• Radiation Oncology Journal
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• 제37권1호
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• pp.51-59
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• 2019

Purpose: We evaluated failure pattern and treatment outcomes of observational approach on regional lymph node (LN) in cutaneous melanoma of extremities and sought to find clinico-pathologic factors related to LN metastases. Material and Methods: We retrospectively reviewed 73 patients with cutaneous melanoma of extremities between 2005 and 2016. If preoperative 18-F-fluorodeoxyglucose (FDG)-positron emission tomography/computed tomography (PET/CT) findings were non-specific for regional LNs, surgical resection of primary tumors with adequate margins was performed without sentinel lymph node biopsy (SLNB) and/or complete lymph node dissection (CLND), irrespective of tumor thickness or size. In patients with suspicious or positive findings on PET/CT or CT, SLNB followed by CLND or CLND was performed at the discretion of the surgeon. We defined LN dissection (LND) as SLNB and/or CLND. Results: With a median follow-up of 38 months (range, 6 to 138 months), the dominant pattern of failure was regional failure (17 of total 23 events, 74%) in the observation group (n = 56). Pathologic LN metastases were significant factor for poor regional failure-free survival (hazard ration [HR] = 3.21; 95% confidence interval [CI], 1.03-10.33; p = 0.044) and overall survival (HR = 3.62; 95% CI, 1.02-12.94; p = 0.047) in multivariate analysis. In subgroup analysis for cN0 patients according to the preoperative PET/CT findings, LND group showed the better trend of LRFFS (log rank test, p = 0.192) and RFFS (p = 0.310), although which is not statistically significant. Conclusion: Observational approach on regional LNs on the basis of the PET/CT in patients with cutaneous melanoma of extremities showed the dominant regional failure pattern compared to upfront LND approach. To reveal regional lymph node status, SLND for cN0 patients may of importance in managing cutaneous melanoma patients.

• 대한물리의학회지
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• 제9권2호
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• pp.201-211
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• 2014

PURPOSE: The purpose of this study was to investigate the inter-rater absolute reliability and the concurrent validity of the Tinetti-gait scale that was translated into Korean for chronic stroke patients. METHODS: Fifty-two patients with post-stroke participated in this study. Inter-rater reliability was analyzed by Intraclass Correlation Coefficient ($ICC_{3,1}$) and Kappa coefficient, and absolute reliability was analyzed by the Standard Error of Measurement (SEM), and the Minimal Detectable Change (MDC). Concurrent validity was analyzed by correlating between the Tinetti-gait scale and physical functions. The physical functions were measured by using the Dynamic Gait Index(DGI), 10m walking test(10WT), One Leg Standing Test of affected/non-affected side(OLST), Sit to Stand test(STS), (Fugl Meyer assessment of Lower Extremity(FM-LE). RESULTS: The inter-rater reliability of the Tinetti-gait scale was high; $ICC_{(3,1)}=.91$ (95% CI=.85~.95) (very reliable), the range of Kappa coefficient were .73~.92 (substantial~good). The inter-rater agreement of the each item in Tinetti-gait scale ranged from .74 to .92 (95 % CI=.59~.95) (reliable~very reliable). The SEM and MDC were .56 and 1.55, respectively. In the results of concurrent validity, there were moderate positive correlation between Tinetti-gait scale and DGI (r=.78), 10WT (r=.74), OLST (r=.65~.73), FM-LE (r=67). And there was moderate negative correlation between Tinetti-gait scale and STS (r=-79) (p<.01). CONCLUSION: The Tinetti-gait scale(Korean version) was a reliable and valid tool to measure gait ability in patients with chronic stroke. Thus, it could be a useful tool for examining a gait ability of post-stroke patients. Further study should be conducted to investigate the usability to predict fall risk of post-stroke patients of the Tinetti-gait scale.

• Childhood Kidney Diseases
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• 제24권2호
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• pp.83-90
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• 2020

Purpose: To investigate the association between urinary neutrophil gelatinase-associated lipocalin (uNGAL) and leukocyte differential count in children with urinary tract infections (UTIs). Methods: A retrospective chart review was performed in children undergoing uNGAL measurements between June 2018 and September 2019. Patients with suspected or diagnosed UTIs were included. The relationship between uNGAL and blood leukocyte differential count was investigated in children. Results: A total of 197 children were included in this study, 119 of whom (60%) had UTIs. The non-UTI patients (n=78) were diagnosed with pneumonia, acute gastroenteritis, viral upper respiratory infection, and others. After adjusting for age, gender, and fever duration, the leukocyte count, monocyte count, and uNGAL levels were higher in the UTI group than in the non-UTI group (P<0.05). uNGAL showed positive correlations with neutrophil counts, monocyte counts, the neutrophil-to-lymphocyte ratio, and the monocyte-to-lymphocyte ratio in the UTI group (P<0.05). uNGAL levels were only associated with the neutrophil-to-lymphocyte ratio in the non-UTI group (P<0.05). In a multivariable logistic regression analysis, only uNGAL was associated with the presence of UTI (P<0.05). The area under the receiver operating characteristic curves for uNGAL and monocyte counts to identify UTI were 0.89 (95% confidence interval (CI): 0.824-0.939; P=0.025) and 0.7 (95% CI: 0.627-0.774; P=0.038), respectively. Conclusions: In children with UTIs, uNGAL levels may be associated with blood leukocyte differential counts. uNGAL measurements and monocyte counts can be helpful in children with suspected UTIs.

