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Background: Various clinical applications have been attempted using artificial intelligence (AI) clinical decision support system (CDSS), and it has become a starting point for personalized cancer treatment. We aimed to identify the degree of agreement between the AI?CDSS, Watson for Oncology (WFO), and the clinician in treatment recommendations for Korean breast cancer patients and to provide guidelines for future improvement. Methods: One hundred and eighty?three breast cancer patients who underwent treatment at the Pusan National University Hospital between January 1, 2016 and May 31, 2017 were enrolled in this study. The concordance between WFO抯 and clinicians� treatment recommendations were examined according to various factors. Results: WFO gave the same treatment option recommendations as clinicians in 74 (40.4%) of the cases. According to the logistic regression, the difference in recommendation concordance between stage I and stage III was statistically significant (P = 0.004), and there was no difference among other factors. Conclusion: The concordance of treatment recommendations was low overall. However, this is largely attributable to the differences of medical insurance system and healthcare environment between the United States and Korea. In the future, region?specific features should be considered or reflected during the development of AI?CDSS.
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Purpose@#We report a patient diagnosed with COVID-19-associated hypertensive anterior uveitis and endotheliitis of the cornea.Case Summary: A 71-year-old male visited our hospital with decreased visual acuity, ocular pain, eyelid swelling of in his right eye, and headache for 8 days. He had been diagnosed with COVID-19 pneumonia 10 days before the visit. The best-corrected visual acuity was 0.04 in his right eye and 0.15 in his left eye. Severe conjunctival injection, moderate corneal edema with Descemet membrane folding, diffuse keratic precipitates and mild anterior chamber reaction were observed in the right eye, which were not present in the previous examination. Pupils in both eyes were moderately dilated and slow to react in response to direct light. The density of endothelial cells in the right eye was 711 cells/mm2 and an owl’s eye morphology of endothelial cells was observed via specular microscopy. During follow up, elevated intraocular pressure (IOP) in the right eye was noted. Polymerase chain reaction (PCR) examination of the aqueous humor for cytomegalovirus was negative. After 2 weeks of applying prednisolone eye drops and anti-glaucoma eye drops, corneal edema decreased, and his vision improved to 0.5. However, the density of the corneal endothelium remained low. @*Conclusions@#Although there have been worldwide case reports of conjunctivitis, keratitis, or uveitis after COVID-19 infection, this study presents the first reported case of COVID-19 associated hypertensive anterior uveitis and endotheliitis of the cornea.
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Odontogenic keratocysts (OKCs) located in the maxillae have rarely been reported in the literature. Standard treatment modalities for OKC range from marsupialization to marginal resection. However, most of the studies on OKC treatment have been related to mandibular OKCs. The anatomical structure and loose bone density of the maxillae and the empty space of the maxillary sinus could allow rapid growth of a lesion and the ability to tolerate tumor occupancy in the entire maxilla within a short period of time. Therefore, OKCs of the maxillae require more aggressive surgery, such as resection. As an alternative, this report introduces a modified Carnoy’s solution, a strong acid, as an adjuvant chemotherapy after cyst enucleation. This report describes the clinical outcomes of enucleation using a modified Carnoy’s solution in patients with large OKCs on the posterior maxillae. In three cases, application of a modified Carnoy’s solution had few side effects or morbidity. Each patient was followed for four to six years, and none showed any signs of recurrence. In conclusion, adjuvant treatment with a modified Carnoy’s solution can be considered a treatment option capable of reducing the recurrence rate of OKC in the maxillae.
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Objectives@#This case series aims to introduce the nasal floor approach for extracting inverted mesiodens. @*Materials and Methods@#Through a retrospective chart review between January 2022 and February 2023, we included the mesiodens patients using nasal floor approach, and analysis the location of mesiodens from the anterior nasal spine (ANS), total operation time, and complications. @*Results@#Each mesiodens was located 10 to 12 mm from the ANS and was covered with a cortical layer of the nasal floor. All mesiodens were successfully extracted without exposing the adjacent incisors or nasopalatine nerve within 30 minutes from draping to postoperative dressing. @*Conclusion@#The nasal floor approach is an efficient extraction method that reduces bone removal and prevents anatomical damage while removing the mesiodens just below the nasal floor bone.
