• Clinical and Experimental Reproductive Medicine
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• v.48 no.1
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• pp.80-84
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• 2021

Objective: The aim of the study was to investigate pregnancy, obstetric, and neonatal outcomes in women with small (<4 cm) unilateral endometriomas. Methods: This retrospective study included 177 patients: 91 patients with small endometriomas and 86 controls with unexplained or tubal factor infertility who were treated at the Süleymaniye Gynecology and Maternity Training and Research Hospital Infertility Unit between January 2010 and July 2015. The groups were matched with regards to demographic characteristics such as age, body mass index, and infertility duration. All of the women in this study conceived via intracytoplasmic sperm injection. We compared pregnancy, obstetric, and neonatal outcomes between these groups. Results: Women with endometriomas had a higher biochemical pregnancy rate, but lower clinical pregnancy and live birth rates than women with unexplained and tubal factor infertility (p<0.05 for all). However no significant differences were found in terms of obstetric and neonatal complications between the two groups (p>0.05 for all). Conclusion: In this study, we found that women with endometriomas less than 4 cm were more prone to early pregnancy complications. We also showed that this group did not have any increased risks of late pregnancy, obstetric, and neonatal complications.

• Asia-Pacific Journal of Business
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• v.14 no.1
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• pp.231-246
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• 2023

Purpose - This study attempts to provide a new theoretical perspective on the quality signaling and its impact on a market under information asymmetry, focusing on how the accuracy and the cost of quality signaling affect sellers' and buyers' profit, suggesting appropriate designs of quality signaling methods which mitigates information asymmetry. Design/methodology/approach - In order to examine the effect of quality signaling on strategic interactions within the market, we establish an analytic model where market outcomes are determined by seller's quality claim and price, and buyers are risk-neutral. By investigating this analytic model through relevant game trees, we find the subgame perfect Nash equilibria of the market and predict related market outcomes based on sellers' quality signaling strategy. Findings - Our analytic model shows counterintuitive results that seller profit will be the lowest with inaccurate quality signaling and the highest with no quality signaling, mostly due to the certification cost. Consequently, sellers should proceed with caution if the quality signaling is less than accurate, as it may backfire. We believe that this is due to the fact that the inaccuracy of quality signaling causes some confusion and uncertainty in both sellers and buyers' decision to maximize profit, making it hard for sellers to predict buyers' behavior. Research implications or Originality - Although the sources and types of quality signaling errors have been investigated in the literature, there has not been satisfactory understanding regarding how inaccuracy of quality certification affects specific market outcomes. We expect that our theoretical model would provide important implications on how to utilize quality signaling to solve adverse selection issues in markets under information asymmetry.

• The Korea Journal of Herbology
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• v.35 no.1
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• pp.45-55
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• 2020

Objectives : The purpose of this study is to determine whether Rhus verniciflua Stokes with Latin name Lacca Sinica Exsiccata, and Eucommia ulmoides Oliver with Latin name Eucommiae Cortex Extract Combination (ILF-RE) improves laboratory test results in participants with liver function disorder. Methods : This study was conducted at Woosuk university Korean medicine hospital where participants with high serum alanine transaminase (ALT) levels from 45 to 135 U/L were enrolled. Subjects received ILF-RE 3.6 g (1.2 g/day as ILF-RE) or placebo 3.6 g for 12 weeks. It was confirmed that urushiol was not detected in ILF-RE. The primary outcomes were the decrement degree of serum ALT and gamma-glutamyl transferase (GGT) levels between two groups. The secondary outcomes were the decrement degree of serum aspartate transaminase (AST), alkaline phosphatase (ALP), lactate dehydrogenase (LD), total bilirubin, total cholesterol, triglyceride (TG) and fatty liver index (FLI) levels between two groups. Adverse events, skin prick tests, laboratory tests, and vital signs were observed and analyzed to confirm the safety of ILF-RE.1) Results : In the ILF-RE group, the liver function index ALT, GGT, lipid metabolism index TG, and fatty liver index FLI were significantly decreased compared to the placebo group. There was no significant difference in ILF-RE group in terms of adverse events, severe adverse events, skin prick test, laboratory test, and vital signs compared with placebo group. Conclusions : ILF-RE was found to be effective in improving liver function. In addition, no clinically significant adverse events or body changes were observed during this study.

