• The Korean Journal of Pain
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• 제33권2호
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• pp.144-152
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• 2020

Background: Hemidiaphragmatic paralysis, a frequent complication of the brachial plexus block performed above the clavicle, is rarely associated with an infraclavicular approach. The costoclavicular brachial plexus block is emerging as a promising infraclavicular approach. However, it may increase the risk of hemidiaphragmatic paralysis because the proximity to the phrenic nerve is greater than in the classical infraclavicular approach. Methods: This retrospective analysis compared the incidence of hemidiaphragmatic paralysis in patients undergoing costoclavicular and supraclavicular brachial plexus blocks. Of 315 patients who underwent brachial plexus block performed by a single anesthesiologist, 118 underwent costoclavicular, and 197 underwent supraclavicular brachial plexus block. Propensity score matching selected 118 pairs of patients. The primary outcome was the incidence of hemidiaphragmatic paralysis, defined as a postoperative elevation of the hemidiaphragm > 20 mm. Factors affecting the incidence of hemidiaphragmatic paralysis were also evaluated. Results: Hemidiaphragmatic paralysis was observed in three patients (2.5%) who underwent costoclavicular and 47 (39.8%) who underwent supraclavicular brachial plexus blocks (P < 0.001; odds ratio, 0.04; 95% confidence interval, 0.01-0.13). Both the brachial plexus block approach and the injected volume of local anesthetic were significantly associated with hemidiaphragmatic paralysis. Conclusions: The incidence of hemidiaphragmatic paralysis is significantly lower with costoclavicular than with supraclavicular brachial plexus block.

• Journal of Periodontal and Implant Science
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• 제50권5호
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• pp.303-312
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• 2020

Purpose: The purpose of this study was to evaluate severe periodontitis with tooth loss as a modifiable risk factor for Alzheimer dementia (AD), vascular dementia (VaD), and mixed dementia (MD) using the National Health Insurance Service-National Health Screening Retrospective Cohort database with long-term follow-up over 14 years. Methods: Multivariate Cox hazards regression analysis was applied to a longitudinal retrospective database, which was updated in 2018, to evaluate the association between severe periodontitis with few remaining teeth and dementia after adjusting for potential risk factors, including sociodemographic factors and comorbid diseases. Results: Among 514,866 individuals in South Korea, 237,940 (46.2%) participants satisfying the inclusion criteria were selected. A total of 10,115 age- and sex-matched participants with severe periodontitis and 10,115 periodontally healthy participants were randomly selected and evenly assigned. The results showed that the risks of AD (hazard ratio [HR], 1.08), VaD (HR, 1.24), and MD (HR, 1.16) were significantly higher in patients with severe periodontitis with 1-9 remaining teeth after adjustment for sociodemographic factors, anthropomorphic measurements, lifestyle factors, and comorbidities. Conclusions: Severe periodontitis with few remaining teeth (1-9) may be considered a modifiable risk factor for the development of AD, VaD, and MD in Korean adults.

• 한방재활의학과학회지
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• 제30권3호
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• pp.117-127
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• 2020

Objectives The purpose of this study was to compare the effect of herb medication based on 'Go-bang' treatment, 'Huse-bang' treatment for patients with acute neck pain caused by traffic accidents. Methods We studied 40 patients with acute neck pain after traffic accidents who had admitted to Department of Korean Medicine Rehabilitation, College of Korean Medicine, Daejeon University from November 25, 2018 to November 25, 2019. 20 patients had received Herb Medication Based on 'Go-bang' and 20 patients had received herb medication based on 'Huse-bang' three times a day. The study was conducted as a retrospective observation study which analyze the patient's medical records. We used visual analogue scale (VAS) to evaluate pain reduction and neck disability index (NDI) to evaluate function improvement twice (hospitalization day and 5 days later). Statistical analysis was performed using the IBM SPSS statistics 25 program. Result The VAS scores, NDI scores decreased statistically significantly after treatment in all patients. Both 'Go-bang' and 'Huse-bang'groups showed a statistically significant VAS reduction and improvement of NDI on the fifth day of hospitalization. In the 'Huse-bang' group, there was a statistically significant improvement of NDI than in the 'Go-bang' group. Conclusion We found that both types of herbal-medication were significantly effective on acute neck pain and neck disability after traffic accident. Further study is needed about the comparison of effectiveness between Go-bang' and 'Huse-bang'groups.

