Search

Purpose: This study aimed to develop a nursing simulation learning module for coronavirus disease 2019 (COVID-19) patient-care and examine its effects on clinical reasoning competence, clinical competence, performance confidence, and anxiety in COVID-19 patient care for nursing students. Methods: A non-equivalent control group pre- and post-test design was employed. The study participants included 47 nursing students (23 in the experimental group and 24 in the control group) from G City. A simulation learning module for COVID-19 patient-care was developed based on the Jeffries simulation model. The module consisted of a briefing, simulation practice, and debriefing. The effects of the simulation module were measured using clinical reasoning competence, clinical competence, performance confidence, and anxiety in COVID-19 patient-care. Data were analyzed using χ²-test, Fisher's exact test, t-test, Wilcoxon signed-rank test, and Mann--Whitney U test. Results: The levels of clinical reasoning competence, clinical competence, and performance confidence of the experimental group were significantly higher than that of the control group, and the level of anxiety was significantly low after simulation learning. Conclusion: The nursing simulation learning module for COVID-19 patient-care is more effective than the traditional method in terms of improving students' clinical reasoning competence, clinical competence, and performance confidence, and reducing their anxiety. The module is expected to be useful for educational and clinical environments as an effective teaching and learning strategy to empower nursing competency and contribute to nursing education and clinical changes. [ABSTRACT FROM AUTHOR]

Purpose: This study aimed to evaluate the effectiveness of a customized health promotion program (CHPP) on depression, cognitive functioning, and physical health of elderly women living alone in the community. Methods: A randomized comparison of pre-and post-test design was used with 62 participants assigned to either an intervention (n=32 in seven clusters) or a control group (n=30 in seven clusters) in 14 areas of a town. The final sample included 30 intervention participants who completed the CHPP for 10 weeks, and 26 control participants. The intervention group participated in the CHPP weekly; they were provided with instructions about coping with their chronic illnesses, lifestyle modification, risk management, providing emotional support to each other, and floor-seated exercise, which they were encouraged to do three times a week in their homes. Results: Significant group differences were found in depression (U=48.50, p<.001), cognitive functioning (U=2.50, p<.001), left arm flexibility (U=251.50, p=.023), right arm flexibility (U=225.00, p=.007), static balance (U=237.00, p=.012), and gait ability (U=190.50, p=.004). However, there were no significant differences in bothgrip strength and muscle mass between the two groups. Conclusion: The findings indicate that CHPP was overall effective at improving depression, cognitive functioning, and physical functioning of elderly women living alone, and could therefore be considered a positive program for community-dwelling elderly women living alone. [ABSTRACT FROM AUTHOR]

Purpose: There is evidence that parent-child cohesion is a potentially influential factor in children's self-esteem and acculturation. However, no research to date has examined cohesion with parents as a potential pathway between Korean proficiency and self-esteem or acculturation among children from multicultural families. This study was done to address these limitations by examining whether and to what extent cohesion with parents mediated the effect of Korean proficiency on self-esteem and acculturation among children from multicultural families. Methods: Data were collected from a sample of 138 mothers and their children living in Seoul, Daegu, Kyungi province, and Kyungpook province. Multiple regression analysis was used to examine the relationships between the variables of interest. Mediation effects of cohesion with parents were tested by following the procedure recommended by Baron and Kenny (1986). Results: Cohesion with parents partially mediated the relationship between Korean proficiency and self-esteem. For children's acculturation, the effect of Korean proficiency was partially mediated through father-child cohesion. Mother-child cohesion completely mediated the relationship between Korean proficiency and acculturation. Conclusion: These findings suggest that to help children from multicultural families experiencing difficulties with self-esteem or acculturation, it might be useful to develop programs that are aimed at strengthen cohesion with parents. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study was to explore the experiences of Korean mothers in parenting children with Hunter's syndrome, an X linked recessive genetically inherited disease usually affecting boys. Methods: Data were collected from 14 mothers having children with Hunter's syndrome, through two focus group interviews and individual in-depth interviews. Qualitative data from the field notes and transcribed notes were analyzed using the grounded theory methodology developed by Strauss & Corbin (1998). Results: The core category about the process of rearing children with Hunter's syndrome was identified as "navigating in the maze". The process of rearing children with Hunter's syndrome passed through three phases; 'entering an unknown region', 'struggling to escape from the unknown region', 'settling down in the unknown region'. Conclusion: In this study "navigating in the maze", as the core category deeply showed joys and sorrows of mothers in the process of rearing their children with Hunter's syndrome. In this rearing process they gradually adjusted themselves to their given condition. Also they gained initiatively coping strategies to care for, and protect their children. Therefore health care providers can establish supportive programs in the clinical field to empower these mothers by reflecting their proactive coping strategies. [ABSTRACT FROM AUTHOR]

Purpose: This study was conducted to evaluate the effect of a one-session spouse-support enhancement childbirth education on childbirth self-efficacy and perception of childbirth experience. Methods: The design of this study was a nonequivalent control group pretest-posttest experiment. The participants in the study were 31 couples in the experimental group and 30 in the control group. The experimental couples were provided with one session on spouse-support enhancement childbirth education the night before delivery. Data were collected at two hours after delivery using the Childbirth Self-Efficacy Inventory (CBSEI) and perception of childbirth experience scale. Data were analyzed using PASW statistics 18 program. Frequencies, percentage, mean, x² test, t-test were used for data analysis. Results: Childbirth self-efficacy significantly increased in the experimental group as compared to the control group, but there was no significant difference in perception of childbirth experience in the experimental group compared to the control group. Conclusion: The results suggest that a one-session childbirth education has beneficial effects on enhancing childbirth self-efficacy in pregnant couples. A one-session spouse-support enhancement childbirth education is recommended as an effective nursing intervention to promote couple's childbirth self-efficacy and it is also recommended that modifications of program to promote women's childbirth experience should be considered. [ABSTRACT FROM AUTHOR]

Objectives Heavy metals eluted from mine waste pollute surrounding soil and water systems, which can spread to crops and have a harmful effect on the human body. The purpose of this study was to evaluate the feasibility of recycling discarded mussel shells(MS) and manila clam shells (MC) as stabilizers for the immobilization of arsenic(As) and heavy metals(Pb, Zn) in soil. Methods MS and MC were processed with -#10 mesh natural material, -#20 mesh natural material, and -#10 mesh calcined material and treated at 0-10 wt%. After 1 week or 4 weeks of wet curing, it was eluted with 0.1 N HCl and the concentrations of As, Pb, and Zn in the soil were analyzed through inductively coupled plasma optical emission spectroscopy(ICP-OES) analysis. In addition, red lettuce was cultivated in the stabilized soil and the concentration of heavy metals that were transferred to crops was evaluated. The stabilization mechanism was investigated by scanning electron microscopy-energy dispersive X-ray spectroscopy(SEM-EDX) analysis. Results and Discussion The stabilization efficiency for arsenic and heavy metals was in the order of natural -#10 mesh < natural -#20 mesh < calcined -#10 mesh. The calcined stabilizer showed a high stabilization efficiency of 98% at a 2 wt% treatment level. Pb was not detected in the red lettuce grown in the stabiliz ed soil, and the standard for leafy vegetables (Pb-0.3 mg/kg or less) was satisfied according to the Ministry of Food and Drug Safety. The SEM-EDX analysis revealed that As was stabilized through Ca-As precipitation and heavy metals(Pb, Zn) were stabilized through pozzolanic reactions. Conclusion Stabilizers developed from MS and MC can be effectively applied to the stabilization of As and heavy metal-contaminated soil, and are expected to be used as economical and environmentally friendly stabilizers.

