• Maxillofacial Plastic and Reconstructive Surgery
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• v.42
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• pp.14.1-14.11
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• 2020

Background: The purpose of this study is to introduce our modified disc plication technique using MITEK mini anchors and to evaluate the clinical outcome for patients with internal derangement (ID) of the temporomandibular joint (TMJ). Patients and methods: We evaluated 65 joints in 46 patients, comprised 32 women and 14 men, who first visited the Asan Medical Center from December 2012 to December 2016. The age of the patients ranged from 14 to 79 years, with a mean age of 36.6 years. The patients presented with joint problems including pain, joint noise, and mouth opening limitation (MOL). Patients who met our inclusion criteria underwent unilateral or bilateral disc repositioning surgery with our minimally invasive disc plication technique using MITEK mini anchors and No. 2-0 Ethibond^® braided polyester sutures. The variables taken into account in this study were the range of maximum mouth opening (MMO), painful symptoms (evaluated with the visual analog scale, VAS), and the type of noise (click, popping, crepitus) in the TMJ. Results: Preoperative examination revealed painful symptoms in 50.7% (n = 35) of the operated joints (n = 69) and the presence of clicks in 56.5% (n = 39). Postoperative examination revealed that 4.3% (n = 3) of the operated joints had painful symptoms with lower intensity than that in the preoperative condition. Additionally, 17.4% (n = 12) had residual noise in the TMJ, among which two were clicking and the other 10 had mild crepitus. The intensity of the postoperative residual noise was significantly decreased in all cases compared to that in the preoperative condition. Among patients with MOL below 38 mm (n = 18), the mean MMO was 31.4 mm preoperatively and 44.2 mm at 6 months postoperatively, with a mean increase of 13.8 mm. A barely visible scar at the operation site was noted during the postoperative observation period, with no significant complications such as facial palsy or permanent occlusal disharmony. Conclusion: Subjective symptoms in all patients improved following the surgery. TMJ disc plication using MITEK mini anchors with our minimally invasive approach may be a feasible and effective surgical option for treating TMJ ID patients who are not responsive to conservative treatment.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.20 no.2
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• pp.721-731
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• 2019

The purpose of this study was to investigate the knowledge, attitude, infection management intention and educational needs among nurses with no experience of new respiratory infectious diseases (NRID: SARS and MERS). Data were collected from 162 nurses working at the general hospitals in B city using structured questionnaires from October 10 to 31, 2017. The infection management intention of NRID was high in those who were over 30 years old, married, highly educated, and had a total working experience of more than 5 years. Nurses' infection management intention for NRID showed a positive correlation between knowledge of NRID (r=.27, p<.001) and attitude toward NRID (r=.65, p<.001). In other words, the higher the knowledge score for NRID, the more positive the attitude and the higher the infection management intention. In addition, the knowledge score related to incubation period, treatment, isolation, and release criteria was low while the educational needs were high. Therefore, in preparation for the possibility of NRID relapse and other NRID in the future, a systematic program addressing these educational needs for nurses should be periodically implemented to enhance infection management.

• Korean Journal of Clinical Laboratory Science
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• v.50 no.4
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• pp.501-510
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• 2018

This study examined the neurotoxicity induced by lead acetate (LA) on cultured C6 glioma cells and the protective effects of Euphorbiae humifusae L. (EH) extract against LA-induced cytotoxicity. In this study, LA exhibited neurotoxicity in a dose-dependent manner compared to the control, and was determined to be highly-toxic according to the toxic criteria. The $XTT_{50}$ value of LA was calculated at a concentration of $38.6{\mu}M$ after C6 glioma cells were incubated for 72 hours in the media containing $30{\sim}50{\mu}M$ of LA, respectively. In addition, LA-induced neurotoxicity was suggested to correlate with the level of oxidative stress because vitamin E, an antioxidant, increased the cell viability damaged by LA-induced cytotoxicity. The EH extract effectively prevented cell injury from LA-induced cytotoxicity via its antioxidative effects, such as inhibitory ability of lipid peroxidation, superoxide dismutase-like activity and 1,1-diphenyl-2-picrylhydrazyl-radical scavenging activity. These antioxidative effects may result in components, such as polyphenol or flavonoids including gallic acid or quercetin. In conclusion, natural resources, such as EH extracts, may be a useful putative agent for the treatment of diseases associated with oxidative stress, such as lead neurotoxicity.

