Effect of Loop Electrosurgical Excision Procedure on Sexual Dysfunction in Korean Women

Background@#The role of the cervix in female sexual functioning is controversial. The loop electrosurgical excision procedure (LEEP) induces structural changes in the cervix. This study aimed to investigate whether LEEP affected sexual dysfunction in Korean women. @*Methods@#A prospective cohort study enrolled 61 sexually active women with abnormal Papanicolaou smear or cervical punch biopsy results and required LEEP. The patients were assessed before and six to twelve months after LEEP using the Female Sexual Function Index (FSFI) and the Female Sexual Distress Scale (FSDS). @*Results@#The prevalence of female sexual dysfunction according to FSFI scores before and after LEEP was 62.5% and 66.7%, respectively. LEEP-related changes in total FSFI and FSDS scores were not significant (P = 0.399 and P = 0.670, respectively). The frequency of sexual dysfunction in the desire, arousal, lubrication, orgasm, satisfaction, and pain subdomains of the FSFI was not significantly altered by LEEP (P > 0.05). The proportion of women experiencing sexual distress according to FSDS scores did not significantly increase after LEEP (P = 0.687). @*Conclusion@#A large proportion of women with cervical dysplasia experience sexual dysfunction and distress both before and after LEEP. LEEP itself may be not associated with negative effects on female sexual function.

Acute Autonomic and Sensory Neuropathy in a Patient with Atypical Stepwise Progression

Acute autonomic and sensory neuropathy (AASN) is very rare immune mediated neuropathy characterized by prominent dysautonomia and sensory involvement without motor weakness. Most of AASN patients have a rapid onset reaching its worst within four weeks like Guillain-Barré syndrome. The treatment response is variable. Recently, we experienced a patient diagnosed as AASN with progressive autonomic and sensory symptoms more than 1 year, and showed good response in immunotherapy.

Comparison of Pregnancy Prognosis for Gestational Diabetes Diagnosed by the 1-Step and 2-Step Methods

Purpose@#To compare pregnancy complications between the 2 groups of patients with gestational diabetes mellitus (GDM): those diagnosed by the 1-step method and those diagnosed by the 2-step method. @*Methods@#In this retrospective cohort study, the data from outpatient and hospitalization medical records of 201 patients diagnosed with GDM between 2013 and 2017 were reviewed. We compared the pregnancy complications of these patients based on whether they were diagnosed by the 1-step or 2-step method. SPSS ver. 20.0 was used to analyze the data from the 2 groups. The odds ratio and 95% confidence interval of the pregnancy outcomes were estimated using binary logistic regression analysis. @*Results@#On comparing pregnancy-related complications between the groups, there was no significant difference in the incidence of preeclampsia or delivery by cesarean section (p>0.99 and p=0.50, respectively). In the 1-step and 2-step groups, the prevalence of premature birth was significantly high at 19.7 % and 40.3% (p=0.01), respectively. There were no significant differences between the 2 groups in terms of macrosomia, large for gestational age (LGA), small for gestational age (SGA), low APGAR score, and neonatal hypoglycemia (p>0.99, p>0.26, p>0.62, p>0.57, and p>0.45, respectively). @*Conclusion@#On comparing the 2 groups, we found that the 1-step and 2-step GDM groups had similar risks of pregnancy complications, namely preeclampsia, delivery by cesarean section, macrosomia, LGA, SGA, low APGAR scores, and neonatal hypoglycemia.

Analysis of Dental Hygienist Job Recognition Using Text Mining / 치위생과학회지

Background@#The aim of this study was to analyze the public demand for information about the job of dental hygienists by mining text data collected from the online Q & A section on an Internet portal site. @*Methods@#Text data were collected from inquiries that were posted on the Naver Q & A section from January 2003 to July 2020 using “dental hygienist job recognition,” “role recognition,” “medical assistance,” and “scaling” as search keywords. Text mining techniques were used to identify significant Korean words and their frequency of occurrence. In addition, the association between words was analyzed. @*Results@#A total of 10,753 Korean words related to the job of dental hygienists were extracted from the text data. “Chi-lyo (treatment),” “chigwa (dental clinic),” “ske-illing (scaling),” “itmom (gum),” and “chia (tooth)” were the five most frequently used words. The words were classified into the following areas of job of the dental hygienist: periodontal disease treatment and prevention, medical assistance, patient care and consultation, and others. Among these areas, the number of words related to medical assistance was the largest, with sixty-six association rules found between the words, and “chi-lyo,” “chigwa,” and “ske-illing” as core words. @*Conclusion@#The public demand for information about the job of dental hygienists was mainly related to “chi-lyo,” “chigwa,” and “ske-illing” as core words, demonstrating that scaling is recognized by the public as the job of a dental hygienist. However, the high demand for information related to treatment and medical assistance in the context of dental hygienists indicates that the job of dental hygienists is recognized by the public as being more focused on medical assistance than preventive dental care that are provided with job autonomy.