Background Osteoporosis is the most common metabolic bone disease and can cause fragility fractures. Despite this, screening utilization rates for osteoporosis remain low among populations at risk. Automated bone mineral density (BMD) estimation using computed tomography (CT) can help bridge this gap and serve as an alternative screening method to dual-energy X-ray absorptiometry (DXA). Methods The feasibility of an opportunistic and population agnostic screening method for osteoporosis using abdominal CT scans without bone densitometry phantom-based calibration was investigated in this retrospective study. A total of 268 abdominal CT-DXA pairs and 99 abdominal CT studies without DXA scores were obtained from an oncology specialty clinic in the Republic of Korea. The center axial CT slices from the L1, L2, L3, and L4 lumbar vertebrae were annotated with the CT slice level and spine segmentation labels for each subject. Deep learning models were trained to localize the center axial slice from the CT scan of the torso, segment the vertebral bone, and estimate BMD for the top four lumbar vertebrae. Results Automated vertebra-level DXA measurements showed a mean absolute error (MAE) of 0.079, Pearson’s r of 0.852 (P

Background Coronary artery calcification (CAC) is highly prevalent in patients with chronic kidney disease (CKD) and is associated with major adverse cardiovascular events and metabolic disturbances. The triglyceride-glucose index (TyGI), a novel surrogate marker of metabolic syndrome and insulin resistance, is associated with CAC in the general population and in patients with diabetes. This study investigated the association between the TyGI and CAC progression in patients with CKD, which is unknown. Methods A total of 1,154 patients with CKD (grades 1–5; age, 52.8 ± 11.9 years; male, 688 [59.6%]) were enrolled from the KNOW-CKD (KoreaN Cohort Study for Outcomes in Patients With Chronic Kidney Disease). The TyGI was calculated as follows: ln (fasting triglycerides × fasting glucose/2). Patients were classified into tertiles (low, intermediate, high) based on the TyGI. The primary outcome was annualized percentage change in CAC score [(percent change in CAC score + 1)12/follow-up months – 1] of ≥15%, defined as CAC progression. Results During the 4-year follow-up, the percentage of patients with CAC progression increased across TyGI groups (28.6%, 37.5%, and 46.2% in low, intermediate, and high groups, respectively; p < 0.001). A high TyGI was associated with an increased risk of CAC progression (odds ratio [OR], 2.11; 95% confidence interval [CI], 1.14–3.88; p = 0.02) compared to the low group. Moreover, a 1-point increase in the TyGI was related to increased risk of CAC progression (OR, 1.55; 95% CI, 1.06–1.76; p = 0.02) after adjustment. Conclusion A high TyGI may be a useful predictor of CAC progression in CKD.

Objectives In this study, the absorption of heavy metals in the soil from smoking areas using indoor plants and electrical grounding was investigated to increase the utility of indoor plants for soil decontamination. Methods Soil from plant pots in a smoking area was collected for the experimental plant pot preparations. Some of the prepared pots were connected to electrical ground via an electrode. Kidney beans (Phaseolus vulgaris) were seeded, and their growth were observed. After 30 days of the cultivation, TOC (Total Organic Carbon), and metagenomics profiles in the soil was analyzed. To estimate the behavior of the heavy metals in soil and plants, Cadmium concentrations in the samples were analyzed using ICP-MS (Inductively Coupled Plasma-Mass Spectrometry). Results and Discussion The connection of the electrical ground to the plant pot induced the rapid growth of plant (48.2 ± 2.3% increase in stem growth), compare to the plant in the pot without the electrical ground. TOC analysis showed that the soil from the grounded pots showed the highest value, compared to the control soil (3.08 ± 1.22%), and the soil from the pot without ground connection (2.3 ± 0.1%). The ICP-MS analysis indicated that the plant body in the grounded pot had the highest cadmium concentration at 0.33 ± 0.018 μg/kg. Using the metagenomic analysis, biomineralization related bacterial species (Nocardioides sp., Streptomyces sp., Sphingomonas sp. etc.) were identified from the grounded soil sample. These results suggested that the indoor plant cultivation with the electrical ground connection as an electrical fertilizer enhances the cadmium absorption by plant, exudate secretion from the plant root, and bacterial flora change in the rhizosphere. Conclusion Cadmium in the soil from the smoking area was absorbed by indoor plant with the electrical ground. Therefore, the application of the electrical ground connection (earth) to the electrically insulated outdoor plant pots might enhance the plant growth rate and physiological activity. This application could be a novel soil decontamination method using plants.

Background Health Insurance Review and Assessment Service’s (HIRA) claims data have been used in studies of hemodialysis patients even though information about mortality is not provided in this database. Mortality analysis using HIRA data has been conducted using various operational definitions that have not been validated. This study aimed to validate operational definitions of mortality for maintenance hemodialysis patients that have been used when analyzing the Korean HIRA database. Methods This study utilized claims data of the Korean National Health Insurance Service (NHIS) between January 2008 and December 2019. We estimated mortality based on operational definitions applied in previous studies using the HIRA database and compared it with NHIS mortality information to validate accuracy. Results A total of 128,876 patients who started maintenance hemodialysis between January 2009 and December 2019 were analyzed. The accuracy of estimated mortality was the highest at 96% in the group where mortality was defined as an absence of claims data for 150 days. If the period of no claims data was set to 90 days or less, there was a risk of overestimating the mortality for the entire study period. When it was set to 180 days or more, there was a risk of underestimating the mortality, as the follow-up time was close to the end of the study period. Conclusion When mortality analysis of maintenance hemodialysis patients is performed using HIRA data, it is most accurate to set the operational definition period as the absence of claims data for 150 days.

In July 2020, total RNA was extracted from passion fruit (Passiflora edulis) leaves showing virus symptoms such as chlorotic spots and vein banding in Haenam, South Korea. Cucumber mosaic virus (CMV)-HN2 was identified through reverse transcription polymerase chain reaction and sequencing analysis. To confirm the biological characteristics of the CMV infecting passion fruit, 10 indicator plants were inoculated with CMV-HN2, and the results showed a typical CMV symptoms. Phylogenetic analysis based on the amino acid of the coat protein (CP) of CMVs revealed that the CMV passion fruit isolates belonged to subgroup I, among which CMV-HN2 belonged to subgroup IA. Additionally, CMVs isolated from passion fruit in Korea have amino acid sequence variation between the subgroup. Among them, CMV-HN2 had four to eight amino acid differences in CP from other CMV isolates from passion fruit. These results confirm the presence of genetic diversity in the CPs of passion fruit CMV isolates.

Objectives The soil around waste mine sites can be contaminated with heavy metals by mine tailings and leachate, and heavy metals can accumulate in the body through crops harvested from contaminated soil. The stabilization method is often applied to the restoration of contaminated soil around abandoned mines, but it is necessary to develop natural stabilizers that are not harmful to the environment. In this study, starfish(Asterina pectinifera) and cockle shells were evaluated as stabilizers for arsenic and heavy metal(Pb, Zn) contaminated soil. Methods Starfish and cockle shells were processed into -#10 mesh, -#20 mesh, and calcined (900°C, 2hr) -#10 mesh to evaluate their characteristics through XRD and XRF analyses. The stabilized soil was eluted at 0.1 N HCl. Then the stabilization efficiency was evaluated with ICP-OES analysis, and the stabilization mechanism was identified with SEM-EDX analysis. Afterwards, lettuce was cultivated in the stabilized soil and the concentration of heavy metals transferred from the soil to the lettuce was evaluated. Results and Discussion The calcination process converts the CaCO3 in the natural stabilizer into CaO. Arsenic and heavy metals are effectively immobilized within the soil through pozzolanic reactions and Ca-As precipitation. Nitric acid decomposition of lettuce grown in the stabilized soil demonstrated the absence of arsenic, meeting the safety standards outlined in the Korean Food Standard Codex. Conclusion The stabilization of soil contaminated with arsenic and heavy metals by starfish and cockle shell was confirmed to be attributed to pozzolanic reactions and the formation of insoluble precipitates. In addition, they could be used as natural waste stabilizers based on their high calcium carbonate content.

