• Journal of The Korean Society of Clinical Toxicology
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• v.18 no.2
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• pp.110-115
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• 2020

Purpose: Acute kidney injury (AKI) in patients with glyphosate poisoning has a poor prognosis. This study aimed to predict the risk factors for AKI in patients with glyphosate poisoning at the emergency department (ED). Methods: Clinical data on glyphosate poisoning patients at ED who were older than 18 years were collected retrospectively between January 2013 and December 2019. The clinical characteristics and clinical outcomes of the AKI group in patients with glyphosate poisoning were compared with the non-AKI (NAKI) group. Results: Of 63 glyphosate poisoning patients, AKI was observed in 15 (23.8%). The AKI patients group showed the following: old age (p=0.038), low systolic blood pressure (p=0.021), large amount of ingestion (p=0.026), delayed hospital visits (p=0.009), high white blood cells (WBC) (p<0.001), high neutrophil counts (p<0.001), high neutrophil-lymphocyte (LN) ratios (p<0.001), high serum potassium (p=0.005), low arterial blood pH (p=0.015), and low pO2 (p=0.021), low bicarbonate (p=0.009), and high Poisoning Severity Score (PSS) (p<0.001). AKI patients required hemodialysis, ventilator care (p<0.001, p=0.002), and inotropics (p<0.001). They also showed more intensive care unit admission (p<0.001), longer hospitalization (p<0.001), and high mortality (p<0.001). Logistic multivariate regression analysis showed that high WBCs (OR, 1.223) and increased LN ratios (OR, 1.414) were independently associated with the occurrence of AKI. Conclusion: In patients with glyphosate poisoning at ED, high WBCs and increased LN ratios can help predict the occurrence of AKI.

• Journal of the korean academy of Pediatric Dentistry
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• v.48 no.4
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• pp.405-413
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• 2021

The purpose of this in vivo study was to assess the clinical screening performance of a quantitative light-induced fluorescence (QLF) device in detecting proximal caries in primary molars. Fluorescence loss, red autofluorescence and a simplified QLF score for proximal caries (QS-proximal) were evaluated for their validity in detecting proximal caries in primary molars compared to bitewing radiography. Three hundred and forty-four primary molar surfaces were included in the study. Carious lesions were scored according to lesion severity assessed by visual-tactile and radiographic examinations. The QLF images were analyzed for two quantitative parameters, fluorescence loss and red autofluorescence, as well as for QS-proximal. For both quantitative parameters and QS-proximal, the sensitivity, specificity and area under receiver operating curve (AUROC) were calculated as a function of the radiographic scoring index at enamel and dentin caries levels. Both quantitative parameters showed fair AUROC values for detecting dentine level caries (△F = 0.794, △R = 0.750). QS-proximal showed higher AUROC values (0.757 - 0.769) than that of visual-tactile scores (0.653) in detecting dentine level caries. The QLF device showed fair screening performance in detecting proximal caries in primary molars compared to bitewing radiography.

• Tuberculosis and Respiratory Diseases
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• v.86 no.2
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• pp.111-119
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• 2023

Background: The objective of this study was to investigate whether alcohol consumption might affect the quality of life (QOL), depressive mood, and metabolic syndrome in patients with obstructive lung disease (OLD). Methods: Data were obtained from the Korean National Health and Nutrition Examination Survey from 2014 and 2016. OLD was defined as spirometry of forced expiratory volume in 1 second/forced vital capacity <0.7 in those aged more than 40 years. QOL was evaluated using the European Quality of Life Questionnaire-5D (EQ-5D) index. Patient Health Questionnaire-9 (PHQ-9) was used to assess the severity of depressive mood. Alcohol consumption was based on a history of alcohol ingestion during the previous month. Results: A total of 984 participants with OLD (695 males, 289 females, age 65.8±9.7 years) were enrolled. The EQ-5D index was significantly higher in alcohol drinkers (n=525) than in non-alcohol drinkers (n=459) (0.94±0.11 vs. 0.91±0.13, p=0.002). PHQ9 scores were considerably lower in alcohol drinkers than in non-alcohol drinkers (2.15±3.57 vs. 2.78±4.13, p=0.013). However, multiple logistic regression analysis showed that alcohol consumption was not associated with EQ-5D index or PHQ-9 score. Body mass index ≥25 kg/m², triglyceride ≥150 mg/dL, high-density lipoprotein <40 mg/dL in men and <50 mg/dL in women, and blood pressure ≥130/85 mm Hg were significantly more common in alcohol drinkers than in non-alcohol drinkers (all p<0.05). Conclusion: Alcohol consumption did not change the QOL or depressive mood of OLD patients. However, metabolic syndrome-related factors were more common in alcohol drinkers than in non-alcohol drinkers.

