• Tuberculosis and Respiratory Diseases
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• v.68 no.2
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• pp.74-79
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• 2010

Background: Legionella pneumophila has been recognized as an important cause of pneumonia. However, limited data are available in the literature regarding legionella pneumonia in Korea. The objective of this study was to compare epidemiological data and clinical presentation of legionella pneumonia and pneumococcal pneumonia. Methods: We retrospectively compared clinical, radiological, and laboratory data, antimicrobial treatment, and treatment outcomes between 28 cases of legionella pneumonia and 56 cases of pneumococcal pneumonia. Diagnoses of both legionella and pneumococcal pneumonia were based on commercial urinary antigen tests. Results: Legionella pneumonia patients included 23 men and 5 women, with a mean age of 61.6 years (range 36~88). Fifteen were smokers and 26 had some underlying diseases. Legionella pneumonia occurred more frequently in healthcare-associated settings than pneumococcal pneumonia (42.9% vs 21.4%, respectively, p=0.040). There were no significant differences in clinical signs and symptoms. Compared to patients with pneumococcal pneumonia, patients with legionella pneumonia presented more frequently with anemia (39.3% vs 8.9%, p=0.001), increased C-reactive protein (57.1% vs 30.4%, p=0.018) and increased alkaline phosphatase (46.4% vs 16.1%, p=0.003). Also, legionella pneumonia patients more often showed pleural effusion on simple chest X-rays (50.0% vs 12.5%, p<0.001). Conclusion: Legionella pneumonia and pneumococcal pneumonia can not be distinguished by clinical manifestations alone. However, legionella pneumonia occurred as a healthcare-associated pneumonia more frequently and was more often associated with anemia and increased CRP and alkaline phosphatase levels.

• Journal of Chest Surgery
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• v.54 no.5
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• pp.369-376
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• 2021

Background: Sutureless and rapid deployment valves for aortic valve replacement (AVR) were introduced in Korea in December 2016. This study evaluated changing trends in the prosthetic valves used for AVR in Korea after the introduction of sutureless and rapid deployment valves. Methods: From December 2016 to December 2018, 4,899 patients underwent AVR in Korea. After applying the exclusion criteria, 4,872 patients were analyzed to determine changes in the type of prosthetic valve used for AVR. The study period was divided into 5 groups corresponding to 5-month intervals. Results: The total number of AVR cases was 194.88±28.78 per month during the study period. Mechanical valves were used in approximately 27% to 33% of cases, and the proportion of mechanical valve use showed a tendency to decrease, with marginal significance overall (p=0.078) and significant decreases in patients less than 60 years of age and in men (p=0.013 and p=0.023, respectively). The use of sutureless valves increased from 13.4% to 25.8% of cases (p<0.001), especially in elderly patients (>70 years) and those requiring concomitant surgery. In a comparison between sutureless and rapid deployment valves, the use of Perceval S valves (a type of sutureless valve), gradually increased (p<0.001). Conclusion: After the introduction of sutureless and rapid deployment valves in Korea, the rate of use of these new valves remarkably increased, especially in elderly patients and those requiring concomitant surgery. Further studies should investigate the clinical outcomes of these new prostheses.

• Journal of Convergence for Information Technology
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• v.12 no.5
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• pp.159-167
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• 2022

At the present time, no systematic review has been conducted to report the project's outcomes or trends. This study systematically reviewed existing evidence related with community care pilot project. A total of 61 articles, including 18 original literatures and 43 review literatures were finally selected. For original literatures, the most frequent literatures focused on demand surveys (n=4) and model proposals (n=4), the utilization of touchpoint (n=3), space design and architectural model (n=3), manpower training and role establishment (n=2), followed by prioritizing objectives (n=1) and research trend study (n=1). For review literatures, the most frequent literature focused on the elderly (n=12) and relatively few literature on the disabled and mental illness (n=2). Since the pilot project for community care has been implemented for only about one year, the present study indicates that more future research is needed to the disabled, mental illness, and homeless should be conducted as well as elderly.

• Safety and Health at Work
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• v.13 no.3
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• pp.263-268
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• 2022

