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Background and Objectives The aim of this study was to identify the frequency of indicators of National Health Insurance (NHI) coverage for positive airway pressure (PAP) therapy and to investigate the changes in patients receiving coverage for PAP therapy after the alterations were made in the insurance benefit standards for mild obstructive sleep apnea (OSA).Subjects and Method We divided the mild OSA patients into two groups according to altered categorization in insurance benefit standards (Mild1: 5≤AHI

In this study, the crystallization behavior of polyvinylidene fluoride (PVDF) in NMP/DMF solvent at 9 to 67 weight percent (wt%) was analyzed by molecular dynamics (MD) simulation.

Background and Objectives The aim of this study was to evaluate the effect of sleep position and nasal cavity dimension according to minimal cross-sectional area (MCA) on the severity of obstructive sleep apnea (OSA).Subjects and Method This study enrolled 528 consecutive patients who completed overnight polysomnography (PSG) and acoustic rhinometry. Positional sleep time and apnea-hypopnea index (AHI) were compared between the right and left lateral sleep positions (RLSP vs. LLSP), and between the wide and narrow lateral side sleep position (WLSP vs. NLSP) according to MCA.Results The sleep time was longer for LSP than for WLSP (20.35%±19.69% and 15.92%±16.35%, respectively) with a statistically significant difference (p=0.001). However, the AHI was not significantly different between the two groups. The sleep time was longer for RLSP than for LLSP (20.65%±19.31% and 15.39%±16.05%, respectively) with a statistically significant difference (pp=0.001). However, we found that the AHI value was not significantly different according to sleep posture and nasal cavity dimension.Conclusion Snoring patients preferred RLSP to LLSP, and preferred to sleep on the lateral side of the narrow nasal cavity. The OSA severity was not different according to sleep position and nasal cavity dimension.

Background and Objectives The aim of this study was to compare adherence to positive airway pressure (PAP) therapy in patients with obstructive sleep apnea (OSA) of different severity.Subjects and Method We conducted a retrospective study including 270 adult OSA patients who used a PAP device for at least 3 months. We assessed the percentage of days on which the device was used, the percentage of days on which the device was used for ≥4 h, and the average duration of PAP device usage at 12 weeks of PAP therapy. We also evaluated adequate adherence to PAP therapy using a PAP device for ≥4 h/day and during ≥70% of nights.Results The percentage of days on which a PAP device used did not differ significantly according to OSA severity (median [Q1-Q3]; mild: 91.40% [81.25%-97.65%], moderate: 94.50% [86.90%-100%], severe: 95.90% [88.10%-100%], p=0.268). We also found that the percentage of days on which a PAP device was used during sleep for ≥4 h was not significantly different in patients with different OSA severity (median [Q1-Q3], mild: 76.20% [69.70%-89.90%], moderate: 89.30% [67.65%-95.70%], severe: 85.70% [75.85%-95.45%], p=0.097). The percentage of patients with adequate PAP adherence did not differ significantly according to OSA severity (mild: 74.2%, moderate: 72.1%, severe: 83.0%, p=0.084). Moreover, the mean duration (minutes) of PAP device usage during sleep did not differ significantly according to OSA severity in the mild, moderate, and severe OSA groups (mean±standard deviation, mild: 348.03± 47.78 min, moderate: 358.58±85.22 min, severe: 363.79±57.21 min, p=0.440).Conclusion Adherence to PAP therapy did not differ significantly according to OSA severity. Therefore, it is necessary to continuously expand and maintain the insurance for health promotion in OSA patient in South Korea.

Patients with severe pneumonia of unknown etiology presented in December 2019 in Wuhan, China. A novel coronavirus, severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), was isolated from the respiratory tracts of these patients. The World Health Organization (WHO) defined respiratory diseases due to SARS-CoV-2 infection as coronavirus disease 2019 (COVID-19). Many researchers have reported that the nasal cavity is an important initial route for SARS-CoV-2 infection and that the spike protein of this virus binds to angiotensin-converting enzyme 2 (ACE2) on epithelial cell surfaces. Therefore, COVID-19 is thought to significantly affect nasal symptoms and various rhinological diseases. In this review, we summarize the association between COVID-19 and various rhinological diseases, such as olfactory dysfunction, rhinosinusitis, and allergic rhinitis.

