Your browser doesn't support javascript.
loading
Show: 20 | 50 | 100
Results 1 - 20 de 167
Filter
1.
Article in Korean | WPRIM | ID: wpr-926401

ABSTRACT

Background and Objectives@#Globus pharyngeus is one of the most common symptoms of patients visiting otorhinolaryngology out-patient clinic, and usually long-lasting, difficult to treat, and frequently recurrent. Mucomyst®, N-acetyl cysteine is an inhalation agent mainly used for mucolysis and reducing inflammation in airway via antioxidative effect. The purpose of this study was to evaluate the efficacy of inhaled Mucomyst® treatment in patients with globus pharyngeus refractory to proton pump inhibitor (PPI).Materials and Method We prospectively evaluated the efficacy of Mucomyst® in relieving symptoms of globus pharyngeus refractory to PPI in nine medical centers. Three hundred and three patients enrolled and finally 229 patients finished the inhaled Mucomyst® therapy for 8 weeks. We analyzed the change of Reflux Symptom Index (RSI), Reflux Finding Score (RFS), Visual Analogue Scale (VAS) for globus, and Globus Pharyngeus Symptom Scale (GPS) after use of Mucomyst® for 4 and 8 weeks. @*Results@#The GPS, RSI, RFS, and VAS score significantly decreased serially in patients who finished 8 week-inhalation treatment. The GPS improvement gap was significantly correlated with initial GPS (p<0.001) in multiple regression analysis. @*Conclusion@#Inhaled Mucomyst® therapy was effective for the reduction of both subjective and objective findings in refractory globus patients. This study might suggest new treatment option for patients with globus. However, further thorough studies would be needed to assess the real effect of inhaled Mucomyst® treatment as a standard treatment for globus.

2.
Article in English | WPRIM | ID: wpr-925898

ABSTRACT

Background@#The urinary levels of volatile organic compound (VOC) metabolites provide individual exposure levels compared to data obtained by measuring these compounds in ambient air. We aimed to investigate the association between personal urinary concentrations of VOC metabolites and symptoms of atopic dermatitis in schoolchildren. @*Methods@#Nine urinary VOC metabolites were analyzed from urine samples of 149 children. Diagnosis of atopic dermatitis was determined using standardized questionnaires. Pediatricians visited the schools and rated the severity of symptoms using the SCORing Atopic Dermatitis (SCORAD) in all children. @*Results@#Forty-five children (30.2%) had atopic dermatitis based on the International Study of Asthma and Allergies in Childhood (ISAAC) results and 35 children (23.8%) had symptoms of atopic dermatitis with positive SCORAD index values (defined as SCORAD ≥ 5). Children with benzylmercapturic acid detected in personal urines were associated with presence of atopic dermatitis and positive SCORAD index values. Children in the highest quartile of mandelic acid concentration were associated with presence of atopic dermatitis and positive SCORAD results. @*Conclusion@#Personal exposure to VOCs, as indicated by urinary levels of VOC metabolites, was associated with presence of atopic dermatitis and the SCORAD index value.

3.
Article in English | WPRIM | ID: wpr-894199

ABSTRACT

The purpose of this study was to compare physical and biodegradable properties of 3D printed resorbable membranes that are used for guided tissue regenerations in periodontal tissues. Three types of 3D printed membranes (two types of non β-TCP and one type of β-TCP) were considered. The form and element compositions of 3D printed membranes were analyzed by field-emission scanning electron microscopy (FE-SEM) with energy-dispersive X-ray spectroscopy (EDS). Porosity and pore size were measured using Micro-CT. Also, tensile strength, biodegradability tests were performed. Statistical analyses were carried in tensile strength and cell viability test (p<0.05). The result of SEM images with EDS analyses showed linear layers of lattice structure with presence of C and O in all groups. There was a slight difference in Ca and P among some groups. Tensile strength was significantly different among all groups (p<0.05), and biodegradability showed that the group containing β-TCP resulted in the fastest degradation rate. Therefore, the results of this study concluded that the 3D printed resorbable membrane has variable physical and biodegradable properties for clinical use, where such information would be useful to be considered for the future development of related products and clinical application of the products.

