• 한국노년학
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• v.37 no.4
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• pp.909-924
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• 2017

The purpose of this study was to identify the impact of chewing ability on cognitive function of older people in Korea and the mediation effect of physical function and depression using the nationwide data from "Survey of the Living Conditions and Welfare Needs of Korean Older Persons in 2014", in Korea. This study was conducted on a total of 10,451 respondents in the "Survey of the Living Conditions and Welfare Needs of Korean Older Persons in 2014" and the data collection period was from June 11, to September 4, 2014. Chewing ability was used in the scale on level of daily life inconvenience in chewing ability (meat or hardness). Cognitive function was measured using MMSE-DS, physical function using K-IADL, and depression using SGDS-K. The data were analyzed using the SPSS 24.0 program and Process Macro. Total effects of chewing ability on cognitive function were not significant(p>.05). Direct effects of chewing ability on cognitive function were not significant(p>.05). There were the dual mediation effect(p<.05) of physical function and depression, a complete mediating effect by physical function(p<.05) or depression(p<.05) in the impact of chewing ability on cognitive function of older people in Korea. These results indicate that physical function and depression effect directly and indirectly in the impact of chewing ability on cognitive function of older people. In conclusion, it is suggested that to prevent the decline of cognitive function in older people, it is necessary to consider not only nursing strategies for strengthening chewing ability and physical function, but also nursing interventions for relieving or preventing depression in older people.

• Journal of Korea Water Resources Association
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• v.52 no.1
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• pp.21-33
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• 2019

This study performed to simulate the watershed storm runoff using data of S-band dual-polarization radar rain, GPM (Global Precipitation Mission) satellite rain, and observed rainfall at 21 ground stations operated by KMA (Korea Meteorological Administration) respectively. For the 3 water level gauge stations (Sancheong, Changchon, and Namgang) of NamgangDam watershed ($2,293km^2$), the KIMSTORM2 (KIneMatic wave STOrm Runoff Model2) was applied and calibrated with parameters of initial soil moisture contents, Manning's roughness of overland and stream to the event of typhoon CHABA (82 mm in watershed aveprage) in $5^{th}$ October 2016. The radar and GPM data was corrected with CM (Conditional Merging) method such as CM-corrected Radar and CM-corrected GPM. The CM has been used for accurate rainfall estimation in water resources and meteorological field and the method combined measured ground rainfall and spatial data such as radar and satellite images by the kriging interpolation technique. For the CM-corrected Radar and CM-corrected GPM data application, the determination coefficient ($R^2$) was 0.96 respectively. The Nash-Sutcliffe efficiency (NSE) was 0.96 and the Volume Conservation Index (VCI) was 1.03 respectively. The CM-corrected data of Radar and GPM showed good results for the CHABA peak runoff and runoff volume simulation and improved all of $R^2$, NSE, and VCI comparing with the original data application. Thus, we need to use and apply the radar and satellite data to monitor the flood within the watershed.

• Journal of Korean Neurosurgical Society
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• v.62 no.4
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• pp.442-449
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• 2019

Objective : Bone mineral density (BMD) is an important consideration during fusion surgery. Although dual X-ray absorptiometry is considered as the gold standard for assessing BMD, quantitative computed tomography (QCT) provides more accurate data in spine osteoporosis. However, QCT has the disadvantage of additional radiation hazard and cost. The present study was to demonstrate the utility of artificial intelligence and machine learning algorithm for assessing osteoporosis using Hounsfield units (HU) of preoperative lumbar CT coupling with data of QCT. Methods : We reviewed 70 patients undergoing both QCT and conventional lumbar CT for spine surgery. The T-scores of 198 lumbar vertebra was assessed in QCT and the HU of vertebral body at the same level were measured in conventional CT by the picture archiving and communication system (PACS) system. A multiple regression algorithm was applied to predict the T-score using three independent variables (age, sex, and HU of vertebral body on conventional CT) coupling with T-score of QCT. Next, a logistic regression algorithm was applied to predict osteoporotic or non-osteoporotic vertebra. The Tensor flow and Python were used as the machine learning tools. The Tensor flow user interface developed in our institute was used for easy code generation. Results : The predictive model with multiple regression algorithm estimated similar T-scores with data of QCT. HU demonstrates the similar results as QCT without the discordance in only one non-osteoporotic vertebra that indicated osteoporosis. From the training set, the predictive model classified the lumbar vertebra into two groups (osteoporotic vs. non-osteoporotic spine) with 88.0% accuracy. In a test set of 40 vertebrae, classification accuracy was 92.5% when the learning rate was 0.0001 (precision, 0.939; recall, 0.969; F1 score, 0.954; area under the curve, 0.900). Conclusion : This study is a simple machine learning model applicable in the spine research field. The machine learning model can predict the T-score and osteoporotic vertebrae solely by measuring the HU of conventional CT, and this would help spine surgeons not to under-estimate the osteoporotic spine preoperatively. If applied to a bigger data set, we believe the predictive accuracy of our model will further increase. We propose that machine learning is an important modality of the medical research field.