• The Korean journal of internal medicine
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• v.33 no.6
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• pp.1224-1233
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• 2018

Background/Aims: The objective of this study was to determine the efficacy and safety of add-on therapy with certolizumab pegol (CZP) in active rheumatoid arthritis (RA) patients of a single ethnicity. Methods: In this 24-week, phase 3, randomized, double-blind, placebo-controlled trial, eligible patients (n = 127) were randomized 2:1 to subcutaneous CZP + methotrexate (MTX; 400 mg at week 0, 2, and 4 followed by 200 mg every 2 weeks) or placebo + MTX. Results: At week 24, the American College of Rheumatology criteria for 20% (ACR20) response rate was significantly greater with CZP + MTX than with placebo (66.7% vs. 27.5%, p < 0.001). Differences in ACR20 response rates for CZP vs. placebo were significant from week 1 (p < 0.05) and remained significant through week 24. The CZP group reported significant improvement in physical function and disability compared to the placebo group (p < 0.001) at week 24, as assessed by Korean Health Assessment Questionnaire-Disability Index (KHAQ-DI). Post hoc analysis indicated that the proportion of patients who had ACR70 responses, Disease Activity Score 28 (DAS28) low disease activity, and DAS28 remission at week 24 was greater in CZP + MTX-treated patients who achieved a decrease in DAS28 ${\geq}1.2$ (43.8%) at week 4 than in nonresponders. Among 18 (22.2%) and 14 patients (35.0%) in CZP and placebo groups who had latent tuberculosis (TB), none developed active TB. Most adverse events were mild or moderate. Conclusions: CZP treatment combined with MTX in active RA patients with moderate to severe disease activity and an inadequate response to MTX resulted in rapid onset of efficacy, which is associated with better clinical outcome at week 24 and has an acceptable safety profile, especially in an intermediate TB-burden population.

• Journal of Oriental Neuropsychiatry
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• v.29 no.4
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• pp.267-280
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• 2018

Objectives: The objective of this study was to provide clinical evidence to support the use of a herbal medicine (Cheonwangbosim-Dan/Tianwangbuxin-Pellet (TWBXP)) for insomnia. Methods: Randomized controlled trials that verified effects of Herbal Medicine (Cheonwangbosim-Dan, Tianwangbuxin-Pellet) treating primary insomnia were carried out. A literature search of English, Chinese, Korean databases was also performed. The selected literature were assessed by Risk of Bias (RoB). Results: The total number of selected trials was 13 RCTs. Among the 13 RCTs, 10 were meta-analyzed. The Chinese Classification of Mental Disorders-3 (CCMD-3) was frequently used as the diagnostic criteria for interventions during the analysis of the use of herbal medicine (Cheonwangbosim-Dan/Tianwangbuxin-Pellet) for management of primary insomnia. As for outcome measurement, the effective rate was used. From the Meta-analysis of the studies, it was established that the insomnia cure effective rate in the TWBXP group was higher than that in the Western Medicine (WM) group (RR: 1.15, 95% CI: 1.07 to 1.24, p<0.0001, $I^2=33%$). Also, the effective rate in the TWBXP+ACU group was significantly different compared to the WM group (RR: 1.32, 95% CI: 1.13 to 1.54, p=0.0004, $I^2=0%$). The quality of the selected RCTs was low. Conclusions: Herbal medicine (Cheonwangbosim-Dan/Tianwangbuxin-Pellet) is effective for treating primary insomnia. It is worth noting that this studies were of relatively poor quality. The sample sizes were also small. Therefore, further investigations into the diagnosis and treatment of insomnia are warranted.

• Journal of Korean Neurosurgical Society
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• v.62 no.6
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• pp.643-648
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• 2019

