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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.

Objectives The adenoid pad, which is located between the orifice of the Eustachian tube (ET) and posterior nasal cavity, can affect the development of otitis media with effusion (OME) because of its anatomical location. The aim of the present study was to evaluate adenoid microbial colonization through 16S ribosomal RNA (rRNA) pyrosequencing, an advanced molecular technique, and to document the relationship with OME. Materials and methods Adenoid samples were collected using sterile cotton from 32 children during ventilation tube insertion. Sixteen children with OME who underwent tonsillectomy and adenoidectomy due to obstructive symptoms were assigned to the OME group and sixteen children without OME were assigned to the control group. We performed a 16S rRNA-based culture-independent survey of bacterial communities using the MiSeq platform. Results The diversity index, mean operational taxonomic units, and Shannon index were lower in the OME group than those in the control group. A taxonomic analysis showed differences in microbiota distribution between the OME and control groups at the phylum, genus, and species levels. The analysis, which was based on weighted UniFrac distances, revealed differences in microbial composition between the two groups. Conclusion Bacterial community analysis using 16S rRNA pyrosequencing allows us to understand the relationship between the microbial communities of adenoids and the development of OME better.

This study performed two different analyses using a large set of population data from the Korean National Health Insurance Service Health Screening Cohort to evaluate the interactional association between temporomandibular disorder (TMD) and Parkinson’s disease (PD). Two nested case–control population-based studies were conducted on 514,866 participants. In Study I, 4455 participants with TMD were matched with 17,820 control participants, with a ratio of 1:4. In Study II, 6076 participants with PD were matched with 24,304 control participants, with a ratio of 1:4. Obesity, smoking, alcohol consumption, systolic, diastolic blood pressure, fasting blood glucose level, and total cholesterol were adjusted. The adjusted odds ratio (OR) for TMD was 1.43 (95% confidence interval (CI) = 1.02–2.00) in PD patients compared to non-PD patients in Study I (p < 0.001). The adjusted OR for PD was 1.56 (95% CI = 1.13–2.15) in TMD patients compared to non-TMD patients in Study II (p = 0.007). This study demonstrated that patients with TMD have a significantly higher risk of developing PD and, conversely, those with PD have a significantly higher risk of developing TMD.

Background and objectives: Obstructive sleep apnea (OSA) is closely associated with insulin resistance (IR) and is an independent risk factor for incident type 2 diabetes mellitus (T2DM). Most studies evaluate the correlation between OSA and IR in only obese or T2DM patients. Therefore, we tried to investigate the effect of OSA on metabolic syndrome and IR in the general healthy male population. Materials and Methods: 184 subjects who visited a preventive health examination program were recruited for this study. All subjects received overnight polysomnography by a portable device (Watch-PAT 200). We examined several metabolic parameters and a homeostasis model of assessment for insulin resistance index (HOMA-IR). The subjects were divided into three groups by AHI (Apnea-hyponea index): normal group (AHI &lt, 5), mild OSA group (5 ≤ AHI &lt, 15), and moderate-severe OSA group (AHI ≥ 15). They were also divided into two groups according to minimum oxygen saturation: low group, Min-SpO2 &lt, 88%, and high group, Min-SpO2 ≥ 88%. Results: Parameters of metabolic syndrome, including waist circumference, systolic and diastolic blood pressure, triglyceride, and high-density lipoprotein cholesterol showed significant differences among the AHI groups. Furthermore, HOMA-IR showed significant differences among the AHI groups. Those parameters, including metabolic syndrome and HOMA-IR, also showed differences between Min-SpO2 groups. Conclusions: In summary, this study helps confirm that AHI is associated with HOMA-IR in the general male population. Furthermore, the severity of AHI correlated with the parameters of metabolic syndrome. Therefore, AHI might be an indicator for evaluating both T2DM and metabolic syndrome, even in the general male population.

It was hypothesized that periodontal diseases could be influenced by nutrition and food types. However, the role of nutritional factors in the risk of periodontal disease has not been clearly elucidated. This study was aimed at investigating the relationship between coffee, green tea, or soft drink intake and periodontitis. This prospective cohort study used epidemiological data from 2004 to 2016 from the Korean Genome and Epidemiology Study. Among 173,209 participants, 9,933 with periodontitis and 124,922 controls were selected. The frequency histories of coffee/green tea/soft drink intake among the participants were analyzed, and intake was categorized as no drink, mild drink (one time a month through six times a week), and heavy drink (one or more times a day). Variable factors were adjusted using logistic regression analysis (adjusted model). The chi-square test and independent t -test were used for statistical analysis. Adjusted odds ratio (aOR) for coffee or green tea intake and periodontitis were not statistically significant. The aOR was 1.16 (95% confidence interval CI = 1.11 –1.21, P < 0.001 ) for mild soft drink intake and 1.02 ( 95 % CI = 0.96 –1.09, P = 0.518 ) for heavy soft drink intake. Subgroup analysis showed that mild soft drink intake was significant across all groups ( P < 0.05 ), whereas coffee and green tea intakes were not significant in any subgroup. Overall, the study elucidated an association between mild soft drink intake and periodontitis.

This study assessed the association between thyroid cancer and family history. This cross-sectional study used epidemiological data from the Korean Genome and Epidemiology Study from 2001 to 2013. Among 211,708 participants, 988 were in the thyroid cancer group and 199,588 were in the control group. Trained interviewers questioned the participants to obtain their thyroid cancer history and age at onset. The participants were examined according to their age, sex, monthly household income, obesity, smoking, alcohol consumption, and past medical history. The adjusted odds ratios (95% confidence intervals) for the family histories of fathers, mothers, and siblings were 6.59 (2.05&ndash, 21.21), 4.76 (2.59&ndash, 8.74), and 9.53 (6.92&ndash, 13.11), respectively, and were significant. The results for the subgroup analyses according to sex were consistent. The rate of family histories of thyroid cancer for fathers and siblings were not different according to the thyroid cancer onset, while that of mothers were higher in participants with a younger age at onset (&lt, 50 years old group, 11/523 [2.1%], p = 0.007). This study demonstrated that thyroid cancer incidence was associated with thyroid cancer family history. This supports regular examination of individuals with a family history of thyroid cancer to prevent disease progression and ensure early management.

