• Korean Journal of Clinical Laboratory Science
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• v.43 no.1
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• pp.19-25
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• 2011

The purpose of this study was to analyse brainstem auditory evoked potentials (BAEP) wave change data during microvascular decompression (MVD). The nerve function of Cranial Nerve VIII is at risk during MVD. Intraoperative monitoring of BAEP can be a useful tool to decrease the danger of hearing loss. Between January and December 2009, 242 patients had MVD for hemifacial spasm (HFS) and trigeminal neuralgia (TN). Among intraoperative BAEP changes, amplitude of V-V' was the most frequently observed during cerebellar retraction and decompression step of the MVD procedure. 138 patients (57%) had no BAEP change while 104 patients (42.98%) had BAEP change. 69 patients (28.5%) had Type A-I, 16 patients (6.6%) had Type A-II, 5 patients (2.1%) had Type B, and 13 patients (5.37%) had Type C. MVD is a surgical procedure to relieve the symptoms (e.g. pain, muscle twitching) caused by compression of a nerve by an artery or vein. During BAEP intraoperative monitoring, the surgical step is important in interpreting the changes of wave V. Several potential mechanisms of injury may affect the cochlear nerve, and complete loss of BAEP is often associated with postoperative hearing loss. Intraoperative BAEP monitoring may provide an early warning of hearing disturbance after MVD.

• Asian Pacific Journal of Cancer Prevention
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• v.17 no.12
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• pp.5315-5320
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• 2016

Purpose: Tumor cell growth and sensitivity to chemotherapy depend on many factors, among which insulin-like growth factors (IGFs) may play important roles. The aim of the present study was to evaluate the levels of insulin-like growth factors (IGFs) and IGF binding proteins (IGFBPs) in primary tumors and ascites as predictors of response to neoadjuvant chemotherapy in ovarian cancer (OC) patients. Materials and Methods: Tumor tissue samples and ascitic fluid were obtained from 59 patients with advanced OC. The levels of IGF-I, IGF-II, IGFBP-3, IGFBP-4 and PAPP-A were determined using ELISA kits. Taking into account the data on expression of these IGF-related proteins and outcome, logistic regression was performed to identify predictors of response to neoajuvant chemotherapy. Results: Human ovarian tumors expressed IGFs, IGFBP-3, IGFBP-4 and PAPP-A and these proteins were also present in ascites fluid and associated with its volume. IGFs and IGFBPs in ascites and soluble PAPP-A might play a key role in ovarian cancer progression. However, levels of proteins of the IGF system in tumors were not significant predictors of objective clinical response (oCR). Univariate analysis showed that the level of IGF-I in ascites was the only independent predictor for oCR. Conclusion: The level of IGF-I in ascites was shown to be an independent predictor of objective clinical response to chemotherapy for OC patients treated with neoadjuvant chemotherapy and debulking surgery.

• Journal of Korean Medical Science
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• v.33 no.48
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• pp.295.1-295.7
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• 2018

Background: Vancomycin-resistant enterococci (VRE) infections have become a major healthcare-associated pathogen problem worldwide. Nosocomial VRE infections could be effectively controlled by screening patients at high risk of harboring VRE and thereby lowering the influx of VRE into healthcare centers. In this study, we evaluated factors associated with VRE colonization in patients transferred to emergency departments, to detect patients at risk for VRE carriage. Methods: This study was conducted in the emergency department of a medical college-affiliated hospital in Korea. Every patient transferred to the emergency department and admitted to the hospital from January to December 2016 was screened for VRE using rectal cultures. In this cross-sectional study, the dependent variable was VRE colonization and the independent variables were demographic and clinical factors of the patients and factors related to the transferring hospital. Patients were divided into two groups, VRE and non-VRE, and previously collected patient data were analyzed. Then we performed logistic regression analyses of characteristics that differed significantly between groups. Results: Out of 650 patients, 106 (16.3%) had positive VRE culture results. Significant variables in the logistic analysis were transfer from geriatric long-term care hospital (adjusted odds ration [aOR]: 8.017; 95% confidence interval [CI]: 1.378-46.651), hospital days (4-7 days; aOR: 7.246; 95% CI: 3.229-16.261), duration of antimicrobial exposure (1-3 days; aOR: 1.976; 95% CI: 1.137-3.436), and age (aOR: 1.025; 95% CI: 1.007-1.043). Conclusion: VRE colonization in patients transferred to the emergency department is associated primarily with factors related to the transferred hospitals rather than demographic and clinical characteristics.

