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Stomach cancer has a high annual mortality rate worldwide necessitating early detection and accurate treatment. Even experienced specialists can make erroneous judgments based on several factors. Artificial intelligence (AI) technologies are being developed rapidly to assist in this field. Here, we aimed to determine how AI technology is used in gastric cancer diagnosis and analyze how it helps patients and surgeons. Early detection and correct treatment of early gastric cancer (EGC) can greatly increase survival rates. To determine this, it is important to accurately determine the diagnosis and depth of the lesion and the presence or absence of metastasis to the lymph nodes, and suggest an appropriate treatment method. The deep learning algorithm, which has learned gastric lesion endoscopyimages, morphological characteristics, and patient clinical information, detects gastric lesions with high accuracy, sensitivity, and specificity, and predicts morphological characteristics. Through this, AI assists the judgment of specialists to help select the correct treatment method among endoscopic procedures and radical resections and helps to predict the resection margins of lesions.Additionally, AI technology has increased the diagnostic rate of both relatively inexperienced and skilled endoscopic diagnosticians. However, there were limitations in the data used for learning, such as the amount of quantitatively insufficient data, retrospective study design, single-center design, and cases of non-various lesions. Nevertheless, this assisted endoscopic diagnosis technology that incorporates deep learning technology is sufficiently practical and future-oriented and can play an important role in suggesting accurate treatment plans to surgeons for resection of lesions in the treatment of EGC.
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Purpose@#The purpose of this study was to identify the gaps in research related to developmentally supportive care in the neonatal intensive care unit (NICU). The ultimate goal was to explore directions of further research on developmentally supportive care for premature patients. @*Methods@#The Arksey and O'Malley scoping review method was used. Articles on developmentally supportive care for preterm infants in the NICU, written in English or Korean, were identified through electronic search engines. A total of 279 papers were identified in the initial search, of which 22 full-text papers were included in this review. @*Results@#Several nursing studies have been published in the past 5 years. The important elements of developmentally supportive care were family-centered care and management of the NICU environment. The primary developmentally supportive care interventions were training programs to promote the care competency of NICU nurses. @*Conclusion@#It is necessary to actively develop comprehensive developmental support interventions that consider the various elements of developmentally supportive care for preterm infants. Additional studies should be done to develop programs that provide direct intervention for premature infant and their families.
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Rheumatoid arthritis (RA) is a common autoimmune disease that mainly affects the joints and systemic organs, such as the skin, eyes, heart, gastrointestinal tract, and lungs. In particular, among various pulmonary involvements, interstitial lung disease (ILD) is closely related to the selection of anti-rheumatic drugs and the long-term prognosis of patients with RA. Although the exact pathogenesis of RA-ILD is not well defined, several mechanistic pathways, similar to those of idiopathic pulmonary fibrosis, have been elucidated recently. Conversely, RA-related autoantibodies, including anti-cyclic citrullinated peptide antibody, are detectable in circulation and in the lungs, even in the absence of articular symptoms. RA-ILD can also predate years before the occurrence of joint symptoms. This evidence supports the fact that local dysregulated mucosal immunity in the lung causes systemic autoimmunity, resulting in clinically evident polyarthritis of RA. Because the early diagnosis of RA-ILD is important, imaging tests, such as computed tomography and pulmonary function tests, are being used for early diagnosis, but there is no clear guideline for the early diagnosis of RA-ILD and selection of optimal disease-modifying anti-rheumatic drugs for the treatment of patients with RA with ILD. In addition, the efficacy of nintedanib, a new anti-fibrotic agent, for RA-ILD treatment, has been investigated recently.This review collectively discusses the basic and clinical aspects, such as pathogenesis, animal models, diagnosis, and treatment, of RA-ILD.
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Objective@#This study examined the characteristics of acute poisoning patients who visited the emergency room to use as data for developing the treatment support project of acute poisoning patients. @*Methods@#A total of 2,586 acute in-depth survey data were used for a cross-analysis for poisoning severity, emergency medical treatment result and poisoning reason by age group, and multivariate logistic regression analysis was performed to identify the association of poisoning intentionality and other variables. @*Results@#Poisoning intentionality risk analysis identified that males had a lower risk than females (P<0.001), and young adults (aged 13-29 years) had the highest risk (P<0.001). In addition, the higher poisoning severity patients had a higher risk than patients who had no poisoning symptom (severe P<0.001, death P=0.029). The older patients had the higher poisoning severity proportion, and the poisoning substance of expired patients was mostly pesticides. @*Conclusion@#To develop the appropriate emergency medical response system for acute poisoning patients, it is necessary to provide an integrated system for poisoning treatment information and analysis.
