• Journal of Nutrition and Health
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• v.54 no.5
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• pp.459-473
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• 2021

Purpose: Although numerous systematic reviews or meta-analysis have reported the hypotensive effects of garlic, the application of these results in the area of functional food is limited. This is because the trials used various garlic preparations and patients with differing hypertensive intensities. To validate the use of garlic powder as a blood pressure lowering functional food, we performed the current meta-analysis, focusing on the study of prehypertensive subjects. Methods: Literature search was carried out using various database up to July 2020, including PubMed, Cochrane, ScienceDirect and Korean studies Information Service System, and each study was screened by pre-stated inclusion/exclusion criteria. We identified nine trials that met the eligibility, of which two studies with moderate or high risk of bias were excluded. Results: Meta-analysis of the seven studies revealed that an intake of garlic powder significantly lowered the systolic blood pressure (SBP) and diastolic blood pressure (DBP) by -6.0 mmHg (95% confidence interval [CI], -11.2, -0.8; p = 0.025) and -2.7 mmHg (95% CI, -5.3, -0.1; p = 0.046), respectively. Shapes of the funnel plot for both SBP and DBP seemed symmetrical, and the Egger's regression revealed no publication bias. Moreover, duration of the intervention period was inversely associated with the pooled effects of garlic powder on SBP (p = 0.019) and DBP (p = 0.019), and this result was supported by the subgroup-analysis. The daily dose of garlic powder, baseline value of each biomarker, and subject number, did not moderate the effects on SBP and DBP. Conclusion: Results of the present meta-analysis indicate that garlic powder supplements are superior to placebo for improving the BP in prehypertensive individuals.

• Journal of Korean Medicine Rehabilitation
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• v.32 no.3
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• pp.131-140
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• 2022

Objectives This study aimed to investigate whether the concurrent use of conventional and herbal medications affects liver and kidney function, by examining blood test data. Methods We retrospectively reviewed the electronic medical records of 590 inpatients with musculoskeletal diseases between 2013 and 2017. We investigated cases of drug-induced liver injury (DILI) according to the Roussel Uclaf Causality Assessment Method criteria and cases of drug-induced kidney injury (DIKI) based on the Kidney Disease Improving Global Outcomes definition. Results One case (0.17%) of DILI and one case (0.17%) of DIKI were identified. Significant improvements in serum laboratory data were observed after the concurrent use of both types of medications (p<0.05). The kappa coefficients ranged from 0.26 to 0.72, indicating that the values after the concurrent use of conventional and herbal medications showed a fair similarity to the baseline values of the patients. The linear regression test showed that female sex and high body mass index (BMI) were risk factors for an increase in the serum blood levels of liver function parameters. Conclusions The concurrent use of conventional and herbal medications for musculoskeletal disorders is relatively safe; however, clinicians should exercise caution when prescribing these medications to female patients and patients with a high BMI because of their potential effect on hepatic function.

• Journal of Korean Neurosurgical Society
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• v.65 no.4
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• pp.539-548
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• 2022

Objective : Although full-endoscopic lumbar interbody fusion (Endo-LIF) has been tried as the latest alternative technique to minimally invasive transforaminal lumbar interobody fusion (MIS-TLIF) since mid-2010, the evidence is still lacking. We compared the clinical outcome and safety of Endo-LIF to MIS-TLIF for lumbar degenerative disease. Methods : We systematically searched electronic databases, including PubMed, EMBASE, and Cochrane Library to find literature comparing Endo-LIF to MIS-TLIF. The results retrieved were last updated on December 11, 2020. The perioperative outcome included the operation time, blood loss, complication, and hospital stay. The clinical outcomes included Visual analog scale (VAS) of low back pain and leg pain and Oswestry disability index (ODI), and the radiological outcome included pseudoarthosis rate with 12-month minimum follow-up. Results : Four retrospective observational studies and one prospective observational study comprising 423 patients (183 Endo-LIF and 241 MIS-TLIF) were included, and the pooled data analysis revealed low heterogeneity between studies in our review. Baseline characteristics including age and sex were not different between the two groups. Operation time was significantly longer in Endo-LIF (mean difference [MD], 23.220 minutes; 95% confidence interval [CI], 10.669-35.771; p=0.001). However, Endo-LIF resulted in less perioperative blood loss (MD, -144.710 mL; 95% CI, 247.941-41.478; p=0.023). Although VAS back pain at final (MD, -0.120; p=0.586), leg pain within 2 weeks (MD, 0.005; p=0.293), VAS leg pain at final (MD, 0.099; p=0.099), ODI at final (MD, 0.141; p=0.093) were not different, VAS back pain within 2 weeks was more favorable in the Endo-LIF (MD, -1.538; 95% CI, -2.044 to -1.032; p<0.001). On the other hand, no statistically significant group difference in complication rate (relative risk [RR], 0.709; p=0.774), hospital stay (MD, -2.399; p=0.151), and pseudoarthrosis rate (RR, 1.284; p=0.736) were found. Conclusion : Relative to MIS-TLIF, immediate outcomes were favorable in Endo-LIF in terms of blood loss and immediate VAS back pain, although complication rate, mid-term clinical outcomes, and fusion rate were not different. However, the challenges for Endo-LIF include longer operation time which means a difficult learning curve and limited surgical indication which means patient selection bias. Larger-scale, well-designed study with long-term follow-up and randomized controlled trials are needed to confirm and update the results of this systematic review.

