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Panax ginseng is a medicinal plant is a material with various pharmacological activities and research suggests that it is particularly effective in representative metabolic diseases such as hyperglycemia, hypertension, and hyperlipidemia. Therefore, in this study, systematic review and meta-analysis were performed to investigate the comprehensive effect of P. ginseng on metabolic parameters representing these metabolic diseases. A total of 23 papers were collected for inclusion in the study, from which 27 datasets were collected. The investigational products included P. ginseng and Korean Red ginseng. Across the included studies, the dose ranged from 200 mg to 8 g and the supplementation period lasted from four to 24 weeks. The study subjects varied from healthy adults to those with diabetes, hypertension, obesity, and/or hyperlipidemia. As a result of the analysis, the levels of glucose and insulin area under the curves, % body fat, systolic and diastolic blood pressures, total cholesterol, triglycerides, and low-density lipoprotein cholesterol were significantly reduced in the P. ginseng group as compared with in the placebo group. In conclusion, P. ginseng supplementation may act as an adjuvant to prevent the development of metabolic diseases by improving markers related to blood glucose, blood pressure, and blood lipids.

Hysterectomy is one of the most commonly performed gynecological procedures. Several studies have reported an association between hysterectomy and coronary heart disease (CHD), but the conclusions are controversial. This study aimed to evaluate the association between hysterectomy and the occurrence of CHD using a national sample cohort from South Korea.Using the national cohort from the Korean National Health Insurance Service, we extracted data on patients who had undergone hysterectomy (n = 8,642) and on controls matched at a ratio of 1:4 (n = 34,568) and then analyzed the occurrence of CHD from 2002 to 2013. Patients were matched according to age, income, region of residence, obesity, smoking, alcohol consumption, and medical history.A Cox proportional hazards model was used to analyze the hazard ratios (HRs) and 95% confidence intervals (CIs). Subgroup analyses were performed based on both age and bilateral salpingo-oophorectomy (BSO) status. The age of the participants was defined as that at the time of hysterectomy.The HR for CHD was 1.05 (95% CI = 0.96-1.16, p = 0.286) in the hysterectomy group. The HRs for CHD according to the different age subgroups were 1.19 (95% CI = 1.03-1.38, p = 0.018) for patients aged50 years, 1.05 (95% CI = 0.89-1.25, p = 0.561) for patients aged 50-59 years, and 0.88 (95% CI = 0.73-1.05, p = 0.147) for patients aged ≥ 60 years.The incidence of CHD was statistically significantly higher in women who underwent hysterectomy when they were under 50 years of age than in the matched controls.

The purpose of this study was to review randomized controlled trials (RCTs) of pes anserinus tendinitis or bursitis (PATB) syndrome in the China National Knowledge Infrastructure database to investigate the efficacy of traditional Chinese medicine treatment for PATB syndrome. There were 20 RCTs published from 2001 to 2021 which were selected for analysis by publication year, number of samples, evaluation criteria, treatment duration, and treatment method. Out of the 142 retrieved RCTs, 20 were relevant to this review, and had performed Chinese medicine treatments including acupuncture (the most common treatment typically using acupoints SP10, ST35, SP9, and LR8), manipulation (typically using acupoints ST35, SP10, and SP9), and external application therapy (typically herbal medicine) in the treatment of PATB syndrome. Chinese medicine treatments were used widely in the treatment of PATB syndrome. We hope in the future, this review may initiate the development of treatments for PATB syndrome using Korean medicine.

We aimed to investigate the associations of previous influenza/URI with the susceptibility of COVID-19 patients compared to that of non-COVID-19 participants. A nationwide COVID-19 cohort database was collected by the Korea National Health Insurance Corporation. A total of 8,070 COVID-19 patients (1 January 2020 through 4 June 2020) were matched with 32,280 control participants. Severe COVID-19 morbidity was defined based on the treatment histories of the intensive care unit, invasive ventilation, and extracorporeal membrane oxygenation and death. The susceptibility/morbidity/mortality associated with prior histories of 1–14, 1–30, 1–90, 15–45, 15–90, and 31–90 days before COVID-19 onset were analyzed using conditional/unconditional logistic regression. Prior influenza infection was related to increased susceptibility to COVID-19 (adjusted odds ratio [95% confidence interval] = 3.07 [1.61–5.85] for 1–14 days and 1.91 [1.54–2.37] for 1–90 days). Prior URI was also associated with increased susceptibility to COVID-19 (6.95 [6.38–7.58] for 1–14 days, 4.99 [4.64–5.37] for 1–30 days, and 2.70 [2.55–2.86] for 1–90 days). COVID-19 morbidity was positively associated with influenza (3.64 [1.55–9.21] and 3.59 [1.42–9.05]) and URI (1.40 [1.11–1.78] and 1.28 [1.02–1.61]) at 1–14 days and 1–30 days, respectively. Overall, previous influenza/URI did not show an association with COVID-19 mortality. Previous influenza/URI histories were associated with increased COVID-19 susceptibility and morbidity. Our findings indicate why controlling influenza/URI is important during the COVID-19 pandemic.

Currently, we are developing an AC/DC conversion technology with the development of power semiconductors. Accordingly, DC is attracting attention because it is advantageous in the current transmission system. However, it has a problem that the cut-off technology required for DC system operation has not been secured yet. We are researching and developing a DC cut-off technology in several ways. We proposed a model that combines a superconducting fault current limiter and a DC circuit breaker. This is a configuration which a superconducting fault current limiter and a mechanical DC circuit breaker are connected in series. The superconducting fault current limiter limits the initial fault current and the mechanical DC circuit breaker cuts off the fault current. The mechanical DC circuit breaker consists of a high-speed DC switch, a LC divergent oscillation circuit and a surge arrester. This creates an artificial zero-point by affecting the blocking of the DC fault current according to the LC diverging oscillation circuit. In this paper, we analyzed the effect of the LC divergent oscillation circuit on the superconducting DC circuit breaker according to Reactor (L) and Capacitor (C). As a result, we analyzed the operating characteristics of the superconducting DC circuit breaker according to the application of the LC divergent oscillation circuit using the PSCAD/EMTDC program. Also, we confirmed the characteristics of the initial fault current limit rate of the superconducting fault current limiter and the possibility of controlling how the LC divergent oscillation circuit affects the DC arc generated at the opening of the mechanical DC contacts.

