Background/Aims: Tegoprazan is a novel potassium-competitive acid blocker that has beneficial effects on acid-related disorders such as gastroesophageal reflux and peptic ulcer diseases.This study aimed to validate the effect of tegoprazan on endoscopic submucosal dissection (ESD)-induced artificial ulcers. Methods: Patients from 16 centers in Korea who underwent ESD for gastric neoplasia were enrolled. After ESD, pantoprazole was administered intravenously for 48 hours. The patients were randomly allocated to either the tegoprazan or esomeprazole group. Tegoprazan 50 mg or esomeprazole 40 mg were administered for 4 weeks, after which gastroscopic evaluation was performed. If the artificial ulcer had not healed, the same dose of tegoprazan or esomeprazole was administered for an additional 4 weeks, and a gastroscopic evaluation was performed. Results: One hundred sixty patients were enrolled in this study. The healing rates of artificial ulcers at 4 weeks were 30.3% (23/76) and 22.1% (15/68) in the tegoprazan and esomeprazole groups, respectively (p=0.006). At 8 weeks after ESD, the cumulative ulcer healing rates were 73.7% (56/76) and 77.9% (53/68) in the tegoprazan and esomeprazole groups, respectively (p=0.210). Delayed bleeding occurred in two patients in the tegoprazan group (2.6%) and in one patient in the esomeprazole group (1.5%). Other adverse events were negligible in both groups. Conclusions Tegoprazan showed similar effects on post-ESD artificial ulcer healing in comparison with esomeprazole.

Purpose: This study investigated the immediate biomechanical effects of unilateral mastication for 10 minutes on the temporomandibular joint (TMJ) with 21 healthy adult participants. Methods: The gum group chewed gum on the right side for 10 minutes, and the control group rested for 10 minutes. Biomechanical data were obtained using a three-dimensional infrared camera before and after intervention. An independent t-test assessed the variation of kinematic data to identify differences between before and after intervention. Results: Among biomechanical variables, the gum group’s length of the left forehead middle region and the temporomandibular joint angle decreased compared to the control group (p<0.05). Conclusion Caution with unilateral masticatory activity is recommended, as unilateral mastication causes biomechanical changes due to excessive load on the soft tissues of the contralateral TMJ.

Purpose: This study aims to compare the effect on balance during core and ankle muscle strengthening exercises using the Thera-Band. Methods: 21 healthy college students were recruited. The participants were divided into a core strengthening group (CSG), an ankle strengthening group (ASG), and a non-exercise group (NEG). CSG and ASG were performed twice a week for a total of 4 weeks, and static and dynamic balance were measured before and after the intervention. The static balance were measured as stability index and weight distribution index using Tetrax®. The dynamic balance was measured in each direction by the Y balance test. The Thera-Band intensity was increased after 2 weeks of exercise, and the exercise was subsequently performed. Results: Participants showed static balance with Tetrax®, a significant difference was noted between normal eye closes and pillow with eye closes in ASG (p < 0.05). In the case of dynamic balance with the Y balance test, a significant difference was observed in posterolateral direction (PL) and composite score (CS) between each group for the pre- and post-intervention differences (p < 0.05). A significant difference was observed between PL and CS in CSG (p < 0.05). Conclusion These findings show that the progressive Thera-Band exercise had a positive effect on balance abilities. It was confirmed that core strengthening was effective for dynamic balance, and ankle strengthening was effective for static balance.

Purpose: This study aimed to determine which interventions are effective in increasing hamstring flexibility due to changes in the range of motion (ROM) and pennation angle (PA) when foam rolling (FR) and proprioceptive neuromuscular facilitation (PNF) stretching were performed. Methods: A total of 24 healthy participants who agreed to participate in the study were randomly chosen. The participants were divided into three groups of eight people: Control, FR, and PNF stretching groups. The hip flexion angle (ROM) and PA of the hamstrings were measured before and after the experiment. The Wilcoxon signed-rank test was used to analyze the ROM and PA for each group by comparing the before and after results. The Kruskal-Wallis test and the Mann-Whitney U test were used to analyze the increase in hamstring flexibility between the groups. Results: A statistically significant difference was observed in the ROM and PA within all groups, and only the ROM was significant in the comparison between the three groups. In the comparison between the control and other two groups, a significant difference was noted in both the ROM and PA in the FR group and only the ROM in the PNF stretching group (p < 0.05). In the comparison between the FR and PNF stretching groups, no significant difference was observed (p > 0.05). Conclusion These findings FR and PNF stretching increased the ROM; however, no change in PA was observed. Therefore, FR and PNF stretching were considered effective interventions in immediately increasing hamstring flexibility.