Health care workers (HCWs) are more than ten times more likely to be infected with coronavirus infectious disease 2019 (COVID-19) than the general population, thus demonstrating the burden of COVID-19 among HCWs. Factors that expose HCWs to a differentially high-risk of COVID-19 acquisition are important to elucidate, enable appropriate public health interventions to mitigate against high risk and reduce adverse outcomes from the infection. We conducted a systematic review and meta-analysis to summarize and critically analyze the existing evidence on SARS-CoV-2 risk factors among HCWs. With no geographical limitation, we included studies, in any country, that reported (i) the PCR laboratory diagnosis of COVID-19 as an independent variable (ii) one or more COVID-19 risk factors among HCWs with risk estimates (relative risk, odds ratio, or hazard ratio) (iii) original, quantitative study design, and published in English or Mandarian. Our initial search resulted in 470 articles overall, however, only 10 studies met the inclusion criteria for this review. Out of the 10 studies included in the review, inadequate/lack of protective personal equipment, performing tracheal intubation, and gender were the most common risk factors of COVID-19. Based on the random effects adjusted pooled relative risk, HCWs who reported the use of protective personal equipment were 29% (95% CI: 16% to 41%) less likely to test positive for COVID-19. The study also revealed that HCWs who performed tracheal intubations were 34% (95% CI: 14% to 57%) more likely to test positive for COVID-19. Interestingly, this study showed that female HCWs are at 11% higher risk (RR 1.11 95% CI 1.01-1.21) of COVID-19 than their male counterparts. This article presents initial findings from a living systematic review and meta-analysis, therefore, did not yield many studies; however, it revealed a significant insight into better understanding COVID-19 risk factors among HCWs; insights important for devising preventive strategies that protect them from this infection.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.27 no.4
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• pp.206-214
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• 2024

Purpose: Few studies have reported the prevalence of inflammatory bowel disease unclassified (IBDU) among Korean pediatric IBD (PIBD) population. To address this gap, we used two tertiary centers and nationwide population-based healthcare administrative data to estimate the prevalence of Korean pediatric IBDU at the time of diagnosis. Methods: We identified 136 patients aged 2-17 years with newly diagnosed IBD (94 Crohn's disease [CD] and 42 ulcerative colitis [UC]) from two tertiary centers in Korea between 2005 and 2017. We reclassified these 136 patients using the revised Porto criteria. To estimate the population-based prevalence, we analyzed Korean administrative healthcare data between 2005 and 2016, which revealed 3,650 IBD patients, including 2,538 CD and 1,112 UC. By extrapolating the reclassified results to a population-based dataset, we estimated the prevalence of PIBD subtypes. Results: Among the 94 CD, the original diagnosis remained unchanged in 93 (98.9%), while the diagnosis of one (1.1%) patient was changed to IBDU. Among the 42 UC, the original diagnosis remained unchanged in 13 (31.0%), while the diagnoses in 11 (26.2%), 17 (40.5%), and one (2.4%) patient changed to atypical UC, IBDU, and CD, respectively. The estimated prevalences of CD, UC, atypical UC, and IBDU in the Korean population were 69.5%, 9.4%, 8.0%, and 13.1%, respectively. Conclusion: This study is the first in Korea to estimate the prevalence of pediatric IBDU. This prevalence (13.1%) aligns with findings from Western studies. Large-scale prospective multicenter studies on PIBDU are required to examine the clinical features and outcomes of this condition.

• Radiation Oncology Journal
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• v.33 no.3
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• pp.198-206
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• 2015

Purpose: We evaluated the prognostic factors and clinical outcomes of 56 patients with vulvar cancer treated with curative radiotherapy (RT) or concurrent chemoradiotherapy. Materials and Methods: Overall survival (OS) and disease-free survival (DFS) were assessed retrospectively. Prognostic factors evaluated included age, International Federation of Gynecology and Obstetrics (FIGO) stage, TNM classification, tumor size, treatment modality, RT duration, and RT field. The association between the tumor human papillomavirus (HPV) status and survival was analyzed in 35 patients. Results: During the median follow-up of 2.8 years (range, 0.3 to 18.9 years), 21 patients (37.5%) experienced treatment failure. Fifteen patients (27%) had local failure: nine (16%) local failure only, three (5%) locoregional failure, two (4%) local and distant failure, and one (2%) locoregional and distant failure. Of 56 patients, seven (13%) had persistent disease at the first follow-up at 2 months and all but one died within a year after completing RT. The 5-year OS and DFS were 51.6% and 44.0%, respectively. In multivariate analysis, clinical size ${\geq}3$ cm predicted a poor prognostic factor for DFS (p = 0.040) and age (${\geq}70years$) was poor prognostic for DFS (p = 0.032) and OS (p = 0.048). Patients with HPV-positive tumors tended to have better 5-year OS and DFS, but the differences were not significant statistically. Conclusion: Clinical size ${\geq}3$ cm was a significant prognostic factor for DFS. However, age was the most important prognostic factor for DFS and OS in patients treated with curative RT. Further studies are needed to determine which treatment should be considered for old age ${\geq}70years$.

