PURPOSE: The aim of this study was to examine the relationship between tooth loss and sub-clinical atherosclerosis in Korean adults. MATERIALS AND METHODS: The subjects were part of a cohort study conducted in Ansan city by the Korea University medical school as part of the Korean Genome project. 749 subjects over than 40 years old were evaluated. After taking panoramic radiography, the amount of tooth loss was calculated. The intima-media thickness (IMT) was assessed by using ultrasonography at the common carotid artery. Traditional cardiovascular risk factors for atherosclerosis were also evaluated. The relationship between tooth loss and the IMT was evaluated using ANOVA with Scheffe's multiple comparison method in univariate analysis. Multiple regression analysis was also performed to determine the significance between the IMT and tooth loss. RESULTS: With age, tooth loss increased, but there was no significant increase in other traditional cardiovascular risk factors. Univariate analysis revealed the IMT to be positively related with the amount of tooth loss. Regression analysis of the IMT in the anterior and posterior tooth loss revealed that only the posterior tooth loss was significantly related with the IMT at all sites of the common carotid artery (right far wall, P = .015; left far wall, P = .008; right near wall, P < .001; left near wall, P = .001). CONCLUSION: This study verified the positive relationship between the increased tooth loss at the posterior area and the accumulation of atheroma in arteries.
Adult ; Arteries ; Atherosclerosis ; Carotid Artery, Common ; Carotid Intima-Media Thickness ; Cohort Studies ; Genome ; Humans ; Korea ; Plaque, Atherosclerotic ; Radiography, Panoramic ; Risk Factors ; Schools, Medical ; Tooth ; Tooth Loss

PURPOSE: This study examined the nutrient intake and dietary habits based on breakfast consumption in Korean adolescents. METHODS: The data of the 2013 ~ 2015 Korea National Health and Nutrition Examination Survey (KNHANES) were used in this study. The analysis included 1,281 adolescents aged 12 to 18 years. The subjects were divided into two groups (EBF: eating breakfast, n = 911; SBF: skipping breakfast, n = 370). RESULTS: The EBF group was significantly younger than the SBF group. In addition, the EBF group had a significantly lower frequency of skipping dinner than the SBF group. The EBF group consumed significantly higher levels of most nutrients except for vitamin A than the SBF group. The percent of nutrient intake under the EAR (estimated average requirements) in the EBF group were also significantly lower than that in the SBF group. Moreover, the NAR (nutrient adequacy ratio) and MAR (mean adequacy ratio) of the EBF group were significantly higher than those of the SBP group. The intake of cereal, sugars and sweeteners, vegetables, and eggs in the EBF group was significantly higher than that in the SBF group. CONCLUSION: The habit of skipping breakfast in adolescents leads to a decrease in the total nutrient intake and imbalanced dietary habits. Breakfast consumption in adolescence is very important. Therefore, more studies will be needed to develop nutrition education systematically in Korean adolescents.
Adolescent ; Breakfast ; Carbohydrates ; Ear ; Eating ; Edible Grain ; Education ; Eggs ; Food Habits ; Humans ; Korea ; Meals ; Nutrition Surveys ; Ovum ; Sweetening Agents ; Vegetables ; Vitamin A

BACKGROUND: The role of clinical pharmacists in medication therapy to improve clinical and economic outcomes has been reported in the literature. This study was conducted to analyze the changes in details of medication interventions before and after the introduction of clinical pharmacists into the care of neurocritical care unit (NCU) patients, and to evaluate the economic effects of clinical pharmacists by calculating the avoidance cost. METHODS: A retrospective study was conducted reviewing the electronic medical records from June 2013 to May 2014 (before), and from June 2016 to May 2017 (after). We calculated the number and rates of intervention, the acceptance rates of it, and also reviewed the list of interventions. We calculated avoidance cost if there was no intervention. RESULTS: The monthly mean number of interventions increased from 8.0 (±5.7) to 31.7 (±12.8) (P < 0.001) and the frequency of intervention also increased from 0.8% to 1.6% (P=0.003). The most frequently provided pharmacist intervention was nutritional support before introduction of clinical pharmacists and discussions on the medication plan after. The number of classified interventions was 14 before introduction of clinical pharmacist services and 33 after. The calculated cost avoidance associated with a clinical pharmacists' integration was 77,990,615 won per year. CONCLUSION: Introduction of clinicals pharmacist into the NCU was associated with increased intervention rates and expanded types of clinical interventions. The cost avoidance achieved by the pharmacists' interventions can be further explored to evaluate if similar expansions of pharmacists' services achieve similar results in other settings.
Costs and Cost Analysis ; Electronic Health Records ; Humans ; Intensive Care Units ; Medication Reconciliation ; Nutritional Support ; Pharmacists ; Retrospective Studies