• Korean Journal of Community Nutrition
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• v.9 no.4
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• pp.483-490
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• 2004

Elevated maternal plasma homocysteine concentrations have been associated with adverse pregnancy outcomes, including birth defects, low birth weight, preeclampsia, spontaneous abortion, placental abruption, and other maternal or fetal complications. The purpose of this study was to assess the maternal plasma homocysteine level during pregnancy and to investigate the relationship between the plasma homocysteine concentrations and pregnancy outcomes. Venous blood samples were drawn from 82 pregnant women who were grouped with gestational age, 1st trimester (n = 26), 2nd trimester (n = 27) and 3rd trimester (n = 29). The concentration of plasma homocysteine was analyzed by HPLC, and pregnancy outcomes including gestational length, maternal weight gain, infant birth weight, and Apgar score were collected with the medical records of the pregnant women. The levels of plasma homocysteine of the pregnant women at the 1st, 2nd, and 3rd trimester were 5.7 $$\pm$ 3.7\mu㏖/L,\;5.6 \pm4.1\mu㏖/L\; and\; 7.0\pm 4.5\mu㏖/L$, respectively, which had not showed any significant difference. The result of this study showed that in case of the pregnant women at the 1st trimester, the maternal plasma homocysteine level of the pregnant women whose gestational length was less than 38 weeks was significantly high (p < 0.01) compared to that of the pregnants whose gestational length was more than 38 weeks. And also, the level of homocysteine of the pregnant women at the 2nd trimester was significantly low when the maternal weight gain was high (p < 0.05). These findings suggest that maternal plasma homocysteine level at early stage of gestation will be a predicter of gestational length and maternal weight gain.

• Clinical Endoscopy
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• v.56 no.5
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• pp.650-657
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• 2023

Background/Aims: Endoscopic ultrasound gallbladder drainage (EUS-GBD) is gaining attention as a treatment method for cholecystitis. However, only a few studies have assessed the outcomes of permanent stenting with EUS-GBD. Therefore, we evaluated the clinical outcomes of permanent stenting using EUS-GBD. Methods: This was a retrospective, single-center cohort study. The criteria for EUS-GBD at our institution are a high risk for surgery, inability to perform surgery owing to poor performance status, and inability to obtain consent for emergency surgery. EUS-GBD was performed using a 7-Fr double-pigtail plastic stent with a dilating device. The primary outcomes were the recurrence-free rate of cholecystitis and the late-stage complication-avoidance rate. Secondary outcomes were technical success, clinical success, and procedural adverse events. Results: A total of 41 patients were included in the analysis. The median follow-up period was 168 (range, 10-1,238) days. The recurrence-free and late-stage complication-avoidance rates during the follow-up period were 95% (38 cases) and 90% (36 cases), respectively. There were only two cases of cholecystitis recurrence during the study period. Conclusions: EUS-GBD using double-pigtail plastic stent was safe and effective with few complications, even in the long term, in patients with acute cholecystitis.

• Journal of Korean Medicine Rehabilitation
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• v.18 no.4
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• pp.103-120
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• 2008

Objectives : This study aims to educate clinical doctors of the valuable practice of Manipulative Therapy(MT) as an opportunity for evidence-based medicine. Consequently it also serves to review the effectiveness and safety of MT. Methods : The literature studies of overseas were done by Cochrane Library and Medline website; those of domestic researches were completed by utilizing the sources which are gained from KERIS, KISS, DBpia, Kisti, and domestic institutes related with MT. Results : Eight papers related to the effectiveness of MT were published in South Korea, which concluded with the positive effects of MT. None of them are, however, well-designed randomized controlled trials(RCT). On the other hand, fifteen cases of nine articles indicate the adverse reaction of MT, and numbers of the researches in overseas revealed the side effects of MT in order of cervical, lumbar, and thoracic vertebrae. A vascular adverse reaction such as vertebral and carotid artery dissection was a highly reported cervical adverse reaction; in the thoracic and lumbar regions, neurological adverse reaction in terms of disc hemiation was frequently discovered. Conclusions : Henceforth, highly qualitative studies are required developing the effective outcomes and preventing any possible complications of MT. Therefore, systemic curriculums in institutions and sufficient clinical training in the filed are strongly recommended.

• Journal of Korean Medicine for Obesity Research
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• v.23 no.2
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• pp.112-124
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• 2023

Objectives: Obesity is a chronic metabolic disease that negatively affects quality of life and health. It is associated with various disease and its prevalence is on the rise. Although various treatments for obesity are used, they have several adverse effects. Pharmacoacupuncture is a widely used method for treating various diseases and has the advantage of having fewer adverse effects. This systematic review and meta-analysis evaluate the efficacy of pharmacoacupuncture in treating obesity. Methods: Eight electronic databases were searched from their inception to August 2023. Only randomized controlled trials were included in this review. Intervention groups included pharmacoacupuncture. Control groups had no limitation. The primary outcome was body mass index (BMI), and the secondary outcomes were body weight (BW), waist circumference (WC), and adverse effects. Continuous outcome data were presented as mean differences (MD) with 95% confidence intervals (CI). Results: Four randomized controlled trials (RCTs) involving 139 participants were included in this systematic review and meta-analysis. Results revealed that BMI ((MD)=-0.98, 95% CI -1.84 to -0.11, Z=2.22, P=0.03, I²=0%), WC (MD=-4.29, 95% CI -7.51 to -1.08, Z=2.62, P=0.009, I²=38%) were significantly improved in the intervention groups compared to control groups. Adverse effects were reported in two studies. Conclusions: This systematic review and meta-analysis suggests that pharmacoacupuncture is an effective and safe therapy for simple obesity. Further detailed studies should be conducted on effects of pharmacoacupuncture for obesity to increase reliability.

