%) and A (25.2%) but without a significant difference. Conclusion: FET following GnRH agonist pretreatment tended to increase the pregnancy rate in patients with adenomyosis. Further largescale prospective studies are required to confirm this result.

Efficacy of the Split Insemination Method Combining Conventional IVF and ICSI in Non-male Factor Infertile Couples with Normal Sperm Parameters (정상 정자 소견을 나타내는 불임 부부에서 일반적인 체외수정과 세포질내 정자주입술을 병행하는 분할 수정법의 효용성)

  • Hong, Seung-Bum;Park, Dong-Wook;Shin, Mi-Ra;Choi, Su-Jin;Lee, Sun-Hee;Song, In-Ok;Jun, Jin-Hyun
    • Clinical and Experimental Reproductive Medicine
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    • v.34 no.4
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    • pp.305-312
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    • 2007
  • Objective: To evaluate the efficacy of split insemination method in treatments for non-male factor infertility. Method: Laboratory and clinical data were collected from 505 cycles of split insemination during 2002$\sim$2005 in our center. The subjects were non-male factor infertility such as endometriosis, tubal, uterine, PCOS and idiopathic infertility without any sperm defects. Retrieved oocytes were randomly divided, and inseminated by conventional IVF or ICSI. Fertilized zygotes were cultured for 2$\sim$5 days to ET date, and surplus zygotes and embryos were frozen for subsequent frozen-thawed ET cycles. Clinical outcomes according to insemination method were compared by statistical analysis. Results: The overall fertilization per retrieved oocytes was significantly higher in ICSI than that of conventional IVF in sibling oocytes (62.5$\pm$22.3% vs 52.9$\pm$28.0%, p<0.01). Total fertilization failure occurred only in 2 of 505 cycles (0.4%) in split insemination cycles. Incidence of fertilization failure and poor fertilization rate less than 30% by ICSI were significantly lower than those of conventional IVF (1.1% and 7.5% vs 8.5% and 22.0%, p<0.01). Delivery rates after transfer of fresh and thawed embryos from split insemination cycles were 40.0% (185/462) and 35.0% (55/157), respectively. There was no significant difference in the implantation and delivery rates of ET with embryos from conventional IVF or ICSI. Conclusion: Taken together, the split insemination method improves poor fertilization rates resulting in successful clinical outcomes and thus could be used for non-male factor infertile couples in human ART program.

uPetCare : Ubiquitous Pet-Care System using Web2.0 (uPetCare : 웹2.0을 이용한 유비쿼터스 펫 케어 시스템)

  • Park, Jun-Sung;Lee, Gwi-Ro;Cho, Jin-Sung
    • Journal of KIISE:Computing Practices and Letters
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    • v.15 no.4
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    • pp.260-264
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    • 2009
  • There have been many studies on u-Healthcare system for human using sensor network systems. In this paper, we design and implement a healthcare system for pets called uPetCare(Ubiquitous Pet-Care System) that can manage the status of pet on the web. The main functions of this system are 1) gathering data using sensor network, 2) multi-hop communication in sensor network, 3) data compression and aggregation at sink node, 4) storing data in web server, 5) real-time data monitoring using AJAX, 6) activity recognition of pet.

Investigation on Factors Affecting Adolescent Depression: Using Korean Children and Youth Panel Survey (청소년 우울증 영향요인에 관한 연구 : 아동·청소년 패널데이터 이용)

  • Choi, Young Jin;Gang, Hong Ik;Kim, Dong Wook;Seong, Gyu Hwan;Han, Whiejong M
    • The Journal of Korean Society for School & Community Health Education
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    • v.18 no.3
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    • pp.45-53
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    • 2017
  • Objectives: This study aimed to analyze the association between adolescent depression and personal factors such as interpersonal relationship and personal characteristics. Methods: The data used for this study was taken from the 2014 Korean Children and Youth Panel Survey. Of those 2,351 subjects in a data set, data of 1,938 subjects were analyzed after excluding 413 subjects with missing information. Hierarchical regression analysis was conducted for multi-variate analysis. In addition, controlling effects of ego-resiliency was analyzed. SPSS 22.0. was utilized for statistical analyses. Results: The study found that the depressive index was higher in women than men, and lower in adolescent who has a good relationship with parents and friends. This study also found that adolescents with high ego-resiliency are more vulnerable to depression. Conclusions: It is recommended to understand and to utilize ego-resiliency of adolescents, in order to reduce adolescents depression. Promoting good relationship with parents and friends will also positively impact to lower adolescents depression.

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Factors Influencing the Unmet Healthcare Needs of Elderly with Chronic Diseases : Focusing on the 2017 Korean National Survey on Elderly (노인 만성질환자의 미충족 의료에 영향을 미치는 요인 : 2017년도 노인실태조사를 중심으로)

  • Park, Ji-Kyeong
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.20 no.12
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    • pp.306-313
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    • 2019
  • This study endeavors to provide basic data for healthcare policy development by identifying factors that influence the unmet healthcare needs of the elderly with chronic diseases. The study utilized data from the 2017 Korean National Survey on the Elderly, and analyzed 9,117 elders afflicted with more than 1 chronic disease. We determined that 851 (9.3%) elders experienced unmet healthcare needs from hospital & clinical treatment, and 1,469 (16.1%) elders experienced unmet dental treatment. 'Economic difficulty' was the most common reason expressed by 425 (49.9%) elders for unmet healthcare needs from hospital and clinical treatment, and by 1,066 (72.6%) elders for dental treatment. Furthermore, unmet healthcare needs in hospital and clinical treatment were affected by various factors, including spouse, education, self-rated health status and exercise, whereas unmet healthcare needs in dental treatment were affected by factors such as spouse, education, medical aids, self-rated health status, smoking, and exercise. Based on the research results achieved, we propose a necessity to establish healthcare policies that consider the influencing factors, and help resolve the unmet healthcare needs of the elderly with chronic diseases.

The Effects of a Mobile Computerized System for Individual Tailored Home Care Services in a City (일 지역 이동형 방문보건 전산시스템의 재구축과 활용의 효과)

  • Park, Nam-Hee;Jang, Rang;Kim, Jung-Young;Kim, Myoung-Soo
    • Research in Community and Public Health Nursing
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    • v.23 no.1
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    • pp.71-81
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    • 2012
  • Purpose: The aim of this study was to evaluate the process and outcome of a mobile computerized system for individual home visiting healthcare. Methods: A nonequivalent control group non-synchronized design was employed for this study. The newly constructed system was administered to 80 healthcare providers in the experimental group for 8 weeks. Data were analyzed using descriptive analysis, t-test, and ANCOVA with the SPSS 18.0 program. Results: In the process stage, the difference in the frequency of computerized information usage between the experimental and control groups was significant as $8.88{\pm}3.20$ and $7.08{\pm}2.92$, respectively (t=3.90, p<.001). In the outcome evaluation stage, all kinds of healthy lifestyle such as alcohol use, nutrition, weight management and mental health were not improved. Conclusion: The findings of this study showed that the revised mobile computerized system was an effective device for individual visiting healthcare providers. Further advanced strategies for using this system should be developed and applied in a broad range of community healthcare.