• Nuclear Engineering and Technology
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• v.55 no.1
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• pp.270-277
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• 2023

Exposure to ionizing radiation induces free radicals in human nails. These free radicals generate a radiation-induced signal (RIS) in electron paramagnetic resonance (EPR) spectroscopy. Compared with the RIS of tooth enamel samples, that in human nails is more affected by moisture and heat, but has the advantages of being sensitive to radiation and easy to collect. The fingernail as a biological sample is applicable in retrospective dosimetry in cases of localized hand exposure accidents. In this study, the dosimetric characteristics of fingernails were analyzed in fingernail clippings collected from Korean donors. The dose response, fading of radiation-induced and mechanically induced signals, treatment method for evaluation of background signal, minimum detectable dose, and minimum detectable mass were investigated to propose a fingernail-EPR dosimetry protocol. In addition, to validate the practicality of the protocol, blind and field experiments were performed in the laboratory and a non-destructive testing facility. The relative biases in the dose assessment result of the blind and field experiments were 8.43% and 21.68% on average between the reference and reconstructed doses. The results of this study suggest that fingernail-EPR dosimetry can be a useful method for the application of retrospective dosimetry in cases of radiological accidents.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.49 no.3
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• pp.135-141
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• 2023

Objectives: This study aimed to develop and validate machine learning (ML) models using H₂O-AutoML, an automated ML program, for predicting medication-related osteonecrosis of the jaw (MRONJ) in patients with osteoporosis undergoing tooth extraction or implantation. Patients and Methods: We conducted a retrospective chart review of 340 patients who visited Dankook University Dental Hospital between January 2019 and June 2022 who met the following inclusion criteria: female, age ≥55 years, osteoporosis treated with antiresorptive therapy, and recent dental extraction or implantation. We considered medication administration and duration, demographics, and systemic factors (age and medical history). Local factors, such as surgical method, number of operated teeth, and operation area, were also included. Six algorithms were used to generate the MRONJ prediction model. Results: Gradient boosting demonstrated the best diagnostic accuracy, with an area under the receiver operating characteristic curve (AUC) of 0.8283. Validation with the test dataset yielded a stable AUC of 0.7526. Variable importance analysis identified duration of medication as the most important variable, followed by age, number of teeth operated, and operation site. Conclusion: ML models can help predict MRONJ occurrence in patients with osteoporosis undergoing tooth extraction or implantation based on questionnaire data acquired at the first visit.

• Child Health Nursing Research
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• v.29 no.4
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• pp.280-289
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• 2023

Purpose: This study investigated weight status in survivors of childhood acute lymphocytic leukemia (ALL) and identified related factors. Methods: A retrospective review of the electronic medical records of survivors of childhood ALL (n=230) was conducted. We analyzed the survivors' characteristics, including sex, age, weight status at diagnosis, central nervous system involvement, risk classification, length of treatment, radiation therapy, and hematopoietic stem cell transplantation. Analysis of variance and the chi-squared test were applied to investigate influencing factors. Results: The weight status distribution was as follows: 23 individuals (10.0%) were classified as underweight, 151 individuals (65.7%) were healthy weight, and 56 individuals (24.3%) were overweight/obese. Age at diagnosis (F=10.03, p<.001), weight status at diagnosis (x²=43.41, p<.001), and risk classification (F=10.98, p=0.027) showed significant differences among the weight status groups. Survivors who were older at diagnosis and those in the very high-risk category had a higher likelihood of experiencing underweight status during their survivorship, while survivors who were overweight/obese at diagnosis were more likely to remain overweight/obese at the time of survival. Conclusion: Considering the potential health implications related to an unhealthy weight status in survivors of ALL, it is imperative to undertake early identification and implement interventions for at-risk individuals.

• The Korean Journal of Pain
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• v.33 no.2
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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.

• Quality Improvement in Health Care
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• v.6 no.1_2
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• pp.80-91
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• 1999

Background : With the CQI concepts, which emphasize doing the right things right the first time, we tried to enhance the timely completion of medical records by changing the review process from retrospective method to concurrent one. Methods : Against the current retrospective QA activity, Medical record administrator did the concurrent QA of the inpatient medical records with the deficiency sheets. One general surgery ward was chosen as a trial one. The deficiency rate of the medical records of the discharged patients was compared before and after the enforcement of the system. Job analysis of the medical record departments was done about four tertiary care hospitals located in Seoul to estimate the cost and the time consumed by current system. Results : There was a little improvement in the completion rate of the medical records after the trial. The new system was effective. And job analysis showed that much money and time were wasted by current retrospective feedback system. Conclusion : Though the result was not so satisfactory, it should be considered that this test was a voluntary one and the interns and residents were not forced to complete the medical records during this trial period. If there be any strong motivation to complete the medical record in time, this system is sure to be succeed. As the DRG system requires the concurrent review of the medical records to confirm severity of the patient's illness and to assure the timely discharge, it is desirable to enforce this method with the DRG system together. DRG coding and reducing deficiency rate of the medical records can be accomplished simultaneously.

