• The Journal of Korea Assosiation for Disability and Oral Health
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• v.15 no.1
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• pp.29-34
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• 2019

Prader-Willi Syndrome (PWS) is a rare neurologic disorder with a prevalence 1/10,000-30,000. The cause of PWS is an abnormalities of chromosome 15q11.2-q13 which is an imprinting gene. Obesity and hyperphagia are characteristic features on a PWS adult. On the other hand, the birth weight, height and body mass index (BMI) of PWS infants are 15-20% lower than those of normal babies and there is a failure to thrive until 24-month-old. Most of PWS patients are treated under general anesthesia and conscious sedation. This case is a treatment of severe caries in a PWS 46 month-old child without general anesthesia and conscious sedation. He came to the Department of Pediatric Dentistry, Kyung Hee University Dental Hospital at Gangdong, Seoul, Korea with a trauma history. He had a medical history with heart surgery and needed to take antibiotics prophylaxis. The luxated left upper primary tooth were removed and caries treatment were done as an outpatient without general anesthesia, conscious sedation.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.19 no.12
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• pp.584-591
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• 2018

This study was conducted to determine the levels of cognitive impairment (MMSE-K) among centenarians, and to reveal their association with related variables. The study subjects were 268 centenarians who received medical check-ups from the National Health Insurance Corporation during the period of 2016-2017. The levels of cognitive impairment were significantly reduced among females as well as those living with spouses and children, lower monthly income, lower BMI and individuals who engaged in smoking and alcohol consumption without regular exercise relative to their respective counterparts. The risk of definitive cognitive impairment in study subjects was significantly higher among women (ORs=9.85, 95% CI=2.88-33.59) than men and was lower in obese group (ORs=0.25, 95% CI=0.07-0.86) than in low weight groups, as well as in non-smoking (ORs=0.30, 95% CI=0.10-0.83) than smoking groups. The factors influencing the cognitive impairment of study subjects were sex, living status, monthly income, BMI and smoking status. Taken together, these results suggest that the levels of cognitive impairments among centenarians differed significantly in response to socio-demographic characteristics and health related variables. Especially, the levels of cognitive impairments decreased among those with poor health related variables such as smoking, alcohol consumption and regular exercise.

• Journal of The Korean Society of Clinical Toxicology
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• v.16 no.2
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• pp.61-67
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• 2018

Purpose: To evaluate the association between neutrophil-to-lymphocyte ratio (NLR) and occurrence of aspiration pneumonia in drug intoxication (DI) patients in the emergency department (ED) and to evaluate the relationship between NLR and length of hospital admission/intensive care unit (ICU) admission Methods: A total of 466 patients diagnosed with DI in the ED from January 2016 to December 2017 were included in the analysis. The clinical and laboratory results, including NLR, were evaluated as variables. NLR was calculated as the absolute neutrophil count/absolute lymphocyte count. To evaluate the prognosis of DI, data on the development of aspiration pneumonia were obtained. Also, we evaluated the relationship between NLR and length of hospital admission and between NLR and length of ICU admission. Statistically, multivariate logistic regression analyses, receiver-operating characteristic (ROC) curve analysis, and Pearson's correlation (${\rho}$) were performed. Results: Among the 466 DI patients, 86 (18.5%) developed aspiration pneumonia. Multivariate logistic regression analysis revealed NLR as an independent factor in predicting aspiration pneumonia (odds ratio, 1.7; p=0.001). NLR showed excellent predictive performance for aspiration pneumonia (areas under the ROC curves, 0.815; cut-off value, 3.47; p<0.001) with a sensitivity of 86.0% and a specificity of 72.6%. No correlations between NLR and length of hospital admission (${\rho}=0.195$) and between NLR and length of ICU admission (${\rho}=0.092$) were observed. Conclusion: The NLR is a simple and effective marker for predicting the occurrence of aspiration pneumonia in DI patients. Emergency physicians should be alert for aspiration pneumonia in DI patients with high NLR value (>3.47).

• Investigative Magnetic Resonance Imaging
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• v.25 no.3
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• pp.164-171
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• 2021

Purpose: Mild cognitive impairment (MCI) is a prodromal stage of Alzheimer's disease (AD). Brain atrophy in this disease spectrum begins in the medial temporal lobe structure, which can be recognized by magnetic resonance imaging. To overcome the unsatisfactory inter-observer reliability of visual evaluation, quantitative brain volumetry has been developed and widely investigated for the diagnosis of MCI and AD. The aim of this study was to assess the prediction accuracy of quantitative brain volumetry using a fully automated segmentation software package, NeuroQuant^®, for the diagnosis of MCI. Materials and Methods: A total of 418 subjects from the Korean Brain Aging Study for Early Diagnosis and Prediction of Alzheimer's Disease cohort were included in our study. Each participant was allocated to either a cognitively normal old group (n = 285) or an MCI group (n = 133). Brain volumetric data were obtained from T1-weighted images using the NeuroQuant software package. Logistic regression and receiver operating characteristic (ROC) curve analyses were performed to investigate relevant brain regions and their prediction accuracies. Results: Multivariate logistic regression analysis revealed that normative percentiles of the hippocampus (P < 0.001), amygdala (P = 0.003), frontal lobe (P = 0.049), medial parietal lobe (P = 0.023), and third ventricle (P = 0.012) were independent predictive factors for MCI. In ROC analysis, normative percentiles of the hippocampus and amygdala showed fair accuracies in the diagnosis of MCI (area under the curve: 0.739 and 0.727, respectively). Conclusion: Normative percentiles of the hippocampus and amygdala provided by the fully automated segmentation software could be used for screening MCI with a reasonable post-processing time. This information might help us interpret structural MRI in patients with cognitive impairment.

