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The Association between Resting Heart Rate and Colorectal Cancer Prevalence in Korean adults: The Korea National Health and Nutrition Examination Survey (KNHANES) 2005-2014 (한국 성인의 안정시 심박수와 대장암 유병율의 관계: 국민건강 영양조사 2005년부터 2014년 자료를 바탕으로)

  • Min, Ji Hee;Lee, Dong Hoon;Kim, Ji young;Kang, Dong-Woo;An, Ki Yong;Jeon, Y Justin
    • 한국체육학회지인문사회과학편
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    • v.57 no.2
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    • pp.509-518
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    • 2018
  • The purpose of this study was to examine the association between resting heart rate (RHR) and the prevalence of colorectal cancer in Korean adults. A cross sectional analysis was performed using the Korea National Health and Nutrition Examination Survey (2005 to 2014). Total number of subjects were 10,564 adults aged over 19 years. The results showed that individuals in the highest quartile of RHR had a significantly higher prevalence of colorectal cancer (Odds ratio (OR) 2.27, 95% confidence interval (CI): 1.34-3.85 to OR 3.00, 95%CI: 1.30-6.92) compared to those in the lowest quartile. Futhermore, every 10 beat per minutes (bpm) increase in RHR was associated with 27% (95%CI: 1.03-1.58) increased prevalence of colorectal cancer. In addition, after stratification by age and gender, the result showed that older people (>65 years) in the highest quartile of RHR had a significantly higher prevalence of colorectal cancer compared to those who were in the lowest quartile of RHR. (male OR 3.19, 95%CI: 1.10-9.24 to OR 3.38, 95%CI: 1.18-9.73; female OR 2.90, 95%CI: 1.13-7.42 to OR 5.59, 95%CI: 1.20-25.99). In this study, we examined the feasibility of RHR as a predictive factor of colorectal cancer prevalence. Moreover, we found that RHR was closely related to the prevalence of colorectal cancer in the age of over 65 years.

Strategies for Managing Dementia Patients through Improving Oral Health and Occlusal Rehabilitation: A Review and Meta-analysis

  • Yeon-Hee Lee;Sung-Woo Lee;Hak Young Rhee;Min Kyu Sim;Su-Jin Jeong;Chang Won Won
    • Journal of Korean Dental Science
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    • v.16 no.2
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    • pp.128-148
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    • 2023
  • Dementia is an umbrella term that describes the loss of thinking, memory, attention, logical reasoning, and other mental abilities to the extent that it interferes with the activities of daily living. More than 50 million individuals worldwide live with dementia, which is expected to increase to 131 million by 2050. Recent research has shown that poor oral health increases the risk of dementia, while oral health declines with cognitive decline. In this narrative review, the literature was based on the "hypothesis" that dementia and oral health have a close relationship, and appropriate oral health and occlusal rehabilitation treatment can improve the quality of life of patients with dementia and prevent progression. We conducted a literature search in PubMed and Google Scholar databases, using the search terms "dementia," "major neurocognitive disorder," "dentition," "occlusion," "tooth loss," "dental prosthesis," "dental implant," and "occlusal rehabilitation" in the title field over the past 30 years. A total of 131 studies that scientifically addressed dementia, oral health, and/or oral rehabilitation were included. In a meta-analysis, the random effect model demonstrated significant tooth loss increasing the dementia risk 3.64-fold (pooled odds ratio=3.64, 95% confidence interval [2.50~5.32], P-value=0.0348). Tooth loss can be an important indicator of cognitive function decline. As the number of missing teeth increases, the risk of dementia increases. Loss of teeth can lead to a decrease in the ascending information to the brain and reduced masticatory ability, cerebral blood flow, and psychological atrophy. Oral microbiome dysbiosis and migration of key bacterial species to the brain can also cause dementia. Additionally, inflammation in the oral cavity affects the inflammatory response of the brain and the complete body. Conversely, proper oral hygiene management, the placement of dental implants or prostheses to replace lost teeth, and the restoration of masticatory function can inhibit symptom progression in patients with dementia. Therefore, improving oral health can prevent dementia progression and improve the quality of life of patients.

