• Journal of Digital Convergence
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• v.17 no.8
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• pp.429-437
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• 2019

This study examined diverse capital dynamics and the effect of the dynamics on the quality of life of Korean baby boomers living in Jeonju. Also this study investigated the moderating effect of birth cohort. A structural equation modeling conducted with 303 baby boomers for verification. The results are as follows: First, the human capital of baby boomer directly or indirectly affected psychological, economic, social capital, and quality of life. Second, economic capital directly or indirectly affected psychological, social capital, and quality of life. Third, psychological capital directly or indirectly affected social capital and quality of life. Fourth, social capital affected the quality of life. Fifth, the birth cohort moderated the impacts of economic capital on psychological capital and quality of life. The results provided an understanding of the quality of life of baby boomer and the direction of intervention.

• Journal of Chest Surgery
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• v.52 no.1
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• pp.1-8
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• 2019

Background: Neoadjuvant chemoradiation therapy (nCRT) has become the standard of care for esophageal cancer patients prior to esophagectomy. However, the optimal timing for surgery after completion of nCRT remains unclear. Methods: A retrospective review was performed of patients who underwent esophagectomy with cervical anastomosis for esophageal cancer at a single institution between January 2000 and June 2015. Patients were categorized into 3 cohorts: those who did not receive nCRT prior to esophagectomy (no nCRT), those who underwent esophagectomy within 35 days after nCRT (${\leq}35d$), and those who underwent esophagectomy more than 35 days after nCRT (>35d). Results: A total of 366 esophagectomies were performed during the study period, and 348 patients met the inclusion criteria. Anastomotic leaks occurred in 11.8% of all patients included in the study (41 of 348). Within each cohort, anastomotic leaks were detected in 14.7% of patients (17 of 116) in the no nCRT cohort, 7.3% (13 of 177) in the ${\leq}35d$ cohort, and 20.0% (11 of 55) in the >35d cohort (p=0.020). Significant differences in the occurrence of anastomotic leaks were observed between the no nCRT and ${\leq}35d$ cohorts (p=0.044), and between the ${\leq}35d$ and >35d cohorts (p=0.007). Conclusion: Esophagectomy with cervical anastomosis within 35 days of nCRT resulted in a lower percentage of anastomotic leaks.

• The Journal of Health Technology Assessment
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• v.6 no.2
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• pp.142-147
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• 2018

Objectives: The purpose of this study is to evaluate the safety and effectiveness of Robot-Assisted Brain Stereotactic Surgery with a systematic review. Methods: Electronic literature was searched using KoreaMed, Ovid-MEDLINE, Ovid-EMBASE, and Cochrane Library on 6th April 2017. Two authors screened 1218 citations. Duplicated articles of 456 excluded, the remaining 762 articles were reviewed with title and abstract. Results: A total of 8 studies were selected in this review. The device used in all studies was $ROSA^{TM}$. In one cohort study comparing the intervention ($ROSA^{TM}$) with the control (conventional stereotactic surgery), hematoma was reported no significant difference between groups. In six descriptive studies, one study reported hematoma 10% (10/100) and temporary nerve impairment 6% (6/100) using the ROSA; while five descriptive study did not report any complications. In one cohort, the localization precision were 1.2 mm in the intervention group and 1.1 mm in the control group; the localization success rate as 78.2% in the intervention group and 76.2% in the control group in one cohort; and the average time for surgery as 130 min for the intervention group and 352 min for the control group in one cohort. Four studies reported the localization success rate as 100%; two out of three articles reported the overall time for surgery as 56 min and 90 min, while one article reported the time as less than one hour in 50% of patients (50/100); two articles reported in epilepsy patients, the condition after the surgery was Engel level I in 66.2%, 75% patients, Engel level II-III in 25%, 26.5% patients, and Engel level 4 in 7.3% patients. Conclusion: Robot-Assisted Brain Stereotactic Surgery is a safe and accurate technique that can significantly reduce the time for the brain stereotactic surgery. However, further studies are needed to generalize the results.