• Journal of Chest Surgery
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• v.55 no.5
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• pp.388-396
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• 2022

Background: In this study, we present recent trends in heart valve surgery in Korea through analyses of data from the Korea Heart Valve Surgery Registry (KHVSR). Methods: We enrolled 8,981 patients who were registered in the KHVSR from 2017 to 2020. Yearly trends in patients' baseline characteristics, surgical profiles, and early mortality rates were explored. The observed/expected mortality ratio (O/E ratio), calculated from the actual mortality in the KHVSR and the predicted mortality estimated using the EuroSCORE II, was also analyzed. Results: The proportion of aortic valve surgery significantly increased from 56.8% in 2017 to 60.3% in 2020. The proportion of all combined procedures and minimally invasive surgery significantly increased over the 4-year study period. The operative mortality rate was 2.9% in the entire cohort, while mitral valve repair showed the lowest mortality risk (0.9%). The mortality rates of isolated aortic valve replacement (AVR) significantly decreased from 2.1% in 2017 to 0.8% in 2020 (p=0.016). Overall, the O/E ratio was 0.784 (95% confidence interval [CI], 0.677-0.902) demonstrating significantly lower actual mortality risks than expected based on the EuroSCORE II. In particular, the O/E ratios were as low as 0.364 (95% CI, 0.208-0.591) for isolated AVR. Conclusion: The recent data from the KHVSR showed increasing trends for complex procedures and minimally invasive surgery in heart valve surgery in Korea, and demonstrated remarkably low risks of operative mortality.

• Journal of Food Hygiene and Safety
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• v.37 no.3
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• pp.198-205
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• 2022

Hepatic diseases are divided into two types: alcoholic and non-alcoholic. Non-alcoholic liver injury finally induces fatty liver and damages liver function. Many studies have demonstrated that Ecklonia stolonifera has antioxidative, anti-inflammatory, and hepatoprotective activities. We conducted a 12-week double-blind, placebo-controlled, randomized trial to examine the efficacy of E. stolonifera extracts (ESE) on biochemical markers of hepatic function. Sixty-five subjects with mild or moderate liver injuries were randomly allocated to receive either 420 mg/d of ESE or a placebo for 12 weeks. Fifty-five participants completed the trial. No significant adverse events were observed among the subjects during the study. The primary end points were changes in plasma levels of aspartate transaminase (AST), alanine transaminase (ALT), and γ-glutamyltransferase (γ-GT). The secondary end points were changes in lipid profile levels, including total cholesterol (TC), triglyceride (TG), high-density lipoprotein cholesterol (HDL), and low-density lipoprotein cholesterol (LDL). Compared with the baseline, AST and ALT levels decreased significantly in the ESE group compared to those in the placebo group (P<0.001). In addition, γ-GT levels in the ESE group were significantly lower than those in the placebo group (P=0.016). There were no differences in the TC, TG, HDL, and LDL levels between groups. In conclusion, ESE consumption for 12 weeks improved liver parameters in subjects with liver injury. Regular consumption of ESE could maintain liver health in individuals at risk of hepatic damage.