Purpose: This study investigated the effects of open kinetic chain (OKC) exercise for the gastrocnemius (GCM) and tibialis anterior (TA) muscles on static and dynamic balance and muscle strength. Methods: We recruited 21 healthy participants, dividing them into 3 groups (GCM, TA, and non-exercise). Each group contains 7 participants. Two exercise groups (GCM and TA) performed OKC exercise with elastic bands twice per week for 4 weeks, while non-exercise group did nothing. We obtained the data for static and dynamic balance and muscle strength before and after the intervention. We used the Kruskal–Wallis test to compare and analyze the pre–post-intervention differences among the groups. Results: For static balance, the stability index of the TA group was the lowest for the dynamic platform (p < 0.05). The dynamic balance of the TA group increased for the anterior and posteromedial directions (p < 0.05). The peak torque increased in the TA group for dorsiflexion (D/F) movement and in the GCM group for plantar flexion movement compared with the other groups, except for the left direction during D/F (p < 0.05). Conclusion OKC exercises with elastic bands were effective for selectively increasing muscle strength. It is clinically thought that strength training for TA muscles will be effective among the muscles of the ankle.

Background: Although patients with chronic obstructive pulmonary disease (COPD) experience high morbidity and mortality worldwide, few biomarkers are available for COPD.Here, we analyzed potential biomarkers for the diagnosis of COPD by using word embedding. Methods: To determine which biomarkers are likely to be associated with COPD, we selected respiratory disease-related biomarkers. Degrees of similarity between the 26 selected biomarkers and COPD were measured by word embedding. And we infer the similarity with COPD through the word embedding model trained in the large-capacity medical corpus, and search for biomarkers with high similarity among them. We used Word2Vec, Canonical Correlation Analysis, and Global Vector for word embedding. We evaluated the associations of selected biomarkers with COPD parameters in a cohort of patients with COPD. Results: Cytokeratin 19 fragment (Cyfra 21-1) was selected because of its high similarity and its significant correlation with the COPD phenotype. Serum Cyfra 21-1 levels were determined in patients with COPD and controls (4.3 ± 5.9 vs. 3.9 ± 3.6 ng/mL, P = 0.611). The emphysema index was significantly correlated with the serum Cyfra 21-1 level (correlation coefficient = 0.219,P = 0.015). Conclusion Word embedding may be used for the discovery of biomarkers for COPD and Cyfra 21-1 may be used as a biomarker for emphysema. Additional studies are needed to validate Cyfra 21-1 as a biomarker for COPD.

Background: Although patients with chronic obstructive pulmonary disease (COPD) experience high morbidity and mortality worldwide, few biomarkers are available for COPD.Here, we analyzed potential biomarkers for the diagnosis of COPD by using word embedding. Methods: To determine which biomarkers are likely to be associated with COPD, we selected respiratory disease-related biomarkers. Degrees of similarity between the 26 selected biomarkers and COPD were measured by word embedding. And we infer the similarity with COPD through the word embedding model trained in the large-capacity medical corpus, and search for biomarkers with high similarity among them. We used Word2Vec, Canonical Correlation Analysis, and Global Vector for word embedding. We evaluated the associations of selected biomarkers with COPD parameters in a cohort of patients with COPD. Results: Cytokeratin 19 fragment (Cyfra 21-1) was selected because of its high similarity and its significant correlation with the COPD phenotype. Serum Cyfra 21-1 levels were determined in patients with COPD and controls (4.3 ± 5.9 vs. 3.9 ± 3.6 ng/mL, P = 0.611). The emphysema index was significantly correlated with the serum Cyfra 21-1 level (correlation coefficient = 0.219,P = 0.015). Conclusion Word embedding may be used for the discovery of biomarkers for COPD and Cyfra 21-1 may be used as a biomarker for emphysema. Additional studies are needed to validate Cyfra 21-1 as a biomarker for COPD.