4.
Korean Circulation Journal ; : 610-622, 2021.
Article in English | WPRIM | ID: wpr-893914

ABSTRACT

Background and Objectives@#To evaluate the cost-effectiveness of routine hypertension (HTN) screening as a part of the national health-screening program. @*Methods@#Two aspects of cost-effectiveness were examined using the national general healthscreening program. First, the cost of case-finding was computed for 5-year interval age groups. Second, the cost per quality adjusted life years (QALYs) gained were estimated for 12 different scenarios varying examination starting age, pattern and interval compared with no screening. @*Results@#The cost of finding one new HTN case was low as 26,284 Korean won (KRW) (approximately [approx.] United States Dollar 21) for 70–79 years old to as high as 70,552 KRW for 40–44 years old. Compared with no screening, the costs per QALYs of the following screening strategies were below the incremental cost-effectiveness ratio threshold (approx.KRW 30.5 million): first screening examination with the second confirmatory examination in adults aged ≥40 years every 3 years (KRW 10.2 million), every 2 years (KRW 13.2 million), or annually (KRW 19.9 million). One-way sensitivity analyses suggest that the results were mostly influenced by the sensitivity of the first screening examination, followed by the examination rate of the second confirmatory examination. @*Conclusions@#HTN screening as a part of routine national health screening program was cost-effective for adults aged 40 years or older. The most cost-effective HTN screening strategy was the first screening examination with the second confirmatory examination in aged 40 years or older every 3 years.

5.
Article in Korean | WPRIM | ID: wpr-893529

ABSTRACT

Muscle tension dysphonia (MTD) is a voice disorder characterized by excessive tension of the laryngeal muscles during phonation. Voice therapy is the gold standard of treatment for MTD. However, patients with MTD do not always respond to voice therapy. Multidisciplinary approaches have been attempted to treat intractable MTD such as lidocaine instillation, lidocaine injection to recurrent laryngeal nerve, botox injection and excision of false ventricle using CO2 laser. Recently, injection laryngoplasty is suggested that assists in more efficient phonation and voice therapy to MTD patients. A patient with intractable MTD underwent lidocaine injection and injection laryngoplasty showed improved voice quality and remained stable until postoperative 3 months without any complications.

6.
Article in English | WPRIM | ID: wpr-892292

ABSTRACT

Background@#There is increasing interest in the quality of health care and considerable efforts are being made to improve it. Rheumatoid arthritis (RA) is a disease that can result in favorable outcomes when appropriate diagnosis and treatment are provided. However, several studies have shown that RA is often managed inappropriately. Therefore, the Korean College of Rheumatology aimed to develop quality indicators (QIs) to evaluate and improve the health care of patients with RA. @*Methods@#Preliminary QIs were derived based on the existing guidelines and QIs for RA. The final QIs were determined through two separate consensus meetings of experts. The consensus was achieved through a panel of experts who voted using the modified Delphi method. @*Results@#Fourteen final QIs were selected among 70 preliminary QIs. These included early referral to and regular follow-up with a rheumatologist, radiographs of the hands and feet, early initiation and maintenance of disease-modifying anti-rheumatic drug (DMARD) therapy, periodic assessment of disease activity, screening for drug safety and comorbidities,including viral hepatitis and tuberculosis before biologic DMARD therapy, periodic laboratory testing, supplementation with folic acid, assessment of the risk for cervical spine instability before general anesthesia, patient education, and specialized nurse. @*Conclusion@#These QIs can be used to assess and improve the quality of health care for patients with RA.

7.
Article in English | WPRIM | ID: wpr-901903

ABSTRACT

The purpose of this study was to compare physical and biodegradable properties of 3D printed resorbable membranes that are used for guided tissue regenerations in periodontal tissues. Three types of 3D printed membranes (two types of non β-TCP and one type of β-TCP) were considered. The form and element compositions of 3D printed membranes were analyzed by field-emission scanning electron microscopy (FE-SEM) with energy-dispersive X-ray spectroscopy (EDS). Porosity and pore size were measured using Micro-CT. Also, tensile strength, biodegradability tests were performed. Statistical analyses were carried in tensile strength and cell viability test (p<0.05). The result of SEM images with EDS analyses showed linear layers of lattice structure with presence of C and O in all groups. There was a slight difference in Ca and P among some groups. Tensile strength was significantly different among all groups (p<0.05), and biodegradability showed that the group containing β-TCP resulted in the fastest degradation rate. Therefore, the results of this study concluded that the 3D printed resorbable membrane has variable physical and biodegradable properties for clinical use, where such information would be useful to be considered for the future development of related products and clinical application of the products.

