• Health Policy and Management
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• v.29 no.3
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• pp.357-367
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• 2019

Background: This study evaluated the cost-effectiveness of 21 different national dyslipidemia screening strategies according to total cholesterol (TC) cutoff and screening interval among 40 years or more for the primary prevention of coronary heart disease over a lifetime in Korea, from a societal perspective. Methods: A decision tree was used to estimate disease detection with the 21 different screening strategies, while a Markov model was used to model disease progression until death, quality-adjusted life years (QALYs) and costs from a Korea societal perspective. Results: The results showed that the strategy with TC 200 mg/dL and 4-year interval cost \4,625,446 for 16.65105 QALYs per person and strategy with TC 200 mg/dL and 3-year interval cost \4,691,771 for 16.65164 QALYs compared with \3,061,371 for 16.59877 QALYs for strategy with no screening. The incremental cost-effectiveness ratio of strategy with TC 200 mg/dL and 4-year interval versus strategy with no screening was \29,916,271/QALY. At a Korea willingness-to-pay threshold of \30,500,000/QALY, strategy with TC 200 mg/dL and 4-year interval is cost-effective compared with strategy with no screening. Sensitivity analyses showed that results were robust to reasonable variations in model parameters. Conclusion: In this study, revised national dyslipidemia screening strategy with TC 200 mg/dL and 4-year interval could be a cost-effective option. A better understanding of the Korean dyslipidemia population may be necessary to aid in future efforts to improve dyslipidemia diagnosis and management.

• Clinical and Experimental Pediatrics
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• v.64 no.2
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• pp.68-75
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• 2021

The novel coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection has been spreading worldwide since December 2019. Hundreds of cases of children and adolescents with Kawasaki disease (KD)-like hyperinflammatory illness have been reported in Europe and the United States during the peak of the COVID-19 pandemic with or without shock and cardiac dysfunction. These patients tested positive for the polymerase chain reaction or antibody test for SARS-CoV-2 or had a history of recent exposure to COVID-19. Clinicians managing such patients coined new terms for this new illness, such as COVID-19-associated hyperinflammatory response syndrome, pediatric inflammatory multisystem syndrome temporally associated with COVID-19, or COVID-19-associated multisystem inflammatory syndrome in children (MIS-C). The pathogenesis of MIS-C is unclear; however, it appears similar to that of cytokine storm syndrome. MIS-C shows clinical features similar to KD, but differences between them exist with respect to age, sex, and racial distributions and proportions of patients with shock or cardiac dysfunction. Recommended treatments for MIS-C include intravenous immunoglobulin, corticosteroids, and inotropic or vasopressor support. For refractory patients, monoclonal antibody to interleukin-6 receptor (tocilizumab), interleukin-1 receptor antagonist (anakinra), or monoclonal antibody to tumor necrosis factor (infliximab) may be recommended. Patients with coronary aneurysms require aspirin or anticoagulant therapy. The prognosis of MIS-C seemed favorable without sequelae in most patients despite a reported mortality rate of approximately 1.5%.

• Korean Journal of Radiology
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• v.19 no.6
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• pp.1031-1041
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• 2018

Objective: To compare image quality and radiation dose of high-pitch dual-source spiral cardiothoracic computed tomography (CT) between non-electrocardiography (ECG)-synchronized and prospectively ECG-triggered data acquisitions in young children with congenital heart disease. Materials and Methods: Eighty-six children (${\leq}3$ years) with congenital heart disease who underwent high-pitch dual-source spiral cardiothoracic CT were included in this retrospective study. They were divided into two groups (n = 43 for each; group 1 with non-ECG-synchronization and group 2 with prospective ECG triggering). Patient-related parameters, radiation dose, and image quality were compared between the two groups. Results: There were no significant differences in patient-related parameters including age, cross-sectional area, body density, and water-equivalent area between the two groups (p > 0.05). Regarding radiation dose parameters, only volume CT dose index values were significantly different between group 1 ($1.13{\pm}0.09mGy$) and group 2 ($1.07{\pm}0.12mGy$, p < 0.02). Among image quality parameters, significantly higher image noise ($3.8{\pm}0.7$ Hounsfield units [HU] vs. $3.3{\pm}0.6HU$, p < 0.001), significantly lower signal-to-noise ratio ($105.0{\pm}28.9$ vs. $134.1{\pm}44.4$, p = 0.001) and contrast-to-noise ratio ($84.5{\pm}27.2$ vs. $110.1{\pm}43.2$, p = 0.002), and significantly less diaphragm motion artifacts ($3.8{\pm}0.5$ vs. $3.7{\pm}0.4$, p < 0.04) were found in group 1 compared with group 2. Image quality grades of cardiac structures, coronary arteries, ascending aorta, pulmonary trunk, lung markings, and chest wall showed no significant difference between groups (p > 0.05). Conclusion: In high-pitch dual-source spiral pediatric cardiothoracic CT, additional ECG triggering does not substantially reduce motion artifacts in young children with congenital heart disease.