• Asian Journal of Atmospheric Environment
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• 제8권4호
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• pp.212-224
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• 2014

There are several studies on the effects of emissions of highly reactive volatile organic compounds (HRVOC) from the industrial sources in the Houston-Galveston-Brazoria (HGB) area on the high ozone events during the Texas Air Quality Study (TexAQS) in summer of 2000. They showed that the modeled atmosphere lacked reactivity to produce the observed high ozone event and suggested "imputation" of HRVOC emissions from the base inventory. Byun et al. (2007b) showed the imputed inventory leads to too high ethylene concentrations compared to the measurements at the chemical super sites but still too little aloft compared to the NOAA aircraft. The paper suggested that the lack of reactivity in the modeled Houston atmosphere must be corrected by targeted, and sometimes of episodic, increase of HRVOC emissions from the large sources such as flares in the Houston Ship Channel (HSC) distributed into the deeper level of the boundary layer. We performed retrospective meteorological and air quality modeling to achieve better air quality prediction of ozone by comparison with various chemical and meteorological measurements during the Texas Air Quality Study periods in August-September 2006 (TexA QS-II). After identifying several shortcomings of the forecast meteorological simulations and emissions inputs, we prepared new retrospective meteorological simulations and updated emissions inputs. We utilized assimilated MM5 inputs to achieve better meteorological simulations (detailed description of MM5 assimilation can be found in F. Ngan et al., 2012) and used them in this study for air quality simulations. Using the better predicted meteorological results, we focused on the emissions uncertainty in order to capture high peak ozone which occasionally happens in the HGB area. We described how the ozone predictions are affected by emissions uncertainty in the air quality simulations utilizing different emission inventories and adjustments.

• The Korean Journal of Pain
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• 제33권3호
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• pp.267-274
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• 2020

Background: General anesthesia (GA) has been considered the anesthetic technique which most frequent leads to phantom limb pain (PLP) after a limb amputation. However, these prior reports were limited by small sample sizes. The aims of this study were to evaluate the incidence of PLP according to the various anesthetic techniques used for limb amputation and also to compare the occurrence of PLP according to amputation etiology using the Korean Health Insurance Review and Assessment Service for large-scale demographic information. Methods: The claims of patients who underwent limb amputation were reviewed by analyzing the codes used to classify standardized medical behaviors. The patients were categorized into three groups-GA, neuraxial anesthesia (NA), and peripheral nerve block (PNB)-in accordance with the anesthetic technique. The recorded diagnosis was confirmed using the diagnostic codes for PLP registered within one year after the limb amputation. Results: Finally, 7,613 individuals were analyzed. According to the recorded diagnoses, 362 patients (4.8%) developed PLP after amputation. Among the 2,992 patients exposed to GA, 191 (6.4%) were diagnosed with PLP, whereas 121 (4.3%) of the 2,840 patients anesthetized with NA, and 50 (2.8%) of the 1,781 patients anesthetized under PNB developed PLP. The relative risks were 0.67 (95% confidence interval [CI], 0.53-0.84; P < 0.001) for NA and 0.43 (95% CI, 0.32-0.59; P < 0.001) for PNB. Conclusions: In this retrospective cohort study, using large-scale population-based databases, the incidence rates of PLP after limb amputations were, in the order of frequency, GA, NA, and PNB.

• Clinical and Experimental Reproductive Medicine
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• 제48권3호
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• pp.262-267
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• 2021

Objective: Progesterone application for luteal phase support is a well-established concept in in vitro fertilization (IVF) treatment. Water-soluble subcutaneous progesterone injections have shown pregnancy rates equivalent to those observed in patients receiving vaginal administration in randomized controlled trials. Our study aimed to investigate whether the results from those pivotal trials could be reproduced in daily clinical practice in an unselected patient population. Methods: In this retrospective cohort study in non-standardized daily clinical practice, we compared 273 IVF cycles from 195 women undergoing IVF at our center for luteal phase support with vaginal administration of 200 mg of micronized progesterone three times daily or subcutaneous injection of 25 mg of progesterone per day. Results: Various patient characteristics including age, weight, height, number of oocytes, and body mass index were similar between both groups. We observed no significant differences in the clinical pregnancy rate (CPR) per treatment cycle between the subcutaneous (39.9%) and vaginal group (36.5%) (p=0.630). Covariate analysis showed significant correlations of the number of transferred embryos and the total dosage of stimulation medication with the CPR. However, after adjustment of the CPR for these covariates using a regression model, no significant difference was observed between the two groups (odds ratio, 0.956; 95% confidence interval, 0.512-1.786; p=0.888). Conclusion: In agreement with randomized controlled trials in study populations with strict selection criteria, our study determined that subcutaneous progesterone was equally effective as vaginally applied progesterone in daily clinical practice in an unselected patient population.