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Purpose@#The purpose of this study was to identify the supportive care needs of parents of preterm children in South Korea using text data from a portal site. @*Methods@#In total, 628 online newspaper articles and 1,966 social network service posts published between January 1 and December 31, 2019 were analyzed. The procedures in this study were conducted in the following order: keyword selection, data collection, morpheme analysis, keyword analysis, and topic modeling. @*Results@#The term "yirundung-yi", which is a native Korean word referring to premature infants, was confirmed to be a useful term for parents. The following four topics were identified as the supportive care needs of parents of preterm children: 1) a vague fear of caring for a baby upon imminent neonatal intensive care unit discharge, 2) real-world difficulties encountered while caring for preterm children, 3) concerns about growth and development problems, and 4) anxiety about possible complications. @*Conclusion@#Supportive care interventions for parents of preterm children should include general parenting methods for babies. A team composed of multidisciplinary experts must support the individual growth and development of preterm children and manage the complications of prematurity using highly accessible media.
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Background/Aims@#To investigate the short- and long-term efficacy of intra-articular glucocorticoid injections (IAGI) in patients with rheumatoid arthritis (RA). @*Methods@#This was a retrospective study of RA patients who had active arthritis in the hand or wrist joints and who received IAGI (or not) as an adjunct to disease- modifying antirheumatic drugs (DMARDs). Short-term efficacy was assessed based on changes in the disease activity score in 28 joints (DAS28) after 3 months and long-term efficacy was assessed based on changes in the van der Heijde Sharp score (HSS) of hand radiographs over 2 years. Radiographic progression was defined as ΔHSS/year ≥ 2. Logistic regression analysis identified predictors of early achievement of low disease activity (LDA) and radiographic progression. @*Results@#Overall, 126 RA patients received IAGI into the hand or wrist joints and 107 were IAGI-naive. After 3 months, 67% of IAGI-treated patients and 48% of IAGI-naive patients achieved LDA (p = 0.002). Over the next 2 years, 35% of patients treated with IAGI showed radiographic progression compared with 27% of IAGI-naive patients (p = 0.2). IAGI plus biologic DMARDs was associated with achievement of LDA in 3 months. Achieving LDA in 3 months (odds ratio [OR], 0.403; 95% confidence interval [CI], 0.192 to 0.847), wrist arthritis (OR, 2.408; 95% CI, 1.184 to 4.897), and baseline HSS (OR, 1.021; 95% CI, 1.003 to 1.039) were associated with radiographic progression. @*Conclusions@#IAGI was associated with early achievement of LDA. LDA was associated with slower radiographic progression. The wrist is more vulnerable to joint damage and requires more aggressive treatment.
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Background@#Physicians and caregivers are conflicted over whether to inform patients that their disease is terminal. Studies examining the effect of awareness of prognosis on the survival and quality of life of terminally ill cancer patients report conflicting results. This study aimed to assess the effects of prognosis awareness on the survival time and psychological health of terminally ill cancer patients. @*Methods@#Patients in the hospice wards of two general hospitals were asked to complete a questionnaire. All were mentally alert and could express themselves clearly. Awareness of prognosis was defined as knowing both the diagnosis and exact prognosis. Survival time was defined as the time from hospital admission to death. Multiple psychological examinations were conducted to verify the effect of prognosis awareness on psychological health. @*Results@#Of the 98 subjects who met the inclusion criteria, 65 (66.3%) were aware of their terminal status. The patients’ awareness was significantly related to survival time after adjusting for clinical variables with a hazard ratio of 1.70 (95% confidence interval [CI], 1.01–2.86). Furthermore, the unaware group had a higher risk of cognitive impairment (Mini-Mental State Examination <24; adjusted odds ratio [aOR], 3.65; 95% CI, 1.26–10.59) and a poorer quality of life (physical component summary of the Short Form 36-item Health Survey <20; aOR, 3.61; 95% CI, 1.12– 11.60) than the aware group. @*Conclusion@#Knowledge of the exact prognosis might have a positive effect on the survival and quality of life of terminally ill cancer patients.