OBJECTIVE: The purpose of this study was to determine whether screw fixation without bone fusion in patients with a low lumbar burst fracture has satisfactory outcomes. METHODS: Twelve patients that underwent screw fixation without bone fusion for a low lumbar burst fracture (L3-5) between 2006 and 2009, were included in this study. Motor power was intact despite severe canal compromise in all. Surgical procedures included postural reduction for 2 days and screw fixation without bone fusion. Imaging and clinical findings, including level of the involved vertebra, vertebral height, canal compromise, clinical outcomes, and related complications were analyzed. RESULTS: Mean follow-up was 23.1+/-11.0 months. Mean pain score (visual analogue scale) prior to surgery was 7.8+/-2.0 and this decreased to 1.8+/-1.0 at final follow-up. In 5 patients, open screw fixation by midline skin incision was performed and 7 patients underwent percutaneous screw fixation at one level above, one level below the fractured vertebra and fractured level itself. The proportion of canal compromise at the fractured level improved significantly from 60% to 30% at final follow-up (p<0.001). Mean preoperative vertebral height loss was 31.0%, and improved to 20.5% at final follow-up, though this improvement was not statistically significant (p<0.001). No neurological aggravation related to neural injury was observed. CONCLUSION: Short segment pedicle screw fixation without bone fusion can be an effective and safe operative technique for the management of selected low lumbar burst fractures.
Follow-Up Studies ; Humans ; Lumbar Vertebrae ; Skin ; Spine

PURPOSE: This study was conducted to identify the spiritual well-being and spiritual care of hospice team members. METHOD: Between December 2005 and February 2006, a questionnaire was given to 192 hospice team members. The instruments used in this study were the Spiritual Well-Being Scale(SWBS) developed by Paloutzian, & Ellison(1984), and a Spiritual Care Performance Scale developed by the authors. RESULTS: The levels of spiritual well-being were relatively high: significantly lower in the 25-29 years old, in the unmarried, and in the 1-2 million won income groups, and significantly higher in Protestants, Catholics, clergy, and volunteers. The levels of performance of spiritual care were intermediate; significantly higher in clergy, and those with 10 or more years of experience. There was a positive correlation between: levels of spiritual well-being and age; levels of spiritual well-being and performance of spiritual care; and levels of performance of spiritual care and age. The factors affecting the levels of spiritual well-being included religion, age, and performance of spiritual care. The factors affecting the levels of performance of spiritual care were the years of hospice experience and spiritual well-being. CONCLUSION: Because there was a positive correlation between levels of spiritual well-being and performance of spiritual care, there is a need to develop a strategies to increase the spiritual well-being of hospice team members.
Clergy ; Hospice Care ; Hospices* ; Humans ; Protestantism ; Surveys and Questionnaires ; Single Person ; Spirituality ; Volunteers

BACKGROUND: Spinal cord stimulation is a well-established method for the management of several types of chronic and intractable pain. This form of stimulation elicits a tingling sensation (paresthesia) in the corresponding dermatomes. The goal of this study was to establish a correlation between the spinal levels of the implanted epidural electrodes and the paresthesia elicited due to stimulation of the neural structures. METHODS: Thirty five patients, who received trial spinal cord stimulation, were evaluated. After the insertion of the lead to the selected position, the areas of paresthesia evoked by stimulation were evaluated. RESULTS: Seventy-one percent of cases showed paresthesia in the shoulder area when the tip of the electrode was located between the C2 C4 levels. At the upper extremities, paresthesia was evoked in 86 93% of cases, regardless of the location of the electrode tip within the cervical spinal segments. The most common tip placement of the leads eliciting hand stimulation was at the C5 level. The most common level of electrode tip placement eliciting paresthesia of the anterior and posterior thigh and the foot were at the T7 T12, T10 L1 and T11 L1 vertebral segments, respectively. CONCLUSIONS: Detailed knowledge of the patterns of stimulation induced paresthesia in relation to the spine level of the implanted electrodes has allowed the more consistent and successful placement of epidural electrodes at the desired spine level.
Electrodes* ; Electrodes, Implanted ; Foot ; Hand ; Humans ; Pain, Intractable ; Paresthesia* ; Sensation ; Shoulder ; Spinal Cord Stimulation* ; Spinal Cord* ; Spine ; Thigh ; Upper Extremity