The indolent nature and favorable outcomes associated with papillary thyroid microcarcinoma have prompted numerous prospective studies on active surveillance (AS) and its adoption as an alternative to immediate surgery in managing low-risk thyroid cancer. This article reviews the current status of AS, as outlined in various international practice guidelines. AS is typically recommended for tumors that measure 1 cm or less in diameter and do not exhibit aggressive subtypes on cytology, extrathyroidal extension, lymph node metastasis, or distant metastasis. To determine the most appropriate candidates for AS, factors such as tumor size, location, multiplicity, and ultrasound findings are considered, along with patient characteristics like medical condition, age, and family history. Moreover, shared decision-making, which includes patient-reported outcomes such as quality of life and cost-effectiveness, is essential. During AS, patients undergo regular ultrasound examinations to monitor for signs of disease progression, including tumor growth, extrathyroidal extension, or lymph node metastasis. In conclusion, while AS is a feasible and reliable approach for managing low-risk thyroid cancer, it requires careful patient selection, effective communication for shared decision-making, standardized follow-up protocols, and a clear definition of disease progression.

According to our previous study, 500 species of yeast exist in Korea, including nine variants comprising 142 genera and 48 classes in two phyla. Additionally, 4,483 fungal species have been documented at the National Institute of Biological Resources (NIBR). However, despite the industrial use of several yeasts, only 173 species formed part of the National Species List of Korea (NSLK) as of December 2021, mainly due to the lack of taxonomic descriptions. This study aimed to investigate the taxonomy of seven newly isolated yeast species (Hyphopichia burtonii, Starmerella sorbosivorans, Cyberlindnera mycetangii, Cutaneotrichosporon oleaginosum, Nakazawaea ernobii, Pichia kudriavzevii, and Schizosaccharomyces japonicus) for inclusion in the NSLK. The strains were clustered for the phylogenetic analysis of fungal rDNA (D1/D2-26S) sequences. This study provides descriptions of their cell morphology and physiological characteristics, the results of which confirm the indigenous origin of these seven species in Korea and recommend their inclusion in the NSLK.

Background: The purpose of this study is to investigate the tooth whitening effect of Listerine Healthy White and provide effective management of extrinsic discoloration by comparing the whitening effects of existing whitening products.Methods: The included study four groups: those using whitening gel, whitening toothpaste, and Listerine Healthy White and a control using artificial saliva. Each group received 40 bovine tooth specimens, which were stained with commonly consumed tooth-coloring-inducing foods; black tea, black coffee, and instant noodles for 72 hours. The specimens were treated with tooth whitening materials for 5 weeks, after which the lightness (L*) was measured weekly using a spectrophotometer. Results: There was a significant difference in lightness among the groups between the 1st and 5th week of treatment for all tooth-coloring-inducing foods (p＜0.05). When comparing the changes in lightness values from before whitening to the 5th week of whitening for all tooth-coloring-inducing foods, the order of change was as follows: whitening gel, whitening toothpaste, Listerine Healthy White, and artificial saliva. Listerine Healthy White showed a significant whitening effect for all tooth- coloring-inducing foods (p＜0.05). Particularly, changes in lightness values for specimens stained by black tea after 5 weeks of whitening were in the following order: whitening gel (21.72), whitening toothpaste (14.89), Listerine Healthy White (12.91), and artificial saliva (3.85). For specimens stained by black coffee, the changes in lightness values were in the following order: whitening gel (12.99), whitening toothpaste (9.66), Listerine Healthy White (7.91), and artificial saliva (3.12). Lastly, changes in lightness values for specimens stained by instant noodles were as follows: whitening gel (10.84), whitening toothpaste (9.85), Listerine Healthy White (7.71), and artificial saliva (2.61). Conclusion: Listerine Healthy White exhibits continuous whitening effects over time, and for consumers seeking convenient ways to achieve tooth whitening effects at home, consistent use of Listerine Healthy White is recommended.

This study was conducted to analyze the distribution and characteristics of fungal species in meju using the traditional method. Fungal distribution in meju was investigated using metagenomic and morphological analyses, based on which Aspergillus flavus/oryzae strains were identified as the dominant fungi in all meju samples, followed by Pichia, Rhizopus and Lichtheimia spp. As A. flavus/oryzae was dominant, we further evaluated the aflatoxin production ability and enzymatic activity of the isolates. Thin-layer chromatography and polymerase chain reaction revealed that the A. flavus/oryzae strains isolated from meju are non-aflatoxigenic fungi. Based on the analyses of amylase and protease activities, strains with high activities of amylase or protease were identified, which are proposed to be used as starters for meju fermentation.

OBJECTIVES The purpose of this study is to identify the effects of differences in muscle function training of Taekwondo sparring athletes on body composition, basic physical fitness, isokinetic muscle function, and electronic hogu hitting ability, and to present basic data for a training program for Taekwondo sparring athletes. METHODS This study randomly sampled 25(M: 20, F: 5) Taekwondo sparring athletes. The sampled subjects were divided into a weight training group (n=8), a plyometric training(plyometric) group (n=8), and a control group (n=9) and trained for 60 minutes, 5 times a week, for 12 weeks. Body composition, basic physical fitness, isokinetic muscle function, and electronic hogu hitting ability were evaluated before and after training. Statistical tests of RM Two-way ANOVA were conducted to verify the interaction between groups and times, main effects of times, and main effects between groups according to 12 weeks of training. Post-hoc was conducted using paired-T test(times) and One-way ANOVA test(groups). RESULTS Taekwondo sparring athletes showed positive changes in body composition(weight, BMI, Lean body mass, % body fat, WHR), basic physical fitness(muscle endurance, flexibility), isokinetic muscle function(knee endurance, low back strength), and electronic hogu hitting ability(round house kick, Turning back kick, number of hit) after participating in weight training for 12 weeks (All p

Background: This study investigated the effects of positive psychological capital on the relationship between emotional labor and job satisfaction among dental hygienists.Methods: Data were collected from 296 dental hygienists working at clinical sites in Korea between July 25 and August 15, 2022. Participants were surveyed using structured questionnaires. Statistical analysis was performed using an independent t-test, ANOVA, descriptive statistics, and stepwise multiple regression analysis using SPSS/WIN 21.0. The mediating effect of positive psychological capital on the relationship between emotional labor and job satisfaction was tested using Baron and Kenny’s 3-step hierarchical regression analysis. Results: Emotional labor was negatively correlated with positive psychological capital (r=−0.148, p=0.011) and job satisfaction (r=−0.214, p＜0.001). Positive psychological capital had a positive correlation with job satisfaction (r=0.441, p＜0.001). In addition, the positive psychological capital, had a partial mediating effect (z=−2.472, p=0.013) on the relationship between emotional labor and job satisfaction. Conclusion: Attitudes that reduce emotional labor, which adversely affects job satisfaction, and bolster positive psychological capital are needed.