Korean Dental Hygienists’ Job Description Based on Systematic Review / 치위생과학회지

Background@#Korean dental hygienists perform various tasks under the supervision of dentists in addition to the tasks listed in the law. Many meaningful studies have been conducted to determine the actual tasks of dental hygienists, but these studies did not show common results due to the differences in research methods or designs. Hence, this study aimed to review the reported data on the tasks of dental hygienists in Korea and to clarify them based on a systematic literature review. @*Methods@#For the literature search, the COre, Standard, and Ideal model presented by the National Library of Medicine was referenced. Seven databases were searched for literatures published in Korea, including PubMed, and Google Scholar. Of the 352 studies found using key words, titles, and abstracts, 46 were finally extracted based on the first and second exclusion criteria. After confirming the tasks of Korean dental hygienists in 46 literatures, 136 tasks were listed and calculated as appearance rate in the literature. @*Results@#The most common tasks in 46 studies were fluoride application (67.2%), radiography (65.4%), scaling (65.4%), sealant (60.7%), patient management and counseling (56.7%), tooth-brushing education (52.2%), impression taking with alginate (50.1%), and making temporary crowns (47.9%). The most mentioned tasks of dental hygienists in public health centers were fluoride application (100%), sealant (100%), oral health education (71.4%), public oral health program evaluation (71.4%), school fluoride mouth-rinsing program (71.4%), water fluoridation (57.1%), tooth-brushing education (57.1%), school oral health programs (57.1%), and public elderly oral health programs (57.1%). @*Conclusion@#This study showed that Korean dental hygienists had 136 tasks by reviewing 46 related studies and that the main job of Korean dental hygienists was oral disease prevention including scaling, sealant, and fluoride application.

Parameters Affecting India Ink Artifacts on Opposed-Phase MR Images

PURPOSE: To determine the MR parameters affecting India ink artifacts on opposed-phase chemical shift magnetic resonance (MR) imaging.MATERIALS AND METHODS: The use of a female Sprague-Dawley rat was approved by our Institutional Animal Care and Use Committee. Using an iterative decomposition of water and fat with echo asymmetry and least-squares estimation (IDEAL) images, which is a modified Dixon method, axial opposed-phase images of the abdominal cavity were obtained with different MR parameters: series 1, different repetition times (TRs; 400, 2000, and 4000 ms); series 2, different echo times (TEs; 10, 50, and 100 ms); series 3, different field of views (FOVs; 6, 8, 16, and 24 cm); series 4, different echo train lengths (ETLs; 2, 4, and 8); series 5, different bandwidths (25, 50, and 85); and series 6, different slice thicknesses (1, 2, 4, 8, and 16 mm). Artifacts on opposed images obtained with different parameters were compared subjectively by two radiologists. For objective analysis, the thickness of the artifact was measured. Spearman's correlation between altered MR parameters and thicknesses of India ink artifact was obtained via objective analysis.RESULTS: India ink artifact was increasingly apparent using shorter TE, larger FOV and ETL, and thicker slices upon subjective analysis. The objective analysis revealed a strong negative correlation between the thickness of the artifact and TE (r = -0.870, P < 0.01); however, strong positive correlations were found between FOV (r = 0.854, P < 0.01) and slice thickness (r = 0.971, P < 0.01).CONCLUSION: India ink artifact was thicker with shorter TE, larger FOV, and larger slice thickness.

A Case of Thoracic Extradural Chordoid Meningioma: Focusing on Radiologic Features

Chordoid meningioma, an uncommon subtype of meningioma, occurs rarely in the spine. In this case report, the authors present a case of spinal chordoid meningioma in a young female patient, and include a detailed description of imaging findings and a literature review.