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Purpose@#This study aimed to examine social networking service (SNS) use and recommended information utilization (SURU) according to the food-related lifestyles (FRLs) of consumers and analyze how the interaction between the FRL and SURU affects the practice of eating alone and visiting restaurants. @*Methods@#Data on 4,624 adults in their 20s to 50s were collected from the 2021 Consumer Behavior Survey for Food. Statistical methods included factor analysis, K-means cluster analysis, the complex samples general linear model, the complex samples Rao-Scott χ2 test, and the general linear model. @*Results@#The following three factors were extracted from the FRL data: Convenience pursuit, rational consumption pursuit, and gastronomy pursuit, and the subjects were classified into three groups, namely the rational consumption, convenient gastronomy, and smart gourmet groups. An examination of the difference in SURU according to the FRL showed that the smart gourmet group had the highest score. The result of analyzing the effects of the FRL and SURU on eating alone revealed that both the main effect and the interaction effect were significant (p < 0.01, p < 0.001). The higher the SURU, the higher the frequency of eating alone in the convenience pursuit, and gastronomy pursuit groups. The main and interaction effects of the FRL and SURU on the frequency of eating out were also significant (p < 0.01, p < 0.001). In all the FRL groups, the higher the SURU level, the higher the frequency of visiting restaurants. Specifically, the two groups with convenience and gastronomic tendencies showed a steeper increase. @*Conclusion@#This study provides important basic data for research on consumer behavior related to food SNS, market segmentation of restaurant consumers, and development of marketing strategies using SNS in the future.
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Purpose@#This study identified words closely associated with the keyword “dietary supplement” (DS) using big data in Korean social media and investigated consumer perceptions and trends related to DSs before (2019) and after the coronavirus disease 2019 (COVID-19) pandemic (2021). @*Methods@#A total of 37,313 keywords were found for the 2019 period, and 35,336 keywords were found for the 2021 period using blogs and cafes on Daum and Naver. Results were derived by text mining, semantic networking, network visualization analysis, and sentiment analysis. @*Results@#The DS-related keywords that frequently appeared before and after COVID-19 were “recommend”, “vitamin”, “health”, “children”, “multiple”, and “lactobacillus”. “Calcium”, “lutein”, “skin”, and “immunity” also had high frequency-inverse document frequency (TF-IDF) values. These keywords imply a keen interest in DSs among Korean consumers. Big data results also reflected social phenomena related to DSs; for example, “baby” and “pregnant woman” had lower TD-IDF values after the pandemic, suggesting lower marriage and birth rates but higher values for “joint”, indicating reduced physical activity. A network centered on vitamins and health care was produced by semantic network analysis in 2019. In 2021, values were highest for deficiency and need, indicating that individuals were searching for DSs after the COVID-19 pandemic due to a lack an awareness of the need for adequate nutrient intake. Before the pandemic, DSs and vitamins were associated with healthcare and life cycle-related topics, such as pregnancy, but after the COVID-19 pandemic, consumer interests changed to disease prevention and treatment. @*Conclusion@#This study provides meaningful clues regarding consumer perceptions and trends related to DSs before and after the COVID-19 pandemic and fundamental data on the effect of the pandemic on consumer interest in dietary supplements.
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Purpose@#This study evaluates the potential protective effects of hemp (Cannabis sativa L.) seed oil supplementation in rats fed a high-cholesterol diet. @*Methods@#Rats were fed a 1.25% cholesterol diet for 8 weeks, followed by oral administration of either of the two doses of hemp seed oil (HO) (0.5 mL/kg (HOL group) or 1 mL/kg (HOH group) body weight/day) or simvastatin at 10 mg/kg body weight/day. Oxidative stress, lipids, liver enzymes, and renal markers were measured in the serum. Western blot analysis was applied for evaluating the expressions of inflammatory makers. @*Results@#Except for HDL-cholesterol, the altered levels of lipoproteins, aminotransferases, urea, and creatine kinases in hypercholesterolemic rats were significantly corrected by HO administration. Especially, compared to the HOH group, HOL treatment further reduced AST, ALT, creatinine, TC, and LDL-cholesterol levels. Moreover, both the atherogenic index and cardiac risk factor (CRF) in the HOL group were more restrained compared to the HOH group. Increased levels of p-AMPK coincided with the inhibition of SREBP-2 activation which subsequently suppressed the expression of HMGCR. Nuclear factor (NF)-κB activation coincided with the PI3K/Akt pathway activation and the increased phosphorylation of p38;these levels were significantly suppressed by HO treatment. In addition, HO treatment markedly reversed the changes in chemokines such as ICAM-1, VCAM-1, and MCP-1.Histological alterations induced by cholesterol overload in cardiac and hepatic tissues were ameliorated by HO supplementation. @*Conclusion@#Taken together, our results indicate a low concentration of HO demonstrates improved dysfunctions caused by a high-cholesterol diet via inhibition of the PI3K/Akt/NF-κB signaling pathway.
