• Investigative and Clinical Urology
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• v.59 no.6
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• pp.410-415
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• 2018

Purpose: Despite meticulous techniques, surgical complications continue to be problematic in kidney transplant recipients. Role of routine stenting to reduce complications is controversial. In this study, we compare incidence of early urological complications, lymphoceles, urinary tract infections (UTI) and graft function; with or without double-J stenting. Materials and Methods: All patients who underwent live related donor renal transplantation from February 2014 to February 2016 were included. Transplants prior to February 2015 were without routine stenting; subsequent transplants were with routine stenting. Patients with neurogenic bladder, previously operated bladder and delayed or low urinary output were excluded. Followup was for at least three months. Descriptive statistics was performed for all parameters. Chi square test and Fisher's Exact test were used for qualitative variables. For quantitative variables, Mann-Whitney test was used to test median difference and independent samples t-test for mean difference. The p-value ${\leq}0.05$ was considered significant. Results: We analysed 74 patients (34 stented and 40 non-stented). There was no difference in the incidence of urinary leak, anastomotic obstruction, lymphoceles or UTI (p>0.4 for all comparisons). However, mean estimated glomerular filtration rate at sixth day, 14th day, one month and two months were 76.1 vs. 61.5 (p=0.025), 72.1 vs. 56.6 (p=0.005), 79.4 vs. 63.1 (p=0.002) and 82.0 vs. 63.3 (p=0.001) in the stented versus non-stented groups. Conclusions: Placement of ureteral stent in renal transplant does not significantly affect the incidence of early urinary complications or UTI. However, graft function is significantly better in stented recipients, at least in the short term.

• Asian Spine Journal
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• v.12 no.6
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• pp.1017-1027
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• 2018

Study Design: This retrospective study was conducted including 18 patients who underwent posterior-only stabilization and fusion procedure for pseudoarthrosis in the ankylosed spine from October 2007 to May 2015. Purpose: This study aimed to describe the treatment outcomes in 18 patients with Andersson lesion (AL) who were managed using the posterior-only approach. Literature Review: AL is an unstable, localized, vertebral, or discovertebral lesion of the spine. It is observed in patients with ankylosing spondylitis. The exact etiology of this disorder remains unclear, and the treatment guidelines are not clearly described. Methods: We analyzed 18 patients with AL who were treated with posterior long segment spinal fusion without any anterior interbody grafting or posterior osteotomy. Pre- and postoperative radiography, computed tomography, and recent follow-up images were examined. The pre- and postoperative Visual Analog Scale score and the Oswestry Disability Index score were evaluated for all patients. Whiteclouds' outcome analysis criteria were applied at the follow-up. Moreover, at study completion, patient feedback was collected; all the patients were asked to provide their opinion regarding the surgery and were asked whether they would recommend this procedure to other patients and them self undergo the same procedure again if required. Results: The most common site was the thoracolumbar junction. The symptom duration ranged from 1 month to 10 years preoperatively. Most patients experienced fusion by the end of 1 year, and the fusion mass could be observed as early as 4 months. Pseudoarthrosis void of up to 2.5 cm was noted to be healed in subsequent imaging. In addition, clinically, the patients reported good symptomatic relief. No patient required revision surgery. Whiteclouds' outcome analysis score at the latest follow-up revealed goodto-excellent outcomes in all patients. Conclusions: ALs can be treated using the posterior-only approach with long segment fixation and posterior spinal fusion. This is a safe, simple, and quick procedure that prevents the morbidity of anterior surgery.