Economic Feasibility Analysis of Nationwide Expansion of Agro-meteorological Early Warning Service for Weather Risk Management in Korea (농업기상재해 조기경보서비스의 전국 확대에 따른 경제적 타당성 분석)

  • Sangtaek Seo;Yun Hee Jeong;Soo Jin Kim;Kyo-Moon Shim
    • Korean Journal of Agricultural and Forest Meteorology
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    • v.25 no.3
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    • pp.236-244
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    • 2023
  • The purpose of this study was to examine the economic feasibility of providing services according to the nationwide expansion of early warning services. The net present value method, one of the cost-benefit analysis methods, was applied to the analysis. As a benefit item that constituted the net present value, the damage reduction amount using crop insurance data and the willingness to pay for the use of early warning services were used. The cost items included system construction and maintenance costs, and text transmission costs. As a result of the analysis, it was found that the nationwide expansion of early warning services had economic feasibility, and its economic effect varied depending on the level of text message use (10 % to 40 %, 10 %p interval) of participating farmers. In the future, the economic effect of early warning services is expected to increase further due to the increase in the number of farmers participating in early warning services and the increase in crop damage caused by climate change. It is necessary to further enhance the economic effect of early warning services by actively utilizing information delivery means through apps or the web as well as text messages.

Effectiveness of Two-dose Varicella Vaccination: Bayesian Network Meta-analysis

  • Kwan Hong;Young June Choe;Young Hwa Lee;Yoonsun Yoon;Yun-Kyung Kim
    • Pediatric Infection and Vaccine
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    • v.31 no.1
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    • pp.55-63
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    • 2024
  • Purpose: A 2-dose varicella vaccination strategy has been introduced in many countries worldwide, aiming to increase vaccine effectiveness (VE) against varicella infection. In this network meta-analysis, we aimed to provide a comprehensive evaluation and an overall estimated effect of varicella vaccination strategies, via a Bayesian model. Methods: For each eligible study, we collected trial characteristics, such as: 1-dose vs. 2-dose, demographic characteristics, and outcomes of interest. For studies involving different doses, we aggregated the data for the same number of doses delivered into one arm. The preventive effect of 1-dose vs. 2-dose of varicella vaccine were evaluated in terms of the odds ratio (OR) and corresponding equal-tailed 95% confidence interval (95% CI). Results: A total of 903 studies were retrieved during our literature search, and 25 interventional or observational studies were selected for the Bayesian network meta-analysis. A total of 49,265 observed individuals were included in this network meta-analysis. Compared to the 0-dose control group, the OR of all varicella infections were 0.087 (95% CI, 0.046-0.164) and 0.310 (95% CI, 0.198-0.484) for 2-doses and one-dose, respectively, which corresponded to VE of 69.0% (95% CI, 51.6-81.2) and VE of 91.3% (95% CI, 83.6-95.4) for 1- and 2-doses, respectively. Conclusions: A 2-dose vaccine strategy was able to significantly reduce varicella burden. The effectiveness of 2-dose vaccination on reducing the risk of infection was demonstrated by sound statistical evidence, which highlights the public health need for a 2-dose vaccine recommendation.

Coronary Artery Lumen Segmentation Using Location-Adaptive Threshold in Coronary Computed Tomographic Angiography: A Proof-of-Concept