• The Journal of Internal Korean Medicine
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• v.39 no.6
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• pp.1181-1190
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• 2018

Objective: This study investigated the effect of purified medical herb extracts such as Alisma canaliculatum and Polyporus umbellatuson adipogenic differentiation of human bone marrow derived mesenchymal stromal stem cells (hBMSCs). Methods: Two different medical herb were extracted using hot distilled water. The optimal concentration of extracts were fixed at 100 ng/ml by means of cell viability and cytotoxic assay. To test the adipogenic differentiation ability of extracts, we induced the adipogenesis of hBMSCs for 21 days. At day 5, the cell was harvested to check mRNA and protein expression level of adipogenic related factors. The efficacy of lipid droplet formation was evaluated using the oil-red O staining method at days 21. Results: Two different medical herb extracts have no toxicity on hBMSCs. And two different medical herb extracts significantly decreased formation of lipid droplet compared with control groups in hBMSCs. The A. canaliculatum extract group showed the lowest mRNA and protein expression level of adipossgenic related transcription factors. This data suggests that extract of A. canaliculatum and P. umbellata decrease the adipogenic differentiation of hBMSCs. Conclusions: Our findings indicate that water-extract of A. canaliculatum and P. umbellata will be useful therapeutic reagents for prevention of obesity related disease such as diabetes, hyperlipidemia, coronary artery disease, and osteoporosis.

• Healthcare Informatics Research
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• v.24 no.4
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• pp.346-358
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• 2018

Objectives: The association between obstructive sleep apnea (OSA) and mortality or serious cardiovascular events over a long period of time is not clearly understood. The aim of this observational study was to estimate the clinical effectiveness of continuous positive airway pressure (CPAP) treatment on an outcome variable combining mortality, acute myocardial infarction (AMI), and cerebrovascular insult (CVI) during a follow-up period of 15.5 years ($186{\pm}58$ months). Methods: The data set consisted of 978 patients with an apnea-hypopnea index (AHI) ${\geq}5.0$. One-third had used CPAP treatment. For the first time, a data-driven causal Bayesian network (DDBN) and a hypothesis-driven causal Bayesian network (HDBN) were used to investigate the effectiveness of CPAP. Results: In the DDBN, coronary heart disease (CHD), congestive heart failure (CHF), and diuretic use were directly associated with the outcome variable. Sleep apnea parameters and CPAP treatment had no direct association with the outcome variable. In the HDBN, CPAP treatment showed an average improvement of 5.3 percentage points in the outcome. The greatest improvement was seen in patients aged ${\leq}55$ years. The effect of CPAP treatment was weaker in older patients (>55 years) and in patients with CHD. In CHF patients, CPAP treatment was associated with an increased risk of mortality, AMI, or CVI. Conclusions: The effectiveness of CPAP is modest in younger patients. Long-term effectiveness is limited in older patients and in patients with heart disease (CHD or CHF).

• CELLMED
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• v.8 no.4
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• pp.20.1-20.5
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• 2018

Cancer is considered one of the deadly diseases in the world. According to WHO cancer now causes more deaths than all coronary heart disease. The incidence and mortality of the worldwide major cancers are now available in the GLOBOCAN series of the International Agency for Research on Cancer. The transition of global demographic and epidemiologic shows that burden of cancer will increase particularly in low and middle income countries, with over 20 million new cancer cases expected annually as early as 2025. Medicinal plants made known to be prospective and useful job for the treatment of several diseases and disorders from prehistoric days to nowadays. One of the commonly used plants, which have supporting evidences from the recent scientific data for the different types of cancers, is Carica papaya. Papaya (Carica papaya) is widely used as folk caloric herbal medicine, being a powerhouse of nutrients and accessible throughout the year. It is a rich source of three powerful antioxidants, the minerals, vitamins and contains high content of fibre. Carica papaya has provided many remedies for various diseases from ancient days to nowadays, and is regarded as a Nutraceutical. Because of this comprehensive medicinal value of Carica papaya, we are trying here to convey the reports studied especially for the anticancer activities of the age-old fruit, which will help researchers to pull in concert data and may be a "lead" for the one of the dangerous disease in the world.