• The Journal of Korean Obstetrics and Gynecology
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• v.36 no.4
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• pp.96-120
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• 2023

Objectives: This study reports the findings that support the efficacy of herbal medicine (HM) for premenstrual syndrome (PMS). Methods: We conducted meta-analysis of findings from randomized controlled trials (RCTs) for PMS treated with HM. The articles were published before July 2022, located using 9 databases (Pubmed, EMBASE, Cochrane Library, CINAHL, CNKI, CiNii, SCIENCE ON, KoreaMed, OASIS). Results: We observed 2,034 studies, of which 23 RCTs met our inclusion criteria. The risk of bias in the included studies was relatively unclear or high. Meta-analysis of 3 RCTs showed that HM group had a significantly higher total effective rate than the western medicine group (RR 1.20 [95% CI 1.06, 1.36, p=0.004]). Meta-analysis of 1 RCT showed that HM group had a significantly lower symptom score (MD -3.04 [95% CI -5.36, -0.72, p=0.01]), while there was no significant difference in daily record of severity of problems scale (MD -20.52 [95% CI -49.33, 8.29, p=0.16]). Conclusions: HM significantly improved PMS symptoms than general treatment and no serious adverse events were reported. However, the evidence on the effectiveness and safety of HM for PMS was not enough to provide reliable results due to the small number and low quality of included studies. We believe that rigorous RCTs will lead to more reliable evidence of the intervention.

• Journal of TMJ Balancing Medicine
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• v.13 no.1
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• pp.21-26
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• 2023

Objectives: The purpose of this study is to report the effect of Korean medical treatment with Temporomandibular Joint Balancing Therapy (TBT) on Tic disorder patient who often glancing up when feels nerves, frightened or tired. Methods: In this study, Tic disorder patient was treated to △△ Korean medicine Hospital from June 12nd, 2022 to July 26th, 2023 by outpatient way. During the clinic period, the patient was treated by Korean medical treatment (acupuncture, cupping, herb medicine), especially using TBT. YGTSS (Yale Global Tic Severity Scale), NDI (Neck Disability Index) and VAS were used for measuring the Tic disorder and neck pain. Results: After treatment for 46 days, the YGTSS showed a decrease from 17 to 3, the VAS associated with Tic disorder also decreased from 6 to 1 and NDI associated with neck pain decreased from 7 to 4. Conclusions: These results showed that Korean medical treatment especially using TBT may have an effect on reducing symptoms of Tic disorder and neck pain. But the further researches are needed.

• Journal of the Korean Society of Radiology
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• v.81 no.6
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• pp.1348-1363
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• 2020

The newly revised 2018 Organ Injury Scale (OIS) has a similar format to the previous American Association for Surgery and Trauma (AAST) Emergency General Surgery Grading System, dividing the criteria for grading solid organ damage into three groups; imaging, operation, and pathology. The most significant alteration in the OIS system 2018 revision is the incorporation of multidetector CT (MDCT) findings of vascular injury including pseudoaneurysm and arteriovenous fistula. Similar to the previous OIS, the highest of the three criteria is assigned the final grade. In addition, if multiple grade I or II injuries are present, one grade is advanced for multiple injuries up to grade III. This pictorial essay demonstrates the MDCT findings of solid organ injury grades based on the 2018 OIS system.