Alcohol consumption causes metabolic disorders and is a known risk factor for cardiovascular disease. However, some studies suggested that low level alcohol consumption improves insulin resistance. We evaluated the effects of alcohol consumption on insulin resistance using the homeostatic model assessment for insulin resistance (HOMA-IR).This study included 280,194 people without diabetes who underwent comprehensive health examinations more than twice between 2011 and 2018. The levels of alcohol intake were obtained through a self-questionnaire. All subjects were divided into two groups based on the Korean standard cut-off value of HOMA-IR, 2.2. Cox proportional hazard analysis was used to assess the risk of insulin resistance according to alcohol consumption. The mean age of the study subjects was 38.2 years and 55.7% were men. During the follow-up period (median 4.13 years), HOMA-IR progressed from2.2 to ≥2.2 in 64,443 subjects (23.0%) and improved from ≥2.2 to2.2 in 21,673 subjects (7.7%). In the parametric survival analysis, alcohol consumption was associated with improvement of HOMA-IR (HR [95% CI], 1.09[1.03-1.14], 1.11[1.06-1.17] and 1.20[1.13-1.26], respectively). In the analysis classified according to changes in alcohol consumption amounts, increased alcohol consumption tended to prevent the progression of HOMA-IR (0.97[0.96-0.99]; p = 0.004). However, the association between the changes in alcohol consumption amounts and improvement of HOMA-IR was not statistically significant.This retrospective observational study has shown that alcohol consumption can improve insulin resistance and increased alcohol consumption amounts may have preventive effects on the progression of HOMA-IR compared to the baseline level.

Objective Many epidemiological studies have observed the association of air pollutant exposure with the onset, progression, and mortality of stroke. The aim of this study was to investigate the associations of air pollutants, including SO2, NO2, O3, CO, and PM10, with stroke according to exposure duration. Methods Data from the Korean National Health Insurance Service-Health Screening Cohort from 2002 to 2015 were obtained. The 21,240 patients who were admitted for or died due to stroke were 1:4 matched for age, sex, income, and region of residence with 84,960 control participants. The meteorological factors of mean, highest, and lowest temperatures; relative humidity; ambient atmospheric pressure; and air pollutant concentrations (SO2, NO2, O3, CO, and PM10) were analyzed to determine their associations with stroke. The odds ratios for stroke after exposure to each meteorological factor and air pollutant at 7 and 30 days were calculated in the stroke and control groups. Subgroup analyses were conducted according to age, sex, income, and region of residence. Results The odds ratio associated with seven days of exposure to CO was 1.16 (95% CI = 1.04–1.31) in stroke patients. For 30 days of exposure, the odds ratio associated with CO was 1.16 (95% CI = 1.02–1.32) in stroke patients. Seven and 30 days of NO2 exposure were inversely associated with stroke. The odds ratio associated with seven days of exposure to O3 was 1.16 (95% CI = 1.01–1.32) in ischemic stroke patients. Both ischemic and hemorrhagic stroke had negative associations with 7 and 30 days of NO2 exposure. Conclusion Both short- and long-term exposure to CO were related to stroke.

Currently, power semiconductors (IGBT, Thyristor, etc.) are used for the stability and high reliability of DC system operation. However, we have proposed a current limiting DC circuit breaker with superconducting winding to improve the stability of the DC system. This is superior in terms of fast cut-off speed and economy of power semiconductors, and is suitable for changes to the Point to Loads DC system that will be expanded in the future. A superconducting DC circuit breaker is a model in which a superconducting current limiter and a DC circuit breaker are combined. The superconducting fault current limiter uses a superconducting wire made of GdBCO material to limit the initial fault current to lower the current level of the fault current, and the DC circuit breaker blocks the reduced fault current from the superconducting fault current limiter by configuring a mechanical cutoff switch, passive elements L, C and SPD. In this paper, this superconducting DC circuit breaker model was designed and tested by giving two variables, and the operating characteristics were analyzed. The first is the superconducting wire connection method, and the second is the power supply voltage. In addition, the initial fault current, the time when the zero point of the fault current is generated, and the time when the shutdown is completed were compared and analyzed. As a result, it was confirmed that the helical type showed a higher current limiting rate than the spiral type, and the result of reaching a fast current zero point was confirmed.

We have studied the operation of the circuit breaker for 15 kV DC power grid with the combination of the breaker and the HTS Fault Current Limiter (FCL). The HTS FCL limits the fault current by introduce of the impedance under the fault condition, so the circuit breaker with the HTS FCL module can be expected to be able to break the higher prospective fault current successfully. As an attached module to the DC circuit breaker, we performed a design work for a DC resistive HTS FCL module with SuNAM's REBCO conductor with the stainless-steel stabilizer. Considering the operation delay time of the DC circuit breaker, the HTS FCL module should generate a proper impedance for 16 milliseconds at most without any damages. To verify the design results, we designed and make scaled-down model of the HTS FCL module. We also carried out the DC short-circuit test to check the feasibility and the fault current limiting characteristics of the suggested model.

The association between air pollutants and Meniere’s disease has not been explored. The present study investigated the relationship between meteorological factors and air pollutants on Meniere’s disease. Participants, aged ≥ 40 years, of the Korean National Health Insurance Service-Health Screening Cohort were included in this study. The 7725 patients with Meniere’s disease were matched with 30,900 control participants. The moving average meteorological and air pollution data of the previous 7 days, 1 month, 3 months, and 6 months before the onset of Meniere’s disease were compared between the Meniere’s disease and control groups using conditional logistic regression analyses. Additional analyses were conducted according to age, sex, income, and residential area. Temperature range; ambient atmospheric pressure; sunshine duration; and levels of SO2, NO2, O3, CO, and PM10 for 1 month and 6 months were associated with Meniere’s disease. Adjusted ORs (odds ratios with 95% confidence interval [CI]) for 1 and 6 months of O3 concentration were 1.29 (95% CI 1.23–1.35) and 1.31 (95% CI 1.22–1.42), respectively; that for the 1 and 6 months of CO concentration were 3.34 (95% CI 2.39–4.68) and 4.19 (95% CI 2.79–6.30), respectively. Subgroup analyses indicated a steady relationship of O3 and CO concentrations with Meniere’s disease. Meteorological factors and air pollutants were associated with the rate of Meniere’s disease. In particular, CO and O3 concentrations were positively related to the occurrence of Meniere’s disease.