• Journal of Korean Medical Science
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• v.33 no.43
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• pp.239.1-239.12
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• 2018

Background: We described a novel multi-step retinal fundus image reading system for providing high-quality large data for machine learning algorithms, and assessed the grader variability in the large-scale dataset generated with this system. Methods: A 5-step retinal fundus image reading tool was developed that rates image quality, presence of abnormality, findings with location information, diagnoses, and clinical significance. Each image was evaluated by 3 different graders. Agreements among graders for each decision were evaluated. Results: The 234,242 readings of 79,458 images were collected from 55 licensed ophthalmologists during 6 months. The 34,364 images were graded as abnormal by at-least one rater. Of these, all three raters agreed in 46.6% in abnormality, while 69.9% of the images were rated as abnormal by two or more raters. Agreement rate of at-least two raters on a certain finding was 26.7%-65.2%, and complete agreement rate of all-three raters was 5.7%-43.3%. As for diagnoses, agreement of at-least two raters was 35.6%-65.6%, and complete agreement rate was 11.0%-40.0%. Agreement of findings and diagnoses were higher when restricted to images with prior complete agreement on abnormality. Retinal/glaucoma specialists showed higher agreements on findings and diagnoses of their corresponding subspecialties. Conclusion: This novel reading tool for retinal fundus images generated a large-scale dataset with high level of information, which can be utilized in future development of machine learning-based algorithms for automated identification of abnormal conditions and clinical decision supporting system. These results emphasize the importance of addressing grader variability in algorithm developments.

• The korean journal of orthodontics
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• v.49 no.6
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• pp.381-392
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• 2019

Objective: The objective of this two-arm parallel trial was to compare the type of tooth movement during en masse retraction of the maxillary anterior teeth using labial versus lingual biocreative therapy. Methods: Twenty-eight subjects were randomized in a 1 : 1 ratio to either the labial or lingual group. En masse anterior retraction was performed using labial biocreative therapy in group A and lingual biocreative therapy in group B. Cone beam computed tomography scans were taken before and after retraction and the primary outcome was the type of tooth movement during anterior retraction. Data were analyzed using paired t-tests for comparisons within each group and independent-sample t-test for comparison of the mean treatment changes between the two groups. Results: Significant differences were found between the two groups in relation to the type of tooth movement (labiolingual inclination of the central incisor; mean difference, $5.85{\pm}1.85^{\circ}$). The canine showed significant distal tipping in the lingual group (mean difference, $6.98{\pm}1.25^{\circ}$). The canine was significantly more intruded in the lingual group (mean difference, $1.67{\pm}0.49mm$). Good anchorage control and significant soft tissue changes occurred in both groups. No serious adverse effects were detected. Conclusions: With a 10-mm retraction hook, the labial biocreative technique with the reverse curve overlay provided anterior retraction with good torque control, while in the lingual group, anterior retraction occurred with controlled tipping movement with significant distal tipping and intrusion of the canine (trial registration: The trial was registered at ClinicalTrials.gov [NCT03239275]).

• The Journal of Korean Medicine
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• v.40 no.2
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• pp.1-16
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• 2019

Objectives: The purpose of this study was to increase the utilization of Korean Medicine Clinical Practice Guidelines(KMCGP) for ankle sprain by investigating the recognition of guideline developed in 2015 and evaluating the current status of treatment. Methods: An e - mail questionnaire survey was conducted for Korean medicine doctor(K.M.D) registered in Korean Medicine Association. Survey data were analyzed through Excel. Results: The most common Korean medicine treatments used in clinic were acupuncture(adjacent points)(28.5%), cupping therapy(19.7%) and pharmacopuncture(9.8%). The treatments with high patient satisfaction were acupuncture (adjacent points)(27.9%), moxibustion(22.4%) and herbal medicine(10.4%). Herbal medicine(17.9%), tuina(10.7%) and embedding therapy(9.2%) were difficult to perform during treatment because of cost. In the case of a later revision, respondents most thought it is necessary to update evidence and adjust recommendation ratings. A majority of all respondents said they would like to know about the revised guideline through the Internet. In the expected revision effect, the first order was 'presentation of standardized treatment method', the second was 'establishing the basis of Korean medicine treatment', and the third was 'strengthening the status of Korean medicine as therapeutic medicine'. Many respondents wished to add exercise therapy. In order to increase the utilization rate of the guideline, many respondents thought it should be included in textbooks and 90.6% of respondents answered that they would use more than 50% of the revised guideline. Conclusion: It is necessary to update evidence and adjust recommendation ratings and to promote KMCGP. At the same time treatment methods should be taught to K.M.D

• The Journal of Internal Korean Medicine
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• v.41 no.6
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• pp.1030-1051
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• 2020

