• Clinical and Experimental Reproductive Medicine
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• v.38 no.1
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• pp.31-36
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• 2011

Objective: To determine whether the serum ${\beta}$-human chorionic gonadotropin (hCG) profile following preimplantation genetic diagnosis (PGD) is lower than that of intracytoplasmic sperm injection (ICSI) cycles. Methods: A total of 129 PGD cycles and 1,161 age-matched ICSI cycles, which resulted in pregnancy (serum ${\beta}-hCG{\geq}5$ mIU/mL) on post-ovulation day (POD) 12 were included. We compared the mean serum ${\beta}$-hCG levels on POD 12, 14, 21, and 28, doubling time of serum hCG, and created a cut-off value for predicting a singleton pregnancy in each group. Results: The mean serum ${\beta}$-hCG concentration of the PGD group was significantly lower than that of the control group on POD 12, 14, and 21. The doubling time of serum ${\beta}$-hCG at each time interval showed no significant difference. The cut-off-value of serum ${\beta}$-hCG for predicting a single viable pregnancy was 32.5 mIU/mL on POD 12 and 113.5 mIU/mL on POD 14 for the PGD group, which was lower than that for the control group. Conclusion: Blastomere biopsy may decrease the ${\beta}$-hCG-producing activity of the trophoblasts, especially in early pregnancy. Setting a lower cut-off value of serum ${\beta}$-hCG for predicting pregnancy outcomes in PGD may be needed.

• Journal of Korean Society of Occupational and Environmental Hygiene
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• v.34 no.1
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• pp.77-84
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• 2024

Objectives: Interventions promoting physical exercise and healthy habits in workplaces have been shown to be effective in reducing risk factors for metabolic syndrome. This study was conducted to examine the effects of an individualized conditioning exercise program of IT company office workers with or at higher risk of metabolic syndrome. Methods: A total of 444 IT company office workers with or at higher risk of metabolic syndrome participated in a 3-month conditioning exercise program. Body composition data using bioelectrical impedance analysis and cardiopulmonary data using cardiopulmonary exercise testing from 53 individuals (mean age: 34.8 ± 7.1 years, sex : 21% female, height : 170.4 ± 6.8 cm, weight : 75.2±12.2 kg, body mass index : 25.8±3.3 kg/m²) who have successfully completed pre-test, intervention, and post-test were analyzed. The 12 weeks intervention encompassed: (1) health counseling (2) supervised exercise(endurance-based, aerobic exercise, or circuit training once a week for 50 minutes at heart rate reserve(HRR) of 77-95%) (3) self-directed exercise and biweekly health screening checks. Results: The results indicated a significant decrease in body weight, body fat mass and body mass index, respectively. Moreover, VO₂peak, AT VO₂ and AT Time significantly improved, respectively. Resting blood pressure(SBP/DBP) showed positive changes but were not statistically significant. We observed the correlation between characteristics of participants and rate of changes in cardiopulmonary outcomes of participants, there are no significant correlation. These results indicate positive changes in body composition and cardiorespiratory fitness parameters following individualized conditioning exercise program. Conclusions: Individualized workplace exercise program for preventing metabolic syndrome can lead to improvements in body composition and cardiorespiratory fitness.

• Journal of Trauma and Injury
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• v.36 no.1
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• pp.39-48
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• 2023

Purpose: Sports offer several health benefits but are not free of injury risk. Activity dynamics vary across sports, impacting the injury profile and thereby influencing healthcare resource utilization and health outcomes. The purpose of this study was to investigate sports-related major trauma cases and compare differences across sports and activity groups. Methods: A retrospective case notes review of sports-related major traumas over a 5-year period was conducted. Demographic, hospital episode-related, and health outcome-related data were analyzed, and differences were compared across sports and activity groups. The Glasgow Outcome Scale (GOS) at discharge was used as the primary outcome measure and the length of hospital stay as the secondary outcome measure. Results: In total, 76% of cases had good recovery at discharge (GOS, 5), 19% had moderate disability (GOS, 4), and 5% had severe disability (GOS, 3). The mean length of hospital stay was 11.2 days (range, 1-121 days). The most severely injured body region was the limbs (29.1%) and vertebral/spinal injuries were most common (33%) in terms of location. A significant difference (P<0.05) existed in GOS across sports groups, with motor sports having the lowest GOS. However, no significant differences (P>0.05) were found in other health-outcome variables or injury patterns across sports or activity groups, although more competitive sports cases (67%) required admission than recreational sports cases (33%). Conclusions: Spinal injuries are the most frequent sports injuries, bear the worst health outcomes, and warrant better preventive measures. Head injuries previously dominated the worst outcomes; this change is likely due to better preventive and management modalities. Competitive sports had a higher injury frequency than recreational sports, but no difference in health outcomes or injury patterns.