• Journal of Intelligence and Information Systems
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• v.29 no.3
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• pp.419-437
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• 2023

As the number of thin filers in Korea surpasses 12 million, there is a growing interest in enhancing the accuracy of assessing their credit default risk to generate additional revenue. Specifically, researchers are actively pursuing the development of default prediction models using machine learning and deep learning algorithms, in contrast to traditional statistical default prediction methods, which struggle to capture nonlinearity. Among these efforts, Graph Neural Network (GNN) architecture is noteworthy for predicting default in situations with limited data on thin filers. This is due to their ability to incorporate network information between borrowers alongside conventional credit-related data. However, prior research employing graph neural networks has faced limitations in effectively handling diverse categorical variables present in credit information. In this study, we introduce the Transformer embedded Graph Convolutional Network (TeGCN), which aims to address these limitations and enable effective default prediction for thin filers. TeGCN combines the TabTransformer, capable of extracting contextual information from categorical variables, with the Graph Convolutional Network, which captures network information between borrowers. Our TeGCN model surpasses the baseline model's performance across both the general borrower dataset and the thin filer dataset. Specially, our model performs outstanding results in thin filer default prediction. This study achieves high default prediction accuracy by a model structure tailored to characteristics of credit information containing numerous categorical variables, especially in the context of thin filers with limited data. Our study can contribute to resolving the financial exclusion issues faced by thin filers and facilitate additional revenue within the financial industry.

• Journal of Korean Neurosurgical Society
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• v.66 no.3
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• pp.316-323
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• 2023

Objective : Owing to advances in critical care treatment, the overall survival rate of preterm infants born at a gestational age (GA) <32 weeks has consistently improved. However, the incidence of severe intraventricular hemorrhage (IVH) has persisted, and there are few reports on in-hospital morbidity and mortality. Therefore, the aim of the present study was to investigate trends surrounding in-hospital morbidity and mortality of preterm infants with severe IVH over a 14-year period. Methods : This single-center retrospective study included 620 infants born at a GA <32 weeks, admitted between January 2007 and December 2020. After applying exclusion criteria, 596 patients were included in this study. Infants were grouped based on the most severe IVH grade documented on brain ultrasonography during their admission, with grades 3 and 4 defined as severe. We compared in-hospital mortality and clinical outcomes of preterm infants with severe IVH for two time periods : 2007-2013 (phase I) and 2014-2020 (phase II). Baseline characteristics of infants who died and survived during hospitalization were analyzed. Results : A total of 54 infants (9.0%) were diagnosed with severe IVH over a 14-year period; overall in-hospital mortality rate was 29.6%. Late in-hospital mortality rate (>7 days after birth) for infants with severe IVH significantly improved over time, decreasing from 39.1% in phase I to 14.3% in phase II (p=0.043). A history of hypotension treated with vasoactive medication within 1 week after birth (adjusted odds ratio, 7.39; p=0.025) was found to be an independent risk factor for mortality. When comparing major morbidities of surviving infants, those in phase II were significantly more likely to have undergone surgery for necrotizing enterocolitis (NEC) (29.2% vs. 0.0%; p=0.027). Additionally, rates of late-onset sepsis (45.8% vs. 14.3%; p=0.049) and central nervous system infection (25.0% vs. 0.0%; p=0.049) were significantly higher in phase II survivors than in phase I survivors. Conclusion : In-hospital mortality in preterm infants with severe IVH decreased over the last decade, whereas major neonatal morbidities increased, particularly surgical NEC and sepsis. This study suggests the importance of multidisciplinary specialized medical and surgical neonatal intensive care in preterm infants with severe IVH.

• Journal of Trauma and Injury
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• v.36 no.3
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• pp.196-205
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• 2023

Purpose: Surgical stabilization of rib fractures (SSRF) is widely used in patients with flail chests, and several studies have reported the efficacy of SSRF even in multiple rib fractures. However, few reports have discussed the hardware failure (HF) of implanted plates. We aimed to evaluate the clinical characteristics of patients with HF after SSRF and further investigate the related factors. Methods: We retrospectively reviewed the electronic medical records of patients who underwent SSRF for multiple rib fractures at a level I trauma center in Korea between January 2014 and January 2021. We defined HF as the unintentional loosening of screws, dislocation, or breakage of the implanted plates. The baseline characteristics, surgical outcomes, and types of HF were assessed. Results: During the study period, 728 patients underwent SSRF, of whom 80 (10.9%) were diagnosed with HF. The mean age of HF patients was 56.5±13.6 years, and 66 (82.5%) were men. There were 59 cases (73.8%) of screw loosening, 21 (26.3%) of plate breakage, 17 (21.3%) of screw migration, and seven (8.8%) of plate dislocation. Nine patients (11.3%) experienced wound infection, and 35 patients (43.8%) experienced chronic pain. A total of 21 patients (26.3%) underwent reoperation for plate removal. The patients in the reoperation group were significantly younger, had fewer fractures and plates, underwent costal fixation, and had a longer follow-up. There were no significant differences in subjective chest symptoms or lung capacity. Conclusions: HF after SSRF occurred in 10.9% of the cases, and screw loosening was the most common. Further longitudinal studies are needed to identify risk factors for SSRF failure.