This cross-sectional study aimed to evaluate the association between periodontitis and cardiovascular disease (CVD) by reviewing and discussing the role of the oral microbiome in periodontitis and CVD. This prospective cohort study used epidemiological data from the Korean Genome and Epidemiology Study from 2004 to 2016. We selected 9973 patients with periodontitis and 125,304 controls (non-periodontitis) from 173,209 participants and analyzed their medical histories to determine the relationship between cerebral stroke/ischemic heart disease and periodontitis. The participants were questioned about any previous history of hypertension, diabetes mellitus, hyperlipidemia, cerebral stroke (hemorrhagic or ischemic), ischemic heart disease (angina or myocardial infarction), and periodontitis. Their body mass index, smoking habit, alcohol intake, nutritional intake, and income were recorded. The Chi-square test, independent t-test, and two-tailed analyses were used for statistical analysis. The adjusted OR (aOR) of periodontitis for stroke was 1.35 (95% confidence interval (CI) = 1.16&ndash, 1.57, p &lt, 0.001). The aOR of periodontitis for ischemic heart disease was 1.34 (95% CI = 1.22&ndash, 1.48, p &lt, 0.001). We concluded that periodontitis was associated with CVD and may be a risk factor for CVD. However, further studies are required to determine the association between periodontal treatment and CVD.

Previous studies have reported that chronic rhinosinusitis (CRS) is closely related to depression. The present study aims to elucidate the association between CRS without nasal polyp and depression using a national sample cohort. Using the national sample cohort from Korean Health Insurance Review and Assessment Service, we matched patients with CRS (n = 21,707) to control participants (n = 86,828), at a ratio of 1:4, according to age, sex, household income, region of residence. The stratified Cox proportional-hazards model was used to evaluate the hazard ratio (HR) between CRS and depression. A subgroup analysis was performed according to age group and gender. The HR for depression was significantly higher in patients with CRS than in control participants (adjusted HR = 1.41, 95% confidence interval = 1.33-1.48) after adjustment for age, sex, household income, region of residence, and medical history. The risk of depression was also elevated in the subgroup analysis, regardless of age or gender. In conclusion, CRS was significantly associated with the increased risk of depression.

The aim of the present study was to investigate the association between periodontitis and chronic gastritis/peptic ulcer using a cross-sectional study design. The present prospective cohort study used epidemiological data from the Korean Genome and Epidemiology Study (KoGES) recorded from 2004 to 2016. Among 173,209 participants, 9983 with periodontitis and 125,336 with no periodontitis were selected. Histories of chronic gastritis and peptic ulcer between periodontitis and no periodontitis participants were analyzed. The participants were questioned around any history of hypertension, diabetes mellitus, hyperlipidemia, cerebral stroke, ischemic heart disease, periodontitis, body mass index, smoking, alcohol consumption, nutritional intake, and financial income. Chi-square tests, independent t-tests, two-tailed analyses were used in statistical analysis of the data. The adjusted odds ratio of chronic gastritis was 2.22 (95% confidence interval [CI] = 2.10&ndash, 2.34, p &lt, 0.001) and that of peptic ulcer was 1.86 (95% CI = 1.74&ndash, 1.98, p &lt, 0.001) in model 2. This study demonstrated that periodontitis was associated with an increased risk of chronic gastritis/peptic ulcer. These findings provide additional evidence for an association between periodontitis and chronic gastritis/peptic ulcer.

This study aimed to compare the risk of chronic periodontitis (CP) between participants who underwent tonsillectomy and those who did not (control participants) using a national cohort dataset. Patients who underwent tonsillectomy were selected from a total of 514,866 participants. A control group was included if participants had not undergone tonsillectomy from 2002 to 2015. The number of CP treatments was counted from the date of the tonsillectomy treatment. Patients who underwent tonsillectomy were matched 1:4 with control participants who were categorized based on age, sex, income, and region of residence. Finally, 1044 patients who underwent tonsillectomy were matched 1:4 with 4176 control participants. The adjusted estimated value of the number of post-index date (ID) CP did not reach statistical significance in any post-ID year (each of p &gt, 0.05). In another subgroup analysis according to the number of pre- ID CP, it did not show statistical significance. This study revealed that tonsillectomy was not strongly associated with reducing the risk of CP. Even though the tonsils and periodontium are located adjacently, and tonsillectomy and CP may be related to bacterial inflammation, there was no significant risk of CP in patients undergoing tonsillectomy.

This study compared the risk of chronic periodontitis (CP) between chronic rhinosinusitis (CRS) and non-chronic rhinosinusitis (control) patients using a national cohort dataset from the Korean Health Insurance Review and Assessment Service. CRS (n = 5951) and control participants (n = 23,804) were selected after 1:4 ratio matching for age, sex, income, region of residence, and preoperative CP visits. Postoperative CP visits were measured between 2002 and 2015. The margin of equivalence of the difference between the CRS and control groups was set between &minus, 0.5 and 0.5. Statistical significance was noted in the post-index date (ID) of the third, fourth, and fifth year periods. In subgroup analyses according to age and sex, statistical significance was observed in 40&ndash, 59-year-old males in post-ID third, fourth, and fifth year periods, &ge, 60-year-old males in post-ID third and fourth year periods, and &ge, 60-year-old females in post-ID fifth year period (p &lt, 0.05, each). In another subgroup analysis based on the number of pre-ID CP visits, statistical significance was observed for pre-ID CP (0 time) in the third, fourth, and fifth year periods (p &lt, 0.05, each). This study revealed that CRS participants were likely to receive CP diagnosis and treatment.