Objective: This study investigated the measurement interval in the ultrasonographic gastric emptying test for patients with functional dyspepsia (FD) and the correlation between gastric emptying and the findings of various questionnaires. Methods: In total, 119 patients (59 patients with FD and 60 healthy controls) were recruited from July 2018 to June 2020. Gastric volume (GV) and gastric emptying half-time (T1/2) were measured by ultrasonography at fasting and again at 0, 5, 10, 15, 30, 45, 60, 90, and 120 min after meals (apple juice, 500 mL, 224 kcal), and the average half-time (average T1/2) was calculated. Questionnaires on food retention (FRQ), phlegm pattern e (PPQ), cold and heat (CHQ), deficiency and excess (DEQ), and spleen-qi deficiency (SQDQ), stomach qi deficiency pattern (SSDQ), visual analogue scale (VAS), and Nepean dyspepsia index-Korean version (NDI-K) were completed by all participants. The differences in GV and T1/2 were analyzed in participants whose maximal GV occurred at 0 min versus after 0 min. The correlation of the average T1/2 with the questionnaire scores was also analyzed after excluding erroneous data. Results: Patients with FD who took a certain amount of time to reach maximal GV after meals had a greater gastric volume up to about 30 minutes after meals, and the PPQ, DEQ, and NDI-K scores, especially for upper gastrointestinal symptoms and general weakness-related symptoms, showed statistically significant correlations with average T1/2. Conclusions: Ultrasonography can be a quantitative evaluation tool for FD. However, further studies on measurement methods based on FD physiopathology are required.

• Journal of Microbiology and Biotechnology
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• v.31 no.12
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• pp.1716-1721
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• 2021

Chikungunya fever is an arboviral disease caused by the Chikungunya virus (CHIKV). The disease has similar clinical manifestations with other acute febrile illnesses which complicates differential diagnosis in low-resource settings. We aimed to develop a rapid test for CHIKV detection based on the nucleic acid lateral flow immunoassay technology. The system consists of a primer set that recognizes the E1 region of the CHIKV genome and test strips in an enclosed cassette which are used to detect amplicons labeled with FITC/biotin. Amplification of the viral genome was done using open-source PCR, a low-cost open-source thermal cycler. Assay performance was evaluated using a panel of RNA isolated from patients' blood with confirmed CHIKV (n = 8) and dengue virus (n = 20) infection. The open-source PCR-NALFIA platform had a limit of detection of 10 RNA copies/ml. The assay had a sensitivity and specificity of 100% (95% CI: 67.56% - 100%) and 100% (95% CI: 83.89% - 100%), respectively, compared to reference standards of any positive virus culture on C6/36 cell lines and/or qRT-PCR. Further evaluation of its performance using a larger sample size may provide important data to extend its usefulness, especially its utilization in the peripheral healthcare facilities with scarce resources and outbreak situations.

• Journal of Veterinary Science
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• v.21 no.2
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• pp.25.1-25.16
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• 2020

Porcine epidemic diarrhea virus (PEDV) emerged into Canada in January 2014, primarily affecting sow herds. Subsequent epidemiological analyses suggested contaminated feed was the most likely transmission pathway. The primary objective of this study was to describe general biosecurity and management practices implemented in PEDV-positive sow herds and matched control herds at the time the virus emerged. The secondary objective was to determine if any of these general biosecurity and farm management practices were important in explaining PEDV infection status from January 22, 2014 to March 1, 2014. A case herd was defined as a swine herd with clinical signs and a positive test result for PEDV. A questionnaire was used to a gather 30-day history of herd management practices, animal movements on/off site, feed management practices, semen deliveries and biosecurity practices for case (n = 8) and control (n = 12) herds, primarily located in Ontario. Data was analyzed using descriptive statistics and random forests (RFs). Case herds were larger in size than control herds. Case herds had more animal movements and non-staff movements onto the site. Also, case herds had higher quantities of pigs delivered, feed deliveries and semen deliveries on-site. The biosecurity practices of case herds were considered more rigorous based on herd management, feed deliveries, transportation and truck driver practices than control herds. The RF model found that the most important variables for predicting herd status were related to herd size and feed management variables. Nonetheless, predictive accuracy of the final RF model was 72%.

• Journal of Chest Surgery
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• v.56 no.1
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• pp.6-13
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• 2023

Background: Coronavirus disease 2019 (COVID-19) has been found to cause life-threatening respiratory failure, which can progress to irreversible lung damage. Lung transplantation can be a life-saving treatment in patients with terminal lung disease (e.g., acute respiratory distress syndrome caused by infection). This study aimed to present the clinical course and results after initial lung transplantation in patients with severe COVID-19 who did not recover even with optimal medical care. Methods: From August 2019 to February 2022, this study enrolled 10 patients with COVID-19 (5 men; median age, 55.7 years) who underwent lung transplantation at a single center in Korea. All patients' characteristics, clinical pathway, overall survival, complications, and operative data were collected and analyzed. Results: Veno-venous extracorporeal membrane oxygenation or an oxygenator in a right ventricular assist device circuit was applied to 90% of the patients, and the median length of extracorporeal life support before operation was 48.5 days. There were no cases of mortality after a median follow-up of 372.8 days (interquartile range, 262.25-489 days). The major complications included the requirement for postoperative extracorporeal membrane oxygenation support in 2 cases (20%), re-transplantation in 1 case (10%), and re-exploration due to bleeding in 2 cases (20%). During the follow-up period, 3 out of 10 patients died. Conclusion: Excellent early outcomes were observed for patients who underwent lung transplantation. Thus, lung transplantation can be an effective and feasible treatment for patients with end-stage lung disease caused by COVID-19.