• Journal of Periodontal and Implant Science
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• v.51 no.2
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• pp.114-123
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• 2021

Purpose: This retrospective cohort study aimed to assess the effect of nonsurgical periodontal therapy on glycated hemoglobin (HbA1c) levels in patients with both type 2 diabetes and chronic periodontitis. Methods: The intervention cohort (IC) comprised 133 patients with type 2 diabetes who received nonsurgical periodontal treatment, while the matching cohort (MC) included 4787 patients with type 2 diabetes who visited the Department of Endocrinology and Metabolism of Asan Medical Center. The patients in each cohort were divided into 3 groups according to their baseline HbA1c level: subgroup 1, HbA1c <7%; subgroup 2, 7%≤ HbA1c <9%; and subgroup 3, HbA1c ≥9%. Changes in HbA1c levels from baseline to 6 and 12 months were analyzed. In addition, the association between changes in HbA1c levels and the number of periodontal maintenance visits was investigated. Results: There were no statistically significant changes in HbA1c levels in the IC and MC or their subgroups when evaluated with repeated-measures analysis of variance. However, the IC showed maintenance of baseline HbA1c levels, while the MC had a trend for HbA1c levels to steadily increase as shown by pairwise comparisons (baseline to 6 months and baseline to 12 months). IC subgroup 1 also maintained steady HbA1c levels from 6 months to 12 months, whereas MC subgroup 1 presented a steady increase during the same period. The number of periodontal maintenance visits had no association with changes in HbA1c levels during the 1-year study duration. Conclusions: For patients with both type 2 diabetes and periodontitis, nonsurgical periodontal treatment and periodontal maintenance may help to control HbA1c levels.

• Journal of Gastric Cancer
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• v.21 no.1
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• pp.49-62
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• 2021

Purpose: This study aimed to investigate the prognostic value of lymph node ratio (LNR) in patients with locally advanced gastric cancer who received neoadjuvant chemotherapy. Materials and Methods: We retrospectively enrolled gastric cancer patients treated with neoadjuvant chemotherapy and curative surgery at the First Affiliated Hospital of Zhejiang University from 2004 to 2015 as the study cohort. Patients with the same inclusion criteria treated in 2016-2017 were enrolled as the validation cohort. Kaplan-Meier curves were assessed using the log-rank test to analyze the differences in overall survival (OS). Multivariate survival analysis was performed using the Cox proportional hazards model. The areas under the receiver operating characteristic curve of ypN and LNR categories for predicting the actual 3-year OS were compared. Results: A total of 265 patients were included in the proposal cohort. The median number of retrieved lymph nodes (rLNs) was 32. The number of positive lymph nodes (pLNs) increased as rLN increased (P=0.037), but the LNR remained relatively constant (P=0.462). The LNR was categorized into 4 groups according to the prognosis: ypNr0, node-negative with rLN>25; ypNr1, node-negative with rLN≤25 or 00.3. In the validation cohort of 43 enrolled patients, there was a clear distinction in OS that significantly (P<0.001) varied depending on the LNR values and LNR was the only independent prognostic factor in multivariate analysis (P<0.001). Conclusions: LNR was an independent prognostic factor for survival of patients with gastric cancer after preoperative chemotherapy and might be an alternative predictor for ypN stage.

• 한국노년학
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• v.41 no.3
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• pp.397-420
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• 2021

The paper tried to determine relationships between volunteering and hypertension risks, symptom betterment, activity difficulty occurrences, and medicine treatment among middle-aged and older adults, with a prospective cohort study. Multilevel mixed-effects generalized linear models were used for the analysis of longitudinal panel data collected over 10 years from 2008 to 2018, using 5,867 cohort samples. The results showed that those who volunteered at least 200 hours per year were 3.4 times more lower than not-volunteering in risks of hypertension, those who volunteered yearly 50~99 hours were a lot more improved than not-volunteering in the symptom betterment, those who volunteered yearly at least 200 hours were 7.7 times lower than not-volunteering in activity difficulty occurrences, and those who volunteered yearly 50~99 hours were 2.5 times lower than not-volunteering in the occurrences of medicine treatment. These indicate that volunteering among middle-aged and older adults may have health benefits against incident hypertension. Finally the thesis discusses the study limitations, future directions of studies, and the practices implications.

• Nutrition Research and Practice
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• v.16 no.sup1
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• pp.21-36
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• 2022

BACKGROUND/OBJECTIVES: The long-term health impacts of dietary sugar have begun to be reported. The committee on the 2020 Dietary Reference Intakes for Koreans for sugar intended to update the scientific evidence on the association of added sugar intake with health outcomes, including mortality. This study evaluated the evidence on the association of dietary sugar with the all-cause and cardiovascular disease mortality from cohort studies. SUBJECTS/METHODS: The PubMed and ScienceDirect databases were searched until July 2021. The search terms were based on multiple combinations of keywords, such as added sugar, beverage, and mortality, included in the title or abstract. Two authors independently assessed the eligibility criteria of study selection and extracted the information from each selected article for this systematic review. RESULTS: The literature search identified 276 articles. Seventeen cohort studies met the inclusion criteria and were included in this systematic review. This study extracted information on the cohort and participants, dietary assessment methods, exposure and its comparison groups, health outcomes, and risk measures. Five articles reported added sugar intake, and 15 articles reported the food sources of the added sugar in the association with mortality. Increased mortality was observed in higher added sugar intake and a lower intake of less than 5% of energy, while higher discrepancies between gender, age groups, and countries were noted. In addition, nutritious sugary foods and beverages did not increase mortality. CONCLUSIONS: A 'U' or 'J' shaped relationship between the added sugar intake and mortality was estimated. The observed discrepancy indicated the need for more evidence to establish the dose-response relationship for Koreans.