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Purpose@#The purpose of this study was to test the validity of the Korean version of the Nurses’ Involvement in Dying Patients and Family Care (NIDPFC) instrument. @*Methods@#Data were collected from 410 registered nurses at a university hospital, general hospitals, and a convalescent hospital. Data were collected from June 23 to July 17, 2020. Internal consistency reliability, construct validity, and criterion validity were examined using the SPSS and AMOS software. @*Results@#Of the 35 preliminary items of the instrument, 24 items were finally selected after evaluating the content validity, analyzing the items, and assessing construct validity. The following four factors were derived: “burden” (seven items), “deep involvement” (eight items), “resilience” (five items), and “empathy” (four items), with a cumulative explanatory variance of 55.2%. For criterion validity, a significant positive relationship was found between the NIDPFC and attitudes toward caring for the dying. For internal consistency reliability, the Cronbach’s α was 0.82. @*Conclusion@#The validity and reliability of the NIDPFC were verified. Therefore, the NIDPFC is an effective instrument to use in further studies.
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Purpose@#The purpose of this study was to test the validity of the Korean version of the Nurses’ Involvement in Dying Patients and Family Care (NIDPFC) instrument. @*Methods@#Data were collected from 410 registered nurses at a university hospital, general hospitals, and a convalescent hospital. Data were collected from June 23 to July 17, 2020. Internal consistency reliability, construct validity, and criterion validity were examined using the SPSS and AMOS software. @*Results@#Of the 35 preliminary items of the instrument, 24 items were finally selected after evaluating the content validity, analyzing the items, and assessing construct validity. The following four factors were derived: “burden” (seven items), “deep involvement” (eight items), “resilience” (five items), and “empathy” (four items), with a cumulative explanatory variance of 55.2%. For criterion validity, a significant positive relationship was found between the NIDPFC and attitudes toward caring for the dying. For internal consistency reliability, the Cronbach’s α was 0.82. @*Conclusion@#The validity and reliability of the NIDPFC were verified. Therefore, the NIDPFC is an effective instrument to use in further studies.
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PURPOSE: This study aimed to identify the directionality of the causal relationship and interaction between depression and amount of smoking over time in hardcore smokers using longitudinal descriptive analysis. METHODS: Secondary data from the Korean Welfare Panel Study were analyzed using autoregressive cross-lagged modeling. Participants included 342 hardcore smokers who participated in the 8th to 11th waves of the panel study. RESULTS: Analyses revealed that change(s) in depression levels according to time had a significant positive relationship with the total amount of smoking per day (β=.29, β=.19, β=.17, p < .001), while change(s) in total amount of smoking per day according to time had a significant positive relationship with depression (β=.43, β=.50, β=.38, p < .001). Analysis of the cross-lagged effect between depression and total amount of smoking per day showed that depression at one time point had a significantly positive relationship with the total amount of smoking per day at the next time point (β=.14, β=.13, β=.13, p=.021), and that the total amount of smoking per day at one time point had a significant positive relationship with depression at the next time point (β=.04, β=.04, β=.03, p=.044). CONCLUSION: The findings in the present study confirmed a cross-interaction between depression and total amount of smoking per day in hardcore smokers. The present findings could be used to develop appropriate smoking-related interventions.
Subject(s)
Depression , Longitudinal Studies , Smoke , SmokingABSTRACT
PURPOSE@#This study aimed to identify the directionality of the causal relationship and interaction between depression and amount of smoking over time in hardcore smokers using longitudinal descriptive analysis.@*METHODS@#Secondary data from the Korean Welfare Panel Study were analyzed using autoregressive cross-lagged modeling. Participants included 342 hardcore smokers who participated in the 8th to 11th waves of the panel study.@*RESULTS@#Analyses revealed that change(s) in depression levels according to time had a significant positive relationship with the total amount of smoking per day (β=.29, β=.19, β=.17, p < .001), while change(s) in total amount of smoking per day according to time had a significant positive relationship with depression (β=.43, β=.50, β=.38, p < .001). Analysis of the cross-lagged effect between depression and total amount of smoking per day showed that depression at one time point had a significantly positive relationship with the total amount of smoking per day at the next time point (β=.14, β=.13, β=.13, p=.021), and that the total amount of smoking per day at one time point had a significant positive relationship with depression at the next time point (β=.04, β=.04, β=.03, p=.044).@*CONCLUSION@#The findings in the present study confirmed a cross-interaction between depression and total amount of smoking per day in hardcore smokers. The present findings could be used to develop appropriate smoking-related interventions.