• Journal of muscle and joint health
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• v.26 no.1
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• pp.15-26
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• 2019

Purpose: The purpose of this study was to develop a Dongsasub training applying aroma necklace for nursing students in clinical practicum, and to evaluate the training programs' effects on perceived stress, self-esteem, depression, and clinical competence of the participants. Methods: This study used a cluster-randomized controlled trial design. Participants were 56 nursing students taking clinical practicum courses (26 in the experimental group and 30 in the control group). The training program consisted of four sessions of Dongsasub training and wearing a necklace where a mixture of aroma oils attached. Participants in experimental group were given a necklace with essential oil mixture of lavender, bergamot, and geranium with the ratio of 1:1:1 for 2 weeks. The control group received no intervention. Outcome variables included perceived stress, self-esteem, depression, and clinical competence. Data were analyzed with Fisher's exact test, Chi-square, Independent t-test using the SPSS/WIN 21.0. Results: Independent t-test revealed that perceived stress (t=3.15, p=.003), depression (t=4.62, p<.001) were significantly lower in the experimental group than the control group; self-esteem (t=-3.03, p=.004), clinical competence (t=-2.15, p=.036) scored significantly greater than the control group. Conclusion: The results indicate that the Dongsasub training with application of the aroma necklace can be used as an effective nursing intervention for lowering perceived stress, depression and improving self-esteem, clinical competence of nursing students.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.30 no.2
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• pp.74-82
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• 2019

Objectives: The objective of this study was to investigate clinical and neuropsychological factors associated with treatment response and adverse events of atomoxetine in children with attention-deficit/hyperactivity disorder (ADHD) in Korea. Methods: Children with ADHD were recruited at the Department of Psychiatry of Asan Medical Center from April 2015 to April 2018. Diagnoses of ADHD and comorbid psychiatric disorders were confirmed with the Kiddie-Schedule for Affective Disorders and Schizophrenia-Present and Lifetime Version. The subjects were subsequently treated with atomoxetine for 12 weeks and illness severity was scored using the ADHD Rating Scale, Clinical Global Impression-Severity scale (CGI-S) and/or Improvement scale (CGI-I), at pre- and post-treatment. They also completed the Advanced Test of Attention (ATA), while their caregivers completed the Korean Personality Rating Scale for Children (KPRC) at pre- and post-treatment. Independent t-test, Fisher's exact test, ${\chi}^2$ test, mixed between-within analysis of variance and correlation analysis were used for statistical analysis. Results: Sixty-five children with ADHD (mean age: $7.9{\pm}1.4years$, 57 boys) were enrolled, of which, 33 (50.8%) were treatment responders. Scores on the social dysfunction subscale of the KPRC (p=0.021) and commission errors on the visual ATA (p=0.036) at baseline were higher in treatment non-responders than in responders; however, the statistical significances disappeared after adjusting for multiple comparisons. Mood changes were also observed in 13 subjects (20.0%), and three of them discontinued atomoxetine due to this. Additionally, atomoxetine-emergent mood change was observed more frequently in girls (p=0.006), while the intelligence quotient (p=0.040) was higher in those subjects with mood changes than in those without. Conclusion: The results of our study suggest that clinical and neuropsychological factors could be associated with treatment response or adverse events of atomoxetine in children with ADHD. Further long-term studies with larger samples are needed.

• Tuberculosis and Respiratory Diseases
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• v.82 no.3
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• pp.194-200
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• 2019

Background: Tuberculosis (TB) is a major infectious disease in South Korea causing substantial disease burden, particularly in the elderly. This study aimed to identify the case detection rate of mobile TB screening for the elderly conducted in the Jeollanam-do region and to analyze risk factors of active TB. Methods: We screened the elderly population (${\geq}65$ years old) in Jeollanam-do from August to December 2017. Chest radiography was performed for all participants. Participants with TB presumptive signs were asked to submit sputum specimen(s). Sputum smear, culture, and polymerase chain reaction analyses were performed. Cascade analysis, chi-squared tests, and Fisher exact tests were used to evaluate screening performance. Results: In total, 12,402 participants were screened, and 211 (1.7%) were suspected to have active TB; 181 of the suspected patients (85.8%) underwent sputum smear test, and 16 (8.8%) patients were confirmed to have TB. The TB prevalence among the elderly was bacteriologically confirmed to be 129 per 100,000 individuals, which was similar to national TB notification data for the same age groups. The proportion of active TB cases increased with age, and differed based on sex and past TB history. However, TB-related symptoms, comorbidity status, and TB screening history within 12 months were not predictive of active TB. Conclusion: This study identified that the prevalence rate was similar to national TB notification data from the same age groups. Periodic, community-based, systematic TB screening among the elderly population is recommended.