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Background@#In Korea, there have been no reports comparing the prevalence of major congenital anomalies with other countries and no reports on surgical treatment and longterm mortality. We investigated the prevalence of 67 major congenital anomalies in Korea and compared the prevalence with that of the European network of population-based registries for the epidemiological surveillance of congenital anomalies (EUROCAT). We also investigated the mortality and age at death, the proportion of preterm births, and the surgical rate for the 67 major congenital anomalies. @*Methods@#Korean National Health Insurance claim data were obtained for neonates born in 2013–2014 and admitted within one-year-old. Sixty-seven major congenital anomalies were defined by medical diagnoses classified by International Classification of Diseases-10 codes according to the EUROCAT definition version 2014. Mortality and surgery were defined if any death or surgery claim code was confirmed until 2020. Poisson distribution was used to calculate the 95% confidence interval of the congenital anomaly prevalence. @*Results@#The total prevalence of the 67 major anomalies was 433.5/10,000 livebirths. When compared with the prevalence of each major anomaly in EUROCAT, the prevalence of spina bifida, atrial septal defect (ASD), congenital megacolon, hip dislocation and/or dysplasia and skeletal dysplasia were more than five times higher in Korea. In contrast, the prevalence of aortic atresia/interrupted aortic arch and gastroschisis was less than one-fifth in Korea. The proportion of preterm births was 15.7%; however, more than 40% of infants with anencephaly, annular pancreas and gastroschisis were preterm infants. Additionally, 29.2% of the major anomalies were admitted to the neonatal intensive care units at birth, and 25.6% received surgical operation. The mortality rate was 1.7%, and 78.2% of the deaths occurred within the first year of life. However, in neonates with tricuspid valve atresia and stenosis, duodenal atresia or stenosis, and diaphragmatic hernia, more than half died within their first month of life. ASD and ventricular septal defect were the most common anomalies, and trisomy 18 and hypoplastic left heart syndrome were the most fatal anomalies. All infants with aortic atresia/interrupted aortic arch and conjoined twins received surgery. @*Conclusion@#The proportion of surgeries, preterm births and mortality was high in infants with major congenital anomalies. The establishment of a national registry of congenital anomalies and systematic support by national medical policies are needed for infants with major congenital anomalies in Korea.
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Background@#A previous national study found that Korean children who were breastfed for at least one year had lesser weight gain, lower protein, calcium, and iron intake relative to calories, and different dietary patterns in the second year of life, compared with children weaned before 12 months of age or those who were never breastfed. Therefore, this study aimed to investigate whether growth status, dietary and nutrient intake patterns differed by prolonged breastfeeding (PBF) experience even in the third year of life, when weaning is considered complete. @*Methods@#This cross-sectional study was based on the data of children aged 24 to 35 months from the National Health and Nutrition Examination Survey (2010–2020). Data on anthropometry, dietary behavior, food and nutrient intake, maternal education, and household income were extracted to analyze the association between PBF and growth, dietary and nutrient intake patterns. @*Results@#In the final analysis, 31.6% of the 931 children with a birth weight of ≥ 2.5 kg continued to breastfeed for at least 12 months of age, and their mean breastfeeding (BF) duration was 15.9 months. Children with PBF had significantly less postnatal weight gain than those without (P = 0.006). Regarding food group intake, PBF was significantly associated with lower legume and soy product intake (β [95% confidence interval], −10.688 [−19.314, −2.062], P = 0.015) and higher fruit intake (32.978 [3.349, 62.608], P = 0.029), after adjusting for sex, age in month, total caloric intake, maternal education and household income. Regarding nutrient intake, after adjusting for these variables, PBF had significantly associated with higher dietary fiber (β [95% CI], 1.607 [0.218, 2.996], P = 0.023), iron (0.848 [0.317, 1.380], P = 0.002) and niacin (0.728 [0.222, 1.235], P = 0.005) intake and was significantly associated with lower saturated fatty acid intake (−1.217 [−2.364, −0.071], P = 0.037) and percentage of energy from fat (−1.351 [−2.666, −0.035], P = 0.044). @*Conclusion@#Even in the third year of life, children who have been breastfed for over one year continue to have relatively slow growth. However, they do appear to have better intake of some beneficial nutrients, which may be attributed to healthier dietary intake patterns in children with PBF. The results of this study can be used to support the recommendation of long-term BF for Korean infants and toddlers.
