• Journal of the Korean Orthopaedic Association
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• v.54 no.2
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• pp.100-109
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• 2019

The rapidly increasing rate of shoulder arthroplasty is certain to increase the number of revision arthroplasties because of parallel increases in complication numbers. It has been widely reported that the causes of revision shoulder arthroplasty include rotator cuff deficiency, instability, glenoid or humeral component loosening, implant failure, periprosthetic fracture, and infection. Revision arthroplasty can be technically challenging, and surgical options available for failed shoulder arthroplasty are limited, especially in patients with glenoid bone loss or an irreparable rotator cuff tear. Furthermore, the outcomes of revision arthroplasty are consistently inferior to those of primary arthroplasty. Accordingly, surgical decision making requires a good understanding of the etiology of failure. Here, we provide a review of indications of revision arthroplasty and of the surgical techniques used by failure etiology.

• Journal of Chest Surgery
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• v.38 no.3 s.248
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• pp.197-203
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• 2005

Homograft aortic valve replacement (AVR) has many advantages such as excellent hemodynamic performance, faster left ventricular hypertrophy regression, resistance to infection and excellent freedom of thromboembolism. To find out the results of homograft AVR, we reviewed our surgical experiences. Material and Method: Eighteen patients (male female=16 : 2, mean age=39.3$\pm$16.2 years, range: 14$\~$68 years) who underwent homo-graft aortic valve replacement between May 1995 and May 2004 were reviewed. The number of homografts was 20 (17 aortic and 3 pulmonic homografts) including two re-operations. Ten patients had a history of previous aortic valve surgery. Indications for the use of a homograft were native valve endocarditis (n=7), prosthetic valve endocarditis (n=5), or Behcet's disease (n=8). The homograft had been implanted predominantly as a full root except in one patient in the subcoronary position. Result: Mean follow-up was 41.3 $\pm$ 26.2 months. There was one operative mortality. Postoperative complications included postoperative bleeding in 3 patients, and wound infection in 1. There was no late death. Three patients underwent redo-AVR. The etiology of the three reoperated patients was Behcet's disease (p=0.025). Freedom from reoperation was $87.5\pm8.3\%$, $78.8\pm11.2\%$ at 1, 5 years respectively, In patients with infective endocarditis, there was no recurrence of endocarditis. There was no thromboembolic complication. Conclusion: Although longer term follow-up with larger numbers of patients is necessary, the operative and mid-term results for homograft AVR was good when we took into account the operative risks of Behcet's disease or infective endocarditis. Behest's disease was a risk factor for reoperation after the homograft AVR. We think homograft AVR is the procedure of choice, particularly in patients with infective endocarditis.

• Journal of agricultural medicine and community health
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• v.43 no.4
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• pp.258-269
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• 2018

Objectives: There was an outbreak of foodborne and waterborne disease among high school students at Okcheon in June, 2018. First attack occurred June $5^{th}$ but seven days later it was notified. The purpose of this investigation was to evaluate the pathogen of outbreak and cause of delayed notification. Methods: First, we did a questionnaire survey for 61 cases and 122 controls to find what symptoms they had and whether they ate foods or drank water from June $2^{nd}$ to June $12^{th}$. Second, we investigated the environment of cafeteria and drinking water. Third, we examined specimen of cases and environment to identify bacteria or virus. Results: Attack rate of this outbreak was 7.8%. Drinking water was strongly suspected as a source of infection in questionnaire survey but we could not find the exact time of exposure. Norovirus was identified in specimen of cases (2 students), drinking water (at main building and dormitory) and cafeteria (knife, dishtowel, hand of chef) Conclusions: We decided norovirus as the pathogen of this outbreak based on the clinical features of cases with diarrhea vomiting, abdominal pain and recovery within 2 or 3 days after onset, outbreak due to drinking water and microbiologic examination, And the cause of delayed notification might be the non-existence of the nurse teacher at that time and the lack of understanding of teachers on immediate notification under the outbreak. To prevent the delayed notification, notification system about outbreak of foodborne and waterborne disease in school is needed to be improved.

• The Korean Society of Law and Medicine
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• v.20 no.3
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• pp.235-262
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• 2019

While traditionally threatening human infectious diseases are decreasing, chronic diseases such as cancer and diabetes, including cardiovascular diseases, are spreading rapidly. Reflecting the characteristics of chronic diseases that are difficult to treat, the management of risk factors and the preparation of health promotion policies corresponding to them have emerged as important concerns around the world. Providing so-called multi-sector approach such as health promotion and disease prevention policy and solution for community response, The value of primary care is once again highlighted in the changed medical environment. As the existing medical delivery system has become difficult to cope with the people's desire for rapid aging, disease paradigm change, and quality of life improvement, European Union countries have made various efforts to improve the quality of their primary medical system, which provides continuous, com- prehensive and coordinated management. This paper examines the current status and problems of the healthcare delivery system in Korea, draws implications from the European Union examples related to the strengthening of primary care, and discusses the plans for establishing a patient-centered future medical delivery system.