Introduction: Powered intracapsular tonsillectomy (PIT) is a technique that protects the tonsillar capsule by using a microdebrider, resulting in faster wound-healing and reduced suffering. Many studies have found PIT to be effective, particularly in pediatric patients with obstructive sleep apnea (OSA). However, previous studies have not included patients with a history of recurrent tonsillitis. Objective: The aim of this study was to determine the efficacy of PIT in pediatric patients even with a history of recurrent tonsillitis, and therefore, we want to expand the indication for PIT and reveal its safety. Methods: A total of 886 pediatric patients underwent PIT between February 2013 and March 2016. All patients rated their postoperative pain using a visual analog scale (VAS) and completed the Korean obstructive sleep apnea (KOSA)-18 questionnaire for assessment of their quality of life (QOL). There were 539 males and 347 females. Their mean age was 6.2 years (range 2–14 years). The majority (77.7%) underwent the operation for OSA, and the rest (22.3%) had a history of recurrent tonsillitis. To compare the efficacy of PIT with traditional tonsillectomy, we selected 191 patients who underwent extracapsular tonsillectomy (ECT), a conventional technique, during the same time period. The median follow-up period was 16.7 months. During the follow-up period, instances of delayed bleeding and recurrent pharyngitis were monitored. Results: In comparison to the patients who underwent ECT, the PIT group showed significantly fewer cases of postoperative bleeding (p = 0.027). Thirteen patients in the PIT group (1.5%) visited the hospital during the follow-up period for pharyngitis, while 8 in the ECT group (4.2%) visited for pharyngitis. The mean postoperative pain score, as assessed by a VAS, was 4.6 ± 3.2, and pain improved within an average of 2.9 days after surgery in the PIT group. The mean KOSA-18 score for the QOL of the patients was 65.9 preoperatively and 35.6 postoperatively in the PIT group. Conclusions: Pediatric tonsillectomy using PIT is valid for reducing postoperative pain and improving the QOL of OSA patients. PIT is also effective and safe for patients with a history of recurrent tonsillitis.

We hypothesized that differences in the microbiome could be a cause of the substantial differences in the symptoms of and treatment options for adult and pediatric patients with chronic rhinosinusitis (CRS). First, we characterized the differences in the nasal microbiomes of pediatric and adult CRS patients. Swabs were obtained from 19 patients with chronic rhinosinusitis (9 children and 10 adults). The bacterial 16S rRNA gene was pyrosequenced to compare the microbiota of the middle meatus. No significant differences were found in species richness and alpha-diversity indices between the two groups. However, in the comparison of diversity between groups using the unweighted pair group method with arithmetic mean (UPGMA) clustering of microbiome taxonomic profiles, we observed a relatively clear separation between the adult and pediatric groups. Actinobacteria had a significantly higher relative abundance in the adult group than in the pediatric group at the phylum level. At the genus level, Corynebacterium showed significantly higher relative abundance in the adult group than in the pediatric group. This is a comparative study between the microbiomes of adult and pediatric CRS patients. We expect this study to be the first step in understanding the pathogenesis of CRS in adults and children using microbiome analysis.

The objective of this cross-sectional study was to evaluate the association between periodontitis and glaucoma. This prospective cohort study used epidemiological data from the Korean Genome and Epidemiology Study performed between 2004 and 2016. Among 173,209 participants, 9572 patients with periodontitis and 115,332 controls (nonperiodontitis) were selected. We analysed the history of glaucoma in periodontitis and control participants. The participants were interviewed regarding their history of hypertension, diabetes mellitus, hyperlipidaemia, periodontitis, glaucoma, smoking, and alcohol consumption by trained interviewers. A logistic regression model was created to analyse the odds ratio of having a history of glaucoma among patients with periodontitis. Two-tailed analyses using chi-square and independent t-tests were used for statistical analysis. The adjusted odds ratio of periodontitis as a risk factor for glaucoma was 3.44 (95% confidence interval = 2.99–3.97, p < 0.001 ). This study demonstrated that glaucoma was associated with periodontitis.

Crossed cerebellar (CC) diaschisis refers to a decrease in cerebellar perfusion in the presence of contralateral supratentorial lesions. Most of the previous studies have examined stroke patients. In contrast to strokes, seizure-related cerebral cortical lesions (SCCLs) usually show hyperperfusion, and therefore, cerebellar perfusion patterns are expected to be different from those of strokes. With arterial spin labelling (ASL), we evaluated the cerebellar perfusion status in patients with SCCLs. Using a search of the recent database over the last 31 months, 26 patients were enrolled in this study. The inclusion criteria were as follows: (1) a history of seizures, (2) MR examination taken within 24 h from the last seizure, (3) the presence of SCCLs on T2/FLAIR or DWI, (4) hyperperfusion in the corresponding areas of SCCLs on ASL, and (5) no structural abnormality in the cerebellum. The perfusion status in the contralateral cerebellum was evaluated and categorized as hyper-, iso- and hypoperfusion. The asymmetric index (AI) of cerebellar perfusion was calculated by ROI measurement of the signal intensity on ASL. The mean time between the last seizure and MR examinations was 5 h 30 min. CC hyperperfusion was observed in 17 patients (65.4%), hypoperfusion in 7 (26.9%) and isoperfusion in 2 (7.7%). Regarding the location of SCCLs, CC hyperperfusion was more frequent (71.4 vs. 58.3%), and the mean AI was higher (42.0 vs. 11.5) when the lesion involved the frontal lobe. In patients with SCCLs, CC hyperperfusion occurred more often than hypo- and isoperfusion, especially when the lesions involved the frontal lobe.

