• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.24 no.1
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• pp.100-108
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• 2021

Purpose: Percutaneous endoscopic gastrostomy (PEG) tube placements are commonly performed pediatric endoscopic procedures. Because of underlying disease, these patients are at increased risk for airway-related complications. This study compares patient characteristics and complications following initial PEG insertion with general endotracheal anesthesia (GETA) vs. anesthesia-directed deep sedation with a natural airway (ADDS). Methods: All patients 6 months to 18 years undergoing initial PEG insertion within the endoscopy suite were considered for inclusion in this retrospective cohort study. Selection of GETA vs. ADDS was made by the anesthesia attending after discussion with the gastroenterologist. Results: This study included 168 patients (GETA n=38, ADDS n=130). Cohorts had similar characteristics with respect to sex, race, and weight. Compared to ADDS, GETA patients were younger (1.5 years vs. 2.9 years, p=0.04), had higher rates of severe American Society of Anesthesiologists (ASA) disease severity scores (ASA 4-5) (21% vs. 3%, p<0.001), and higher rates of cardiac comorbidities (39.5% vs. 18.5%, p=0.02). Significant associations were not observed between GETA/ADDS status and airway support, 30-day readmission, fever, or pain medication in unadjusted or adjusted models. GETA patients had significantly increased length of stay (eβ=1.55, 95% confidence interval [CI]=1.11-2.18) after adjusting for ASA class, room time, anesthesia time, fever, and cardiac diagnosis. GETA patients also had increased room time (eβ=1.20, 95% CI=1.08-1.33) and anesthesia time (eβ=1.50, 95% CI=1.30-1.74) in adjusted models. Conclusion: Study results indicate that younger and higher risk patients are more likely to undergo GETA. Children selected for GETA experienced longer room times, anesthesia times, and hospital length of stay.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.26 no.1
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• pp.50-57
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• 2023

Purpose: The purpose of this study was to determine the pattern of human leukocyte antigen (HLA)-DQ genotype in children diagnosed with celiac disease (CD) (biopsy proven), and to compare this with a control group; and secondarily, to correlate HLA genotypes with clinical profiles of CD. Methods: This cross-sectional comparative observational study included 26 controls and 52 patients diagnosed with CD who presented at Sir Padampat Mother and Child Health Institute, Jaipur, from May, 2017 to October, 2018. HLA DQ genotype was assessed for each patients and correlated with clinical profiles. Results: HLA DQ2/DQ8 genotypes were significantly more common in CD (present in 100.0% cases) than in controls (23.1%) in Northern India (Rajasthan). When HLA DQ2.5 and DQ8 were present together, individuals had significantly more atypical presentations and severe findings on duodenal biopsy. Similarly, patients with the HLA DQ 2.5 genotype were also predisposed to more severe endoscopic findings, while HLA DQ2.2 predisposed them to less severe biopsy findings. HLA DQ8 was significantly associated with later age at diagnosis (>5 years) and shorter stature. The highest HLA DQ relative risk (RR) for CD development was associated with HLA DQ2.5 and DQ2.2 in combination, followed by HLA DQ2.5 and DQ8 in combination, while HLA DQx.5 and HLA DQ2.2 together had the lowest risk. Conclusion: HLA DQ2/DQ8 genotypes are strongly associated with pediatric CD patients in northern India. These genotypes and their combinations may be associated with different clinical presentations of CD, and may help predict severity of CD.

• The korean journal of orthodontics
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• v.53 no.1
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• pp.3-15
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• 2023

Objective: Body dysmorphic disorder (BDD) is a form of obsessive-compulsive disorder that may be negatively associated with the self-image. It might be associated with orthodontic treatment demand and outcome, and therefore is important. Thus, this study was conducted. Methods: The Yale-Brown Obsessive-Compulsive Scale modified for Body Dysmorphic Disorder (BDD-YBOCS) questionnaire was used in 699 orthodontic patients above 12 years of age (222 males, 477 females), at seven clinics in two cities (2020-2021). BDD diagnosis and severity were calculated based on the first 3 items and all 12 items of the questionnaire. The dental health component of the index of orthodontic treatment need (IOTN-DHC) was assessed by orthodontists. Multivariable and bivariable statistical analyses were performed on ordinal and dichotomized BDD diagnoses to assess potentially associated factors (IOTN-DHC, age, sex, marital status, education level, and previous orthodontic consultation) (α = 0.05). Results: IOTN-DHC scores 1-5 were seen in 13.0%, 39.9%, 29.8%, 12.4%, and 4.9% of patients. Age/sex/marital status/education were not associated with IOTN-DHC (p > 0.05). Based on 3-item questionnaire, 17.02% of patients had BDD (14.02% mild). Based on 12-item questionnaire, 2.86% had BDD. BDD was more prevalent or severer in females, married patients, patients with a previous history of orthodontic consultation, and patients with milder IOTN-DHCs (p < 0.05). Conclusions: IOTNDHC was negatively/slightly associated with BDD in orthodontic patients. Being female and married may increase BDD risk.