• Journal of Korea Technology Innovation Society
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• v.12 no.3
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• pp.471-498
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• 2009

The ability to judge a country's scientific standing is vital for the governments and businesses that must decide scientific priorities and funding. In this paper, we analyze the output and outcomes from research investment over the recent years, to measure the quality of scientific research on national scales and to set it in an international context. There are many ways to evaluate the quality of scientific research, but few have proved satisfactory. To measure the quantity and quality of science in different nations, we analyzed the numbers of published research papers and their citations. The number of citations per paper is a useful measure of the impact of a nation's research output. Essential at a were acquired from SCI database by Thomson Scientific, which indexes more than 8,000 journals, representing most significant materials in science and engineering. The purpose of this paper is to evaluate and compare the output and outcomes among nations in a variety of viewpoints and criteria. One of the implications in response to the result of analysis is that sustainable economic development in highly competitive world markets requires a direct engagement in the generation of knowledge. Even modest improvement in healthcare, clean water, sanitation, food, and transport need capabilities in engineering, technology, and medicine beyond many countries' reach. Nations exporting natural resources such as gold and oil can import technology and expertise, but only until these resources are exhausted. For them, sustainability should imply investment in alternative agricultural and technological capabilities through improvements in their skills base. A strong science base does not necessarily leat to wealth generation. However, strength in science has additional benefits for individual nations, and for the world as a whole.

• Journal of Preventive Medicine and Public Health
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• v.36 no.2
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• pp.117-124
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• 2003

Objectives : This study was performed to examine the relationship between maternal exposure to environmental tobacco smoke (ETS) and pregnancy outcomes (low birth weight or preform baby) in a prospective cohort study. Methods : We made a pregnant women's cohort, and followed the pregnancy outcomes, between May 1st 2001 and August 31st 2002. We surveyed 2,250 women who visited our hospital during their 35th gestational week, with a self-administered questionnaire. The final total of mother-infant pairs analyzed in this study was 1,712. We used a multiple logistic regression analysis to analyze the effect of maternal ETS on the incidence of preform or low birth weight, and a linear regression analysis for the birth weight and gestational age. Results : Higher exposure to ETS (>=1 hours/day) during pregnancy was more negatively associated with the gestational age and birth weight, than no exposure to ETS (no or less than 1 hour). Maternal exposure to ETS was associated with preform baby(adjusted odds ratio (AOR) 1.7; 95% confidence interval (CI) 0.9, 3.3) and low birth weight (AOR 2.3; 95% CI 0.9, 5.5). In addition, we found that maternal ETS may reduce the birth weight by 70g after adjusting for potential confounding factors. Conclusions : This study suggests that maternal exposure to ETS during pregnancy may increase the frequency of low birth weights and preform births.

• Journal of Hospice and Palliative Care
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• v.21 no.2
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• pp.41-50
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• 2018

Spirituality is an essential part of human beings. Spiritual care, designed to meet the spiritual needs of terminally ill patients and their families, is one of the most important aspects of hospice and palliative care (HPC). This study reviewed and analyzed literature utilizing the most commonly used Korean and international healthcare databases to identify care models that adequately address the spiritual needs of terminally ill patients and their families in practice. The results of this study show that spirituality is an intrinsic part of humans, meaning that people are holistic beings. The literature has provided ten evidence-based theories that can be used as models in HPC. Three of the models focus on how the spiritual care outcomes of viewing spiritual health, quality of life, and coping, are important outcomes. The remaining seven models focus on implementation of spiritual care. The "whole-person care model" addresses the multidisciplinary collaboration within HPC. The "existential functioning model" emphasizes the existential needs of human beings. The "open pluralism view" considers the cultural diversity and other types of diversity of care recipients. The "spiritual-relational view" and "framework of systemic organization" models focus on the relationship between hospital palliative care teams and terminally ill patients. The "principal components model" and "actioning spirituality and spiritual care in education and training model" explain the overall dynamics of the spiritual care process. Based on these models, continuous clinical research efforts are needed to establish an optimal spiritual care model for HPC.

• Korea Journal of Hospital Management
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• v.20 no.2
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• pp.15-27
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• 2015

As patient satisfaction is a crucial component of improved health care outcomes, there is a need to evaluate the relationship between physicians' attitude and patients' satisfaction. The objective of this study is to examine the relationship between patients' satisfaction and physicians' friendly and caring attitudes by using recent physician ratings by patients. Data from a cross-sectional survey using a convenience sampling was utilized to examine the relationship between physicians' attitudes and patients' satisfaction. The independent variable was the physician's attitude, and the dependent variables were patients' satisfaction with the physician and the office setting. A total of 273,994 patients it the US were included. The patients' average (standard deviation, SD) satisfaction with the physician was 78.08 (0.14), and the average (SD) satisfaction with the office setting was 78.62 (0.12) out of 100. Physicians' attitude was a significant predicting factor impacting the patients' satisfaction with the physician and the office setting (p < 0.001). To facilitate patients' satisfaction with healthcare, a continuous effort to develop physicians' ability to communicate in an empathetic manner should be undertaken so that patients perceive their physicians as empathetic.