Korea rarely has a system to transport patients from abroad. However, single-patient transfers are steadily being performed, and there was an experience of transferring a large number of personnel regardless of whether they were confirmed or not due to coronavirus disease 2019. Recently, a national soccer game was held abroad, and a total of 8 players and staff were infected. A total of 15 people were transported through a charter fully equipped with quarantine equipment by a medical response team with experience in air transport.

Summary Background Laparoscopic surgery has been widely used for rectal cancer; however, its long-term outcomes remain controversial. This study aimed to assess the long-term oncological safety of laparoscopic surgery for rectal cancer using 10-year follow-up data of the Comparison of Open versus laparoscopic surgery for mid or low REctal cancer After Neoadjuvant chemoradiotherapy (COREAN) trial. Methods The COREAN trial is a, open-label, non-inferiority, randomised controlled trial. Eligible participants were aged 18–80 years, had cT3N0–2M0 middle or low rectal cancer with lesions located within 9 cm of the anal verge, and had been treated with preoperative chemoradiotherapy. Patients were randomly assigned (1:1) to open or laparoscopic surgery with a computer-generated random allocation sequence with a random permuted block design. Neither patients nor clinicians were masked to treatment assignment. Open or laparoscopic total mesorectal excision was done 6–8 weeks after the administration of preoperative concurrent chemoradiotherapy (fluoropyrimidines alone, doublet therapy, or triplet therapy) at a dose of 50·5 Gy over 5·5 weeks. Postoperative adjuvant chemotherapy was administered for 4 months. The primary endpoint of 3-year disease-free survival was published previously. Here, we report 10-year overall survival, disease-free survival, and local recurrence. Analyses were done in the modified intention-to-treat population of all participants who were randomly assigned and provided follow-up data. This study is registered with ClinicalTrials.gov, NCT00470951. Findings Of the 340 patients enrolled in the COREAN trial between April 4, 2006, and Aug 26, 2009 (170 patients in each group), two patients in the laparoscopic surgery group moved abroad and were lost to follow-up, so were not included in this 10-year analysis. The median duration of follow-up was 143 months (IQR 122–156). No differences were observed in 10-year overall survival (74·1% [95% CI 66·8–80·0] in the open surgery group vs 76·8% [69·6–82·5] in the laparoscopic surgery group; p=0·44), 10-year disease-free survival (59·3% [51·1–66·5] vs 64·3% [56·0–71·5]; p=0·20), or 10-year local recurrence (8·9% [5·2–15·0] vs 3·4% [1·4–7·9]; p=0·050) between the open surgery and laparoscopic surgery groups at 10 years after surgery. The stratified hazard ratios, adjusted for ypT and ypN classification and tumour regression grade, for open surgery versus laparoscopic surgery were 0·94 (95% CI 0·63–1·43) for overall survival, 1·05 (0·74–1·49) for disease-free survival, and 2·22 (0·78–6·34) for local recurrence. Interpretation The 10-year follow-up of the COREAN trial confirms the long-term oncological safety of laparoscopic surgery in patients with rectal cancer treated with preoperative chemoradiotherapy. Similar to open surgery, laparoscopic surgery does not compromise long-term survival outcomes in rectal cancer when performed by well trained surgeons. Funding National Cancer Center, Goyang, South Korea.

This study aimed to investigate the association of previous stain use with hearing impairment in an adult population. Data from the ≥ 40-year-old population in the Korean National Health Insurance Service Health Screening Cohort were used. The hearing impairment group was classified based on the national registry of hearing-impaired persons. Control participants were randomly selected and matched for age, sex, income, and region of residence. The number of days of statin prescription during the 2 years before the diagnosis of hearing impairment was compared between the hearing impairment group and the control group using conditional logistic regression analysis. Additional analyses were conducted according to age and sex. The number of days of previous statin use was not different between the hearing impairment group and the control group (adjusted odds ratio [aOR] = 0.94, 95% confidence interval (CI) = 0.86–1.02, P = 0.118). According to age, in the ≥ 70-year-old group, those with hearing impairment had 11% lower rates of previous statin use than those in the control group (aOR = 0.89, 95% CI = 0.80–0.99, P = 0.039). According to sex, in the male group, 12% lower rates of previous statin use were observed among those with hearing impairment than among those in the control group (aOR = 0.88, 95% CI = 0.79–0.99, P = 0.037). Previous statin use might have an effect on reducing the prevalence of hearing impairment in elderly individuals and men.

This study aimed to evaluate the association between cervical cancer and the occurrence of osteoporosis and osteoporotic fracture using data from the Korean Genome and Epidemiology Study (KoGES). In this national cohort study using KoGES health examination (HEXA) data, we extracted data for patients with cervical cancer (n = 493) and control participants (n = 77,571); we then analyzed the occurrence of osteoporosis and osteoporotic fracture at baseline from 2004 to 2013 and during follow-up from 2012 to 2016. A logistic regression model was used to analyze the odds ratios (ORs) and the 95% confidence intervals (CIs). The ORs (95% CIs) for osteoporosis and osteoporotic fracture were 1.49 (95% CI 1.15–1.92, p = 0.03) and 1.06 (95% CI 0.82–1.38, p = 0.634), respectively, in the cervical cancer group. The ORs (95% CIs) for osteoporosis were 2.12 (95% CI 1.14–3.95, p = 0.018) in the ≤ 51-year-old group and 1.43 (95% CI 1.08–1.89, p = 0.011) in the ≥ 52-year-old group of cervical cancer patients. We concluded that Korean women with cervical cancer had a higher risk of osteoporosis than healthy women, but the same finding was not observed for osteoporotic fracture.

