• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.44 no.6
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• pp.275-281
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• 2018

Objectives: Isolated mandibular fractures contribute to approximately 45% of maxillofacial traumas. Improper management of mandibular fractures can cause myriad potential complications and can lead to serious functional and aesthetic sequelae. The objective of the study is to design a stepwise approach for managing isolated mandibular fractures using open reduction and internal fixation (ORIF) with regional anesthesia on outpatient basis. Materials and Methods: Patients with isolated mandibular fractures presenting to the department of maxillofacial surgery were selected for ORIF under regional anesthesia based on occlusion, age, socioeconomic status, general condition, habits, and allied medical ailments. Standard preoperative, intraoperative, and postoperative protocols were followed. All patients were followed up for a minimum of 4 weeks up to a maximum of 1 year. Results: Of 23 patients who received regional anesthesia, all but one had good postoperative functional occlusion. One patient was hypersensitive and had difficulty tolerating the procedure. Two patients developed an extraoral draining sinus, one of whom was managed with local curettage, while the other required hardware removal. One patient, who was a chronic alcoholic, returned 1 week after treatment with deranged fracture segments after he fell while intoxicated. Conclusion: With proper case selection following a stepwise protocol, the majority of mandibular fractures requiring ORIF can be managed with regional anesthesia and yield minimal to no complications.

• Journal of Korean Academy of Nursing
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• v.49 no.5
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• pp.538-549
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• 2019

Purpose: This study aimed to explore and compare the knowledge structure of pain management nursing research, between Korea and other countries, applying a text network analysis. Methods: 321 Korean and 6,685 international study abstracts of pain management, published from 2004 to 2017, were collected. Keywords and meaningful morphemes from the abstracts were analyzed and refined, and their co-occurrence matrix was generated. Two networks of 140 and 424 keywords, respectively, of domestic and international studies were analyzed using NetMiner 4.3 software for degree centrality, closeness centrality, betweenness centrality, and eigenvector community analysis. Results: In both Korean and international studies, the most important, core-keywords were "pain," "patient," "pain management," "registered nurses," "care," "cancer," "need," "analgesia," "assessment," and "surgery." While some keywords like "education," "knowledge," and "patient-controlled analgesia" found to be important in Korean studies; "treatment," "hospice palliative care," and "children" were critical keywords in international studies. Three common sub-topic groups found in Korean and international studies were "pain and accompanying symptoms," "target groups of pain management," and "RNs' performance of pain management." It is only in recent years (2016~17), that keywords such as "performance," "attitude," "depression," and "sleep" have become more important in Korean studies than, while keywords such as "assessment," "intervention," "analgesia," and "chronic pain" have become important in international studies. Conclusion: It is suggested that Korean pain-management researchers should expand their concerns to children and adolescents, the elderly, patients with chronic pain, patients in diverse healthcare settings, and patients' use of opioid analgesia. Moreover, researchers need to approach pain-management with a quality of life perspective rather than a mere focus on individual symptoms.

• Nuclear Engineering and Technology
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• v.51 no.4
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• pp.1037-1040
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• 2019

For the past 50 years, graphite has been widely used as a moderator, reflector and fuel matrix in different kinds of gas-cooled reactors. Resulting in approximately 250,000 metric tons of irradiated graphite waste. One of the most significant long-lived radioisotope from graphite reactors is carbon-14 ($^{14}C$) with a half-life of 5730 years, this makes it a huge concern for deep geologic disposal of nuclear graphite (NG). Considering the lifecycle of NG a number of waste management options have been developed, mainly focused on the achievement the radiological requirements for disposal. The existing approaches for recycling depend on the cost to be economically viable. In this new study, an affordable process to remove $^{14}C$ has been proposed using samples taken from the Nuclear Power Plant in Latina (Italy) which have been used to investigate the capability of organic and inorganic solvents in removing $^{14}C$ from exfoliated nuclear graphite, with the aim to design a practicable approach to obtain graphite for recycling or/and safety disposed as L& LLW.

• Proceedings of the Plant Resources Society of Korea Conference
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• 2019.04a
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• pp.33-33
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• 2019

