Purpose: Immunochemical fecal occult blood tests (iFOBT) have been utilized as the primary method for colorectal cancer screening within Korea's National Cancer Screening Program. This study aimed to evaluate the impact of the accreditation program for clinical laboratories and external quality assessment (EQA) programs on colorectal cancer screening. Methods: We analyzed the false-positive rates of iFOBT in colorectal cancer screening from 2016 to 2020 according to participation and performance in the Outstanding Laboratory Accreditation Program (OLAP) conducted by the Laboratory Medicine Foundation, and the External Quality Assessment programs run by the Korean Association of External Quality Assessment Service. Results: False-positive rates of iFOBT were lower among institutions accredited by OLAP (2.35%) compared with non-accredited (3.04%) and non-participating institutions (5.60%). Similarly, institutions participating in the EQA program exhibited lower false-positive rates (3.79%) compared to non-participants (7.04%). Within the iFOBT-specific EQA program, institutions that passed demonstrated the lowest false-positive rate (3.37%), while failing institutions showed the highest rate (9.07%), surpassing even non-participating institutions (6.44%). Conclusion Participation in quality management programs such as OLAP and EQA was associated with lower false-positive rates in iFOBT for colorectal cancer screening. These findings suggest that quality management initiatives can increase the accuracy of iFOBT, potentially improving the effectiveness of colorectal cancer screening programs, and reducing unnecessary follow-up procedures and associated healthcare costs.

Purpose: Immunochemical fecal occult blood tests (iFOBT) have been utilized as the primary method for colorectal cancer screening within Korea's National Cancer Screening Program. This study aimed to evaluate the impact of the accreditation program for clinical laboratories and external quality assessment (EQA) programs on colorectal cancer screening. Methods: We analyzed the false-positive rates of iFOBT in colorectal cancer screening from 2016 to 2020 according to participation and performance in the Outstanding Laboratory Accreditation Program (OLAP) conducted by the Laboratory Medicine Foundation, and the External Quality Assessment programs run by the Korean Association of External Quality Assessment Service. Results: False-positive rates of iFOBT were lower among institutions accredited by OLAP (2.35%) compared with non-accredited (3.04%) and non-participating institutions (5.60%). Similarly, institutions participating in the EQA program exhibited lower false-positive rates (3.79%) compared to non-participants (7.04%). Within the iFOBT-specific EQA program, institutions that passed demonstrated the lowest false-positive rate (3.37%), while failing institutions showed the highest rate (9.07%), surpassing even non-participating institutions (6.44%). Conclusion Participation in quality management programs such as OLAP and EQA was associated with lower false-positive rates in iFOBT for colorectal cancer screening. These findings suggest that quality management initiatives can increase the accuracy of iFOBT, potentially improving the effectiveness of colorectal cancer screening programs, and reducing unnecessary follow-up procedures and associated healthcare costs.

Purpose: Immunochemical fecal occult blood tests (iFOBT) have been utilized as the primary method for colorectal cancer screening within Korea's National Cancer Screening Program. This study aimed to evaluate the impact of the accreditation program for clinical laboratories and external quality assessment (EQA) programs on colorectal cancer screening. Methods: We analyzed the false-positive rates of iFOBT in colorectal cancer screening from 2016 to 2020 according to participation and performance in the Outstanding Laboratory Accreditation Program (OLAP) conducted by the Laboratory Medicine Foundation, and the External Quality Assessment programs run by the Korean Association of External Quality Assessment Service. Results: False-positive rates of iFOBT were lower among institutions accredited by OLAP (2.35%) compared with non-accredited (3.04%) and non-participating institutions (5.60%). Similarly, institutions participating in the EQA program exhibited lower false-positive rates (3.79%) compared to non-participants (7.04%). Within the iFOBT-specific EQA program, institutions that passed demonstrated the lowest false-positive rate (3.37%), while failing institutions showed the highest rate (9.07%), surpassing even non-participating institutions (6.44%). Conclusion Participation in quality management programs such as OLAP and EQA was associated with lower false-positive rates in iFOBT for colorectal cancer screening. These findings suggest that quality management initiatives can increase the accuracy of iFOBT, potentially improving the effectiveness of colorectal cancer screening programs, and reducing unnecessary follow-up procedures and associated healthcare costs.