The sinonasal microbiota in human upper airway may play an important role in chronic rhinosinusitis (CRS). Thus, this study aimed to investigate the human upper airway microbiome in patients with unilateral CRS, and compare the sinonasal microbiome of the unilateral diseased site with that of a contralateral healthy site. Thirty samples, 15 each from the diseased and healthy sites, were collected from the middle meatus and/or anterior ethmoid region of 15 patients with unilateral CRS during endoscopic sinus surgery. DNA extraction and bacterial microbiome analysis via 16S rRNA gene sequencing were then performed. Corynebacterium showed the highest relative abundance, followed by Staphylococcus in samples from both the diseased and healthy sites. Further, the relative abundances of Staphylococcus and Pseudomonas were significantly lower in samples from diseased sites than in those from healthy sites. Conversely, anaerobes, including Fusobacterium, Bacteroides, and Propionibacterium, were abundantly present in samples from both sites, more so in samples from diseased sites. However, the sites showed no significant difference with respect to richness or diversity (p &gt, 0.05). Our results indicate that CRS might be a polymicrobial infection, and also suggest that Corynebacterium and Staphylococcus may exist as commensals on the sinus mucosal surface in the upper respiratory tract.

현재 국내 유도무기 사격시험의 경우, 유도무기 사격 수량 대비 명중 수량으로 계산된 명중률만을 이용하여 국내 유도무기의 성능을 판단하고 있다. 명중률만으로는 생산된 유도무기 전체의 특성을 표현하지 못하므로 유도무기 사격시험결과에 따라 계산된 명중률을 활용하여 생산된 모든 유도무기의 성능을 판단하기에는 ...

Convolutional neural networks (CNNs), a popular type of deep neural network, have been actively applied to image recognition, object detection, object localization, semantic segmentation, and object instance segmentation. Accordingly, the applicability of deep learning to the analysis of medical images has increased. This paper presents a novel application of state-of-the-art CNN models, such as DenseNet, to the automatic detection of the tympanic membrane (TM) and middle ear (ME) infection. We collected 2,484 oto-endoscopic images (OEIs) and classified them into one of three categories: normal, chronic otitis media (COM) with TM perforation, and otitis media with effusion (OME). Our results indicate that CNN models have significant potential for the automatic recognition of TM and ME infections, demonstrating a competitive accuracy of 95% in classifying TM and middle ear effusion (MEE) from OEIs. In addition to accuracy measurement, our approach achieves nearly perfect measures of 0.99 in terms of the average area under the receiver operating characteristics curve (AUROC). All these results indicate robust performance when recognizing TM and ME effusions in OEIs. Visualization through a class activation mapping (CAM) heatmap demonstrates that our proposed model performs prediction based on the correct region of OEIs. All these outcomes ensure the reliability of our method; hence, the study can aid otolaryngologists and primary care physicians in real-world scenarios.

This is a rare case of a 73-year-old male patient who presented with hematochezia and was treated using transcatheter arterial embolization following upper gastrointestinal bleeding in the third portion of the duodenum. The cause of the bleeding was not found on gastrointestinal endoscopy and CT. On the third day of hospitalization, the hemoglobin level continued to decrease. A technetium-99m-labeled red blood cell scan revealed suspicious bleeding in the diverticulum of the third portion of the duodenum. Superior mesenteric artery angiography showed active bleeding from the posteroinferior pancreaticoduodenal artery, which was embolized with N-butyl cyanoacrylate. The patient was discharged on the seventh day after embolization without re-bleeding or complication. We report a rare case of a patient with active bleeding from a duodenal diverticulum that was difficult to diagnose using routine modalities. Herein, we report a rare case of a patient with active bleeding from a duodenal diverticulum that was difficult to diagnose using routine modalities. We also conducted a relavant literature review.

A 53-year-old woman presented with dyspnea. She had undergone extended thymectomy for an invasive thymoma two months prior. CT revealed numerous small nodules in the lung. After that, she deteriorated owing to acute respiratory distress syndrome (ARDS), and the vascular surgeon planned veno-venous extracorporeal membrane oxygenation (ECMO). During percutaneous cannulation through the left femoral vein, a vascular injury was suspected, and the patient’s vital signs became unstable. Diagnostic angiography showed a ruptured left common iliac vein, and the bleeding was stopped by placement of a stent-graft. May-Thurner syndrome was diagnosed on abdominal CT. Here, we report a rare case of ECMO-related vascular injury in a patient with an unrecognized anatomical variant, May-Thurner syndrome.

Design thinking as a mindset and as a process for design and business innovation receives a lot of attention. Thus, concrete and structured methods for design thinking need to be devised, and design thinking competencies should be fostered proactively. Design thinking is underpinned by visual thinking composed of interactive iterations of Seeing&mdash, Imagining&mdash, Drawing. The visual reasoning model developed to understand and support visual thinking describes the process with cognitive activities as well as knowledge and schema. The visual reasoning model could serve as a framework to devise structured methods and tools for design thinking and to foster design thinking competencies. It would be desirable if schema to serve as underlying models in imagining service activities are to be identified so that cognitive activities in seeing&mdash, imagining&mdash, drawing can be systematically structured in service design, where the objects of designing are human activities and experiences. In this paper, three structured design methods developed for service design have been described and characterized in the framework of the visual reasoning model. Particularly the context-based activity modeling has been demonstrated as schema in structured imagining of service activities for product-service systems, as it serves the underlying role in organizing information on human activities consistently and yet with different interactions with other constituents of these three imagining methods.