Adult-onset Alexander Disease (AOAD) is a rare genetically determined leukoencephalopathy that presents with ataxia, spastic paraparesis, or brain stem signs including speech abnormalities, swallowing difficulties, and frequent vomiting. The diagnosis of AOAD is frequently proposed based on the findings on MRI. We demonstrate two cases (37-year-old female and 61-year-old female) with characteristic imaging findings and changes in follow-up MRI in patients with AOAD, which were confirmed via glial fibrillary acidic protein (GFAP ) mutation analysis. On MRI, the typical tadpole-like brainstem atrophy and periventricular white matter abnormalities were noted. The presumptive diagnoses were made based on the typical MRI appearances and, subsequently, confirmed via GFAP mutation analysis. Follow-up MRI demonstrated the progression of atrophy in the medulla and upper cervical spinal cord. Our report could help raise awareness of characteristic MRI findings of AOAD, thus helping clinicians use GFAP analysis for AOAD diagnosis confirmation.

Objectives To confirm both efficiency and sustainability of algal growth inhibition, various laboratory-scale experiments were conducted and the growth inhibitory effect of Microcystis aeruginosa (M. aeruginosa) was investigated through ultrasonic re-irradiation during the regrowth period after the first ultrasound irradiation. Methods Experiments with different times of irradiation [i.e., control group A (0 hr), experimental group B (2 hr) applied with only the first ultrasound irradiation, and experimental group C (0.5 hr), D (1 hr), and E (1.5 hr) applied with both first and second irradiations] were performed. Results and Discussion As a result of both Chlorophyll-a (Chl-a) concentration and cell number of M. aeruginosa, the experimental group (B) with only first ultrasound irradiation (2 hr) displayed rapid regrowth of algae after initial decrease whereas the experimental group (C, D, and E) with both first ultrasound irradiation (2 hr) and second ultrasound irradiation (0.5 hr, 1 hr, and 1.5 hr) confirmed the delay of algae regrowth. Based on the specific growth rate constant (µ) and first order decay rate constant (k), algal growth from the experimental groups (C, D, E) with the secondary ultrasound irradiation was more significantly inhibited due to repetitive inactivation of algae growth. According to the SEM and TEM results, damages to algae cells were clearly observed under the influence of ultrasound, and both decrease in gas vesicles and rupture of cell membrane in M. aeruginosa were also monitored. Conclusion Through this study, the algae growth inhibitory effect by ultrasonic irradiations was confirmed, and the re-irradiation of ultrasound contributed to the repetitive inactivation of algae growth, indicating that the second ultrasonic irradiation time required to inhibit algal regrowth can be reduced compared to the first irradiation. Therefore, periodic ultrasonic irradiation is required for long-term inhibition of algae growth in stagnant waters, but the appropriate frequency of ultrasonic irradiation may vary depending on the influence of various complex factors such as the size of the stagnant waters, the frequency of algal blooms, water temperature, light irradiation, nutrients, flow rate, etc. Finally, many field studies under various conditions are warranted to establish an optimized ultrasound irradiation protocol.

Background: The purpose of this study was to investigate the effect of salad dressings on the flowable composite resin surface and the erosion-inhibitory effect of calcium.Methods: The experiment included six groups: oriental dressing, balsamic dressing, lemon-garlic dressing, lemon-garlic dressing supplemented with 3% calcium, mineral water as a negative control group, and orange juice as a positive control group. pH and titratable acidity were measured. The prepared specimens were immersed in the experimental solutions for 1, 3, 5, 15, and 30 minutes. The surface microhardness was measured using the Vickers hardness number before and after the treatment, and the surface of the specimens was observed using a scanning electron microscope (SEM). Results: The pH values of the experimental groups in increasing order were as follows: lemon-garlic dressing (2.49±0.03), balsamic dressing (3.12±0.06), lemon-garlic dressing ＋3% calcium (3.27±0.09), oriental dressing (3.75±0.03), orange juice (3.82±0.02), and mineral water (7.32±0.16). The largest surface hardness reduction value was shown in lemon-garlic dressing (−9.61±1.16), followed by balsamic dressing (−9.17±1.63), oriental dressing (−8.62±1.09), orange juice (−8.19±1.36), lemon-garlic dressing +3% calcium (−6.76±1.23), and mineral water (−1.63±2.47). According to the SEM findings, the experimental and positive control groups showed rough surfaces and micropores, whereas the negative control group showed a smooth surface. Moreover, the lemon-garlic dressing with +3% calcium showed fewer micropores and a smoother surface than the lemon-garlic dressing. Conclusion: The intake of salad dressings at a low pH could weaken the surface microhardness of the flowable composite resin. However, adding calcium to these salad dressings can reduce the risk of microhardness reduction on the flowable composite resin surface.

Background: The purpose of this study is to investigate the pro-con of re-implementation by administrative areas and the difference in perception of community water fluoridation in implemented and non-implemented areas after the community water fluoridation in Korea was suspended. Through this, we intend to provide basic data that can help find ways to increase the support and interest of local residents.Methods: The 601 questionnaires collected through the survey and statistical analysis was conducted using SPSS Statistics 28.0. Results: As a result of analyzing the perception of the community water fluoridation according to the understanding of fluorine, the proportion of people who were not recognized by both fluorine and community water fluoridation was the highest (p＜0.05). As a result of the analysis of the pro-con of re-implementation of community water fluoridation, the approval was high. Among those who responded in favor, the place of re-implementation showed that ‘implementation nationwide’ was high. As for the reason for favor, it was found that it was possible to prevent dental caries disease. The reason for the objection was the lack of knowledge about fluoride. Conclusion: The results of the survey for the pro-con of the re-implementation of community water fluoridation showed a higher degree of ‘agree’ and showed that people in the area where community water fluoridation was not implemented showed higher interest in oral health prevention and management. Through this, not only oral education, but also correct information on the implementation method of community water fluoridation, the benefits of community water fluoridation, and the facts that were misunderstood in the past, as well as oral education, can be provided to raise interest in community water fluoridation. It is thought that the expected effect of the re-implementation of community water fluoridation can be obtained if such activities are carried out.

Background This study investigated the diagnostic performance of biopsy criteria in four society ultrasonography risk stratification systems (RSSs) for thyroid nodules, including the 2021 Korean (K)-Thyroid Imaging Reporting and Data System (TIRADS). Methods The Ovid-MEDLINE, Embase, Cochrane, and KoreaMed databases were searched and a manual search was conducted to identify original articles investigating the diagnostic performance of biopsy criteria for thyroid nodules (≥1 cm) in four widely used society RSSs. Results Eleven articles were included. The pooled sensitivity and specificity were 82% (95% confidence interval [CI], 74% to 87%) and 60% (95% CI, 52% to 67%) for the American College of Radiology (ACR)-TIRADS, 89% (95% CI, 85% to 93%) and 34% (95% CI, 26% to 42%) for the American Thyroid Association (ATA) system, 88% (95% CI, 81% to 92%) and 42% (95% CI, 22% to 67%) for the European (EU)-TIRADS, and 96% (95% CI, 94% to 97%) and 21% (95% CI, 17% to 25%) for the 2016 K-TIRADS. The sensitivity and specificity were 76% (95% CI, 74% to 79%) and 50% (95% CI, 49% to 52%) for the 2021 K-TIRADS1.5 (1.5-cm size cut-off for intermediate-suspicion nodules). The pooled unnecessary biopsy rates of the ACR-TIRADS, ATA system, EU-TIRADS, and 2016 K-TIRADS were 41% (95% CI, 32% to 49%), 65% (95% CI, 56% to 74%), 68% (95% CI, 60% to 75%), and 79% (95% CI, 74% to 83%), respectively. The unnecessary biopsy rate was 50% (95% CI, 47% to 53%) for the 2021 K-TIRADS1.5. Conclusion The unnecessary biopsy rate of the 2021 K-TIRADS1.5 was substantially lower than that of the 2016 K-TIRADS and comparable to that of the ACR-TIRADS. The 2021 K-TIRADS may help reduce potential harm due to unnecessary biopsies.