• Korean Journal of Radiology
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• v.23 no.4
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• pp.389-401
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• 2022

Objective: This study aimed to determine a factor for predicting suboptimal image quality of the hepatobiliary phase (HBP) of gadoxetic acid-enhanced MRI in patients with extrahepatic bile duct (EHD) cancer before MRI examination. Materials and Methods: We retrospectively evaluated 259 patients (mean age ± standard deviation: 68.0 ± 8.3 years; 162 male and 97 female) with EHD cancer who underwent gadoxetic acid-enhanced MRI between 2011 and 2017. Patients were divided into a primary analysis set (n = 184) and a validation set (n = 75) based on the diagnosis date of January 2014. Two reviewers assigned the functional liver imaging score (FLIS) to reflect the HBP image quality. The FLIS consists of the sum of three HBP features, each scored on a 0-2 scale: liver parenchymal enhancement, biliary excretion, and signal intensity of the portal vein. Patients were classified into low-FLIS (0-3) or high-FLIS (4-6) groups. Multivariable analysis was performed to determine a predictor of low FLIS using serum biochemical and imaging parameters of cholestasis severity. The optimal cutoff value for predicting low FLIS was obtained using receiver operating characteristic analysis, and validation was performed. Results: Of the 259 patients, 140 (54.0%) and 119 (46.0%) were classified into the low-FLIS and high-FLIS groups, respectively. In the primary analysis set, total bilirubin was an independent factor associated with low FLIS (adjusted odds ratio per 1-mg/dL increase, 1.62; 95% confidence interval [CI], 1.32-1.98). The optimal cutoff value of total bilirubin for predicting low FLIS was 2.1 mg/dL with a sensitivity of 95.1% (95% CI: 88.9-98.4) and a specificity of 89.0% (95% CI: 80.2-94.9). In the validation set, the total bilirubin cutoff showed a sensitivity of 92.1% (95% CI: 78.6-98.3) and a specificity of 83.8% (95% CI: 68.0-93.8). Conclusion: Serum total bilirubin before acquisition of gadoxetic acid-enhanced MRI may help predict suboptimal HBP image quality in patients with EHD cancer.

• Journal of The Korean Society of Clinical Toxicology
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• v.21 no.2
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• pp.117-127
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• 2023

Purpose: No consensus currently exists regarding the maximal pressure of hyperbaric oxygen (HBO₂) therapy performed within 24 hours of acute carbon monoxide (CO) poisoning. This study aimed to evaluate the difference in therapeutic effects according to the first HBO₂ pressure (3.0 atmospheres absolute [ATA] vs. 2.8 ATA). Methods: We used prospectively collected registry data on CO poisoning at a tertiary academic hospital in the Republic of Korea. Adult patients with acute CO poisoning treated with HBO₂ within 24 hours after arrival at the emergency department and without the use of additional HBO₂ after 24 hours between January 2007 and February 2022 were included. Data from 595 patients were analyzed using propensity score matching (PSM). Patients with mild (non-intubated) and severe (intubated) poisoning were also compared. Neurocognitive outcomes at 1 month after CO poisoning were evaluated using the Global Deterioration Scale combined with neurological impairment. Results: After PSM, the neurocognitive outcomes at 1-month post-CO exposure were not significantly different between the 2.8 ATA (110 patients) and 3.0 ATA (55 patients) groups (p=1.000). Similarly, there was also no significant difference in outcomes in a subgroup analysis according to poisoning severity in matched patients (165 patients) (mild [non-intubated]: p=0.053; severe [intubated]: p=1.000). Conclusion: Neurocognitive sequelae at 1 month were not significantly different between HBO₂ therapy pressures of 2.8 ATA and 3.0 ATA in patients with acute CO poisoning. In addition, the 1-month neurocognitive sequelae did not differ significantly between intubated and non-intubated patients.

• Korean Journal of Radiology
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• v.22 no.11
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• pp.1841-1849
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• 2021