• 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.

• Archives of Plastic Surgery
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• 제46권3호
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• pp.248-254
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• 2019

Background No head to head comparison is available between surgical lip lifting and upper lip filler injections to decide which technique yields the best results in patients. Despite the growing popularity of upper lip augmentation, its effect on societal perceptions of attractiveness, successfulness and overall health in woman is unknown. Methods Blinded casual observers viewed three versions of independent images of 15 unique patient lower faces for a total of 45 images. Observers rated the attractiveness, perceived success, and perceived overall health for each patient image. Facial perception questions were answered on a visual analog scale from 0 to 100, where higher scores corresponded to more positive responses. Results Two hundred and seventeen random observers with an average age of 47 years (standard deviation, 15.9) rated the images. The majority of observers were females (n=183, 84%) of white race (n=174, 80%) and had at least some college education (n=202, 93%). The marginal mean score for perceived attractiveness from the natural condition was 1.5 points (95% confidence interval [CI], 0.9-2.18) higher than perceived attractiveness from the simulated upper lip filler injection condition, and 2.6 points higher (95% CI, 1.95-3.24) than the simulated upper lip lift condition. There was a moderate to strong correlation between the scores of the same observer. Conclusions Simulated upper lip augmentation is amenable to social perception analysis. Scores of the same observer for attractiveness, successfulness, and overall health are strongly correlated. Overall, the natural condition had the highest scores in all categories, followed by simulated upper lip filler, and lastly simulated upper lip lift.

• Physical Therapy Rehabilitation Science
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• 제8권1호
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• pp.52-59
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• 2019

Objective: The purpose of this review was to investigate whether motor imagery training has an effect on the recovery of upper extremity function in individuals with hemiparetic stroke or not. Design: A systematic review and meta-analysis. Methods: PubMed and three other databases were searched up to December 18th, 2018 and randomized controlled trials (RCTs) evaluating motor imagery training on upper extremity function in persons with a diagnosis of hemiparetic stroke were included. This review selected the following information from each study: surname of the first author, published year, nation, population, intervention, therapeutic intensity of intervention, therapeutic comparison, outcome measures, additional therapy, summary of results, and descriptive statistics of outcome measures. Results: This review selected seventeen RCTs with 487 stroke survivors and the following intervention methods: six motor imagery training with additional therapeutic technology, two motor imagery training with additional modified constraint-induced therapy, four mirror therapy, and five motor imagery training. Ten RCTs were eligible for meta-analysis after systematic review. The motor imagery group were more effective than the control group based on the Fugl-Meyer assessment (3.43; 95% confidence interval [CI], 1.65 to 5.22; heterogeneity [$chi^2=8.03$, df=8, $I^2=0%$], test of overall effect Z=3.76; test for subgroup differences [$chi^2=2.56$, df=2, $I^2=21.8%$]) and the Action Research Arm Test (1.32; 95% CI, -8.12 to 10.76; heterogeneity [$Tau^2=70.74$, $chi^2=15.22$, df=3, $I^2=80%$], test of overall effect Z=3.76). Conclusions: The results of this review suggests that motor imagery shows positive effectiveness on improving upper extremity function in persons with hemiparetic stroke.

• Safety and Health at Work
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• 제12권1호
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• pp.66-73
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• 2021

Background: The objective was to assess the knowledge level, attitude, and practice of health care workers towards standard precautions, and to identify the related factors. Furthermore, it was attempted to identify the proportion of having the experience of needle stick injuries (NSIs) and associated factors among participants. Methods: A cross-sectional study was conducted in a teaching hospital among 233 health workers using a self-administrated questionnaire. The questionnaire included eight knowledge items, seven practice items, and five attitude items. Based on the mean score of each category, responses were grouped into "satisfactory" and "unsatisfactory". Univariate, bivariate, and multivariable logistic regression analyses were done. Results: The mean age of the participants 32.95 (SD ± 9.70) and 62.2% of them were women. 57.5% of the staff had a satisfactory level of correct knowledge (>5 correct answers), 37.3% had a satisfactory positive attitude (>3 correct answers), and 30.9% had a satisfactory practice (>3 correct answers) towards standard precautions. The occupation was one of the predictors as doctors were less likely to have satisfactory knowledge and practice compared to nurses (OR = 0.269, 95% CI: 0.10-0.70 and OR = 0.248, 95% CI: 0.08-0.77, respectively). Out of 174 participants, 31.6% of them reported experiencing NSIs and support staff were 71% less likely to experience NSIs compared to nurses & paramedics. Conclusion: The findings revealed a substandard adherence of standard precautions among participants, which highlighted the necessity of the provision of a periodic, tailored training program based on the occupation and risk exposure.

