1.A Lung Cancer Risk Prediction Model from Healthy Korean Adults: A Single Center Cohort Study
Yong Ho LEE ; Taewon HWANG ; Sunwoo CHO ; Hyungseok OH ; Jung Ah LEE
Korean Journal of Family Practice 2024;14(2):90-97
Background:
Lung cancer has a high incidence and mortality worldwide, and smoking, age, sex, and body mass index are known risk factors. Using a health examination cohort, we constructed a comprehensive lung cancer risk-prediction model.
Methods:
This study comprised 308,804 adults aged 20 years and older who underwent health examinations at one general hospital in Korea, from 2011 to 2018. We developed a lung cancer risk prediction model using a multivariate Cox proportional hazards regression analysis for lung cancer risk factors and estimated the hazard ratios and coefficients. The model evaluation included discrimination and calibration assessments.
Results:
Among the 308,804 adults in the study cohort, there were 338 (0.11%) patients lung cancer, with 215 males (0.07% of 169,420 males) and 123 females (0.04% of 139,384 females). The prevalence of lung cancer was higher in males and females aged over 60 years. Age, sex, body mass index, and smoking behavior were identified as risk factors for lung cancer prevalence in this model through multivariate Cox proportional hazards analysis. The C-statistic of the development cohort was 0.785 (0.749, 0.821) and that of the validation cohort was 0.823 (0.769, 0.878).
Conclusion
Our lung cancer risk prediction model showed statistical significance, similar to previous prediction models, among variables that included young age, female sex, and body mass index. Future improvements should focus on population-wide applicability and associated health examination policies.
2.The Influence of Coronavirus Disease 2019 Pandemic-Related Daily Life Restrictions on Daily Life Satisfaction
Inwook LEE ; Sung SUNWOO ; Jung Ah LEE
Korean Journal of Family Practice 2024;14(3):126-132
Background:
The study aim was to investigate the level of restrictions on daily life and concern about economic damage caused by the coronavirus disease 2019 (COVID-19) pandemic and analyze the effects on daily life satisfaction.
Methods:
2021 Community Health Survey data of 229,242 individuals were analyzed. Such factors as restrictions on daily life, changes in physical activity and instant food consumption and concern about economic damage were selected as variables for analysis, as they were presumed to impact daily life satisfaction during the COVID-19 pandemic.
Results:
The odds ratio for poor daily life satisfaction was 1.88 (95% confidence interval [CI], 1.83–1.94) for those who experienced moderate restrictions and 3.48 (95% CI, 3.31–3.65) for those who experienced severe restrictions, compared to those who had no restrictions in daily life. The group with reduced physical activity had an odds ratio of 1.29 (95% CI, 1.26–1.33) for poor daily life satisfaction compared to the group with no change. The group with increased consumption of instant foods had an odds ratio of 1.23 (95% CI, 1.18–1.28) for poor daily life satisfaction compared to the group without such an increase. Regarding the economic damage caused by the COVID-19 pandemic, the odds ratio for experiencing negative daily life satisfaction was 1.17 (95% CI, 1.10–1.24) for those with moderate concern and 1.43 (95% CI, 1.37–1.50) for those with severe concern, compared to those who were not worried.
Conclusion
The results of this study could be helpful in planning public health and medical policies for population groups that are relatively vulnerable to decreased daily life satisfaction.
3.A Lung Cancer Risk Prediction Model from Healthy Korean Adults: A Single Center Cohort Study
Yong Ho LEE ; Taewon HWANG ; Sunwoo CHO ; Hyungseok OH ; Jung Ah LEE
Korean Journal of Family Practice 2024;14(2):90-97
Background:
Lung cancer has a high incidence and mortality worldwide, and smoking, age, sex, and body mass index are known risk factors. Using a health examination cohort, we constructed a comprehensive lung cancer risk-prediction model.
Methods:
This study comprised 308,804 adults aged 20 years and older who underwent health examinations at one general hospital in Korea, from 2011 to 2018. We developed a lung cancer risk prediction model using a multivariate Cox proportional hazards regression analysis for lung cancer risk factors and estimated the hazard ratios and coefficients. The model evaluation included discrimination and calibration assessments.
