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Background: This study aimed to evaluate the effects of kombucha on the surface of composite resins and to examine the degradation-inhibiting effect of adding calcium to kombucha. Methods: Six experimental groups were established, with three types of liquid kombucha: one with 3% added calcium, carbonated water as a positive control, and mineral water as a negative control. The pH and titratable acidity values of the experimental groups were measured. The samples were filled with condensed composite resin and placed in the experimental drinks for 5, 15, 30, and 60 minutes. The Vickers microhardness of the surface was measured before and after immersion, and the changes were compared. Results: The pH values of the experimental group were I’m alive (2.87±0.02), Hollys (2.95±0.01), Ediya (2.99±0.01), I’m alive +3% Ca (4.09±0.01), carbonated water (4.66±0.01), and mineral water (7.67±0.02). I’m alive (–12.35) showed the largest reduction in surface hardness, followed by Hollys (–9.78), carbonated water (–7.97), I’m alive +3% Ca (–7.82), Ediya (–7.60), and mineral water (–1.56). In the Vickers microhardness measurements, all experimental groups, except for the mineral water group, showed significant differences (p＜0.05). The scanning electron microscope results showed that the experimental group and positive control had rough surfaces and micropores. Conclusion: The surface hardness was significantly reduced in all experimental groups except for water. In particular, in the case of kombucha with low pH, the reduction rate increased, weakening the physical properties of the material. In addition, the reduction rate of surface hardness was lower in kombucha with added calcium, and it is believed that drinking kombucha containing calcium can minimize the erosion of dental materials.

Background: This study aimed to investigate the erosive potential of powdered vitamin C on the bovine enamel tooth surface. Methods: The experiment included five groups: Lemona, Vitagran, Korea Eundan, Coca-Cola (positive controls), and artificial saliva (negative controls). The pH and titratable acidity were measured. Bovine enamel specimens were immersed in the experimental solutions for 15 minutes each day for 7 days. The surface microhardness was measured using the Vickers hardness number before immersion and on the 1st, 3rd, 5th, and 7th days. The surfaces of the bovine enamel specimens were observed by scanning electron microscopy (SEM). Results: The pH of the experimental groups was as follows: Lemona (2.04±0.04) had the lowest pH, followed by Vitagran (2.56±0.01), the positive control group Coca-Cola (2.60±0.03), Korea Eundan (3.14±0.02), and the negative control group artificial saliva (7.06±0.05). Surface microhardness decreased significantly during the immersion period (p＜0.001). The largest surface microhardness reduction value was shown in Lemona (–201.22±20.60), followed by Vitagran (–190.02±14.73), Korea Eundan (–189.27±27.14), Coca-Cola (–99.28±17.21), artificial saliva (–10.99±9.94). According to the SEM findings, the experimental and positive control groups exhibited rough surfaces with micropores, whereas the negative control group exhibited smooth surfaces before specimen immersion. Conclusion: Consuming powdered vitamin C at a low pH may degrade the enamel surface. To reduce the erosive effect, it is recommended to rinse the mouth with water and brush the teeth after an hour.

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 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.

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.

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.

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.

Purpose Patients with multiple trauma necessitate assistance from a wide range of departments and professions for their successful reintegration into society. Historically, the primary focus of trauma treatment in Korea has been on reducing mortality rates. This study was conducted with the objective of evaluating the current state of multidisciplinary treatment for patients with severe trauma in Korea. Based on the insights of trauma specialists (i.e., medical professionals), we aim to suggest potential improvements. Methods An online questionnaire was conducted among 871 surgical specialists who were members of the Korean Society of Traumatology. The questionnaire covered participant demographics, current multidisciplinary practices, perceived challenges in collaboration with rehabilitation, psychiatry, and anesthesiology departments, and the perceived necessity for multidisciplinary treatment. Results Out of the 41 hospitals with which participants were affiliated, only nine conducted multidisciplinary meetings or rounds with nonsurgical departments. The process of transferring patients to rehabilitation facilities was not widespread, and delays in these transfers were frequently observed. Financial constraints were identified by the respondents as a significant barrier to multidisciplinary collaboration. Despite these hurdles, the majority of respondents acknowledged the importance of multidisciplinary treatment, especially in relation to rehabilitation, psychiatry, and anesthesiology involvement. Conclusions This survey showed that medical staff specializing in trauma care perceive several issues stemming from the absence of a multidisciplinary system for patient-centered care in Korea. There is a need to develop an effective multidisciplinary treatment system to facilitate the recovery of trauma patients.