We evaluated the incidence of temporomandibular disorder (TMD) in patients with rheumatoid arthritis (RA) and examined the association between TMD and RA, through longitudinal follow-up. Population data from the Korean National Health Insurance Service-Health Screening Cohort from 2002 to 2015 was used. From 514,866 subjects, 3122 with RA were matched with 12,488 controls in a 1:4 ratio. The crude and adjusted models (for obesity, smoking, alcohol consumption, blood pressure, blood glucose, total cholesterol, and Charlson Comorbidity Index scores) were calculated. Chi-square tests, Kaplan-Meier (KM) analysis, and two-tailed analyses were used for statistical analysis. Stratified Cox proportional hazard models were used to assess the hazard ratios (HR) and 95% confidence intervals (CI) for TMD in the RA group, compared to those in the control group. The adjusted HR for TMD in RA was 2.52 (95% CI = 1.70&ndash, 3.74), compared to the control group. The results were consistent with the subgroup analyses, according to age and sex, except in men older than 60 years of age. KM analysis showed similar results. Hence, we found that patients with RA have a higher risk of TMD, and should be observed for symptoms of the initial stage of TMD to prevent the risk of aggravation.

The aim of this case-control study was to evaluate the association between chronic rhinosinusitis (CRS) and neurodegenerative dementia in a large representative Korean population. The ≥ 50-year-old population was selected from the Korean Health Insurance Review and Assessment Service – National Sample Cohort from 2002 to 2015. A total of 17,634 neurodegenerative dementia patients were matched in a 1:4 ratio with 70,536 control participants for age, sex, income, and region of residence. Neurodegenerative dementia was defined using the ICD-10 codes G30 and F00. CRS was identified based on the ICD-10 code J32. Among the cohort, we selected participants who were treated ≥ 2 times and those who underwent head and neck computed tomography. The odds ratio (OR) for CRS in patients with dementia was analyzed using a conditional logistic regression model. Subgroup analyses were conducted according to age and sex. There was no difference in the prevalence of CRS with/without nasal polyps between the dementia (1.1%) and control (1.2%) groups (P = .825). CRS with/without nasal polyps was not significantly associated with dementia (adjusted OR = 0.96, 95% CI = 0.82–1.13, P = .653). In the subgroup analyses according to age and sex, the adjusted ORs for CRS with/without nasal polyps were not higher in the dementia group than in the control group. Previous CRS was not associated with neurodegenerative dementia in the Korean population.

Background and Objectives: Preoperative prophylactic balloon-assisted occlusion (PBAO) of the internal iliac arteries minimizes blood loss and facilitates surgery performance, through reductions in the rate of uterine perfusion, which allow for better control in hysterectomy performance, with decreased rates of bleeding and surgical complications. We aimed to investigate the maternal and fetal outcomes associated with PBAO use in women with placenta increta or percreta. Material and Methods: The records of 42 consecutive patients with a diagnosis of placenta increta or percreta were retrospectively reviewed. Of 42 patients, 17 patients (40.5%) with placenta increta or percreta underwent cesarean delivery after prophylactic balloon catheter placement in the bilateral internal iliac artery (balloon group). The blood loss volume, transfusion volume, postoperative hemoglobin changes, rates of hysterectomy and hospitalization, and infant Apgar score in this group were compared to those of 25 similar women who underwent cesarean delivery without balloon placement (surgical group). Results: The mean intraoperative blood loss volume in the balloon group (2319 &plusmn, 1191 mL, range 1000&ndash, 4500 mL) was significantly lower than that in the surgical group (4435 &plusmn, 1376 mL, range 1500&ndash, 10,500 mL) (p = 0.037). The mean blood unit volume transfused in the balloon group (2060 &plusmn, 1154 mL, range 1200&ndash, 8000 mL) was significantly lower than that in the surgical group (3840 &plusmn, 1464 mL, range 1800&ndash, 15,200 mL) (p = 0.043). There was no significant difference in the postoperative hemoglobin change, hysterectomy rates, length of hospitalization, or infant Apgar score between the groups. Conclusion: PBAO of the internal iliac artery prior to cesarean delivery in patients with placenta increta or percreta is a safe and minimally invasive technique that reduces the rate of intraoperative blood loss and transfusion requirements.

A number of studies have evaluated the variable courses of facial artery. However, the results of these differed substantially from each other so not consistent relationships have yet been established. There has also yet to be a relevant study using conventional angiography.We assessed the variant branching pattern of the facial artery and its branches using conventional angiography.Two radiologists retrospectively reviewed 284 cases of angiographies of the external carotid artery in 198 patients. The courses of the facial artery and infraorbital branch of the maxillary artery were classified into 4 types and 2 types, according to the end branch.Among 284 cases of facial artery, type 1 (angular branch) made up 104 cases (36.6%), type 2 (lateral nasal branch) made up 138 cases (48.6%), type 3 (superior labial branch) made up 24 cases (8.5%), and type 4 (inferior labial branch) made up 18 cases (6.3%).Regarding the 284 total cases of maxillary artery, 163 cases (57.4%) had anastomosis with the angular artery or extended to the territory of the angular artery. In addition, 121 cases (42.6%) had nothing done in regard to the angular artery.The results may be helpful for avoiding complications related to facial and maxillary arteries during facial surgeries and cosmetic procedures.

Although several recent studies reported that probiotics might be beneficial for allergic rhinitis (AR), the effect of probiotics on AR is not consistent and have not been reproduced between studies. We aimed to determine the efficacy and safety of probiotic NVP-1703, a mixture of Bifidobacterium longum and Lactobacillus plantarum, in subjects with perennial AR. Adult subjects with perennial AR received either NVP-1703 (n = 47) or placebo (n = 48) for four weeks. Total nasal symptom scores (TNSS), rhinitis control assessment test (RCAT), blood eosinophil count, allergen-specific IgE, and immunological parameters in serum and urine were compared at baseline and after four weeks. TNSS changes from baseline at weeks 1, 3, and 4 were significant between the NVP-1703 and placebo groups (p = 0.033, 0.031, and 0.029, respectively). RCAT score showed significant differences between the NVP-1703 and placebo groups (p = 0.049) at week 4. Dermatophagoides farinae-specific IgE levels and serum IL-10 levels were significantly different between the NVP-1703 and placebo groups (p = 0.033 and p = 0.047, respectively). IL-10/IL-4 and IL-10/IL-13 ratios were different between the NVP-1703 and placebo groups at week 4 (p = 0.046 and 0.018, respectively). NVP-1703 treatment reduced urinary prostaglandin F2&alpha, and leukotriene E4 levels (p &gt, 0.05). Therefore, NVP-1703 can be treatment option for perennial AR.