Results:
Among the 308,804 adults in the study cohort, there were 338 (0.11%) patients lung cancer, with 215 males (0.07% of 169,420 males) and 123 females (0.04% of 139,384 females). The prevalence of lung cancer was higher in males and females aged over 60 years. Age, sex, body mass index, and smoking behavior were identified as risk factors for lung cancer prevalence in this model through multivariate Cox proportional hazards analysis. The C-statistic of the development cohort was 0.785 (0.749, 0.821) and that of the validation cohort was 0.823 (0.769, 0.878).
Conclusion
Our lung cancer risk prediction model showed statistical significance, similar to previous prediction models, among variables that included young age, female sex, and body mass index. Future improvements should focus on population-wide applicability and associated health examination policies.
4.The Influence of Coronavirus Disease 2019 Pandemic-Related Daily Life Restrictions on Daily Life Satisfaction
Inwook LEE ; Sung SUNWOO ; Jung Ah LEE
Korean Journal of Family Practice 2024;14(3):126-132
Background:
The study aim was to investigate the level of restrictions on daily life and concern about economic damage caused by the coronavirus disease 2019 (COVID-19) pandemic and analyze the effects on daily life satisfaction.
Methods:
2021 Community Health Survey data of 229,242 individuals were analyzed. Such factors as restrictions on daily life, changes in physical activity and instant food consumption and concern about economic damage were selected as variables for analysis, as they were presumed to impact daily life satisfaction during the COVID-19 pandemic.
Results:
The odds ratio for poor daily life satisfaction was 1.88 (95% confidence interval [CI], 1.83–1.94) for those who experienced moderate restrictions and 3.48 (95% CI, 3.31–3.65) for those who experienced severe restrictions, compared to those who had no restrictions in daily life. The group with reduced physical activity had an odds ratio of 1.29 (95% CI, 1.26–1.33) for poor daily life satisfaction compared to the group with no change. The group with increased consumption of instant foods had an odds ratio of 1.23 (95% CI, 1.18–1.28) for poor daily life satisfaction compared to the group without such an increase. Regarding the economic damage caused by the COVID-19 pandemic, the odds ratio for experiencing negative daily life satisfaction was 1.17 (95% CI, 1.10–1.24) for those with moderate concern and 1.43 (95% CI, 1.37–1.50) for those with severe concern, compared to those who were not worried.
Conclusion
The results of this study could be helpful in planning public health and medical policies for population groups that are relatively vulnerable to decreased daily life satisfaction.
5.A Lung Cancer Risk Prediction Model from Healthy Korean Adults: A Single Center Cohort Study
Yong Ho LEE ; Taewon HWANG ; Sunwoo CHO ; Hyungseok OH ; Jung Ah LEE
Korean Journal of Family Practice 2024;14(2):90-97
Background:
Lung cancer has a high incidence and mortality worldwide, and smoking, age, sex, and body mass index are known risk factors. Using a health examination cohort, we constructed a comprehensive lung cancer risk-prediction model.
Methods:
This study comprised 308,804 adults aged 20 years and older who underwent health examinations at one general hospital in Korea, from 2011 to 2018. We developed a lung cancer risk prediction model using a multivariate Cox proportional hazards regression analysis for lung cancer risk factors and estimated the hazard ratios and coefficients. The model evaluation included discrimination and calibration assessments.
Results:
Among the 308,804 adults in the study cohort, there were 338 (0.11%) patients lung cancer, with 215 males (0.07% of 169,420 males) and 123 females (0.04% of 139,384 females). The prevalence of lung cancer was higher in males and females aged over 60 years. Age, sex, body mass index, and smoking behavior were identified as risk factors for lung cancer prevalence in this model through multivariate Cox proportional hazards analysis. The C-statistic of the development cohort was 0.785 (0.749, 0.821) and that of the validation cohort was 0.823 (0.769, 0.878).
Conclusion
Our lung cancer risk prediction model showed statistical significance, similar to previous prediction models, among variables that included young age, female sex, and body mass index. Future improvements should focus on population-wide applicability and associated health examination policies.
6.The Influence of Coronavirus Disease 2019 Pandemic-Related Daily Life Restrictions on Daily Life Satisfaction
Inwook LEE ; Sung SUNWOO ; Jung Ah LEE
Korean Journal of Family Practice 2024;14(3):126-132
Background:
The study aim was to investigate the level of restrictions on daily life and concern about economic damage caused by the coronavirus disease 2019 (COVID-19) pandemic and analyze the effects on daily life satisfaction.