• Korean Journal of Clinical Laboratory Science
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• v.53 no.2
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• pp.151-157
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• 2021

Charcot-Marie-Tooth disease (CMT) is a slowly progressive hereditary degenerative disease and chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) is an acquired immune-mediated disorder characterized by weakness and sensory deficits. The purpose of this study was to analyze and compare the electrophysiological characteristics observed in sensory nerve conduction studies (SNCS) of both diseases. A retrospective study of 65 patients with a diagnosis of CIDP (N=35) and CMT type I (N=30) was performed. This study analyzed No potentials ratio, distal compound nerve action potential (dCNAP) of various nerve types, and a correlation coefficient analysis of the sensory nerve conduction velocity (SNCV). As a result, I found that CMT 1 was more severe systemic demyelinating and axonal polyneuropathy better than CIDP (P<0.05). In a quantitative analysis of dCNAP and SNCV, especially sural nerve was the most severe nerve injury observed in both diseases. In correlation and scatter plot analysis, CMT 1 showed relatively high correlations compared to CIDP based on the correlation coefficient analysis (Fisher's Z test) of SNCV. The results of this study suggested that CMT 1 showed the slowness in SNCV, one of the characteristics of demyelinating polyneuropathy, and this slowing had a uniform pattern. In conclusion, electrophysiological characteristic of SNCS may be useful in the diagnosis and research between patients with CMT 1 and CIDP.

• Journal of The Korean Society of Clinical Toxicology
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• v.18 no.2
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• pp.66-77
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• 2020

Purpose: The aims of the present study were twofold. First, the research investigated the effect of an individual's risk factors and the prevalence of psychotropic drugs on QTc prolongation, TdP (torsades de pointes), and death. Second, the study compared the risk scoring systems (the Mayo Pro-QT risk score and the Tisadale risk score) on QTc prolongation. Methods: The medical records of intoxicated patients who visited the emergency department between March 2010 and February 2019 were reviewed retrospectively. Among 733 patients, the present study included 426 psychotropic drug-intoxicated patients. The patients were categorized according to the QTc value. The known risk factors of QTc prolongation were examined, and the Mayo Pro-QT risk score and the Tisadale risk score were calculated. The analysis was performed using multiple logistic regression, Spearman correlation, and ROC (receiver operating characteristic). Results: The numbers in the mild to moderate group (male: 470≤QTc<500 ms, female: 480≤QTc<500 ms) and severe group (QTc≥500 ms or increase of QTc at least 60ms from baseline, both sex) were 68 and 95, respectively. TdP did not occur, and the only cause of death was aspiration pneumonia. The statically significant risk factors were multidrug intoxications of TCA (tricyclic antidepressant), atypical antipsychotics, an atypical antidepressant, panic disorder, and hypokalemia. The Tisadale risk score was larger than the Mayo Pro-QT risk score. Conclusion: Multiple psychotropic drugs intoxication (TCA, an atypical antidepressant, and atypical antipsychotics), panic disorder, and hypokalemia have been proven to be the main risk factors of QTc prolongation, which require enhanced attention. The present study showed that the Tisadale score had a stronger correlation and predictive accuracy for QTc prolongation than the Mayo Pro-QT score. As a result, the Tisadale risk score is a crucial assessment tool for psychotropic drug-intoxicated patients in a clinical setting.

• Journal of Naturopathy
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• v.11 no.1
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• pp.1-8
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• 2022

Background: A validation study is needed to make domestic applications of German Kneipp therapy. Purpose: The study aims to test the effect of a Kneipp therapeutic program in a domestic forest environment on the autonomic nervous system. Methods: The program was made considering the 4 key elements ('exercise', 'regulative therapy', 'nutrition', and 'phytotherapy') of the Kneipp therapy. Total 3 sessions (once a week for 5 hours in each session) were performed to 40 domestic adults divided into four groups (10 in each group). HRV was measured on the subjects before and after the intervention, and its 6 characteristic parameters (TP, VLF, LF, HF, LF/HF, CSI: Cumulative Stress Index) were compared for statistical analysis. Results: For 33 subjects excluding 7 who were disturbed by interrupt factors during measurements, significant improvements after the intervention, were observed in TP(8.64%, p < ..001), VLF(6.96%, p < .05), LF(15.86%, p < .001), HF(8.46%, p < .01), LF/HF(5.77%, p < .05) and CSI(-16.06%, p < ..001). Conclusions: The Kneipp therapy performed in the forest environment was shown to activate the autonomic nervous system and in particular the sympathetic and parasympatheric nervous to promote heart activity, and was also shown to most significantly reduce cumulative stress. The present observations would be the first preliminary evidence that the Kneipp therapeutic interventation in a domestic forest environment results in positive responses of the autonomic nervous system including stress relief.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.22 no.5
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• pp.403-410
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• 2021