Objective : Shunt-dependent hydrocephalus (SdHCP) is a well-known complication of aneurysmal subarachnoid hemorrhage (SAH). The risk factors for SdHCP have been widely investigated, but few risk scoring systems have been established to predict SdHCP. This study was performed to investigate the risk factors for SdHCP and devise a risk scoring system for use before aneurysm obliteration. Methods : We reviewed the data of 301 consecutive patients who underwent aneurysm obliteration following SAH from September 2007 to December 2016. The exclusion criteria for this study were previous aneurysm obliteration, previous major cerebral infarction, the presence of a cavum septum pellucidum, a midline shift of >10 mm on initial computed tomography (CT), and in-hospital mortality. We finally recruited 254 patients and analyzed the following data according to the presence or absence of SdHCP : age, sex, history of hypertension and diabetes mellitus, Hunt-Hess grade, Fisher grade, aneurysm size and location, type of treatment, bicaudate index on initial CT, intraventricular hemorrhage, cerebrospinal fluid drainage, vasospasm, and modified Rankin scale score at discharge. Results : In the multivariate analysis, acute HCP (bicaudate index of ${\geq}0.2$) (odds ratio [OR], 6.749; 95% confidence interval [CI], 2.843-16.021; p=0.000), Fisher grade of 4 (OR, 4.108; 95% CI, 1.044-16.169; p=0.043), and an age of ${\geq}50years$ (OR, 3.938; 95% CI, 1.375-11.275; p=0.011) were significantly associated with the occurrence of SdHCP. The risk scoring system using above parameters of acute HCP, Fisher grade, and age (AFA score) assigned 1 point to each (total score of 0-3 points). SdHCP occurred in 4.3% of patients with a score of 0, 8.5% with a score of 1, 25.5% with a score of 2, and 61.7% with a score of 3 (p=0.000). In the receiver operating characteristic curve analysis, the area under the curve (AUC) for the risk scoring system was 0.820 (p=0.080; 95% CI, 0.750-0.890). In the internal validation of the risk scoring system, the score reliably predicted SdHCP (AUC, 0.895; p=0.000; 95% CI, 0.847-0.943). Conclusion : Our results suggest that the herein-described AFA score is a useful tool for predicting SdHCP before aneurysm obliteration. Prospective validation is needed.

• Journal of Animal Reproduction and Biotechnology
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• v.34 no.1
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• pp.10-19
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• 2019

Morphology of cumulus-oocyte-complexes (COCs) at germinal vesicle (GV) stage as one of the evaluation criteria for oocyte maturation quality after in vitro maturation (IVM) plays important roles on the meiotic maturation, fertilization and early embryonic development in pigs. When cumulus cells of COCs are insufficient, which is induced the low oocyte maturation rate by the increasing of reactive oxygen species (ROS) in porcine oocyte during IVM. The ROS are known to generate including superoxide and hydrogen peroxide from electron transport system of mitochondria during oocyte maturation in pigs. To regulate the ROS production, the cumulus cells is secreted the various antioxidant enzymes during IVM of porcine oocyte. Our previous study showed that Mito-TEMPO, superoxide specific scavenger, improves the embryonic developmental competence and blastocyst formation rate by regulating of mitochondria functions in pigs. However, the effects of Mito-TEMPO as a superoxide scavenger to help the anti-oxidant functions from cumulus cells of COCs on meiotic maturation during porcine oocyte IVM has not been reported. Here, we categorized experimental groups into two groups (Grade 1: G1; high cumulus cells and Grade 2: G2; low cumulus cells) by using hemocytometer. The meiotic maturation rate from G2 was significantly (p < 0.05) decreased (G1: $79.9{\pm}3.8%$ vs G2: $57.5{\pm}4.6%$) compared to G1. To investigate the production of mitochondria derived superoxide, we used the mitochondrial superoxide dye, Mito-SOX. Red fluorescence of Mito-SOX detected superoxide was significantly (p < 0.05) increased in COCs of G2 compared with G1. And, we examined expression levels of genes associated with mitochondrial antioxidant such as SOD1, SOD2 and PRDX3 using a RT-PCR in porcine COCs at 44 h of IVM. The mRNA levels of three antioxidant enzymes expression in COCs from G2 were significantly (p < 0.05) lower than COCs of G1. In addition, we investigated the anti-oxidative effects of Mito-TEMPO on meiotic maturation of porcine oocyte from G1 and G2. Meiotic maturation and mRNA levels of antioxidant enzymes were significantly (p < 0.05) recovered in G2 by Mito-TEMPO ($0.1{\mu}M$, MT) treatment (G2: $68.4{\pm}3.2%$ vs G2 + MT: $73.9{\pm}1.4%$). Therefore, our results suggest that reduction of mitochondria derived superoxide by Mito-TEMPO may improves the meiotic maturation in IVM of porcine oocyte.