• Neonatal Medicine
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• v.25 no.3
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• pp.118-125
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• 2018

Purpose: The pre-pregnancy body mass index (BMI) is associated with adverse neonatal outcomes. However, studies on very low birth weight (VLBW) infants are rare. This study aimed to investigate the effect of maternal pre-pregnancy BMI on VLBW infants. Methods: This retrospective study evaluated singleton VLBW infants born at the CHA Gangnam Medical Center from 2006 to 2016. The neonates were classified into three groups according to the maternal pre-pregnancy BMI: underweight (<$18.5kg/m^2$), normal weight (${\geq}18.5$ to <$23kg/m^2$), and overweight or obese (${\geq}23kg/m^2$). Clinical characteristics and morbidities of mothers and infants were analyzed. Results: A total of 181 infants belonging to underweight (16.6%), normal weight (58.6%), and overweight or obese (24.8%) groups were enrolled. The pre-pregnancy BMI had a significant negative correlation with gestational age (r=-0.198, P=0.001) and a significant positive correlation with the z-score of the birth weight (r=0.078, P=0.001) and body length (r=0.067, P=0.008). The number of extremely preterm infants was significantly higher in the overweight or obese group. The proportion of risk of small for gestational age infants was higher in the underweight group (adjusted odds ratio [OR], 2.958; 95% confidence interval [CI], 1.113 to 7.864), whereas that of infants with severe retinopathy of prematurity was higher in the overweight or obese group (adjusted OR, 9.546; 95% CI, 1.230 to 74.109). Conclusion: In our population of VLBW infants, the pre-pregnancy BMI was associated with gestational age, intrauterine growth, and adverse neonatal outcomes. Therefore, proper weight control before pregnancy is important.

• Journal of Korean Neurosurgical Society
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• v.52 no.2
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• pp.85-91
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• 2012

Objective : Hemifacial spasm (HFS) caused by vertebrobasilar dolichoectasia (VBD) is very rare, and in theses cases, it is difficult to decompress the nerve from its vascular compression. The objective of this study was to investigate the outcome of microvascular decompression (MVD) for HFS caused by VBD. Methods : There were 10 patients of HFS caused by VBD at our hospital between September 1978 and September 2008. We evaluated magnetic resonance angiography (MRA) and time of flight magnetic resonance imaginge (TOF MRI) findings using the criteria for VBD. We compared the clinical outcomes of MVD for the 10 patients with VBD with the overall outcomes of the total 2058 MVDs performed for HFS. Results : The results of MVD for HFS caused by VBD were successful in 90.9% of cases. The postoperative complication rate in VBD was 45.5%. Offending vessels in patients with VBD were identified visually during surgery. Adverse effects after MVD were found in 4 patients. We found that the diameter of VBD was significantly greater in patients with complications than in those with no complications (p=0.028). Conclusion : Our data shows that MVD may be a good treatment modality for HFS caused by VBD but care must be taken to avoid adverse effects from the procedure. It is important to detach the dolichoectatic artery from its surrounding structures sufficiently to allow it to be easily movable. In addition, attempts should be made to lessen the retraction of the cerebellum during release of the dolichoectatic artery.

• Journal of Chest Surgery
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• v.50 no.1
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• pp.14-21
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• 2017

Background: Off-pump coronary artery bypass (OPCAB) is performed worldwide, but significant risks are associated with conversion to on-pump surgery. Therefore, we evaluated the composite outcomes between an OPCAB group and a conversion group. Methods: From January 2008 to December 2012, 100 consecutive patients underwent OPCAB at Hallym University Sacred Heart Hospital, of whom 84 underwent OPCAB without adverse events (OPCAB group), and 16 were converted to on-pump surgery (conversion group). Early morbidity, early and long-term mortality, and major adverse cardiac and cerebrovascular events (MACCEs) were the primary and long-term composite endpoints. Results: The mean follow-up period was $55{\pm}26months$, with 93% of the patients completing follow-up. The composite outcomes in the OPCAB and conversion groups were as follows: early morbidity, 2.3% versus 12.5%; early mortality, 4.7% versus 0%; long-term mortality, 14.3% versus 25.0%; and MACCEs, 14.3% versus 18.8%, respectively. No composite endpoints showed statistically significant differences. Preoperative acute myocardial infarction (AMI) was identified as an independent risk factor for conversion (p=0.025). Conclusion: The conversion group showed no statistically significant differences in early mortality and morbidity, MACCEs, or long-term mortality compared with the OPCAB group. The preoperative diagnosis of AMI was associated with an increased number of conversions to on-pump surgery.