• Journal of the Korean Association of Oral and Maxillofacial Surgeons
• /
• v.47 no.3
• /
• pp.175-182
• /
• 2021

Objectives: In this prospective randomized controlled trial, we measured the primary and secondary stability of two surface-treated implants placed in the posterior maxilla, applied 3-month loading protocols, and compared and analyzed the short-term outcomes of the implants. Patients and Methods: From June 2018 to June 2019, patients with a residual bone height of 4 mm in the posterior maxilla were enrolled and randomly divided into two groups to place SA implants (Osstem Implants, Korea) in Group A and NH implants (Hiossen, USA) in Group B. Finally, 14 implants placed in 13 patients in Group A and 17 implants placed in 14 patients in Group B were analyzed. The measured primary and secondary stability of each implant was represented by implant stability quotient (ISQ), and treatment outcomes were evaluated. Results: Group A consisted of patients with an average age of 62.2 years (range, 48-80 years), and Group B consisted of patients with an average age of 58.1 years (range, 35-82 years). Primary stability was 73.86±6.40 and 71.24±5.32 in Groups A and B, respectively (P=0.222). Secondary stability was 79.07±5.21 in Group A and 78.29±4.74 in Group B (P=0.667). A steep increase in ISQ during the healing period was observed in Group B, though it was not significant (P=0.265). The mean follow-up period was 378.5±164.6 days in Group A and 385.3±167.9 days in Group B. All implants in each group met the success criteria, and the success rate was 100%. Conclusion: Two surface-treated implants placed in the posterior maxilla with greater than 4 mm alveolar bone height exhibited successful one-year treatment outcomes if a primary stability of 65 or higher ISQ was obtained and a 3-month early loading protocol was applied.

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

• Journal of Environmental Health Sciences
• /
• v.47 no.3
• /
• pp.193-204
• /
• 2021

Objectives: In January 2021, the former heads of the manufacturer SK Chemical and the vendor Aekyung were acquitted for manufacturing and selling humidifier disinfectant (HD) containing 5-chloro-2-methylisothiazol-3(2H)-one/2-methylisothiazol-3(2H)-one (CMIT/MIT). In this article, we analyzed the rationale used in this judgement in the light of scientific consideration. Methods: The sentencing document for the judgements was obtained from the Korea Supreme Court Service. In particular, the judgements made by the court related to the toxicological and individual association with HD perspectives were discussed based on scientific evidence. Results: The ruling stated that the necessary conditions for causality between CMIT/MIT and such diseases were not met based on the fact that asthma and lung damage were not found in the inhalation exposure animal experiments. The judgment overlooked the inevitable limitations of using animal experiments for verifying health effects in humans, which are often inconsistent with the observations in animals. Among 11 governmentaffirmed lung injury cases with CMIT/MIT usage, three patients' humidifier disinfectant-associated lung injury (HDLI) pathology proved that CMIT/MIT could cause lung injury similar to that caused by PHMG and PGH. In addition, five children showed decreased lung function related to damage caused by humidifier disinfectant exposure. Conclusions: We conclude that there is sufficient evidence supporting the assertion that HDs containing CMIT/MIT cause lung injuries, including asthma, contrary to the court's decision.

• Journal of the Korea Academia-Industrial cooperation Society
• /
• v.22 no.3
• /
• pp.138-147
• /
• 2021

The purpose of this study was to develop a measuring tool for the health promotion behavior of Korean nurses. This would address the lack of a proven tool that reflects the nature of the nurses' nursing environment. This study was conducted on 530 nurses from January to December 2019. A literature review and focus group interview were conducted, data analysis was carried out to measure validity and reliability, and the conceptual framework was constructed by applying the IMB model. Five factors namely self-concept (2 questions), hospital life management (4 questions), knowledge and information regarding health (5 questions), physical and mental stress management (3 questions), and work adaptation (2 questions) were framed into 16 questions. The model fit was 346.23 (��<.001), Parsimonious Normed Fit Index (PNFI) was 0.60, and Parsimonious Comparative Fit Index (PCFI) was 0.63, which met the acceptance criteria, and the Root Mean Square Error of Approximation (RMSEA) was 0.10. Goodness of Fit Index (GFI) was 0.88, Comparative Fit Index (CFI) was 0.85, and Incremental Fit Index (IFI) was 0.85 which were found to be acceptable as per the applicable standards. All items had a Cronbach's �� score of .85, which ensured stable reliability. The nurse's health promotion behavior measurement tool developed in this study will be used to measure the nurse's health promotion behavior in terms of nursing practice which will help in understanding the broad contours of this behavior.