It is critical to design for affordances, which is the messages of products and services that help human activities when properly perceived, in both product design and service design. Although research on product design for user activities or user-friendly design has been conducted, few efforts have been dedicated to product design for diverse service considerations. In the context of servitization and product-service systems, many new services are devised starting with a product. A systematic method is proposed to redesign products so that value propositions through services can be enhanced by dealing with service activities specifically. By integrating service activities and product functions, affordances for service activities are identified. Affordance features for those affordances are designed and combined into the redesign of a product to support service activities. An illustrative case of a standing wheelchair redesign is described to validate the applicability of the proposed method for product redesign for service considerations. The proposed method enhances through the redesign of products diverse life-cycle services in which many stakeholders are participating to co-create values for societal, entrepreneurial, and ecological sustainability.

Most currently available commercial vaccines are delivered by systemic injection. However, needle-free oral vaccine delivery is currently of great interest for several reasons, including the ability to elicit mucosal immune responses, ease of administration, and the relatively improved safety. This review summarizes the biological basis, various physiological and immunological barriers, current delivery systems with delivery criteria, and suggestions for strategies to enhance the delivery of oral vaccines. In oral vaccine delivery, basic requirements are the protection of antigens from the GI environment, targeting of M cells and activation of the innate immune response. Approaches to address these requirements aim to provide new vaccines and delivery systems that mimic the pathogen’s properties, which are capable of eliciting a protective mucosal immune response and a systemic immune response and that make an impact on current oral vaccine development.

Despite the previous studies showing the relationship between microalbuminuria and insulin resistance, longitudinal effect of insulin resistance on development of microalbuminuria is not clearly identified in non-diabetic population.One thousand six hundred three non-diabetic Korean men without microalbuminuria in 2005 had been followed up for the development of microalbuminuria until 2010. Microalbuminuria was evaluated by urine-albumin creatinine ration, and insulin resistance was evaluated by homeostasis model assessment of insulin resistance (HOMA-IR). Cox proportional hazards model was used to estimate the risk for microalbuminuria according to the tertile of HOMA-IR.During 5465.8 person-y of average follow-up, microalbuminuria developed in 76 (4.7%) participants. Incidence of microalbuminuria increased in proportion to the level of HOMA-IR (tertile 1: 3.0%, tertile 2: 4.1%, tertile 3: 7.1%, P0.001). When the 1st tertile of HOMA-IR was set as reference, hazard ratios and 95% confidence interval were 1.15 (0.56-2.35) and 2.07 (1.05-4.09) for those in the 2nd and 3rd tertiles of HOMA-IR, even after adjusting multiple covariates, respectively (P for linear trend=0.054).Increased insulin resistance was a predictor of microalbuminuria in Korean men.

The performance of an isolated high voltage full bridge converter is improved using a voltage doubler. In a conventional high voltage full bridge converter, the diode of the transformer secondary voltage undergoes a voltage spike due to the leakage inductance of the transformer and the resonance occurring with the parasitic capacitance of the diode. In addition, in the phase shift control, conduction loss largely increases from the freewheeling mode because of the circulating current. The efficiency of the converter is thus reduced. However, in the proposed converter, the high voltage dual converter consists of a voltage doubler because the circulating current of the converter is reduced to increase efficiency. On the other hand, in the proposed converter, an input current is distributed when using parallel input / serial output and the output voltage can be doubled. However, the voltages in the 2 serial DC links might be unbalanced due to line impedance, passive and active components impedance, and sensor error. Considering these problems, DC injection is performed due to the complementary operations of half bridge inverters as well as the disadvantage of the unbalance in the DC link. Therefore, the serial output of the converter needs to control the balance of the algorithm. In this paper, the performance of the conventional converter is improved and a balance control algorithm is proposed for the proposed converter. Also, the system of the 1.5[kW] PCS is verified through an experiment examining the operation and stability.

Increasing renewable energy, ESS and digital loads can be combined with DC power distribution to achieve high energy utilization efficiency. Emergency power supply needs consideration to prepare power failure of AC grid due to characteristic of DC distribution system connected with AC grid and digital loads. The application of emergency generators should be considered as the ESS cannot perfectly satisfy the emergency power supply. However, the slow response characteristic of the emergency generator interrupts the quick stabilization of the DC grid voltage. In this paper, an emergency power supply system using an emergency generator in DC distribution has been proposed. An emergency power supply system using a 13.3 [kW] emergency generator was constructed for DC distribution and an operation method was proposed to minimize the voltage drop occurring at the initial startup. The proposed method is verified by simulation.

Contains fulltext : 182713.pdf (Publisher’s version ) (Closed access) Rapamycin (RM), a drug that inhibits the mechanistic target of rapamycin (mTOR) pathway and responds to nutrient availability, seemingly mimics the effects of caloric restriction (CR) on healthy life span. However, the extent of the mechanistic overlap between RM and CR remains incompletely understood. Here, we compared the impact of CR and RM on cellular metabolic status. Both regimens maintained intracellular ATP through the chronological aging process and showed enhanced mitochondrial capacity. Comparative transcriptome analysis showed that CR had a stronger impact on global gene expression than RM. We observed a like impact on the metabolome and identified distinct metabolites affected by CR and RM. CR severely reduced the level of energy storage molecules including glycogen and lipid droplets, whereas RM did not. RM boosted the production of enzymes responsible for the breakdown of glycogen and lipid droplets. Collectively, these results provide insights into the distinct energy metabolism mechanisms induced by CR and RM, suggesting that these two anti-aging regimens might extend life span through distinctive pathways.