Aquacultured fish are the richest natural source of protein. However, their overproduced biomass is often discarded due to production imbalance, causing considerable losses to the fishery industry. Therefore, it is necessary to utilize surplus fish and add value to overproduced fish. We performed complex enzyme-assisted hydrolysis to determine the correlation between its physical characteristics and anti-hypertensive activity in vitro and in vivo using an SHR model. Protamex-Pepsin assisted hydrolysate from Paralichthys olivaceus (POppH) produced by complex enzyme-assisted hydrolysis contained low-molecular-weight peptides and amino acids with anti-hypertensive activity. POppH regulated blood pressure and serum angiotensin II and angiotensin-I-converting enzyme levels, and histological and ultrasound image analysis revealed substantially reduced thickness and diameter of the carotid aorta in the POppH-administered SHR group. Therefore, we propose to reduce food loss due to overproduction by utilizing the anti-hypertensive activity and physical properties of POppH; the results demonstrate its application as a therapeutic agent.

Purpose: Rehabilitation motivation is very important for veterans who have had a stroke because they already have primary disabilities they suffered during their official duties. The purpose of this study was to identify factors associated with the rehabilitation motivation of hospitalized veterans after a stroke.Methods: The research was a cross-sectional, descriptive design using questionnaires. The participants were 128 veterans hospitalized following a stroke in five veterans’ hospitals in five major cities in South Korea. Data were analyzed using descriptive statistics, t-test, ANOVA and multiple regression with the SPSS 25.0 program.Results: There were statistically significant differences in rehabilitation motivation according to monthly income and time since duagnosis. The rehabilitation motivation of these veterans showed significant positive correlations with self efficacy and social support, and a significant negative correlation with depression. Multiple regression analysis for rehabilitation motivation revealed that the significant predictors were self efficacy, family support, time since diagnosis and monthly income. These factors explained 35.6% of the variance.Conclusion: The results indicate a need to enhance self efficacy and social support to improve the rehabilitation motivation of veterans. The findings also suggest that individual characteristics through time since diagnosis and monthly income should be considered for tailored interventions related to rehabilitation motivation. Furthermore, it is necessary to develop programs enhancing self efficacy and social support to improve the rehabilitation motivation for veterans who have had a stroke.

The aim of this study was to evaluate the associations between objective sleep parameters of obstructive sleep apnea (OSA) and progression of subclinical cardiovascular disease as measured by the coronary artery calcium (CAC) score. We reviewed the medical records of 196 patients who underwent both polysomnography (PSG) and repeated coronary artery computed tomography (CT) for screening purposes. For each participant, the first coronary CT scan was conducted within 12 months of PSG. Follow-up CT was performed voluntarily. The CAC score was log-transformed to obtain normally distributed data. We evaluated potential associations between various sleep parameters by analyzing overnight-attended PSG and CAC score progression over time. ST90 (total sleep time of SaO2

OBJECTIVES The aim of this study was to analyze the association between obstructive sleep apnea (OSA) severity and various cardiopulmonary coupling (CPC) parameters in children with OSA. STUDY DESIGN Retrospective cross-sectional study. METHODS A cross-sectional study was conducted among 117 children (aged 7.96 ± 3.54 years, 86 male) who underwent both full-night polysomnography (PSG) and CPC for suspicion of sleep-disordered breathing (SDB). We analyzed the association between various CPC and PSG findings. RESULTS The apnea-hypopnea index (AHI) was negatively correlated with high frequency coupling (HFC, r = -0.374, P