There are positive effects, such as pain reduction, when rheumatism patients exercise in water, but the cause of the pain reduction is unclear, and research on this is inadequate. This study examined the flow of the surface of the foot and the principles of pain relief. Unsteady simulations were conducted to analyze the flow, which was performed by repeatedly setting the movement of the foot raising and descending three times. Pressure fluctuations and frequencies were analyzed by designating pressure points at the painful location. The results showed that a positive and negative pressure of approximately ±500Pa was applied overall. A pressure of approximately ±2000Pa was applied when the direction of movement was changed. A frequency of approximately 35 to 80Hz was generated in the area where rheumatoid arthritis pain frequently occurs. The effects of reducing pain could be predicted when continuous pressure fluctuations and frequencies are applied repeatedly to the painful location, blood circulation promotion. The results could be used as basic data to understand the principles of aquatic exercise and support the development of underwater exercise programs and developing related medical equipment.

• Journal of the Korean Society of Radiology
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• v.17 no.1
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• pp.1-9
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• 2023

For optimal image quality of computer tomography angiography (CTA), different iodine concentrations and scan parameters were applied to quantitatively evaluate the image quality characteristics of filtered back projection (FBP), hybrid-iterative reconstruction (hybrid-IR), and deep learning reconstruction (DLR). A 320-row-detector CT scanner scanned a phantom with various iodine concentrations (1.2, 2.9, 4.9, 6.9, 10.4, 14.3, 18.4, and 25.9 mg/mL) located at the edge of a cylindrical water phantom with a diameter of 19 cm. Data obtained using each reconstruction technique was analyzed through noise, coefficient of variation (COV), and root mean square error (RMSE). As the iodine concentration increased, the CT number value increased, but the noise change did not show any special characteristics. COV decreased with increasing iodine concentration for FBP, adaptive iterative dose reduction (AIDR) 3D, and advanced intelligent clear-IQ engine (AiCE) at various tube voltages and tube currents. In addition, when the iodine concentration was low, there was a slight difference in COV between the reconstitution techniques, but there was little difference as the iodine concentration increased. AiCE showed the characteristic that RMSE decreased as the iodine concentration increased but rather increased after a specific concentration (4.9 mg/mL). Therefore, the user will have to consider the characteristics of scan parameters such as tube current and tube voltage as well as iodine concentration according to the reconstruction technique for optimal CTA image acquisition.

• Investigative Magnetic Resonance Imaging
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• v.26 no.2
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• pp.104-116
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• 2022

The purpose of this study is to systematically determine an optimal percentile cut-off in histogram analysis for calculating the mean parameters obtained from a non-Gaussian continuous-time random-walk (CTRW) diffusion model for differentiating individual glioma grades. This retrospective study included 90 patients with histopathologically proven gliomas (42 grade II, 19 grade III, and 29 grade IV). We performed diffusion-weighted imaging using 17 b-values (0-4000 s/mm²) at 3T, and analyzed the images with the CTRW model to produce an anomalous diffusion coefficient (D_m) along with temporal (𝛼) and spatial (𝛽) diffusion heterogeneity parameters. Given the tumor ROIs, we created a histogram of each parameter; computed the P-values (using a Student's t-test) for the statistical differences in the mean D_m, 𝛼, or 𝛽 for differentiating grade II vs. grade III gliomas and grade III vs. grade IV gliomas at different percentiles (1% to 100%); and selected the highest percentile with P < 0.05 as the optimal percentile. We used the mean parameter values calculated from the optimal percentile cut-offs to do a receiver operating characteristic (ROC) analysis based on individual parameters or their combinations. We compared the results with those obtained by averaging data over the entire region of interest (i.e., 100th percentile). We found the optimal percentiles for D_m, 𝛼, and 𝛽 to be 68%, 75%, and 100% for differentiating grade II vs. III and 58%, 19%, and 100% for differentiating grade III vs. IV gliomas, respectively. The optimal percentile cut-offs outperformed the entire-ROI-based analysis in sensitivity (0.761 vs. 0.690), specificity (0.578 vs. 0.526), accuracy (0.704 vs. 0.639), and AUC (0.671 vs. 0.599) for grade II vs. III differentiations and in sensitivity (0.789 vs. 0.578) and AUC (0.637 vs. 0.620) for grade III vs. IV differentiations, respectively. Percentile-based histogram analysis, coupled with the multi-parametric approach enabled by the CTRW diffusion model using high b-values, can improve glioma grading.