A case of intra-abdominal abscess caused by unconsciously ingestion of fish bone in elderly patient / 고신대학교의과대학학술지

Cases showing complications such as esophageal injury, deep neck infection, and mediastinitis caused by accidental ingestion of fish bone are common. But ingestion of fish bone rarely causes perforation of the gastrointestinal tract or an intra-abdominal abscess. We report herein a case of a 78-year-old man with a periumbilical mesenteric abscess caused by fish bone which was ingested unconsciously. The fish bone was found in the terminal ileum and it was removed by colonoscopy. The patient improved and he was discharged after systemic antibiotic therapy. Occasionally, when patients swallow fish bone without a foreign body sensation, clinicians should suspect perforation caused by fish bone in case of an intra-abdominal abscess of unknown cause.

Follow-up of thyroid ultrasonography in patients with hemodialysis / 영남의대학술지

BACKGROUND: Chronic kidney disease is considered a risk factor for thyroid nodules as well as thyroid dysfunction such as hypothyroidism. Among patients on hemodialysis, we assessed the size of thyroid nodule and goiter at baseline and 1 year later with ultrasonography.METHODS: We prospectively selected 47 patients with hemodialysis at January 2012 and reviewed their medical records. We checked goiter and thyroid nodules at January 2012 and December 2012.RESULTS: In the hemodialysis patients (n=47), 24 patients (51.1%) had thyroid nodules and 33 patients (70.2%) had goiter at baseline. Parathyroid hormone (PTH) was higher in patients with thyroid nodules (204.4±102.9 vs. 129.9±93.6 pg/mL, p=0.01). Thyroid ultrasonography was conducted in 29 patients after 1 year. The thickness of the thyroid isthmus increased (2.8±1.6 vs. 3.2±1.9 mm, p=0.003), but the number of nodules did not change (1.2±1.9 vs. 1.4±2.0, p=0.109). PTH was associated with the enlargement of thyroid nodules significantly through logistic regression analysis.CONCLUSION: Thyroid goiter and nodules in hemodialysis patients were more prevalent than in the general population. PTH influenced the production of thyroid nodules in hemodialysis patients. Regular examination with thyroid ultrasonography and thyroid function test should be considered in hemodialysis patients.

Follow-up of thyroid ultrasonography in patients with hemodialysis / 영남의대학술지

BACKGROUND: Chronic kidney disease is considered a risk factor for thyroid nodules as well as thyroid dysfunction such as hypothyroidism. Among patients on hemodialysis, we assessed the size of thyroid nodule and goiter at baseline and 1 year later with ultrasonography. METHODS: We prospectively selected 47 patients with hemodialysis at January 2012 and reviewed their medical records. We checked goiter and thyroid nodules at January 2012 and December 2012. RESULTS: In the hemodialysis patients (n=47), 24 patients (51.1%) had thyroid nodules and 33 patients (70.2%) had goiter at baseline. Parathyroid hormone (PTH) was higher in patients with thyroid nodules (204.4±102.9 vs. 129.9±93.6 pg/mL, p=0.01). Thyroid ultrasonography was conducted in 29 patients after 1 year. The thickness of the thyroid isthmus increased (2.8±1.6 vs. 3.2±1.9 mm, p=0.003), but the number of nodules did not change (1.2±1.9 vs. 1.4±2.0, p=0.109). PTH was associated with the enlargement of thyroid nodules significantly through logistic regression analysis. CONCLUSION: Thyroid goiter and nodules in hemodialysis patients were more prevalent than in the general population. PTH influenced the production of thyroid nodules in hemodialysis patients. Regular examination with thyroid ultrasonography and thyroid function test should be considered in hemodialysis patients.