Background: Previous studies have applied interview-oriented self-reported or peer-centered evaluation methods, rather than an objective and quantitative method, to evaluate outcome of a postgraduate capacity-building program and have mainly focused on the cognitive level. Objectives: To investigate the feasibility of the objective structured clinical examination (OSCE) in an international setting and report the results of the outcome evaluation for the behavioral aspect. Research Design: A case–control study. Subjects: Ninety examinees divided into 2 case–control groups: 17 program-experienced doctors and 17 control doctors in the first group, and 28 mentees of the program-experienced doctors and 28 control doctors in the second group. Measures: A six-station OSCE was implemented. The OSCE scores were measured to evaluate (1) the direct educational effect regarding learning in the first group and (2) the indirect educational effects regarding transfer in the second group. Written questionnaire and interview data were collected for qualitative analysis. Results: The quantitative results of the overall or subcomponent OSCE scores indicated no significant differences in the comparisons of the first and second case-control groups. The qualitative data indicated that the program improved participants’ medical knowledge, skills, and self-confidence, however, it also revealed limited learning environment provided by the program. Conclusions: This transnational study has demonstrated the process for introducing and successfully completing the testing of an OSCE in Laos. Discrepancy in the goals of the OSCE and the education program limited the usefulness of OSCE as an assessment tool, leading to the lack of significant differences in its results.

There are two types of maintenance policies for equipment: breakdown maintenance and preventive maintenance. In the case of applying preventive maintenance, the maintenance is carried out based on time or the condition of the equipment. However, with the development of Information and Communications Technologies (ICT) and the Internet of Things (IoT) technology, the data collected from equipment has rapidly increased and the use of Condition-Based Maintenance (CBM) to perform appropriate maintenance based on the condition of the equipment is increasing. In this study, based on gathered sensor data, we introduce an approach to diagnosing the condition of the equipment by extracting specific data features related to the types of failures that occur with equipment. To this end, we used the K-means clustering method, support vector machine (SVM) classifier, and Pattern Frequency–Inverse Failure mode Frequency (PF–IFF) method with the Term Frequency–Inverse Document Frequency (TF–IDF) method. As a case study, we applied the proposed approach to a centrifugal pump and carried out computational experiments for assessing the performance and validity of the proposed approach.

Olfactory and gustatory dysfunctions are important initial symptoms of coronavirus disease 2019 (COVID-19). However, the treatment modality for these conditions has yet to be clearly established. Therefore, most physicians have been administering empirical treatments for COVID-19-associated olfactory dysfunction, including topical or systemic steroid supplementation and olfactory training. In this literature review, we summarize the clinical course and effects of various treatments currently being conducted in patients with COVID-19-associated olfactory and gustatory dysfunctions.

OBJECTIVES The aim of this study was to assess the sleep quality and sleep stability according to the severity of obstructive sleep apnea (OSA) by using questionnaires and cardiopulmonary coupling (CPC) analysis. METHODS Two hundred and twenty-one adults were evaluated using subjective sleep questionnaires, CPC parameters, and respiratory parameters measured during full-night polysomnography. We measured the differences in the CPC parameters of each OSA group and the correlation between the apnea-hypopnea index (AHI) and CPC parameters. RESULTS AHI and CPC parameters were not associated with sleep questionnaires. AHI is negatively correlated with high frequency coupling (HFC, r = -0.725, P

본 조사는 제주지역 감염병 매개체인 모기를 대상으로 계절적 발생밀도를 조사하기 위해 축사, 철새도래지, 도심으로 나누어 2018년 3월부터 11월까지 9개월간 월 2회 모기를 BL과 BG를 이용하여 모기를 채집한 후 분류 및 동정을 실시하고, RT-PCR을 이용하여 flavivirus의 보유여부를 확인하였다. 채집된 모기는 6속 12종으로 1,847마리가 채집되었다. 채집 장소 중에서 철새도래지에서는 공방주변 잡목림, 서귀포 도심에서는 중앙동에서 가장 많이 채집되었다. 가장 많은 개체수로는 빨간집모기(Culex pipiens pallens)가 76.9%로 우점종이었고, 그 다음으로 흰줄숲모기(Aedes albopictus)가 8.9%로 나타났다. 가장 많은 모기개체수가 채집된 시기는 6월, 8월, 10월 순으로 나타났다. 채집한 모기 1,847마리를 50 pools로 나누어 flavivirus의 보유 여부를 RT-PCR검사하였으나, 모두 음성으로 확인되었다. 그러나 조사결과 작은빨간집모기(Culex tritaeniorhychus), 흰줄숲모기(Aedes albopictus), 중국얼룩날개모기(Anopheles sinensis) 서식하는 것으로 확인 되어 향 후 모기에 대한 종합적인 방제 관리기준으로 활용될 수 있다.