  • Cheong-Il Shin;Sang Joon Park;Ji-Hyun Kim;Yeonyee Elizabeth Yoon;Eun-Ah Park;Bon-Kwon Koo;Whal Lee
    • Korean Journal of Radiology
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    • v.22 no.5
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    • pp.688-698
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    • 2021
  • Objective: To compare the lumen parameters measured by the location-adaptive threshold method (LATM), in which the inter- and intra-scan attenuation variabilities of coronary computed tomographic angiography (CCTA) were corrected, and the scan-adaptive threshold method (SATM), in which only the inter-scan variability was corrected, with the reference standard measurement by intravascular ultrasonography (IVUS). Materials and Methods: The Hounsfield unit (HU) values of whole voxels and the centerline in each of the cross-sections of the 22 target coronary artery segments were obtained from 15 patients between March 2009 and June 2010, in addition to the corresponding voxel size. Lumen volume was calculated mathematically as the voxel volume multiplied by the number of voxels with HU within a given range, defined as the lumen for each method, and compared with the IVUS-derived reference standard. Subgroup analysis of the lumen area was performed to investigate the effect of lumen size on the studied methods. Bland-Altman plots were used to evaluate the agreement between the measurements. Results: Lumen volumes measured by SATM was significantly smaller than that measured by IVUS (mean difference, 14.6 mm3; 95% confidence interval [CI], 4.9-24.3 mm3); the lumen volumes measured by LATM and IVUS were not significantly different (mean difference, -0.7 mm3; 95% CI, -9.1-7.7 mm3). The lumen area measured by SATM was significantly smaller than that measured by LATM in the smaller lumen area group (mean of difference, 1.07 mm2; 95% CI, 0.89-1.25 mm2) but not in the larger lumen area group (mean of difference, -0.07 mm2; 95% CI, -0.22-0.08 mm2). In the smaller lumen group, the mean difference was lower in the Bland-Altman plot of IVUS and LATM (0.46 mm2; 95% CI, 0.27-0.65 mm2) than in that of IVUS and SATM (1.53 mm2; 95% CI, 1.27-1.79 mm2). Conclusion: SATM underestimated the lumen parameters for computed lumen segmentation in CCTA, and this may be overcome by using LATM.

Accuracy of Digital Breast Tomosynthesis for Detecting Breast Cancer in the Diagnostic Setting: A Systematic Review and Meta-Analysis

  • Min Jung Ko;Dong A Park;Sung Hyun Kim;Eun Sook Ko;Kyung Hwan Shin;Woosung Lim;Beom Seok Kwak;Jung Min Chang
    • Korean Journal of Radiology
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    • v.22 no.8
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    • pp.1240-1252
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    • 2021
  • Objective: To compare the accuracy for detecting breast cancer in the diagnostic setting between the use of digital breast tomosynthesis (DBT), defined as DBT alone or combined DBT and digital mammography (DM), and the use of DM alone through a systematic review and meta-analysis. Materials and Methods: Ovid-MEDLINE, Ovid-Embase, Cochrane Library and five Korean local databases were searched for articles published until March 25, 2020. We selected studies that reported diagnostic accuracy in women who were recalled after screening or symptomatic. Study quality was assessed using the Quality Assessment of Diagnostic Accuracy Studies-2 tool. A bivariate random effects model was used to estimate pooled sensitivity and specificity. We compared the diagnostic accuracy between DBT and DM alone using meta-regression and subgroup analyses by modality of intervention, country, existence of calcifications, breast density, Breast Imaging Reporting and Data System category threshold, study design, protocol for participant sampling, sample size, reason for diagnostic examination, and number of readers who interpreted the studies. Results: Twenty studies (n = 44513) that compared DBT and DM alone were included. The pooled sensitivity and specificity were 0.90 (95% confidence interval [CI] 0.86-0.93) and 0.90 (95% CI 0.84-0.94), respectively, for DBT, which were higher than 0.76 (95% CI 0.68-0.83) and 0.83 (95% CI 0.73-0.89), respectively, for DM alone (p < 0.001). The area under the summary receiver operating characteristics curve was 0.95 (95% CI 0.93-0.97) for DBT and 0.86 (95% CI 0.82-0.88) for DM alone. The higher sensitivity and specificity of DBT than DM alone were consistently noted in most subgroup and meta-regression analyses. Conclusion: Use of DBT was more accurate than DM alone for the diagnosis of breast cancer. Women with clinical symptoms or abnormal screening findings could be more effectively evaluated for breast cancer using DBT, which has a superior diagnostic performance compared to DM alone.