Objectives In order to recycle and resource waste glass, the feasibility of foam glass as filter media was evaluated, and column experiments using foam glass media were conducted to confirm the applicability as filter media in rain garden. Through this experiment, various design factors to be considered can be derived in application of foam glass media in the rain garden. Methods Sieve analysis and SEM/EDS analysis were conducted to confirm the physicochemical properties of the foam glass. Column experiments filled with only foam glass and mixtures of sand and foam glass were conducted to simulate rain garden to evaluate the removal efficiency of suspended solids and turbidity using the foam glass media, head difference (Δh) and hydraulic conductivity (K) changes, and calculation of filtered suspended solids loading using both discrete and cumulative mass approach. Finally, comparison of filtration performance with various filter media used in LID facilities was performed to evaluate the feasibility of foam glass media in rain garden. Results and Discussion Since foam glass media has a lower density than water, homogeneous particle size, and smooth surface with pores of various sizes, foam glass media effectively induces internal capture and external adsorption of suspended solids. Foam glass media has been applied to high suspended solids and turbidity removal efficiency. As the suspended solids inflow load increased, clogging occurred in the pores and the removal efficiency gradually decreased, but the foam glass media with lower density than water was continuously disturbed and rearranged due to the head difference energy, and some clogging were alleviated by rearrangement of pores and channels. The load of suspended solids in precipitated, adsorbed, and retained on the foam glass was calculated using the effluent sample (discrete) collected at regular time intervals and the continuously accumulated sample (cumulative) from the output. The filtered suspended solids load calculated using the cumulative mass approach was higher due to the estimation of the amounts of suspended solids remaining in the filtration column is lower because the samples (discrete) collected at regular time intervals from the output do not reflect the amount of suspended solids that change over time. Thus, the amounts of suspended solids removed through the filtration process can be much more accurately estimated using the cumulative samples. Finally, when comparing the removal efficiency with other filter media, foam glass can be used as excellent filter media with higher removal efficiency and greater lifespan. Conclusion Foam glass media with smooth surface, pores of various sizes, and lower density than water can rearrange and regenerate pores to alleviate some clogging, resulting in high suspended solids and turbidity removal efficiency for a long period of time. Considering that the amount of suspended solids filtered is determined by various factors such as particle size and distribution, porosity, depth, linear velocity, and inflow load of the suspended solids, the feasibility test using foam glass media through long-term field experiments is warranted. The amounts of suspended solids removed through the filtration process can be much more accurately estimated using the cumulative samples.

Background: This study analyzed the practice of dental medical dispute prevention rules of dental hygienists to present an improvement plan for improving perceived importance and practice and provide data for the development of effective medical dispute prevention programs.Methods: A self-administered questionnaire survey was conducted targeting dental hygienists who were providing assistance at dental hospitals and dental clinics in Seoul and Gyeonggi-do regions from March 22 to April 28, 2022. The questionnaire collected from 273 dental hygienists consisted of eight questions on general characteristics, 30 questions on medical dispute experience, and 14 questions on medical dispute prevention. Results: Complaints showed a high experience rate in ‘Consultation & reservation’, medical disputes in ‘Patient handling (unkind) related’, and ‘Prosthesis installation and cement removal’. In both the importance and practice of medical dispute prevention rules, ‘Preservation of medical records and other medical-related data’ was high, and ‘Management of patients on standby for a long time’ was low in terms of practice. ‘Lack of time’ and ‘Lack of manpower’ were cited as reasons for not resolving dental treatment disputes. The importance of dental dispute prevention rules was found to be significant according to age and position, and it was also found to affect the level of practice. Conclusion: Seventy-six-point six percent of the respondents said that education on the prevention of medical disputes was necessary, although they lacked recognition of prevention rules compared to their perceptions and experiences. This study suggested specifying prevention rules in dental hygiene subjects and expanding education, improvement of dental treatment system, revise the law on the range of work to improve the recognition and practice of prevention rules.

PURPOSE Neuromarketing measures and analyzes the unconscious response of consumer brain waves to marketing stimuli in real time. This study examined how a sensational scene (accident) in a sport game influences the sponsorship effects through electroencephalography (EEG) analysis. METHODS The current study uses an experimental method. First, as an experimental stimulus, a video of F1 racing edited in a total of 9 min and 39 s was used, and an accident scene was inserted in the middle of the video. A total of 46 people participated in the experiment, and all participants watched the F1 video, including the accident scene. Participants' brain waves were observed in two prefrontal and two occipital lobes. The relationship between scene sensation and sponsorship effect was analyzed based on alpha waves and the sponsor brand recall measured by questionnaires. RESULTS First, the accident scene of the race caused the power of alpha wave to be abruptly reduced (i.e., alpha blocking). Second, the difference between the alpha power level of the group that recalled the sponsor brand and that of the group that did not recall was statistically insignificant; hence, the hypothesis was rejected. Third, the right-brain dominance (negative emotion) in the accident scene of the race was statistically insignificant; therefore, the hypothesis was rejected. Finally, the group that recalled the sponsor brand showed a left-brain dominance (positive emotion), which was statistically significant. CONCLUSIONS This study confirmed the marketing communication and neuromarketing theories on the sponsorship effects created by stimulation, attention, and memory in a sport sponsorship setting, observing alpha blocking phenomena in a sensational scene (accidents). In addition, it was revealed that the group that watched the same accident scene relatively positively and exited remembered the sponsor brand better than the group that did not watch it. The result implied that sport fan’s personal trait (e.g., sensation seeking) to sensation in sponsorship activities affects the sponsorship effect. The results also emphasized the importance of selecting target customers of sports fans in sponsorship to maximize sponsorship effects.

Common carotid artery (CCA) rupture during parathyroid cancer surgery is extremely rare and is generally life-threatening. We present a case of successful management of a ruptured CCA following the emergency placement of stent-graft in a 59-year-old male diagnosed with recurrent parathyroid cancer. During recurrent parathyroid cancer surgery, his right CCA ruptured unexpectedly, and his vital signs deteriorated rapidly despite surgical management. After stent replacement, his unstable vital signs improved and, thereafter, he was discharged without any complications.

Purpose Wieacker-Wolff syndrome is a rare disease caused by X-linked zinc finger C4H2-type containing (ZC4H2) mutations. It is characterized by arthrogryposis multiplex congenita (AMC) and intellectual disability (ID), including impairment of central and peripheral synaptic plasticity. Currently, it is named “ZC4H2-associated rare disease” (ZARD) due to various clinical features other than AMC and ID. Here, we report six cases of ZARD, and describe their variable clinical phenotypes. Methods We analyzed the detailed clinical features and genotypes of six patients diagnosed by whole-exome sequencing or a chromosomal microarray. Results In the four male patients, hemizygous mutations were found (c. 245A>C in two patients, c. 610C>A in one patient, and c.637C>T in one patient), and all variants were identified by Sanger sequencing. In the female patients, a 1.16-Mb deletion in Xq11.2, including ZC4H2, was identified by chromosomal microarray. All patients had heterogeneous phenotypes with variable severities. Motor delay was observed in all patients, four of whom could not walk independently. Other neurological features included ID, spasticity, and seizures. The craniofacial features included microcephaly, low-set ears, strabismus, ptosis, ocular motor apraxia, a U-shaped upper lip vermilion, short neck, and microretrognathia. The most common musculoskeletal symptoms were multiple arthrogryposis: metacarpophalangeal joint contracture, clubfoot, distal muscle weakness, Achilles tendon contracture, knee flexion contracture, camptodactyly, elbow flexion contracture, and hip subluxation. Conclusion The ZARD phenotypes were prominent in male patients, and female patients with loss of function showed more severe symptoms. Further research is needed to clarify phenotypic variability in this rare disorder.

