• Journal of Yeungnam Medical Science
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• v.38 no.3
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• pp.208-218
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• 2021

Background: Hemophagocytic lymphohistiocytosis (HLH) is a rare but severe, life-threatening inflammatory condition if untreated. We aimed to investigate the etiologies, outcomes, and risk factors for death in children and adults with HLH. Methods: The medical records of patients who met the HLH criteria of two regional university hospitals in Korea between January 2001 and December 2019 were retrospectively investigated. Results: Sixty patients with HLH (35 children and 25 adults) were included. The median age at diagnosis was 7.0 years (range, 0.1-83 years), and the median follow-up duration was 8.5 months (range, 0-204 months). Four patients had primary HLH, 48 patients had secondary HLH (20 infection-associated, 18 neoplasm-associated, and 10 autoimmune-associated HLH), and eight patients had HLH of unknown cause. Infection was the most common cause in children (14/35, 40.0%), whereas neoplasia was the most common cause in adults (13/25, 52.0%). Twenty-eight patients were treated with HLH-2004/94 immunochemotherapy. The 5-year overall survival (OS) rate for all HLH patients was 59.9%. The 5-year OS rates for patients with primary, infection-associated, neoplasm-associated, autoimmune-associated, and unknown cause HLH were 25.0%, 85.0%, 26.7%, 87.5%, and 62.5%, respectively. Using multivariate analysis, neoplasm-induced HLH (p=0.001) and a platelet count <50×10⁹/L (p=0.008) were identified as independent risk factors for poor prognosis in patients with HLH. Conclusion: Infection was the most common cause of HLH in children, while it was neoplasia in adults. The 5-year OS rate for all HLH patients was 59.9%. HLH caused by an underlying neoplasm or a low platelet count at the time of diagnosis were risk factors for poor prognosis.

• Journal of Neurogastroenterology and Motility
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• v.25 no.3
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• pp.343-362
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• 2019

Background/Aims There has been major progress in our understanding of the irritable bowel syndrome (IBS), and novel treatment classes have emerged. The Rome IV guidelines were published in 2016 and together with the growing body of Asian data on IBS, we felt it is timely to update the Asian IBS Consensus. Methods Key opinion leaders from Asian countries were organized into 4 teams to review 4 themes: symptoms and epidemiology, pathophysiology, diagnosis and investigations, and lifestyle modifications and treatments. The consensus development process was carried out by using a modified Delphi method. Results Thirty-seven statements were developed. Asian data substantiate the current global viewpoint that IBS is a disorder of gut-brain interaction. Socio-cultural and environmental factors in Asia appear to influence the greater overlap between IBS and upper gastrointestinal symptoms. New classes of treatments comprising low fermentable oligo-, di-, monosacharides, and polyols diet, probiotics, non-absorbable antibiotics, and secretagogues have good evidence base for their efficacy. Conclusions Our consensus is that all patients with functional gastrointestinal disorders should be evaluated comprehensively with a view to holistic management. Physicians should be encouraged to take a positive attitude to the treatment outcomes for IBS patients.

• Journal of Dental Anesthesia and Pain Medicine
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• v.21 no.4
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• pp.283-309
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• 2021

Achieving profound anesthesia in mandibular molars with irreversible pulpitis is a tedious task. This review aimed at evaluating the success of buccal/lingual infiltrations administered with a primary inferior alveolar nerve block (IANB) injection or as a supplemental injection after the failure of the primary injection in symptomatic and asymptomatic patients with irreversible pulpitis in human mandibular molars. The review question was "What will be the success of primary and supplemental infiltration injection in the endodontic treatment of patients with irreversible pulpitis in human mandibular molars?" We searched electronic databases, including Pubmed, Scopus, and Ebsco host and we did a comprehensive manual search. The review protocol was framed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) checklist. We included clinical studies that evaluated and compared the anesthetic outcomes of primary IANB with primary and/or supplementary infiltration injections. Standard evaluation of the included studies was performed and suitable data and inferences were assessed. Twenty-six studies were included, of which 13 were selected for the meta-analysis. In the forest plot representation of the studies evaluating infiltrations, the combined risk ratio (RR) was 1.88 (95% CI: 1.49, 2.37), in favor of the secondary infiltrations with a statistical heterogeneity of 77%. The forest plot analysis for studies comparing primary IANB + infiltration versus primary IANB alone showed a low heterogeneity (0%). The included studies had similar RRs and the combined RR was 1.84 (95% CI: 1.44, 2.34). These findings suggest that supplemental infiltrations given along with a primary IANB provide a better success rate. L'Abbe plots were generated to measure the statistical heterogeneity among the studies. Trial sequential analysis suggested that the number of patients included in the analysis was adequate. Based on the qualitative and quantitative analyses, we concluded that the infiltration technique, either as a primary injection or as a supplementary injection, given after the failure of primary IANB, increases the overall anesthetic efficacy.

