• Tuberculosis and Respiratory Diseases
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• v.84 no.4
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• pp.282-290
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• 2021

Background: Radial probe endobronchial ultrasound-guided transbronchial lung biopsy (RP-EBUS-TBLB) has improved the diagnostic yield of bronchoscopic biopsy of peripheral pulmonary lesions (PPLs). The diagnostic yield and complications of RP-EBUS-TBLB for PPLs vary depending on the technique, such as using a guide sheath (GS) or fluoroscopy. In this study, we investigated the utility of RP-EBUS-TBLB using a GS without fluoroscopy for diagnosing PPLs. Methods: We retrospectively reviewed data from 607 patients who underwent RP-EBUS of PPLs from January 2019 to July 2020. TBLB was performed using RP-EBUS with a GS without fluoroscopy. The diagnostic yield and complications were assessed. Multivariable logistic regression analyses were used to identify factors affecting the diagnostic yields. Results: The overall diagnostic accuracy was 76.1% (462/607). In multivariable analyses, the size of the lesion (≥20 mm; odds ratio [OR], 2.06; 95% confidence interval [CI], 1.27-3.33; p=0.003), positive bronchus sign in chest computed tomography (OR, 2.30; 95% CI, 1.40-3.78; p=0.001), a solid lesion (OR, 2.40; 95% CI, 1.31-4.41; p=0.005), and an EBUS image with the probe within the lesion (OR, 6.98; 95% CI, 4.38-11.12; p<0.001) were associated with diagnostic success. Pneumothorax occurred in 2.0% (12/607) of cases and chest tube insertion was required in 0.5% (3/607) of patients. Conclusion: RP-EBUS-TBLB using a GS without fluoroscopy is a highly accurate diagnostic method in diagnosing PPLs that does not involve radiation exposure and has acceptable complication rates.

• Journal of the Korean Society for information Management
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• v.38 no.3
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• pp.239-262
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• 2021

The Korean Medical Journal (1930-1937) is the first Korean medical journal published by The Korean Medical Association, which Korean doctors established to resist Japanese medical organizations during the Japanese colonial period. Using the bibliometric research method for The Korean Medical Journal, this study aimed to analyze the journal as follows. First, the study analyzed the subject trends of medical research by extracting the MeSH terms from the title of the articles. Next, the study identified characteristics of authors, type of language used in the papers, publication year and countries of references included in the papers. Also, this study identified the researchers' interests by analyzing the frequency of keywords appearing in the roundtable titles. As a result of the research, infections, pathological symptoms and diseases of the digestive system were studied most often. Most authors belonged to Severance Union Medical College, and internal medicine and general surgery departments had the most authors. Most of the titles and texts of the papers were written in Korean and Chinese characters in combination. Of the 131 papers, only 40 contained abstracts, 22 of which were English abstracts, the most number. The study analyzed 1,103 references in the papers and found that the authors mainly cited the latest journals published in Japan, Germany, and the United States. The topics discussed the most in the roundtable talks were tuberculosis, neurasthenia, and gonorrhea in order. This research examined the history of the publication of The Korean medical journal. Also, it showed that Korean doctors accumulated their academic medical research results and contributed to improving medical conditions.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.19 no.11
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• pp.635-644
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• 2018

This descriptive study examined the practical nursing guidelines for the prevention of pressure injuries (PI) in operating rooms and their application. Method: Four general hospitals and three specialized hospitals located in Seoul, Incheon, and Gyeonggido province were selected through an online randomization program and nurses at these hospitals who participated in operations and had at least six months work experience were surveyed. Data were collected from January to April 2018 through a survey distributed to 150 nurses, 129 of whom returned the survey (86% recovery rate). The results showed that 43 nurses provided PI prevention care for patients in a lateral position (33.3%), 37 for patients in a supine position (28.7%), and 36 for patients in a prone position (27.9%). Gel was most widely used as the supporting surface material (102 nurses; 79.1%), followed by sponge (62 nurses; 48.1%), and cotton (47 nurses; 36.4%). Skin was often inspected twice, before and after the use of a supporting surface (90nurses; 69.8%), but no designated tool was used to determine the risk of PI developing (76 nurses; 58.9%). Additionally, the patient's position during surgery (83 nurses; 64.3%) and the length of the operation (i.e., more than two hours, in this case) (49 nurses; 38.0%) were determining factors for whether to use a supporting surface. The operating room nurses used the gel, sponge, and cotton as the supporting surfaces for the prevention of PI and confirmed that the cutoff operation time for the use of a supporting surface was more than 2 hours.