• Nuclear Engineering and Technology
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• v.56 no.5
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• pp.1925-1931
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• 2024

The study conducted in the northwest region of Jordan aimed to assess the levels of natural radioactivity in soil and olive mill pomace (OMP) samples. The researchers used Nal (TI) gamma-ray spectrometry to measure the activity concentrations of ²²⁶Ra, ²³²Th, ⁴⁰K, and ¹³⁷Cs in the samples. The average activity concentrations of ²²⁶Ra, ²³²Th, ⁴⁰K, and ¹³⁷Cs in the soil samples were found to be 18.624 ± 5.82, 12.276 ± 5.728, 518.33 ± 212.57, and 0.140 ± 0.09 (Bq, kg^-1), respectively. In the OMP samples, the average activity concentrations of ²²⁶Ra, ²³²Th, and ⁴⁰K were 7.272 ± 4.386, 3.454 ± 1.503, and 169.997 ± 81.873 (Bq kg^-1), respectively, and no ¹³⁷Cs was detected. The study also investigated fundamental parameters associated with radon, specifically the radon emanation coefficient (Rn_EC) and radon mass exhalation rate (E_x). The Rn_EC values ranged from 0.621 to 0.78 (Bq kg^-1), with an average value of 0.71 ± 0.06 (Bq kg^-1). The estimated E_x from the soil samples ranged from 65.83 to 124.86 (mBq kg^-1h^-1), with an average value of 99.74 ± 21.73 (mBq kg^-1h^-1). Regarding radiological hazards, the study examined various parameters, including radium equivalent activity, external and internal hazard indices, gamma and alpha indices, absorbed gamma dose rate, and excess lifetime cancer risk. All of these assessed values were found to be below the worldwide recommended limits for radiological safety. Additionally, the study analyzed the concentrations of gross alpha and gross beta radioactivities in soil and OMP samples. The soil samples had an average gross alpha activity of 4.642 ± 1.04 (Bq kg^-1) and an average gross beta activity of 48.13 ± 14.50 (Bq kg^-1). The OMP samples showed an average gross alpha activity of 0.32 ± 0.27 (Bq kg^-1) and an average gross beta activity of 59.19 ± 12.94 (Bq kg^-1). Overall, the obtained results are crucial for evaluating the radiological risks associated with natural radioactivity in the northwest region of Jordan. The findings establish baseline data for comparison and reference for radioactivity levels in the environment.

• Korean Circulation Journal
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• v.52 no.3
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• pp.205-217
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• 2022

Background and Objectives: The prognostic value of left atrial (LA) function in terms of long-term clinical outcomes after mitral regurgitation (MR) surgery remains unclear. Therefore, we investigated the impact of preoperative LA global longitudinal strain (LAGLS) on the long-term postoperative clinical outcomes in chronic severe MR patients who underwent mitral valve (MV) repair surgery. Methods: From January 2012 to December 2017, we analyzed 338 patients (mean age, 51.9±12.5 years; 218 males [64.5%]) treated with MV repair surgery for severe MR. The primary outcome was cardiovascular events, defined as the composite of all-cause death, newly developed atrial fibrillation (AF), and re-hospitalization for cardiovascular causes. Results: During a median follow-up of 45 months (interquartile range, 26-65), 30 (8.9%) cardiovascular events, 5 (1.5%) all-cause death, 8 (2.4%) newly developed AF, and 26 (7.7%) re-hospitalizations occurred. On multivariable analysis, baseline LAGLS was an independent predictor of cardiovascular events (adjusted hazard ratio [HR], 0.91; 95% confidential interval [CI], 0.85-0.97; p=0.004) and re-hospitalization (adjusted HR, 0.93; 95% CI, 0.86-1.00; p=0.037). According to the optimal cutoff value of LAGLS, patients with low LAGLS (<23.6%) had a significantly higher risk of cardiovascular events (adjusted HR, 2.70; 95% CI, 1.04-7.00; p=0.041) than those with high LAGLS (≥23.6%). In a subgroup analysis, patients with high LAGLS had better clinical outcomes regardless of whether the patient had a LA volume index <60 mL/m². Conclusions: In patients with chronic severe MR who received successful MV repair surgery, preoperative LAGLS is an independent predictor of long-term postoperative outcomes.