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This study was performed to examine the effects of various macromolecules in in vitro growth (IVG) media on the growth, maturation, and parthenogenesis (PA) of pig oocytes derived from small antral follicles (SAF). Immature oocytes were cultured for two days in IVG medium supplemented with 10% (v/v) fetal bovine serum (FBS), 10% (v/v) pig follicular fluid (PFF), 0.4% (w/v) bovine serum albumin (BSA), or 0.1% (w/v) polyvinyl alcohol (PVA) and then maintained for 44 h for maturation. After IVG, the mean diameters of the SAF treated with FBS, PVA, and no IVG-MAF (113.0–114.8 µm) were significantly larger than that of no IVG-SAF (111.8 µm). The proportion of metaphase II oocytes was higher in PFF (73.6%) than in BSA (43.5%) and PVA (53.7%) but similar to that in the FBS treatment (61.5%). FBS and PFF increased cumulus expansion significantly compared to PVA and BSA while the intraoocyte glutathione content was not influenced by the macromolecules. Blastocyst formation of PA oocytes treated with FBS (51.8%), PFF (50.4%), and PVA (45.2%) was significantly higher than that of the BSA-treated oocytes (20.6%). These results show that the PFF and FBS treatments during IVG improved the growth, maturation, and embryonic development of SAF.
Subject(s)
Female , Pregnancy , Blastocyst , Embryonic Development , Follicular Fluid , Glutathione , In Vitro Techniques , Metaphase , Oocytes , Parthenogenesis , Polyvinyl Alcohol , Serum Albumin, BovineABSTRACT
PURPOSE@#This study was done to examine incidence of diarrhea and explore factors influencing occurrence of diarrhea in patients admitted to intensive care units (ICU).@*METHODS@#For this retrospective research, data based on inclusion criteria were collected from the electronic medical records for 142 patients admitted to a university hospital ICU from September 2014 to August 2015. Statistical analysis was conducted using SPSS/WIN 22.0 program.@*RESULTS@#Incidence of diarrhea was 53.5% during the 12-month study period. Diarrhea occurred at 4.54 days and continued for 1.79 days on average. Average total frequency of diarrhea was 5.56 times. Increased ICU stay, enteral nutrition, and infection state were significant predictors of the occurrence of diarrhea. Infection increased risk of diarrhea 3.4 times and enteral nutrition increased risk of diarrhea to 2.2 times greater than patients not receivng enteral nutrition.@*CONCLUSION@#Diarrhea in ICU patients is associated with multiple factors that should be considered to implement preventive strategies. Infection control should be emphasized, and close monitoring of diarrhea should be provided for those with enteral nutrition. Further studies are warranted to determine standardized clinical definition of diarrhea and diarrhea risk factors in ICU patients with different levels of severity and comorbidity.
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This study was performed to examine the effects of various macromolecules in in vitro growth (IVG) media on the growth, maturation, and parthenogenesis (PA) of pig oocytes derived from small antral follicles (SAF). Immature oocytes were cultured for two days in IVG medium supplemented with 10% (v/v) fetal bovine serum (FBS), 10% (v/v) pig follicular fluid (PFF), 0.4% (w/v) bovine serum albumin (BSA), or 0.1% (w/v) polyvinyl alcohol (PVA) and then maintained for 44 h for maturation. After IVG, the mean diameters of the SAF treated with FBS, PVA, and no IVG-MAF (113.0–114.8 µm) were significantly larger than that of no IVG-SAF (111.8 µm). The proportion of metaphase II oocytes was higher in PFF (73.6%) than in BSA (43.5%) and PVA (53.7%) but similar to that in the FBS treatment (61.5%). FBS and PFF increased cumulus expansion significantly compared to PVA and BSA while the intraoocyte glutathione content was not influenced by the macromolecules. Blastocyst formation of PA oocytes treated with FBS (51.8%), PFF (50.4%), and PVA (45.2%) was significantly higher than that of the BSA-treated oocytes (20.6%). These results show that the PFF and FBS treatments during IVG improved the growth, maturation, and embryonic development of SAF.
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PURPOSE: This study was conducted to examine the longitudinal effects of parenting stress and parental control attitudes on problem behaviors in preschool children, using a latent growth model. METHODS: Participants were 1,724 pairs of parents and 1,724 preschool children who had completed the panel survey on Korean children (5th~7th survey panels). RESULTS: An analysis of the multivariate latent growth model of parenting stress, parental control attitudes, and children's problem behaviors suggested that the parents' intercepts for parenting stress influenced their intercepts for parental control attitudes (father: β=.21, p < .001; mother: β=.55, p < .001). In addition, the slopes for fathers' parenting stress was the only aspect that affected the slopes for mothers' parental control attitudes (β=.77, p < .001). Moreover, both the intercepts and slopes of parenting stress and parental control attitudes significantly affected the children's problem behaviors. CONCLUSION: This study is significant as it provides longitudinal evidence of the impact of parenting stress and parental control attitudes on children's problem behaviors. The findings suggest that accurately assessing changes in parenting stress and parental control attitudes and developing intervention programs to reduce them will be effective in reducing problem behaviors in children.