• The Journal of Korea Institute of Information, Electronics, and Communication Technology
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• v.12 no.4
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• pp.336-342
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• 2019

With the entry of an aging society, the average life span of accreditation has been extended. Therefore, interest in the appearance of men and women in modern society has increased. It is the wrinkles of the face that can judge the most outwardly. People tend to have various kinds of treatments to have a clean, wrinkle-free and resilient healthy skin regardless of sex. There is a lot of practice of lifting procedures in one of the procedures. A suture using a melting thread is a method of lifting by squeezing it into the skin as a non-incision type centering on a region where the thread can be fixed in the skin by injecting it into the subcutaneous fat layer. To evaluate the lifting efficacy of Cog - type suture for the improvement of skin wrinkles, preclinical experiments were conducted. We developed a wrinkle evaluation program using Labview. Data from preclinical experiments were used at 8 weeks after suturing. The average wrinkle depth was 415.6 mm in the control group. At 8 weeks, the depth of wrinkles was deepened to 888.3mm due to the aging process of the control group. On the other hand, the depth of the wrinkles before surgery was 640.3 mm in the suture group. It was confirmed that the depth of wrinkles decreased to 566.5mm at 8th week after the suture operation.

• Journal of The Korean Society of Emergency Medicine
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• v.29 no.6
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• pp.649-655
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• 2018

Objective: This paper reports the possibility of using of a locking horizontal mattress suture technique in repairing lacerations that are difficult to suture with staples. Methods: Data were collected retrospectively over a 6-month period regarding the routine repair of scalp lacerations: those in areas injured by a high energy blunt mechanism, continued to bleed after pressure, nonlinear or damaged skin repaired with a locking horizontal mattress technique, and simple interrupted technique. The effects of the two techniques used to repair scalp lacerations on wound healing, complication rate, and patient satisfaction were examined. The categorical variables are expressed as the number and percent. A Mann-Whitney-Wilcoxon test was used for statistical analysis. A P-value less than 0.05 was considered significant. Results: Thirty-seven consecutive patients with scalp lacerations presented for care. Wound closure was accomplished with the locking horizontal mattress sutures in 40.5% (n=15) (median length, 5.0 cm; interquartile range [IQR], 4.0-7.0 cm). Simple interrupted sutures (median length, 4 cm; IQR, 3.0-5.0 cm) were used in 59.5% (n=22) (P=0.015). The frequency of additional bandage compression (P=0.008), frequency of exudative hemorrhage (P=0.018), and suture mark frequency at suture removal (P=0.047) were significantly lower in the locking horizontal mattress group. Conclusion: The locking horizontal mattress suture, which has the advantage of a horizontal mattress suture, may be one of the ways that can be used alternatively to treat scalp lacerations that difficult to suture with staples.

• Journal of the Korean Crystal Growth and Crystal Technology
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• v.30 no.6
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• pp.244-250
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• 2020

β-Tricalcium phosphate (β-TCP, Ca3(PO4)2) is a kind of biodegradable calcium phosphate ceramics with chemical and mineral compositions similar to those of bone. It is a potential candidate for bone repair surgery. To improve the bioactivity and osteoinductivity of β-TCP, various ions doped calcium phosphate have been studied. Among them, Iron is a trace element and its deficiency in the human body causes various problems. In this study, we investigated the effect of Fe ions on the structural variation, degradation behavior of β-TCP. Fe-doped β-TCP powders were synthesized by the coprecipitation method, and the heat treatment temperature was set at 925 and 1100℃. The structural analysis was carried out by Rietveld refinement using the X-ray diffraction results. Fe ions existed in a different state (Fe2+ or Fe3+) with different heat treatment temperatures, and the substitution sites (Ca-(4) and Ca-(5)) also changed with temperature. The degradation rate was fastest at Fe-doped β-TCP with heated at 1100℃. The cell viability behavior was also enhanced with the substitution of Fe ions. Therefore, the substitution of Fe ion has accelerated the degradation of β-TCP and improved the biocompatibility. It could be more utilized in biomedical devices.

