BACKGROUND: The gradually increasing demand for coffee worldwide has prompted increased interest in the relationship between coffee and health issues as well as a need for research on metabolic syndrome in adults. METHODS: Data from 3,321 subjects (1,268 men and 2,053 women) enrolled in the 2013–2014 Korean National Health and Nutrition Examination Survey were analyzed. The subjects were divided into three groups according to their daily coffee consumption. The odds ratios (ORs) and 95% confidence intervals (95% CIs) for metabolic syndrome in the coffee-drinking groups were calculated using multiple logistic regression analysis by adjusting for confounding variables. RESULTS: The prevalence of metabolic syndrome was 15.5%, 10.7%, and 9.7% in men and 3.0%, 7.1%, and 6.5% in women according to their coffee consumption (less than one, one or two, or more than three cups of coffee per day), respectively. Compared with the non-coffee consumption group, the ORs (95% CIs) for metabolic syndrome in the group that consumed more than three cups of coffee was 0.638 (0.328–1.244) for men and 1.344 (0.627–2.881) for women after adjusting for age, body mass index, household income, education, smoking, alcohol, regular exercise, and daily caloric intake. CONCLUSION: The OR of metabolic syndrome was not statistically significant in both men and women.
Adult* ; Body Mass Index ; Coffee* ; Confounding Factors (Epidemiology) ; Education ; Energy Intake ; Family Characteristics ; Female ; Humans ; Korea* ; Logistic Models ; Male ; Nutrition Surveys* ; Odds Ratio ; Prevalence ; Smoke ; Smoking ; Waist Circumference

Objective: : Decompressive craniectomy (DC) with duroplasty is one of the common surgical treatments for life-threatening increased intracranial pressure (ICP). Once ICP is controlled, cranioplasty (CP) with reinsertion of the cryopreserved autologous bone flap or a synthetic implant is considered for protection and esthetics. Although with the risk of autologous bone flap resorption (BFR), cryopreserved autologous bone flap for CP is one of the important material due to its cost effectiveness. In this article, we performed conventional statistical analysis and the machine learning technique understand the risk factors for BFR. Methods: : Patients aged >18 years who underwent autologous bone CP between January 2015 and December 2021 were reviewed. Demographic data, medical records, and volumetric measurements of the autologous bone flap volume from 94 patients were collected. BFR was defined with absolute quantitative method (BFR-A) and relative quantitative method (BFR%). Conventional statistical analysis and random forest with hyper-ensemble approach (RF with HEA) was performed. And overlapped partial dependence plots (PDP) were generated. Results: : Conventional statistical analysis showed that only the initial autologous bone flap volume was statistically significant on BFR-A. RF with HEA showed that the initial autologous bone flap volume, interval between DC and CP, and bone quality were the factors with most contribution to BFR-A, while, trauma, bone quality, and initial autologous bone flap volume were the factors with most contribution to BFR%. Overlapped PDPs of the initial autologous bone flap volume on the BRF-A crossed at approximately 60 mL, and a relatively clear separation was found between the non-BFR and BFR groups. Therefore, the initial autologous bone flap of over 60 mL could be a possible risk factor for BFR. Conclusion : From the present study, BFR in patients who underwent CP with autologous bone flap might be inevitable. However, the degree of BFR may differ from one to another. Therefore, considering artificial bone flaps as implants for patients with large DC could be reasonable. Still, the risk factors for BFR are not clearly understood. Therefore, chronological analysis and pathophysiologic studies are needed.

