• Journal of Preventive Medicine and Public Health
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• v.50 no.3
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• pp.177-187
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• 2017

Objectives: Medical students represent a primary target for tobacco cessation training. This study assessed the prevalence of medical students' tobacco use, attitudes, clinical skills, and tobacco-related curricula in two countries, the US and Italy, with known baseline disparities in hopes of identifying potential corrective interventions. Methods: From September to December 2013, medical students enrolled at the University of Bologna and at Brown University were recruited via email to answer survey questions assessing the prevalence of medical students' tobacco use, attitudes and clinical skills related to patients' smoking, and elements of medical school curricula related to tobacco use. Results: Of the 449 medical students enrolled at Brown and the 1426 enrolled at Bologna, 174 Brown students (38.7%) and 527 Bologna students (36.9%) participated in this study. Italian students were more likely to smoke (29.5% vs. 6.1%; p<0.001) and less likely to receive smoking cessation training (9.4% vs. 80.3%; p<0.001) than their American counterparts, even though the majority of students in both countries desired smoking cessation training (98.6% at Brown, 85.4% at Bologna; p<0.001). Additionally, negative beliefs regarding tobacco usage, the absence of formal training in smoking cessation counseling, and a negative interest in receiving specific training on smoking cessation were associated with a higher risk of not investigating a patient's smoking status during a routine history and not offering tobacco cessation treatment to patients. Conclusions: Medical curricula on tobacco-related health hazards and on smoking cessation should be mandatory in order to reduce smoking among medical students, physicians, and patients, thereby improving tobacco-related global health.

• Communications for Statistical Applications and Methods
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• v.16 no.1
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• pp.115-125
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• 2009

Simultaneous equation models, which are widely used in business and economic areas, generally consist of endogenous variables determined within models and exogenous variables externally determined and in the simultaneous equations model framework there are rank and order conditions for the model identification and the existence of unique solutions. By contrast, their estimating results have less efficiencies and furthermore do not exist, since the most estimating procedures are performed under the assumptions for rank and order conditions. We propose the new statistical test for sufficiency of the rank condition under the order condition, and show the asymptotic properties for the test. The Monte Carlo simulation studies are achieved in order to evaluate its power and to suggest the baseline for satisfying the rank conditions.

• Journal of Microbiology and Biotechnology
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• v.25 no.4
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• pp.521-525
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• 2015

Bacteremia and sepsis are common causes of morbidity and mortality worldwide, with incorrect or delayed diagnoses being associated with increased mortality. New tests or markers that allow a more rapid and less costly detection of bacteremia and sepsis have been investigated. The aim of this study was to clarify the cutoff value of the neutrophillymphocyte ratio (NLR) according to procalcitonin (PCT) level in the decision-making processes for bacteremia and sepsis. In addition, other white blood cell subgroup parameters, which are assessed in all hospitals, for bacteremia and sepsis were explored. This retrospective study included 1,468 patients with suspected bacteremia and sepsis. Patients were grouped according to the following PCT criteria: levels <0.05 ng/ml (healthy group), 0.05-0.5 ng/ml (local infection group), 0.5-2 ng/ml (systemic infection group), 2-10 ng/ml (sepsis group), and >10 ng/ml (sepsis shock group). One important finding of this study, which will serve as a baseline to measure future progress, is the presence of many gaps in the information on pathogens that constitute a major health risk. In addition, clinical decisions are generally not coordinated, compromising the ability to assess and monitor a situation. This report represents the first study to determine the limits of the use of NLR in the diagnosis of infection or sepsis using a cutoff value of <5 when sufficient exclusion criteria are used.

• Korean Journal of Clinical Pharmacy
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• v.29 no.4
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• pp.254-266
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• 2019