• Korean Journal of Biological Psychiatry
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• v.25 no.4
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• pp.110-117
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• 2018

Objectives This study aimed to investigate the relationship between depressive and anxiety symptoms and tardive dyskinesia (TD) and reveal the association of cognitive function and TD in patients with schizophrenia. Methods We recruited 30 schizophrenia patients with TD and 31 without TD from a national mental hospital in South Korea. To assess depressive and anxiety symptoms, the Beck Depression Inventory-II (BDI-II) and the Beck Anxiety Inventory (BAI) were conducted. Using the five-factor structure of the BDI-II and BAI, somatic anxiety, cognitive depression, somatic depression, subjective anxiety, and autonomic anxiety were assessed. Computerized neurocognitive function test (CNT) was performed to assess levels of cognitive functions. We compared the clinical characteristics, levels of cognitive functions, and depressive and anxiety symptoms between schizophrenia patients with TD and without TD. Chi-square test, Fisher's exact test, independent t-test and Mann Whitney U test were conducted to compare two groups. Pearson correlation analysis was conducted to evaluate relationships among the abnormal involuntary movement scale (AIMS), BDI-II, BAI, somatic anxiety, cognitive depression, somatic depression, subjective anxiety, and autonomic anxiety. Results The subjects with TD had significantly lower score on the cognitive depression than those without TD (t = -2.087, p = 0.041). There were significant correlations between the AIMS score and the BDI-II score (r = -0.386, p = 0.035) and between the AIMS score and cognitive depression score (r = - 0.385, p = 0.035). Conclusions Our findings suggest the inverse relationship between severities in TD and depression and support the assumption that there is an inverse relationship between the pathophysiology of TD and depression.

• Imaging Science in Dentistry
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• v.49 no.1
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• pp.53-58
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• 2019

Purpose: To present characteristic findings of Tc-99m hydroxymethylene diphosphonate (HMDP) scintigraphy, computed tomography (CT), and magnetic resonance (MR) imaging for osteonecrosis in the mandible, especially osteoradionecrosis(ORN) and medication-related osteonecrosis of the jaw(MRONJ). Materials and Methods: Thirteen patients with MRONJ and 7 patients with ORN in the mandible underwent Tc-99m HMDP scintigraphy, CT, and MR imaging (T1-weighted images[T1WI], T2-weighted images[T2WI], short inversion time inversion recovery images[STIR]), diffusion-weighted images[DWI], and apparent diffusion coefficient [ADC] mapping). The associations of scintigraphy, CT, and MR imaging findings with MRONJ and ORN were analyzed using the chi-square test with the Pearson exact test. Results: Thirteen patients with MRONJ and 7 patients with ORN in the mandible showed low signal intensity on T1WI and ADC mapping, high signal intensity on STIR and DWI, and increased uptake on scintigraphy. Periosteal bone proliferation on CT was observed in 69.2% of patients with MRONJ(9 of 13) versus 14.3% of patients with ORN(1 of 7)(P=0.019). Conclusion: This study presented characteristic imaging findings of MRONJ and ORN on scintigraphy, CT, and MR imaging. Our results suggest that CT can be effective for detecting MRONJ and ORN.

