• Clinical and Experimental Pediatrics
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• v.62 no.7
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• pp.274-280
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• 2019

Purpose: To analyze the growth response to growth hormone (GH) therapy in prepubertal patients with Noonan syndrome (NS) harboring different genetic mutations. Methods: Twenty-three patients with prepubertal NS treated at Pusan National University Children's Hospital between March 2009 and July 2017 were enrolled. According to the disease-causing genes identified, the patients with NS were divided into 4 groups. Three groups were positive for mutations of the PTPN11, RAF1, and SOS1 genes. The five genes undetected (FGU) group was negative for PTPN11, RAF1, SOS1, KRAS, and BRAF gene mutations. The influence of genotype was retrospectively analyzed by comparing the growth parameters after GH therapy. Results: The mean chronological age at the start of GH treatment was $5.85{\pm}2.67years$. At the beginning of the GH treatment, the height standard deviation score (SDS), growth velocity (GV), and lower levels of insulin-like growth factor-1 (IGF)-1 levels were not statistically different among the groups. All the 23 NS patients had significantly increased height SDS and serum IGF-1 level during the 3 years of treatment. GV was highest during the first year of treatment. During the 3 years of GH therapy, the PTPN11, RAF1, and SOS1 groups showed less improvement in height SDS, IGF-1 SDS, and GV, and less increase in bone age-to-chronological age ratio than the FGU group. Conclusion: The 3-year GH therapy in the 23 prepubertal patients with NS was effective in improving height SDS, GV, and serum IGF-1 levels. The FGU group showed a better response to recombinant human GH therapy than the PTPN11, RAF1, and SOS1 groups.

• Journal of Periodontal and Implant Science
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• v.49 no.4
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• pp.206-214
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• 2019

Purpose: The purpose of this study was to examine the association between the intake of semi-solid yogurt and periodontitis in Korean adults using a national database. Methods: The data analyzed in this study are a subset of the sixth Korean National Health and Nutrition Examination Survey conducted in 2015 by the Korea Centers for Disease Control and Prevention. The sample size for this study was 4,727. We collected data on sociodemographic characteristics, oral health-related variables, oral and general health status, and intake of semi-solid yogurt. Semi-solid yogurt intake (YI) was calculated by multiplying the frequency of YI over the previous week by the average intake per serving. We assessed periodontal conditions using the Community Periodontal Index (CPI) and defined periodontitis as a CPI score ${\geq}3$. Multivariate logistic regression analyses were performed after adjusting for sociodemographic variables, and oral and general health behaviors and status. Results: The mean weekly YI among those without periodontitis ($1.03{\pm}0.06cups$) was significantly higher than among those with periodontitis ($0.77{\pm}0.08cups$) (P<0.001). Individuals who consumed more than 2 cups of yogurt per day were 76% less likely to have periodontitis than those who consumed less than 1 cup of yogurt per week after adjusting for all covariates (odds ratio, 0.24; 95% confidence interval, 0.10-0.60). Conclusions: We found a significant association between increased intake of semi-solid yogurt and periodontal health. We therefore recommend daily consumption of semi-solid yogurt as a probiotic to improve periodontal health. Further longitudinal studies are required to elucidate plausible mechanisms through which probiotics impact periodontal disease, considering both periodontal pathogens and clinical periodontal parameters.

• The Journal of Korean Medicine
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• v.40 no.3
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• pp.1-20
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• 2019

Objectives: This study aims to investigate the effects of Korean Medicine Hospital Utilization (KMHU) on major adverse cardiovascular events (MACE), myocardial infarction (MI), stroke, and death in hypertensive patients taking antihypertensives. Methods: Using the Korean National Health Insurance Service-National Sample Cohort database, this study identified and diagnosed 68,457 hypertensive patients taking antihypertensives between 2003 and 2006. They were divided into KMHU and non-KMHU groups. The follow-up period ended with the diagnosis of myocardial infarction, stroke, or death. After propensity score matching (PSM), there were 18,242 patients each in the non-KMHU and KMHU groups. We calculated the incidence rate, hazard ratio (HR), and 95% confidence interval (CI) for MACE, myocardial infarction, stroke, and death in patients with hypertension using a stratified Cox proportional hazard model. In addition, secondary outcome analyses for stroke and cardiovascular mortality were performed. Results: After PSM, the HRs for MACE (HR: 0.84, 95% CI: 0.81-0.87), all-cause mortality (HR: 0.75, 95% CI: 0.72-0.79), and myocardial infarction (HR: 0.90, 95% CI: 0.83-0.97) were significantly lower in the KMHU group than in the non-KMHU group. Moreover, the HRs for stroke-related mortality, haemorrhage and ischaemic stroke-related mortality, and ischaemic heart disease-related and circulatory system disease-related mortality were significantly lower in the KMHU group than in the non-KMHU group. Conclusions: On long-term follow-up observation, this study supported the effect of KMHU for managing hypertension and reducing the burden of cardiovascular diseases.