Positional change during sleep influences upper airway patency. However, few studies have used imaging techniques to demonstrate the change. This study aims to determine the effect of positional change on the upper airway space. A total of 118 subjects with sleep breathing disorders were analyzed. Participants underwent upper airway CT scans in the supine and lateral decubitus positions (right and left). They were divided into non-obstructive sleep apnea (n = 28) and obstructive sleep apnea (n = 90) groups. We measured the minimal cross-sectional area of the retropalatal/retroglossal spaces and compared the differences of those two spaces in the supine and lateral positions. CT was performed while patients were awake. The minimal cross-sectional area in the OSA group was significantly smaller than non-OSA group in both supine (median[interquartile range], 8.3[0.0–25.1] vs 22.2[1.0–39.6]; P = 0.018) and lateral decubitus positions (5.2[0.0–16.9] vs 21.3[6.1–38.4]; P = 0.002). As the body position of OSA patients shifted from supine to lateral, the retroglossal space increased significantly (67.3[25.1–116.3] vs 93.3[43.4–160.1]; P

Objectives Improvements in sleep-related quality of life (QOL) and behavioral problems have been observed in children with obstructive sleep apnea (OSA) during a short-term follow-up after adenotonsillectomy. Whether this trend continues beyond the short term remains unclear. Therefore, we aimed to evaluate the long-term effects of surgery in children with OSA. Methods The study participants comprised 20 children with OSA who underwent adenotonsillectomy. We used the scores from the Attention Deficit and Hyperactivity Disorder Rating Scale (ADHD-RS) and total scores from the Korean OSA-18 Survey (KOSA-18) before and after adenotonsillectomy to compare and analyze behavioral problems and OSA-specific health-related QOL, respectively, during a long-term follow-up. Respiratory disturbance parameters from standard polysomnography and subjective symptom scores for snoring and apnea were also investigated. Results The mean patient age was 6.6 ± 3.4 years (range, 3-13), and the male-to-female ratio was 15:5. The mean follow-up period was 54.5 months (range, 27-98). The total scores for both ADHD-RS (from 17.6 to 10.5; P = 0.006) and KOSA-18 (from 74.3 to 40.7; P = 0.001) decreased significantly from before to after surgery. Significant decreases were also observed in the subjective symptom scores for snoring (from 5.4 to 2.4; P = 0.000) and apnea (from 3.3 to 0.8; P = 0.002). Conclusion Significant improvement was observed in sleep-related QOL and behavioral problems in children with OSA during long-term follow-up after adenotonsillectomy. Level of evidence 4 Laryngoscope, 130:546-550, 2020.

Background The aim of this study was to evaluate the subjective and objective olfactory function in coronavirus disease 2019 (COVID-19) patients and the effect of olfactory training. Methods A prospective cohort study was performed in 53 patients who recovered from COVID-19 and visited our tertiary hospital. Subjective olfactory function was evaluated using the 11-point Likert scale (0–10) and the Korean version of the Questionnaire of Olfactory Disorders (QOD). Objective olfactory function was evaluated using Cross-Cultural Smell Identification Test (CC-SIT). Confirmed patients were followed up after 2 months of olfactory training. Results The median, interquartile range (Q1–Q3) score of subjective olfactory function significantly deteriorated in patients with olfactory dysfunction (OD) than in those without OD, even after 3 months of onset (11-point Likert scale, 8, 6–9 vs. 10, 10–10; short version of QOD-negative statements, 19, 16–21 vs. 21, 21–21; QOD-visual analogue scale, 7, 1–13 vs. 0, 0–0; all P < 0.001). However, the objective olfactory function was not significantly different between the two groups (median, interquartile range; 11, 9–11 vs. 11, 9–11, P = 0.887). The percentage of patients with objective hyposmia (CC-SIT ≤ 10) was also not significantly different (47.4% vs. 40%, P = 0.762). OD in COVID-19 was normalized after 2 months of olfactory training in 70% of patients even after 3 months of olfactory impairment. Conclusion Although subjective olfactory function is significantly decreased in the OD group, the objective olfactory function was not significantly different. Moreover, olfactory training is effective in COVID-19 patients with OD., Graphical Abstract