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.

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.

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

Purpose As resuscitative endovascular balloon occlusion of the aorta (REBOA) is performed in an extremely emergent situation, achieving competent clinical practice is mandatory. Although there are several educational courses that teach the REBOA procedure, there have been no reports evaluating the impact of training on clinical practice. Therefore, this study is aimed to evaluate the effects of the course on procedural performance during resuscitation and on clinical outcomes. Methods Patients who were managed at a regional trauma center in Dankook University Hospital from August 2016 to February 2018 were included and were grouped as precourse (August 2016–August 2017, n=9) and postcourse (September 2017–February 2018, n=9). Variables regarding injury, parameters regarding REBOA procedure, morbidity, and mortality were prospectively collected and reviewed for comparison between the groups. Results Demographics and REBOA variables did not differ between groups. The time required from arterial puncture to balloon inflation was significantly shortened from 9.0 to 5.0 minutes (P=0.003). There were no complications associated with REBOA after the course. Mortality did not show any statistical difference before and after the course. Conclusions The endovascular training for REBOA pilot course, which uses a modified form of flipped learning, realistic simulation of ultrasound-guided catheter insertion and balloon manipulation, and competence assessment, significantly improved procedural performance during resuscitation of trauma patients.

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 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.

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.

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 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 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 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

Purpose To evaluate the accuracy of MRI in predicting the pathological complete response (pCR) and the residual tumor size of breast cancer after neoadjucant chemotherapy (NAC), and to determine the factors affecting the accuarcy. Materials and Methods Eighty-eight breast cancer patients who underwent surgery after NAC at our center between 2010 and 2017 were included in this study. pCR was defined as the absence of invasive cancer on pathological evaluation. The maximum diameter of the residual tumor on post-NAC MRI was compared with the tumor size of the surgical specimen measured pathologically. Statistical analysis was performed to elucidate the factors affecting pCR and the residual tumor size-discrepancy between the MRI and the pathological measurements. Results The pCR rate was 10%. The diagnostic accuracy of MRI and the area under the curve for predicting pCR were 90.91% and 0.8017, respectively. The residual tumor sizes obtained using MRI and pathological measurements showed a strong correlation (r = 0.9, p < 0.001), especially in patients with a single mass lesion (p = 0.047). The size discrepancy between MRI and the pathological measurements was significantly greater in patients with the luminal type (p = 0.023) and multifocal tumors/non-mass enhancement on pre-NAC MRI (p = 0.047). Conclusion MRI is an accurate tool for evaluating pCR and residual tumor size in breast cancer patients who receive NAC. Tumor subtype and initial MRI features affect the accuracy of MRI.

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.

Traumatic flank hernia is a relatively rare hernia. We report a case of a male patient with severe multiple trauma, including abdominal injury, who presented with flank hernia 3 years postinjury. The hernia was successfully repaired using mesh strips suture, and at the 12-month follow-up, no complications or recurrence was found. Our findings indicate that when it is difficult to secure a sufficient operative field for mesh anchoring in a traumatic flank hernia, a technique of sutured repair with mesh strips may be considered as a treatment option as it requires less dissection. Compared to the conventional planar mesh repair, this technique decreases the risk of injuries and ischemic necrosis of the surrounding tissues.

Background: This study tries to compare and analyze the removal effect of dental plaque of general dentifrice and pregnant women’s dentifrice and quantify the results to provide basic data so that consumers can make reasonable choices when purchasing dentifrice, and also increase interest in the dental plaque.Methods: After forming a dental plaque (carbohydrate porridge) on the labial surface of the bovine teeth, a disclosing agent was applied. Then the same experimenter brushed the surface of the bovine teeth using an electric toothbrush and took photographs using a DSLR camera. Thereafter, the residual amount of dental plaque was analyzed using the ImageJ program, and SPSS 26.0 was used for statistical processing.Results: The average residual amount of dental plaque using the general dentifrice was 11.71% for Perio, 9.45% for Cliden, and 8.47% for 2080, and the average residual amount for the three types was approximately 9.88%. The average residual amount of dental plaque of pregnant women’s dentifrice was 13.95% for Jeninmothers, 12.53% for Tntnmoms, and 12.63% for Mommiracle, and the average residual amount of the three types was approximately 13.04%. On comparing the average residual amount of dental plaque between general and pregnant women’s dentifrices, it was observed to be 3.16% higher for the latter. However, the results were not statistically significant.Conclusion: According to the research results, there was no significant difference in removal effects of general dentifrice and pregnant women’s dentifrice. In addition, when a pregnant woman uses the right toothbrushing method with pregnant women’s dentifrice, it can prevent or inhibit the progression of the gestational periodontal disease. Therefore, we recommend pregnant women to use pregnant women’s dentifrices.