Subject(s)
Child , Child, Preschool , Humans , Mothers , Parenting , Parents , Problem BehaviorABSTRACT
Vitiligo is a commonly acquired cutaneous depigmentation disorder that affects 0.5~1% of the population worldwide. While phototherapy is the primary treatment for vitiligo, surgical methods can be used for treating patients who are refractory to conventional treatments. Herein, we present the case of a 14-year-old Korean girl who developed vitiligo after hematopoietic stem cell transplantation for the treatment of acute lymphoblastic leukemia. She had multiple depigmented patches on her lower legs that did not respond to narrow-band ultraviolet B phototherapy for 7 months. The depigmented patches were successfully treated by transplantation of non-cultured epidermal cell suspension from the epidermal roof of the suction blister in the right inner thigh. No adverse event, such as secondary infection or scarring in both the donor and recipient sites, was noted. We recommended that non-cultured epidermal cell suspension transplantation using the suction blister method would be a safe and effective option for the treatment of refractory vitiligo.
Subject(s)
Adolescent , Female , Humans , Blister , Cicatrix , Coinfection , Hematopoietic Stem Cell Transplantation , Leg , Methods , Phototherapy , Precursor Cell Lymphoblastic Leukemia-Lymphoma , Suction , Thigh , Tissue Donors , VitiligoABSTRACT
PURPOSE@#This study was conducted to examine the longitudinal effects of parenting stress and parental control attitudes on problem behaviors in preschool children, using a latent growth model.@*METHODS@#Participants were 1,724 pairs of parents and 1,724 preschool children who had completed the panel survey on Korean children (5th~7th survey panels).@*RESULTS@#An analysis of the multivariate latent growth model of parenting stress, parental control attitudes, and children's problem behaviors suggested that the parents' intercepts for parenting stress influenced their intercepts for parental control attitudes (father: β=.21, p < .001; mother: β=.55, p < .001). In addition, the slopes for fathers' parenting stress was the only aspect that affected the slopes for mothers' parental control attitudes (β=.77, p < .001). Moreover, both the intercepts and slopes of parenting stress and parental control attitudes significantly affected the children's problem behaviors.@*CONCLUSION@#This study is significant as it provides longitudinal evidence of the impact of parenting stress and parental control attitudes on children's problem behaviors. The findings suggest that accurately assessing changes in parenting stress and parental control attitudes and developing intervention programs to reduce them will be effective in reducing problem behaviors in children.
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PURPOSE: The purpose of this study was to develop a system dynamics model for adolescent obesity in Korea that could be used for obesity policy analysis. METHODS: On the basis of the casual loop diagram, a model was developed by converting to stock and flow diagram. The Vensim DSS 5.0 program was used in the model development. We simulated method of moments to the calibration of this model with data from The Korea Youth Risk Behavior Web-based Survey 2005 to 2013. We ran the scenario simulation. RESULTS: This model can be used to understand the current adolescent obesity rate, predict the future obesity rate, and be utilized as a tool for controlling the risk factors. The results of the model simulation match well with the data. It was identified that a proper model, able to predict obesity probability, was established. CONCLUSION: These results of stock and flow diagram modeling in adolescent obesity can be helpful in development of obesity by policy planners and other stakeholders to better anticipate the multiple effects of interventions in both the short and the long term. In the future we suggest the development of an expanded model based on this adolescent obesity model.
Subject(s)
Adolescent , Humans , Internet , Nonlinear Dynamics , Obesity/pathology , Republic of Korea , Risk Factors , Risk-Taking , Surveys and QuestionnairesABSTRACT
Fibrocartilaginous dysplasia (FCD) has occasionally led to a misdiagnosis and wrong decision which can significantly alter the outcome of the patients. A 9-yr-old boy presented with pain on his left distal thigh for 6 months without any trauma history. Initial radiographs showed moth eaten both osteolytic and osteosclerotic lesions and biopsy findings showed that the lesion revealed many irregular shaped and sclerotic mature and immature bony trabeculae. Initial diagnostic suggestions were varied from the conventional osteosarcoma to low grade central osteosarcoma or benign intramedullary bone forming lesion, but close observation was done. This study demonstrated a case of unusual fibrocartilaginous intramedullary bone forming tumor mimicking osteosarcoma, so that possible misdiagnosis might be made and unnecessary extensive surgical treatment could be performed. In conclusion, the role of orthopaedic oncologist as a decision maker is very important when the diagnosis is uncertain.