• Tuberculosis and Respiratory Diseases
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• v.86 no.3
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• pp.234-244
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• 2023

Background: Effective treatment of fluoroquinolone-resistant multidrug-resistant tuberculosis (FQr-MDR-TB) is difficult because of the limited number of available core anti-TB drugs and high rates of resistance to anti-TB drugs other than FQs. However, few studies have examined anti-TB drugs that are effective in treating patients with FQr-MDR-TB in a real-world setting. Methods: The impact of anti-TB drug use on treatment outcomes in patients with pulmonary FQr-MDR-TB was retrospectively evaluated using a nationwide integrated TB database (Korean Tuberculosis and Post-Tuberculosis). Data from 2011 to 2017 were included. Results: The study population consisted of 1,082 patients with FQr-MDR-TB. The overall treatment outcomes were as follows: treatment success (69.7%), death (13.7%), lost to follow-up or not evaluated (12.8%), and treatment failure (3.9%). On a propensity-score-matched multivariate logistic regression analysis, the use of bedaquiline (BDQ), linezolid (LZD), levofloxacin (LFX), cycloserine (CS), ethambutol (EMB), pyrazinamide, kanamycin (KM), prothionamide (PTO), and para-aminosalicylic acid against susceptible strains increased the treatment success rate (vs. unfavorable outcomes). The use of LFX, CS, EMB, and PTO against susceptible strains decreased the mortality (vs. treatment success). Conclusion: A therapeutic regimen guided by drug-susceptibility testing can improve the treatment of patients with pulmonary FQr-MDR-TB. In addition to core anti-TB drugs, such as BDQ and LZD, treatment of susceptible strains with later-generation FQs and KM may be beneficial for FQr-MDR-TB patients with limited treatment options.

• Annals of Hepato-Biliary-Pancreatic Surgery
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• v.28 no.1
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• pp.1-13
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• 2024

Hepatocellular carcinoma (HCC) is the sixth most diagnosed cancer worldwide. Healthcare resource constraints may predispose treatment delays. We aim to review existing literature on whether delayed treatment results in worse outcomes in HCC. PubMed, Embase, The Cochrane Library, and Scopus were systematically searched from inception till December 2022. Primary outcomes were overall survival (OS) and disease-free survival (DFS). Secondary outcomes included post-treatment mortality, readmission rates, and complications. Fourteen studies with a total of 135,389 patients (delayed n = 25,516, no delay n = 109,873) were included. Age, incidence of male patients, Child-Pugh B cirrhosis, and Barcelona Clinic Liver Cancer Stage 0/A HCC were comparable between delayed and no delay groups. Tumor size was significantly smaller in delayed versus no delay group (mean difference, -0.70 cm; 95% confidence interval [CI]: -1.14, 0.26; p = 0.002). More patients received radiofrequency ablation in delayed versus no delay group (OR, 1.22; 95% CI: 1.16, 1.27; p < 0.0001). OS was comparable between delayed and no delay in HCC treatment (hazard ratio [HR], 1.13; 95% CI: 0.99, 1.29; p = 0.07). Comparable DFS between delayed and no delay groups (HR, 0.99; 95% CI: 0.75, 1.30; p = 0.95) was observed. Subgroup analysis of studies that defined treatment delay as > 90 days showed comparable OS in the delayed group (HR, 1.04; 95% CI: 0.93, 1.16; p = 0.51). OS and DFS for delayed treatment were non-inferior compared to no delay, but might be due to better tumor biology/smaller tumor size in the delayed group.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.12
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• pp.4787-4793
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• 2014

Background: Many cancer patients experience poor pain control due to various factors, including misconceptions regarding the use of opioid analgesics. For management of cancer pain, interventions involving education of both patients and physicians have been attempted. Objectives: This review aimed to assess the current evidence of the benefits of education for the management of cancer pain. Methods: We searched the Medline, EMBASE, Cochrane library, and major Korean databases to identify relevant studies. We included most study designs, but excluded case series. The primary outcomes were pain intensity and quality of life (QoL). Two reviewers assessed the risk of bias using the Cochrane's tool for RCT and Risk of Bias Assessment tool for Non-randomized Studies (RoBANS) for non-randomized studies, independently. Results: After extensive searches, 3,324 publications were screened, and 32 studies were selected. The education interventions used in the included studies included a wide variety of education methods, but the most common method was a booklet produced for patients. Regardless of the education method used, the results of the meta-analysis were as follows. The SMDs of the most severe, average, and current pain in the RCTs were significant. The SMD of worst, average, and current pain were -0.34 (-0.55, -0.13), -0.40 (-0.64, -0.15), and -0.79 (-1.35, -0.23). In the non-randomized studies, the effects on average pain were significant, but those on worst and current pain were not. Conclusions: Education intervention reduced the pain of cancer patients. Therefore, patient education could be considered to be an effective method of cancer pain management. However, our data should be interpreted with caution, and studies using standardized protocols are needed to confirm these observations.