The aim of the present study was to evaluate the association between hyperuricemia and osteoporosis in a Korean population. Data from participants of the Korean Genome and Epidemiology Study who were ≥ 40 years old were collected from 2004 to 2016. Among 173,209 participants, 11,781 with hyperuricemia (> 7.0 mg/dL in men and > 6.0 mg/dL in women) and 156,580 controls were selected based on serum measurements. Odds ratios (ORs) of osteoporosis between individuals with hyperuricemia and controls were analyzed using a logistic regression model. In the adjusted model, age, sex, income group, body mass index, smoking, alcohol consumption, hypertension, diabetes mellitus, hyperlipidemia history and nutritional intake were adjusted. The adjusted OR (aOR) of osteoporosis was 0.79 [95% confidence interval (CI) = 0.71–0.87, P 60 years old and in women > 50 years old. In another subgroup analysis according to past medical history, significant differences were found according to hypertension (aOR = 0.83, 95% CI = 0.73–0.94, and 0.75, 95% CI = 0.64–0.87), diabetes mellitus (aOR = 0.77, 95% CI = 0.69–0.86), and hyperlipidemia (aOR = 0.74, 95% CI = 0.61–0.89, and 0.81, 95% CI = 0.72–0.91). This study demonstrated that hyperuricemia was associated with a decreased risk of osteoporosis.

Background: This study aimed to investigate the demographic characteristics of patients with knee pain caused by traffic accidents and test the effectiveness of Korean medicine (KM) treatment.Methods: The medical charts of 114 inpatients with knee pain caused by a traffic accident were reviewed from July 1, 2019 to October 31, 2019 at Bucheon Jaseng Hospital of KM. The patients’ demographics including gender, age, period of hospitalization, and type of pharmacopuncture and herbal medicine prescribed were reviewed. The Numeric Rating Scale scores and Western Ontario and McMaster Universities Osteoarthritis Index scores were used to assess subjective knee pain.Results: There were more females (55%) than males in this study. Patients were more likely to be in their 30s (27.2%), be hospitalized for 11-14 days (41.2%), treated with Hwangryunhaedok pharmacopuncture (78.1%), and be prescribed Hwalhyeoljitong decoction (62.3%).The mean Numeric Rating Scale score for patients with knee pain caused by a traffic accident decreased significantly from 4.26 ± 1.39 to 2.53 ± 1.60 (p < 0.001), and the mean Western Ontario and McMaster Universities Osteoarthritis Index score also decreased significantly from 32.72 ± 18.36 to 23.40 ± 15.80 (p < 0.001) following KM treatment.Conclusion: As a result of analyzing 114 hospitalized patients with knee joint pain due to TAs, inpatients were more likely to be female (55%), a patient in their 30s (27.2%), and be a patient hospitalized for 11-14 days (41.2%). KM treatment of traumatic knee injury using pharmacopuncture therapy and herbal medicine can be an may be effective at reducing pain, and healing functional disorders of the knee.

This study investigated the association of previous use of proton pump inhibitors (PPIs) with the rate of hearing impairment. The ≥40-year-old population in the Korean National Health Insurance Service-Health Screening Cohort was enrolled. The 6626 registered hearing-impaired patients were matched with 508,240 control participants for age, sex, income, region of residence, and index date (date of hearing impairment diagnosis). The prescription histories of PPIs were collected for 2 years before the index date. The odds ratios of the duration of PPI use for hearing impairment were analyzed using conditional logistic regression. Subgroups of age/sex and severity of hearing impairments were additionally analyzed for the relation of PPI use with hearing impairment. PPI use for 30–365 days was associated with a 1.65-times higher odds of hearing impairment (95% confidence interval (CI) = 1.47–1.86 for 30–365 days of PPI medication). PPI use for ≥365 days was also related to 1.52-times higher odds of hearing impairment (95% CI = 1.35–1.72, p &lt, 0.001). All age and sex subgroups demonstrated a positive association between PPI use and hearing impairment. Severe hearing impairment showed consistently higher odds of a relation with PPI use. PPI use was associated with an increased rate of hearing impairment.

The association of thyroid cancer with statin use is controversial. This study aimed to investigate the association of previous statin use with thyroid cancer in the ≥ 40-year-old population in the Korean National Health Insurance Service-Health Screening Cohort. The 5501 patients in the thyroid cancer group were matched with the 22,004 patients in the non-thyroid cancer group for age, sex, income, and region of residence. Previous statin use during the 2 years before the diagnosis of thyroid cancer was examined. The odds ratios (ORs) with 95% confidence intervals (CIs) of previous statin use for thyroid cancer were estimated using conditional logistic regression analyses. Additionally, subgroup analyses were conducted. The thyroid cancer group showed more days of previous statin use than the non-thyroid cancer group (72.3, standard deviation [SD] = 181.2 days vs. 64.3, SD = 174.4 days, P = 0.003). Although the odds of previous statin use for thyroid cancer were high in the crude model (OR = 1.10, 95% CI 1.04–1.17, P = 0.002), they were low in the fully adjusted model (OR = 0.89, 95% CI 0.82–0.95, P = 0.001). According to age and sex subgroups, the younger (

Previous studies have suggested an increased risk of ischemic heart disease related to air pollution. This study aimed to explore both the short-term and long-term effects of air pollutants on the risk of ischemic heart disease after adjusting for meteorological factors. The Korean National Health Insurance Service-Health Screening Cohort from 2002 to 2013 was used. Overall, 2155 participants with ischemic heart disease and 8620 control participants were analyzed. The meteorological data and air pollution data, including SO2 (ppm), NO2 (ppm), O3 (ppm), CO (ppm), and particulate matter (PM)10 (μg/m3), were analyzed using conditional logistic regression. Subgroup analyses were performed according to age, sex, income, and region of residence. One-month exposure to SO2 was related to 1.36-fold higher odds for ischemic heart disease (95% confidence interval [95% CI] 1.06–1.75). One-year exposure to SO2, O3, and PM10 was associated with 1.58- (95% CI 1.01–2.47), 1.53- (95% CI 1.27–1.84), and 1.14 (95% CI 1.02–1.26)-fold higher odds for ischemic heart disease. In subgroup analyses, the ≥ 60-year-old group, men, individuals with low income, and urban groups demonstrated higher odds associated with 1-month exposure to SO2. Short-term exposure to SO2 and long-term exposure to SO2, O3, and PM10 were related to ischemic heart disease.