BACKGROUND: The AutoVue Innova (Ortho Clinical Diagnostic, Raritan, NJ, USA) is an automatic instrument for blood bank tests, and it has recently been introduced in Korea for the first time at our hospital. This instrument employs column agglutination technology and it performs blood bank tests automatically. We evaluated this instrument and we report on the results. METHODS: We performed ABO/RhD typing and antibody screening for 250 randomly selected samples, and crossmatching for 261 samples with using the AutoVue Innova in parallel with the conventional manual methods. For a sensitivity test, we added 3 samples of A(2)B(3) and 2 samples of weak-D and serially diluted reagent antisera to the test pool and we measured turnaround time (TAT) for the antibody screening test. RESULTS: The concordance rates between AutoVue Innova and the manual methods for ABO/RhD blood typing, antibody screening and crossmatching tests were 99.6%, 100% and 98.9%, respectively. The overall retest rate was 0.5% and the main cause of the discrepancy was revealed to be hemolysis or an inadequate amount of the samples. The overall sensitivity of AutoVue Innova seems to be same as or better than the manual methods. The TAT for the antibody screening test was significantly shorter for the AutoVue Innova (64+/-43 min, n=512) than for the tube method (89+/-57 min, n=99) (P<0.001). CONCLUSION: The test results of AutoVue Innova were accurate and sensitive for the ABO/RhD typing, crossmatching and antibody screening tests. The TAT for the antibody screening test was remarkably shortened up to five times more samples could be tested without an increase of manpower.
Agglutination ; Blood Banks ; Blood Grouping and Crossmatching ; Hemolysis ; Immune Sera ; Korea ; Mass Screening

We report a case of group O losing anti-B selectively. A 25-year-old male donated blood; on the donor test an ABO discrepancy was noted, and a further evaluation study was performed. ABO genotyping with an allele specific polymerase chain reaction assay revealed O/O and DNA sequencing of exons 6 and 7 of the ABO gene showed O01/O02. The serum gammaglobulin level was decreased and only 0.2% CD19 pan-B positive lymphocytes were present in a subset of lymphocytes. In a previous donor study, anti-B of the patient was lost from a third donor study and was still not detected.
Adult ; Agammaglobulinemia ; Alleles ; Exons ; Humans ; Lymphocytes ; Male ; Polymerase Chain Reaction ; Sequence Analysis, DNA ; Tissue Donors

OBJECTIVE: To investigate the clinical significance of thrombophilia in patients admitted with ovarian hyperstimulation syndrome (OHSS). METHODS: Twenty-five infertile women who were admitted into university hospital due to OHSS after ovarian hyperstimulation for intrauterine insemination or in vitro fertilization. Blood samples were drawn at the time of admission and three thrombophilic factors were assayed; antithrombin III, protein C and protein S. Subjects were divided into severe (n=18) and mild-to-moderate (n=7) OHSS, and laboratory parameters including three thrombophilic factors were compared. RESULTS: Antithrombin III level was abnormal in 40% of subjects, protein C in 12%, and protein S in 72%. There was no significant difference in the laboratory parameters between the patients with normal (n=15) and abnormal antithrombin III levels (n=10). However, the patients with abnormal antithrombin III levels had significantly more severe OHSS than those with normal value (100% vs 55.6%, P=0.013). The patients with at least one abnormal thrombophilic factor had significantly more severe OHSS than those with all normal value (94.4% vs 42.9%, P=0.012). CONCLUSIONS: Thrombophilic factors, particularly antithrombin III, may be associated with disease severity in patients with OHSS.
Antithrombin III ; Female ; Fertilization in Vitro ; Humans ; Insemination ; Ovarian Hyperstimulation Syndrome ; Protein C ; Protein S ; Reference Values ; Thrombophilia

PURPOSE: To assess the normal range of transverse and AP diameter of the trachea on simple chest radiographs and to determine whether or not there is any correlation between tracheal diameter and age, sex, height, or bodyweight. MATERIALS AND METHODS: Six hundred and ninety patients with no lesion on chest radiographs and noclinical evidence of respiratory disease were involved in this study. To obtein transverse and lateral diameters,the internal diameter of the tracheal air column was measured at a level 2 cm above the top of the aortic arch onboth posteroanterior and lateral radiographs. RESULTS: The normal ranges of AP and transverse diameters of thetrachea were 16 to 25mm, and 14 to 22mm in men, respectively and 12 to 20mm and 12 to 18mm in women. Statistically significant differences were observed between AP and transverse diameter in both in men and women, the former being consistently larger than the latter in both sexes. In men, significant correlations were observed between transverse diameter and patients' height, and between AP diameter and age as well as height. In women, significant differences were observed between AP diameter and patients' height, and transverse diameter and height as well asbody weight of patients. CONCLUSIONS: Normal tracheal diameter was larger in men than in women. and AP diameter was larger than transverse diameter. Patients' height showed persistent correlation with luminal diameter.
Aorta, Thoracic ; Female ; Humans ; Male ; Phenobarbital* ; Radiography, Thoracic* ; Reference Values ; Thorax* ; Trachea