Background This study aims to statistically analyze and compare the curative effect and satisfaction level between typical traditional Korean medicine treatment and nonsurgical spinal decompression treatment. Methods Of the patients who were diagnosed with the cervical or lumbar herniated intervertebral disc at the Department of Acupuncture and Moxibustion Medicine at the Daejeon Korean Medicine Hospital from April 14th to August 25th, 2019, this study retrospectively analyzed the medical records of 31 patients who underwent nonsurgical spinal decompression treatment and traditional Korean medicine (assigned to Group A) and another 31 patients who received typical traditional Korean medicine alone (assigned to Group B). The clinical data were analyzed using IBM SPSS Version 23.0. Results No statistically significant differences appeared in terms of sociodemographic, condition, and therapeutic characteristics, except whether the patient received Western medicine treatment, before or after a treatment with traditional Korean medicine. Group A exhibited higher variations in numeric rating scale, EuroQol- 5 dimension and EuroQol visual analogue scale scores compared to Group B as determined by independent sample t test and analysis of covariance. In addition, the satisfaction score of Group A was higher than that of Group B The result of cross analysis revealed that desire for continued treatment in Group A was higher than that of Group B. Conclusion This retrospective observational study showed that the patients with nonsurgical spinal decompression treatment reported a greater reduction in pain, improved quality of life and satisfaction than patients receiving typical traditional Korean medicine.

Resuscitative endovascular balloon occlusion of the aorta (REBOA) is widely performed as an adjunct to resuscitation or bridge to definitive control of non-compressible torso hemorrhage in patients with hemorrhagic shock. It is a crucial adjunct for the maintenance of cerebral and coronary perfusion during resuscitation. However, in polytrauma patients with concomitant neurotrauma, such as traumatic brain injury (TBI) or spinal cord injury, the physiological effects of REBOA are unclear. In this report on REBOA performed in a clinical setting for polytrauma patients with spinal cord injury or TBI, the physiological effects of REBOA in neurotrauma are reviewed.

Purpose This retrospective multicenter study analyzed trauma patients who underwent resuscitative endovascular balloon occlusion of the aorta (REBOA) in the Republic of Korea. Methods This study was conducted from February 2017 to May 2018 at three regional trauma centers in the Republic of Korea. The patients were divided into two groups (cardiopulmonary resuscitation [CPR] and No-CPR) for comparative analysis based on two criteria (complication and mortality) for logistic regression analysis (LRA). Results There were significant differences between the CPR and No-CPR groups in mortality (p=0.003) and treatment administered (p=0.016). By LRA for complications, total occlusion has significantly lesser risk than intermittent or partial occlusion in both univariate (odds ratio [OR] 0.06, 95% confidence interval [CI] 0.00-0.36, p=0.01) and multivariate (OR 0.05, 95% CI 0.00-0.38, p=0.01) analyses. The Rescue had a higher risk than the Coda or Reliant in univariate analysis (OR 4.91, 95% CI 1.14-34.25, p=0.05); however, it was not statistically significant in multivariate analysis (OR 6.98, 95% CI 1.03-74.52, p=0.07). By LRA for mortality, the CPR group was the only variable that had a significantly higher risk of mortality than the No-CPR group in both univariate (OR 17.59, 95% CI 3.05-335.25, p=0.01), and multivariate (OR 24.92, 95% CI 3.77-520.51, p=0.01) analyses. Conclusions This study was conducted in the early stages of REBOA implementation in the Republic of Korea and showed conflicting results from studies conducted by multiple institutions. Therefore, additional research with more accumulated data is needed.