Background Chronic periodontitis is a multifactorial inflammatory disease resulting in patients exhibiting high levels of inflammatory factors causing systemic inflammatory bone destruction that may lead to osteoporosis development. The association between periodontitis and osteoporosis has been documented; however, the findings remain unclear. This study aimed to identify the association between periodontitis and osteoporosis using a cross-sectional study design and Korean Genome and Epidemiology Study (KoGES) health examinee data. Methods This cross-sectional study used epidemiological data from the KoGES during 2004–2016. Of 125,324 participants (age, 40–79 years), 9969 with periodontitis and 115,332 controls (without periodontitis) were selected. We analyzed the history of osteoporosis and fractures of all participants. All participants were examined according to age, sex, income group, obesity, smoking habits, alcohol consumption, and food intake. To analyze the odds ratio (OR) of periodontitis for those with osteoporosis and fractures, a logistic regression model was used. Results The adjusted odds ratio (aOR) of periodontitis for osteoporosis was 2.16 (95% confidence interval [CI], 2.01–2.31; P P Conclusion Osteoporosis and fractures are associated with periodontitis. Performing regular oral hygiene and examinations of bone mineral density are recommended to prevent aggravation of osteoporosis and periodontitis.

BACKGROUND/OBJECTIVE Although previous studies reported the relationship between psoriasis and herpes zoster, the number of study is not sufficient to support the conclusions. The purpose of this study was to evaluate the association between psoriasis and herpes zoster. METHODS The data of a nationally representative Korean cohort collected in the Korean Health Insurance Review and Assessment (HIRA) System from 2002 to 2013 were used. Psoriasis was defined ≥ 2 International Classification of Diseases 10th revision (ICD-10) L40 codes. Among them, severe psoriasis was defined as psoriatic medication use, including acitretin, systemic corticosteroid, cyclosporine and methotrexate. Other psoriasis was defined as mild psoriasis. Herpes zoster was defined as ≥ 2 ICD-10 B02 codes or ≥ 1 B02 code with antiviral medication use. Psoriasis patients (n = 11 009) and control participants (n = 44 036) were matched 1:4 by age, sex, income and region of residence. A stratified Cox proportional hazard model was used stratified by age, sex, income and region of residence. Crude and adjusted hazard ratios (HRs) were calculated for the risk of herpes zoster in the total psoriasis group, mild psoriasis group, and severe psoriasis group and compared with those in each matched control group. RESULTS The HR for herpes zoster was higher in the psoriasis group than in control group (adjusted HR = 1.22, 95% CI = 1.12-1.33, P

Purpose: This study aimed to evaluate the effects of a rational emotive behavior therapy (REBT)-based emotional regulation program for mothers of premature infants in the neonatal intensive care unit (NICU). Methods: The study utilized a nonequivalent control group pretest-posttest design. Seventeen mothers were recruited for the experimental group and 21 mothers for the control group. Data were collected from July 9, 2018, to Oct 12, 2018 from mothers of premature infants in the NICU regarding parental stress, state anxiety, depression, and maladaptive cognitive emotion regulation. The experimental group received eight sessions of the REBT-based emotional regulation program for 3~4 weeks, and the control group only received standard nursing care.Results: Significant differences were found between the two groups in maladaptive cognitive emotion regulation (Z=-3.88, pp=.006), state anxiety (Z=-3.72, pp=.009) after the intervention in the experimental group.Conclusion: The REBT-based emotional regulation program for mothers of premature infants was effective for reducing maladaptive cognitive emotion regulation, stress, anxiety, and postpartum depression. Therefore, it may be necessary to provide an REBT-based emotional regulation program for mothers of premature infants in the NICU in clinical practice.

Objectives: The hearing process involves complex peripheral and central auditory pathways and could be influenced by various situations or medications. To date, there is very little known about the effects of alcohol on the auditory performances. The purpose of the present study was to evaluate how acute alcohol administration affects various aspects of hearing performance in human subjects, from the auditory perceptive threshold to the speech-in-noise task, which is cognitively demanding. Methods: A total of 43 healthy volunteers were recruited, and each of the participants received calculated amounts of alcohol according to their body weight and sex with a targeted blood alcohol content level of 0.05% using the Widmark formula. Hearing was tested in alcohol-free conditions (no alcohol intake within the previous 24 h) and acute alcohol conditions. A test battery composed of pure-tone audiometry, speech reception threshold (SRT), word recognition score (WRS), distortion product otoacoustic emission (DPOAE), gaps-in-noise (GIN) test, and Korean matrix sentence test (testing speech perception in noise) was performed in the 2 conditions. Results: Acute alcohol intake elevated pure-tone hearing thresholds and SRT but did not affect WRS. Both otoacoustic emissions recorded with DPOAE and the temporal resolution measured with the GIN test were not influenced by alcohol intake. The hearing performance in a noisy environment in both easy (−2 dB signal-to-noise ratio [SNR]) and difficult (−8 dB SNR) conditions was decreased by alcohol. Conclusions: Acute alcohol elevated auditory perceptive thresholds and affected performance in complex and difficult auditory tasks rather than simple tasks.