• The Journal of Korean Medicine
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• v.43 no.4
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• pp.102-130
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• 2022

Objectives: The persistence and unpredictability of coronavirus disease (COVID-19) and new measures to prevent direct medical intervention (e.g., social distancing and quarantine) have induced various psychological symptoms and disorders that require self-treatment approaches and integrative treatment interventions. To address these issues, the Korean Medicine Mental Health (KMMH) center developed a field manual by reviewing previous literature and preexisting manuals. Methods: The working group of the KMMH center conducted a keyword search in PubMed in June 2021 using "COVID-19" and "SARS-CoV-2". Review articles were examined using the following filters: "review," "systematic review," and "meta-analysis." We conducted a narrative review of the retrieved articles and extracted content relevant to previous manuals. We then created a treatment algorithm and recommendations by referring to the results of the review. Results: During the initial assessment, subjective symptom severity was measured using a numerical rating scale, and patients were classified as low- or moderate-high risk. Moderate-high-risk patients should be classified as having either a psychiatric emergency or significant psychiatric condition. The developed manual presents appropriate psychological support for each group based on the following dominant symptoms: tension, anxiety-dominant, anger-dominant, depression-dominant, and somatization. Conclusions: We identified the characteristics of mental health problems during the COVID-19 pandemic and developed a clinical mental health support manual in the field of Korean medicine. When symptoms meet the diagnostic criteria for a mental disorder, doctors of Korean medicine can treat the patients according to the manual for the corresponding disorder.

• International conference on construction engineering and project management
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• 2022.06a
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• pp.823-830
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• 2022

The risk of project execution increases due to the enlargement and complexity of Engineering, Procurement, and Construction (EPC) plant projects. In the fourth industrial revolution era, there is an increasing need to utilize a large amount of data generated during project execution. The design is a key element for the success of the EPC plant project. Although the design cost is about 5% of the total EPC project cost, it is a critical process that affects the entire subsequent process, such as construction, installation, and operation & maintenance (O&M). This study aims to develop a system using machine-learning (ML) techniques to predict risks and support decision-making based on big data generated in an EPC project's design and construction stages. As a result, three main modules were developed: (M1) the design cost estimation module, (M2) the design error check module, and (M3) the change order forecasting module. M1 estimated design cost based on project data such as contract amount, construction period, total design cost, and man-hour (M/H). M2 and M3 are applications for predicting the severity of schedule delay and cost over-run due to design errors and change orders through unstructured text data extracted from engineering documents. A validation test was performed through a case study to verify the model applied to each module. It is expected to improve the risk response capability of EPC contractors in the design and construction stage through this study.

• The Journal of Korean Medicine
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• v.45 no.1
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• pp.127-138
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• 2024

Objectives: Cold extremities have been suggested to correlate with sleep disturbances. This study aims to explore the relationship between thermal sensations in body, encompassing both cold and heat sensations, with sleep quality and insomnia. Methods: Self-administered questionnaires were utilized to assess thermal sensations in body, sleep quality and symptoms of insomnia in middle-aged women. A multiple logistic regression analysis was performed to ascertain the association between thermal sensations in body and both sleep quality and insomnia symptoms. Results: Among 899 participants, 255 (28.4%) were categorized in the cold sensation group, 95 (10.6%) in the heat sensation group, 70 (7.8%) in the group with both cold and heat sensations, and 479 (53.3%) in the no-sensation group. Pittsburgh Sleep Quality Index and Insomnia Severity Index were notably higher in the group experiencing both sensations when compared to the no-sensation group. After adjustments for covariates, the odds ratios for poor sleep quality, moderate/severe insomnia, and long sleep latency were significantly elevated in the group with both sensations when compared to the no-sensation group. The odds ratios for poor sleep quality in the cold sensation group and for moderate/severe insomnia and low sleep efficiency in the heat sensation group were significantly higher when compared to the no-sensation group. Conclusions: The risk for sleep disturbances varied depending on the presence of thermal sensations in body, with the greatest risk observed for low sleep quality and insomnia in individuals experiencing both cold and heat sensations.