• Journal of Periodontal and Implant Science
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• v.50 no.5
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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.

• Korean Journal of Clinical Pharmacy
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• v.22 no.4
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• pp.291-303
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• 2012

As respiratory tract infections (RTI) account for about 60% of all antibiotic prescriptions in outpatient care setting, there are significant concerns about emerging resistance that are largely due to the excessive or inappropriate use of antibacterial agents for viral respiratory infections. This study was aimed to develop retrospective drug utilization review (DUR) program of antibiotics for RTIs using Delphi methods. Retrospective DUR criteria of antibiotics for RTIs were identified based on clinical practice guidelines and opinion of experts. Expert panel members were clinical doctors and pharmacists and Delphi method was applied by survey on 16 members of panels. The claim data from Korean Health Insurance Review & Assessment (HIRA) were used to examine trends in outpatient antibiotic prescription between Janunary to December of 2008. As results, Quality index for RTI was assessed for the claim type, antibiotics use of quantity, duration, number and cost. Antibiotic prescription rate for RTIs, Defined Daily Dose (DDD), and duration of antibiotics use were more recognized as significant quality index by experts' opinion. Use of first line agents suggested by guidelines was low and duration of antibiotics use was shorter compared to the recommendations. Antibiotics were over prescribed for RITs. However, dose and duration of antibiotics were under-used.

• The Journal of Advanced Prosthodontics
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• v.7 no.4
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• pp.338-342
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• 2015

PURPOSE. This retrospective study evaluated the outcome of implant-retained overdentures (IODs) after 5-19 years of clinical function. MATERIALS AND METHODS. A retrospective analysis of patient files was performed referring to 27 patients who received 36 IODs with 3 different bar designs (group A=prefabricated round bars, n=7; group B=one-piece anterior milled bars, n=20; and group C=two bilaterally placed milled bars, n=9) in the mandible (n=24) and/or in the maxilla (n=12). The analysis focused on the survival and success rates (according to Kaplan-Meier) of the implants and prostheses. Technical complication rates for each type of restoration were analyzed and compared via one-way ANOVA and the Chi-squared test. The prevalence of peri-implantitis (radiographic bone loss ${\geq}3.5mm$) was evaluated by digital analysis of panoramic radiographs taken postoperative (baseline) and after 5-19 years of clinical function (follow-up). RESULTS. The mean observational time was 7.3 years. The survival rates of the prostheses and implants were 100% and 97.7%, respectively. Technical complications occurred more frequently in group A (mean: 3.5 during observational time) than in the other two groups (B: 0.8; C: 1.0). However, this difference was not statistically significant (P=0.58). Peri-implantitis was diagnosed for 12.4% of the implants in 37% of the patients. CONCLUSION. Bar-retained IODs are an adequate treatment option for edentulous jaws. These restorations may exhibit high implant/prosthesis survival rates (>97%), and a limited incidence of technical complications after a mean observational period of >7 years. Nevertheless, peri-implantitis was identified as a frequent and serious biological complication for this type of reconstruction.

• Journal of radiological science and technology
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• v.34 no.4
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• pp.315-321
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• 2011

The goal of this study is to reduce patient exposure dose by providing image quality and radiation dose according to inspection methods. Volume Computed Tomography Dose Index(CTDIvol) and Dose Length Product(DLP) of prospective and retrospective ECG gating snapshot segment of Coronary CT angiography(CTA) were measured each snapshot segment methods. CT number, noise, uniformity, and resolution were also measured using phantom under the same condition of coronary CTA. The results showed that CT number, noise, uniformity and resolution are similar to each other. In terms of CTDIvol and DLP, however, measurement dose of prospective ECG gating snapshot segment was lower than the retrospective case by 37.5% and 40.3%. Therefore, it is highly recommended that in the coronary CTA, prospective ECG gating scan mode should be chosen to reduce patient dose.

• Journal of Environmental Impact Assessment
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• v.21 no.2
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• pp.327-338
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• 2012

Environmental specimen banks provide the baselines for the scientists and decision makers to do research using the past and present specimens to expect the possible contaminant implications of the future. Many chemicals that are considered harmless now but not found may be found and pose threats in the future. Collected specimens of animals and plants should be conserved without contamination for future analysis. To ensure the availability of samples for the retrospective analysis, the establishment and maintenance of specimen banks in the developing and developed nations has become absolutely necessary. National Environmental Specimen Bank (NESB) established at National Institute of Environmental Research (NIER) in 2009. For the application of NESB, several activities such as standard operating procedures (SOPs) development have been prepared. This study applied the guidelines for sampling and sample treatment of five environmental specimens which had been prepared from 2007 to 2009. The target species were shoots of red pine and Korean pine, leaves of Mongolian oak, eggs of domestic pigeon and muscles and livers of common carp. The NESB will enhance the quality of environmental assessment and environmental monitoring based on real time and retrospective analysis.