Resuscitative endovascular balloon occlusion of the aorta (REBOA) has been accepted as an adjunct procedure for non-compressible torso hemorrhage in patients with hemorrhagic shock. With appropriate indications, REBOA should be performed for resuscitation regardless of the physician’s specialty. Despite its effectiveness in traumatized patients with hemorrhagic shock, performing REBOA has been challenging due to physicians’ lack of experience. Even though training in endovascular skills is mandatory, many physicians cannot undergo sufficient training because of the limited number of endovascular simulation programs. Herein, we share simulation video clips, including those of a vascular circuit model for simulation; sheath preparation; long guidewire and balloon catheter preparation; ultrasound-guided arterial access; sheath insertion or upsizing; and balloon positioning, inflation, and migration. The aim of this study was to provide educational video clips to improve physicians’ endovascular skills for REBOA.

Resuscitative endovascular balloon occlusion of the aorta (REBOA) has been increasingly used in recent years as a resuscitative adjunct for trauma patients with life-threatening non-compressible torso hemorrhage. By blocking the aorta temporarily with an inflated balloon, REBOA preserves cerebral and coronary perfusion while diminishing exsanguination below the balloon, thereby providing time for resuscitation and definitive bleeding control. When determining the occlusion zone during the REBOA procedure, factors such tortuosity of the aorta, co-occurring minor chest injuries, and the severity of shock must be considered, as well as the main injury site. This paper describes a case of high Zone I REBOA in an elderly patient with a tortuous aorta who had concomitant injuries of the chest and pelvis.

This case report describes a 60-year-old female patient diagnosed with intercostal neuropathy and vertebral compression fractures which occurred following an electric shock injury. The patient received acupuncture, pharmacopuncture, and herbal medicine administration between February 10th, 2020 and April 25th, 2020. The pain level in the thoracic and left intercostal areas was assessed using the Numerical Rating Scale. The Self-report of the Leeds Assessment of Neuropathic Symptoms and Signs Pain Scale were used to diagnose neuropathic pain. The Neuropathic-Pain -Scale was used to evaluate the degree of neuropathic symptoms. The Oswestry Disability Index and the European Quality of Life-5 Dimensions were used to assess quality of life scales and functional disorder. Following combined Korean medicine treatment, the patient exhibited reduced levels of pain and significant improvement in functional disorder symptoms and quality of life.

Background This study assessed the proportion of risk-stratified Korean patients with dyslipidemia achieving their low-density lipoprotein cholesterol (LDL-C) targets as defined by the European Society of Cardiology/European Atherosclerosis Society (ESC/EAS) (2011) guidelines while receiving lipid-modifying treatments (LMTs). Methods In this multicenter, cross-sectional, observational study, we evaluated data from Korean patients aged ≥19 years who were receiving LMTs for ≥3 months and had an LDL-C value within the previous 12 months on the same LMT. Data were collected for demographics, cardiovascular (CV) risk factors, medical history, and healthcare consumption. Patients were risk-stratified according to the ESC Systematic COronary Risk Evaluation (SCORE) chart and LDL-C target achievement rate was assessed. Results Guideline-based risk-stratification of the 1,034 patients showed the majority (72.2%) to be in the very high-risk category. Investigators’ assessment of risk was underestimated in 71.6% compared to ESC/EAS guidelines. Overall LDL-C target achievement rate was 44.3%; target achievement was the highest (66.0%) in moderate-risk patients and the lowest (39.0%) in very high-risk patients. Overall 97.1% patients were receiving statin therapy, mostly as a single-agent (89.2%). High-intensity statins and the highest permissible dose of high-intensity statins had been prescribed to only 9.1% and 7.3% patients in the very high-risk group, respectively. Physician satisfaction with patients’ LDL-C levels was the primary reason for non-intensification of statin therapy. Conclusion Achievement of target LDL-C level is suboptimal in Korean patients with dyslipidemia, especially in those at very high-risk of CV events. Current practices in LMTs need to be improved based on precise CV risk evaluation posed by dyslipidemia.

