• 한방비만학회지
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• 제15권2호
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• pp.153-161
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• 2015

감로수는 궁중음료인 제호탕과 동의보감의 생맥산에서 유래한 절식보조음료이다. 감로수를 이용한 절식요법의 보완과 향후 예정된 임상시험을 위한 임상지표 선정을 위해 정상인 1예, 비만인 1예, 고도비만인 1예를 대상으로 10일간의 절식요법 전, 후로 증례를 관찰하였다. 절식 후 체중은 평균 -6.3%, 체지방은 평균 -6.5%, 근육은 평균 -6.6% 감소하였고, 영양지표에 해당하는 RBC, hemoglobin, hematocrit, T-protein, albumin의 수치는 증가하였고 염증지표에 해당하는 hs- CRP, CRP, ESR, WBC 수치는 감소하였다. 절식 후에도 간기능, 신기능, 전해질수치는 정상수준을 유지하였고, 산화스트레스는 감소하였으며, 항산화력이 증가하는 결과를 나타내었다. 피로도는 절식 전보다 다소 개선되었고, 절식기 동안 불면 이외에 별다른 불편증상을 호소하지 않았다. 다만 혈중 빌리루빈수치 상승, 케톤 증가로 인한 체액의 약산성화는 절식요법을 시행함에 있어 추후 보완해야 할 사안이라 생각된다. 결론적으로 감로수의 디톡스 프로파일은 적합하며 관찰된 결과는 후속연구에 고려될 것이다.

• Clinical Endoscopy
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• 제51권6호
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• pp.558-562
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• 2018

Background/Aims: While the occurrence of multiple whitish flat elevated lesions (MWFL) was first reported in 2007, no studies on MWFL have been published to date. The present retrospective observational study aimed to clarify the endoscopic findings and clinicopathological features of MWFL. Methods: Subjects were consecutive patients who underwent upper gastrointestinal endoscopy as part of routine screening between April 2014 and March 2015. The conventional white-light, non-magnifying and magnifying narrow-band images were reviewed. Clinical features were compared between patients with and without MWFL. Results: The conventional endoscopic findings of MWFL include multiple whitish, flat, and slightly elevated lesions of various sizes, mainly located in the gastric body and fundus. Narrow-band imaging enhanced the contrast of MWFL and background mucosa, and magnifying narrow-band imaging depicted a uniformly long, narrow, and elliptical marginal crypt epithelium with an unclear microvascular pattern. Histopathological findings revealed hyperplastic changes of the foveolar epithelium, and parietal cell protrusions and oxyntic gland dilatations were observed in the fundic glands, without any intestinal metaplasia. The rate of acid-reducing drug use was significantly higher in patients with MWFL than in those without (100% [13/13] vs. 53.7% [88/164], p<0.001). Conclusions: The present study indicated a relationship between the presence and endoscopic features of MWFL and history of acid-reducing drug use.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제22권4호
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• pp.350-357
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• 2019

Purpose: This study aimed to evaluate a possible association between the anti-tissue transglutaminase antibody (anti-tTG) titer and stage of duodenal mucosal damage and assess a possible cut-off value of anti-tTG at which celiac disease (CD) may be diagnosed in children in conjunction with clinical judgment. Methods: This observational study was conducted at a gastroenterology clinic in a tertiary hospital from April 2012 to May 2013. Seventy children between 6-months and 18-years-old with suspected CD underwent celiac serology and duodenal biopsy. Statistical analyses were done using SPSS 16. Diagnostic test values were determined for comparing the anti-tTG titer with duodenal biopsy. An analysis of variance and Tukey-Kramer tests were performed for comparing the means between groups. A receiver operating characteristics curve was plotted to determine various cut-off values of anti-tTG. Results: The mean antibody titer increased with severity of Marsh staging (p<0.001). An immunoglobulin (Ig) A-tTG value at 115 AU/mL had 76% sensitivity and 100% specificity with a 100% positive predictive value (PPV) and 17% negative predictive value (NPV) for diagnosis of CD (p<0.001, 95% confidence interval [CI], 0.75-1). Conclusion: There is an association between the anti-tTG titer and stage of duodenal mucosal injury in children with CD. An anti-tTG value of 115 AU/mL (6.4 times the upper normal limit) had 76% sensitivity, 100% specificity, with a 100% PPV, and 17% NPV for diagnosing CD (95% CI, 0.75-1). This cut-off may be used in combination with clinical judgment to diagnose CD.