Background Radioactive iodine (RAI) therapy is a successful therapeutic modality for Graves’ disease. However, RAI therapy can fail, and RAI therapy after antithyroid drugs (ATDs) has a lower remission rate. Therefore, many patients require repeated RAI therapy. This study investigated the clinical outcomes of repeated RAI therapy for Graves’ disease. Methods Patients who underwent RAI therapy as second-line therapy after failure of ATD treatment between 2001 and 2015 were reviewed. Remission was defined as hypothyroid or euthyroid status without ATD, and with or without levothyroxine at 12 months after RAI therapy. Results The 1-year remission rate after 2nd RAI therapy (66%, 152/230) is significantly higher than that after 1st RAI therapy (48%, 393/815) or long-term ATD treatment after 1st RAI therapy failure (42%). The clinical response to 2nd RAI therapy was more rapid. The median time intervals from the 2nd RAI therapy to ATD discontinuation (1.3 months) and to the start of levothyroxine replacement (2.5 months) were significantly shorter than those for the 1st RAI therapy. A smaller goiter size, a longer time interval between the 1st and 2nd RAI therapies, and a longer ATD discontinuation period predicted remission after the 2nd RAI therapy. Finally, in 78 patients who failed the 2nd RAI therapy, the mean ATD dosage significantly reduced 5.1 mg over 12 months. Conclusion Repeated RAI therapy can be a good therapeutic option, especially in patients with smaller goiters and those who are more responsive to the 1st RAI therapy.

Purpose To evaluate the effectiveness of the transradial artery approach (TRA) for treating malfunctioning arteriovenous fistulas (AVFs) in patients on hemodialysis. Materials and Methods A retrospective analysis was conducted in this single-center study of TRA endovascular procedures in 73 patients (43 male and 30 female; mean age of 67.4 years (range, 42–92 years) with malfunctioning AVFs, between January 2008 and April 2019. Patients’ baseline and lesion characteristics, technical and clinical success, and complications were evaluated, and functional patency was analyzed using the Kaplan-Meier method. Results Radial artery approaches were successful in all patients. Angioplasty performed using the TRA achieved technical and clinical success rates of 98.6%(72/73) and 91.7%(67/73), respectively. The median primary patency time was 18.8 ± 15.9 months. The primary functional patency rates at 3, 6, and 12 months were 82.1%, 68.6%, and 63.9%, respectively. There were no major complications or adverse events, such as hand ischemia, related to the radial artery approach. Conclusion In selected cases, the TRA can be used complementary to the transvenous approach to treat malfunctioning AVFs.

Objectives The optimal ultrasonic irradiation conditions were derived through laboratory-scale experiments to evaluate growth inhibition effect of Microcystis aeruginosa (M. aeruginosa), which is the main specie of Cyanobacterial Harmful Algal Blooms (CyanoHABs) in Republic of Korea. Methods The experiment was conducted by changing ultrasonic frequency, intensity, and initial cell concentration to observe the growth inhibition effect of M. aerginosa. The experiment was performed using shielded acrylic reactor [20 cm (W) × 20 cm (L) × 30 cm (H)]. Experiments were conducted using large volume (7.2 L) of water samples with high concentrations of M. aeruginosa, and the ultrasonic irradiation time was fixed at 3 hours. Results and Discussion In all experiments, pictorial view of M. aeruginosa samples, chlorophyll-a (Chl-a) and cell number of M. aerginosa were observed. As a result of ultrasonic irradiation on M. aeruginosa, the decrease in both Chl-a concentration and cell number of M. aeruginosa was monitored after sonication compared to the decrease during sonication. In addition, the rebound growth was confirmed after certain period of growth inhibition of M. aeruginosa. The optimal ultrasonic irradiation conditions for the growth inhibition of M. aeruginosa were obtained at the lower frequency and the higher intensity. Whereas algal growth inhibition was observed with high concentration (4.5 × 106 cells mL-1) of M. aeruginosa, algal growth inhibition was not monitored with low concentration (1.1 × 106 cells mL-1) of M. aeruginosa. Conclusion Through this study, the algal growth inhibition by ultrasonic was effective. Although the growth inhibition effect persisted for a certain period of time, subsequent regrowth was observed. Therefore, periodic ultrasonic irradiation is necessary for long-term growth inhibition of algal in field applications.

The liberation period in Korea was when creative imagination and various debates existed about plans for political, economic, and social systems. Among them was the debate over the national health security underlying the social safety net. Although the US influenced the Korean health security after liberation, major political groups on the Korean peninsula also expressed various opinions. However, previous studies have shown little interest in national health security, which operates the public health and medical care systems. To overcome these limitations, this study focuses on the ideas on national health security presented by major political groups, analyzing the reply proposal of “Jŏnpyŏng” and the health care proposal of the US military government, which has not been reviewed before. The opinions of major political groups including the right-wing Im-hyŏp and left-wing Min-chŏn diverged on national health security issue regarding insurance coverage, measures to secure financial resources, items of insurance benefits, and measures to stabilize the supply and demand of medical personnel. The claims of the US military government can be understood by “Labor Problems and Policies in Korea (Korean Subcommittee),” “Korean Labor Report (Stewart Meacham),” and “Proposed Political Platform Provisional Korean Democratic Government (Sub-commission #2).” The major political groups and the US military government agreed on the need for social protection against death, old age, disability, disease, injury, and unemployment. All of them claimed national health security, in which the roles of the private sector and the government were mixed, should be gradually introduced. The major political groups, in particular, proposed to (1) set workers as beneficiaries of insurance, (2) share financial resources jointly among the state, employers, and workers, and (3) promote the expansion of the number of doctors and medical institutions and prefer cooperative operations of the hospitals established in small administrative units. This paper argues that the ideas on national health security during the liberation period did not completely deviate from the global trend immediately after World War II when countries tried to expand the number of people covered by national health security and strengthen its coverage. Although these ideas were not fully reflected in the Constitution of 1948, it is significant in that the Constitution codified for the first time the state’s responsibility for those who have no ability for living due to their health conditions.

Purpose To develop a denoising convolutional neural network-based image processing technique and investigate its efficacy in diagnosing breast cancer using low-dose mammography imaging. Materials and Methods A total of 6 breast radiologists were included in this prospective study. All radiologists independently evaluated low-dose images for lesion detection and rated them for diagnostic quality using a qualitative scale. After application of the denoising network, the same radiologists evaluated lesion detectability and image quality. For clinical application, a consensus on lesion type and localization on preoperative mammographic examinations of breast cancer patients was reached after discussion. Thereafter, coded low-dose, reconstructed full-dose, and full-dose images were presented and assessed in a random order. Results Lesions on 40% reconstructed full-dose images were better perceived when compared with low-dose images of mastectomy specimens as a reference. In clinical application, as compared to 40% reconstructed images, higher values were given on full-dose images for resolution (p < 0.001); diagnostic quality for calcifications (p < 0.001); and for masses, asymmetry, or architectural distortion (p = 0.037). The 40% reconstructed images showed comparable values to 100% full-dose images for overall quality (p = 0.547), lesion visibility (p = 0.120), and contrast (p = 0.083), without significant differences. Conclusion Effective denoising and image reconstruction processing techniques can enable breast cancer diagnosis with substantial radiation dose reduction.