• Journal of Microbiology and Biotechnology
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• 제31권12호
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• pp.1716-1721
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• 2021

Chikungunya fever is an arboviral disease caused by the Chikungunya virus (CHIKV). The disease has similar clinical manifestations with other acute febrile illnesses which complicates differential diagnosis in low-resource settings. We aimed to develop a rapid test for CHIKV detection based on the nucleic acid lateral flow immunoassay technology. The system consists of a primer set that recognizes the E1 region of the CHIKV genome and test strips in an enclosed cassette which are used to detect amplicons labeled with FITC/biotin. Amplification of the viral genome was done using open-source PCR, a low-cost open-source thermal cycler. Assay performance was evaluated using a panel of RNA isolated from patients' blood with confirmed CHIKV (n = 8) and dengue virus (n = 20) infection. The open-source PCR-NALFIA platform had a limit of detection of 10 RNA copies/ml. The assay had a sensitivity and specificity of 100% (95% CI: 67.56% - 100%) and 100% (95% CI: 83.89% - 100%), respectively, compared to reference standards of any positive virus culture on C6/36 cell lines and/or qRT-PCR. Further evaluation of its performance using a larger sample size may provide important data to extend its usefulness, especially its utilization in the peripheral healthcare facilities with scarce resources and outbreak situations.

• Physical Therapy Rehabilitation Science
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• 제9권4호
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• pp.309-317
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• 2020

Objective: One of the treatment strategies for controlling chronic pain and preventing disability is patient education. Pain neuroscience education (PNE) has been proven to be effective in explaining the biological and physiological processes associated with pain experiences to patients. The purpose of this review is to investigate the effectiveness of PNE for kinesiophobia such as avoidance response in patients with chronic pain. Design: A systematic review and meta-analysis. Methods: MEDLINE, EMBASE, CINAHL, PEDro, and the Cochrane Central Register of controlled trials databases were searched through November 2020 and included a randomized controlled trials evaluating kinesiophobia in musculoskeletal patients with chronic pain. In 8 randomized controlled trial studies, 'Cochrane's risk of bias (RoB) tool was used for qualitative analysis, and results of post-intervention were analyzed through RevMan 5.4 for quantitative analysis. Results: For this review, 8 randomized controlled trials of 369 patients with chronic pain were selected for PNE. A systematic review and meta-analysis also included 8 randomized controlled trials. The effect on kinesiophobia was more effective than the control group (-0.86; 95% confidence interval [CI], -1.22 to -0.51; heterogeneity [χ²=21.18, df=7, I²=67%]; overall effect [Z=4.80]). In addition, the effect on pain was more effective than the control group (-0.53; 95% CI, -1.05 to -0.01; heterogeneity [χ²=47.42, df=7, I²=85%]; overall effect [Z=2.01]). Conclusions: The results of this review suggest that PNE and combined PNE have a positive effect on the improvement of pain and kinesiophobia in patients with chronic pain.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제25권4호
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• pp.312-320
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• 2022

Purpose: Screening serologic tests are important tools for the diagnosis of celiac disease (CD). Immunoglobulin (Ig)G anti-deamidated gliadin peptide (anti-DGP) is a relatively new autoantibody thought to have good diagnostic accuracy, comparable to that of anti-tissue transglutaminase (anti-tTG) antibody. Methods: Pediatric patients (n=86) with a clinical suspicion of CD were included. Duodenal biopsy, anti-tTG, and IgG anti-DGP antibody tests were performed. The patients were divided into CD and control groups based on the pathological evaluation of duodenal biopsies. The diagnostic accuracy of serological tests was determined. Results: IgA anti-tTG and IgG anti-DGP antibodies were positive in 86.3% and 95.4% of patients, respectively. The sensitivity, specificity, and diagnostic accuracy of the IgA anti-tTG test were 86.3%, 50.0%, and 68.6%, respectively, and those of the IgG anti-DGP test were 95.4%, 85.7%, and 90.7%, respectively. The area under the receiver operating characteristic (ROC) curve was 0.84 (95% confidence interval [CI], 0.74-0.91) for IgA anti-tTG test and 0.93 (95% CI, 0.86-0.97) for IgG anti-DGP test. The comparison of IgA anti-tTG and IgG anti-DGP ROC curves showed a higher sensitivity and specificity of the IgG anti-DGP test. Conclusion: IgG anti-DGP is a reliable serological test for CD diagnosis in children. High tTG and DGP titers in the serum are suggestive of severe duodenal atrophy. The combined use of IgA anti-tTG and IgG anti-DGP tests for the initial screening of CD can improve diagnostic sensitivity.