• BLOOD RESEARCH
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• 제53권4호
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• pp.276-280
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• 2018

Background Chronic lymphocytic leukemia (CLL) exhibits profound heterogeneity in its clinical course. Its clinicohematological and cytogenetic features play a significant role in determining the clinical course and in predicting the treatment response and prognosis. In this context, 17p deletion is known to predict a poor prognosis, as these cases are refractory to conventional therapy. This study aimed to evaluate the clinicohematological characteristics, outcomes, and prognostic factors among CLL patients with and without del 17p in Pakistan. Methods This prospective observational study was conducted at the Department of Haematology, Armed Forces Institute of Pathology (Rawalpindi, Pakistan) between January 2013 and December 2017. Patients were diagnosed based on the International Workshop on Chronic Lymphocytic Leukaemia IWCLL criteria, their clinicohematological parameters were recorded, and cytogenetic analyses were performed. The time from diagnosis to treatment and the 2-year overall survival rate were also evaluated. Results We evaluated 130 CLL cases, including 24 patients (18.5%) with del 17p, who included 18 men (75%) and 6 women (25%). The median age was 68 years. Binet stage C was detected at the presentation in 16 patients (67%). Treatment was administered to 14 patients (70%) at a median interval of 11 months (range, 0-28 mo) after diagnosis. The overall response rate was 64.3%, the median event-free survival was 9 months (range, 1-23 mo), and the 2-year overall survival rate was 65%. Conclusion Del 17p is relatively common in Pakistan, and patients harboring this deletion had poor treatment response and survival outcomes.

• 대한임상독성학회지
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• 제18권2호
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• pp.123-129
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• 2020

Purpose: Atropine is an antidote used to relieve muscarinic symptoms in patients with organophosphate and carbamate poisoning. Nutritional support via the enteral nutrition (EN) route might be associated with improved clinical outcomes in critically ill patients. This study examined the administration of nutritional support in patients undergoing atropinization, including methods of supply, outcomes, and complications. Methods: A retrospective observational study was conducted in a tertiary care teaching hospital from 2010 to 2018. Forty-five patients, who were administered with atropine and on mechanical ventilation (MV) due to organophosphate or carbamate poisoning, were enrolled. Results: Nutritional support was initiated on the third day of hospitalization. Thirty-three patients (73.3%) were initially supported using parenteral nutrition (PN). During atropinization, 32 patients (71.1%) received nutritional support via EN (9) or PN (23). There was no obvious reason for not starting EN during atropinization (61.1%). Pneumonia was observed in both patient groups on EN and PN (p=0.049). Patients without nutritional support had a shorter MV duration (p=0.034) than patients with nutritional support. The methods of nutritional support during atropinization did not show differences in the number of hospital days (p=0.711), MV duration (p=0.933), duration of ICU stay (p=0.850), or recovery at discharge (p=0.197). Conclusion: Most patients undergoing atropinization were administered PN without obvious reasons to preclude EN. Nutritional support was not correlated with the treatment outcomes or pneumonia. From these results, it might be possible to choose EN in patients undergoing atropinization, but further studies will be necessary.

• Clinical and Experimental Reproductive Medicine
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• 제48권2호
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• pp.163-173
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• 2021

Objective: This study aimed to characterize a validated model for predicting oocyte retrieval in controlled ovarian stimulation (COS) and to construct model-based nomograms for assistance in clinical decision-making regarding the gonadotropin protocol and dose. Methods: This observational, retrospective, cohort study included 636 women with primary unexplained infertility and a normal menstrual cycle who were attempting assisted reproductive therapy for the first time. The enrolled women were split into an index group (n=497) for model building and a validation group (n=139). The primary outcome was absolute oocyte count. The dose-response relationship was tested using modified Poisson, negative binomial, hybrid Poisson-E_max, and linear models. The validation group was similarly analyzed, and its results were compared to that of the index group. Results: The Poisson model with the log-link function demonstrated superior predictive performance and precision (Akaike information criterion, 2,704; λ=8.27; relative standard error (λ)=2.02%). The covariate analysis included women's age (p<0.001), antral follicle count (p<0.001), basal follicle-stimulating hormone level (p<0.001), gonadotropin dose (p=0.042), and protocol type (p=0.002 and p<0.001 for short and antagonist protocols, respectively). The estimates from 500 bootstrap samples were close to those of the original model. The validation group showed model assessment metrics comparable to the index model. Based on the fitted model, a static nomogram was built to improve visualization. In addition, a dynamic electronic tool was created for convenience of use. Conclusion: Based on our validated model, nomograms were constructed to help clinicians individualize the stimulation protocol and gonadotropin doses in COS cycles.

• Imaging Science in Dentistry
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• 제51권1호
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• pp.9-16
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• 2021

Purpose: The purpose of this study was to analyze the reliability of 7 panoramic radiographic signs for predicting proximity of the root apices of mandibular third molars to the mandibular canal using cone-beam computed tomography and to correlate these findings with the Pell and Gregory and the Winter classification systems. Materials and Methods: An observational, cross-sectional, descriptive study was conducted on 74 patients with bilateral impacted mandibular third molars. Four panoramic radiographic signs were observed in the tooth root (darkening, deflection, and narrowing of the root apices, and bifid apices), and another 3 in the mandibular canal (diversion, narrowing, and interruption of the mandibular canal). Cone-beam computed tomography images were analyzed to identify disruption and diversion of the mandibular canal and root deflection. Results: Binary logistic regression showed that only 4 of the 7 panoramic radiographic signs were able to predict proximity of the root apices of the mandibular third molars to the mandibular canal: darkening of the root, deflection of the root, narrowing of the root, and interruption of the mandibular canal(P<0.05). Conclusion: Darkening, deflection, and narrowing of the root, in tandem with the interruption of the mandibular canal on panoramic radiographs, indicate that cone-beam computed tomography should be performed when planning the extraction of impacted mandibular third molars. Proximity between mandibular third molars and the mandibular canal is correlated with the Winter classification.