The aims of this study are to analysis about surface muscle activity of lower and upper musculus erector spinae according to walkers form. The subjects of the current step is inconvenient to use a walker and five people over the age of 65 valid samples were selected as final. All the subjects were measured in three forms. Wireless EMG muscle activity is a measure of surface measurements were measured using a system, both musculus vastus lateralis, outside the erector spinae muscle, musculus biceps femoris, gastrocnemius muscle was attached to the channel electrodes. According to the results, First, gastrocnemius muscle activity showed significant differences by type of gait. Second, the muscle activity of the erector spinae muscle walking showed significant differences by type, side grip type showed the lowest muscle activity. Consequently, the present study is the efficient use of the four-wheel walker will provide the baseline data.

Background and Objective Treatment modalities, such as hyperthermia and photodynamic therapy (PDT) have been used in the treatment of a variety of head and neck squamous cell carcinoma (HNSCC), either alone or as an adjuvant therapy. Macrophages loaded with gold nanoshells, which convert near-infrared light to heat, can be used as transport vectors for photothermal hyperthermia of tumors. The purpose of this study was to investigate the effects of combined macrophage mediated photothermal therapy (PTT) and PDT on HNSCC cells.

Currently, a variety of materials are available for the treatment of glottal insufficiency. Ideal injection materials should be inexpensive, easily obtainable, nontoxic, and biocompatible. Plasma gel has recently been developed as an injectable, autologous material used in plastic surgery. The aim of this study was to evaluate the histological changes in rabbit vocal folds (VFs) after an injection of plasma gel, compared with collagen (Artecoll) or hyaluronic acid (Reviderm Intra).Experimental prospective animal study.Animal laboratory.Blood samples were collected from 12 New Zealand rabbits. Plasma collected from each rabbit was centrifuged and processed using a gel heating system. All rabbits received a 0.05 ml injection of plasma gel into the right VF, while an equivalent volume of Artecoll or Reviderm Intra was injected into the left VFs of each 6 rabbits randomly. The larynges were collected 2, 4, and 8 weeks after injection, and the tissues were stained for histological analysis.In comparison with left VFs injected with Artecoll or Reviderm Intra, there was significantly less inflammatory response and foreign body reaction in the plasma gel injected right VFs (P.05). Multinucleated foreign body type giant cells were also more prevalent in the left VFs. There were no quantitative differences in the rates of neovascularization or collagen deposition between groups.Plasma gel is a biologically compatible material that may serve as a suitable augmentation material in injection laryngoplasty. Further studies that examine the long-term effects in a larger number of subjects are needed.

This paper proposed a compensation method for reducing sampling delay through ADC(Analog-to-Digital Converter) module of MCU(Micro Controller Unit) using ZDPWM method. In case of conventional PWM method of 3-level NPC inverter, the switching devices which is composed of silicon compounds are conducted complementary operation by both reference and carrier waveform. And this operating method needs to contain dead time state to prevent short-circuit fault. However, the phase voltage distortion is caused by the dead time state in conventional method. As a results, THD of phase current is increased when inverter system is operating. ZDPWM method which is non-complementary operation is suggested to compensate the distortion through dead time in 3-level NPC inverter. The ZDPWM method has some advantages such as simple operation through carrier waveform as same as conventional method and low harmonic factor at phase current based on non-complementary operation. However, the unexpected distortion of phase current can occur by phase angle delay through sampling of ADC module when the ZDPWM is used in experiment by MCU. Therefore, this paper proposed simple method to compensate sampling delay based on the modeling of delayed phase angle. The proposed method is demonstrated by experiment, and the method compares with same conditions as both conventional PWM method and the ZDPWM due to uncompensated sampling delay.

In this paper, a fast voltage strategy of three-phase AC/DC pulse width modulation (PWM) converter applying a feedforward compensation method is proposed. Conventional PI regulator control method and soft staring method are easy to generate inrush current from startup period. It leads to influence device's parts life, system reliability and increase the stresses on the switches. The paper analyzed Three-phase PWM converter and researched cause of inrush current during startup. Also, it solved the small signal modeling with output current. Based on contents, this paper determines feedforward compensation value and prevents saturating PI controller by applying feedforward compensation. The proposed feed forward compensation method is illustrated with PSIM simulation.

Recently, The necessity of renewable energy be on the rise in as fossil fuel is depleted. Study of offshore wind power generation is being carried out as part of the renewable energy business. The 3-level inverter for use in the offshore wind power system studied is increasing as high capacity about offshore wind power. The 3-level inverter had an advantage that make reference voltage higher than 2-level reference voltage. Also, study of the 3-phase inverter has increased nowadays. However, 3-level NPC (Neutral-Point-Clamped) inverter, two capacitors and the neutral point are connected in series, it can lead to problems reduces stability of the system and unbalance voltage. It is SVPWM (Space Vector Pulse Width Modulation) method. Because DPWM (Discontinuous Pulse Width Modulation) method didn't neutral point control as same method from SVPWM, each DPWM method need a method of neutral point control. This paper proposed a method of applying the offset voltage attem pts to resolve the difficulties of the neutral point voltage control. The equation for the offset voltage to be applied to the system of each DPWM was determined. The proposed method is implemented by comparison of block diagram. The proposed algorithm is verified by the simulation.