• Journal of Medicine and Life Science
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• v.15 no.2
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• pp.108-111
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• 2018

Extra-corporeal membrane oxygenation (ECMO) has the potential to rescue patients in cardiac arrest or respiratory failure. ECMO has two systems such as veno-arterial and veno-venous circulation. In cardiac arrest resulting from acute myocardial infarction, veno-arterial ECMO is mandatory for systemic circulation and oxygenation. A 75-year old female patient underwent primary coronary intervention for acute myocardial infarction. Despite successful revascularization, recurrent ventricular tachycardia and heart failure were progressing. We performed a veno-arterial ECMO through the femoral artery and vein, then the patient seemed to be stable clinically. However, laboratory studies, echocardiography, and vital signs indicated multi-organ failure and decreasing cardiac function. We found out an error that we performed veno-venous ECMO instead of veno-arterial ECMO. We added a femoral artery cannula and exchange the circuit system to veno-arterial ECMO. While the systemic circulation seemed to be recovered, the left ventricular function was decreased persistently. A hypovolemia resulting from pulmonary hemorrhage was occurred, which lead to ECMO failure. The patient died of cardiac arrest and multi-organ failure 23 hours after ECMO. Because the color of arterial and venous circuits represent the position and efficacy of ECMO, if unexpected or abnormal circuit colors are detected, prompt and aggressive evaluation for ECMO function is mandatory.

• Food Science and Industry
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• v.52 no.1
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• pp.84-99
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• 2019

Dietary fiber is defined as soluble and insoluble polysaccharide consisted in the plant cell wall-associated fibers naturally occurring in fruits, vegetables, and cereal products, and of isolated fibers that are added to processed foods which are also artificially modified. There are so many difference types of dietary fibers as arabinoxylan, polydextrose chicory, oligosccharide. inulin, pectin, bran, cellulose, ${\beta}$-glucan, resistant starch and some seaweed polymers as alginate. Most of them provide many biological benefits in the intestine, as lower risk for developing coronary heart disease, stroke, hypertension, diabetes, obesity and some of the gastrointestinal disease like as colon cancer. And also lowering cholesterol levels, improves glycemic and insulin sensitivity to non-diabetic and diabetic persons including immune system. Beside of many benefits, average consumers in developed and under developing countries take far less amounts of dietary fiber that international organization recommended. Adequate intake of dietary fiber is 14g/1,000kcal base using the energy guide line of 2,000kcal/day for women and 26,000 kcal/day for men, dietary intake is 28g/day of adult women and 36g/day for adult men. The mechanisms behind the reported effects of dietary fiber on metabolic health are not fully well established. It is suggested that changes in intestinal viscosity resulting mucus increasing, macro-nutrients absorption, rate of passage of large intestinal, production of short chain fatty acids by fermentation. Production of gut hormones and changes of microbiota in intestine. It is necessary to do more research in this field in the future and combined interdisciplinary works together.

• Journal of Digital Convergence
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• v.17 no.4
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• pp.211-217
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• 2019

As the widespread use of mobile health intervention among Korean patients with chronic disease, it is needed to identify research trends in mobile health intervention on chronic care using text mining technique. This secondary data analysis was conducted to investigate characteristics and main research topics in intervention studies from 2005 to 2018 with a total of 20 peer reviewed articles. Microsoft Excel and Text Analyzer were used for data analysis. Mobile health interventions were mainly applied to hypertension, diabetes, stroke, and coronary artery disease. The most common type of intervention was to develop mobile application. Lately, 'feasibility', 'mobile health', and 'outcome measure' were frequently presented. Future larger studies are needed to identify the relationships among key terms and the effectiveness of mobile health intervention using social network analysis.

• Tuberculosis and Respiratory Diseases
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• v.84 no.2
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• pp.140-147
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• 2021

Background: For generations, cigarette smoking has presented an important public health concern. This study aimed to compare the health-promoting behavior, exercise capacity, physical activity level, health literacy, and knowledge level of smoking-related diseases between smokers and non-smokers. Methods: The study included 71 smokers (mean age, 32.69±8.55 years) and 72 non-smokers (mean age, 31.88±9.94 years) between the ages of 20 and 60 years. Assessments included a 6-minute walking test (6MWT), Godin Leisure-Time Physical Activity Questionnaire, Health-Promoting Lifestyle Profile II (HPLP-II), Cardiovascular Risk Factors Knowledge Level Scale (CARRF-KL), Asthma/COPD Awareness Questionnaire, the World Health Organization Quality of Life-Bref questionnaire (WHOQoL-Bref [TR]), and Health Literacy Questionnaire (HLQ). Results: The results from the study show that the number of coronary artery disease risk factors measured significantly higher among the smoker group members when compared to that of the non-smoker group members (p=0.001). Smokers had significantly lower %6MWT distance than non-smokers (84.83±4.72 and 93.45±7.16, respectively; p<0.05). However, there were no significant differences between the smokers and non-smokers in terms of physical activity, CARRF-KL, HLQ, WHOQoL-Bref, and HPLP-II subscales or total scores (p>0.05). Additionally, while only forty-one smokers (57.7%) were active, 48 of the non-smoker group was active (66.7%). Conclusion: Smokers suffer greater negative effects to their exercise capacity in comparison to non-smokers. Although smokers and non-smokers have similar levels of health literacy and similar levels of knowledge about cardiovascular disease risk factors and obstructive lung diseases, health professionals could continue to further increase individuals' awareness of smoking-related risk factors and continue to emphasize the importance of physical activity and exercise for protecting cardiopulmonary health.