Effects of Overactive Bladder Symptoms in Stroke Patients' Health Related Quality of Life and Their Performance Scale

OBJECTIVE: To identify the effects of overactive bladder (OAB) symptoms on the health-related quality of life (HRQOL) in stroke patients since OAB symptoms are common in such patients, but their effects on stroke rehabilitation over time are unclear. METHODS: This study included 30 post-acute stroke patients who had been admitted for rehabilitation treatments. All participants completed a questionnaire evaluating urinary symptoms, including the Overactive Bladder Symptom Score (OABSS) and general HRQOL with a Short-Form 36 (SF-36) health survey. We assessed their performance in terms of the Function Ambulation Category, Modified Rankin Scale (MRS), Modified Barthel Index, and Mini-Mental State Examination (MMSE). All assessments were carried out twice at baseline and at 3 months. We divided patients into an OAB and non-OAB group with OABSS. A correlation analysis and multivariate regression were then performed. RESULTS: All performance scales showed an improvement over 3 months in the non-OAB group (n=18; p < 0.02), but, MRS and MMSE scores did not improve significantly in the OAB group (n=12) (p=0.15 and p=0.20, respectively). In the OAB group, the vitality and mental health scores significantly decreased over 3 months (p=0.011 and p=0,041, respectively), and the mental component summary (MCS) score showed a marginal decrease over 3 months (p=0.05). A multivariate regression analysis revealed that OAB symptoms were negatively correlated with the 3 months MCS score (B=−8.15, p=0.034). CONCLUSION: These results indicated that OAB symptoms could have negative effects on HRQOL and performance in patients suffering from a stroke.

Effects of Overactive Bladder Symptoms in Stroke Patients' Health Related Quality of Life and Their Performance Scale

OBJECTIVE: To identify the effects of overactive bladder (OAB) symptoms on the health-related quality of life (HRQOL) in stroke patients since OAB symptoms are common in such patients, but their effects on stroke rehabilitation over time are unclear. METHODS: This study included 30 post-acute stroke patients who had been admitted for rehabilitation treatments. All participants completed a questionnaire evaluating urinary symptoms, including the Overactive Bladder Symptom Score (OABSS) and general HRQOL with a Short-Form 36 (SF-36) health survey. We assessed their performance in terms of the Function Ambulation Category, Modified Rankin Scale (MRS), Modified Barthel Index, and Mini-Mental State Examination (MMSE). All assessments were carried out twice at baseline and at 3 months. We divided patients into an OAB and non-OAB group with OABSS. A correlation analysis and multivariate regression were then performed. RESULTS: All performance scales showed an improvement over 3 months in the non-OAB group (n=18; p < 0.02), but, MRS and MMSE scores did not improve significantly in the OAB group (n=12) (p=0.15 and p=0.20, respectively). In the OAB group, the vitality and mental health scores significantly decreased over 3 months (p=0.011 and p=0,041, respectively), and the mental component summary (MCS) score showed a marginal decrease over 3 months (p=0.05). A multivariate regression analysis revealed that OAB symptoms were negatively correlated with the 3 months MCS score (B=−8.15, p=0.034). CONCLUSION: These results indicated that OAB symptoms could have negative effects on HRQOL and performance in patients suffering from a stroke.

Predictive Factors for the Therapeutic Response to Concomitant Treatment with DPP-4 Inhibitors in Type 2 Diabetes with Short-Term Follow-Up / 고신대학교의과대학학술지

OBJECTIVES: To evaluate the efficacy and predictive factors of Dipeptidyl peptidase-4 (DPP-4) inhibitors in type 2 diabetes mellitus (T2DM) patients who were not well controlled with other oral antidiabetic drugs or insulin in real clinical practice. METHODS: From December 2012 to January 2014, retrospective longitudinal observation study was conducted for patients with T2DM who were not reached a glycemic target (glycated hemoglobin [HbA1c] > 6.5%) with other oral antidiabetic drugs or insulins. Type 1 diabetes or other types of diabetes were excluded. Responders were eligible with decreased HbA1c from baseline for more than 5% during follow up period. RESULTS: Of total 135 T2DM patients having an average 9.0 months follow-up period, 84 (62.2%) of patients were responder to DPP-4 inhibitors. After concomitant treatment with DPP-4 inhibitors, patients had a mean decrease in HbA1c of 0.69 ± 1.3%, fasting plasma glucose of 13 ± 52 mg/㎗, and postprandial plasma glucose of 29 ± 85 mg/㎗ from baseline (all P < 0.05). Independent predictive factor for an improvement of glycemic control with DPP-4 inhibitors was higher baseline HbA1c (odds ratio 2.07 with 95% confidence interval 1.15-3.72) compared with non-responders. CONCLUSIONS: A clinical meaningful improvement in glycemic control was seen when DPP-4 inhibitors were added to other anti-diabetic medications in patients with T2DM regardless of age, duration of T2DM, type of combination treatment regimen. Patients who had higher HbA1c were more easily respond to DPP-4 inhibitors treatment in short-term follow-up period.