• Journal of the korean academy of Pediatric Dentistry
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• v.43 no.4
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• pp.410-418
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• 2016

This study examined the prevalence of MIH and severity of hypomineralization exhibited by MIH-affected tooth based on the clinical examination of 950 children between age 8 and 9 in the city of Jeonju. The etiology was also studied utilizing a questionnaire on the MIH risk factors. The prevalence of MIH was 7.1%. The examined MIH-affected teeth showed statically significant difference in the degree of their hypomineralization (p < 0.05). The permanent first molar showed greater frequency of MIH compared to the permanent incisor, and the MIH code 2a and 3 were only observed in the permanent first molar (p < 0.05). From the questionnaire, showed the significant relationship between the occurrence of MIH and risk factors such as stress and antibiotics intake during pregnancy, low birth weight and events like hospital admission, frequent respiratory infection, high fever and long-term antibiotics intake within the three years of children's lives (p < 0.05). Among all the possible risk factors, the antibiotics intake during pregnancy only showed high correlation with the incidence of MIH (p < 0.05).

• Journal of the Korean Society of Marine Environment & Safety
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• v.22 no.7
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• pp.791-799
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• 2016

The purpose of this work is to analyse the impact of new accident risks on maritime safety in Korea. The new accident risks have been induced from new/rare or unprecedented events in world maritime transportation, as identified by 46 experts in the previous study. To measure the impact of these new accident risks on maritime safety in Korea, the statistical accident data reported by the Korean Maritime Safety Tribunals (KMST) has been used for calculation, and the concept of Risk Index (RI) = Frequency Index (FI) + Severity Index (SI)established in a Formal Safety Assessment (FSA) by the IMO has also been introduced. After calculating two kinds of weight for FI and SI from the statistical accident data, high ranked scenarios were identified and their relationships between new risks and these scenarios were analysed. The results from this analysis showed, the root cause of the top-ranked scenario to be "developing high technology", which leads to "shorten cargo handling time". These results differed from optimum RCOs such as "business competition" and "crewing problems" which were identified in the previous study.

• Clinical and Experimental Pediatrics
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• v.50 no.6
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• pp.519-523
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• 2007

Aplastic anemia is a rare disease, which is characterized by pancytopenia and hypocellular bone marrow without infiltration of abnormal cells or fibrosis. The incidence in Asia is higher than in the West and new cases are diagnosed at a rate of 5.1 per million pediatric populations per year in Korea. The pathophysiology is understood roughly by defective hematopoiesis, impaired bone marrow micro-environment and immune mechanism. Treatments are performed on basis of pathogenesis and selected depending on the severity. Immunosuppressive therapy with antilymphocyte or antithymocyte globulin and cyclosporine is effective in the majority of patients but has some problems including relapse or clonal evolution. Recently, there have been clinical trials of immunosuppression with hematopoietic growth factors or other drugs. Allogeneic hematopoietic stem cell transplantation (HSCT) is curative in children with severe aplastic anemia. The overall survival in HSCT from HLA-identical sibling is higher than alternative donor, including HLA matched unrelated donor or cord blood. We have to consider quality of life after HSCT because of high survival rate. However, chronic graft versus host disease and graft failure are important factors that affect the quality of life and overall survival. We need further investigation to make new regimens aimed at overcoming these risk factors and perform clinical trials.

• Clinical and Experimental Pediatrics
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• v.55 no.6
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• pp.185-192
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• 2012

The prevalence of allergic diseases has increased worldwide, a phenomenon that can be largely attributed to environmental effects. Among environmental factors, air pollution due to traffic is thought to be a major threat to childhood health. Residing near busy roadways is associated with increased asthma hospitalization, decreased lung function, and increased prevalence and severity of wheezing and allergic rhinitis. Recently, prospective cohort studies using more accurate measurements of individual exposure to air pollution have been conducted and have provided definitive evidence of the impact of air pollution on allergic diseases. Particulate matter and ground-level ozone are the most frequent air pollutants that cause harmful effects, and the mechanisms underlying these effects may be related to oxidative stress. The reactive oxidative species produced in response to air pollutants can overwhelm the redox system and damage the cell wall, lipids, proteins, and DNA, leading to airway inflammation and hyper-reactivity. Pollutants may also cause harmful effects via epigenetic mechanisms, which control the expression of genes without changing the DNA sequence itself. These mechanisms are likely to be a target for the prevention of allergies. Further studies are necessary to identify children at risk and understand how these mechanisms regulate gene-environment interactions. This review provides an update of the current understanding on the impact of air pollution on allergic diseases in children and facilitates the integration of issues regarding air pollution and allergies into pediatric practices, with the goal of improving pediatric health.