• Safety and Health at Work
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• 제12권3호
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• pp.390-395
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• 2021

Background: Health-care providers typically undergo shift work and are subjected to increased stress. Night shift work may induce disturbed sleep cycles and circadian rhythm. The objective of this study was to explore if night shift workers (NSWs) show an increased risk of abnormal thyroid-stimulating hormone (TSH). Methods: We conducted a retrospective cohort study of 574 employees without thyroid disease and abnormal TSH at baseline who underwent annual check-ups between 2007 and 2016 in a medical center. NSWs were defined as those with working time schedules other than daytime hours. We calculated the incidence rate and estimated the adjusted hazard ratio (HR) for incident abnormal TSH and subclinical hypothyroidism compared with non-NSWs using a Cox regression model. Results: A total of 56 incident abnormal TSH cases and 39 subclinical hypothyroidism cases in NSWs were identified during 3000 person-years of follow-up. In models adjusted for age, sex, obesity, and working departments, we found no increased relative risk for incident abnormal TSH (HR: 0.72, 95% confidence interval: 0.33-1.60) or subclinical hypothyroidism (HR: 0.52, 95% confidence interval: 0.19-1.45) when comparing NSWs to non-NSWs; nor were incidence rates significantly different among exclusively medical employees after excluding administrative staff. Conclusion: In this hospital-based nine-year follow-up retrospective cohort study, NSWs were not associated with increased relative risk of incident abnormal TSH and subclinical hypothyroidism, in contrast to previous cross-sectional studies.

• 대한두개안면성형외과학회지
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• 제22권3호
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• pp.141-147
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• 2021

Background: Arteriovenous malformation (AVM) which is a high-blood-flow lesion with connections between arteries and veins without an intervening capillary bed, is difficult to manage. The ear is the second most common site of extracranial AVM. However, studies regarding the management of this condition remain lacking. The purpose of this study was to share managing experiences in our center and to investigate the treatment effect through a retrospective analysis of cases. Methods: Among 265 patients with AVM treated in our vascular anomalies center between January 2008 and January 2021, 10 patients with auricular AVM were included in the study to investigate the lesion distribution, clinical stage, and treatment methods by performing a retrospective evaluation. Results: Among 10 patients, five patients had AVMs distributed in the upper half of the ear, one patient in the lower half of the ear, and four patients in whole ear, respectively. Seven patients had Schobinger stage II, and three had stage III. One patient received surgical treatment only, four patients received sclerotherapy only, and five patients received both surgical treatment and sclerotherapy. The posttreatment status was checked as controlled in two patients, improved in seven patients, persistent in one patient. There were no worsening patients. Conclusion: Auricular AVM is a disease that is difficult to manage by one specific department, thus requiring a collaborative management effort from multidisciplinary team.

• 대한한방내과학회지
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• 제43권3호
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• pp.413-422
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• 2022

Objectives: To investigate the weight loss effect of Gambi-tang in obese and overweight adults. Methods: From September 1, 2016 to December 31, 2021, a retrospective chart analysis was conducted on adult men and women who were prescribed Gambi-tang to address obesity and overweight in the National Medical Center (NMC). Partial analysis by age, obesity (Body Mass Index, BMI), duration of dose, and cumulative dose was also conducted. Results: The weight and BMI of the study subjects showed a significant decrease of more than 5% on average before and after treatment. In an analysis of age, significant differences by age could not be confirmed. In the analysis by obesity level, the effect of reducing weight, body fat, and abdominal fat rates in the obese and highly obese groups was greater than in the normal and overweight groups. There was no significant difference by group in the analysis by dosage period. In the analysis by cumulative dose, the greater the cumulative dose up to 1,800 g, the greater the decrease in weight and body fat. The side effect that patients appealed to the most was misjudgment, but not to a serious extent. Conclusions: Gambi-tang has been shown to be effective in weight and body fat loss for both obese and overweight adult men and women.

• 한방재활의학과학회지
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• 제32권3호
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• pp.109-117
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• 2022

Objectives To compare the therapeutic effect of ultrasound guided soyeom pharmacopuncture therapy and unguided soyeom pharmacopuncture therapy on cervical facet joint of patient who have cervical pain caused by traffic accidents. Methods The study was planned as a retrospective study that analyzes the patient's medical records. We analyzed medical records of 20 patients with acute cervical pain caused by traffic accidents from April 1, 2022 to May 31, 2022. 10 patients (Group A) were treated ultrasound guided soyeom pharmacopuncture therapy on cervical facet joint, 10 patients (Group B) were treated unguided soyeom pharmacopuncture therapy on cervical facet joint. We used visual analogue scale (VAS) and neck disability index (NDI) to evaluate improvements in cervical functions and pain, five point Likert scale to estimate patient's satisfaction. We used the IBM SPSS Statistics version 25 program (IBM Co., Armonk, NY, USA) for statistical analysis. Results Group A showed a significant decrease in the VAS on the 5^th day of the soyeom pharmacopuncture therapy (p=0.001). However, there was no statistically significant difference of VAS between two groups (p=0.142). Group A showed significant decrease in the NDI on the 5^th day of the therapy (p=0.002). Also, there was statistically significant difference on NDI between two groups (p=0.018). Difference of five point Likert scale between two groups was not statistically significant (p=0.407). Conclusions In patients of acute cervical pain caused by traffic accidents, ultrasound guided soyeom pharmacopuncture therapy on cervical facet joint showed significant efficacy on reduction of neck disability compared with unguided therapy.