Background and objectives Some patients experiencing dizziness also report psychological distress. However, the association between vestibular deficits and psychological symptoms remains controversial. Thus, the aim of this paper is to report the proportion of patients who complained of dizziness who also had high depression and anxiety indices. Also we investigated the severity of their dizziness and the distribution of the diseases underlying this symptom. Subjects and methods We assessed the dizziness and psychological distress of 544 patients experiencing dizziness using the Korean versions of the Dizziness Handicap Inventory (DHI), the Beck Depression Inventory (BDI), and the Spielberger State-Trait Anxiety Inventory (STAI). We also reviewed the audio-vestibular symtoms of patients with high levels of depression and anxiety. Results The incidences of high depression and anxiety scores were 11% (60/544) and 18% (98/544), respectively. Patients with vestibular migraine were most likely to have high depression and anxiety indices. Patients in the high-BDI or high-STAI groups (117/544) obtained significantly higher DHI scores than those in neither the high-BDI nor the high-STAI group (427/544). We noticed that about 20% of the patients experiencing dizziness had high levels of psychological distress in this study; this group also suffered from various vestibular diseases and more symptoms of dizziness. Conclusions The results of the study suggest that psychological evaluation should be considered when assessing patients with vertigo.

Background Hearing loss can lead to a number of disabilities, subsequently reducing the quality of life. In general, hearing thresholds of adolescents are better than adults and the elderly. However, occasionally, adolescents acquire hearing loss for a number of reasons. In this study, our goal was to estimate the prevalence of hearing loss in the Korean population and to investigate the factors related to hearing thresholds in adolescents. Methods A cross-sectional study was conducted using data from the Korean National Health and Nutrition Examination Survey (KNHANES) between 2010 and 2012. We enrolled a total of 1,658 participants, ages 13 to 18 years. We investigated the prevalence of hearing loss and the factors associated with hearing thresholds at various frequencies (0.5, 1, 2, 3, 4, and 6 KHz). Results Weighted prevalence of unilateral and bilateral hearing loss in Korean adolescents was 2.2% and 0.4%, respectively. Weighted prevalence of hearing thresholds ≥ 20 dB at speech and high frequencies were 3.1% and 5.0%, respectively, for unilateral hearing loss and 0.7% and 1.9%, respectively, for bilateral. Age group, tympanometric data, and household income were significantly related to unilateral or bilateral hearing thresholds ≥ 20 dB at speech frequencies. Earphone use in noisy places was associated with bilateral hearing thresholds ≥ 20 dB at high frequencies. Conclusions The prevalence of hearing loss in Korean adolescents was 2.6% using the general standard threshold associated with hearing loss. However, the prevalence of hearing thresholds ≥ 20 dB for speech and high frequencies was much higher. The results from this study provide an estimate of hearing loss in adolescents and suggest the need for early detection and hearing preservation programs among adolescents.

Electromechanical reshaping (EMR) is a promising surgical technique used to reshape cartilage by direct current and mechanical deformation. It causes local stress relaxation and permanent alterations in the shape of cartilage. The major advantages of EMR are its minimally invasive nature and nonthermal electrochemical mechanism of action. The purpose of this study is to validate that EMR does not cause thermal damage and to observe structural changes in post-EMR cartilage using several imaging modalities. Three imaging modality metrics were used to validate the performance of EMR by identifying structural deformation during cartilage reshaping: infrared thermography was used to sense the temperature of the flat cartilages (16.7°C at 6 V), optical coherence tomography (OCT) was used to examine the change in the cartilage by gauging deformation in the tissue matrix during EMR, and scanning electron microscopy (SEM) was used to show that EMR-treated cartilage is irregularly arranged and the thickness of collagen fibers varies, which affects the change in shape of the cartilage. In conclusion, the three imaging modalities reveal the nonthermal and electromechanical mechanisms of EMR and demonstrate that use of an EMR device is feasible for reshaping cartilage in a minimally invasive manner.

The flows of paper are analyzed throughout the papermaking processes, with the year 2007 and Korea defined as the system boundaries. In practice, the statistical data on the production, import and export of paper or pulp can be collected with relative ease from the government and industrial associations. However, the input data regarding the volumes of pulp and wastepaper used in different paper products, such as newsprint, printing papers, sanitary and household papers, specialty papers, and corrugating board base, are difficult to obtain because such information is generally kept confidential in the course of corporate operations. The production processes of paper products in Korea are modeled using information on raw materials, their compositions and production yields of products in order to identify and quantify the amounts of pulp and wastepaper used in each paper product. The material flows of paper are then analyzed based on the calculation model derived from the correlation of input and output flows between the individual processes throughout the entire paper lifecycle. Accuracy analysis using both mean absolute error (MAE) and mean absolute percent error (MAPE) is conducted to verify the amounts of pulp and wastepaper calculated from the proposed model against the volumes of domestically consumed pulp and wastepaper provided in the national statistics. Although the calculated values for the past (i.e., the 1980s and 1990s) differ to some degree from the statistical values, the data for the 2000s have a relatively higher level of accuracy, with the MAPE of the total pulp and recycling volume at 5.39% and 5.30%, respectively, thus validating the adequacy of the proposed modeling method. The proposed calculation model can be effectively used in the material flow analysis (MFA) of paper to reduce the burden of data collection and obtain relatively accurate results.

Material flow analysis (MFA) is an evaluation technique that systematically identifies the flows and stocks of materials within predefined spatial and temporal boundaries. In this paper, the steel resources in Korea are investigated using dynamic MFA. Iron ore and steel scrap are added as raw material components during the production processes of steel, which is then used in a variety of product groups such as construction products, transportation equipment, machinery/metal products, electrical/electronic devices, and other products through fabrication and manufacturing processes. When such product groups are discarded, they are either recycled or landfilled. With consideration for the lifetimes of various product groups in conjunction with steel resource flows in Korea, dynamic MFA is conducted on the flows of steel stock change and annual scrap generation. By 2020, these two flows are expected to increase by as much as 40% and 30%, respectively, compared to 2008, with transportation equipment, in particular, envisaged to experience high growth. At the current recycling rate, however, it will be hard to meet future scrap demand. According to the scenario analysis, 100% of this future scrap demand can be supplied domestically if the recycling rate is increased to over 70% for all product groups, except construction products and transportation equipment, which already have high recycling rates. By 2020, the reduction in scrap importation costs is projected to offer a financial gain of 2.3 billion dollars.