• Journal of Biomedical Engineering Research
• /
• v.42 no.4
• /
• pp.150-158
• /
• 2021

Intracranial hemorrhage (ICH) refers to acute bleeding inside the intracranial vault. Not only does this devastating disease record a very high mortality rate, but it can also cause serious chronic impairment of sensory, motor, and cognitive functions. Therefore, a prompt and professional diagnosis of the disease is highly critical. Noninvasive brain imaging data are essential for clinicians to efficiently diagnose the locus of brain lesion, volume of bleeding, and subsequent cortical damage, and to take clinical interventions. In particular, computed tomography (CT) images are used most often for the diagnosis of ICH. In order to diagnose ICH through CT images, not only medical specialists with a sufficient number of diagnosis experiences are required, but even when this condition is met, there are many cases where bleeding cannot be successfully detected due to factors such as low signal ratio and artifacts of the image itself. In addition, discrepancies between interpretations or even misinterpretations might exist causing critical clinical consequences. To resolve these clinical problems, we developed a diagnostic model predicting intracranial bleeding and its subtypes (intraparenchymal, intraventricular, subarachnoid, subdural, and epidural) by applying deep learning algorithms to CT images. We also constructed a visualization tool highlighting important regions in a CT image for predicting ICH. Specifically, 1) 27,758 CT brain images from RSNA were pre-processed to minimize the computational load. 2) Three different CNN-based models (ResNet, EfficientNet-B2, and EfficientNet-B7) were trained based on a training image data set. 3) Diagnosis performance of each of the three models was evaluated based on an independent test image data set: As a result of the model comparison, EfficientNet-B7's performance (classification accuracy = 91%) was a way greater than the other models. 4) Finally, based on the result of EfficientNet-B7, we visualized the lesions of internal bleeding using the Grad-CAM. Our research suggests that artificial intelligence-based diagnostic systems can help diagnose and treat brain diseases resolving various problems in clinical situations.

• Therapeutic Science for Rehabilitation
• /
• v.10 no.3
• /
• pp.57-69
• /
• 2021

Objective : The purpose of this study was to identify occupational therapy guidelines for patients with stroke according to the clinical guidelines, and to investigate the quality and characteristics of the identified guidelines. Methods : This involved a review of domestic and foreign rehabilitation treatment guidelines from 2008 to 2019. These guidelines were searched using, the search terms: 'stroke', 'guideline', 'practice guideline', 'recommendation', 'protocol compliance', 'practice guideline', and 'stroke guidelines'. Results : A total of 708 papers were identified from the search. Eight guidelines met the selection criteria and were included in this review. The selected guidelines were developed in Canada, Australia, the United States, the United Kingdom, and Korea. One of the eight guidelines was occupational therapy guidelines, and the other seven were rehabilitation guidelines. The guidelines were categorized into a total of 36 topics, including 28 guidelines for stroke rehabilitation in Australia, 24 guidelines for the British and American Heart Association, and 23 guidelines for stroke rehabilitation developed in Korea. Conclusion : In this study, the guidelines for occupational therapy for existing stroke patients were identified, and the quality and characteristics of the guidelines were compared. The results of this study will provide important basic data for the development of occupational therapy guidelines for stroke in the future.

• Journal of the Korean Geosynthetics Society
• /
• v.20 no.4
• /
• pp.1-7
• /
• 2021

In response to the carbon emission reduction trends and the depletion of natural sand caused by the use of cement in construction works, graphene oxide and porous feldspar were applied as countermeasures in this study. By using (3-aminopropyl)trimethoxysilane-functionalized graphene oxide with enhanced bond characteristics, a concrete specimen was prepared with 5% less cement content than that in a standard mortar mix, and the compressive strengths of the specimens were examined. The compressive strengths of the specimen with (3-aminopropyl)trimethoxysilane-functionalized graphene oxide and porous feldspar and the specimen with standard mixing were 26MPa and 28MPa, respectively, showing only a small difference. In addition, both specimens met the compressive strength of cement mortar required for geotechnical structures. It is believed that a reasonable level of compressive strength was maintained in spite of the lower cement content because the high content of pozzolans, namely SiO₂ and Al₂O₃, in the porous feldspar enhanced the reactions with Ca(OH)₂ during hydration, the nano-sized graphene surface acted as a reactive surface for the hydration products to react actively, and the strong covalent bonding of the carboxyl functional group increased the bonding strength of the hydration products.