Purpose The purpose of this study is to investigate the physical activity (PA) and exercise barriers of stages 0-3 breast cancer survivors according to the Transtheoretical Model (TTM). Methods This cross-sectional study that included data from a total of 295 breast cancer survivors (Age: 52.2±8.2 years, BMI: 23.5±3.3 kg/m2), at Shinchon Severance Hospital, Seoul, Korea. The levels of PA and exercise barriers according to TTM were investigated using questionnaires. Results PA participation increased in the TTM stage. The proportion of participants categorized according to TTM stage differed according to the time since cancer diagnosis: a higher proportion of participants were in pre-contemplation/contemplation within one year after diagnosis, while a higher proportion of participants were in maintenance after three three years since diagnosis. The five most prevalent exercise barriers were fatigue, low level of physical fitness, poor health, lack of interest, and tendency to be physically inactive. Fatigue is the most prevalent exercise barrier regardless of TTM stage, while most exercise barriers tend to reduce as participants are in the preparation/action and maintenance stages. Conclusions In this study, we confirmed that the participants in the maintenance stage were the most active, while the proportion of participants in the TTM stage varied according to time since diagnosis. Since PA and exercise barriers vary according to the TTM stage, the TTM stage may increase PA participation in breast cancer patients.

Purpose Numerous studies claim that Taekwondo can effectively help obese children improve their physical fitness. In addition, Taekwondo might help prevent lifestyle diseases and metabolic syndrome caused by obesity. However, studies and reviews on the effectiveness of Taekwondo Poomsae are very few compared to those on Taekwondo Kyorugi. Based on previous reviews, this study aims to clarify the effect of Taekwondo Poomsae training on improving body composition, physical fitness, and blood composition of children and adolescents of different groups. Furthermore, the applicability of Taekwondo Poomsae training is to be determined. Methods Two-hundred and two studies were searched via Korea electronic databases RISS, KISS, and DBPIA from March 1 to 3, 2021, and 22 of these were included in this review. Results Our review confirms that Taekwondo Poomsae is effective in improving the physical condition of developing children and adolescents. However, we cannot assert that this sport is also an effective exercise therapy for special youth groups, such as those who are overweight, obese, or have a metabolic growth or development syndrome. Conclusions We suggest that sports implementers, Taekwando experts, coaches, and other sport professionals provide more Taekwondo Poomsae training programs suitable for physical and physiotherapeutic exercises for different ages and groups.

Natural killer (NK) cell enteropathy is not well understood. Although NK-cell enteropathy is typically benign, aggressive NK-cell lymphoma is an important differential diagnosis. This paper reports a rare case of NK-cell enteropathy of the stomach presenting with dyspepsia and weight loss. In this case, upper endoscopy revealed an ulcer-like lesion (approximately 7 mm) surrounded by erythema, edema, and mucosal hemorrhage. The biopsy revealed atypical lymphocyte cells expressing CD56 without an Epstein-Barr virus infection, which is consistent with NK-cell enteropathy. Follow-up endoscopy 2 months later revealed lesion regression with mild erythema. The patient was observed closely for 6 months, with no evidence of lymphoma.

Background Epidemiological data have shown that vitamin D deficiency is highly prevalent in Korea. Genetic factors influencing vitamin D deficiency in humans have been studied in Europe but are less known in East Asian countries, including Korea. We aimed to investigate the genetic factors related to vitamin D levels in Korean people using a genome-wide association study (GWAS). Methods We included 12,642 subjects from three different genetic cohorts consisting of Korean participants. The GWAS was performed on 7,590 individuals using linear or logistic regression meta- and mega-analyses. After identifying significant single nucleotide polymorphisms (SNPs), we calculated heritability and performed replication and rare variant analyses. In addition, expression quantitative trait locus (eQTL) analysis for significant SNPs was performed. Results rs12803256, in the actin epsilon 1, pseudogene (ACTE1P) gene, was identified as a novel polymorphism associated with vitamin D deficiency. SNPs, such as rs11723621 and rs7041, in the group-specific component gene (GC) and rs11023332 in the phosphodiesterase 3B (PDE3B) gene were significantly associated with vitamin D deficiency in both meta- and mega-analyses. The SNP heritability of the vitamin D concentration was estimated to be 7.23%. eQTL analysis for rs12803256 for the genes related to vitamin D metabolism, including glutamine-dependent NAD(+) synthetase (NADSYN1) and 7-dehydrocholesterol reductase (DHCR7), showed significantly different expression according to alleles. Conclusion The genetic factors underlying vitamin D deficiency in Korea included polymorphisms in the GC, PDE3B, NADSYN1, and ACTE1P genes. The biological mechanism of a non-coding SNP (rs12803256) for DHCR7/NADSYN1 on vitamin D concentrations is unclear, warranting further investigations.

Purpose To investigate the incidence of tuberculosis (TB) in healthcare workers (HCWs) with positive interferon-gamma release assay (IGRA) results based on chest X-ray (CXR) and CT findings and determine the role of imaging in the diagnosis of TB. Materials and Methods Among 1976 hospital personnel screened for TB using IGRA, IGRApositive subjects were retrospectively investigated. Clustered nodular and/or linear streaky opacities in the upper lung zone were considered positive on CXR. The CT findings were classified as active, indeterminate, inactive, or normal. The active or indeterminate class was considered CT-positive. Results IGRA was positive in 255 subjects (12.9%). CXR and CT were performed in 249 (99.2%) and 113 subjects (45.0%), respectively. CXR- and CT-positive findings were found in 7 of 249 (2.8%) and 9 of 113 (8.0%) patients, respectively. Among the nine CT-positive subjects, active and indeterminate TB findings were found in 6 (5.3%) and 3 (2.7%) patients, respectively. Microbiological tests, including acid-fast bacilli staining, culture, and polymerase chain action for TB, were negative in all nine CT-positive subjects. Empirical anti-TB medications were administered to 9 CT-positive subjects, and 3 of these nine subjects were CXR-negative for pulmonary TB. Conclusion CT helped diagnose asymptomatic TB in IGRA-positive HCWs.

The purpose of this study was to analyze the Korean medicine treatment methods for Postherpetic Neuralgia (PHN) in Korea. There were 5 online databases searched (OASIS, NDSL, RISS, KISS and KMBASE) for studies which were related to PHN. A total of 12 studies were selected. Various treatments such as acupuncture, herbal medicine, and moxibustion were reported treatments for PHN, some of which included Western medicine and Korean medicine treatment. Korean herbal medicine was the most frequently used treatment method, followed by manual acupuncture. Sipjeondaebotanggami was the most frequently used prescription. Poria Sclerotium was the most frequently used principal herb, followed by Angelicae Gigantis Radix, Zingiberis Rhizoma, and Ginseng Radix. GB44, LI4, LR3 were the common acupoints used for the treatment of PHN. CV12 was the most frequently used moxibustion point, and gabapentin was the most frequently used concomitant Western drug. Additional research on Korean medicine treatment of PHN is expected in the future.