• Clinical and Experimental Pediatrics
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• v.50 no.4
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• pp.348-354
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• 2007

Purpose : Perinatal hepatitis B viral infection is decreasing; however, 10% of babies to HBeAg positive mothers still become chronic carriers despite perinatal prophylaxis. Although, the cause of prophylaxis failure is still unclear, an importance of maternal HBV-DNA level at the delivery time has been suggested. This study was established to certify if it would be a useful predictable factor for the outcome of perinatal prophylaxis. Methods : Twenty-nine HBeAg positive mothers whose babies had known outcomes of prophylaxis were selected. To determine the amount of maternal HBV-DNA, a quantitative PCR was performed with the WHO International Standard for HBV DNA NAT assays. Results : The mean logarithm HBV-DNA level of mothers with failed outcomes was significantly higher than that of mothers with succeessful outcomes (7.99 vs. 6.72, P=0.015). The predictable maternal HBV-DNA cut-off level to prophylaxis outcome was $2.83{\times}10^7copies/mL$ (100 pg/mL). None out of the case 16 (0%) who had below this level, and 5 out of 13 (38.5%) who had above this level of maternal HBV-DNA failed in perinatal prophylaxis. Conclusion : Mothers with higher levels of HBV-DNA at delivery time would be prone to a worse outcome of prophylaxis using the conventional approach. Perinatal prophylaxis failure rate can be reduced, if we try to introduce more potent prophylactic treatment into the cases with this risk factor.

• Journal of Periodontal and Implant Science
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• v.35 no.3
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• pp.649-659
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• 2005

The purpose of this study was to quantify and compare the level of MMP-1 in the healthy or inflamed gingival tissue of patients with or without type 2 diabetic mellitus. We investigated whether mean amount of MMP-1 was changed by chronic periodontitis and type 2 DM. Gingival tissue samples were obtained during periodontal surgery or tooth extraction. According to the patient's systemic condition & clinical criteria of gingiva, each gingival sample was divided into the three group. Group 1(n=8) was clinically healthy gingiva without bleeding and no evidence of bone resorption or periodontal pockets, obtained from systemically healthy 8 patients. Group 2(n=8) was inflamed gingiva from patients with chronic periodontitis. Group 3(n=8) was inflamed gingiva from patients with chronic periodontitis and type 2 diabetes. Tissue samples were prepared and analyzed by Western blotting. The quantitative analysis of MMP-1 was performed using a densitometer and statistically analyzed by ANOVA. MMP-1 was expressed in all samples and an increased MMP-1 level was observed in group 2 compared to group 1 and decreased MMP-1 level was found group 3 compared to group 2, but the differences among 3 groups were not statistically significant. In conclusion, this study demonstrated that MMP-1 levels of inflamed gingiva of systemically healthy patient(group 2) were higher than normal gingiva of systemically health patients and although the severity of gingival inflammation in group 2 and 3 were similar, MMP-1 expression was decreased in diabetic patients than systemically healthy periodontal patients.

• Journal of Veterinary Clinics
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• v.32 no.4
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• pp.324-329
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• 2015

The primary aim of this study was to investigate biosecurity practices in pig farms and to determine the major risk factors associated with PCV2 infection for a sampled swine population in Korea. To this end, we analyzed data from a cross-sectional study of 296 farrow-to-finish farms, which was conducted between March and September 2014 to explore the prevalence of swine disease at farm level. Face-to-face interviews by on-site visit of trained veterinarians were conducted with the farm owners or managers using a standardized questionnaires with information about basic demographical data and management practices. Farms were classified as negative or positive through the use of infection profiles that combined data on serological testing including PCR antigen test result, antibody titer and sero-conversion pattern at each age category taking into account vaccination status. Data were analyzed using multivariate ordinal logistic regression. Results from this study indicated that biosecurity level of the farms was considered not good given low compliance of the biosecurity programs and facilities in the farm: off-site removal of dead stocks (7%), off-site location of storage facility for incoming feeds (12.6%), off-site pick-up location for finishers (19.3%), restrictions on feed supplier vehicles for farm entrance (19.6%), restriction of finisher trucks entering the farm (22.4%), and restriction on manure disposal trucks entering the farm (26.4%). In the final model (n = 255), allowance of finisher truck driver to the pig unit had increased risk of infection (OR = 2.4, 95% CI 1.22-4.67) whereas farms with a sign forbidding the entrance had decreased risk of infection (OR = 0.19, 95% CI 0.10-0.58). Further comprehensive research with larger sample size is required to better understand the multifactorial characteristic that some predisposing risk factors that were not available in this study. To the best knowledge of the authors, this was the first study to use empirical data to report risk factors associated with PCV2 infection in the Korean pig farms. Results from the current study could be used to decide optimal biosecurity measures to reduce the impact of PCV2 infection to farmers and policy makers.