Despite their benign nature some symptomatic aggressive vertebral haemangiomas (AVH) require surgery to decompress spinal cord and/or stabilise pathological fractures. Preoperative embolisation may reduce the considerable blood loss during surgical decompression. This systematic review investigated whether preoperative embolisation reduced surgical blood loss during treatment of symptomatic AVH. PubMed Medline, Web of Science, and Ovid Medline were searched for case reports and clinical studies on surgical AVH treatment. Included were cases from all publications on surgical treatment of AVH where the amount of surgical blood loss and the use of preoperative embolisation were documented. 51 cases with surgically treated AVH were retrieved from the included studies. Blood loss in the embolised treatment group (980+/-683 mL) was lower than the non-embolised control group (1,629+/-946 mL). This systematic review found that embolisation prior to AVH resection reduced surgical blood loss (level of evidence, very low) and can be recommended (strong recommendation).
Blood Loss, Surgical ; Decompression, Surgical ; Fractures, Spontaneous ; Hemangioma ; Spinal Cord ; Spinal Cord Compression

Firefighters are facing occupational hazards such as exposures to a variety of carcinogens and toxic agents, heat, physical stress and psychological stress. This occupation involves an increased risk of particular health concerns including cardiovascular diseases, cancers, and reproductive hazards. Cardiovascular diseases are the leading cause of lifetime mortality among the firefighters as well as the principal cause of on-duty deaths. In spite of "healthy worker effect", a number of studies have found an increased risk of cardiovascular disease morbidity and mortality in firefighters. There are various carcinogens in the fire smoke. Many studies address that some types of cancers are related to firefighting. These cancers include brain tumors, cancers of hematopoietic and lymphatic systems, cancers of genitourinary tract, and skin cancers. To date, the relationship between firefighting and reproductive hazards has not been widely studied. However, since firefighters are exposed to various chemical and physical hazards which might influence the reproductive systems, the concerns are raising. It is important to recognize that firefighters are at a risk of several significant health problems. To reduce the risk, it should be encouraged to use protective equipments efficiently and manage physically exerted firefighters appropriately at the fire scene. Furthermore, we should activate not only screening programs to detect health risk factors, but also medical programs to help firefighters maintain a good physical fitness.
Brain Neoplasms ; Carcinogens ; Cardiovascular Diseases ; Firefighters ; Fires ; Hot Temperature ; Humans ; Lymphatic System ; Mass Screening ; Occupations ; Risk Factors ; Skin Neoplasms ; Smoke ; Stress, Psychological

Deep learning has recently achieved remarkable results in the field of medical imaging. However, as a deep learning network becomes deeper to improve its performance, it becomes more difficult to interpret the processes within. This can especially be a critical problem in medical fields where diagnostic decisions are directly related to a patient's survival. In order to solve this, explainable artificial intelligence techniques are being widely studied, and an attention mechanism was developed as part of this approach. In this paper, attention techniques are divided into two types: post hoc attention, which aims to analyze a network that has already been trained, and trainable attention, which further improves network performance. Detailed comparisons of each method, examples of applications in medical imaging, and future perspectives will be covered.

This review focused on the research published to date on the treatment of phalangeal fractures according to the anatomical location of the finger bones, excluding the thumb. In many finger fracture cases, conservative treatment should be prioritized over surgical treatment. The three determinants of surgical treatment are the presence of an intra-articular fracture, the stability of the fracture itself, and the degree of damage to the surrounding soft tissues. Surgical treatment is recommended when bone fragments of 3 mm or more and distal phalanx subluxation are present in the bony mallet finger, and the main surgical treatment is closed reduction and extension block pin fixation. It is essential to pay attention to rotational deformation asf ractures occur proximally. Since intra-articular fractures can cause stiffness and arthritis in the future, a computed tomography scan is recommended to confirm the fracture pattern. These fractures require anatomical reduction of the bone fragments within the joint, and the instability of the joint itself must be corrected. There are no superior surgical treatment methods. It is therefore advantageous for the surgeon to select a surgical method that he is familiar with and confident of performing, considering the fracture itself and various patient-related clinical factors. Nonunion is rare as a complication of a finger fracture, and finger stiffness is the most common complication. Ensuring rapid joint movement as soon as possible can reduce finger stiffness.