• Journal of Yeungnam Medical Science
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• v.41 no.1
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• pp.39-44
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• 2024

Background: Medication-related osteonecrosis of the jaw (MRONJ) is a significant concern, particularly among patients taking bisphosphonates (BPs), denosumab, and selective estrogen receptor modulators (SERMs) for osteoporosis. Despite the known risks, large-scale cohort studies examining the incidence and severity of MRONJ are lacking. We aimed to ascertain the incidence and risk of MRONJ among these patients, whom we stratified by age groups, medication types, and duration of use. Methods: We utilized data from the National Health Insurance Service's sample cohort database, focusing on patients aged 40 years and above diagnosed with osteoporosis. The patients were divided into three groups: those prescribed BPs only, those prescribed SERMs only, and those prescribed both. Results: The overall incidence rate of MRONJ was 0.17%. A significantly higher incidence rate was observed among those taking osteoporosis medications, particularly among females with a relative risk of 4.99 (95% confidence interval, 3.21-7.74). The SERM group also had an incidence rate comparable to that of the BP group. Severity was assessed based on the invasiveness of the treatment methods, with 71.3% undergoing invasive treatment in the medication group. Conclusion: This study provides valuable insights into the incidence and severity of MRONJ among a large cohort of patients with osteoporosis. It underscores the need for comprehensive guidance on MRONJ risks across different medication groups and sets the stage for future research focusing on specific populations and treatment outcomes.

• Annals of Occupational and Environmental Medicine
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• v.35
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• pp.11.1-11.17
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• 2023

Background: Studies on the relationship between organic solvent exposure and chronic kidney disease (CKD) have presented inconsistent results. Definition of CKD has changed in 2012, and other cohort studies have been newly published. Therefore, this study aimed to newly confirm the relationship between organic solvent exposure and CKD through an updated meta-analysis including additional studies. Methods: This systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. The search was conducted on January 2, 2023 using Embase and MEDLINE databases. Case-control and cohort studies on the relationship between organic solvent exposure and CKD were included. Two authors independently reviewed full-text. Results: Of 5,109 studies identified, a total of 19 studies (control studies: 14 and cohort studies: 5) were finally included in our meta-analysis. The pooled risk of CKD in the organic solvent exposed group was 2.44 (1.72-3.47). The risk of a low-level exposure group was 1.07 (0.77-1.49). The total risk of a high-level exposure group was 2.44 (1.19-5.00). The risk of glomerulonephritis was 2.69 (1.18-6.11). The risk was 1.46 (1.29-1.64) for worsening of renal function. The pooled risk was 2.41 (1.57-3.70) in case-control studies and 2.51 (1.34-4.70) in cohort studies. The risk of subgroup classified as 'good' by the Newcastle Ottawa scale score was 1.93 (1.43-2.61). Conclusions: This study confirmed that the risk of CKD was significantly increased in workers exposed to mixed organic solvents. Further research is needed to determine the exact mechanisms and thresholds. Surveillance for kidney damage in the group exposed to high levels of organic solvents should be conducted.

• Tuberculosis and Respiratory Diseases
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• v.76 no.4
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• pp.169-174
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• 2014

Background: The Korean Obstructive Lung Disease (KOLD) Cohort Study is a prospective longitudinal study of patients with chronic obstructive pulmonary disease (COPD), asthma, or other unclassified obstructive lung diseases. It was designed to develop new classification models and biomarkers that predict clinically relevant outcomes for patients with obstructive lung diseases. Methods: Patients over 18 years old who have chronic respiratory symptoms and airflow limitations or bronchial hyper-responsiveness were enrolled at 17 centers in South Korea. After a baseline visit, the subjects were followed up every 3 months for various assessments. Results: From June 2005 to October 2013, a total of 477 subjects (433 [91%] males; 381 [80%] diagnosed with COPD) were enrolled. Analyses of the KOLD Cohort Study identified distinct phenotypes in patients with COPD, and predictors of therapeutic responses and exacerbations as well as the factors related to pulmonary hypertension in COPD. In addition, several genotypes were associated with radiological phenotypes and therapeutic responses among Korean COPD patients. Conclusion: The KOLD Cohort Study is one of the leading long-term prospective longitudinal studies investigating heterogeneity of the COPD and is expected to provide new insights for pathogenesis and the long-term progression of COPD.