Objective: To prospectively investigate the feasibility of shear wave elastography (SWE) as a new quantitative and objective method for evaluating the stiffness of the gastrocnemius medialis (GM) muscle during passive stretching in patients with Parkinson's disease (PD). Materials and Methods: SWE of the GM muscle was performed in 28 patients with PD [13 female and 15 male; mean age ± standard deviation (SD): 63.0 ± 8.5 years] and 12 healthy controls (5 female and 7 male; mean age ± SD: 59.3 ± 6.4 years) during passive ankle rotation. A Young's modulus-ankle angle curve was constructed. The GM slack angle and baseline Young's modulus (E₀) were compared between the markedly symptomatic and mildly symptomatic sides of patients with PD, and healthy controls. Additionally, the correlation between the GM slack angle and the severity of rigidity, and the observer reproducibility of SWE in determining the GM slack angle were evaluated. Results: The GM slack angle was smaller on both the markedly and mildly symptomatic sides in patients with PD than in healthy controls (mean ± SD of -29.13° ± 3.79° and -25.65° ± 3.39°, respectively, vs. -21.22° ± 3.52°; p < 0.001 and p = 0.006, respectively). Additionally, in patients with PD, the GM slack angle on the markedly symptomatic side was smaller than that on the mildly symptomatic side (p = 0.003). The E0 value was lower on both the markedly and mildly symptomatic sides in patients with PD than in healthy controls (mean ± SD of 10.11 ± 2.85 kPa and 10.08 ± 1.88 kPa, respectively, vs. 12.23 ± 1.02 kPa; p = 0.012 and p < 0.001, respectively). However, no significant difference was found between the markedly and mildly symptomatic sides in patients with PD (p = 0.634). A negative linear relationship was observed between the GM slack angle and lower limb rigidity score on the markedly symptomatic side in patients with PD (r = -0.719; p < 0.001). The intraclass correlation coefficients for observer reproducibility of SWE ranged from 0.880 to 0.951. Conclusion: The slack angle determined by SWE may be a useful quantitative and reproducible method for evaluating muscle stiffness in patients with PD.

• Journal of Physiology & Pathology in Korean Medicine
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• v.22 no.6
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• pp.1359-1367
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• 2008

DSOM(Diagnosis System of Oriental Medicine) was made as a computerized assistant program for oriental medicine doctors to be able to diagnose with statistical basis. Then DSOM uses questionnaires filled out by subjects without enough explanatory guide. If the subject misunderstand the meaning of the passages, we might not rely on that result. So I designed this study to investigate the diagnostic correspondent rates between DSOM and practitioners. First, let the respondents answer to DSOM(DSOM-Ⅰ for the rest). After that, three doctors diagnosed the respondents and marked how much they had symptoms about 16 pathogenic factors in the score range 0${\sim}$5('0' means they didn't have that symptom, '1' means they had that symptom but mild, '3' means they had that symptom moderately, '5' means they had that symptom severely. And let the respondents answer to DSOM(DSOM-Ⅱ for the rest) again. Finally, we investigated the correspondent rates of diagnosis between DSOM-Ⅰ,Ⅱ and doctors'. We obtained conclusions as following. In the comparison of output frequency rate of the pathogenic factors, the difference between DSOM-Ⅰ and Ⅱ was 1%. In the correspondent rates of diagnosis between DSOM-Ⅰ,Ⅱ and doctors', In DSOM-Ⅰ and Ⅱ answered by subjects two times respectively, the correspondent rate was highest in insufficiency of Yang(陽虛) and liver(肝) as 93.2%, lowest in damp(濕) as 69.5% and showed 81.9% in all 16 pathogenic factors mean. In DSOM-Ⅰ and Ⅱ, and Doctors' diagnose, they showed the complete correspondent rates of 15.3${\sim}$61.0%, 15.3${\sim}$59.3% in individual pathogenic factor, 36.5%, 37.3% in all 16 pathogenic factors mean each, and within ${\pm}$1 errorrange, they showed the correspondent rates of 32.2${\sim}$93.2%, 35.6${\sim}$89.8% in individual pathogenic factor, 67.6%, 67.3% in all 16 pathogenic factors mean each, and within ${\pm}$2 error range, they showed the correspondent rates of 62.7${\sim}$98.3%, 71.2${\sim}$100% in individual pathogenic factor, 85.1 87.6%% in all 16 pathogenic factors mean each. In the correspondent rates of the severe case, In the cases that the Doctors' diagnostic score mean was over 3(the severity of disease is middle), there were deficiency of qi(氣虛), stagnation of qi(氣滯), blood stasis(血瘀), damp(濕), liver(肝), heart(心), spleen(脾) and they all showed the correspondent rates of over 60 except blood stasis(血瘀). In the cases that the weighed pathogenic factor was above 9, the correspondent rates were 50${\sim}$100%. deficiency of qi(氣虛), blood-deficiency(血虛), stagnation of qi(氣滯), blood stasis(血瘀), insufficiency of Yin(陽虛), insufficiency of Yang(陽虛), coldness(寒), heat (熱), damp(濕), dryness(燥), liver(肝), heart(心), spleen(脾), kidney(腎), phlegm(痰).