• Clinical Endoscopy
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• v.55 no.6
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• pp.801-809
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• 2022

Background/Aims: Current society guidelines recommend antibiotic prophylaxis for 3 to 5 days after endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) of pancreatic cystic lesions (PCLs). The overall quality of the evidence supporting this recommendation is low. In this study, we aimed to assess cyst infection and adverse event rates after EUS-FNA of PCLs among patients treated with or without postprocedural prophylactic antibiotics. Methods: We retrospectively reviewed all patients who underwent EUS-FNA of PCLs between 2015 and 2019 at two large-volume academic medical centers with different practice patterns of postprocedural antibiotic prophylaxis. Data on patient demographics, cyst characteristics, fine-needle aspiration technique, periprocedural and postprocedural antibiotic prophylaxis, and adverse events were retrospectively extracted. Results: A total of 470 EUS-FNA procedures were performed by experienced endosonographers for the evaluation of PCLs in 448 patients, 58.7% of whom were women. The mean age was 66.3±12.8 years. The mean cyst size was 25.7±16.9 mm. Postprocedural antibiotics were administered in 274 cases (POSTAB+ group, 58.3%) but not in 196 cases (POSTAB- group, 41.7%). None of the patients in either group developed systemic or localized infection within the 30-day follow-up period. Procedure-related adverse events included mild abdominal pain (8 patients), intra-abdominal hematoma (1 patient), mild pancreatitis (1 patient), and perforation (1 patient). One additional case of pancreatitis was recorded; however, the patient also underwent endoscopic retrograde cholangiopancreatography. Conclusions: The incidence of infection after EUS-FNA of PCLs is negligible. Routine use of postprocedural antibiotics does not add a significant benefit.

• The Journal of Internal Korean Medicine
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• v.32 no.4
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• pp.473-486
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• 2011

Objectives : This study was designed to investigate the clinical characteristics and usefulness of comprehensive diagnosis of Yin-deficiency and heart rate variability in patients with burning mouth syndrome (BMS). Methods : We surveyed 30 burning mouth syndrome patients visiting the Oral Diseases Clinic of Kyung Hee University Oriental Medicine Hospital from April to September of 2011. The subjects were evaluated on self-assessed severity of burning mouth syndrome and xerostomia using visual analogue scale (VAS) score and Yin-deficiency condition (based on the 10-item Yin-deficiency questionnaire). Salivary function was measured by the unstimulated salivary flow rate (USFR), and heart rate variability (HRV) parameters were recorded by SA-2000E (Medicore Co., Ltd., Korea). Results : There were substantial significant positive correlations between burning sensation VAS scores in mouth and Yin-deficiency scores. There was significant negative correlation between xerostomia VAS score and USFR. Compared to the normal range of total power (TP) in HRV parameters, the burning mouth syndrome patients showed significant lower values of TP. Conclusions : The results of this study suggest that comprehensive diagnosis of Yin-deficiecny and HRV parameters are useful in diagnosing of burning mouth syndrome patients. Therefore, we assume that improvement of Yin-deficiency condition can be a potentially effective way to treat burning mouth syndrome.

• The Journal of Internal Korean Medicine
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• v.35 no.4
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• pp.532-545
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• 2014

Objectives: The purpose of this study was to evaluate the clinical effect of Korean medical treatments such as herbal medicine, acupuncture, and electroacupuncture by using the portable gas chromatograph OralChroma$^{TM}$ (Abimedical, Japan) in halitosis patients. Methods: We surveyed 30 halitosis patients who had visited the Oral Diseases Clinic in the Korean Medical Hospital of Kyunghee University from October, 2013 to November, 2014. Before starting Korean medical treatment, the subjects were evaluated on sociodemographic characteristics, severity of discomfort using visual analogue scale (VAS), unstimulated salivary flow rate (USFR), and halitosis associated life-quality test (HALT) score. To evaluate the therapeutic effect, we measured the volatile sulfur compounds (VSCs) in breath by using OralChroma$^{TM}$ before and after 3 weeks treatment. Results: The concentration of total VSCs measured by OralChroma$^{TM}$ significantly decreased (p=0.001). Furthermore, the level of hydrogen sulfide and methyl mercaptan also significantly decreased (p<0.05). However, although the level of dimethyl sulfide decreased as well, there was no significance(p>0.05). Conclusions: Korean medical treatment was effective in treating halitosis by decreasing VSCs. Further study, with well-designed randomized controlled trials with larger number of cases will be needed in the future.