Few studies have evaluated the effects of energy drinks on allergic diseases. The purpose of this investigation was to evaluate the association between energy drinks and various allergic diseases, including asthma, allergic rhinitis, and atopic dermatitis, in a large representative Korean adolescent population. This cross-sectional study used data from the Korea Youth Risk Behavior Web-based Survey collected from 2015 to 2016. A total of 129,809 participants (n = 67,056 for males; n = 62,753 for females) aged 12–18 years were included and were asked about their frequency of consumption of energy drinks such as Hot6®, Redbull®, and Bacchus®. Their history of asthma, allergic rhinitis, and atopic dermatitis throughout life and in the last 12 months were obtained. The association between the frequency of energy-drink consumption and allergic diseases was analyzed using multiple logistic regression with adjustment for various covariates. Age, sex, physical activity, obesity, region of residence, economic level, paternal and maternal educational level, smoking, and alcohol consumption differed significantly according to the frequency of energy-drink consumption (each P

Objective To determine the risk factors for herpes zoster (HZ) in patients with rheumatic diseases in Korea. Methods We used the nationwide database of the Health Insurance Review & Assessment Service to analyse patients aged ≥20 years who had visited a hospital more than twice for rheumatic disease as a principal diagnosis from January 2009 to April 2013. HZ was identified using HZ-related Korean Standard Classification of Diseases 6 (KCD-6) codes and the prescription of antiviral agents. The relationship between demographics, comorbidities and medications and HZ risk was analysed by Cox proportional hazards models. Results HZ developed in 1869 patients. In Cox proportional hazards models, female sex but not age showed an increased adjusted hazard ratio (HR) for HZ. Comorbidities such as haematologic malignancies, hypertension, diabetes mellitus, and chronic lung and liver diseases led to an increased HR. HZ risk was higher in patients with SLE (HR: 4.29, 95% CI: 3.49, 5.27) and Behçet’s syndrome (BS, HR: 4.54; 95% CI: 3.66, 5.64) than with RA. The use of conventional DMARDs, immunosuppressants, TNF inhibitors, glucocorticoids and NSAIDs increased the HR. Infliximab and glucocorticoids (equivalent prednisolone dose >15 mg/day) produced the highest HZ risk (HR: 2.91, 95% CI: 1.72, 4.89; HR: 2.85, 95% CI: 2.15, 3.77, respectively). Conclusion Female sex, comorbidities and medications increased HZ risk in patients with rheumatic diseases and even young patients could develop HZ. Compared with RA, SLE and BS are stronger HZ risk factors. Patients with rheumatic diseases and these risk factors are potential target populations for HZ vaccination.

The effect of statin on sudden sensorineural hearing loss (SSNHL) remains unclear. Thus, this study aimed to investigate the association between prior statin use and SSNHL.A nested case-control study.Participants aged ≥40 years were enrolled from the 2002-2015 Korean National Health Insurance Service-Health Screening Cohort.A total of 5876 patients with SSNHL were matched with 23,504 control participants for age, sex, income, and region of residence. History of statin use for 2 years before SSNHL onset was investigated between the groups. The odds ratios (ORs) of the length of statin use for SSNHL stratified by age, sex, income, and region of residence were analyzed with conditional logistic regression. Dyslipidemia, total cholesterol, blood pressure, blood glucose, hemoglobin, obesity, smoking, alcohol consumption, and Charlson Comorbidity Index score were adjusted. The adjusted variables were subjected to subgroup analyses.The SSNHL group had a longer duration of statin use than the control group (mean [SD], 81.9 [197.7] days vs 72.7 [188.0] days;Previous statin use was not associated with SSNHL.

We found that combination of high-intensity PA and high 25(OH)D levels was associated with low prevalence of osteoporosis/osteopenia. In addition, the prevalence of osteoporosis was lower in the low PA with high 25(OH)D levels than in the moderate or high PA with low 25(OH)D levels. The aim of this study was to explore the association of physical activity (PA) and serum 25-hydroxyvitamin D (25[OH]D) levels with osteopenia/osteoporosis. The Korean National Health and Nutrition Examination Survey data from 2008 to 2011 were used in this study. Data from 6868 individuals were selected. Each individual’s level of PA was classified as ‘low’, ‘moderate’, or ‘high’. Serum 25(OH)D levels were classified as ‘low’ or ‘high’. Accordingly, the combined PA and 25(OH)D groups were divided into 6 groups. Bone mineral density (BMD) was classified as ‘normal (T score ≥ − 1.0)’, ‘osteopenia (− 2.5 < T score < − 1.0)’ or ‘osteoporosis (T score ≤ − 2.5)’. Crude and adjusted odds ratios (AORs) with 95% confidence intervals (CIs) were calculated using multinomial logistic regression models. The AORs (95% CIs) for osteopenia were 0.64 (0.50–0.83) in the high PA with high 25(OH)D group and 0.69 (0.53–0.88) in the moderate PA with high 25(OH)D group. The AORs (95% CIs) for osteoporosis were increased in the groups in ascending order as follows: high PA with high 25(OH)D (0.40 [0.28–0.57]) < moderate PA with high 25(OH)D (0.47 [0.33–0.66]) < low PA with high 25(OH)D (0.59 [0.42–0.83]) < high PA with low 25(OH)D (0.70 [0.49–1.00]) < moderate PA with low 25(OH)D (0.76 [0.53–1.07]) < low PA with low 25(OH)D. This result was consistent in males but not evident in females. We suggest that the combination of high-intensity PA and high 25(OH)D levels is positively associated with high BMD.

A total of 25,306 psoriasis participants were matched to 101,224 controls, and the occurrence of osteoporosis was analyzed. Additionally, 79,212 osteoporosis patients were matched to 79,212 controls and a previous history of psoriasis was analyzed. Psoriasis increased the risk of osteoporosis among participants aged ≥ 40 years. The aim of the present study was to evaluate the association between psoriasis and osteoporosis using two different studies. Data from the Korean National Health Insurance Service-Health Screening Cohort of participants aged ≥ 40 years were collected from 2002 to 2013. Psoriasis and osteoporosis were included using International Classification of Diseases (ICD)-10 codes. In study I (a follow-up study), a total of 25,306 psoriasis participants were matched to 101,224 controls with respect to age, sex, income, and region of residence, and the occurrence of osteoporosis was analyzed. Crude (simple) and adjusted hazard ratios (HRs) were analyzed using a stratified Cox proportional hazard model. In study II (a nested case–control study), a total of 79,212 osteoporosis patients were matched to 79,212 controls and a previous history of psoriasis was analyzed. Crude and adjusted odds ratios (ORs) were analyzed using a conditional logistic regression analysis. Subgroup analyses were conducted according to age group and sex. The adjusted HR of osteoporosis was 1.09 (95% confidence interval [CI] = 1.05–1.13, P < 0.001) in study I. In the subgroup analysis according to age and sex, the results were consistent except for ≥ 60-year-old women. The adjusted OR of psoriasis was 1.21 (95% CI = 1.16–1.27, P < 0.001) in study II. All subgroups demonstrated high adjusted ORs of osteoporosis for psoriasis. Psoriasis increased the risk of osteoporosis among participants aged ≥ 40 years in Korea.