Methods:
2021 Community Health Survey data of 229,242 individuals were analyzed. Such factors as restrictions on daily life, changes in physical activity and instant food consumption and concern about economic damage were selected as variables for analysis, as they were presumed to impact daily life satisfaction during the COVID-19 pandemic.
Results:
The odds ratio for poor daily life satisfaction was 1.88 (95% confidence interval [CI], 1.83–1.94) for those who experienced moderate restrictions and 3.48 (95% CI, 3.31–3.65) for those who experienced severe restrictions, compared to those who had no restrictions in daily life. The group with reduced physical activity had an odds ratio of 1.29 (95% CI, 1.26–1.33) for poor daily life satisfaction compared to the group with no change. The group with increased consumption of instant foods had an odds ratio of 1.23 (95% CI, 1.18–1.28) for poor daily life satisfaction compared to the group without such an increase. Regarding the economic damage caused by the COVID-19 pandemic, the odds ratio for experiencing negative daily life satisfaction was 1.17 (95% CI, 1.10–1.24) for those with moderate concern and 1.43 (95% CI, 1.37–1.50) for those with severe concern, compared to those who were not worried.
Conclusion
The results of this study could be helpful in planning public health and medical policies for population groups that are relatively vulnerable to decreased daily life satisfaction.
7.A Lung Cancer Risk Prediction Model from Healthy Korean Adults: A Single Center Cohort Study
Yong Ho LEE ; Taewon HWANG ; Sunwoo CHO ; Hyungseok OH ; Jung Ah LEE
Korean Journal of Family Practice 2024;14(2):90-97
Background:
Lung cancer has a high incidence and mortality worldwide, and smoking, age, sex, and body mass index are known risk factors. Using a health examination cohort, we constructed a comprehensive lung cancer risk-prediction model.
Methods:
This study comprised 308,804 adults aged 20 years and older who underwent health examinations at one general hospital in Korea, from 2011 to 2018. We developed a lung cancer risk prediction model using a multivariate Cox proportional hazards regression analysis for lung cancer risk factors and estimated the hazard ratios and coefficients. The model evaluation included discrimination and calibration assessments.
Results:
Among the 308,804 adults in the study cohort, there were 338 (0.11%) patients lung cancer, with 215 males (0.07% of 169,420 males) and 123 females (0.04% of 139,384 females). The prevalence of lung cancer was higher in males and females aged over 60 years. Age, sex, body mass index, and smoking behavior were identified as risk factors for lung cancer prevalence in this model through multivariate Cox proportional hazards analysis. The C-statistic of the development cohort was 0.785 (0.749, 0.821) and that of the validation cohort was 0.823 (0.769, 0.878).
Conclusion
Our lung cancer risk prediction model showed statistical significance, similar to previous prediction models, among variables that included young age, female sex, and body mass index. Future improvements should focus on population-wide applicability and associated health examination policies.
8.The Influence of Coronavirus Disease 2019 Pandemic-Related Daily Life Restrictions on Daily Life Satisfaction
Inwook LEE ; Sung SUNWOO ; Jung Ah LEE
Korean Journal of Family Practice 2024;14(3):126-132
Background:
The study aim was to investigate the level of restrictions on daily life and concern about economic damage caused by the coronavirus disease 2019 (COVID-19) pandemic and analyze the effects on daily life satisfaction.
Methods:
2021 Community Health Survey data of 229,242 individuals were analyzed. Such factors as restrictions on daily life, changes in physical activity and instant food consumption and concern about economic damage were selected as variables for analysis, as they were presumed to impact daily life satisfaction during the COVID-19 pandemic.
Results:
The odds ratio for poor daily life satisfaction was 1.88 (95% confidence interval [CI], 1.83–1.94) for those who experienced moderate restrictions and 3.48 (95% CI, 3.31–3.65) for those who experienced severe restrictions, compared to those who had no restrictions in daily life. The group with reduced physical activity had an odds ratio of 1.29 (95% CI, 1.26–1.33) for poor daily life satisfaction compared to the group with no change. The group with increased consumption of instant foods had an odds ratio of 1.23 (95% CI, 1.18–1.28) for poor daily life satisfaction compared to the group without such an increase. Regarding the economic damage caused by the COVID-19 pandemic, the odds ratio for experiencing negative daily life satisfaction was 1.17 (95% CI, 1.10–1.24) for those with moderate concern and 1.43 (95% CI, 1.37–1.50) for those with severe concern, compared to those who were not worried.