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The survival rate of children admitted in the neonatal intensive care unit (NICU) after birth is on the increase; hence, proper evaluation and care of their neurodevelopment has become an important issue. Neurodevelopmental assessments of individual domains regarding motor, language, cognition, and sensory perception are crucial in planning prompt interventions for neonates requiring immediate support and rehabilitation treatment. These assessments are essential for identifying areas of weakness and designing targeted interventions to improve future functional outcomes and the quality of lives for both the infants and their families. However, initial stratification of risk to select those who are in danger of neurodevelopmental disorders is also important in terms of cost-effectiveness. Efficient and robust functional evaluations to recognize early signs of developmental disorders will help NICU graduates receive interventions and enhance functional capabilities if needed. Several age-dependent, domain-specific neurodevelopmental assessment tools are available; therefore, this review summarizes the characteristics of these tools and aims to develop multidimensional, standardized, and regular follow-up plans for NICU graduates in Korea.
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Infantile hemangiomas are the most common benign tumors of infancy. However, hemangiomas located in the respiratory tract are rare and could cause life-threatening events due to airway obstruction. To date, the best recommended treatment for infantile hemangioma is oral propranolol because it demonstrates faster effects and fewer adverse effects than systemic corticosteroid therapy. Here, we report a case of a 1-month-old girl who presented with respiratory symptoms and hemangioma on the scalp. The hemangioma extended from the right base of the skull to thoracic inlet, causing inspiratory stridor and dyspnea. Treatment with oral propranolol was initiated and her symptoms regressed. Imaging showed regression of the hemangioma. This is a rare case of skin hemangioma found on the scalp, in which the hemangioma extended from the base of the skull to the subglottis, precipitating respiratory symptoms from airway obstruction. Based on this encounter, the presentation of skin hemangioma on the head, coupled with respiratory symptoms, necessitates the use of imaging studies, such as computed tomography, ultrasound, and magnetic resonance imaging to ascertain the extent of hemangioma.
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White mold (orSclerotinia stem rot), caused bySclerotinia species, is a major air, soil, or seed-transmitted disease affecting numerous crops and wild plants. Microscopic or culturebased methods currently available for their detection and identification are time-consuming, laborious, and often erroneous. Therefore, we developed a multiplex quantitative PCR (qPCR) assay for the discrimination, detection, and quantification of DNA collected from each of the three economically relevant Sclerotinia species, namely, S. sclerotiorum, S. minor, and S. nivalis. TaqMan primer/probe combinations specific for each Sclerotiniaspecies were designed based on the gene sequences encoding aspartyl protease. High specificity and sensitivity of each probe were confirmed for sclerotium and soil samples, as well as pure cultures, using simplex and multiplex qPCRs. This multiplex assay could be helpful in detecting and quantifying specific species of Sclerotinia, and therefore, may be valuable for disease diagnosis, forecasting, and management.