• Asian-Australasian Journal of Animal Sciences
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• v.32 no.4
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• pp.519-526
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• 2019

Objective: We determined the risk factors limiting first service conception (FSC) rate in dairy cows and their economic impact. Methods: Data were collected from 790 lactations regarding cow parity, peri- and postpartum disorders, body condition score (BCS), reproductive performance, and expenses associated with reproductive management (treatment, culling, and others). Initially, we identified the risk factors limiting FSC rate in dairy cows. Various biological and environmental factors, such as herd, cow parity, BCS at 1 month postpartum and first artificial insemination (AI), resumption of cyclicity within 1 month of calving, year, AI season, insemination at detected estrus or timed AI, peri- and postpartum disorders, and calving to first AI interval, were evaluated. Next, we evaluated the economic impact of the success or failure of FSC by comparing the expense associated with reproductive management until conception between cows that did or did not conceive at their first service. Results: Cows with BCS <3.0 had a lower probability of conceiving at first insemination (odds ratio [OR] = 0.64, p<0.05) than cows with $BCS{\geq}3.0$. Cows inseminated during summer were less likely to conceive (OR = 0.44, p<0.001) than cows inseminated during spring. Cows with peri- or postpartum disorders were less likely to conceive (OR = 0.55, p<0.001) than cows without disorders. Survival curves generated using MedCalc showed an 81 day extension in the mean interval between calving and conception in cows that failed to conceive over those that did conceive at first insemination. Cows failing conceive required additional expenditure on reproductive treatment ($55.40) and other management ($567.00) than cows that conceived at first insemination. Conclusion: Lower BCS, hot weather at first insemination, and peri- and postpartum disorders are risk factors limiting FSC, which result in an economic loss of $622.40 per dairy cow.

• Journal of Korean Neurosurgical Society
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• v.62 no.1
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• pp.27-34
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• 2019

Objective : Stent-assisted coil embolization of intracranial wide-necked aneurysm requires long-term postoperative antiplatelet therapy to prevent in-stent thrombosis. This study aimed to demonstrate results of temporary stent placement for coiling wide necked small intracranial aneurysms, which eliminated need for antiplatelet agents, and to discuss its feasibility and safety. Methods : Data of 156 patients who underwent stent-assisted coil embolization between 2011 and 2014 were retrospectively analyzed. Thirteen cases of temporary stent-assisted coil embolization were included, and their clinical and radiological results were evaluated. Results : The aneurysms treated were all unruptured except one case. All of them had wide neck with mean dome-to-neck ratio of 0.96 and were small-sized aneurysms with mean maximal diameter of 4.2 mm. There was no technical failure in retrieval of stent after completion of embolization of the target aneurysm. Immediate angiography revealed 11 complete and two partial embolization (one residual neck and one residual aneurysm). Two cases encountered thrombosis complication, and they were managed without neurological sequelae. The mean follow-up period was 43 months, angiographic follow-up revealed two cases with minor recurrence, and clinical outcome was good with modified Rankin scale score of 0. Conclusion : Temporary stent-assisted coil embolization of small wide-necked intracranial aneurysm using fully retrievable stent appears safe and effective. Further application and evaluation of this technique in more cases with larger size aneurysm is warranted.

• Child Health Nursing Research
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• v.25 no.2
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• pp.103-111
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• 2019

Purpose: This study aimed to investigate incidence of delirium in the pediatric intensive care unit (PICU) and to analyze associated risk factors. Methods: The participants were 95 patients, newborn to 18 years, who were admitted to the PICU. The instruments used were the Richmond Agitation Sedation Scale (RASS), and the Cornell Assessment of Pediatric Delirium. Data analysis was performed using the descriptive, $x^2$ test, t-test, and logistic regression analyses. Results: The incidence of delirium in children admitted to the PICU was 42.1%. There were significant differences according to age ($x^2=14.10$, p=.007), admission type ($x^2=7.40$, p=.007), use of physical restraints ($x^2=26.11$, p<.001), RASS score ($x^2=14.80$, p=.001), need for oxygen ($x^2=5.31$, p=.021), use of a mechanical device ($x^2=9.97$, p=.041), feeding ($x^2=7.85$, p=.005), and the presence of familiar objects ($x^2=29.21$, p<.001). Factors associated with the diagnosis of delirium were the use of physical restraint (odds ratio [OR]=13.82, 95% confidence interval [CI]=4.16~45.95, p<.001) and the presence of familiar objects (OR=0.09, 95% CI=0.03~0.30, p=.002). Conclusion: Periodic delirium assessments and intervention should be actively performed. The use of restraints should be minimized if possible. The caregiver should surround the child with familiar objects and ensure a friendly hospital environment that is appropriate for the child.