• Journal of Korean Neurosurgical Society
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• v.64 no.2
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• pp.297-308
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• 2021

Objective : Shunt infection is a common complication while treating hydrocephalus. The antibiotic-impregnated shunt catheter (AISC) was designed to reduce shunt infection rate. A meta-analysis was conducted to study the effectiveness of AISCs in reduction of shunt infection in terms of age, follow-up time and high-risk patient population. Methods : This study reviewed literature from three databases including PubMed, EMBASE, and Cochrane Library (from 2000 to March 2019). Clinical studies from controlled trials for shunt operation were included in this analysis. A subgroup analysis was performed based on the patient's age, follow-up time and high-risk population. The fixed effect in RevMan 5.3 software (Cochrane Collaboration) was used for this meta-analysis. Results : This study included 19 controlled clinical trials including 10105 operations. The analysis demonstrated that AISC could reduce the infection rate in shunt surgery compared to standard shunt catheter (non-AISC) from 8.13% to 4.09% (odds ratio [OR], 0.48; 95% confidence interval [CI], 0.40-0.58; p=0.01; I2=46%). Subgroup analysis of different age groups showed that AISC had significant antimicrobial effects in all three groups (adult, infant, and adolescent). Follow-up time analysis showed that AISC was effective in preventing early shunt infections (within 6 months after implant). AISC is more effective in high-risk population (OR, 0.24;95% CI, 0.14-0.40; p=0.60; I2=0%) than in general patient population. Conclusion : The results of meta-analysis indicated that AISC is an effective method for reducing shunt infection. We recommend that AISC should be considered for use in infants and high-risk groups. For adult patients, the choice for AISC could be determined based on the treatment cost.

• Journal of Korean Neurosurgical Society
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• v.64 no.4
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• pp.575-584
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• 2021

Objective : Cervical expansive laminoplasty is an effective surgical method to address multilevel cervical spinal stenosis. During surgery, the spinous processes of C2 and C7 are usually preserved to keep the insertion points of the cervical musculature and nuchal ligament intact. In this regard, dome-like laminectomy (undercutting of C7 lamina) instead of laminoplasty is performed on C7 in selected cases. However, resection of the lamina can weaken the C7 lamina, and stress fractures may occur, but this complication has not been characterized in the literature. The objective of the present study was to investigate the incidence and risk factors for C7 laminar fracture after C7 dome-like laminectomy and its impact on clinical and radiological outcomes. Methods : Patients who underwent cervical open-door laminoplasty combined with C7 dome-like laminectomy (n=123) were classified according to the presence of C7 laminar fracture. Clinical parameters (neck/arm pain score and neck disability index) and radiologic parameters (C2-7 angle, C2-7 sagittal vertical axis, and C7-T1 angle) were compared between the groups preoperatively and at postoperatively at 3, 6, 12, and 24 months. Risk factors for complications were evaluated, and a formula estimating C7 fracture risk was suggested. Results : C7 lamina fracture occurred in 32/123 (26%) patients and occurred at the bilateral isthmus in 29 patients and at the spinolaminar junction in three patients. All fractures appeared on X-ray within 3 months postoperatively, but patients did not present any neurological deterioration. The fracture spontaneously healed in 27/32 (84%) patients at 1 year and in 29/32 (91%) at 2 years. During follow-up, clinical outcomes were not significantly different between the groups. However, patients with C7 fractures showed a more lordotic C2-7 angle and kyphotic C7-T1 angle than patients without C7 fractures. C7 fracture was significantly associated with the extent of bone removal. By incorporating significant factors, the probability of C7 laminar fracture could be assessed with the formula 'Risk score = 1.08 × depth (%) + 1.03 × length (%, of the posterior height of C7 vertebral body)', and a cut-off value of 167.9% demonstrated a sensitivity of 90.3% and a specificity of 65.1% (area under the curve, 0.81). Conclusion : C7 laminar fracture can occur after C7 dome-like laminectomy when a substantial amount of lamina is resected. Although C7 fractures may not cause deleterious clinical outcomes, they can lead to an unharmonized cervical curvature. The chance of C7 fracture should be discussed in the shared decision-making process.