• Journal of Korean Society of Health-System Pharmacists
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• v.35 no.4
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• pp.453-462
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• 2018

Background : The prevalence of chronic hepatitis C virus (HCV) tends to be higher in the elderly. Pegylated interferon and ribavirin therapy (Peg-IFN/RBV) was recommended as the first-line treatment in the past decades, but this regimen showed unsatisfactory results in terms of safety and efficacy especially in elderly patients. Recently, it was demonstrated that dual therapy with daclatasvir and asunaprevir was well tolerated and led to high sustained virological response (SVR) rates, irrespective of age. We conducted a study to evaluate the efficacy and safety of daclatasvir plus asunaprevir by involving elderly patients aged above 65 years. Methods : We retrospectively analyzed clinical data from chronic hepatitis C virus (HCV) genotype 1b patients treated with daclatasvir plus asunaprevir from September 2015 to December 2016 at Seoul St. Mary's hospital. The patients were divided into two groups as elderly patients (older than 65 years) and non-elderly patients (younger than 65 years) and compared the efficacy and safety. Results : A total of 112 patients were treated with daclatasvir plus asunaprevir for chronic hepatitis C. Among them, 101 patients completed the whole treatment, and in 88 patients the amount of HCV RNA was measured after 12 weeks of treatment. There was no significant difference in SVR at 12 weeks between both the groups (p=0.68). Typically, 91.4%(32/35) of elderly patients and 94.3%(50/53) of non-elderly patients achieved SVR12. Common adverse events included elevation in transaminase level, headache, and gastrointestinal disorders. There was no statistical difference in the symptoms between the two groups. Conclusions : The combination therapy with daclatasvir plus asunaprevir exhibited similar rates of SVR12 in HCV elderly patients without leading to further adverse events compared to non-elderly patients. Therefore, it is proposed that daclatasvir plus asunaprevir therapy could be considered as an effective and safe treatment, even in patients aged over 65 years.

• Journal of the Korea Society of Computer and Information
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• v.26 no.8
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• pp.197-207
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• 2021

Relationship between bone mineral density (BMD) and type 2 diabetes is still inconsistent. Recently, many epidemiologic data show that fracture risk is increased in type 2 diabetic patients regardless of BMD status. In this study, we used nation-wide data from 2008 to 2011 Korea National Health and Nutrition Examination Survey (KNHANES) to analyze the BMD status in patients with type 2 diabetes compared to non-diabetics. We included subjects aged 50 years or older in men (N=2,959, 2,430 without diabetes, 529 with type 2 diabetes) and postmenopausal women (N=2,902, 2,479 without diabetes, 423 with type 2 diabetes). Subjects with history of medication for osteoporosis or with illness or malignancy affecting bone metabolism were excluded. Data of anthropometric measurements and demographic characteristics were collected by trained examiner. Serum was separated from peripheral venous blood samples obtained after 8 hours of fasting. BMD was measured at lumbar spine and femur using dual-energy X-ray absorptiometry (DXA). There was a significant positive association between lumbar spine BMD and type 2 diabetes after adjusting age, gender, body mass index, monthly house income, education level, physical activity, daily calcium intake and vitamin D concentration by multiple regression analysis in all subjects. In the subgroup analysis by gender, this association was maintained both in male and female after adjusting those confounding factors. However, femur BMD was not different between type 2 diabetic and non-diabetic subjects. In conclusion, lumbar spine BMD was significantly higher in type 2 diabetic patients aged 50 years or more in men and postmenopausal women compared to non-diabetic subjects.