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Background@#In modern society, rapid changes in the medical environment have required medical staff to access various information and be competent in active and effective problem-solving through collegial interactions. In line with these changes, universities are aiming to connect education. This study aimed to provide basic data of connected-convergence education by survey the awareness and needs of college students in health-related fields. @*Methods@#This study included 122 college students from the health field. A survey regarding “the awareness and need of connected-convergence education” was conducted and general characteristics of the participants were collected from June to July 2022. @*Results@#The awareness of connected-convergence education was low at 19.7%, but the intention to participate was high at 74.6%. Subject requirements were 18.0% for medical psychology, 13.5% for communication and counseling, 13.5% for medical artificial intelligence technology convergence, and 10.4% for sports health management. In the group showing high satisfaction with the major curriculum, the demand for connected education was also high. For efficient operation, it was investigated that it was necessary to secure specialized training courses, recognition of liberal arts credits, the right to register for courses equal to those of major students, and secure dedicated classrooms. @*Conclusion@#Although the awareness and experience of connected-convergence education among the participants were low, the intention to participate was high. As such a plan to revitalize the university curriculum was required. It is timely to discuss the nurturing of convergence-type talents and multidisciplinary thinking skills. It is meaningful to provide basic data necessary for connected-convergence education in health-related fields at university. Universities should strive to enhance job competency in the health field by providing connected-convergence education based on student demands.
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Purpose@#To investigate the characteristics and distribution of ocular dominance in primary open-angle glaucoma eyes. In addition, we tried to catch any trend of ocular dominance according to the stage of disease. @*Methods@#Two hundred participants with bilateral open-angle glaucoma underwent ocular dominant testing by “the hole-ina-card” test. Using optical coherence tomography, macular ganglion cell-inner plexiform layer, as well as circumpapillary retinal nerve fiber layer thickness were measured and compared according to ocular dominance. Of the two eyes of one subject, the eye with less glaucomatous damage based on mean deviation was considered to be the “better eye” in our study. @*Results@#Ocular dominance was in the right eye in 66% of the population and ocular dominance was positioned in the better eye in 70% of the population (p = 0.001 and p = 0.002, respectively). In conditional logistic regression analyses, right eye and better mean deviation were significantly associated with ocular dominance (p = 0.001 and p = 0.002, respectively). Ocular dominance tends to be present in the better eye and this trend was more apparent as the severity of glaucoma increased. Intereye comparison of visual field indices and retinal nerve fiber layer thickness between dominant versus nondominant eye become apparent in moderate and advanced glaucoma whereas it was not as apparent in early glaucoma. @*Conclusions@#In glaucomatous eyes, laterality and severity of glaucoma determined ocular dominance. Intereye difference between nondominant and dominant eyes increased with the severity of glaucoma. Our findings suggest the existence of potential reciprocal interactions between ocular dominance and glaucoma.
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The need for globally recognized terminology for dysphagia diet has been continuously proposed. Established in 2012, the International Dysphagia Diet Standardization Initiative (IDDSI) Board developed a framework for the dysphagia diet that can commonly be applied in clinical settings and by the caregivers, for all age groups, patients, food industry partners, and bridging all ethnicities. The application of common expressions will ensure patient safety during transfer between medical institutions, by reducing the confusion resulting from diverse terminologies used, and by minimizing unnecessary re-testing. This review introduces the recently updated IDDSI, and discusses and describes the test methods for each level.
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Myotonic dystrophy (MD) is a systemic disease that affects any level of the gastrointestinal tract. Due to its rare occurrence, achalasia could be misdiagnosed due to symptoms being similar to gastroesophageal reflux (GERD). Moreover, there is no known appropriate treatment for achalasia in patients with MD. A 58-year-old man was diagnosed with type 1 MD. He complained of dyspepsia and chest pain, which showed no improvement even after administering GERD medication. Secondary achalasia was subsequently diagnosed after examining the lower esophageal sphincter by performing a video fluoroscopic-swallowing study (VFSS) and high-resolution manometry. Thereafter, the patient was successfully treated with balloon dilatation, and showed significant improvements in the symptoms. The patient remained well for 1 year. We report a rare case of secondary achalasia in an MD patient. Our study validates that VFSS might be useful for the early diagnosis of achalasia, and esophageal intervention (such as balloon dilatation) should be considered on confirmation of the affliction.
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Superolateral dislocation of the condyle is a rare mandibular fracture. The treatment goal is to return the dislocated condyle to its original position to recover normal function. This study reports on superolateral dislocation of the condyle with mandibular body fracture. The mandibular body was completely separated, and the medial pole of the condyle head was fractured. The condyle segment was unstable and easily dislocated after reduction. The temporalis muscle on the condyle segment might have affected the dislocation of the condyle. A coronoidectomy was performed to disrupt the function of the temporalis muscle on the condyle segment in order to successfully reduce the dislocated condyle. Coronoidectomy is a simple procedure with minimal complications. We successfully performed a coronoidectomy to reduce the superolateral displaced condyle to its original position to achieve normal function. Coronoidectomy can be effectively used for reduction of superolaterally displaced condyles combined with severe maxilla-mandibular fractures.