• The Journal of Internal Korean Medicine
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• v.35 no.3
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• pp.383-397
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• 2014

Objectives: The purpose of this study was to report the effect of traditional Korean medical therapy such as acupuncture, electroacupuncture and herbal medicine in taste disorder patients. Methods: We surveyed 5 taste disorder patients visiting the Oral Diseases Clinic in the Kyung Hee University Oriental Medicine Hospital from January, 2014 to June, 2014. Before starting traditional Korean medical therapy such as acupuncture, electroacupuncture and herbal medicine, the subjects were evaluated on severity of discomfort using visual analogue scale (VAS), salivary flow rate (SFR), quality of life about oral health (based on the 14-item Oral Health Impact Profile-14) and qi-stagnation condition (based on the 23-item qi-stagnation Questionnaire). Visual analogue scale was re-evaluated during the treatment period. Results: There was no relationship between diminished SFR and severity of discomfort. Also change or loss of taste did not influence the quality of life about oral health. However, stress which refers to qi-stagnation could be one of the reasons taste disorder occurs. After receiving traditional Korean medical therapy, all 5 patients' visual analogue scale score decreased. Conclusions: Traditional Korean medical therapy may potentially be an option for taste disorder. Further evaluations including pre-post comparison with larger number of cases will be needed in the future.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.23 no.2
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• pp.146-153
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• 2020

Purpose: Alpha-1 antitrypsin deficiency (A1ATD) in one of the most common genetic causes of liver disease in children. We aimed to analyze the clinical characteristics and outcomes of patients with A1ATD. Methods: This study included patients with A1ATD from five pediatric hepatology units. Demographics, clinical findings, genetics, and outcome of the patients were recorded (n=25). Results: Eight patients (32.0%) had homozygous PiZZ genotype while 17 (68.0%) had heterozygous genotype. Patients with PiZZ genotype had lower alpha-1 antitrypsin levels than patients with PiMZ genotype (37.6±7.7 mg/dL vs. 66.5±22.7 mg/dL, p=0.0001). Patients with PiZZ genotype were diagnosed earlier than patients with PiMZ genotype, but this was not significant (13±6.8 months vs. 23.7±30.1 months, p=0.192). Follow-up revealed the death of one patient (12.5%) with a homozygous mutation, and revealed that one patient had child A cirrhosis, five patients (62.5%) had chronic hepatitis, and one patient (12.5%) was asymptomatic. Nine of the 17 patients with a heterozygous mutation had chronic hepatitis (52.9%), two (11.7%) had child A cirrhosis, and six (35.2%) were asymptomatic. Overall, 18 (72%) of the 25 children had liver pathology in the long-term. Conclusion: Although prevalence is rare, patients with liver disorders should be checked for alpha-1 antitrypsin levels. Moreover, long-term follow-up is essential because most patients have a liver pathology.

• The Korean Journal of Physiology and Pharmacology
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• v.20 no.2
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• pp.147-152
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• 2016

Present study aimed to investigate the effect of curcumin-pretreatment on intestinal I/R injury and on intestinal mucosa barrier. Thirty Wistar rats were randomly divided into: sham, I/R, and curcumin groups (n=10). Animals in curcumin group were pretreated with curcumin by gastric gavage (200 mg/kg) for 2 days before I/R. Small intestine tissues were prepared for Haematoxylin & Eosin (H&E) staining. Serum diamine oxidase (DAO) and tumor necrosis factor (TNF)-${\alpha}$ levels were measured. Expression of intestinal TNF-${\alpha}$ and tight junction protein (ZO-1) proteins was detected by Western blot and/or immunohistochemistry. Serum DAO level and serum and intestinal TNF-${\alpha}$ leves were significantly increased after I/R, and the values were markedly reduced by curcumin pretreatment although still higher than that of sham group (p<0.05 or p<0.001). H&E staining showed the significant injury to intestinal mucosa following I/R, and curcumin pretreatment significantly improved the histological structure of intestinal mucosa. I/R insult also induced significantly down-regulated expression of ZO-1, and the effect was dramatically attenuated by curcumin-pretreatment. Curcumin may protect the intestine from I/R injury through restoration of the epithelial structure, promotion of the recovery of intestinal permeability, as well as enhancement of ZO-1 protein expression, and this effect may be partly attributed to the TNF-${\alpha}$ related pathway.

• The Journal of Internal Korean Medicine
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• v.33 no.2
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• pp.231-242
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• 2012