Assessing the Applicability of Hysteresis Indices for the Interpretation of Suspended Sediment Dynamics in a Forested Catchment (산림유역의 부유토사 동태 해석을 위한 이력현상 지수의 적용성 평가)

  • Ki-Dae Kim;Su-Jin Jang;Soo-Youn Nam;Jae-Uk Lee;Suk-Woo Kim
    • Korean Journal of Environment and Ecology
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    • v.38 no.2
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    • pp.178-188
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    • 2024
  • The dynamics of suspended sediment (SS) in forested catchments vary depending upon human or natural disturbances, including land use change, forestry activity, forest fires, and landslides. Understanding the dynamics of SS originating from the potential sources within a forested catchment is crucial for establishing an effective water quality management strategy. Therefore, to suggest a systematic method for interpreting SS dynamics, we evaluated the performance and applicability of ten methods for calculating the hysteresis index based on observed hydrological data and two calculation models (Lawler's method and Lloyd's method) with five sampling intervals (50th, 25th, 10th, 5th, and 1st percentiles). Our results showed that Lloyd's method, which used a sampling interval at the 1st percentile, had the largest number of analyzable runoff events and exhibited the best performance. The results of this study can contribute to quantifying the hysteresis in the relationship between discharge and SS and provide useful information for interpreting SS dynamics.

A Nationwide Web-Based Survey of Neuroradiologists' Perceptions of Artificial Intelligence Software for Neuro-Applications in Korea

  • Hyunsu Choi;Leonard Sunwoo;Se Jin Cho;Sung Hyun Baik;Yun Jung Bae;Byung Se Choi;Cheolkyu Jung;Jae Hyoung Kim
    • Korean Journal of Radiology
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    • v.24 no.5
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    • pp.454-464
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    • 2023
  • Objective: We aimed to investigate current expectations and clinical adoption of artificial intelligence (AI) software among neuroradiologists in Korea. Materials and Methods: In April 2022, a 30-item online survey was conducted by neuroradiologists from the Korean Society of Neuroradiology (KSNR) to assess current user experiences, perceptions, attitudes, and future expectations regarding AI for neuro-applications. Respondents with experience in AI software were further investigated in terms of the number and type of software used, period of use, clinical usefulness, and future scope. Results were compared between respondents with and without experience with AI software through multivariable logistic regression and mediation analyses. Results: The survey was completed by 73 respondents, accounting for 21.9% (73/334) of the KSNR members; 72.6% (53/73) were familiar with AI and 58.9% (43/73) had used AI software, with approximately 86% (37/43) using 1-3 AI software programs and 51.2% (22/43) having up to one year of experience with AI software. Among AI software types, brain volumetry software was the most common (62.8% [27/43]). Although 52.1% (38/73) assumed that AI is currently useful in practice, 86.3% (63/73) expected it to be useful for clinical practice within 10 years. The main expected benefits were reducing the time spent on repetitive tasks (91.8% [67/73]) and improving reading accuracy and reducing errors (72.6% [53/73]). Those who experienced AI software were more familiar with AI (adjusted odds ratio, 7.1 [95% confidence interval, 1.81-27.81]; P = 0.005). More than half of the respondents with AI software experience (55.8% [24/43]) agreed that AI should be included in training curriculums, while almost all (95.3% [41/43]) believed that radiologists should coordinate to improve its performance. Conclusion: A majority of respondents experienced AI software and showed a proactive attitude toward adopting AI in clinical practice, suggesting that AI should be incorporated into training and active participation in AI development should be encouraged.

Balloon Bronchoplasty for the Treatment of Bronchial Stenosis After Lung Transplantation: A Single-Center 10-Year Experience