Background The purpose of this study was to statistically analyze the treatment effect and patient satisfaction of traditional Korean medicine, including acupotomy treatment of cervical herniated intervertebral disc. Methods This was a retrospective study of 22 patients who received traditional Korean medicine including acupotomy treatment amongst all patients diagnosed with cervical herniated intervertebral discs at the Korean Medicine hospital in Daejeon, Korean, from January 01, 2020 to April 30, 2021. The clinical data from patient medical records were statistically analyzed. Results The Numeric Rating Scale, the European Quality of Life 5 Dimensions, and the European Quality of Life Visual Analogue Scale questionnaire scores were each compared before and after traditional Korean medicine treatment, including acupotomy, showed significantly improved scores after treatment (p < 0.001). Out of a total of 22 patients, 11 rated the treatment “very satisfactory” (50%), 5 “satisfactory” (22.7%), 5 “indifferent” (22.7%), 1 “unsatisfactory” (4.5%), and 0 “very unsatisfactory” (0%). Of the total 22 patients, 17 patients (77.3%) were willing to have further treatment, and 5 patients (22.7%) were not willing. Conclusion Traditional Korean medicine treatment including acupotomy was an effective treatment for cervical herniated intervertebral discs. To determine the effect of an individual application (e.g., acupotomy) of traditional Korean medicine treatment for cervical herniated intervertebral disc, a prospective, controlled study is needed.

Background Subclinical hypothyroidism (SCH) is the most common thyroid dysfunction, and its relationship with blood pressure (BP) has been controversial. The aim of the study was to analyze the association between SCH and newly-diagnosed hypertension. Methods Based on data from the Thyroid disease, Iodine nutrition and Diabetes Epidemiology (TIDE) study, 49,433 euthyroid individuals and 7,719 SCH patients aged ≥18 years were enrolled. Patients with a history of hypertension or thyroid disease were excluded. SCH was determined by manufacturer reference range. Overall hypertension and stage 1 and 2 hypertension were diagnosed according to the guidelines issued by the American College of Cardiology/American Heart Association in 2017. Results The prevalence of overall hypertension (48.7%), including stage 1 (28.9%) and 2 (19.8%) hypertension, increased significantly in SCH patients compared with euthyroid subjects. With elevated serum thyroid stimulating hormone (TSH) level, the hypertension prevalence also increased significantly from the euthyroid to different SCH subgroups, which was more profound in females or subjects aged

Background Adrenal venous sampling (AVS) is performed to distinguish the subtype of primary aldosteronism (PA). The clinical implication of contralateral suppression (CS; aldosterone/cortisolnondominant0.26 after adjusting for other factors. Conclusion CS may not predict postoperative clinical and biochemical outcomes in subjects with unilateral aldosterone excess, but it is associated with postsurgical deterioration of renal function in subjects over 50 years with CSI ≤0.26.

Background Hemophagocytic lymphohistiocytosis (HLH) is a rare but severe, life-threatening inflammatory condition if untreated. We aimed to investigate the etiologies, outcomes, and risk factors for death in children and adults with HLH. Methods The medical records of patients who met the HLH criteria of two regional university hospitals in Korea between January 2001 and December 2019 were retrospectively investigated. Results Sixty patients with HLH (35 children and 25 adults) were included. The median age at diagnosis was 7.0 years (range, 0.1–83 years), and the median follow-up duration was 8.5 months (range, 0–204 months). Four patients had primary HLH, 48 patients had secondary HLH (20 infection-associated, 18 neoplasm-associated, and 10 autoimmune-associated HLH), and eight patients had HLH of unknown cause. Infection was the most common cause in children (14/35, 40.0%), whereas neoplasia was the most common cause in adults (13/25, 52.0%). Twenty-eight patients were treated with HLH-2004/94 immunochemotherapy. The 5-year overall survival (OS) rate for all HLH patients was 59.9%. The 5-year OS rates for patients with primary, infection-associated, neoplasm-associated, autoimmune-associated, and unknown cause HLH were 25.0%, 85.0%, 26.7%, 87.5%, and 62.5%, respectively. Using multivariate analysis, neoplasm-induced HLH (p=0.001) and a platelet count

Langerhans cell histiocytosis (LCH) is a rare condition that usually occurs in children and commonly affects the skeletal system. It is extremely rare in adults, especially in the clavicles. In this report, we describe a pathologically confirmed case of LCH in the clavicle of a 50-year-old male. We report various radiological findings, such as plain radiography, CT, MR, and PET-CT, along with a review of the literature.

The phosphorous balance is clinically important in increasing the long-term outcomes and preventing complications of end-stage renal disease. Sevelamer is a phosphate binder used widely to regulate hyperphosphatemia. On the other hand, gastrointestinal side effects increase with increasing sevelamer intake. A 29-year-old male with end-stage renal disease of IgA nephropathy on maintenance hemodialysis was admitted for diffuse alveolar bleeding and pneumonia. He presented with a low-grade fever and watery diarrhea tinged with blood. Initially, a Clostridioides difficile-associated diarrhea treatment was started with positive findings of Clostridioides difficile toxin and culture. Despite this, there was no improvement in the symptoms even with the appropriate antibiotic treatment. Computed tomography of the abdomen and pelvis revealed an occlusive mass in the rectum and secondary obstructive changes in the sigmoid colon. The initial suspicion was a malignancy or fungal infection. Sigmoidoscopy with a biopsy identified the mass as a lump of mucous material with the entire lumen covered with exudate. The subsequent histopathology examination revealed a colonic mucosal injury and characteristic ''fish scale"-like sevelamer crystals in the exudate. The diagnosis of a sevelamer-induced rectal ulcer was made. We report this case of a sevelamer-associated rectal ulcer of the sigmoid.

Background This study was designed to statistically analyze the year, gender, age, insurance type, and condition/disease of patients who were admitted to the Department of Acupuncture and Moxibustion Medicine at DaeJeon Korean Medicine Hospital over a 5-year period (2015–2020). Methods Patients who visited the Department of Acupuncture and Moxibustion Medicine at DaeJeon Korean Medicine Hospital were classified according to year, gender, age, insurance type, and condition/disease. The statistical analysis was performed using IBM SPSS 23.0. Results There is an increasing number of patients attending the Department of Acupuncture and Moxibustion Medicine year-on-year over the 5-year period, with a higher frequency of females than males each year. The largest age groups represented in these patients were those aged in their 50s, followed by those aged in their 40s, and 60s. Furthermore, the number of patients using health insurance was greater than those using automobile insurance each year. Of the 5,061 patients, the most common group was the patients (n = 991) who reported sprain and strain of cervical spine, followed by lumbar spine, lumbar herniation of the intervertebral disc, and facial paralysis. Conclusion The number of patients seeking traditional Korean medicine treatment continues to increase, particularly in the 40s to 60s age group, with a larger proportion using health insurance and sprain or strain of the cervical spine. The results of this study may be used as a local (Daejeon) reference to develop Korean medicine policies, such as setting up medical benefits for patients using Korean medicine hospitals.

A patient diagnosed with Guillain-Barre syndrome (GBS) suffering from numbness in the toes and fingers, paralysis in the face, and back pain received intravenous immunoglobulin on December 28, 2019. Without an improvement in symptoms the patient was admitted to a Korean medicine hospital on January 1, 2020 to receive combined Korean medicine treatment including herbal medicine (Sipjeondaebo-tanggami and Hyangbujasunkipalmul-tang), acupuncture treatment, moxibustion, cupping treatment, and physical therapy. Treatment was administered over 51 days, of which 17 days were during hospitalization. Paralysis of facial muscle, and numbness in fingers and toes were evaluated using the Yanagihara score and numeric rating scale (NRS) score, respectively. Facial paralysis improved (21 to 40 based on Yanagihara score) and paresthesia of the hands and feet disappeared (NRS score 6–7 to NRS score 0). There were no side effects or sequela. This study suggested combined Korean medicine treatment may be effective for the treatment of GBS.