• Korean Journal of Otorhinolaryngology-Head and Neck Surgery
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• v.62 no.2
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• pp.75-81
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• 2019

The objective of this study was to perform a systematic review of the literature for application of intranasal sodium citrate in the patients with olfactory dysfunction to help determine the sodium citrate treatments for this condition. Two authors independently searched the data base (Medline, Scopus, and the Cochrane database) for relevant studies from inception to January 2018. Included studies were randomized controlled studies published in English comparing topical sodium citrate application (treatment group) with saline (control group) in patients who had olfactory dysfunction. Outcomes of interest included the change of olfactory identification and threshold during 2 hours post-treatment. Three studies were enrolled in the meta-analysis. Compared with control group, treatment group did not increase posttreatment score of olfactory identification [standardized mean difference (SMD)=-0.03; 95% confidence interval (CI)=-0.29-0.24; I²=0%] and olfactory threshold (SMD=0.18; 95% CI=-0.09-0.45; I²=0%) significantly. In the degree of pre-post improvement of two outcomes, although treatment group statistically showed the significant improvement in olfactory threshold (SMD=0.30; 95% CI=0.05-0.55; I²=17%), the clinical significance of this outcome was meaningless. Similarly, there was no significant difference in olfactory identification between two groups (SMD=0.17; 95% CI=-0.11-0.45; I²=22%). Unlike the recent favorable results, our summated results presented the uselessness for the local application of sodium citrate in improving patient's olfactory function. However, we also had some limitation such as small sample size and inconsistent application methods. Therefore, larger trials and standardized methodology are needed to reach more stronger and exact results.

• Journal of Korean Critical Care Nursing
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• v.16 no.2
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• pp.28-41
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• 2023

Purpose : This study aimed to investigate the characteristics and risk factors associated with pressure injuries related to medical devices among patients admitted to the intensive care unit (ICU). Method : A retrospective study analyzed data from 462 ICU patients. Statistical analyses, including independent t-tests, Fisher's exact tests, and logistic regression were performed to analyze the data. Results : Among the 154 subjects, there were a total of 198 medical device-related pressure injuries (MDRPI). Stage 2 and deep tissue pressure injuries were the most frequent. MDRPI occurred most frequently on the face, with nasogastric tubes being its leading cause, followed by endotracheal tubes. The risk factors for MDRPI included male sex (odds ratio [OR]=1.78, 95% confidence interval [CI]=1.12-2.83), department at the time of ICU admission (OR=4.29, 95% CI=2.01-9.15), post-surgery ICU admission (OR=0.43, 95% CI=0.25-0.73), application of extracorporeal membrane oxygenation machines (OR=2.72, 95% CI=1.06-6.95), number of medical devices (OR=1.16, 95% CI=1.05-1.30), inotropic drug administration (OR=2.33, 95% CI=1.19-4.60), and sedative use (OR=2.53, 95% CI=1.17-5.45). Conclusion : These results enable the determination of the characteristics and risk factors associated with MDRPI. It is crucial to acknowledge the risk factors for MDRPI in ICU patients and establish a prevention strategy.

• Journal of Veterinary Science
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• v.25 no.2
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• pp.25.1-25.12
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• 2024

Background: Surgical excision is the treatment of choice for feline intracranial meningioma. Objectives: To report clinical findings, complications, and outcomes following surgery for feline intracranial meningioma. Methods: Medical records (01/2000-01/2017) of cats that underwent surgical excision of an intracranial meningioma at our institution were reviewed. Patient data included signalment, clinical signs, surgical technique, complications, histopathologic diagnosis, survival time, and owners' answers to a satisfaction questionnaire. Survival was assessed using the Kaplan-Meier method and log-rank test. Results: Twenty-six cats were included in this study. The exact cause of death was known in 17 cases and was not related to meningioma in 9/17 cases. Overall median survival time was 881 days (95% confidence interval 518; 1248). The age of the cat did not influence survival (p = 0.94) or the occurrence of complications (p = 0.051). Complications occurred in 13/24 cats, including dramatic complications in 4/24 cats. Most complications appeared in the first 24 hours post-surgery (12/13). Males had more postoperative complications (p = 0.042), including more seizures (p = 0.016). Cats with cranioplasty had fewer complications (p = 0.021). Clinical recurrence was confirmed in 3 out of 17 cats. Recurrence-free survival time was 826 days. Most owners (12/14) were satisfied with the outcome. Conclusions: Surgical treatment of intracranial meningioma in cats was associated with a long median survival time but also with a high rate of minor and major postoperative complications, including early postoperative seizures. Cranioplasty may reduce complications. Age at the time of surgery had no effect on outcomes.