• Journal of Yeungnam Medical Science
• /
• v.39 no.2
• /
• pp.141-149
• /
• 2022

Background: The present study evaluated the clinical implications of adjuvant chemotherapy according to the mismatch repair (MMR) status and clinicopathologic features of patients with intermediate- and high-risk stage II colon cancer (CC). Methods: This study retrospectively reviewed 5,774 patients who were diagnosed with CC and underwent curative surgical resection at Kyungpook National University Chilgok Hospital. The patients were enrolled according to the following criteria: (1) pathologically diagnosed with primary CC; (2) stage II CC classified based on the 7th edition of the American Joint Committee on Cancer staging system; (3) intermediate- and high-risk features; and (4) available test results for MMR status. A total of 286 patients met these criteria and were included in the study. Results: Among the 286 patients, 54 (18.9%) were identified as microsatellite instability-high (MSI-H) or deficient MMR (dMMR). Although all the patients identified as MSI-H/dMMR showed better survival outcomes, T4 tumors and adjuvant chemotherapy were identified as independent prognostic factors for survival. For the intermediate-risk patients identified as MSI-low (MSI-L)/microsatellite stable (MSS) or proficient MMR (pMMR), adjuvant chemotherapy exhibited a significantly better disease-free survival (DFS) but had no impact on overall survival (OS). Oxaliplatin-containing regimens showed no association with DFS or OS. Adjuvant chemotherapy was not associated with DFS in intermediate-risk patients identified as MSI-H/dMMR. Conclusion: The current study found that the use of adjuvant chemotherapy was correlated with better DFS in MSI-L/MSS or pMMR intermediate-risk stage II CC patients.

• Korean Journal of Clinical Pharmacy
• /
• v.32 no.3
• /
• pp.185-190
• /
• 2022

Background: Denosumab (Prolia®) is administered every 6 months for osteoporosis treatment. Co-administration of calcium and vitamin D is required to minimize hypocalcemia risk. We evaluated clinical outcomes based on the administration interval of denosumab and co-prescription with calcium-vitamin D combination products. Methods: A retrospective study was conducted using electronic medical records from 668 patients who started denosumab therapy between January 1 and December 31, 2018, at Seoul National University Bundang Hospital. Clinical outcomes, as measured by changes in T-score, were evaluated by the intervals and concurrent prescriptions with calcium-vitamin D combination products. Results: Of the 668 patients, 333 patients met the eligibility criteria. These patients were divided into two groups based on appropriateness of the administration interval: "Appropriate" (304 patients, 91.3%) and "Inappropriate" (29 patients, 8.3%). T-score changes were significantly higher in the "Appropriate" than in the "Inappropriate" group (0.30±0.44 vs. 0.13±0.37, p=0.048). At the beginning of the treatment, 221 patients (66.4%) were prescribed calcium-vitamin D combination products, but the changes in T-scores were not significantly different by the prescription status of the product (0.29±0.46 vs. 0.28±0.38, p=0.919). Conclusion: T-scores were significantly improved in patients with appropriate administration intervals. No significant changes in T-scores were observed by the prescription status with calcium-vitamin D combination products. For optimal treatment outcomes, prescribers should encourage adherence to the approved prescription information on dosage and administration, and pharmacists should provide medication counseling for patients.

• The Journal of the Convergence on Culture Technology
• /
• v.7 no.2
• /
• pp.419-425
• /
• 2021

This study analyzed the safety of evacuation according to the number of exits and the direction of evacuation routes with evacuation simulations of the Pathfinder in case of a fire at a highway service area. It was also analyzed of the difference in RSET by comparing the single or double types of the exit of a facility. The results were as follows. When only one direction exit was opened, all of the RSET were exceeded. When two or more different directions were opened according to the general principle of evacuation, all results met the RSET. The simulations showed that two or more different directions were more shortened in RSET than the one same direction. The result of the types of doors showed that the single type door was shortened in RSET rather than the double type doors. For the evacuation safety in a fire at the highway service areas, firstly, it is necessary to secure two or more exits in a fire at all times. Secondly, the exits should not be same directions. Finally, it is suggested that the exit should be installed with a single type of door.