• Tuberculosis and Respiratory Diseases
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• v.85 no.3
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• pp.227-236
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• 2022

Background: The use of low-dose inhaled corticosteroid-formoterol as reliever monotherapy has recently been recommended in the asthma treatment guidelines. However, the efficacy of this treatment strategy has not yet been determined during the stepping-down period in moderate asthma. This study aimed to evaluate the feasibility of reducing treatment to as-needed budesonide-formoterol (BFM) in moderate asthma with complete remission. Methods: We randomly assigned 31 patients (8 males and 23 females with a mean age of 57.2 years) with complete remission of asthma by inhaled BFM (160/4.5 ㎍) twice daily to receive BFM (160/4.5 ㎍) as needed (16 patients), or budesonide (BUD) (200 ㎍) twice daily (15 patients). The study was an open-label study done for 48 weeks, with the primary outcome as the cumulative percentages of patients with treatment failure (asthma exacerbation or loss of asthma control or lack of satisfaction after using medications) in the two groups. Results: Six patients (42%) using as-needed BFM had treatment failure, as compared with three patients (21.4%) using BUD maintenance (hazards ratio for as-needed BFM, 1.77; 95% confidential interval, 0.44-7.12; p=0.41). The changes in forced expiratory volume in 1 second were -211.3 mL with as-needed BFM versus -97.8 mL with BUD maintenance (difference, 113.5 mL; p=0.75) and the change in fractional exhaled nitric oxide was significantly higher in both groups, at 8.68 parts per billion (ppb) in the as-needed BFM group and 2.5 ppb. in the BUD maintenance group (difference, 6.18 ppb; p=0.049). Conclusion: Compared with BUD maintenance, there were no significant differences in treatment failure rate in patients who received as-needed BFM during the stepping down period in moderate asthma. However, they showed reduced lung function and relapsed airway inflammation. The results are limited by imprecision, and further large RCTs are needed.

• Tuberculosis and Respiratory Diseases
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• v.84 no.3
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• pp.188-199
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• 2021

Background: Chronic obstructive pulmonary disease (COPD) is a common chronic respiratory disease with increased prevalence in the elderly. Telomeres are repetitive DNA sequences found at the end of the chromosome, which progressively shorten as cells divide. Telomere length is known to be a molecular marker of aging. This study aimed to assess the relationship between telomere length and the risk of COPD, lung function, respiratory symptoms, and emphysema index in Chronic Obstructive Pulmonary Disease in Dusty Areas (CODA) cohort. Methods: We extracted DNA from the peripheral blood samples of 446 participants, including 285 COPD patients and 161 control participants. We measured absolute telomere length using quantitative real-time polymerase chain reaction. All participants underwent spirometry and quantitative computed tomography scan. Questionnaires assessing respiratory symptoms and the COPD Assessment Test was filled by all the participants. Results: The mean age of participants at the baseline visit was 72.5±7.1 years. Males accounted for 72% (321 participants) of the all participants. The mean telomere length was lower in the COPD group compared to the non-COPD group (COPD, 16.81±13.90 kb; non-COPD, 21.97±14.43 kb). In COPD patients, 112 (75.7%) were distributed as tertile 1 (shortest), 91 (61.1%) as tertile 2 and 82 (55%) as tertile 3 (longest). We did not find significant associations between telomere length and lung function, exacerbation, airway wall thickness, and emphysema index after adjusting for sex, age, and smoking status. Conclusion: In this study, the relationship between various COPD phenotypes and telomere length was analyzed, but no significant statistical associations were shown.

• The Journal of Internal Korean Medicine
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• v.43 no.5
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• pp.909-917
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• 2022

Objective: The purpose of this study was to investigate the effect of Samchilgeun powder (panax notoginseng) on the treatment of hematuria in a patient requiring double antiplatelet therapy due to recurrent cerebral infarction. Methods: The patient was treated with Samchilgeun powder (panax notoginseng) combined with Western medicine (an antiplatelet). Urinalysis was performed to observe hematuria and proteinuria levels, and blood tests were used to evaluate anemia levels. Results: After treatment, hematuria levels decreased without exacerbation of anemia and proteinuria and even recurrence of cerebral infarction. Conclusions: This study suggests that Samchilgeun powder (panax notoginseng) can effectively treat patients with hematuria requiring double antiplatelet therapy due to recurrent cerebral infarction, but further studies should be conducted.

