• Journal of Chest Surgery
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• v.56 no.2
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• pp.99-107
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• 2023

Background: The neutrophil-to-lymphocyte ratio (NLR) has been suggested as a novel predictive marker of cardiovascular disease. However, its prognostic role in patients under-going coronary artery bypass grafting (CABG) is unclear. This study aimed to determine the association between the preoperative NLR and early mortality in patients undergoing CABG. Methods: Cardiac surgery was performed in 2,504 patients at Seoul St. Mary's Hospital from January 2010 to December 2021. This study retrospectively reviewed 920 patients who underwent isolated CABG, excluding those for whom the preoperative NLR was unavailable. The primary endpoints were the 30- and 90-day mortality after isolated CABG. Risk factor analysis was performed using logistic regression analysis. Based on the optimal cut-off value of preoperative NLR on the receiver operating characteristic curve, high and low NLR groups were compared. Results: The 30- and 90-day mortality rates were 3.8% (n=35) and 7.0% (n=64), respectively. In the multivariable analysis, preoperative NLR was significantly associated with 30-day mortality (odds ratio [OR], 1.28; 95% confidence interval [CI], 1.17-1.39; p<0.001) and 90-day mortality (OR, 1.17; 95% CI, 1.07-1.28; p<0.001). The optimal cut-off value of the preoperative NLR was 3.4. Compared to the low NLR group (<3.4), the high NLR group (≥3.4) showed higher 30- and 90-day mortality rates (1.4% vs. 12.1%, p<0.001; 2.8% vs. 21.3%, p<0.001, respectively). Conclusion: Preoperative NLR was strongly associated with early mortality after isolated CABG, especially in patients with a high preoperative NLR (≥3.4). Further studies with larger cohorts are necessary to validate these results.

• KSCE Journal of Civil and Environmental Engineering Research
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• v.30 no.5D
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• pp.497-504
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• 2010

In this paper, the author presents a reliability estimation technique to analyze the effects of traffic loads on pavement mean life based on the national highway database of Suwon and Uijeongbu region from 1999 to 2008. The estimation of the mean life, its standard deviation and reliability for pavement sections are calculated by using an appropriate distribution, Lognormal distribution, based on reliability theory. Furthermore, the probability paper method and Maximum likelihood estimation are both used to estimate parameters. The author found that mean life of newly constructed sections and over-layed sections is about 6.5 to 7.9 years and 7.3 to 9.1 years, respectively. The author also ascertained that the results of cumulative failure probability for pavement life between the proposed methods and observed data are similar. Such an assessment methodology and measures based on reliability theory can provide useful information for maintenance plans in pavement management systems as long as additional life data on pavement sections are accumulated.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.49 no.6
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• pp.347-353
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• 2023

This case report presents inferior alveolar nerve (IAN) repositioning as a viable approach for implant placement in the mandibular molar region, where challenges of severe alveolar bone width and height deficiencies can exist. Two patients requiring implant placement in the right mandibular molar region underwent nerve transposition and lateralization. In both cases, inadequate alveolar bone height above the IAN precluded the use of short implants. The first patient exhibited an overall low alveolar ridge from the anterior to posterior regions, with a complex relationship with adjacent implant bone level and the mental nerve, complicating vertical augmentation. In the second case, although vertical bone resorption was not severe, the high positioning of the IAN within the alveolar bone due to orthognathic surgery raised concerns regarding adequate height of the implant prosthesis. Therefore, instead of onlay bone grafting, nerve transposition and lateralization were employed for implant placement. In both cases, the follow-up results demonstrated successful osseointegration of all implants and complete recovery of postoperative numbness in the lower lip and mentum area. IAN repositioning is a valuable surgical technique that allows implant placement in severely compromised posterior mandibular regions, promoting patient comfort and successful implant placement without permanent IAN damage.