• Imaging Science in Dentistry
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• v.49 no.1
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• pp.59-63
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• 2019

Purpose: This study evaluated the prevalence and characteristics of maxillary antroliths using cone-beam computed tomography (CBCT) scans performed for maxillofacial diagnostic purposes. Materials and Methods: CBCT scans of 13,946 patients over the age of 20 were reviewed for maxillary antroliths, and prevalence according to sex, age, and the side of the jaw was calculated. The relationships of single or multiple antroliths with sex, side, and the degree of sinus inflammation were evaluated. The shape and dimension of antroliths were also assessed. The data were analyzed using descriptive statistics, the chi-square or Fisher exact tests, and Kendall's tau-b. Results: A total of 138 (0.99%) of the 13,946 patients showed an antrolith in at least 1 sinus. Only 18 patients presented a bilateral manifestation, which brought the total number of sinuses containing an antrolith to 156 (0.56%). Multiple antroliths were observed in 36 sinuses, and the total number of antroliths was 207: 110 punctate, 65 linear, and 32 amorphous. The antrolith dimensions varied from $1mm^2$ to $91mm^2$ (average, $10.2{\pm}15.5mm^2$). No statistically significant differences were found according to sex, side, and age group (P>0.05). However, there was a statistically significant difference between the multiplicity of antrolith and the degree of sinus inflammation (P<0.05). Conclusion: Cone-beam computed tomography is an effective modality for the detection of incidental antroliths. Maxillary antroliths were found to be very rare and were usually asymptomatic. Dentists should have a comprehensive understanding of their diagnosis and treatment in light of possible associated dental problems.

• Journal of Korean Clinical Nursing Research
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• v.25 no.1
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• pp.55-66
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• 2019

Purpose: This study was done to assess development and postnatal care interventions in postnatal care intervention records for maternity ward nurses in tertiary hospitals and women's hospitals in South Korea. Methods: This mixed-method research was a Time-Motion (TM) study. Data were collected through external observation of 12 nurses in 4 wards over 24 hours. Mann-Whitney U test and independent t-test were employed for the analysis of frequency and provision time of direct/indirect care activity. $x^2$ (Fisher's exact test) was utilized to determine the difference in frequency between two groups. IBM SPSS 22.0 statistical program was employed for calculation. All statistical significance levels were at ${\alpha}=.05$. Results: According to the KPCS-1 (Korean Patient Classification System-1), women's hospitals are group 3 and tertiary hospitals, group 4. With respect to time difference in direct care, tertiary hospitals showed 791 minutes and women's hospitals, 399 a difference of 392 minutes. For time difference in indirect care, women's hospitals had 2,415 minutes while tertiary hospitals, 2,080, a difference of 335 minutes for women's hospitals. No difference was found in the average total care workload between the two institutions. Individual time also showed no difference (p>.05). Conclusion: High-risk maternal care strength in tertiary hospitals and breast-feeding strength in women's hospitals need to be benchmarked with each other.

• Journal of Korean Academy of Nursing
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• v.49 no.1
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• pp.36-45
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• 2019

Purpose: The purpose of this study was to identify the characteristics of and risk factors for medical-device-related pressure ulcer (MDRPU) development in intensive care units. Methods: A prospective cohort study design was used, and the participants were 253 adult patients who had stayed in medical and surgical intensive care units. Data were collected regarding the application of medical devices and MDRPU-related characteristics over a period of six months from June to November, 2017. Data were analyzed using independent t-test, ${\chi}^2-test$, Fisher's exact test, and binary logistic regression analysis with the SPSS 21.0 program. Results: Among the 253 participants, MDRPUs occurred in 51 (19.8%) participants. The results of the logistic regression analysis showed that the risk factors for MDRPUs were the use of endotracheal tubes (OR=5.79, 95% CI: 1.66~20.20), having had surgery (OR=2.95, 95% CI: 1.11~7.77), being in a semi-coma/coma (OR=5.79, 95% CI: 1.04~32.05), and sedation (OR=5.54, 95% CI: 1.39~22.19). Conclusion: On the basis of the study results, it is effectively facilitated by nurses when they care for patients with MDRPUs in intensive care units and the results are expected to be of help in preventive education for MDRPU development as well as preparing the base data for intervention studies.