Objectives : This study was designed to investigate the Efficacy of Gamiyukmijihwang-tang on Recurrent Aphthous Stomatitis. Methods : We surveyed 10 recurrent aphthous stomatitis patients visited the oral diseases clinic in the Kyung Hee University Oriental Medicine Hospital from September, 2011 to March, 2012. Before and 2 weeks after taking Gamiyukmijihwang-tang, the subjects were evaluated on clinical characteristics of recurrent aphthous stomatitis, severity of pain using visual analogue scale (VAS), quality of life about oral health (based on the 14-item Oral Health Impact Profile-14) and yin-deficiency condition (based on the 10-item Yin-deficiency Questionnaire). Then, 5 patients who had already finished treatment were assessed about recurrence of recurrent aphthous stomatitis by telephone survey 6 weeks later. Results : After 2 weeks taking Gamiyukmijihwang-tang, clinical characteristics of 10 patients of recurrent aphthous stomatitis improved; their severity of pain, quality of life about oral health and yin-deficiency condition improved significantly. After 6 weeks, 3 of 5 patients who had already finished treatment didn't experience recurrence of recurrent aphthous stomatitis. The other 2 patients experienced a recurrence, but their clinical characteristics of recurrent aphthous stomatitis improved significantly. Conclusions : Gamiyukmijihwang-tang is effective on recurrent aphthous stomatitis. Studies with a larger number of cases and longer follow-up will be needed in the future.

• The Journal of Internal Korean Medicine
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• v.34 no.4
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• pp.405-411
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• 2013

Objectives : This study was designed to investigate the difference between genuine and pseudo halitosis about qi stagnation and stress. Methods : We recruited 63 halitosis patients who visited the halitosis clinic in the Kyung Hee University Korean Medicine Hospital from June 2012 to August 2013. We classified the halitosis patients into two groups, genuine and pseudo halitosis based on organoleptic assesment (OLT) score and evaluated the severity of self-reported halitosis using visual analog scale (VAS), amount of sulfide compounds using Halimeter, qi stagnation level using qi stagnation questionnaire and stress levels using heart rate variability (HRV) parameters. Results : Comparing the genuine halitosis group and the pseudo halitosis group, there was no significant difference in VAS of halitosis but significant difference in halimeter score. Distribution of qi stagnation and non-qi stagnation groups was significantly different between genuine and pseudo halitosis. Compared to the genuine halitosis group, the pseudo halitosis group showed a significant higher value of low frequency/high frequency ratio (LF/HF ratio). Conclusions : The result of this study suggest that there is significant difference about qi stagnation and stress level between genuine halitosis and pseudo halitosis patients, so when approaching pseudo halitosis patients, we should consider their psychological and emotional status.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.21 no.4
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• pp.306-314
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• 2018

Purpose: The objective of this study was to describe the clinical phenotypes of children and adolescents with cystic fibrosis (CF); and to assess the role of pancreatic insufficiency and neonatal screening in diagnosis. Methods: A cross-sectional study was conducted, which included 77 patients attending a reference center of CF between 2014 and 2016. Epidemiological data, anthropometric measurements, and the presence of pulmonary, pancreatic, gastrointestinal and hepatobiliary manifestations were evaluated based on clinical data and complementary examinations. Results: Of the 77 patients, 51.9% were male, with a median age of 147 months (7.0-297.0 months), and the majority showed adequate nutritional status. The most common phenotype was pulmonary (92.2%), followed by pancreatic (87.0%), with pancreatic insufficiency in most cases. Gastrointestinal manifestation occurred in 46.8%, with constipation being the more common factor. Hepatobiliary disease occurred in 62.3% of patients. The group with pancreatic insufficiency was diagnosed earlier (5.0 months) when compared to the group with sufficiency (84.0 months) (p=0.01). The age of diagnosis was reduced following implementation of neonatal screening protocols for CF (6.0 months before vs. 3.0 months after, p=0.02). Conclusion: The pulmonary phenotype was the most common, although extrapulmonary manifestations were frequent and clinically relevant, and should mandate early detection and treatment. Neonatal screening for CF led to earlier diagnosis in patients with pancreatic failure, and therefore, should be adopted universally.

• The Journal of Internal Korean Medicine
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• v.34 no.2
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• pp.122-133
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• 2013

Objectives : Burning mouth syndrome (BMS) is characterized by chronic pain or a burning sensation in the mouth. There is limited evidence available to provide clear guidelines for treating BMS patients and a variety of different treatments have been used. This study was designed to investigate the Effects of Korean medicine therapies on oral pain in patients with BMS. Methods : We surveyed 30 BMS patients who newly visited the Oral Diseases Clinic in the Kyung Hee University Korean Medicine Hospital from February 2012 to March 2013. When the patients visited the clinic for the first time, they were evaluated on sociodemographic characteristics, BMS questionnaire, severity of pain using visual analogue scale (VAS) and pressure pain threshold (PPT) of the acupuncture point CV17. After 3 weeks of Korean medicine therapies (acupuncture, electroacupuncture, pharmacopuncture and herbal medicine), they were re-evaluated with the VAS and the PPT. Results : After 3 weeks of Korean medicine therapies, 30 patients' oral pain improved and the PPT score on CV17 rose, which means decrease of qi-stagnation score. Conclusions : Korean medicine therapies were effective on oral pain in patients with BMS. To confirm the additional curative effect and evaluate the efficacy of each treatment, well-designed randomized controlled trials will be needed in the future.