8.
Korean Circulation Journal ; : 610-622, 2021.
Article in English | WPRIM | ID: wpr-901618

ABSTRACT

Background and Objectives@#To evaluate the cost-effectiveness of routine hypertension (HTN) screening as a part of the national health-screening program. @*Methods@#Two aspects of cost-effectiveness were examined using the national general healthscreening program. First, the cost of case-finding was computed for 5-year interval age groups. Second, the cost per quality adjusted life years (QALYs) gained were estimated for 12 different scenarios varying examination starting age, pattern and interval compared with no screening. @*Results@#The cost of finding one new HTN case was low as 26,284 Korean won (KRW) (approximately [approx.] United States Dollar 21) for 70–79 years old to as high as 70,552 KRW for 40–44 years old. Compared with no screening, the costs per QALYs of the following screening strategies were below the incremental cost-effectiveness ratio threshold (approx.KRW 30.5 million): first screening examination with the second confirmatory examination in adults aged ≥40 years every 3 years (KRW 10.2 million), every 2 years (KRW 13.2 million), or annually (KRW 19.9 million). One-way sensitivity analyses suggest that the results were mostly influenced by the sensitivity of the first screening examination, followed by the examination rate of the second confirmatory examination. @*Conclusions@#HTN screening as a part of routine national health screening program was cost-effective for adults aged 40 years or older. The most cost-effective HTN screening strategy was the first screening examination with the second confirmatory examination in aged 40 years or older every 3 years.

9.
Article in Korean | WPRIM | ID: wpr-901233

ABSTRACT

Muscle tension dysphonia (MTD) is a voice disorder characterized by excessive tension of the laryngeal muscles during phonation. Voice therapy is the gold standard of treatment for MTD. However, patients with MTD do not always respond to voice therapy. Multidisciplinary approaches have been attempted to treat intractable MTD such as lidocaine instillation, lidocaine injection to recurrent laryngeal nerve, botox injection and excision of false ventricle using CO2 laser. Recently, injection laryngoplasty is suggested that assists in more efficient phonation and voice therapy to MTD patients. A patient with intractable MTD underwent lidocaine injection and injection laryngoplasty showed improved voice quality and remained stable until postoperative 3 months without any complications.

10.
Article in English | WPRIM | ID: wpr-899996

ABSTRACT

Background@#There is increasing interest in the quality of health care and considerable efforts are being made to improve it. Rheumatoid arthritis (RA) is a disease that can result in favorable outcomes when appropriate diagnosis and treatment are provided. However, several studies have shown that RA is often managed inappropriately. Therefore, the Korean College of Rheumatology aimed to develop quality indicators (QIs) to evaluate and improve the health care of patients with RA. @*Methods@#Preliminary QIs were derived based on the existing guidelines and QIs for RA. The final QIs were determined through two separate consensus meetings of experts. The consensus was achieved through a panel of experts who voted using the modified Delphi method. @*Results@#Fourteen final QIs were selected among 70 preliminary QIs. These included early referral to and regular follow-up with a rheumatologist, radiographs of the hands and feet, early initiation and maintenance of disease-modifying anti-rheumatic drug (DMARD) therapy, periodic assessment of disease activity, screening for drug safety and comorbidities,including viral hepatitis and tuberculosis before biologic DMARD therapy, periodic laboratory testing, supplementation with folic acid, assessment of the risk for cervical spine instability before general anesthesia, patient education, and specialized nurse. @*Conclusion@#These QIs can be used to assess and improve the quality of health care for patients with RA.