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Background@#and Purpose The purpose of this study was to determine the cardiac and pulmonary management status of patients with Duchenne muscular dystrophy (DMD) in South Korea based on the Korean National Health Insurance database. @*Methods@#This study used data of patients with code G71.0 in the National Health Information database, and also those with the special case of code V012. Cardiac function was assessed based on whether echocardiography and 24-h electrocardiography were performed, as well as the frequency of these investigations. Furthermore, information on the use of angiotensin-converting enzyme inhibitors (ACEi), angiotensin II receptor blockers (ARB), and beta blockers (BB) in the drug benefit list was checked. Medical charge records were also checked regarding the prescription of respiratory functional assessments and treatments. @*Results@#The diagnostic criteria were met by 479 patients, with 41% of these patients receiving a cardiac evaluation, 29.8% being prescribed ACEi at 14.4±3.7 years of age, 59.5% undergoing pulmonary function tests, and 42.1% received pulmonary rehabilitation. The age at receiving ventilator support was 19.4±2.7 years. The frequency of cardiac and respiratory function tests increased with age, but the interval between tests was longer than the recent DMD care recommendations. The trend of taking ACEi, ARB, and BB for cardiac management in South Korea did not change during the study analysis period. @*Conclusions@#The findings of this study will contribute to recognizing the current status and the importance of applying an anticipatory approach to cardiopulmonary function in DMD patients.
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Purpose@#Recent studies have reported that nasal nitric oxide (NO) increases in patients with allergic rhinitis (AR) and bronchial asthma (BA), and can be used as a noninvasive test to determine treatment efficacy. We aimed to investigate the changes in fractional exhaled NO (FeNO) and nasal NO levels before and after treatment in patients with AR and asthma. @*Methods@#Children aged 6–18 years who visited Dong-A University Hospital from August 2013 to July 2014 were treated for mildpersistent or severe-intermittent AR according to Allergic Rhinitis and its Impact on Asthma guidelines. FeNO and nasal NO were measured using NObreath. Among all patients, rhinitis was treated for 1 month, and the results were evaluated in patients with improved AR (n = 31), improved AR+BA (n = 23), and control (n = 19) groups. @*Results@#Sex, age, body mass index, allergy, serum total eosinophil count and immunoglobulin E, erythrocyte sedimentation rate, and C-reactive protein showed no intergroup differences before or after treatment. Nasal NO before treatment was higher in the BA+AR and AR groups than controls (P = 0.005), but there was no difference between disease groups after treatment. Both groups showed a significant decrease in nasal NO after treatment compared with measurements before treatment (AR, P = 0.044; AR+BA, P = 0.004). @*Conclusion@#Nasal NO can be effectively used as a noninvasive test for clinical efficacy because it was significantly reduced by improving symptoms in AR patients with and without asthma.
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Background and Objectives@#For plunging ranula, excision of the sublingual gland has been the major treatment option, with sclerotherapy being widely used as minimal invasive treatment. We compared the outcomes of these two methods as an initial treatment for ranula and investigated the outcomes of salvage procedure in recurred patients.Subjects and Method Patients were classified into the excision group (n=35) and the sclerotherapy group (n=39) according to the type of their initial treatment. The outcomes of the initial and salvage treatment were determined as recurrence or non-recurrence at 3 months after treatment, and statistically compared between the excision and the sclerotherapy groups. @*Results@#Recurrence in the sclerothearpy group (n=20, 51.3%) showed a significantly higher rate (p<0.001) than in the excision group (n=3, 8.6%). Recurring patients who received treatment different from the initial treatment (n=7) were cured, while those who had same procedure as the initial treatment (n=11) showed recurrence of 72.7% (n=8). There was no procedure related complication among the patients. @*Conclusion@#Sublingual gland excision was more effective than ethanol sclerotherapy for the treatment of plunging ranula. In addition, sublingual gland excision was effective even after the failure of ethanol sclerotherapy.