The AKT signaling pathway is a highly regulated cell signaling system that forms a network with other cell signaling pathways. Hence, the AKT signaling pathway mediates several important cellular functions that include cell survival, proliferation, cell migration, and et cetera. Irregularities that led overactive AKT signaling have been linked to many diseases such as cancer and metabolic-associated diseases. Hence, modulating the overactive AKT signaling pathway via inhibitor is a tantalizing prospect for treatment of cancer and metabolic-associated diseases. Two inhibitors of the AKT signaling pathway will be presented in this symposium: 1) Bisleuconothine A (BisA), a bisindole alkaloid that inhibit autophagy and 2) Ceramicine B (CerB), a limonoid that inhibit adipogenesis. The first topic is on a bisindole alkaloid, BisA and its mechanism in inducing autophagosome formation in lung cancer cell line, A549.(1) Since most autophagy inducing agents generally induce apoptosis, we found that BisA does not induce apoptosis even in high dose. BisA up-regulation of LC3 lipidation is achieved through mTOR inactivation. The phosphorylation of PRAS40, a mTOR repressor was suppressed by BisA. This observation suggested that BisA inactivates mTOR via suppression of PRAS40 phosphorylation. Interestingly, the phosphorylation of AKT, an upstream regulator of PRAS40 phosphorylation was also down-regulated by BisA. These findings suggested that Bis-A induces autophagosomes formation by interfering with the AKT-mTOR signaling pathway. The second topic is on CerB and its mechanism in inhibiting adipogenesis in preadipocytes cell line, MC3T3-G2/PA6.(2,3) CerB inhibits the phosphorylation of protein kinase B (AKT) at the Thr308 position but not the Ser473. Consequently, the phosphorylation of FOXO3 which is located downstream of AKT is also inhibited. Considering that FOXO3 is an important regulator of PPARγ which is a key factor in adipogenesis, CerB may inhibit adipogenesis via the AKT-FOXO3 signaling pathway. Taken together, both BisA and CerB highlighted the potential of AKT signaling pathway modulation as an approach to induce autophagy and inhibit the formation of fat cells, respectively.

• Biomedical Science Letters
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• v.25 no.1
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• pp.99-106
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• 2019

Amyloid positron emission tomography (PET) allows early and accurate diagnosis in suspected cases of Alzheimer's disease (AD) and contributes to future treatment plans. In the present study, a method of implementing a diagnostic system to distinguish ${\beta}$-Amyloid ($A{\beta}$) positive from $A{\beta}$ negative with objectiveness and accuracy was proposed using a machine learning approach, such as the Principal Component Analysis (PCA) and Support Vector Machine (SVM). $^{18}F$-Florbetaben (FBB) brain PET images were arranged in control and patients (total n = 176) with mild cognitive impairment and AD. An SVM was used to classify the slices of registered PET image using PET template, and a system was created to diagnose patients comprehensively from the output of the trained model. To compare the per-slice classification, the PCA-SVM model observing the whole brain (WB) region showed the highest performance (accuracy 92.38, specificity 92.87, sensitivity 92.87), followed by SVM with gray matter masking (GMM) (accuracy 92.22, specificity 92.13, sensitivity 92.28) for $A{\beta}$ positivity. To compare according to per-subject classification, the PCA-SVM with WB also showed the highest performance (accuracy 89.21, specificity 71.67, sensitivity 98.28), followed by PCA-SVM with GMM (accuracy 85.80, specificity 61.67, sensitivity 98.28) for $A{\beta}$ positivity. When comparing the area under curve (AUC), PCA-SVM with WB was the highest for per-slice classifiers (0.992), and the models except for SVM with WM were highest for the per-subject classifier (1.000). We can classify $^{18}F$-Florbetaben amyloid brain PET image for $A{\beta}$ positivity using PCA-SVM model, with no additional effects on GMM.

• Journal of Ginseng Research
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• v.43 no.1
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• pp.143-153
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• 2019

Background: Ginseng is one of the well-known medicinal plants, exhibiting diverse medicinal effects. Its roots possess anticancer and antiaging properties and are being used in the medical systems of East Asian countries. It is grown in low-light and low-temperature conditions, and its growth is strongly inhibited at temperatures above $25^{\circ}C$. However, the molecular responses of ginseng to heat stress are currently poorly understood, especially at the protein level. Methods: We used a shotgun proteomics approach to investigate the effect of heat stress on ginseng leaves. We monitored their photosynthetic efficiency to confirm physiological responses to a high-temperature stress. Results: The results showed a reduction in photosynthetic efficiency on heat treatment ($35^{\circ}C$) starting at 48 h. Label-free quantitative proteome analysis led to the identification of 3,332 proteins, of which 847 were differentially modulated in response to heat stress. The MapMan analysis showed that the proteins with increased abundance were mainly associated with antioxidant and translation-regulating activities, whereas the proteins related to the receptor and structural-binding activities exhibited decreased abundance. Several other proteins including chaperones, G-proteins, calcium-signaling proteins, transcription factors, and transfer/carrier proteins were specifically downregulated. Conclusion: These results increase our understanding of heat stress responses in the leaves of ginseng at the protein level, for the first time providing a resource for the scientific community.