Objective: Dysphagia is a common clinical condition characterized by difficulty in swallowing. It is sub-classified into oropharyngeal dysphagia, which refers to problems in the mouth and pharynx, and esophageal dysphagia, which refers to problems in the esophageal body and esophagogastric junction. Dysphagia can have a significant negative impact one’s physical health and quality of life as its severity increases. Therefore, proper assessment and management of dysphagia are critical for improving swallowing function and preventing complications. Thus a guideline was developed to provide evidence-based recommendations for assessment and management in patients with dysphagia. Methods: Nineteen key questions on dysphagia were developed. These questions dealt with various aspects of problems related to dysphagia, including assessment, management, and complications. A literature search for relevant articles was conducted using Pubmed, Embase, the Cochrane Library, and one domestic database of KoreaMed, until April 2021. The level of evidence and recommendation grade were established according to the Grading of Recommendation Assessment, Development and Evaluation methodology. Results: Early screening and assessment of videofluoroscopic swallowing were recommended for assessing the presence of dysphagia. Therapeutic methods, such as tongue and pharyngeal muscle strengthening exercises and neuromuscular electrical stimulation with swallowing therapy, were effective in improving swallowing function and quality of life in patients with dysphagia. Nutritional intervention and an oral care program were also recommended. Conclusion This guideline presents recommendations for the assessment and management of patients with oropharyngeal dysphagia, including rehabilitative strategies.

OBJECTIVE: To determine post-operative physical performance factors associated with gait speed in patients surgically treated for hip fracture. METHODS: Cross-sectional data from 59 patients (16 males and 43 females; mean age, 79.2±9.1 years) who underwent hip fracture surgery were enrolled. Patients completed a 10-meter walk test (10MWT) to assess gait speed. Additional physical performance tests included the Timed Up and Go test (TUG), the Berg Balance Scale (BBS), maximum voluntary isometric contraction (MVIC) of the knee extensors and flexors on the operated and non-operated sides as well as of the hip abductors (all tested using air-resistance weight machines), and analysis of spatio-temporal gait parameters at about 6 weeks after hip surgery. RESULTS: Bivariate analyses revealed a significant positive correlation between the post-operative 10MWT and the post-operative TUG, age, swing phase duration, and gait cycle duration along with a significant negative correlation between post-operative BBS score, MVIC of the knee extensors and flexors on the operated and non-operated sides, MVIC of the hip abductors, and cadence and stance phase duration. Linear regression analyses revealed that the post-operative TUG (β=0.85, p<0.01), gait cycle duration (β=0.17, p=0.02), and osteoporosis (β=-0.18, p=0.02) were associated with the post-operative 10MWT. CONCLUSION: The presence of osteoporosis, post-operative balance, and isometric muscle strength in the operated and non-operated legs were statistically associated with post-operative gait speed early after hip fracture surgery.
Cross-Sectional Studies ; Female ; Gait ; Hip Fractures ; Hip ; Humans ; Isometric Contraction ; Knee ; Leg ; Linear Models ; Male ; Muscle Strength ; Osteoporosis ; Rehabilitation

OBJECTIVE: To identify the differences in the movement of the hyoid bone and the vocal cord with and without electrical stimulation in normal subjects. METHODS: Two-dimensional motion analysis using a videofluoroscopic swallowing study with and without electrical stimulation was performed. Surface electrical stimulation was applied during swallowing using electrodes placed at three different locations on each subject. All subjects were analyzed three times using the following electrode placements: with one pair of electrodes on the suprahyoid muscles and a second pair on the infrahyoid muscles (SI); with placement of the electrode pairs on only the infrahyoid muscles (IO); and with the electrode pairs placed vertically on the suprahyoid and infrahyoid muscles (SIV). RESULTS: The main outcomes of this study demonstrated an initial downward displacement as well as different movements of the hyoid bone with the three electrode placements used for electrical stimulation. The initial positions of the hyoid bone with the SI and IO placements resulted in an inferior and anterior displaced position. During swallowing, the hyoid bone moved in a more superior and less anterior direction, resulting in almost the same peak position compared with no electrical stimulation. CONCLUSION: These results demonstrate that electrical stimulation caused an initial depression of the hyoid bone, which had nearly the same peak position during swallowing. Electrical stimulation during swallowing was not dependent on the position of the electrode on the neck, such as on the infrahyoid or on both the suprahyoid and infrahyoid muscles.
Deglutition ; Deglutition Disorders ; Depression ; Electric Stimulation* ; Electrodes ; Hyoid Bone ; Jupiter ; Muscles ; Neck ; Neck Muscles ; Vocal Cords

The clinical practice guideline for the stroke rehabilitation was formulated through both extensive review of published literature and consensus meeting of the specialists. The purposes of this study were to provide optimum practical guideline for acute and subacute stroke rehabilitation and to enhance the quality of stroke rehabilitation team in Korea. This guideline contains evidences and recommendations on the organization of post-stroke rehabilitation team, timing, evaluation, and intensity of rehabilitation, detailed management of dysphagia, neurogenic bladder and bowel, movement, shoulder problem, cognition, neglect, language, mood and complications commonly encountered in the acute and subacute period of stroke rehabilitation. Clinicians who are working in the field of stroke rehabilitation can adopt this guideline for their practice and give the feedback for further revision.