This review aimed to compare the effectiveness of Korean medicine (KM) with Korean-Western integrative medicine (KWIM) at treating Bell’s palsy. A literature search of several databases for relevant randomized controlled trials was performed. Six studies that compared KM with KWIM to treat Bell’s palsy were included in this review. Acupuncture and steroids were the most commonly used treatments in KWIM. A comparison of the effectiveness of KW with KWIM did not produce consistent results. Both KM and KWIM were useful intreating Bell’s palsy. KWIM was more effective than KM when the Western medicine was a steroid and was given in the early stages of treatment. However, these findings are limited due to the low quality and number of included studies. KM and KWIM are both effective in Bell’s palsy, and KWIM is more effective than KM. However, more high-quality randomized controlled trials are required.

Background The purpose of this study was to evaluate the long-term mortality and cause of death in patients with tracheostomy. Methods Data from the Korean National Health Insurance Service-Health Screening Cohort were collected from 2002 to 2013. A total of 2394 tracheostomy participants and 9536 control participants were included in this study. The crude and adjusted hazard ratios (HRs) for tracheostomy-associated mortality were analyzed. Subgroup analysis according to age and cause of death was analyzed. Results The tracheostomy group showed a significantly higher rate of death (69.1%) than the nontracheostomy group (13.3%). The adjusted HR for mortality was 13.5 in the tracheostomy group. The most common cause of death after tracheostomy was a circulatory disease, followed by neoplasm, respiratory disease, and trauma. Conclusions Patients with tracheostomy had a significantly increased long-term mortality rate compared with patients with nontracheostomy. The circulatory disease was the most common cause of death following tracheostomy.

Several previous studies have suggested a relationship between GERD and RA. However, no study has investigated the bidirectional relationship between GERD and RA. This study aimed to evaluate the causal relationships between rheumatoid arthritis (RA) and gastroesophageal reflux disease (GERD). Participants aged ≥ 20 years old in the Korean Health Insurance Review and Assessment Service-National Sample Cohort from 2002 to 2013 were enrolled. In study I, 132,140 GERD participants were 1:2 matched with 264,280 control I participants. In study II, 6615 RA participants were 1:4 matched with 26,460 control II participants. Both control I and control II groups were matched with their study groups for age, sex, income, and region of residence. The occurrence of RA (study I) and GERD (study II) were followed up in both the study and control groups. The hazard ratios (HRs) of GERD for RA (study I) and of RA for GERD (study II) were analysed using stratified Cox-proportional hazards models. In study I, 0.8% (1,034/132,140) of the GERD group and 0.5% (1,290/264,280) of the control I group had RA (P < 0.001). The GERD group demonstrated a 1.49-fold higher adjusted HR than did the control I group (95% confidence interval (95% CI) = 1.37-1.62, P < 0.001). In study II, 22.5% (1,490/6,615) of the RA group and 15.2% (4,034/26,460) of the control II group had GERD (P < 0.001). The RA group showed a 1.46-fold higher adjusted HR than did the control II group (95% CI = 1.38-1.55, P < 0.001). GERD and RA have bidirectional associations in Korean adult population. Key Points • Several previous studies have suggested a relationship between gastroesophageal reflux disease (GERD) and rheumatoid arthritis (RA). • However, no study has investigated the bidirectional relationship between GERD and RA. • This is the first study to present a bidirectional relationship between GERD and RA. • GERD and RA have bidirectional relations with each other.

Telomerase reverse transcriptase gene promoter (TERTp) mutation is a potential candidate for pathogenesis and therapeutic target of tonsillar squamous cell carcinomas (TSCCs) in association with human papillomavirus (HPV). Their clinical relevance has not been validated under the new 8th American Joint Committee on Cancer (AJCC) staging system. We analyzed real-time peptide nucleic acid–mediated PCR and sequencing methods (TERTp mutation) and real-time PCR-based assay (HPV) in 80 surgically resected TSCCs. The 8th edition staging system improved the stratification of the early and advanced stages and between T or N categories for overall survival over the 7th edition. TERTp mutation was found in 7.5%, and HPV in 80.0% of the patients. The majority (83.3%) of TERTp mutation cases were HPV-positive TSCCs. Applying the 8th edition staging system, TERTp mutation was an independent factor of poor prognosis for disease-free survival (DFS) in TSCC patients, supporting the clinical significance of TERTp mutation in tonsil cancer. TERTp mutations were also negatively correlated with overall survival and DFS in HPV-negative TSCCs. Conclusively, TERTp mutation provides negative prognostic impact on survival of surgically managed tonsil cancers staged with the AJCC 8th edition.

This study compared the effects of diosmin and its aglycone, diosmetin, on body weight, liver fat, serum cholesterol, and glucose intolerance in male C57BL/6 mice fed a high‐fat high‐sucrose (HFHS) diet for 12 weeks. The mice were divided into four groups that received the following diets: normal diet (ND), HFHS diet, HFHS diet with 0.5% diosmin, and HFHS diet with 0.5% diosmetin. The body weight increased significantly in the HFHS diet group but decreased significantly in the HFHS diet with 0.5% diosmin group. The diosmin and diosmetin treatment inhibited fat accumulation in liver and epididymal tissues, and improved glucose intolerance by lowering glucose levels during a glucose tolerance test; these effects were greater in the diosmin group than those in the diosmetin group. Furthermore, only diosmin significantly ameliorated dyslipidemia, by reducing TC and LDL‐C levels, while diosmetin had little effect on these parameters. Taken together, the results showed that diosmin and diosmetin can prevent fat accumulation and glucose intolerance; however, diosmin was more effective and also showed an antidyslipidemic effect., Diosmin and diosmetin improved major parameters of metabolic disorders including fat accumulation and glucose intolerance. However, the effects of diosmin supplement seem to be greater, particularly in terms of the antihyperlipidemic effect.