11.
Article in Korean | WPRIM | ID: wpr-920148

ABSTRACT

Background and Objectives@#Neck stab wounds should be managed properly as they can result in life-threatening complications and death. However, guns are prohibited in South Korea and many previous studies conducted in other countries are thus inapplicable. Also, most of the existing case reports deal mostly with profound neck injury and might lead to misunderstanding regarding the severity of injuries when considering neck stab wounds. This study analyzed the clinical characteristics of neck stab wounds according to the cause of trauma.Subjects and Method A total of 89 patients with neck stab wounds who visited the emergency room between January 2005 and June 2017 were enrolled. Medical records and radiological findings were reviewed retrospectively. The patients were divided into two groups according to the cause of trauma (suicide attempt or assault by another person). A comparative analysis of the two groups was conducted. @*Results@#The patients consisted of 41 cases of (46.1%) attempted suicides and 26 cases of (29.2%) psychiatric disorders. Of these, more than half had superficial wounds above the platysma, and multiple anatomical lacerations were found in 40 cases (45%). Psychiatric diagnoses were identified only in the attempted-suicide group (p<0.001), and injuries to the posterior neck triangle were observed only in the assault-by-another-person group (p=0.029). There were 11 cases (12.4%) of profound injury, but there was no significant difference between the two groups. One patient with injury by another person died due to the cutting of the common carotid artery. @*Conclusion@#Superficial injuries were more common while profound injuries were relatively uncommon in this study. However, physicians should pay attention to proper evaluation and management comprehensively in cases of neck stab wounds.

12.
Article in Korean | WPRIM | ID: wpr-920140

ABSTRACT

Second primary malignancy (SPM) is a well-known cause of death in head and neck cancers. Recently, with reports of many incidences of human papilloma virus (HPV) associated SPM, the disease has been widely investigated. We report a HPV-positive tracheal cancer in a 49-yearold male who had been diagnosed with HPV-positive squamous cell carcinoma of the right tonsil within intervals of two years. In this case, the metachronous tracheal cancer lesion as well as the primary tonsillar cancer showed the same subtype HPV-16.

13.
Article in Korean | WPRIM | ID: wpr-916568

ABSTRACT

Indications of fiberoptic laryngeal laser surgery (FLS) procedure have broadened by the development of flexible fiberoptic endoscopes and flexible laser systems. FLS procedure performed under local anesthesia and it is the unique value of FLS. The surgery can be performed on patients who are impossible to undergo general anesthesia and difficult to be exposed by laryngeal microsurgery. Main indication of FLS procedure was small to moderate sized hemorrhagic vocal polyp, but we experienced a case of huge vocal polyp with difficult laryngeal exposure treated by FLS procedure under local anesthesia. The vocal polyp was removed successfully without vocal fold scar through fiberoptic laryngeal laser surgery under local anesthesia.

14.
Article in English | WPRIM | ID: wpr-915485

ABSTRACT

Background@#Evidence for the association between underlying non-alcoholic fatty liver disease (NAFLD), the risk of testing severe acute respiratory syndrome coronavirus 2 (SARSCoV-2) positive, and the clinical consequences of coronavirus disease 2019 (COVID-19) is controversial and scarce. We aimed to investigate the association between the presence of NAFLD and the risk of SARS-CoV-2 infectivity and COVID-19-related outcomes. @*Methods@#We used the population-based, nationwide cohort in South Korea linked with the general health examination records between January 1, 2018 and July 30, 2020. Data for 212,768 adults older than 20 years who underwent SARS-CoV-2 testing from January 1 to May 30, 2020, were obtained. The presence of NAFLDs was defined using three definitions, namely hepatic steatosis index (HSI), fatty liver index (FLI), and claims-based definition. The outcomes were SARS-CoV-2 test positive, COVID-19 severe illness, and related death. @*Results@#Among 74,244 adults who completed the general health examination, there were 2,251 (3.0%) who were SARS-CoV-2 positive, 438 (0.6%) with severe COVID-19 illness, and 45 (0.06%) COVID-19-related deaths. After exposure-driven propensity score matching, patients with pre-existing HSI-NAFLD, FLI-NAFLD, or claims-based NAFLD had an 11–23% increased risk of SARS-CoV-2 infection (HSI-NAFLD 95% confidence interval [CI], 1–28%; FLI-NAFLD 95% CI, 2–27%; and claims-based NAFLD 95% CI, 2–31%) and a 35–41% increased risk of severe COVID-19 illness (HSI-NAFLD 95% CI, 8–83%; FLI-NAFLD 95% CI, 5–71%; and claims-based NAFLD 95% CI, 1–92%). These associations are more evident as liver fibrosis advanced (based on the BARD scoring system). Similar patterns were observed in several sensitivity analyses including the full-unmatched cohort. @*Conclusion@#Patients with pre-existing NAFLDs have a higher likelihood of testing SARSCoV-2 positive and severe COVID-19 illness; this association was more evident in patients with NAFLD with advanced fibrosis. Our results suggest that extra attention should be given to the management of patients with NAFLD during the COVID-19 pandemic.