• Stress
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• v.25 no.4
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• pp.239-245
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• 2017

Background: A quasi-experimental study with non-equivalent control groups was performed to determine an effect of aromatherapy foot bath on stress and autonomic nervous activity. Methods: To confirm the effect of aromatherapy foot bath, aromatherapy foot bath group was asked to have a bathing by dropping 0.5 cc in 18 L water after blending with a ratio of 6:3:1 with essential oil lavender, lemon, and tea tree and a foot bath group was asked for bathing only by water. Results: Aromatherapy foot bath group showed significant decrease in subjective stress score (t=3.465, p=0.001) and stress index (t=3.021, p=0.004) in addition to simultaneous increase in sympathetic nervous activity (t=-2.913, p=0.005). However, no significant stimulation of parasympathetic nervous system was observed (t=-1.831, p=0.072). Conclusions: As aromatherapy foot bath is a possible effective intervention for stress relief, it can be applied as an effective method to relieve the stress for healthy adults and patients.

• Anxiety and mood
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• v.17 no.2
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• pp.67-72
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• 2021

Objective : This study examined the prevalence of posttraumatic stress disorder (PTSD) among North Korean defectors during preparation for early settlement. In addition, the correlation between PTSD and other mental disorders with suicidal ideation was assessed. Methods : A total of 639 North Korean defectors aged 19-65 years were included from resettlement and training centers. PTSD was assessed using the PTSD Diagnostic Scale (PDS). The prevalence of other mental disorders and suicidal ideation were assessed using the Korean version of the Psychiatric Diagnostic Screening Questionnaire (K-PDSQ). Results : A total of 6.8% of North Korean defectors had a PDS score >23, which was suggestive of a diagnosis of PTSD. Prior repatriation to North Korea was significantly associated with PTSD. The defectors with PTSD had a higher prevalence of other mental disorders (major depressive disorder prevalence: adjusted odds ratio [AOR], 14.5; 95% confidence interval [CI], 6.7-31.2, panic disorder prevalence: AOR, 9.5; 95% CI, 4.6-20.0, generalized anxiety disorder prevalence: AOR, 5.6; 95% CI, 2.4-13.2). No significant association was found between suicidal ideation and PTSD. Conclusion : North Korean defectors had a relatively high prevalence of PTSD and suicidal ideation during preparation for early settlement. Cohort studies are needed to assess the lasting effects of PTSD on North Korean defectors' settlement in Korea for a longer period.

• The Journal of Internal Korean Medicine
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• v.42 no.5
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• pp.939-948
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• 2021

Objectives: This study considered the effectiveness of Korean medicine for the treatment of eyelid edema post craniotomy. Methods: The patient was diagnosed with Taeumin-one of the four constitution types in Korean medicine-and treated with herbal medicines: Cheongsimyeunja-tang, Chungpyesagan-tang, and Hwangryunhaedok-tang pharmacoacupuncture treatment. The severity of eyelid edema was assessed using Kara and Gokalan's scale, daily imaging of the patient's eyelids, and the ratio of the length of the left eye to that of the right. Results: Following treatment, the Kara and Gokalan score decreased from 3 to 0. The changes in the ratios were 29% and 50%, respectively. The visual field defect due to edema in the left eye was also repaired. Conclusion: This study suggests that Korean medical treatment could be an effective option for treating eyelid edema following craniotomy.

• Journal of Yeungnam Medical Science
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• v.38 no.1
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• pp.39-46
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• 2021

Background: To determine the benefit of pelvic floor muscle exercise (PFME) with visual biofeedback on promoting patient recovery from incontinence, we investigated variables associated with the early restoration of continence for patients who underwent robot-assisted radical prostatectomy (RARP). Methods: Of the 83 patients enrolled, 41 consecutive patients completed PFME (the exercise group), and the other 42 consecutive patients just before the PFME program commenced (the control group). The primary outcome was whether PFME engagement was associated with zero pad continence restoration within 3 months of surgery. Results: Continence restoration percentages (defined as zero pads used per day) at 1, 3, and 6 months after surgery were 49.4%, 77.1%, and 94.0%, respectively. The exercise group achieved significantly higher recovery rates at 1 month (p=0.037), 3 months (p<0.001), and 6 months (p=023). Cox regression analysis demonstrated that a lower Gleason score (<8; hazard ratio [HR], 2.167), lower prostate specific antigen (<20 ng/dL; HR, 2.909), and engagement in PFME (HR, 3.731) were independent predictors of early recovery from postprostatectomy incontinence. Stratification by age showed that those younger than 65 years did not benefit significantly from exercise (log-rank test, p=0.08), but that their elderly counterparts, aged 65-70 years (p=0.007) and >70 years old (p=0.002) benefited significantly. Conclusion: This study suggests that postoperative engagement in PFME with biofeedback speeds up the recovery of continence in elderly patients (≥65 years old) that undergo RARP.