• Archives of Obesity and Metabolism
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• v.3 no.1
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• pp.1-8
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• 2024

Background: This study investigated the association between obesity and cardiometabolic disease clusters in Korean adults aged 19-39 years. Methods: We included 3,785 participants (1,767 men and 2,018 women) aged 19-39 years who participated in the Korea National Health and Nutrition Examination Survey (2020-2022). The risk factors for cardiometabolic disease were defined as follows: high blood pressure; hypertriglyceridemia; hyperuricemia; and high low-density lipoprotein cholesterol, low high-density lipoprotein cholesterol, high fasting plasma glucose, elevated alanine aminotransferase levels. Results: The prevalence of participants with ≥ 1, ≥ 2, and ≥ 3 cardiometabolic disease risk factors was 95.2%, 84.2%, and 65.6% in men and 90.0%, 70.5%, and 43.0%, in women with class 2-3 obesity, respectively. Compared to those for young adults with underweight/normal weight, the odds ratios (ORs) and 95% confidence intervals (CIs) for the clustering of cardiometabolic risk factors were 17.26 (8.32-35.80) for ≥ 1; 19.43 (12.18-31.00) for ≥ 2; and 22.93 (14.15-37.15) for ≥ 3 factors in men with class 2-3 obesity and 14.67 (8.00-26.91) for ≥ 1; 20.88 (12.15-35.88) for ≥ 2; and 36.26 (20.20-65.09) for ≥ 3 factors in women with class 2-3 obesity. Conclusion: Although the patients were young, the prevalence and ORs for cardiometabolic disease risk factor clusters in young adults with obesity were prominently high. Prevention and management of obesity in young Korean adults are urgently needed at both individual and public levels.

• Annals of Hepato-Biliary-Pancreatic Surgery
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• v.27 no.2
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• pp.172-179
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• 2023

Backgrounds/Aims: Cancer stigma (CS), a self-inflicted sense of hopelessness, has been identified as a major factor affecting cancer patients' outcomes. However, few studies have investigated the CS-related outcomes in hepatobiliary and pancreatic (HBP) cancer. Thus, the aim of this study was to investigate effects of CS on quality of life (QoL) of HBP cancer. Methods: From 2017 to 2018, 73 patients who underwent curative surgery for HBP tumor at a single intuitive were enrolled prospectively. The QoL was measured using the European Organization for Research and Treatment of Cancer QoL score, and CS was evaluated in three categories, "impossibility of recovery," "cancer stereotypes," and "social discrimination." the stigma was defined by higher scores of attitudes compared with the median value. Results: The stigma group showed a lower QoL (-17.67, 95% confidence interval [CI]: -26.75 to 8.60, p < 0.001) than the no stigma group. Similarly, most function and symptoms of the stigma group showed worse results than the no stigma group. The difference in function scores between the two groups according to CS was highest in cognitive function (-21.20, 95% CI: -30.36 to 12.04, p < 0.001). Fatigue showed the largest difference between the two groups at 22.84 (95% CI: 12.88-32.07, p < 0.001) and was the most severe symptom in stigma group. Conclusions: CS was an important negative factor affecting the QoL, function, and symptoms of HBP cancer patients. Therefore, appropriate management of CS is crucial for improved postoperative QoL.

• Journal of Hospice and Palliative Care
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• v.27 no.1
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• pp.11-20
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• 2024

Purpose: Advance directives (ADs) are legal documents that outline a person's preferences or decisions regarding end-of-life care ahead of time. In Korea, there is insufficient awareness and knowledge about ADs among patients undergoing hemodialysis. This study explored the relationship between perceptions of a good death, knowledge about ADs, and attitudes toward ADs in this patient population. Methods: This cross-sectional survey enrolled 119 hemodialysis patients from a secondary hospital in 2021. The participants completed a self-administered questionnaire, and the data were analyzed using the t-test, analysis of variance, Pearson correlation coefficients, Spearman rank correlation coefficients, and multiple regression analysis. Results: The average score for perceptions of a good death among hemodialysis patients was 2.80 out of 4, with clinical symptoms identified as the most critical factor. The average scores for knowledge about ADs and attitudes toward ADs were 5.69 out of 9 and 2.79 out of 4, respectively. There was a positive correlation between perceptions of a good death and attitudes toward ADs (r=0.34, P<0.001), as well as between knowledge about Ads and attitudes toward ADs (r=0.19, P=0.037). Factors influencing attitudes toward Ads included employment status (β=0.22, P=0.011), education level (β=0.22, P=0.013), and perceptions of a good death (β=0.29, P=0.001), which accounted for 24.8% of the variance in attitudes toward ADs. Conclusion: A positive perception of a good death among patients undergoing hemodialysis was associated with a positive attitude toward ADs. Educational programs are needed to improve individuals' understanding of a good death and encourage the development of end-of-life care plans.