The risks for hip fracture and vertebral fracture, but not the risk for distal radius fracture, were significantly higher in the blindness group than in the control group with a maximum 12-year follow-up. To evaluate the influence of visual impairment on the risk for osteoporotic fractures at common sites: hip, thoracic/lumbar vertebra, and distal radius. This longitudinal follow-up study used a database of a national sample cohort from 2002 to 2013 provided by the Korean National Health Insurance Service. Of a total of 1,125,691 subjects, 3918 patients with visual impairment and age ≥ 50 years were enrolled in a 1:4 ratio; 15,672 control participants were matched for age, sex, income, and region of residence. Stratified Cox proportional-hazards models were used to evaluate the crude and adjusted (for steroid medication, rheumatoid arthritis, depression, osteoporosis, diabetes mellitus, and stroke history) hazard ratios (HRs) for each fracture site. Fracture diagnoses were based on the ICD-10 codes: hip fracture (S720, S721, S722), vertebral fracture (S220, S320), and distal radius fracture (S525). The HRs for hip and vertebral fracture were significantly higher in the blindness group (adjusted HR = 2.46, p < 0.001 for hip fracture; adjusted HR = 1.42, p = 0.020 for thoracic/lumbar vertebral fracture) than in the matched control group. However, the HR for distal radius fracture was not higher in the blindness group. The HRs for all three fracture sites were not significantly higher in the non-blindness visual impairment group after adjustment. The risks for hip fracture and vertebral fracture were significantly higher in the blindness group. However, the risk for distal radius fracture was not related to visual impairment including blindness.

We research team has proposed a current-limiting superconducting DC circuit breaker that combines a High-temperature superconducting wire (HTS) with a DC circuit breaker, and secured its operation performance in our previous study via simulation. In this paper, we designed and produced an actual current-limiting superconducting DC circuit breaker, as well as analyzed its current limiting and breaking performance. In addition, the operation characteristics at different lengths of the HTS with increasing voltage were analyzed. The operation reliability of the proposed DC circuit breaker was demonstrated by a simulation system that was built similar to the actual system.

A wireless power transfer (WPT) method using superconductors was previously proposed (I. S. Jeong et. al. , 2013). Subsequently, the research team proposes superconducting WPT technology for electric vehicle (EV) application. The technology is designed to maximize efficiency by applying a superconductor to the transmission and reception resonant coils. The efficiency of wireless power transmission is determined by numerous variables, including the magnetic flux, the inductance of the resonant coil, and the mutual inductance. Therefore, it is possible to increase the efficiency by changing the shape of the resonant coil. In this paper, a spiral-type coil with a laminated structure was applied as a resonant coil for wireless power transmission for EV. This can increase the efficiency by generating a greater amount of magnetic flux than the single-layer spiral coil. In addition, a high coupling coefficient (K) and Q-factor can be obtained by applying a superconductor to the resonant coil. As a result, it is possible to implement wireless power transmission with higher efficiency than the conventional wireless power transmission methods. Simulation analysis was performed using High-Frequency Structure Simulation (HFSS), an electromagnetic field analysis program.

BACKGROUND Recent studies have proposed that handwashing can lead to the development of allergic disease by reducing skin epithelial barrier integrity. The purpose of this study was to evaluate the association between personal hygiene practices and allergic rhinitis (AR) in a nationally representative sample of Korean adolescents. METHODS A total of 62,276 adolescent participants (aged 12 to 18 years) were analyzed using the Korea Youth Risk Behavior Web-based Survey, which was conducted in 2017. Participants were asked about the frequency of handwashing considering 5 situations. AR histories throughout life and in the last 12 months were obtained. The associations between AR and hygiene scores were analyzed using multiple logistic regression, with adjustment for possible confounders. Subgroup analyses were conducted for school level, age, economic level, and education level of each parent. RESULTS The analysis of the general characteristics showed that younger age, increased number of days of physical activity, male sex, living in a large city, high economic level, high education levels of father and mother, nonsmoking status, and no alcohol consumption were associated with a relatively high hygiene score (p < 0.001). The adjusted odds ratio (aOR) of AR was 1.12 (95% confidence interval [CI], 1.06 to 1.18; p < 0.001) throughout life and 1.21 (95% CI, 1.14 to 1.29; p < 0.001) for the previous 12 months in the highest compared with the lowest hygiene score groups. Consistent results were obtained in the female sex, any school level, middle economic level, and both parents with any education level. CONCLUSION The association between high hygiene scores and AR was significant in Korean adolescents after adjustment for several variables.

BackgroundThis study aimed to complement previous studies on the risk of herpes zoster in the asthmatic adult population.MethodsThe Korean Health Insurance Review and Assessment Service—National Sample Cohort (HIRA-NSC) from 2002 through 2013 was used. A total of 64,152 participants with herpes zoster were matched for age, sex, income, region of residence, hypertension, diabetes, and dyslipidemia with 239,780 participants who were included as a control group. In both the herpes zoster and control groups, previous history of asthma were investigated. The crude and adjusted odds ratios (ORs) and 95% confidence intervals (CI) of asthma for herpes zoster were analyzed using unconditional logistic regression analysis. Subgroup analyses were conducted according to age and sex.ResultsApproximately 16.2% (9728/59,945) and 12.8% (30,752/239,780) of participants in the herpes zoster and control groups, respectively, had a previous history of asthma (P ConclusionsThe odds for asthma were higher in the herpes zoster group.

In this study, a new type of arc-induced DC (direct current) circuit breaker is proposed as a mechanical circuit breaker suitable for DC systems. It consists of mechanical contacts, induction needles, an induction ring, and a ground line. Powerful DC arcs are generated by the movement of the mechanical contact, but they are induced to the ground by the induction needles, and are exhausted. In this study, the cut-off characteristics of the arc-induced DC circuit breaker were analyzed using the Maxwell software. A simulation model was designed, and the electrical field distribution was analyzed according to the contact pole length. In addition, a prototype was fabricated based on the simulation results, and basic cut-off operation experiments were per-formed. As a result, it was possible to investigate the blocking characteristics of the arc-induced DC circuit breaker through the simulation and experiment. Moreover, it was confirmed that the induction needles can induce DC arcs.