• Korean Journal of Clinical Laboratory Science
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• v.51 no.2
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• pp.235-244
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• 2019

This study examined the neurotoxicity of aluminum sulfate (AS), an environmental pollutant, and the protective effect of Phrymaleptostachya var. asiatica HARA (PLVAH) extract on the neurotoxicity induced by AS in the cultured C6 glioma cells. For this study, the cell viability and antioxidative effects, such as electron donating (ED) activity, lipid peroxidation (LP) activity, and superoxide anion-radical (SAR) scavenging activity, were analyzed. AS decreased the cell viability significantly in a dose-dependent manner and the $XTT_{50}$ value was measured at $120.0{\mu}M$ of AS. The neurotoxicity of AS was determined to be mid-toxic by Borenfreund and Puerner's toxic criteria. In addition, the catalase (CAT), antioxidant enzyme remarkably increased the cell viability injured by AS-induced neurotoxicity in these cultures. Regarding the protective effect of the PLVAH extract on AS-induced neurotoxicity, PLVAH extract significantly increased the ED ability, and the inhibitory ability of the LP and SAR scavenging ability. These findings suggest that oxidative stress is involved in the cytotoxicity of AS, and the PLVAH extract effectively protected against AS-induced neurotoxicity by its antioxidative effects. Natural resources, such as the PLVAH extract may be a putative therapeutic agent for the treatment of the toxicity induced by heavy metallic compounds, such as AS correlated with the oxidative stress.

• Korean Journal of Clinical Laboratory Science
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• v.51 no.2
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• pp.205-213
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• 2019

The protective effect of Agrimonia pilosa var. (AP) extract on potassium dichromate ($K_2Cr_2O_7$)-induced cytotoxicity in cultured NIH3T3 fibroblasts, was examined by performing an XTT assay for the cell viability and antioxidative effects, such as lactate dehydrogenase (LDH) activity and superoxide anion-radical (SAR) scavenging activity. In this study, $K_2Cr_2O_7$ decreased the cell viability significantly in a dose-dependent manner, and the $XTT_{50}$ value was determined to be $37.5{\mu}M$, which was highly-toxic according to the Borenfreund and Puerner' toxic criteria. The antioxidant, butylated hydroxytoluene (BHT), increased remarkably the cell viability damaged by $K_2Cr_2O_7$-induced cytotoxicity in these cultures. With regard to the protective effect of the AP extract on $K_2Cr_2O_7$-induced cytotoxicity, AP extract produced a significant increase in cell viability and antioxidative effects as the inhibitory ability LDH and SAR scavenging ability. These findings suggest that oxidative stress is involved in the cytotoxicity of $K_2Cr_2O_7$, and the AP extract effectively protected the cells from $K_2Cr_2O_7$-induced cytotoxicity by antioxidative effects. These results suggest that natural resources, such as AP extract, may be a putative therapeutic agent for the diminution or treatment of cytotoxicity induced by heavy metallic bases, such as $K_2Cr_2O_7$ correlated with oxidative stress.

• Korean Journal of Psychosomatic Medicine
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• v.28 no.2
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• pp.99-107
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• 2020

Fibromyalgia is a disorder characterized by the core symptom of chronic widespread pain, along with fatigue, sleep disturbances, mood changes, and cognitive difficulties. The etiology of fibromyalgia involves a combination of biological factors, such as genetic vulnerability, alterations in pain processing and stress response system ; psychological factors, such as anxiety, depression, anger, and perceived stress ; environmental factors, such as infections, febrile diseases, and trauma. Central sensitization, which is amplified in the process of sensory stimulation, has been emphasized as a key etiological factor, as supported by enhanced wind-up, delayed aftersensation, decreased nociceptive flexion reflex threshold and functional imaging studies. Several guidelines recommend that a multimodal approach be used to treat fibromyalgia, including both pharmacological and non-pharmacological treatments, tailored to each individual, and that clinicians should provide an intellectual framework through sufficient education and emphasis on the importance of self-management. The prevalence of mood disorders, anxiety disorders, and other psychiatric problems is 7-9 times higher in patients with fibromyalgia than in the general population ; moreover, the association between fibromyalgia and certain psychopathologies or sleep problems has also been suggested. Since psychiatric problems, with shared vulnerabilities and risk factors, interact with fibromyalgia bidirectionally and also affect the disease course, an integrated management approach is needed to determine the risk of comorbidities.