• Safety and Health at Work
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• v.13 no.2
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• pp.163-169
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• 2022

Background: It is estimated that about 13 million artisanal and small-scale miners carry out their activities under harsh, precarious, unfriendly, and risky conditions. Yet, our understanding of the extent to which these workers use personal protective equipment (PPE) and navigate through the various risks and hazards they face is still limited. This article has two main objectives. First, it explores the extent of usage of PPE among artisanal and small-scale miners for the prevention of hazards and risks. Second, it examines the coping strategies used by these miners as a response to experiences of occupational injuries and risks Methods: A cross-sectional survey of small-scale miners was conducted in six communities across three districts in Ghana, West Africa. The mixed methods approach was adopted. A total of 148 small-scale miners participated in the study. Six focus group discussions (FGDs) were held across the six communities. The data were analysed using descriptive statistics. Chi-square tests were used to analyse the relationship between some socio-demographic characteristics (sex, age, and educational background) and the usage of PPE. Open-ended questions and responses from FGDs were analysed based on the content and verbatim quotations from miners. Results: Findings suggest that 78% of the miners interviewed do not use the appropriate PPE citing reasons such as cost, and their personal discomfort associated with use of PPE. There was no significant relationship between socio-demographic characteristics (i.e., sex, age, education and major mining activity) and the usage of PPE. The study further revealed four main coping strategies used by miners to handle the risks. These are rest, taking unprescribed medication and hard drugs, registration with health insurance scheme and savings and investments. Conclusion: This study shows that very few artisanal miners use PPE despite the significant hazards and risks to which they are exposed. The study recommends to the government to put in place measures to ensure that miners adhere to health and safety regulations before undertaking mining activities. This means that health and safety plans and use of PPE should be linked to the license acquisition process for miners.

• Journal of the Korean Institute of Traditional Landscape Architecture
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• v.37 no.1
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• pp.56-67
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• 2019

In order to investigate the issue with the proper name of eshel(Tamarix aphylla) mentioned in the Bible, analysis of morphological taxonomy features of plants, studies on the symbolism of the Tamarix genus, analysis of examples in Korean classics and Chinese classics, and studies on the problems found in translations of Korean, Chinese and Japanese Bibles. The results are as follows. According to plant taxonomy, similar species of the Tamarix genus are differentiated by the leaf and flower, and because the size is very small about 2-4mm, it is difficult to differentiate by the naked eye. However, T. aphylla found in the plains of Israel and T. chinensis of China and Korea have distinctive differences in terms of the shape of the branch that droops and its blooming period. The Tamarix genus is a very precious tree that was planted in royal courtyards of ancient Mesopotamia and the Han(漢) Dynasty of China, and in ancient Egypt, it was said to be a tree that gave life to the dead. In the Bible, it was used as a sign of the covenant that God was with Abraham, and it also symbolized the prophet Samuel and the court of Samuel. When examining the example in Korean classics, the Tamarix genus was used as a common term in the Joseon Dynasty and it was often used as the medical term '$Ch{\bar{e}}ngli{\check{u}}$(檉柳)'. Meanwhile, the term 'wiseonglyu(渭城柳)' was used as a literary term. Upon researching the period and name of literature related to $Ch{\bar{e}}ngli{\check{u}}$(檉柳) among Chinese medicinal herb books, a total of 16 terms were used and among these terms, the term Chuísīliǔ(垂絲柳) used in the Chinese Bible cannot be found. There was no word called 'wiseonglyu(渭城柳)' that originated from the poem by Wang Wei(699-759) of Tang(唐) Dynasty and in fact, the word 'halyu(河柳)' that was related to Zhou(周) China. But when investigating the academic terms of China currently used, the words Chuísīliǔ(垂絲柳) and $Ch{\bar{e}}ngli{\check{u}}$(檉柳) are used equally, and therefore, it appears that the translation of eshel in the Chinese Bible as either Chuísīliǔ (垂絲柳) or $Ch{\bar{e}}ngli{\check{u}}$(檉柳) both appear to be of no issue. There were errors translating tamarix into 'やなぎ(willow)' in the Meiji Testaments(舊新約全書 1887), and translated correctly 'ぎょりゅう(檉柳)' since the Colloquial Japanese Bible(口語譯 聖書 1955). However, there are claims that 'gyoryu(ぎょりゅう 檉柳)' is not an indigenous species but an exotics species in the Edo Period, so it is necessary to reconsider the terminology. As apparent in the Korean classics examples analysis, there is high possibility that Korea's T. chinensis were grown in the Korean Peninsula for medicinal and gardening purposes. Therefore, the use of the medicinal term $Ch{\bar{e}}ngli{\check{u}}$(檉柳) or literary term 'wiseonglyu' in the Korean Bible may not be a big issue. However, the term 'wiseonglyu' is used very rarely even in China and as this may be connected to the admiration of China and Chinese things by literary persons of the Joseon Dynasty, so the use of this term should be reviewed carefully. Therefore, rather than using terms that may be of issue in the Bible, it is more feasible to transliterate the Hebrew word and call it eshel.