A Case of Cerebral Venous Thrombosis in a Patient with Graves' Disease / 고신대학교의과대학학술지

Superior sagittal sinus thrombosis is an uncommon disease, and 25% of cases are considered to be idiopathic. Hypercoagulability, local bloodstream stasis, and vessel wall abnormalities may contribute to the development of this condition. The thyrotoxic phase of Graves’ disease is associated with venous thrombosis caused by hypercoagulability, which is in turn induced by increased levels of homocysteine and factor VIII and decreased fibrinolytic activity. Here, we report the case of a 39-year-old male who presented with superior sagittal sinus thrombosis and concomitant hyperthyroidism.

Diagnostic accuracy of a combination of salivary hemoglobin levels, self-report questionnaires, and age in periodontitis screening

PURPOSE: This study evaluated the predictive performance of a combination of self-report questionnaires, salivary hemoglobin levels, and age as a non-invasive screening method for periodontitis. METHODS: The periodontitis status of 202 adults was examined using salivary hemoglobin levels, responses to 10 questions on a self-report questionnaire, and the Community Periodontal Index (CPI). The ability of those two variables and the combination thereof with age to predict the presence of CPI scores of 3-4 and 4 was assessed using logistic regression and receiver operating characteristic (ROC) curve analysis. RESULTS: CPI scores of 3-4 and 4 were present among 79.7% and 46.5% of the sample, respectively. The area under the ROC curves (AUROCs) of salivary hemoglobin levels for predicting prevalence of CPI scores of 3-4 and 4 were 0.63 and 0.67, respectively (with sensitivity values of 71% and 60% and specificity values of 56% and 72%, respectively). Two distinct sets of five questions were associated with CPI scores of 3-4 and 4, with AUROCs of 0.73 and 0.71, sensitivity values of 76% and 66%, and specificity values of 63% and 69%. The combined model incorporating both variables and age showed the best predictive performance, with AUROCs of 0.78 and 0.76, sensitivity values of 71% and 65%, and specificity values of 68% and 77% for CPI scores of 3-4 and 4, respectively. CONCLUSIONS: The combination of salivary hemoglobin levels and self-report questionnaires was shown to be a valuable screening method for detecting periodontitis.

Botulinum Toxin A Injection into the Subscapularis Muscle to Treat Intractable Hemiplegic Shoulder Pain

OBJECTIVE: To evaluate the beneficial effect of botulinum toxin A (Botox) injection into the subscapularis muscle on intractable hemiplegic shoulder pain. METHODS: Six stroke patients with intractable hemiplegic shoulder pain were included. Botulinum toxin A was injected into the subscapularis muscle. Intractable hemiplegic shoulder pain was evaluated using an 11-point numerical rating scale. Pain-free range of motion was assessed for shoulder abduction and external rotation. The spasticity of the shoulder internal rotator was measured using the modified Ashworth scale. Assessments were carried out at baseline and at 1, 2, 4, and, if possible, 8 weeks. RESULTS: Intractable hemiplegic shoulder pain was improved (p=0.004) after botulinum toxin injection into the subscapularis muscle. Restricted shoulder abduction (p=0.003), external rotation (p=0.005), and spasticity of the shoulder internal rotator (p=0.005) were also improved. Improved hemiplegic shoulder pain was correlated with improved shoulder abduction (r=–1.0, p<0.001), external rotation (r=–1.0, p<0.001), and spasticity of the internal rotator (r=1.0, p<0.001). CONCLUSION: Botulinum toxin A injection into the subscapularis muscle appears to be valuable in the management of intractable hemiplegic shoulder pain.