• Korean Journal of Psychosomatic Medicine
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• v.14 no.1
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• pp.47-52
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• 2006

Backgrounds : Depression has been prevalent in women and maintaining optimal glycemic control is an important goal of diabetes management. Although depression is common in adults with diabetes, its relationship to glycemic control remains unclear, espacilly in Korean women. The current study examined the relationship of depressive symptomatology with glycemic control in Korean women. Methods : Beck depression inventory (BDI), $HbA_{1c}$ as an index of long-term glycemic control, fasting glucose level and body mass index (BMI) were measured in sample of 4,567 women of whom 4.7%, 216 women had diabetes, and the relationship between depression and glycemic control was analyzed. BDI Scores of 16 and above is a cut off point to indicate possible clinical depression. Results The frequency of depressed women (p<0.001) and the mean score of BDI (p<0.001) were significantly higher in diabetic women. The mean level of $HbA_{1c}$ (p<0.01) and fasting glucose (p<0.05) were higher in depressed women. There was a graded relationship between the percentile of depressed women and a degree of glycemic control impairment (p=0.001). Conclusion : The current study found the relationship of depressive symptomatology with glycemic control in Korean women. This relationship may be mediated by decreased self-care behaviors or by neurobiological dysregulation. Improving identification and treatment of depression in women with diabetes might have favorable effects on diabetic outcomes.

• Journal of the Korean Medical Association
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• v.61 no.12
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• pp.765-775
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• 2018

With growing interest in novel digital healthcare devices, such as artificial intelligence (AI) software for medical diagnosis and prediction, and their potential impacts on healthcare, discussions have taken place regarding the regulatory approval, coverage, and clinical implementation of these devices. Despite their potential, 'digital exceptionalism' (i.e., skipping the rigorous clinical validation of such digital tools) is creating significant concerns for patients and healthcare stakeholders. This white paper presents the positions of the Korean Society of Radiology, a leader in medical imaging and digital medicine, on the clinical validation, regulatory approval, coverage decisions, and clinical implementation of novel digital healthcare devices, especially AI software for medical diagnosis and prediction, and explains the scientific principles underlying those positions. Mere regulatory approval by the Food and Drug Administration of Korea, the United States, or other countries should be distinguished from coverage decisions and widespread clinical implementation, as regulatory approval only indicates that a digital tool is allowed for use in patients, not that the device is beneficial or recommended for patient care. Coverage or widespread clinical adoption of AI software tools should require a thorough clinical validation of safety, high accuracy proven by robust external validation, documented benefits for patient outcomes, and cost-effectiveness. The Korean Society of Radiology puts patients first when considering novel digital healthcare tools, and as an impartial professional organization that follows scientific principles and evidence, strives to provide correct information to the public, make reasonable policy suggestions, and build collaborative partnerships with industry and government for the good of our patients.

• Journal of Society of Preventive Korean Medicine
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• v.19 no.1
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• pp.71-82
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• 2015

Objective : The purpose of this study is to present the desirable model for the promotion of care coordination between Korean Medicine and Western Medicine and develope the instrument to measure the level of coordination. Moreover, we verified the validity and reliability of the developed Instrument. Method : In this study, We developed the 16 items regarding care coordination in Korean Medicine and Western Medicine by literature review and expert interviews. In addition, we verified the validity and reliability of the instrument as a methodological research. Results : We developed two factors such as 'Inter-professional activities' and 'Organizational support' as the instrument to measure the level of care coordination, and each of seven, eight total of 15 measurement items are listed. Conclusion : Since the legal permission, the level and type of care coordination and the effects of them are needed to be checked. So, the measurement instrument driven by this study has a political signification in healthcare system specially in these times. In addition, by utilizing this instrument, we propose to perform a variety of future studies on the levels of healthcare coordination and related outcomes.

• Journal of The Korea Institute of Healthcare Architecture
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• v.19 no.1
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• pp.23-34
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• 2013

Purpose: Many researches have clearly begun to address the relationship between people and their physical environments. These represent that children experience traditional hospital environments as unpleasant and scary. More specifically, children in hospitals face many psychological and emotional challenges: isolation, painful procedures, separation from family members, all in unfamiliar settings. For this reason, some have argued that the children's experiences within hospital environments can lead to poorer health outcomes. This study has been started in order to provide basic informations for the planning of Healing rest space in pediatric ward. Methods: Literature reviewes and field surveys to rest space at pediatric ward in Korea and foreign country have been conducted for the data collection. Results: The result of this study can be summarized into eight environment factor for healing rest space in pediatric ward: family, noise, safe, choice opportunity, light, privacy, social support and distract from disease or death. Implications: In the rest space in pediatric ward, it is necessary to consider healing rest space for promoting healing from disease and normal developing of children.