• Journal of Korean Neurosurgical Society
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• v.64 no.5
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• pp.791-798
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• 2021

Objective : The period of mechanical ventilator (MV)-dependent respiratory failure after cervical spinal cord injury (CSCI) varies from patient to patient. This study aimed to identify predictors of MV at hospital discharge (MVDC) due to prolonged respiratory failure among patients with MV after CSCI. Methods : Two hundred forty-three patients with CSCI were admitted to our institution between May 2006 and April 2018. Their medical records and radiographic data were retrospectively reviewed. Level and completeness of injury were defined according to the American Spinal Injury Association (ASIA) standards. Respiratory failure was defined as the requirement for definitive airway and assistance of MV. We also evaluated magnetic resonance imaging characteristics of the cervical spine. These characteristics included : maximum canal compromise (MCC); intramedullary hematoma or cord transection; and integrity of the disco-ligamentous complex for assessment of the Subaxial Cervical Spine Injury Classification (SLIC) scoring. The inclusion criteria were patients with CSCI who underwent decompression surgery within 48 hours after trauma with respiratory failure during hospital stay. Patients with Glasgow coma scale 12 or lower, major fatal trauma of vital organs, or stroke caused by vertebral artery injury were excluded from the study. Results : Out of 243 patients with CSCI, 30 required MV during their hospital stay, and 27 met the inclusion criteria. Among them, 48.1% (13/27) of patients had MVDC with greater than 30 days MV or death caused by aspiration pneumonia. In total, 51.9% (14/27) of patients could be weaned from MV during 30 days or less of hospital stay (MV days : MVDC 38.23±20.79 vs. MV weaning, 13.57±8.40; p<0.001). Vital signs at hospital arrival, smoking, the American Society of Anesthesiologists classification, Associated injury with Injury Severity Score, SLIC score, and length of cord edema did not differ between the MVDC and MV weaning groups. The ASIA impairment scale, level of injury within C3 to C6, and MCC significantly affected MVDC. The MCC significantly correlated with MVDC, and the optimal cutoff value was 51.40%, with 76.9% sensitivity and 78.6% specificity. In multivariate logistic regression analysis, MCC >51.4% was a significant risk factor for MVDC (odds ratio, 7.574; p=0.039). Conclusion : As a method of predicting which patients would be able to undergo weaning from MV early, the MCC is a valid factor. If the MCC exceeds 51.4%, prognosis of respiratory function becomes poor and the probability of MVDC is increased.

• Clinical and Experimental Otorhinolaryngology
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• v.11 no.4
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• pp.281-287
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• 2018

Objectives. Regenerative treatment using stem cells may serve as treatment option for empty nose syndrome (ENS), which is caused by the lack of turbinate tissue and deranged nervous system in the nasal cavity. We aimed to assess the efficacy and safety of the autologous stromal vascular fraction (SVF) in the treatment of ENS. Methods. In this prospective observational clinical study, we enrolled 10 ENS patients who volunteered to undergo treatment of ENS through the injection of autologous SVF. Data, including demographic data, pre- and postoperative Sino-Nasal Outcome Test-25 (SNOT-25) scores, overall patient satisfaction, and postoperative complications, were prospectively collected. Nasal secretion was assessed using the polyurethane foam absorption method, and the levels of biological markers were analyzed in both ENS group and control group using enzyme-linked immunosorbent assay. The SVF extracted from abdominal fat was diluted and injected into both inferior turbinates. Results. Among the 10 initial patients, one was excluded from the study. Subjective satisfaction was rated as "much improved" in two and "no change" in seven. Among the improved patients, the mean preinjection SNOT-25 score was 55.0 and the score at 6 months after injection was 19.5. However, the average SNOT-25 score of nine participants at 6 months after injection (mean${\pm}$standard deviation, $62.4{\pm}35.8$) did not differ significantly from the baseline SNOT-25 score ($70.1{\pm}24.7$, P>0.05, respectively). Among the various inflammatory markers assessed, the levels of interleukin $(IL)-1{\beta}$, IL-8, and calcitonin gene-related peptide were significantly higher in ENS patients. Compared with preinjection secretion level, the nasal secretions from SVF-treated patients showed decreased expressions of $IL-1{\beta}$ and IL-8 after injection. Conclusion. Although SVF treatment appears to decrease the inflammatory cytokine levels in the nasal mucosa, a single SVF injection was not effective in terms of symptom improvement and patient satisfaction. Further trials are needed to identify a more practical and useful regenerative treatment modality for patients with ENS.