Inherited platelet function disorders (IPFDs) are rare and underdiagnosed in individuals with clinically significant bleeding diathesis. IPFDs are classified according to the causative molecular defects involved in the process of primary hemostasis of platelets, which include the following: 1) adhesion (e.g., Bernard?Soulier syndrome and pseudo-von Willebrand disease), 2) activation (e.g., adenosine diphosphatase receptor defect and thromboxane A2 receptor defect), 3) signal transduction and granule secretion (e.g., gray platelet syndrome, Paris?Trousseau/Jacobsen syndrome, Chediak?Higashi syndrome, and Hermansky?Pudlak syndrome), 4) aggregation (e.g., Glanzmann thrombasthenia), and 5) procoagulant activity (e.g., Scott syndrome). Patients with IPFDs typically present with unexpected mucocutaneous bleeding during early childhood. The diagnosis of these conditions requires several laboratory tests including complete blood cell count, peripheral blood smear, platelet function analysis, light-transmission aggregometry, flow cytometry, electron microscopy, and genetic analysis. Platelet transfusion has been the mainstay of treatment. However, antifibrinolytics, desmopressin, and recombinant activated factor VII are also effective when used as a monotherapy or adjunctive therapy. Importantly, the prevention of bleeding event is the most basic strategy in the management of IPFDs. This review aimed to assess the normal platelet physiology and summarize the current knowledge about the molecular defects, diagnostic evaluation, and treatment strategies of the respective IPFDs. If the cause of the bleeding tendency is difficult to identify, IPFDs should be considered.

BackgroundConflicting results have been reported on the efficacy of insulin degludec/insulin aspart (IDegAsp) compared to basal insulin in type 2 diabetes. We investigated the effects of changing basal insulin to IDegAsp on glycemic control and sought to identify factors related to those effects.MethodsIn this retrospective study of patients from three referral hospitals, patients with type 2 diabetes using basal insulin with hemoglobin A1c (HbA1c) levels less than 11.0% were enrolled. Basal insulin was replaced with IDegAsp, and data were analyzed from 3 months before to 3 months after the replacement.ResultsEighty patients were recruited (52.5% male; mean age, 67.0±9.8 years; mean duration of diabetes, 18.9±8.5 years; mean HbA1c, 8.7%±1.0%). HbA1c levels increased during 3 months of basal insulin use, but significantly decreased after changing to IDegAsp (8.28%±1.10%, P=0.0001). The reduction was significant at 6 months in 35 patients whose longer-term data were available. Patients with a measured fasting plasma glucose (m-FPG) lower than their predicted FPG (p-FPG) by regression from HbA1c showed a significant HbA1c reduction caused by the change to IDegAsp, even without a significantly increased insulin dose. However, patients whose m-FPG was higher than their p-FPG did not experience a significant HbA1c reduction, despite a significantly increased insulin dose. Furthermore, the HbA1c reduction caused by IDegAsp was significant in patients with low fasting C-peptide levels and high insulin doses.ConclusionWe observed a significant glucose-lowering effect by replacing basal insulin with IDegAsp, especially in patients with a lower m-FPG than p-FPG.

This case report relates to a 40-year old male patient diagnosed with ankylosing spondylitis who was treated with acupotomy and traditional Korean medicine. He showed a significant improvement in joint range of motion (ROM) in cervical and lumbar vertebrae, and in pain and functional disorder symptoms. The patient received acupotomy, acupuncture, pharmacopuncture, herbal medicine and physical therapy (November 26, 2018 to December 17, 2018). Joint ROM for cervical and lumbar vertebrae was measured, and the pain level was assessed using a numerical rating scale. The functional disorder and quality of life scales were also assessed using the Bath Ankylosing Spondylitis Functional Index, Bath Ankylosing Spondylitis Disease Activity Index, Korean Health Assessment Questionnaire, and Modified Health Assessment Questionnaire. After applying acupotomy and traditional Korean medicine, the patient exhibited increased joint ROM and reduced pain, also in conjunction with improved responses in functional disorder and quality of life.

Background The purpose of this study was to analyze the medical dispute cases in Acupuncture and Moxibustion treatment, and present the guidelines of treatment to prevent medical disputes. Methods Korean Acupuncture and Moxibustion Medicine Society medical dispute cases from January 2013 to September 2018 were collected and analyzed. Results There were 80 cases, which included acupuncture treatment (54 cases), cupping treatment (7 cases), local infection / inflammation (17 cases), and neurological symptoms (13 cases). Analysis of the correlation between types of medical accidents and the treatment methods, showed that local infection and inflammation (12 cases) were the most reported in acupuncture treatment. Conclusions This study was performed to analyze the current status of medical disputes in the field of acupuncture and moxibustion, and provide basic data for guidelines to prevent them. Further study preparing for clinical guidelines to prevent medical disputes in specific departments are warranted in the future.