• Child Health Nursing Research
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• v.19 no.1
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• pp.12-20
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• 2013

Purpose: The purpose of this study was to investigate factors associated with suspicious developmental delay in infants and early childhood. Methods: Participants were 133 infants, aged from birth to 6 years old and their mothers, who were being seen at 16 Public health centers in B city. Korean Denver II was used to test infant development. ${\chi}^2$-test, Fisher's exact test and multiple logistic regression were used with SPSS 19.0 to analyze data. Results: Of participant infants, 7.5% were below the 3rd percentile for the weight percentile, 8.4% is a weight curve that crosses more than 2 percentile lines on the growth charts after previous achievement, and 9.8% had suspicious developmental delay according to Korean Denver II. Further the predictive factors related to suspicious development delay in the children were decrease of weight percentile (Odds Ratio [OR]=6.69, Confidence Interval [CI])=1.22-36.45), low economic state (OR=6.26, CI=1.50-26.00), and development delay perceived by their mothers (OR=4.99, CI=1.24-20.06). Conclusion: It is necessary to build a government level system to follow management of development of infants and children from the time of birth. Especially, it is necessary to develop a program for children in low income families.

• Tuberculosis and Respiratory Diseases
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• v.65 no.6
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• pp.471-475
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• 2008

Background: In order to achieve a maintenance level and to prevent hemorrhagic complications, regular monitoring of the INR is mandatory for patients on oral anticoagulation therapy (OAT). A point-of-care instrument for INR monitoring is convenient for users, but the accuracy of the results has been controversial, and so this calls for exact evaluation of the point-of-care instrument that is used for INR monitoring. Methods: From Aug 2007 through Feb 2008, 85 patients on OAT among the all the patients who were admitted to Soonchunhyang University Bucheon Hospital were involved in this study. Parallel measurements of the PT INR were performed using a CoaguChek-XS and, a CA-7000 laboratory reference instrument and the results were analyzed. In addition, the patients' clinical data, including the diagnosis and the frequency and interval of the INR measurements, were also analyzed. Results: Of the 85 patients, 25 were admitted more than once to undergo INR testing and the mean interval between testing was 8.6 weeks with 39% and 38% of the tests being less than INR 2 units with using the CoaguChek-XS and the reference method, respectively. The coefficients of variation of CoaguChek-XS were 4.50 and 2.45 for the high and low INR patients, respectively. An excellent correlation was found between the two methods with a $R^2$ of 0.966 (p<0.001). Through Bland-Altman analysis, the mean INR difference between the two methods was 0.13 with the limit of agreement being -0.47~+0.72 with a 95% confidence interval. CoaguChek-XS was shown to overestimate the INR value for patients with an increasing INR, as compared to the reference method. Conclusion: CoaguChek-XS demonstrated great precision and accuracy for patients on OAT when compared to the laboratory INR results. Accordingly, the instrument should help to monitor the INR in the patients on OAT.

• Journal of Preventive Medicine and Public Health
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• v.38 no.2
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• pp.147-153
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• 2005

Objectives: Studies on the geographical differences in mortality tend to use a census population, rather than a registration population, as the denominator of mortality rates in South Korea. However, an administratively determined registration population would be the logical denominator, as the geographical areas for death certificates (numerator) have been determined by the administratively registered residence of the deceased, rather than the actual residence at the time of death. The purpose of this study was to examine the differences in the total number of a district population, and the associated district-specific mortality indicators, when two different measures as a population denominator (census and registration) were used. Methods: Population denominators were obtained from census and registration population data, and the numbers of deaths (numerators) were calculated from raw death certificate data. Sex- and 5-year age-specific numbers for the populations and deaths were used to compute sex- and age-standardized mortality rates (by direct standardization methods) and standardized mortality ratios (by indirect standardization methods). Bland-Altman tests were used to compare district populations and district-specific mortality indicators according to the two different population denominators. Results : In 1995, 9 of 232 (3.9%) districts were not included in the 95% confidence interval (CI) of the population differences. A total of 8 (3.4%) among 234 districts had large differences between their census and registration populations in 2000, which exceeded the 95% CI of the population differences. Most districts (13 of 17) exceeding the 95% CI were rural. The results of the sex- and age-standardized mortality rates showed 15 (6.5%) and 16 (6.8%) districts in 1995 and 2000, respectively, were not included in the 95% CI of the differences in their rates. In addition, the differences in the standardized mortality ratios using the two different population denominators were significantly greater among 14 districts in 1995 and 11 districts in 2002 than the 95% CI. Geographical variations in the mortality indicators, using a registration population, were greater than when using a census population. Conclusion: The use of census population denominators may provide biased geographical mortality indicators. The geographical mortality rates when using registration population denominators are logical, but do not necessarily represent the exact mortality rate of a certain district. The removal of districts with large differences between their census and registration populations or associated mortality indicators should be considered to monitor geographical mortality rates in South Korea.