Background: Patients with cardiovascular risks are recommended to use statins and antiplatelet agents to prevent major cerebro-cardiovascular events (MACCE). Antiplatelet agents also possess anti-inflammatory and antioxidant effects, in addition to their inhibitory activity on platelets. The differences in clinical outcomes in ischemic heart disease (IHD) based on the type of antiplatelet therapy combined with statin treatment were investigated in this study. Methods: We conducted a retrospective cohort study using electronic medical records of IHD patients from January 2010 to December 2014 at Ajou University Hospital. Patients on combination therapy of antiplatelet drugs and statins were grouped based on antiplatelet drug types: clopidogrel, cilostazol, or sarpogrelate. Propensity score matching was applied to balance the baseline of the groups of clopidogrel vs. cilostazol and the groups of clopidogrel vs. sarpogrelate. The incidence and risk of MACCE as primary outcomes were assessed between the groups of antiplatelet drugs. Results: Among the approximately 128,500 patients with IHD, 1,049 patients had taken a combination therapy of statin and antiplatelet agents. The cohorts of patients administered clopidogrel, cilostazol, or sarpogrelate were 906, 79, and 64, respectively. The incidence of MACCE was not significantly different among the cohorts (p=0.58), and there were no differences between clopidogrel vs. cilostazol (p=0.72) or clopidogrel vs. sarpogrelate (p=1.00) after propensity score matching. Conclusion: There was no difference in the incidence of MACCE based on the type of antiplatelet drug (clopidogrel, cilostazol, or sarpogrelate) in combination with a statin in patients with IHD.

• Journal of Acupuncture Research
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• v.32 no.1
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• pp.109-118
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• 2015

Objectives : This study aimed to investigate the correlation between fear-avoidance beliefs and neck pain/neck disability caused by traffic accidents. Methods : We surveyed 52 patients who were injured in traffic accidents. The patients completed baseline measures of pain, disability, fear-avoidance beliefs according to the visual analogue scale(VAS), neck disability index(NDI) and a fear-avoidance beliefs questionnaire (FABQ). At the end of medical treatment, VAS and NDI were reassessed. In order to determine the relationship between FABQ(including its subscales), change of VAS and NDI, Pearson correlation coefficients were used. To examine the accuracy of previously reported cut-off scores, we classified the patients into low and high groups and analyzed the change of VAS and NDI. The relationship was measured by Mann-Whitney U-test and a student's T-test. Results : FABQ and its subscales(total, physical activity and work) were significantly correlated with final VAS and NDI. FABQ-T showed low significant negative correlation with change of NDI. Previously reported cut-off scores did not show a statistical significance in this study Conclusions : This study suggests that screening for fear-avoidance beliefs may be useful for identifying patients at risk of prolonged pain after traffic accidents.

• Annals of Clinical Neurophysiology
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• v.17 no.2
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• pp.68-72
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• 2015

Background: The effects of omega-3 polyunsaturated fatty acids (PUFAs) on cerebral vessels have not been clarified until now. Thus we investigated the efficacy of omega-3 PUFAs supplementation on cerebral blood flow velocity and vascular resistance via transcranial doppler (TCD). Methods: Consecutive twenty patients (13 male and 7 female) with at least 1 cerebrovascular risk factor or a known cerebrovascular disease were enrolled. Patients were treated with omega-3 PUFAs (1 g, two times per day) for 12 weeks. Cerebral blood flow velocity, resistance index, and pulsatile index were checked before and after 12 weeks of treatment using TCD. Results: The change of resistance index in right MCA (from $0.58{\pm}0.07$ to $0.55{\pm}0.07$, p = 0.042) and left PCA (from $0.56{\pm}0.07$ to $0.53{\pm}0.06$, p = 0.037) showed significant improvement after 12 weeks of omega-3 PUFAs treatment. The changes in other vessels, however, failed to show any significant changes compared to the baseline. Conclusions: Omega-3 PUFAs treatment showed feasible efficacies for cerebral vascular resistances in this open label trial. To confirm these results, larger samples of patients and longer period of follow-up is warranted.

• Smart Structures and Systems
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• v.21 no.3
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• pp.287-303
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• 2018

Applications of energy harvesting from mechanical vibrations is becoming popular but the full potential of such applications is yet to be explored. This paper addresses this issue by considering an application of energy harvesting for the dual objective of serving as an indicator of structural health monitoring (SHM) and extent of control. Variation of harvested energy from an undamaged baseline is employed for this purpose and the concept is illustrated by implementing it for active vibrations of a pipe structure. Theoretical and experimental analyses are carried out to determine the energy harvesting potential from undamaged and damaged conditions. The use of energy harvesting as indicator for control is subsequently investigated, considering the effect of the introduction of a tuned mass damper (TMD). It is found that energy harvesting can be used for the detection and monitoring of the location and magnitude of damage occurring within a pipe structure. Additionally, the harvested energy acts as an indicator of the extent of reduction of vibration of pipes when a TMD is attached. This paper extends the range of applications of energy harvesting devices for the monitoring of built infrastructure and illustrates the vast potential of energy harvesters as smart sensors.