The aim of this study was to investigate effects of hyaluronidase during IVM on oocyte maturation, oxidative stress status, expression of cumulus expansion-related (PTX, pentraxin; GJA1, gap junction protein alpha 1; PTGS2, prostaglandin-endoperoxide synthase 2) and fatty acid metabolism-related (FADS1, delta-6 desaturase; FADS2, delta-5 desaturase; PPARα, peroxisome proliferator-activated receptor-alpha) mRNA, and embryonic development of porcine oocytes. The cumulus-oocyte complexes (COCs) were incubated with 0.1 mg/mL hyaluronidase for 44 h. Cumulus expansion was measured at 22 h after maturation. At 44 h after maturation, nuclear maturation, intracellular glutathione (GSH) and reactive oxygen species (ROS) levels were measured. Gene expression in cumulus cells was analyzed using real time PCR. The cleavage rate and blastocyst formation were evaluated at Day 2 and 7 after insemination. In results, expansion of cumulus cells was suppressed by treatment of hyaluronidase at 22 h after maturation. Intracellular GSH level was reduced by hyaluronidase treatment (p < 0.05). On the other hand, hyaluronidase increased ROS levels in oocytes (p < 0.05). Only PTGS2 mRNA was enhanced in COCs by hyaluronidase (p < 0.05). Population of oocytes reached at metaphase II stage was higher in control group than hyaluronidase treated group (p < 0.05). Both of cleavage rate and blastocyst formation were higher in control group than hyaluronidase group (p < 0.05). Our present results showed that developmental competence of porcine oocytes could be reduce by hyaluronidase via inducing oxidative stress during maturation process and it might be associated with prostaglandin synthesis. Therefore, we suggest that suppression of cumulus expansion of COCs could induce oxidative stress and decrease nuclear maturation via reduction of GSH synthesis and it caused to decrease developmental competence of mammalian oocytes.

The incidence of inflammatory bowel disease (IBD) is increasing rapidly and extra-intestinal manifestations in IBD are also increasing. The prevalence of renal and urinary involvement in IBD ranges from 4-23%. Nephrolithiasis is the most common urinary complication in IBD patients. Parenchymal renal disease is rare but has been well documented and presents most commonly as glomerulonephritis or tubulointerstitial nephritis. The overall morbidity of IBD-related renal manifestations is significant. Therefore, a high index of clinical suspicion and optimal monitoring of the renal function are needed for the early diagnosis and prevention of IBD-related renal manifestations and complications.

The aim of this study was to report on the resorption of herniated nucleus pulposus following acupotomy treatment. Two patients were treated with acupotomy which included integrative Korean Medicine treatment, for either cervical, or lumbar herniated nucleus pulposus. Magnetic Resonance Imaging was used to produce images before and after (several months) treatment. The Numerical Rating Scale scores and Range of Motion were used to assess the patients at admission and discharge. In both cases, substantial resorption of the respective herniated disc was observed in the magnetic resonance images, with a decrease in the Numerical Rating Scale score. Range of Motion improved in 1 case. This study shows that acupotomy treatment may be a clinically effective treatment for herniated nucleus pulposus resorption and pain relief.

Background : : von Willebrand disease (VWD) is one of the most common inherited bleeding disorders. However, the number of patients who register to the Korea Hemophilia Foundation (KHF) is much lower than the expected prevalence rate and only few hospitals perform tests for diagnosis autonomously. Thus, we surveyed practical realities of VWD in Yeungnam region. Methods : : Patients with VWD (N=267) who were diagnosed at eleven university hospitals from March 1995 to March 2018 were enrolled in this study. We evaluated the medical records from each hospital retrospectively. Results : : Two hundred and twenty-eight children and 39 adults met the diagnostic criteria for VWD. Seventy-eight (57.4%) patients had the blood type O. Fifty-eight patients were definite type 1 (21.7%), 151 were possible type 1 (56.6%), and the others were type 2. Abnormal laboratory findings were the most common factor for the diagnosis in children. VWF mutations were detected in 17 patients. Patients with a family history showed age of diagnosis of 9 y, which is higher than in those with no family history (6 yr), and also showed a higher rate of significant bleeding (32.1% vs. 14.2%). VWF:RCo and VWF:Ag tests were performed in-hospital at only 1 of 11 hospitals. Twelve of 267 patients were enrolled at the KHF (4.5%). Conclusion : : A high rate of out-sourcing studies may result in inaccurate diagnosis. The registration rate to the KHF is still lower than the prevalence rate. A comprehensive nationwide registration system is necessary in order to identify the actual prevalence rate and promote the diagnosis of VWD in Korea.