Background: This study examines the educational effects of a Korean capacity-building study-abroad project, the Dr. Lee Jong Wook-Seoul Project (DLSP), on the clinical performance of Laotian doctors using a standardized patient–based (SP-based) objective structured clinical examination (OSCE), which was the first OSCE conducted in Laos. Methods: An on-site seminar and workshop for the OSCE were held as an implementation strategy prior to the examination. For the outcome evaluation, a six-station SP-based OSCE was implemented among 90 examinees, who comprised two case–control groups: 17 DLSP-experienced doctors and 17 control doctors to evaluate the direct educational effect as learning, 28 mentees of the DLSP-experienced doctors and 28 control doctors to evaluate the indirect educational effects as transfer. Written questionnaire and interview data were also collected from the 90 examinees. Results: No comparisons within the first and second case–control groups showed significant differences in the OSCE overall or subcomponent scores. The same results were found in subgroup analyses by sex, major, and profession. The interview data indicated that the project improved participants’ medical knowledge, skills, and self-confidence, but its effects on clinical ability seemed questionable due to limited opportunities to see patients within the learning environment. Conclusions: This study has demonstrated the process for introducing an SP-based OSCE in Laos and successfully completing the testing. Discrepancy in the goals of the OSCE and DLSP, the educational and technological gap between the two countries, and the short period of project implementation are possible explanations for the lack of significant differences in the OSCE results.

Background Olfactory and gustatory dysfunction has been reported as characteristic symptoms of coronavirus disease 2019 (COVID-19). This study evaluated olfactory and gustatory dysfunction in mild COVID-19 patients using validated assessment methods. Methods A prospective surveillance study was conducted for mild COVID-19 patients who were isolated at the Gyeonggi International Living and Treatment Support Center (LTSC), Korea. Olfactory function was assessed using the Korean version of the Questionnaire of Olfactory Disorders (QOD) and Cross-Cultural Smell Identification Test (CC-SIT). Gustatory function was assessed using an 11-point Likert scale and 6-n-propylthiouracil, phenylthiocarbamide, and control strips. All patients underwent nasal and oral cavity endoscopic examination. Results Of the 62 patients at the LTSC, 15 patients (24.2%) complained of olfactory or gustatory dysfunction on admission. Four of 10 patients who underwent functional evaluation did not have general symptoms and 2 were asymptomatic. The mean short version of QOD-negative statements and QOD-visual analogue scale scores were 13 ± 6 and 4.7 ± 3.6, respectively. The mean CC-SIT score was 8 ± 2. No patients showed anatomical abnormalities associated with olfactory dysfunction on endoscopic examination. The mean Likert scale score for function was 8 ± 2, and there were no abnormal lesions in the oral cavity of any patient. Conclusions The prevalence of olfactory and gustatory dysfunction was 24.2% in mild COVID-19 patients. All patients had hyposmia due to sensorineural olfactory dysfunction, which was confirmed using validated olfactory and gustatory evaluation methods and endoscopic examination. Olfactory and gustatory dysfunction may be characteristic indicators of mild COVID-19., Graphical Abstract

Many physicians recommend endoscopic sinus surgery (ESS) even when an asymptomatic paranasal sinus (PNS) fungal ball is detected incidentally. The aim of this study was to investigate the natural behavior of PNS fungal balls via sinus imaging techniques. A follow-up study of 74 pathologically confirmed fungus balls was conducted in 70 patients who underwent multiple head and neck computed tomography (CT) scans or magnetic resonance imaging (MRI). We investigated the changes in symptoms and lesion size, as well as any new occurrences. Of the 74 fungus balls detected in 70 patients, we observed the renewed formation of a fungal ball in 21 patients, which was not present on initial imaging conducted over a period of 2–162 months. The fungal ball was already present in 53 patients on the initial screening, and the longest follow-up was 197 months (range 1–197 months). Of these 53 lesions, 29 lesions showed an increase in size (29/53, 54.7%), whereas 12 lesions were not associated with any clinical symptoms (12/53, 22.6%). In the 21 newly formed fungal balls, further development was observed in 10 lesions, with 4 lesions showing an increase in size. Thus, size increment occurred in 33 of the 57 fungus balls. The fungal balls can exist without local tissue invasion for up to 17 years and new formation of the fungal balls was observed even within 2 months, especially when accompanied by initial clinical symptoms of sinusitis.