15.
Article in English | WPRIM | ID: wpr-915422

ABSTRACT

Background@#This study examined the relationship of infant feeding with anthropometric indices of children during their first six years of life relative to the Korean National Growth Charts (KNGC) and the World Health Organization Child Growth Standards (WHO-CGS). @*Methods@#The study population consisted of 547,669 Korean infants and children who were 6 months-old to 6 years-old (born in 2008–2009) and participated in the National Health Screening Program for Infants and Children. Data on height, weight, and type of feeding during the first 6 months (exclusively breastfed [BF] vs. mixed- or formula-fed [FF]) were analyzed. @*Results@#BF boys and girls were significantly shorter and lighter than FF counterparts from the age of 6 months to 4 years, but these differences were not significant after the age of 4 years. BF boys and girls only had significantly lower body mass index at the age of 2 years. Under the age of 2 years 6 months, and especially under the age of 1 year, BF boys and girls were significantly taller and heavier than the 50th percentile values of the 50th percentile value of the WHO-CGS. @*Conclusion@#In this study using large-scaled national data, Korean breastfed children are shorter and lighter by 3 years 6 months–4 years 6 months, but afterward, there is no significant difference from those who had mixed- or formula-feeding. Substantial disparities in the anthropometric indices of Korean infants under the age of 1 compared to KNCG and WHO-CGS were found, regardless of their infantile feeding types. Our results emphasize the importance of constructing a nationwide reference chart based on actual measurements of BF Korean infants.

16.
Article in English | WPRIM | ID: wpr-914857

ABSTRACT

Objective@#Macrophages have been shown to play important roles in various pathophysiological processes of the central nervous system via neuroinflammation, leading to an increased interest in macrophage biology. Circulating blood monocytes are among the first cells to infiltrate the brain after ischemic stroke; however, the role of innate immune cells such as monocytes and macrophages remains to be elucidated. Here, we investigated the association between blood monocytes and infarct size following ischemic stroke. @*Methods@#We induced stroke using a focal ischemia mouse model through middle cerebral artery suture occlusion. To deplete circulating blood monocytes, clodronate was injected intraperitoneally 24 h before the surgery. Animals were sacrificed at specified time points, and the infarct size and mRNA expression were then measured. @*Results@#The clodronate-injected mice showed significantly smaller infarct size than the control mice. Immunohistochemical staining revealed that monocyte depletion significantly blocked the infiltration of macrophages and microglia. The mRNA expression levels of macrophage and microglia markers were higher in the left infarcted brain than in the right non-infarcted brain. @*Conclusions@#In summary, monocyte depletion reduced the infarct size and mitigated neurological deficits in mice following ischemic stroke, likely by blocking the infiltration of inflammatory cells such as macrophages and microglia.