The aim of this report is to describe improved symptom changes in eye movement disorders and dizziness of a patient with Miller Fisher syndrome after receiving combined Korean medicine treatment (CKMT). A 24-year-old male was diagnosed with MFS accompanied by eye movement disorder, diplopia, and dizziness. For 6 weeks, the patient received acupuncture, electro-acupuncture, pharmacopuncture, herbal medicine, and physical therapy treatment. Visual analogue scale were checked and other outcomes (the range of eye movement, the distance that diplopia appears, diplopia questionnaire) were measured. Following CKMT, the movement of both eyes improved in both the horizontal and vertical direction. Also for diplopia and dizziness, there was a decrease in the visual analogue scale and the distance that diplopia appeared. The present case report suggests that CKMT may have a role in treating eye movement disorders and dizziness in patient diagnosed with MFS.

Hyalinizing trabecular tumor (HTT) is a rare thyroid tumor with low to minimal malignant potential. HTT is often misinterpreted as other thyroid tumors, including papillary thyroid carcinoma (PTC) and medullary thyroid carcinoma (MTC), on fine-needle aspiration (FNA) cytology, because of its overlapping cytologic features, such as nuclear grooves and intranulcear pseudoinclusions. Although cytopathologists cannot definitely conclude HTT by FNA cytology, suspicion of HTT is necessary to avoid misdiagnosing HTT as PTC or MTC and to avoid unnecessary aggressive treatment. Here, we report a case of HTT with novel cytologic features in CellPrep liquid based cytology that was diagnosed as suspicious for papillary carcinoma by FNA and finally diagnosed as HTT in the surgical specimen.

BackgroundAfter initial radioactive iodine (RAI) treatment in differentiated thyroid cancer patients, we sometimes observe a star-shaped region of intense uptake of 131I on whole body scans (WBSs), called a ‘star artifact.’ We evaluated the clinical implications of star artifacts on the success rate of remnant ablation and long-term prognosis.MethodsTotal 636 patients who received 131I dose of 1.1 GBq for the initial RAI therapy and who did not show distant metastasis at the time of diagnosis were retrospectively evaluated. A negative second WBS was used for evaluating the ablation efficacy of the RAI therapy. Among them, 235 patients (36.9%) showed a star artifact on their first WBS.ResultsIn patients with first stimulated thyroglobulin (sTg) levels ≤2 ng/mL, patients with star artifacts had a higher rate of negative second WBS compared with those without star artifacts (77.8% vs. 63.9%, P=0.044), and showed significantly higher recurrence-free survival (P=0.043) during the median 8.0 years (range, 1.0 to 10.0) of follow-up. The 5- and 10-year recurrence rates (5YRR, 10YRR) were also significantly lower in patients with star artifacts compared with those without (0% vs. 4.9%, respectively, P=0.006 for 5YRR; 0% vs. 6.4%, respectively, P=0.005 for 10YRR). However, ablation success rate or recurrence-free survival was not different among patients whose first sTg levels >2 ng/mL regardless of star artifacts.ConclusionTherefore, star artifacts at initial RAI therapy imply a good ablation efficacy or a favorable long-term prognosis in patients with sTg levels ≤2 ng/mL.

Background: The purpose of this study was to assess the role of hypophosphatemia in major clinical outcomes of patients treated with low- or high-intensity continuous renal replacement therapy (CRRT). Methods: We performed a retrospective analysis of data collected from 492 patients. We divided patients into two CRRT groups based on treatment intensity (greater than or equal to or less than 40 mL/kg/hour of effluent generation) and measured serum phosphate level daily during CRRT. Results: We obtained a total of 1,440 phosphate measurements on days 0, 1, and 2 and identified 39 patients (7.9%), 74 patients (15.0%), and 114 patients (23.1%) with hypophosphatemia on each of these respective days. In patients treated with low-intensity CRRT, there were 23 episodes of hypophosphatemia/1,000 patient days, compared with 83 episodes/1,000 patient days in patients who received high-intensity CRRT (P < 0.01). Multiple Cox proportional hazards analysis showed that Acute Physiology and Chronic Health Evaluation (APACHE) III score, utilization of vasoactive drugs, and arterial pH on the second day of CRRT were significant predictors of mortality, while serum phosphate level was not a significant contributor to mortality. Conclusion: APACHE score, use of vasoactive drugs, and arterial pH on the second CRRT day were identified as significant predictors of mortality. Hypophosphatemia might not be a major risk factor of increased mortality in patients treated with CRRT.