Background: Fungal rhinosinusitis (FRS) with mucosal invasion is not classified by the current criteria, and clinical reports on the topic are limited. The aim of this study was to present our 25-year experience on fungal balls with mucosal invasion that do not appear in the FRS classification. Methods: Of 1318 patients who underwent endoscopic surgery with paranasal FRS between November 1994 and July 2019, 372 underwent mucosal biopsies. Medical chart and pathology review were performed on 13 patients diagnosed as having fungal balls with mucosal invasion without accompanying tissue invasion. Results: Histopathologic findings identified all fungi as belonging to the Aspergillus species. In 13 patients, 7 fungal balls were located in the maxillary sinus, 3 in the sphenoid sinus, and 3 in both the maxillary and ethmoid sinuses. The median age at diagnosis was 67 years (interquartile range (IQR): 62&ndash, 72), and the sex ratio was 1:2 (4 men and 9 women). Five patients had comorbidities&mdash, three with diabetes mellitus and two with hematologic malignancy&mdash, all of whom received postoperative antifungal therapy. The median duration of antifungal treatment was 13 weeks (IQR: 8&ndash, 17). No recurrences occurred during the median follow-up period of 30 months (IQR: 22&ndash, 43). Conclusions: Patients who have been clinically diagnosed with a fungal ball and showed mucosal invasion but no vascular invasion, based on pathologic findings after surgery, may need a new FRS classification category, such as microinvasive FRS, and adjuvant antifungal treatment may be needed for immunocompromised patients with microinvasive FRS. Key points: Fungal rhinosinusitis with mucosal invasion is different from fungal ball and invasive fungal rhinosinusitis and may be classified in a separate category as microinvasive FRS.

To compare postoperative pain, nausea and vomiting, and bleeding between intravascular dexamethasone injection group and control group among children undergoing powered intracapsular tonsillectomy and adenoidectomy (PITA).Retrospective review of medical records was performed for pediatric patients who underwent PITA from March 1, 2017, to February 28, 2021, at a tertiary referral medical center in South Korea. Postoperative pain and nausea were measured using the visual analogue scale (VAS) from the postoperative day (POD) 0 to POD 6. The number of analgesics administered and the number of vomiting episodes were recorded in the same period. The repeatedly measured parameters were statistically analyzed between the dexamethasone group and control group.A total of 71 children with complete questionnaires including 44 boys and 27 girls were included, and the mean age was 7.49 ± 2.44 years. There were 33 patients in the dexamethasone group and 38 in the control group. Postoperative pain (p = 0.169) or nausea (p = 0.460) on the VAS showed no statistically significant difference between the two groups. Postoperative analgesics showed no difference between the groups (p = 0.398), and neither did postoperative vomiting (p = 0.270). In both groups, no child showed signs of postoperative bleeding.This study indicates that the beneficial effects of intravascular dexamethasone administration in PITA may not be evident. This might be due to the superior outcome of the PITA technique compared to total extracapsular tonsillectomy. Therefore, otolaryngologists performing PITA may not necessarily need to administer dexamethasone in children before surgery.

Background Radionecrosis is a complication of nasopharyngeal carcinoma (NPC) that is difficult to treat. Endoscopic debridement is the first-line treatment for radionecrosis. After debridement, however, either bone or the internal carotid artery is exposed and requires mucosal coverage. Objectives This study sought to demonstrate the effectiveness of a nasoseptal flap (NSF) after endoscopic debridement of radionecrosis in the reconstruction ofnasopharyngeal or skull base defects. Methods Nine patients with NPC who underwent navigation-guided endoscopic debridement, followed by NSF reconstruction between April 2013 and July 2016, were included. The patients' clinical features and outcomes were evaluated. Results All nine patients had headaches, and eight had a foul odor associated with their radionecrosis. One patient underwent three radiotherapy treatments, four had two treatments, and the remaining four had just one treatment. The foul odor disappeared after treatment in all the patients who had been affected. The headache was significantly reduced after treatment in all patients. The NSF detached in two patients. In one patient, NSF failed, and the patient experienced postoperative rupture of the internal carotid artery. In the seven other patients, the NSF successfully covered the resultant defects, despite one intraoperative internal carotid artery rupture. Only two patients required further debridement, whereas the others experienced complete healing after just one surgical procedure. The nasopharyngeal surface was healthy-appearing in eight patients (median follow-up, median 11 months). Conclusion Reconstruction by using NSF after endoscopic debridement for radionecrosis of NPC allowed for faster healing and reduced the need for further debridement.