Epstein-Barr Virus Associated Hemophagocytic Syndrome after Scrub Typhus Infection

There have been a small number of cases of scrub typhus-associated hemophagocytic syndrome (HPS), most of which were treated successfully using adequate antibiotics. Here, we report a case of Epstein-Barr virus (EBV)-associated HPS after scrub typhus infection that was not improved using antirickettsial treatment. A 73-year-old male who had been diagnosed with scrub typhus according to an eschar and a positive serology was transferred to our institution because of a persistent fever despite 7-day doxycycline therapy. Physical and laboratory data showed hepatosplenomegaly, bicytopenia, hyperferritinemia, and hypofibrinogenemia. A bone marrow examination (BM) revealed hypercellular marrow with hemophagocytosis and histiocyte infiltration. EBV was detected in BM aspirates using polymerase chain reaction. After a diagnosis of HPS was made, the patient was treated successfully using high-dose steroids.

Respiratory Failure Induced by Severe Hypothyroidism in a Korean Woman

A 76-year-old Korean woman visited to emergency room because of respiratory arrest and admitted to intensive care unit of the hospital. Severe hypothyroidism was diagnosed after repeated failure of weaning mechanical ventilator. Respiratory arrest and weaning failures were considered to be associated with hypoventilation due to hypothyroidism. She was recovered and weaned from mechanical ventilation after replacement of thyroid hormone. Severe hypothyroidism may be a cause of respiratory failure or weaning failure.

Efficacy of dentifrices containing policresulen in controlling dental plaque and gingivitis formation / 대한구강보건학회지

OBJECTIVES: This clinical study aimed to investigate if dentifrices containing policresulen would help to control dental plaque and gingivitis. METHODS: Seventy-eight eligible adults participated in this double-blind and randomized clinical study after an initial oral examination, calculus removal, and tooth prophylaxis. Two weeks after the procedure, the participants were assigned to three groups using the following dentifrices: (1) a dentifrice containing 0.22% NaF (control group); (2) a dentifrice containing 0.22% NaF and 100 ppm policresulen (policresulen group); and (3) a dentifrice containing 0.22% NaF, 100 ppm policresulen, and 1.00% bamboo salt (policresulen/bamboo group). The participants used only the provided dentifrice (for 1 min, twice a day, over 8 weeks) when brushing their teeth and followed their normal brushing habits. Dental plaque accumulation and gingivitis measurements were conducted using the Turesky modification of the Quigley-Hein plaque index (PI), the Loe and Silness gingival index (GI), and the percent bleeding on probing (%BOP) to obtain baseline data and 4- and 8-week data after grouping. RESULTS: A total of 73 participants aged 35.92+/-11.46 years (mean+/-SD) completed the study. The results after 8 weeks demonstrated statistically significant group-by-time interactions for PI, GI, and %BOP (P<0.001). The PI observed in the control groups increased over time up to 6%, while that observed in the dentifrice groups containing policresulen decreased by 5% (P<0.001). For GI and %BOP, the control group exhibited significantly higher values after 8 weeks, while the policresulen and the policresulen/bamboo groups revealed similar index values as the baseline after 4 and 8 weeks. The changes in all indices were significantly different between the control and the two experimental groups. There were no significant differences in the results obtained from the policresulen/bamboo group and the results obtained from the policresulen group. CONCLUSIONS: Use of dentifrices containing policresulen over 8 weeks demonstrated anti-plaque and anti-gingivitis efficacy compared to a control dentifrice.

A Case of Interventional Lung Assist Application in a Patient with Pulmonary Arteriovenous Malformation Complicating Massive Hemoptysis / 계명의대학술지

Percutaneous bronchial artery embolization and lung resection surgery have been effective for treatments of hemoptysis in patients with pulmonary arteriovenous malformation (PAVM). But, it has been little known about management for recurrent massive hemoptsis in patients with PAVM. It has been reported that Pumpless Extracoporeal Interventional Lung Assist (iLA) are effective for removal of hypercapnea in patient with acute respiratory failure. Here, we report a case of iLA support in a patient with PAVM complicating massive hemoptysis. A 38 year old man developed recurrent massive hemoptysis although interventions of bronchial artery embolization and lung resection surgery. The cause of recurrent hemoptysis was turned out PAVM. After a massive hemoptysis, the patient had severe hypercapnea and acidosis though mechanical ventilation and oxygenation. After iLA implantation, the hypercapnea was resolved and the clinical condition of the patient was improved, temporally. In conclusion, iLA may be a useful for bridge support in patients with prolonged massive hemoptysis.