• Journal of Korean Neurosurgical Society
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• 제67권2호
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• pp.177-185
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• 2024

Objective : Delayed cerebral ischemia (DCI) is a major cause of disability in patients who survive aneurysmal subarachnoid hemorrhage (aSAH). Systemic inflammatory markers, such as peripheral leukocyte count and systemic immune-inflammatory index (SII) score, have been considered predictors of DCI in previous studies. This study aims to investigate which systemic biomarkers are significant predictors of DCI. Methods : We conducted a retrospective, observational, single-center study of 170 patients with SAH admitted between May 2018 and March 2022. We analyzed the patients' clinical and laboratory parameters within 1 hour and 3-4 and 5-7 days after admission. The DCI and non-DCI groups were compared. Variables showing statistical significance in the univariate logistic analysis (p<0.05) were entered into a multivariate regression model. Results : Hunt-Hess grade "4-5" at admission, modified Fisher scale grade "3-4" at admission, hydrocephalus, intraventricular hemorrhage, and infection showed statistical significance (p<0.05) on a univariate logistic regression. Lymphocyte and monocyte count at admission, SII scores and C-reactive protein levels on days 3-4, and leukocyte and neutrophil counts on days 5-7 exhibited statistical significance on the univariate logistic regression. Multivariate logistic regression analysis revealed that monocyte count at admission (odds ratio [OR], 1.64; 95% confidence interval [CI], 1.04-2.65; p=0.036) and SII score at days 3-4 (OR, 1.55; 95% CI, 1.02-2.47; p=0.049) were independent predictors of DCI. Conclusion : Monocyte count at admission and SII score 3-4 days after rupture are independent predictors of clinical deterioration caused by DCI after aSAH. Peripheral monocytosis may be the primer for the innate immune reaction, and the SII score at days 3-4 can promptly represent the propagated systemic immune reaction toward DCI.

• 대한물리의학회지
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• 제19권1호
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• pp.61-68
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• 2024

PURPOSE: This study aimed to provide basic clinical data by analyzing the impact of motion observation training and stretching exercises for improving postures on the neck alignment and balance of stroke patients to enable them to accurately recognize the correct exercise method. METHODS: After sampling 20 stroke patients who met the selection criteria, this study randomly assigned 10 people who were administered the stretching exercise with observation training to the experimental group and 10 who received only the stretching exercise intervention to the control group by drawing lots. Next, neck alignment and balance were pre-tested. All interventions were conducted for 30 minutes, 3 times a week for 4 weeks, and when all the interventions were completed after 4 weeks, neck alignment and balance were re-measured in the same way as the pre-test. RESULTS: The comparison of changes in neck alignment and balance within the experimental and control groups showed statistically significant differences in the craniovertebral angle, cranial rotation angle, and balance (p < .05) (p < .01). Between the groups, statistically significant differences were found in the craniovertebral angle, cranial rotation angle, and balance (p < .05) (p < .01). CONCLUSION: A statistically significant difference in neck alignment and balance was observed in the group that underwent stretching exercises combined with observational training and a statistically significant difference was found between the groups. Therefore, it is believed that observation training should be used in clinical practice to improve forward head posture and restore balance in stroke patients.

• 대한한의학회지
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• 제43권2호
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• pp.8-26
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• 2022

Objectives: This study is designed to statistically analyze characteristics, treatment effect and prognosis of patients who were treated for the recurrent Bell's palsy Methods: This study retrospectively analyzed the medical records and telephone questionnaire of 82 patients treated with the recurrent Bell's palsy at the OO Korean Medicine hospital from August 01, 2018 to July 31, 2021. Results: The lower the EQ-VAS^® and HB scale before and after treatment, the higher the satisfaction with the treatment. The average of the number of days and duration of outpatient treatment for male was longer than that for female. The average number of days and duration of outpatient treatment in the group that received combined treatment was longer than that of patients who received Korean Medicine only. The higher the satisfaction of treatment, the higher the willingness to receive treatment in the event of recurrent facial palsy. HB scale after treatment was the lowest in their 40s, and the average value of HB scale after treatment tended to increase as age increased except for those in their 40s. Conclusion: This study showed that the lower the HB scale after treatment, the lower the EQ-VAS®, the higher the treatment satisfaction, and the higher the probability receiving treatment if the facial paralysis recurs. Those in their 10s to 40s showed excellent results after treatment. Comparatively, those in their 50s and above showed a little effect after treatment. Gender, affected side, history of facial palsy, season of onset, age, hypertension and diabetes had no statistically significance with recurrent Bell's palsy prognosis.