소변검사는 다른 검사에 비해 쉽고 간편하면서도 환자에게 부담이 없는 검사로 신장 및 요로계 질환의 진단, 치료 및 예후 결정에 중요한 정보를 제공한다. 요 침전물은 일반적으로 원심분리된 소변을 검사자가 현미경을 통한 검경에 의해 이루어진다. 대한임상검사정도관리협회에서 제안한 가이드라인과 실제로 의료기관에서 시행되고 있는 내용이 다르고 임상병리학을 전공하는 학생들이 사용하고 있는 서적에 제시된 내용도 서로 차이가 있었다. 따라서 요 침전물 표본제작에 따른 차이가 검사결과에 영향을 주는지 확인하기 위하여. 요시험지봉검사에서 잠혈반응과 백혈구 에스터라아제 검사 결과 양성으로 확인된 검체를 무작위로 선별하여 현미경적 검사를 시행하였다. 요 침전물 표본제작 차이는 요 농축 배수에 영향을 주어 cell grade나시야 당 평균 세포 수 결과에 영향을 미쳤다. 침전물의 농도를 결정짓는 첫 번째 요소는 원심력이다. 그러나 많은 의료기관에서 원심분리기 반경을 고려하지 않는 채 1,500 rpm을 사용하고 있었으며 이는 400 G라는 정확한 원심력을 얻을 수 없었다. 결과적으로 요 농축에 있어 차이가 발생하여 결과에도 영향을 미쳤다. 두 번째 요소는 요 침사물의 양이다. 제거하고 남은 요의 상청액의 양은 요 침사물의 농축 계수에 영향을 주어 다른 결과를 초래하였다. 뿐만 아니라 피펫을 사용하여 제시된 정확한 용량을 취하지 않고 대략적으로 한 방울을 떨어뜨린 후 경검했을 때도 결과에 영향을 주었다. 따라서 일관성 있고 보다 정확한 검사결과를 위해 반드시 표본제작 과정이 표준화가 되어야 할 것이다.

폐렴의 한(일개) 환자의 임상검체에서 연속적으로 분리된 Imipenem 내성세균 4균주를 분리하였다. 분리균을 동정하기 위해 Vitek II system의 GN card를 이용하였으며 16S rRNA유전자 염기서열을 기초로 계통학적 분석을 실시하였다. 분리균은 P. aeruginosa (2 strains), P. monteilii (1) 및 P. putida (1) 으로 동정되었다. 분리균들의 항생제에 대한 내성시험은 Vitek II system AST-N225 card를 이용해서 imipenem의 최소억제 농도가 모두 □8 μg/mL을 확인한 후 실험에 사용하였다. β -Lactamase 유전자의 특이 시발체를 이용하여 증폭한 PCR 산물로 imipenem 내성 유전자형을 결정하였는데 분리된 4균주 모두에서 MBL 유전자를 확인하였으며 2균주의 P. aeruginosa는 MBL유전자중 VIM형과 SHV형 유전자를 그리고 또다른 균주는 VIM형과 OXA group II형 유전자를 동시에 보유하고 있었다. 항생제 감수성 결과에서는 amikacin이 다른 항생제보다 감수성을 보였을 뿐 대체적으로 내성율이 높았다. 균주들간의 역학적 연관성 분석을 위해 ERIC-PCR을 이용한 DNA 지문 분석결과, 분리된 2 균주의 P. aeruginosa는 유사한 균주일 것으로 추정하였으나 DNA band 유형의 상동성은 서로 다른 유형임을 알아 볼수 있었다. 특이하게 한 환자에게서 imipenem 내성세균이 4균주가 검출 된 것은 이례적이며 동종의 DNA band 유형도 서로 상이하였다.