• Journal of Korean Academy of Nursing
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• v.53 no.2
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• pp.167-176
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• 2023

Purpose: Despite the high prevalence of visual impairment caused by diabetic retinopathy and nutritional problems among older adults with diabetes, evidence regarding factors related to nutritional risk in this population is limited. Therefore, this study aimed to identify the correlates of nutritional risk among older adults with diabetes, focusing on visual impairment. Methods: This study was a secondary data analysis of the 2020 National Survey of Older Koreans aged 65 years and above. The sample comprised 2,376 older adults with diabetes, and complex sample ANOVA and Rao-Scott chi-square tests were used to compare the groups according to visual impairment. Complex-sample logistic regression analyses were conducted to verify the association between visual impairment and nutritional risk. Results: Older adults with diabetes, who also have severe visual impairment, are more likely to have nutritional risk status than those without impairment after controlling for covariates (odds ratio [OR] = 2.44, 95% confidence interval [CI] 1.16~5.13). Among the covariates, depression (OR = 3.58, 95% CI 2.60~4.94), dependent activities of daily living status (OR = 2.79, 95% CI 1.60~4.86), and experience of hospitalization during the past year (OR = 2.51, 95% CI 1.57~4.03) were strongly associated with nutritional risk. Conclusion: Severe visual impairment increases the nutritional risk among older adults with diabetes. Therefore, it is essential to prevent visual impairment due to exacerbation of diabetes through appropriate management. Additionally, tailored nutritional interventions for visually impaired older adults with diabetes that consider visual characteristics are required.

• Journal of Chest Surgery
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• v.56 no.5
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• pp.328-335
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• 2023

Background: Thromboangiitis obliterans (TAO) poses a higher risk of amputation than atherosclerosis obliterans. It is characterized by onset at a relatively young age. There are currently no clear treatment guidelines for TAO other than smoking cessation. In this study, we aimed to identify factors that could influence a favorable prognosis of TAO. Methods: From January 2009 to December 2019, we retrospectively reviewed the initial symptoms, characteristics, treatments, and disease course of 37 patients (45 limbs) with TAO. Logistic regression analysis was performed to investigate factors affecting the course of symptoms that persisted or worsened despite treatment. Results: Patients' mean age was 37.2±11.4 years, and all patients were men. The mortality rate was 0% during the follow-up period (76.9±51.1 months). All patients were smokers at the time of diagnosis, and 19 patients (51.4%) successfully quit smoking during treatment. When comparing the Rutherford categories before and after treatment, 23 limbs (51.1%) showed improvement, the category was maintained in 11 limbs (24.4%), and 11 limbs (24.4%) worsened. Symptom persistence or exacerbation despite treatment was associated with a higher initial Rutherford category (odds ratio [OR], 1.59; 95% confidence interval [CI], 1.04-2.42; p=0.03) and a higher score of the involved below-knee artery at the time of diagnosis (OR, 2.26; 95% CI, 1.10-4.67; p=0.03). Conclusion: The degree of disease progression at the time of diagnosis significantly affected patients' prognosis. Therefore, early diagnosis and intervention are important to improve the course of TAO.

• Research in Plant Disease
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• v.28 no.4
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• pp.209-220
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• 2022

Charcoal canker of oak, which has recently increased in southern Iran, could pose a serious threat to the entire forest ecosystem in the near future. In addition, it seems that climate change and its consequences, such as drought in the southern regions of Iran, have exacerbated this phenomenon. Consequently, the objective of this study was to identify the fungal pathogens that could cause charcoal canker disease in the oak forests of South Zagros. It was also sought to find associations between changes in the occurrence/exacerbation of charcoal canker disease under non and intense drought stress in non-inoculated or inoculated Quercus brantii seedlings. In total, 120 isolates were obtained from eight oak forests located in the Zagros Mountains of Southern Iran, Kohgiluyeh & Boyer-Ahmad and Fars provinces, which were classified as Biscogniauxia mediterranea based on morphological assessment. Subsequently, molecular assay confirmed the result by phylogenetic inference of internal transcribed spacer-rDNA regions, α-actin, and β-tubulin genes. The results of the pathogenicity test showed that the response of isolates of B. mediterranea (Iran-G1 and Iran-M70) was varied in different environments for the measured necrotic lesion length. In comparison with the control moisture treatments (non-stress), the necrotic lesion length in inoculated treatments increased under intense drought stress. In general, inoculated oak seedlings' exposure to water-deficient stress by the pathogen of B. mediterranea could affect the spread/severity of the charcoal canker disease.

• Archives of Plastic Surgery
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• v.50 no.5
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• pp.446-451
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• 2023

Background Elderly patients often have complications of blepharoptosis surgery that can result in the appearance or exacerbation of superficial punctate keratopathy (SPK). However, postoperative changes to SPK status have not been previously reported. We used subjective assessment of symptoms and measurement of SPK scale classification to investigate the safety and efficacy of blepharoptosis surgery in elderly patients. Methods Included in this prospective study were 22 patients (44 eyes) with bilateral blepharoptosis that underwent surgery. Patients comprised 8 males and 14 females with a mean (±standard deviation) age of 75.7 ± 8.2 years (range: 61-89). Blepharoptosis surgery consisted of transcutaneous levator advancement and blepharoplasty including resection of soft tissue (skin, subcutaneous tissue, and the orbicularis oculi muscle). Margin reflex distance-1 (MRD-1) measurement, a questionnaire survey of symptoms and SPK scale classification, was administered preoperatively and 3 months postoperatively for evaluation. Results The median MRD-1 was 1 mm preoperatively and 2.5 mm postoperatively, representing a significant postoperative improvement. SPK area and density scores were found to increase when the MRD-1 increase was more than 2.5 mm with surgery. All 10 items on the questionnaire tended have increased scores after surgery, and significant differences were observed in 7 items (poor visibility, ocular fatigue, heavy eyelid, foreign body sensation, difficulty in focusing, headaches, and stiff shoulders). Conclusion Blepharoptosis surgery was found to be a safe and effective way to maintain the increase in MRD-1 within 2.0 mm. Despite the benefits, surgeons must nonetheless be aware that blepharoptosis surgery is a delicate procedure in elderly people.