Conclusion
The results of this study could be helpful in planning public health and medical policies for population groups that are relatively vulnerable to decreased daily life satisfaction.
9.Deep Learning-Based Automatic Classification of Ischemic Stroke Subtype Using Diffusion-Weighted Images
Wi-Sun RYU ; Dawid SCHELLINGERHOUT ; Hoyoun LEE ; Keon-Joo LEE ; Chi Kyung KIM ; Beom Joon KIM ; Jong-Won CHUNG ; Jae-Sung LIM ; Joon-Tae KIM ; Dae-Hyun KIM ; Jae-Kwan CHA ; Leonard SUNWOO ; Dongmin KIM ; Sang-Il SUH ; Oh Young BANG ; Hee-Joon BAE ; Dong-Eog KIM
Journal of Stroke 2024;26(2):300-311
Background:
and Purpose Accurate classification of ischemic stroke subtype is important for effective secondary prevention of stroke. We used diffusion-weighted image (DWI) and atrial fibrillation (AF) data to train a deep learning algorithm to classify stroke subtype.
Methods:
Model development was done in 2,988 patients with ischemic stroke from three centers by using U-net for infarct segmentation and EfficientNetV2 for subtype classification. Experienced neurologists (n=5) determined subtypes for external test datasets, while establishing a consensus for clinical trial datasets. Automatically segmented infarcts were fed into the model (DWI-only algorithm). Subsequently, another model was trained, with AF included as a categorical variable (DWI+AF algorithm). These models were tested: (1) internally against the opinion of the labeling experts, (2) against fresh external DWI data, and (3) against clinical trial dataset.
Results:
In the training-and-validation datasets, the mean (±standard deviation) age was 68.0±12.5 (61.1% male). In internal testing, compared with the experts, the DWI-only and the DWI+AF algorithms respectively achieved moderate (65.3%) and near-strong (79.1%) agreement. In external testing, both algorithms again showed good agreements (59.3%–60.7% and 73.7%–74.0%, respectively). In the clinical trial dataset, compared with the expert consensus, percentage agreements and Cohen’s kappa were respectively 58.1% and 0.34 for the DWI-only vs. 72.9% and 0.57 for the DWI+AF algorithms. The corresponding values between experts were comparable (76.0% and 0.61) to the DWI+AF algorithm.
Conclusion
Our model trained on a large dataset of DWI (both with or without AF information) was able to classify ischemic stroke subtypes comparable to a consensus of stroke experts.
10.Dysphagia Only with Unilateral Multiple Ulcerative Lesions in Varicella-Zoster Virus Infection: A Case Report
Sunwoo HWANG ; Ji Yong YOON ; Junil SO ; Hongseo HWANG ; Hayoung BYUN ; Chang Han LEE ; Min-Kyun OH
Journal of the Korean Dysphagia Society 2024;14(1):66-70
Pharyngeal dysphagia can be caused by structural abnormalities or neurological disorders such as stroke, meningitis, and other conditions. Herpes zoster (HZ), caused by the varicella-zoster virus (VZV), is a rare cause of pharyngeal dysphagia. The symptoms of HZ usually involve a painful rash with vesicles along the dermatome area, but it can also affect the cranial nerves (CN), such as CN VII (Ramsay-Hunt syndrome), and less commonly, other CN. A 69-year-old man presented with a sore throat and dysphagia symptoms. A laryngoscopy revealed multiple ulcerative mucosal lesions on the right soft palate and lateral pharynx. The patient was treated with oral valacyclovir, and although the lesions disappeared, the dysphagia symptoms remained. While dysphagia associated with a VZV infection is rare, it can occur with the additional symptoms of vocal cord paralysis. This paper reports a rare case of pharyngeal dysphagia caused by a VZV infection, and the patient presented only with the initial symptoms of sore throat and dysphagia without skin lesions or signs of vocal cord paralysis.

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