• Journal of Korean Medicine Rehabilitation
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• v.28 no.2
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• pp.73-82
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• 2018

Objectives The purpose of this study is to systematically explore the effects and safety of acupuncture treatment for upper extremity peripheral nerve injury and to review the methodology of clinical trials. Methods We searched 9 electronic databases(3 international, 1 Chinese, 5 Korean) including English, Korean and Chinese, up to December 2017 for randomized controlled trials which evaluated the effects of the acupuncture in patients with upper extremity peripheral nerve injury. We abstracted the designs of the randomized clinical trials and the method of acupuncture treatment according to the Standards for Reporting Interventions in Clinical Trials of Acupuncture(STRICTA). Results A total of 8 papers were reviewed. All randomized clinical trials were conducted in China. Of them, five studies(62.5%) were electro-acupuncture as intervention. All randomized clinical trials reported favorable effects of acupuncture treatments compared to baseline or control group with outcomes of efficacy rate. However risk of bias seemed high. LI4, LI11, SI3, PC3, PC6 were most frequently used for acupoints to treat upper extremity peripheral nerve injury. Conclusions These results suggest that it is recommended to develop more detailed reporting standards for acupuncture treatment method. In the future, well designed randomized clinical trials which evaluate the effects and safety of acupuncture treatment for upper extremity peripheral nerve injury is highly needed.

• The Korean Journal of Pain
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• v.27 no.2
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• pp.139-144
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• 2014

Background: To manage intractable cancer pain, an alternative to systemic analgesics is neuraxial analgesia. In long-term treatment, intrathecal administration could provide a more satisfactory pain relief with lower doses of analgesics and fewer side-effects than that of epidural administration. However, implantable drug delivery systems using intrathecal pumps in Korea are very expensive. Considering cost-effectiveness, we performed epidural analgesia as an alternative to intrathecal analgesia. Methods: We retrospectively investigated the efficacy, side effects, and complications of epidural morphine and local anesthetic administration through epidural catheters connected to a subcutaneous injection port in 29 Korean terminal cancer patients. Patient demographic data, the duration of epidural administration, preoperative numerical pain rating scales (NRS), side effects and complications related to the epidural catheterization and the drugs, and the numerical pain rating scales on the 1st, 3rd, 7th and 30th postoperative days were determined from the medical records. Results: The average score for the numerical pain rating scales for the 29 patients decreased from $7{\pm}1.0$ at baseline to $3.6{\pm}1.4$ on postoperative day 1 (P < 0.001). A similar decrease in pain intensity was maintained for 30 days (P < 0.001). Nausea and vomiting were the most frequently reported side effects of the epidural analgesia and two patients (6.9%) experienced paresthesia. Conclusions: Epidural morphine and local anesthetic infusion with a subcutaneous pump seems to have an acceptable risk-benefit ratio and allows a high degree of autonomy to patients with cancer pain.

• Korean Journal of Community Nutrition
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• v.5 no.4
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• pp.654-661
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• 2000

Hypertension is the major risk factor for cardiovascular disease which is considered the leading cause of death in Korea. Since nonpharmarologic dietary intervention is recommended as the first step in the management of hypertension, evaluation of intervention programs is needed to formulate strategies for improving patients' dietary adherence. This study was designed to evaluate the overall effectiveness of a hypertension nutrition education program (HNEP) at a public health center, by assessing changes in nutrition knowledge, food attitude, self-efficacy, dietary behavior, and nutrient intake after program completion. An HNEP was conducted in Suwon city for 5 months in 1999 by a public health center. The program provided 3 sessions of group education with individual nutrition counseling. Thirty-five patients participated fully in the program out of 62 enrollees. Data about nutrition knowledge, food attitude, self-efficacy, dietary behavior, and intake (24-hour recall) were collected before (baseline) and after the program. Post program results indicate the following : 1) nutrition knowledge and perception of importance of nutrition significantly increased, 2) food attitudes also improved, 3) the self-efficacy for maintaining a low salt diet was increased significantly, whereas self-efficacy for maintaining a low fat diet or dietary guidelines was not improved, 4) frequency of intake of processed food, animal fat, and sweets as well as frequency of dining out were significantly reduced, 5) nutrient intake was not improved after the program, 6) the most serious barrier for participating in the program and practicing diet therapy was lack of time and willingness. In conclusion, it appears that HNEP might improve food attitudes, individual perceptions and self-efficacy for desirable eating behavior, but it might not improve dietary intake. It follows then, that a long term intervention program may need to increase effectiveness of patient dietary adherence.