• Journal of Life Science
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• v.33 no.5
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• pp.429-435
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• 2023

Epidemiological studies suggest that maternal infection, maternal stress, and environmental risk factors during pregnancy increase the risk of brain development abnormalities associated with cognitive impairment in the offspring and increase susceptibility to schizophrenia and autism spectrum disorder. Several animal models have demonstrated that maternal immune activation (MIA) is sufficient to induce abnormal brain development and behavioral defects in the fetus. When polyinosine:polycytodylic acid (poly I:C) or lipopolysaccharide (LPS), which is commonly used in maternal immune activation animal models, was introduced into a pregnant dam, an increase in pro-inflammatory cytokines and microglial activity was observed in the offspring's brain. Microglia are brain-resident immune cells that play a mediating role in the central nervous system, and they are responsible for various functions, such as phagocytosis, synapse formation and branching, and angiogenesis. Several studies have reported that microglia are activated in MIA offspring and influence offspring behavior through interactions with various cytokines. In addition, it has been reported that they play an important role in brain circuits through interactions with neurons and astrocytes. However, there is controversy concerning whether microglia are essential to brain development or lead to behavioral defects, and the exact mechanism remains unknown. Therefore, for the potential diagnosis and treatment of brain developmental disorders, a functional study of microglia should be conducted using MIA animal models.

• Journal of the Korean Society of Radiology
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• v.83 no.2
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• pp.265-283
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• 2022

To develop Korean coronavirus disease (COVID-19) chest imaging justification guidelines, eight key questions were selected and the following recommendations were made with the evidence-based clinical imaging guideline adaptation methodology. It is appropriate not to use chest imaging tests (chest radiograph or CT) for the diagnosis of COVID-19 in asymptomatic patients. If reverse transcription-polymerase chain reaction testing is not available or if results are delayed or are initially negative in the presence of symptoms suggestive of COVID-19, chest imaging tests may be considered. In addition to clinical evaluations and laboratory tests, chest imaging may be contemplated to determine hospital admission for asymptomatic or mildly symptomatic un-hospitalized patients with confirmed COVID-19. In hospitalized patients with confirmed COVID-19, chest imaging may be advised to determine or modify treatment alternatives. CT angiography may be considered if hemoptysis or pulmonary embolism is clinically suspected in a patient with confirmed COVID-19. For COVID-19 patients with improved symptoms, chest imaging is not recommended to make decisions regarding hospital discharge. For patients with functional impairment after recovery from COVID-19, chest imaging may be considered to distinguish a potentially treatable disease.

• Clinical and Experimental Pediatrics
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• v.48 no.6
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• pp.594-598
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• 2005

Purpose : Phimosis is the inability to retract the foreskin of the penis over the glans of the penis. Even though phimosis is not pathogenic, the presence of phimosis is known to increase the risk of urinary tract infection in infancy. The use of topical steroids has been advocated as a safe and economical alternative to surgical intervention. The purpose of the study was to assess the effectiveness of topical steroids for the treatment of phimosis in young boys. Methods : A total of 53 boys with phimosis were divided into two groups to distinguish between the efficacy of low-potency topical steroid(group 1, 27 cases) and of high-potency topical steroid (group 2, 26 cases). Results : The success rate increased in the process of time. After 6 weeks, the success rate was 21 cases in group 1 and 22 cases in group 2. There was no significant differences in treatment outcomes between the two groups. The age of the boys, the appearance of prepuce prior to treatment, and the presence of previous symptoms, including symptoms of UTI, and ballooning of the prepuce at micturation had no significant difference on treatment outcomes. Conclusion : Topical steroid was effective in treatment of phimosis in boys younger than 4 years old. Although treatment outcomes between low- and high-potency topical steroids were not significantly different, those treated with a high-potency steroid cream showed more fast improvement. Further studies are necessary to assess systemic side effects of steroid treatment, duration of treatment and prevention of genitourinary tract infection in male infants.