• Asian-Australasian Journal of Animal Sciences
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• v.26 no.10
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• pp.1474-1483
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• 2013

The objective was to evaluate the use of prediction equations based on the chemical composition of feedstuffs to estimate the values of apparent metabolisable energy corrected for nitrogen balance (AMEn) of corn and soybean meal for broilers. For performance and carcass characteristics, 1,200 one-d-old birds (male and female) were allotted to a completely randomised factorial $2{\times}8$ (two genders and eight experimental diets) with three replicates of each sex with 25 birds. In the metabolism trial, 240 eight-d-old birds were distributed in the same design, but with a split plot in time (age of evaluation) with five, four and three birds per plot, respectively, in stages 8 to 21, 22 to 35, and 36 to 42 d of age. The treatments consisted of the use of six equations systems to predict the AMEn content of feedstuffs, tables of food composition and AMEn values obtained by in vivo assay, totalling eight treatments. Means were compared by Scott-Knott test at 5% probability and a confidence interval of 95% was used to check the fit of the energy values of the diets to the requirements of the birds. As a result of this study, the use of prediction equations resulted in better adjustment to the broiler requirements, resulting in better performance and carcass characteristics compared to the use of tables, however, the use of energy values of feedstuffs obtained by in vivo assay is still the most effective. The best equations were: AMEn = 4,021.8-227.55 Ash (for corn) combined with AMEn = -822.33+69.54 CP-45.26 ADF+90.81 EE (for soybean meal); AMEn = 36.21 CP+85.44 EE+37.26 NFE (nitrogen-free extract) (for corn) combined with AMEn = 37.5 CP+46.39 EE+14.9 NFE (for soybean); and AMEn = 4,164.187+51.006 EE-197.663 Ash-35.689 CF-20.593 NDF (for corn and soybean meal).

• Journal of Oriental Neuropsychiatry
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• v.34 no.2
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• pp.71-82
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• 2023

Objectives: The existing reductionist approach has not reached complete understanding of the cause of schizophrenia. The objective of this study was to investigate yin-yang and five-element characteristics reflected on four time pillars of birth of patients with schizophrenia through comparison with the general population in the perspective of consilience-based holistic approach. Methods: This study was conducted using a random sequential recruitment method for the general population and individuals with schizophrenia aged 18 to 64 based on the exact date and time of birth using structured questionnaires. Relative positional relations of yin-yang and five-element with day master were primarily examined. In addition, the strength of day master with a score range of 0~100 points was assessed through operational score allocation. Results: Of 591 participants, 576 (346: general population, 230: individuals with schizophrenia) were analyzed. Between-group analyses showed no significant difference in the distribution of types of day master (χ²=10.41, df=9, p=0.318). However, significant between-group differences were shown in the distribution of the strength of day master (t=2.14, p=0.032) and frequency of restraining month branch (χ²=5.23, df=1, p=0.022). In logistic regression analysis, 10-point increase on the strength of day master decreased the probability of onset of schizophrenia over the age of 30 by 29.6% (p=0.002; 95% confidence interval, 0.566~0.876). Conclusions: Findings in this study suggest that four time pillars of birth might be associated with schizophrenia through yin-yang and five-element theory and synchronicity principle, implicating the plausibility of consilience-based holistic approach in the determination of risk factors or cause of schizophrenia.