  • Dong Kyu Kim;Joon Ho Kwon;Kichang Han;Man-Deuk Kim;Gyoung Min Kim;Sungmo Moon;Juil Park;Jong Yun Won;Hyung Cheol Kim;Sei Hyun Chun;Seung Myeon Choi
    • Korean Journal of Radiology
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    • v.24 no.5
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    • pp.424-433
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    • 2023
  • Objective: To assess the safety and efficacy of balloon dilatation under dual guidance using fluoroscopy and bronchoscopy for treating bronchial stenosis following lung transplantation (LT), and to elucidate the factors associated with patency after the procedure. Materials and Methods: From September, 2012, to April, 2021, 50 patients (mean age ± standard deviation, 54.4 ± 12.2 years) with bronchial stenosis among 361 recipients of LT were retrospectively analyzed. The safety of balloon dilatation was assessed by evaluating procedure-related complications. Efficacy was assessed by evaluating the technical success, primary patency, and secondary patency. Primary and secondary cumulative patency rates were calculated using the Kaplan-Meier method. The factors associated with patency after the procedure were evaluated using multivariable Cox hazard proportional regression analysis. Results: In total, 65 bronchi were treated with balloon dilatation in 50 patients. The total number of treatment sessions was 277 and the technical success rate was 99.3% (275/277 sessions). No major procedure-related complications were noted. During the mean follow-up period of 34.6 ± 30.8 months, primary patency was achieved in 12 of 65 bronchi (18.5%). However, the patency rate improved to 76.9% (50 of 65 bronchi) after repeated balloon dilatation (secondary patency). The 6-month, 1-year, 3-year, and 5-year secondary patency rates were 95.4%, 90.8%, 83.1%, and 78.5%, respectively. The presence of clinical symptoms was a significant prognostic factor associated with reduced primary patency (adjusted hazard ratio [HR], 0.465; 95% confidence interval [CI], 0.220-0.987). Early-stage treatment ≤ 6 months (adjusted HR, 3.588; 95% CI, 1.093-11.780) and prolonged balloon dilatation > 5 min (adjusted HR, 3.285; 95% CI, 1.018-10.598) were associated with significantly higher secondary patency. Conclusion: Repeated balloon dilatation was determined to be safe and effective for treating bronchial stenosis following LT. Early-stage treatment and prolonged balloon dilatation could significantly promote long-term patency.

Use of Artificial Intelligence for Reducing Unnecessary Recalls at Screening Mammography: A Simulation Study

  • Yeon Soo Kim;Myoung-jin Jang;Su Hyun Lee;Soo-Yeon Kim;Su Min Ha;Bo Ra Kwon;Woo Kyung Moon;Jung Min Chang
    • Korean Journal of Radiology
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    • v.23 no.12
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    • pp.1241-1250
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    • 2022
  • Objective: To conduct a simulation study to determine whether artificial intelligence (AI)-aided mammography reading can reduce unnecessary recalls while maintaining cancer detection ability in women recalled after mammography screening. Materials and Methods: A retrospective reader study was performed by screening mammographies of 793 women (mean age ± standard deviation, 50 ± 9 years) recalled to obtain supplemental mammographic views regarding screening mammography-detected abnormalities between January 2016 and December 2019 at two screening centers. Initial screening mammography examinations were interpreted by three dedicated breast radiologists sequentially, case by case, with and without AI aid, in a single session. The area under the receiver operating characteristic curve (AUC), sensitivity, specificity, and recall rate for breast cancer diagnosis were obtained and compared between the two reading modes. Results: Fifty-four mammograms with cancer (35 invasive cancers and 19 ductal carcinomas in situ) and 739 mammograms with benign or negative findings were included. The reader-averaged AUC improved after AI aid, from 0.79 (95% confidence interval [CI], 0.74-0.85) to 0.89 (95% CI, 0.85-0.94) (p < 0.001). The reader-averaged specificities before and after AI aid were 41.9% (95% CI, 39.3%-44.5%) and 53.9% (95% CI, 50.9%-56.9%), respectively (p < 0.001). The reader-averaged sensitivity was not statistically different between AI-unaided and AI-aided readings: 89.5% (95% CI, 83.1%-95.9%) vs. 92.6% (95% CI, 86.2%-99.0%) (p = 0.053), although the sensitivities of the least experienced radiologists before and after AI aid were 79.6% (43 of 54 [95% CI, 66.5%-89.4%]) and 90.7% (49 of 54 [95% CI, 79.7%-96.9%]), respectively (p = 0.031). With AI aid, the reader-averaged recall rate decreased by from 60.4% (95% CI, 57.8%-62.9%) to 49.5% (95% CI, 46.5%-52.4%) (p < 0.001). Conclusion: AI-aided reading reduced the number of recalls and improved the diagnostic performance in our simulation using women initially recalled for supplemental mammographic views after mammography screening.