• Journal of the Korea Society of Computer and Information
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• v.26 no.8
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• pp.209-220
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• 2021

The effect of body composition such as lean mass and fat mass on bone mineral density (BMD) is complex and still controversial. In this study, we investigated the relationship between body composition and bone mineral density using nation-wide data from 2008 to 2011 Korea National Health and Nutrition Examination Survey (KNHANES) in 2,139 men and 2,193 postmenopausal women aged 50 years or older. Subjects with history of medication for osteoporosis or with diseases or malignancy affecting bone metabolism were excluded. Data of anthropometric measurements and demographic characteristics were collected by trained examiner. Fasting blood sample was obtained for blood chemistry analysis. BMD of the lumbar spine, total femur, and femoral neck, and body composition such as total lean mass (TLM), total fat mass (TFM), truncal fat mass (TrFM) were measured using dual-energy X-ray absorptiometry (DXA). There were significant positive correlations between body composition indices such as lean mass and fat mass with BMD. In multiple regression analysis, TLM was positively associated with BMD after adjusting age, body mass index, monthly house income, education level, physical activity, daily calcium intake and vitamin D concentration in both men and postmenopausal women. BMD at lumbar spine and femur in lowest quartile of TLM was significantly lower than other quartiles after adjusting those confounding factors in both gender. TrFM was negatively associated with total femur BMD in male and femur neck BMD in postmenopausal women after adjusting confounding factors. In conclusion, TLM is very important factor in maintaining BMD in subjects aged 50 years or older in men and postmenopausal women.

• Journal of Pharmacopuncture
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• v.25 no.2
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• pp.106-113
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• 2022

Objectives: Herbal medicine is a worldwide health topic. Vitex agnus-castus L. (VAC) is a popular plant used for gynecologic problems due to its hormonal effects. The aim of this study is to reveal VAC extract effect on fetus when this herb is used started from antenatal period or during pregnancy. Methods: Performed from starting day of January 2019 till February 2019, 48 rats were assigned in randomly divided eight-member six groups: control (C1), treated group with 365 mg/kg VAC from initiation of insemination (T1) and 30 days prior to pregnancy (T2), control that underwent caesarean section on 15^th day of gestational age (C2) and treated group with 365 mg/kg VAC from initiation of insemination (T3) and 30 days prior to pregnancy (T4) that underwent caesarean section. Weight, sex and number of fetuses, abortion and still birth rate and estradiol level were evaluated using t-test by SPSS software. Results: We showed increased weight among T1 group considering totally and sex-dependent which is significant (all p-value < 0.05). We also detected significantly decreased weight in T2 in total (p-value < 0.0001) and when considering female fetuses (0.043) but not males (0.17). Although the results showed slightly non-significant increased weight among fetuses of T3 (totally or based on the fetus sex) compared to the control group (C2), T4 group had statistically decreased weight compared to control group. Pregnancy rate and pregnancy outcome were affected by VAC usage. The time of VAC initiation also affected live birth and abortion rates. Conclusion: VAC extract may affect pregnancy rate, live birth rate, abortion and stillbirth rates. Its effect on the weight and the sex showed dual pattern depends on the time of initiation and pregnancy trimester of evaluation. Prescribing this medicinal plant for patients being prone to pregnancy should be with caution. Further study is recommended.

• Journal of Korean Neurosurgical Society
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• v.65 no.1
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• pp.96-106
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• 2022

Objective : The most common complication of anterior cervical discectomy and fusion (ACDF) is cage subsidence and maintenance of disc height affects postoperative clinical outcomes. We considered cage subsidence as an inappropriate indicator for evaluating preservation of disc height. Thus, this study aimed to consider patients with complications such as reduced total disc height compared to that before surgery and evaluate the relevance of several factors before ACDF. Methods : We retrospectively reviewed the medical records of 40 patients who underwent stand-alone single-level ACDF using a polyetheretherketone (PEEK) cage at our institution between January 2012 and December 2018. Our study population comprised 19 male and 21 female patients aged 24-70 years. The minimum follow-up period was 1 year. Twenty-seven patients had preoperative bone mineral density (BMD) data on dual-energy X-ray absorptiometry. Clinical parameters included sex, age, body mass index, smoking history, and prior medical history. Radiologic parameters included the C2-7 cobb angle, segmental angle, sagittal vertical axis, disc height, and total intervertebral height (TIH) at the preoperative and postoperative periods. Cage decrement was defined as the reduction in TIH at the 6-month follow-up compared to preoperative TIH. To evaluate the bone quality, Hounsfield unit (HU) value was calculated in the axial and sagittal images of conventional computed tomography. Results : Lumbar BMD values and cervical HU values were significantly correlated (r=0.733, p<0.001). We divided the patients into two groups based on cage decrement, and 47.5% of the total patients were regarded as cage decrement. There were statistically significant differences in the parameters of measuring the HU value of the vertebra and intraoperative distraction between the two groups. Using these identified factors, we performed a receiver operating characteristic (ROC) curve analysis. Based on the ROC curve, the cut-off point was 530 at the HU value of the upper cortical and cancellous vertebrae (p=0.014; area under the curve [AUC], 0.727; sensitivity, 94.7%; specificity, 42.9%) and 22.41 at intraoperative distraction (p=0.017; AUC, 0.722; sensitivity, 85.7%; specificity, 57.9%). Using this value, we converted these parameters into a bifurcated variable and assessed the multinomial regression analysis to evaluate the risk factors for cage decrement in ACDF. Intraoperative distraction and HU value of the upper vertebral body were independent factors of postoperative subsidence. Conclusion : Insufficient intraoperative distraction and low HU value showed a strong relationship with postoperative intervertebral height reduction following single stand-alone PEEK cage ACDF.