PURPOSE: The purpose of this study is to compare the clinical results of spleen preserving laparoscopic distal pancreatectomy (SPLDP) with en bloc laparoscopic distal pancreatectomy (LDP). METHODS: From March 2005 to August 2008, 52 cases of SPLDP and 84 LDPs were performed at our institution and we retrospectively compared these cases. The enrollment period were chronologically divided to four eras of 10.5 months each. RESULTS: The demographics, including the patients' age, gender and BMI, were not different between the two groups. The final pathologic diagnosis was diverse, and it included cystic tumor, SPT, IPMT, cancer, endocrine tumor, etc and there was no difference between the two groups. The tumor location, operative time, tumor size, perioperative transfusion requirement, the length of the hospital stay and the postoperative complications were not different between the two groups. The mean operative time was gradually shortened by eras (Era 1: 236.3 min, Era 2: 223.6 min, Era 3: 188.8 min, Era 4: 187.9 min) and the proportion of SPLDP was increased by eras from 1.9% to 9.6%, 42.3% and 46.2%, respectively. CONCLUSION: SPLDP might be technically more difficult than LDP, and especially in the initial learning stage of performing laparoscopic pancreatic surgery. After overcoming the learning curve, SPLDP can be performed safely and possibly within a shorter time. SPLDP should be tried whenever possible so that the patients get the maximal benefits of minimal invasive surgery and especially for resecting the more distal pancreatic lesions.
Demography ; Endocrine Gland Neoplasms ; Humans ; Laparoscopy ; Learning ; Learning Curve ; Length of Stay ; Operative Time ; Pancreatectomy ; Postoperative Complications ; Retrospective Studies ; Spleen

BACKGROUND: There is a wide spread increase in the use of CAM by patients with rheumatic disease. This study was performed to identify the prevalence of CAM use and determining factors affecting CAM use by patients with rheumatic disease. METHODS: From October 23 to November 31 in 2003, face-to-face structured interviews were conducted in a rheumatology hospital in Seoul. A total of 182 patients with rheumatic disease, who visited the hospital, participated. RESULTS: CAM was used by 59.3% (95% CI=52.1~66.2%) of the patients with rheumatic disease. The most common use of CAM was traditional Chinese medicine such as acupuncture and herbs. Demographic variables were not predictive for the use of CAM. As the duration of disease was longer, probability on CAM use was lower (odd ratio: 0.922, 95% CI=0.855~0.994). CAM use on disabled people who registered were 4.623 (95% CI=1.105~19.348) times higher than non-disabled. CONCLUSION: CAM use is common in patients with rheumatic disease. The duration of disease and physical disability were the influencing factors for using CAM. These findings support a need for outcome studies on the effectiveness of CAM in rheumatic disease, as well as the improvement of providing patients with information on CAM usage.
Acupuncture ; Complementary Therapies* ; Humans ; Korea* ; Medicine, Chinese Traditional ; Outcome Assessment (Health Care) ; Prevalence ; Rheumatic Diseases ; Rheumatology ; Seoul

BACKGROUND: There is a wide spread increase in the use of CAM by patients with rheumatic disease. This study was performed to identify the prevalence of CAM use and determining factors affecting CAM use by patients with rheumatic disease. METHODS: From October 23 to November 31 in 2003, face-to-face structured interviews were conducted in a rheumatology hospital in Seoul. A total of 182 patients with rheumatic disease, who visited the hospital, participated. RESULTS: CAM was used by 59.3% (95% CI=52.1~66.2%) of the patients with rheumatic disease. The most common use of CAM was traditional Chinese medicine such as acupuncture and herbs. Demographic variables were not predictive for the use of CAM. As the duration of disease was longer, probability on CAM use was lower (odd ratio: 0.922, 95% CI=0.855~0.994). CAM use on disabled people who registered were 4.623 (95% CI=1.105~19.348) times higher than non-disabled. CONCLUSION: CAM use is common in patients with rheumatic disease. The duration of disease and physical disability were the influencing factors for using CAM. These findings support a need for outcome studies on the effectiveness of CAM in rheumatic disease, as well as the improvement of providing patients with information on CAM usage.
Acupuncture ; Complementary Therapies* ; Humans ; Korea* ; Medicine, Chinese Traditional ; Outcome Assessment (Health Care) ; Prevalence ; Rheumatic Diseases ; Rheumatology ; Seoul