• Korean Journal of Radiology
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• v.24 no.10
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• pp.1028-1037
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• 2023

Objective: To evaluate the computed tomography (CT) features for diagnosing metastatic cervical lymph nodes (LNs) in patients with differentiated thyroid cancer (DTC) and validate the CT-based risk stratification system suggested by the Korean Thyroid Imaging Reporting and Data System (K-TIRADS) guidelines. Materials and Methods: A total of 463 LNs from 399 patients with DTC who underwent preoperative CT staging and ultrasound-guided fine-needle aspiration were included. The following CT features for each LN were evaluated: absence of hilum, cystic changes, calcification, strong enhancement, and heterogeneous enhancement. Multivariable logistic regression analysis was performed to identify independent CT features associated with metastatic LNs, and their diagnostic performances were evaluated. LNs were classified into probably benign, indeterminate, and suspicious categories according to the K-TIRADS and the modified LN classification proposed in our study. The diagnostic performance of both classification systems was compared using the exact McNemar and Kosinski tests. Results: The absence of hilum (odds ratio [OR], 4.859; 95% confidence interval [CI], 1.593-14.823; P = 0.005), strong enhancement (OR, 28.755; 95% CI, 12.719-65.007; P < 0.001), and cystic changes (OR, 46.157; 95% CI, 5.07-420.234; P = 0.001) were independently associated with metastatic LNs. All LNs showing calcification were diagnosed as metastases. Heterogeneous enhancement did not show a significant independent association with metastatic LNs. Strong enhancement, calcification, and cystic changes showed moderate to high specificity (70.1%-100%) and positive predictive value (PPV) (91.8%-100%). The absence of the hilum showed high sensitivity (97.8%) but low specificity (34.0%). The modified LN classification, which excluded heterogeneous enhancement from the K-TIRADS, demonstrated higher specificity (70.1% vs. 62.9%, P = 0.016) and PPV (92.5% vs. 90.9%, P = 0.011) than the K-TIRADS. Conclusion: Excluding heterogeneous enhancement as a suspicious feature resulted in a higher specificity and PPV for diagnosing metastatic LNs than the K-TIRADS. Our research results may provide a basis for revising the LN classification in future guidelines.

• Korean Journal of Radiology
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• v.22 no.7
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• pp.1185-1193
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• 2021

Objective: Clear cell sarcoma of the kidney (CCSK) is the second-most common but extremely rare primary renal malignancy in children after Wilms' tumor. The aims of this study were to evaluate the imaging features that could distinguish between CCSK and Wilms' tumor and to assess the features with diagnostic value for identifying CCSK. Materials and Methods: We reviewed the initial contrast-enhanced abdominal-pelvic CT scans of children with CCSK and Wilms' tumor between 2010 to 2019. Fifty-eight children (32 males and 26 females; age, 0.3-10 years), 7 with CCSK, and 51 with Wilms' tumor, were included. The maximum tumor diameter, presence of engorged perinephric vessels, maximum density of the tumor (Tmax) of the enhancing solid portion, paraspinal muscle, contralateral renal vein density, and density ratios (Tmax/muscle and Tmax/vein) were analyzed on the renal parenchymal phase of contrast-enhanced CT. Fisher's exact tests and Mann-Whitney U tests were conducted to analyze the categorical and continuous variables, respectively. Logistic regression and receiver operating characteristic curve analyses were also performed. Results: The age, sex, and tumor diameter did not differ between the two groups. Engorged perinephric vessels were more common in patients in the CCSK group (71% [5/7] vs. 16% [8/51], p = 0.005). Tmax (median, 148.0 vs. 111.0 Hounsfield unit, p = 0.004), Tmax/muscle (median, 2.64 vs. 1.67, p = 0.002), and Tmax/vein (median, 0.94 vs. 0.59, p = 0.002) were higher in the CCSK compared to the Wilms' group. Multiple logistic regression revealed that engorged vessels (odds ratio 13.615; 95% confidence interval [CI], 1.770-104.730) and Tmax/muscle (odds ratio 5.881; 95% CI, 1.337-25.871) were significant predictors of CCSK. The cutoff values of Tmax/muscle (86% sensitivity, 77% specificity) and Tmax/vein (71% sensitivity, 86% specificity) for the diagnosis of CCSK were 1.97 and 0.76, respectively. Conclusion: Perinephric vessel engorgement and greater tumor enhancement (Tmax/muscle > 1.97 or Tmax/vein > 0.76) are helpful for differentiating between CCSK and Wilms' tumor in children aged below 10 years.