Purpose: We aimed to develop and validate individual prognostic models in a large cohort of cervical cancer patients that were primarily treated with radical hysterectomy. Materials and Methods: We analyzed 1,441 patients with early-stage cervical cancer treated between 2000 and 2008 from the Korean Gynecologic Oncology Group multi-institutional cohort: a train cohort (n=788) and a test cohort (n=653). Models predicting the risk for overall survival (OS), disease- free survival (DFS), lymphatic recurrence and hematogenous recurrence were developed using Cox analysis and stepwise backward selection and best-model options. The prognostic performance of each model was assessed in an independent patient cohort. Model-classified risk groups were compared to groups based on traditional risk factors. Results: Independent risk factors for OS, DFS, lymphatic recurrence, and hematogenous recurrence were identified for prediction model development. Different combinations of risk factors were shown for each outcome with best predictive value. In train cohort, area under the curve (AUC) at 2 and 5 years were 0.842/0.836 for recurrence, and 0.939/0.882 for OS. When applied to a test cohort, the model also showed accurate prediction result (AUC at 2 and 5 years were 0.799/0.723 for recurrence, and 0.844/0.806 for OS, respectively). The Kaplan-Meier plot by proposed model-classified risk groups showed more distinctive survival differences between each risk group. Conclusion We developed prognostic models for OS, DFS, lymphatic and hematogenous recurrence in patients with early-stage cervical cancer. Combining weighted clinicopathologic factors, the proposed model can give more individualized predictions in clinical practice.

BACKGROUND: Neuromuscular blocking agents (NMBAs) and neuromuscular monitoring in anesthetic management are integral for endotracheal intubation, better visualization of the surgical field, and prevention of residual neuromuscular blockade and pulmonary complications. Sugammadex is a drug that reduces risk of residual neuromuscular blockade, with more rapid recovery compared to anticholinesterase. The purpose of this study was to investigate current usage status of NMBAs and antagonist with neuromuscular monitoring, among anesthesiologists in Korea.METHODS: Anesthesiologists working in Korea were invited to participate in an online survey via email January 2–February 28, 2018. The questionnaire consisted of 45 items, including preferred NMBAs, antagonists, neuromuscular monitoring, and complications related to the use sugammadex. A total of 174 responses were analyzed.RESULTS: Rocuronium was a commonly used NMBA for endotracheal intubation (98%) of hospitals, and maintenance of anesthesia (83.3%) in of hospitals. Sugammadex, pyridostigmine, and neostigmine were used in 89.1%, 87.9%, and 45.4% of hospitals. Neuromuscular monitoring was employed in 79.3% of hospitals; however only 39.7% of hospitals used neuromuscular monitoring before antagonist administration. Usual dosage range of sugammadex was 2.1–4 mg/kg in 35.1% of hospitals, within 2 mg/kg in 34.5% of hospitals, and 1 vial regardless of body weight in 22.4% of hospitals. Sugammadex-related complications were encountered by 14.9% of respondents.CONCLUSIONS: This survey indicates several minor problems associated with the use of antagonists and neuromuscular monitoring. However, most anesthesiologists appear to have appropriate information regarding the usage of NMBAs and sugammadex.
Anesthesia ; Body Weight ; Delayed Emergence from Anesthesia ; Electronic Mail ; Intubation, Intratracheal ; Korea ; Neostigmine ; Neuromuscular Blockade ; Neuromuscular Blocking Agents ; Neuromuscular Monitoring ; Pyridostigmine Bromide ; Surveys and Questionnaires

PURPOSE: Although previous studies on the screw-home movement (SHM) for autopsy specimen and walking of living persons conducted, the possibility of acquiring SHM based on inertial measurement units received little attention. This study aimed to investigate the possibility of measuring SHM for the non-weighted bearing using a micro-electro-mechanical system-based wearable motion capture system (MEMSS). METHODS: MEMSS and camera-based motion analysis systems were used to obtain kinematic data of the knee joint. The knee joint moved from the flexion position to a fully extended position and then back to the start point. The coefficient of multiple correlation and the difference in the range of motion were used to assess the waveform similarity in the movement measured by two measurement systems. RESULTS: The waveform similarity in the sagittal plane was excellent and the in the transverse plane was good. Significant differences were found in the sagittal plane between the two systems (p<0.05). However, there was no significant difference in the transverse plane between the two systems (p>0.05). CONCLUSION The SHM during the passive motion without muscle contraction in the non-weighted bearing appeared in the entire range. We thought that the MEMSS could be easily applied to the acquisition of biomechanical data on the knee related to physical therapy.