17.
Article in English | WPRIM | ID: wpr-913314

ABSTRACT

Purpose@#There are limited data on the epidemiological and clinical characteristics and outcomes in Korean patients with laboratory-confirmed coronavirus disease 2019 (COVID-19). We aimed to describe the epidemiological and clinical characteristics and outcomes of patients with COVID-19 using the Korean nationwide multicenter database. @*Methods@#In this nationwide multicenter study, we included all confirmed patients of COVID-19 in South Korea from February 1 to April 30, 2020. Subjects were classified into 3 age groups: those at younger than 10 years (children), 10 to 20 years (adolescents), and 20 years or more (adults). Cases were confirmed by laboratory testing using real-time reverse transcriptase-polymerase chain reaction assay and analyzed for epidemiological and clinical features and outcomes. Patents were followed up until April 30, 2020. @*Results@#Of 5,628 patients with COVID-19 (2,320 males [41.2%] and 3,308 females [58.8%]), there were 66 children (1.2%), 206 adolescents (3.7%), and 5,356 adults (95.2%). The common comorbidities were hypertension (1,201, 21.3%), diabetes (691, 12.3%), dementia (224, 4.0%), chronic heart disease (179, 3.2%), cancer (145, 2.6%), and asthma (128, 2.3%). The common presenting symptoms were cough (2,341, 41.6%), sputum (1,619, 28.8%), fever (1,305, 23.2%), headache (967, 17.2%), myalgia (926, 16.5%), and pharyngodynia (881, 15.7%). One hundred sixty-five patients (2.1%) were confirmed as having moderate or severe COVID-19 and 118 (2.1%) as having severe COVID-19. @*Conclusion@#Our descriptive study provides the epidemiological and clinical characteristics and outcomes of patients with laboratory-confirmed COVID-19 in South Korea.

18.
Article | WPRIM | ID: wpr-836464

ABSTRACT

Thoracic epidural anesthesia (TEA) is an efficient procedure for managing intraoperative and postoperative pain caused by liver resection, gastrectomy, or lung surgery. Precise difficulty prediction of TEA has the advantage of reducing the risk of complications. The purpose of this study was to identify factor correlated with TEA performance time under fluoroscopic guidance. From September 2017 to May 2018, 39 patients who were scheduled to receive TEA under fluoroscopic guidance for postoperative pain control were enrolled for this study. All thoracic epidural catheterization was performed by one physician who had more than 5 years of experience in spine intervention. TEA was performed one day before the elective surgery in the outpatient pain clinic. Body mass index (BMI) was found to be a factor associated with TEA procedure time. Correlation coefficients of procedure time with age, height, weight and BMI were 0.099, -0.129, 0.346, and 0.575, respectively. BMI needs to be considered as one factor that affects the difficulty of TEA.

19.
Article | WPRIM | ID: wpr-836429

ABSTRACT

Spasmodic dysphonia is a disease presumed to be a form of focal laryngeal dystonia. The widely used first-line treatment is botulinum toxin injection to the thyroarytenoid muscles. In spite of the effectiveness and safety of this method, it has a temporary effect that lasts only several months, resulting the patients’ symptom fluctuating, called ‘Botox rollercoaster.’ Some surgical techniques had tried, but they had shown several limitations including high rate of recurrence. We tried thyroarytenoid myectomy with selective recurrent laryngeal nerve section in a patient with intractable spasmodic dysphonia. This procedure is an alternative treatment of spasmodic dysphonia to prevent recurrence and improve symptoms. During five years of follow-up, she has shown steady quality voice without any complication. To the best of our knowledgement, this is the longest follow-up case of this operation in South Korea.

20.
Article | WPRIM | ID: wpr-835502

ABSTRACT

The brachial plexus originates from the ventral rami of spinal nerves C5–T1 and lies between the anterior and middle scalene muscles. Brachial plexus injury can occur as a rare complication of neck dissection or in association with trauma, malignancy, or radiotherapy. We performed modified radical neck dissection in a female with cervical lymph node metastasis of a recurrent papillary thyroid carcinoma. Brachial plexus injury occurred because of severe adhesion and anatomical distortion during the surgical revision and was immediately treated via end-to-end neurorrhaphy. After surgery, the patient felt pain and numbness in her right shoulder and arm. Motor function was grade 0 on right shoulder flexion, arm abduction and elbow flexion. After 1 year of follow-up, both motor and sensory function had fully recovered. This is the first reported case of complete motor function restoration after brachial plexus neurorrhaphy in a patient treated in the Republic of Korea.

SELECTION OF CITATIONS
SEARCH DETAIL