• The Journal of Korean Academy of Prosthodontics
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• v.57 no.1
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• pp.75-80
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• 2019

Fall is the most common cause of trauma in the elderly and a major reason of dental injury. Maxillary anterior region is the most vulnerable area to the traumatic fall. Loss of teeth and adjacent tissue in this area results in maxillofacial defects and inappropriate maxillomandibular relationship. Reconstruction of the loss requires comprehensive and careful planning to fulfill not only functional but also esthetic demand. Prosthetic approach can avoid surgically extensive intervention, reducing both treatment cost and time. This clinical report describes a 78-year-old woman with the loss of teeth and alveolar bone in maxillary anterior region due to a traumatic fall, rehabilitated with a metal-ceramic fixed dental prosthesis using gingival porcelain.

• Psychiatry investigation
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• v.15 no.12
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• pp.1188-1202
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• 2018

Objective This study protocol aims to determine, using a rigorous approach in patients with bipolar disorder (BD) and non-seasonal major depressive episode (MDE), the characteristics of bright light therapy (BLT) administration (duration, escalation, morning and mid-day exposures) depending on the tolerance (hypomanic symptoms). Methods Patients with BD I or II and treated by a mood stabilizer are eligible. After 1 week of placebo, patients are randomized between either morning or mid-day exposure for 10 weeks of active BLT with glasses using a dose escalation at 7.5, 10, 15, 30 and 45 minutes/day. A further follow-up visit is planned 6 months after inclusion. Patients will be included by cohorts of 3, with at least 3 days of delay between them, and 1 week between cohorts. If none meet a dose limiting toxicity (DLT; i.e hypomanic symptoms), the initiation dose of the next cohort will be increased. If one patient meet a DLT, an additionnal cohort will start at the same dose. If 2 or 3 patients meet a DLT, from the same cohort or from two cohorts at the same dose initiation, the maximum tolerated dose is defined. This dose escalation will also take into account DLTs observed during the intra-subject escalation on previous cohorts, with a "Target Ceiling Dose" defined if 2 DLTs occured at a dose. Discussion Using an innovative and more ergonomic device in the form of glasses, this study aims to better codify the use of BLT in BD to ensure a good initiation and tolerance.

• Korean Medical Education Review
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• v.21 no.1
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• pp.1-12
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• 2019

This study is a narrative review introducing global trends in patient safety education within medical schools and exploring the status of Korean education. Core competences for patient safety include patient centeredness, teamwork, evidence- and information-based practice, quality improvement, addressing medical errors, managing human factors and system complexity, and patient safety knowledge and responsibility. According to a Korean report addressing the role of doctors, patient safety was described as a subcategory of clinical care. Doctors' roles in patient safety included taking precautions, educating patients about the side effects of drugs, and implementing rapid treatment and appropriate follow-up when patient safety is compromised. The Korean Association of Medical Colleges suggested patient safety competence as one of eight essential human and society-centered learning outcomes. They included appropriate attitude and knowledge, human factors, a systematic approach, teamwork skills, engaging with patients and carers, and dealing with common errors. Four Korean medical schools reported integration of a patient safety course in their preclinical curriculum. Studies have shown that students experience difficulty in reporting medical errors because of hierarchical culture. It seems that patient safety is considered in a narrow sense and its education is limited in Korea. Patient safety is not a topic for dealing with only adverse events, but a science to prevent and detect early system failure. Patient safety emphasizes patient perspectives, so it has a different paradigm of medical ethics and professionalism, which have doctor-centered perspectives. Medical educators in Korea should understand patient safety concepts to implement patient safety curriculum. Further research should be done on communication in hierarchical culture and patient safety education during clerkship.

• Journal of Korean Academy of Nursing
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• v.49 no.4
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• pp.398-410
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• 2019

Purpose: This study used a system dynamics methodology to identify correlation and nonlinear feedback structures among factors affecting adolescent cyberbullying victims (CV) in Korea and to construct and verify a simulation model. Methods: Factors affecting CV were identified by reviewing a theoretical background in existing literature and referencing various statistical data. Related variables were identified through content validity verification by an expert group, after which a causal loop diagram (CLD) was constructed based on the variables. A stock-flow diagram (SFD) using Vensim Professional 7.3 was used to establish a CV model. Results: Based on the literature review and expert verification, 22 variables associated with CV were identified and the CLD was prepared. Next, a model was developed by converting the CLD to an SFD. The simulation results showed that the variables such as negative emotions, stress levels, high levels of conflict in schools, parental monitoring, and time spent using new media had the strongest effects on CV. The model's validity was verified using equation check, sensitivity analysis for timestep and simulation with 4 CV adolescent. Conclusion: The system dynamics model constructed in this study can be used to develop intervention strategies in schools that are focused on counseling that can prevent cyberbullying and assist in the victims' recovery by formulating a feedback structure and capturing the dynamic changes observed in CV. To prevent cyberbullying, it is necessary to develop more effective strategies such as prevention education, counseling and treatment that considers factors pertaining to the individual, family, school, and media.