The aim of this study is to determine the association among various sleep parameters for obstructive sleep apnea (OSA) and subclinical cardiovascular disease measured by coronary artery calcium (CAC) score. A cross-sectional study was conducted among 461 patients who underwent both polysomnography (PSG) and coronary artery computed tomography to evaluate CAC score. For each participant, coronary artery computed tomography was conducted within 12 months of PSG. We evaluated the possible association among various PSG parameters by evaluating overnight-attended PSG and CAC. A univariate analysis with lowest SaO 2 and stage 3 sleep % during sleep was significantly associated with CAC score (β = −5.528, 95% confidence interval [CI] −9.179 to −1.777, p = 0.004 and β = −8.658, 95% CI −16.461 to −0.855, p = 0.030, respectively). However, after adjustment for possible confounders, only the lowest SaO 2 was independently associated with CAC score (β = −5.234, 95% CI −9.215 to −1.253, p = 0.010). This association was stronger in participants aged ≥60 years (β = −26.966, 95% CI −41.874 to −12.058, p = 0.001). In a univariate analysis, apnea-hypopnea index, stage 3 sleep %, and moderate and severe OSA were significantly associated with CAC presence (odds ratio [OR] 1.010, p = 0.035; OR 0.949, p = 0.039; OR 2.186, p = 0.013; and OR 2.019, p = 0.020, respectively). However, after adjusting for possible confounders, there was no significant association. In conclusion, the patients with intermittent hypoxemia during sleep should be considered for evaluation of coronary artery calcification to detect cardiovascular disease in subclinical status.

Objectives The aim of this study was to compare the prescription patterns according to characteristics of physicians using a survey distributed amongst physicians in Korea. Methods We surveyed the prescription patterns for allergic rhinitis (AR) of the members of the Korean Academy of Asthma, Allergy and Clinical Immunology (KAAACI) and the Korean Association of Otorhinolaryngologists (KAO). Questionnaire contained 4 categories with 28 queries. 448 physicians including 98 internal medicine (IM), 113 pediatrics (PED), and 237 otorhinolaryngology (ENT) were responded. Results Although the Allergic Rhinitis and its Impact on Asthma (ARIA) guidelines are most frequently used in all specialties, seasonal or perennial AR is the most frequent classification system. For the definitive diagnosis of AR, ENT physicians reported using multiple allergen simultaneous test (MAST)/radio allergy sorbent test (RAST) more than others (IM, 10.9%; PED, 20.6%; ENT, 44.2%; P

Background: Olfactory and gustatory dysfunction have been reported as characteristic symptoms of coronavirus disease 2019 (COVID-19). This study evaluated olfactory and gustatory dysfunction in mild COVID-19 patients using validated assessment methods. Methods: A prospective surveillance study was conducted for mild COVID-19 patients who were isolated at the Gyeonggi International Living and Treatment Support Center (LTSC), Korea. Olfactory function was assessed using the Korean version of the Questionnaire of Olfactory Disorders (QOD) and Cross-Cultural Smell Identification Test (CC-SIT). Gustatory function was assessed using an 11-point Likert scale and 6-n-propylthiouracil, phenylthiocarbamide, and control strips. All patients underwent nasal and oral cavity endoscopic examination. Findings: Of the 62 patients at the LTSC, 15 patients (24.2%) complained of olfactory or gustatory deterioration on admission. Four of 10 patients who underwent functional evaluation did not have general symptoms and 2 patients were asymptomatic. The mean sQOD-NS and QOD-VAS scores were 13 ± 6 and 4.7 ± 3.6, respectively. The mean CC-SIT score was 8 ± 2. No patients showed anatomical abnormalities associated with olfactory dysfunction on endoscopic examination. The mean Likert scale score for function was 8 ± 2, and there were no abnormal lesions in the oral cavity of any patient. Interpretation: The prevalence of olfactory and gustatory dysfunction was 24.2% in mild COVID-19 patients. All patients had hyposmia due to sensorineural olfactory deterioration, which was confirmed using validated olfactory and gustatory evaluation methods and endoscopic examination. Olfactory and gustatory dysfunction may be characteristic indicators of mild COVID-19. Funding Statement: No funding. Declaration of Interests: The authors declare no competing interests. Ethics Approval Statement: This study protocol was approved by the Institutional Review Board of the Korea University Ansan Hospital (2020AS0122).