Deep learning has recently achieved remarkable results in the field of medical imaging. However, as a deep learning network becomes deeper to improve its performance, it becomes more difficult to interpret the processes within. This can especially be a critical problem in medical fields where diagnostic decisions are directly related to a patient's survival. In order to solve this, explainable artificial intelligence techniques are being widely studied, and an attention mechanism was developed as part of this approach. In this paper, attention techniques are divided into two types: post hoc attention, which aims to analyze a network that has already been trained, and trainable attention, which further improves network performance. Detailed comparisons of each method, examples of applications in medical imaging, and future perspectives will be covered.

Korea has the most rapidly aging population in the world. Medical costs for the elderly are quickly increasing, which raises concerns about the sustainability of health insurance finances. Accordingly, the need to allocate limited medical resources efficiently has increased, with improving the fee schedule seen as an effective way to achieve this. Japan has experienced a super-aging society for at least 20 years prior to Korea and has been successful in improving its fee schedule. Korea’s fee schedule, however, needs to overcome the challenge of being relatively limited in type and simplicity.Current Concepts: The new patient consultation fee in Japan is the same regardless of the type of medical institution and is approximately 40% higher than found in Korea. In the case of established patient consultations, the fee for medical institutions with fewer than 200 beds are substantially higher than for large medical institutions, thereby suppressing re-examination at large hospitals. Japan’s additional points consist of 71 types of items, which is more diverse than Korea’s 28 types, and the additional points for children under six years of age, holidays, and late nights are set significantly higher than that found in Korea.Discussion and Conclusion: Japan designed its fee schedule to structurally reduce the consumption of medical resources and to effectively compensate for the behavior of medical providers. This policy is a standard which Korea’s fee schedule should aim for. In the future, it will be necessary to prepare measures to respond to the super-aging environment through detailed research concerning Japan’s fee schedule.

Cellulitis and deep vein thrombosis (DVT) have similar symptoms (lower extremity pain, erythema, and swelling) and there is the potential for misdiagnosis. In cases of cellulitis, DVT should be ruled out, as the symptoms of cellulitis might mask those of DVT, leading to serious complications such as pulmonary thromboembolism. The reported incidence of DVT in patients with cellulitis is low, especially patients with progression to pulmonary thromboembolism. We present a case of pulmonary thromboembolism following cellulitis of the lower leg in a 54-year-old male.
Cellulitis* ; Diagnostic Errors ; Erythema ; Extremities ; Humans ; Incidence ; Leg* ; Male ; Masks ; Middle Aged ; Pulmonary Embolism ; Venous Thrombosis*

PURPOSE: This study was to examine the pedagogical validity for a the six-years curriculum in pharmacy education in Korea. METHODS: The focus group, composed of 5 specialists, analyzed the pedagogical validity for a six-years curriculum from the perspective of administrative policies of higher education, educational sociology, curriculum composition, and educational economy. In addition, 3 consultants advised on the main issues related to the reformation of the school system in pharmacy education. RESULTS: It is not clear that the reformation of the school system in pharmacy education is aimed at undergraduate or graduate education in view of specialization of a higher education institute. The reformation of the school system is likely to cause educational inequality since a student who lacks financial support and cultural resources might give up entering pharmacy school. It also may ignite a struggle for power between pharmacists and physicians. The six- years curriculum is supposed to offer integrated experiences with a balance of theory and practice, representing characteristics such as consistency, clarity, reliability, and legitimacy. From the educational economy view, the validity of reformation of the school system can only be secured on the premise the expected income exceeds the total costs if the age-earning profile is constant in the current situation. CONCLUSION: Prior to discussions on the reformation of the school system in pharmacy education, the quality of pharmacy education should be improved first through multifarious efforts such as curriculum development, improvement to teaching and learning, introduction to an accreditation system, revision of the license examination, and graduate and continued pharmacy education and so on.
Accreditation ; Consultants ; Curriculum* ; Education ; Education, Graduate ; Education, Pharmacy* ; Financial Support ; Focus Groups ; Humans ; Illegitimacy ; Korea ; Learning ; Licensure ; Pharmacists ; Pharmacy* ; Schools, Pharmacy ; Socioeconomic Factors ; Sociology ; Specialization