• Molecules and Cells
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• v.45 no.7
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• pp.465-478
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• 2022

MicroRNAs (miRNAs) are a class of small non-coding RNAs that regulate the expression of target messenger RNA (mRNA) complementary to the 3' untranslated region (UTR) at the post-transcriptional level. Hsa-miR-422a, which is commonly known as miRNA derived from transposable element (MDTE), was derived from short interspersed nuclear element (SINE). Through expression analysis, hsa-miR-422a was found to be highly expressed in both the small intestine and liver of crab-eating monkey. AT-Rich Interaction Domain 5 B (ARID5B) was selected as the target gene of hsa-miR-422a, which has two binding sites in both the exon and 3'UTR of ARID5B. To identify the interaction between hsa-miR-422a and ARID5B, a dual luciferase assay was conducted in HepG2 cell line. The luciferase activity of cells treated with the hsa-miR-422a mimic was upregulated and inversely downregulated when both the hsa-miR-422a mimic and inhibitor were administered. Nuclear factor erythroid-2 (NF-E2) was selected as the core transcription factor (TF) via feed forward loop analysis. The luciferase expression was downregulated when both the hsa-miR-422a mimic and siRNA of NF-E2 were treated, compared to the treatment of the hsa-miR-422a mimic alone. The present study suggests that hsa-miR-422a derived from SINE could bind to the exon region as well as the 3'UTR of ARID5B. Additionally, hsa-miR-422a was found to share binding sites in ARID5B with several TFs, including NF-E2. The hsa-miR-422a might thus interact with TF to regulate the expression of ARID5B, as demonstrated experimentally. Altogether, hsa-miR-422a acts as a super enhancer miRNA of ARID5B by collaborating with TF and NF-E2.

• The Korean Journal of Pain
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• v.35 no.4
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• pp.423-432
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• 2022

Background: The decreased expression of mu-opioid receptors (MOR) in the amygdala may be a key molecular in chronic post-surgical pain (CPSP). It is known that miR-339-5p expression in the amygdala of a stressed rat model was increased. Analyzed by RNAhybrid, miR-339-5p could target opioid receptor mu 1 (oprm1) which codes MOR directly. So, the authors hypothesized that miR-339-5p could regulate the expression of MOR via targeting oprm1 and cause the effects to CPSP. Methods: To simulate perioperative short-term stress, a perioperative stress prolongs incision-induced pain hypersensitivity without changing basal pain perception rat model was built. A pmiR-RB-REPORT^TM dual luciferase assay was taken to verify whether miR-339-5p could act on oprm1 as a target. The serum glucocorticoid level of rats was test. Differential expressions of MOR, GFAP, and pERK1/2 in each group of the rats' amygdala were tested, and the expressions of miR-339-5p in each group of rats' amygdalas were also measured. Results: Perioperative stress prolonged the recovery time of incision pain. The expression of MOR was down-regulated in the amygdala of rats in stress + incision (S + IN) group significantly compared with other groups (P < 0.050). miR-339-5p was up-regulated in the amygdala of rats in group S + IN significantly compared with other groups (P < 0.050). miR-339-5p acts on oprm1 3'UTR and take MOR mRNA as a target. Conclusions: Perioperative stress could increase the expression of miR-339-5p, and miR-339-5p could cause the expression of MOR to decrease via targeting oprm1. This regulatory pathway maybe an important molecular mechanism of CPSP.