• Korean Journal of Applied Biomechanics
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• v.34 no.2
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• pp.93-103
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• 2024

Objective: The purpose of this study was to investigate whether dancers with chronic ankle instability (CAI) exhibit different characteristics in dynamic postural control ability and ankle joint laxity compared to dancers without CAI and non-dancers with CAI. Method: Twelve dancers with CAI, 14 dancers without CAI, and 12 non-dancers with CAI participated in the study. Dynamic balance was evaluated using the Star Excursion Balance Test (SEBT) and the single-leg hop balance. The laxity of the ankle joint was evaluated through the anterior drawer test and the talar tilt test. SEBT measured maximum reach distances in anterior, posteromedial, and posterolateral directions. Single-leg hop assessed center of pressure (COP) and time-to-boundary (TTB) outcomes. One-way ANOVA and Chi-square tests were performed to compare the outcome variables among the three groups. Results: Dancers with CAI demonstrated greater reach distance in the posterolateral direction compared to non-dancers with CAI during SEBT (p=.014). Secondly, dancers without CAI showed greater reach distance in the posterolateral (p<.001) and posteromedial (p=.001) directions during SEBT compared to non-dancers with CAI. Additionally, dancers without CAI exhibited better postural control with higher TTB AP mean of minima (p=.003) and TTB AP standard deviation of minima (p=.012) during single-leg hop compared to nondancers with CAI. Thirdly, dancers with CAI showed a lower positive rate during the anterior drawer test compared to non-dancers with CAI (p=.019). Conclusion: Dancers with CAI demonstrated better ankle function and reduced mechanical instability compared to non-dancers with CAI. Therefore, to elucidate the underlying mechanisms of lateral ankle sprain and CAI development exacerbation in dancers, additional factors that can affect ankle sprain, such as visual dependence during postural control and evaluation in dance movements, should be explored.

• Journal of the Korean Society of Radiology
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• v.81 no.4
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• pp.972-978
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• 2020

Fentanyl intoxication has occasionally been reported since fentanyl patches became available for medical use. Delayed post-hypoxic leukoencephalopathy is a complication of hypoxia. However, its neuropsychiatric symptoms can be delayed, and it can progress to leukoencephalopathy even after full recovery from coma due to acute intoxication. Herein, we report a case of fentanyl intoxication in a 65-year-old man who was presented to the hospital because of unconsciousness for 13 hours after using ten fentanyl patches simultaneously. Initial brain CT findings were non-specific. Twenty days later, delayed neuropathologic symptoms manifested, and MRI showed bilaterally symmetrical, heterogeneous, confluent high signal intensities on T2-weighted/fluid attenuated inversion recovery MRI in the cerebral white matter with diffusion restriction. This was followed by rapid exacerbation of neuropathological symptoms with diffuse severe cerebral atrophy over 1 year.

• IMMUNE NETWORK
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• v.22 no.2
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• pp.15.1-15.16
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• 2022

Foreign molecules, including viruses and bacteria-derived toxins, can also induce airway inflammation. However, to the best of our knowledge, the roles of these molecules in the development of airway inflammation have not been fully elucidated. Herein, we investigated the precise role and synergistic effect of virus-mimicking double-stranded RNA (dsRNA) and staphylococcal enterotoxin B (SEB) in macrophages and epithelial cells. To identify cytokine expression profiles, both the THP-1-derived macrophages and BEAS-2B epithelial cells were stimulated with dsRNA or SEB. A total of 21 cytokines were evaluated in the culture supernatants. We observed that stimulation with dsRNA induced cytokine production in both cell types. However, cytokine production was not induced in SEB-stimulated epithelial cells, compared to the macrophages. The synergistic effect of dsRNA and SEB was evaluated observing cytokine level and intracellular phospho-signaling. Fifteen different types were detected in high-dose dsRNA-stimulated epithelial cells, and 12 distinct types were detected in macrophages; those found in macrophages lacked interferon production compared to the epithelial cells. Notably, a synergistic effect of cytokine induction by co-stimulation of dsRNA and SEB was observed mainly in epithelial cells, via activation of most intracellular phosphor-signaling. However, macrophages only showed an accumulative effect. This study showed that the type and severity of cytokine productions from the epithelium or macrophages could be affected by different intensities and a combination of dsRNA and SEB. Further studies with this approach may improve our understanding of the development and exacerbation of airway inflammation and asthma.