• The Korean journal of internal medicine
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• v.39 no.1
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• pp.7-24
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• 2024

Post-tuberculosis lung disease (PTLD) is emerging as a significant area of global interest. As the number of patients surviving tuberculosis (TB) increases, the subsequent long-term repercussions have drawn increased attention due to their profound clinical and socioeconomic impacts. A primary obstacle to its comprehensive study has been its marked heterogeneity. The disease presents a spectrum of clinical manifestations which encompass tracheobronchial stenosis, bronchiectasis, granulomas with fibrosis, cavitation with associated aspergillosis, chronic pleural diseases, and small airway diseases-all persistent consequences of PTLD. The spectrum of symptoms a patient may experience varies based on the severity of the initial infection and the efficacy of the treatment received. As a result, the long-term management of PTLD necessitates a detailed and specific approach, addressing each manifestation individually-a tailored strategy. In the immediate aftermath (0-12 months after anti-TB chemotherapy), there should be an emphasis on monitoring for relapse, tracheobronchial stenosis, and smoking cessation. Subsequent management should focus on addressing hemoptysis, managing infection including aspergillosis, and TB-associated chronic obstructive pulmonary disease or restrictive lung function. There remains a vast expanse of knowledge to be discovered in PTLD. This review emphasizes the pressing need for comprehensive, consolidated guidelines for management of patients with PTLD.

• Dementia and Neurocognitive Disorders
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• v.21 no.2
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• pp.45-58
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• 2022

Recently, aducanumab, a beta amyloid targeted immunotherapy, has been approved by the US Food and Drug Administration for the treatment of Alzheimer's dementia (AD). Although many questions need to be answered, this approval provides a promising hope for the development of AD drugs that could be supported by new biomarkers such as blood-based ones and composite neuropsychological tests that can confirm pathologic changes in early stages of AD. It is important to elucidate the complexity of AD which is known to be associated with other factors such as vascular etiologies and neuro-inflammation. Through the second international conference of the Korean Dementia Association (KDA), researchers from all over the world have participated in the exchange of opinions with KDA members on the most up-to-date topics. The Academic Committee of the KDA summarizes lectures to provide the depth of the conference as well as discussions. This will be an important milestone to widen the latest knowledge in the research of AD's diagnosis, therapeutics, pathogenesis that can lead to the establishment of future directions.

• Nuclear Engineering and Technology
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• v.56 no.6
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• pp.2317-2323
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• 2024

Medical linear accelerators with an energy of 8 MV or higher are radiated owing to photonuclear reactions and neutron capture reactions. It is necessary to quantitatively evaluate the concentration of radioactive isotopes when replacing or disposing them. HPGe detectors are commonly used to identify isotopes and measure radioactivity. However, because the detection efficiency is generally calibrated using a standard material with a density of 1.0 g/cm³, a self-absorption effect occurs if the density of the measured material is high. In this study, self-absorption correction factors were calculated for tungsten, lead, copper, and SUS-303, which are the main materials of medical linear accelerator head parts, for each gamma-ray energy using MCNP 6.2 code. The self-absorption effect was more pronounced as the energy of the emitted gamma rays decreased and the density of the measured materials increased. These correction factors were applied to the radioactivity measurements of the in-built and portable HPGe detectors. Furthermore, compared to the surface dose rate measured by the survey meter, the accuracy of the measurements of radioactivity improved by an average of 124.31 and 100.53 % for inbuilt and portable HPGe detectors, respectively. The results showed a good agreement, with an average difference of 3.70 and 5.24 %.

• Journal of Microbiology and Biotechnology
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• v.34 no.8
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• pp.1592-1598
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• 2024

Genotype V (GV) Japanese encephalitis virus (JEV) has been predominantly reported in the Republic of Korea (ROK) since 2010. GV JEV exhibits higher virulence and distinct antigenicity compared to other genotypes, which results in reduced efficacy of existing vaccines. Research on GV JEV is essential to minimize its clinical impact, but the only available clinical strain in the ROK is K15P38, isolated from the cerebrospinal fluid of a patient in 2015. We obtained this virus from National Culture Collection for Pathogens (NCCP) and isolated a variant forming small plaques during our research. We identified that this variant has one amino acid substitution each in the PrM and NS5 proteins compared to the reported K15P38. Additionally, we confirmed that this virus exhibits delayed propagation in vitro and an attenuated phenotype in mice. The isolation of this variant is a critical reference for researchers intending to study K15P38 obtained from NCCP, and the mutations in the small plaque-forming virus are expected to be useful for studying the pathology of GV JEV.