Purpose: Angiotensin-converting enzyme inhibitors and angiotensin II receptor blockers (ARBs) are frequently employed to counteract the detrimental effects of proteinuria on glomerular diseases. However, the effects of ARBs remain poorly examined in pediatric patients with immunoglobulin A (IgA) nephropathy. Herein, we evaluated the efficacy and safety of losartan, an ARB, in pediatric IgA nephropathy with proteinuria. Methods: This prospective, single-arm, multicenter study included children with IgA nephropathy exhibiting proteinuria. Changes in proteinuria, blood pressure, and kidney function were prospectively evaluated before and 4 and 24 weeks after losartan administration. The primary endpoint was the difference in proteinuria between baseline and 24 weeks. Results: In total, 29 patients were enrolled and received losartan treatment. The full analysis set included 28 patients who received losartan at least once and had pre- and post-urinary protein to creatinine ratio measurements (n=28). The per-protocol analysis group included 22 patients who completed all scheduled visits without any serious violations during the study period. In both groups, the mean log (urine protein to creatinine ratio) value decreased significantly at 6 months. After 24 weeks, the urinary protein to creatinine ratio decreased by more than 50% in approximately 40% of the patients. The glomerular filtration rate was not significantly altered during the observation period. Conclusions Losartan decreased proteinuria without decreasing kidney function in patients with IgA nephropathy over 24 weeks. Losartan could be safely employed to reduce proteinuria in this patient population. ClinicalTrials.gov trial registration (NCT0223277)

Background: The purpose of this study was to analyze research trends in articles published in the Journal of Dental Hygiene Science over the past decade. Methods: From 2011 to 2020, 653 studies were reviewed using a keyword analysis. Contents such as academic classification, research type, research method, research topic, data collection method, data analysis method, and financial support were analyzed. Results: Analysis by school type showed 34.2% of clinical dental hygiene studies, 23.3% of educational dental hygiene studies, 22.8% of basic dental hygiene studies, 10.0% of other field studies, and 9.8% of social dental hygiene studies. By type of study, quantitative studies were the most common at 69.5%. Regarding data collection methods, 45.8% of the studies that used surveys were the most common. The subjects of the study were 20.1% experimental studies, 15.6% general adults, and 15.0% dental hygienists. Regarding the data analysis method, 49.3% of the studies that conducted frequency analysis were the most common. The total number of keywords was 2,390, with 107 (4.48%) being ‘dental hygienists.’ Next, oral health was the most common with 67 (2.80%) articles, followed by 31 for the elderly (1.30%), 25 for dental hygiene students (1.05%), and 24 for stress (1.00%). Conclusion For academic development of dental hygiene, it is necessary to explore the diversity of academic topics based on the results of this study. It is necessary to find a way to spread the research results so that the published research can be used for the academic development of dental hygiene.

Background/Aims: The aim of this study was to investigate long-term post-discontinuation outcomes in patients with rheumatoid arthritis (RA) who had been treated with tumor necrosis factor-α inhibitors (TNF-αi) which was then discontinued. Methods: Sixty Korean patients with RA who participated in a 5-year GO-BEFORE and GO-FORWARD extension trials were included in this retrospective study. Golimumab was deliberately discontinued after the extension study (baseline). Patients were then followed by their rheumatologists. We reviewed their medical records for 2 years (max 28 months) following golimumab discontinuation. Patients were divided into a maintained benefit (MB) group and a loss-of-benefit (LB) group based on treatment pattern after golimumab discontinuation. The LB group included patients whose conventional disease-modifying antirheumatic drug(s) were stepped-up or added/switched (SC) and those who restarted biologic therapy (RB). Results: The mean age of patients at baseline was 56.5 years and 55 (91.7%) were females. At the end of follow-up, 23 (38.3%) patients remained in the MB group. In the LB group, 75.7% and 24.3% were assigned into SC and RB subgroups, respectively. Fifty percent of patients lost MB after 23.3 months. Demographics and clinical variables at baseline were comparable between MB and LB groups except for age, C-reactive protein level, and corticosteroid use. Restarting biologic therapy was associated with swollen joint count (adjusted hazard ratio [HR], 1.90; 95% confidence interval [CI], 1.01 to 3.55) and disease duration (adjusted HR, 1.12; 95% CI, 1.02 to 1.23) at baseline. Conclusions Treatment strategies after discontinuing TNF-αi are needed to better maintain disease control and quality of life of patients with RA.

Background: The clinical features of pediatric rhabdomyolysis differ from those of the adults with rhabdomyolysis; however, multicenter studies are lacking. This study aimed to investigate the characteristics of pediatric rhabdomyolysis and reveal the risk factors for acute kidney injury (AKI) in such cases. Methods: This retrospective study analyzed the medical records of children and adolescents diagnosed with rhabdomyolysis at 23 hospitals in South Korea between January 2007 and December 2016. Results: Among 880 patients, those aged 3 to 5 years old composed the largest subgroup (19.4%), and all age subgroups were predominantly male. The incidence of AKI was 11.3%. Neurological disorders (53%) and infection (44%) were the most common underlying disorder and cause of rhabdomyolysis, respectively. The median age at diagnosis in the AKI subgroup was older than that in the non-AKI subgroup (12.2 years vs. 8.0 years). There were no significant differences in body mass index, myalgia, dark-colored urine, or the number of causal factors between the two AKI-status subgroups. The multivariate logistic regression model indicated that the following factors were independently associated with AKI: multiorgan failure, presence of an underlying disorder, strong positive urine occult blood, increased aspartate aminotransferase and uric acid levels, and reduced calcium levels. Conclusions Our study revealed characteristic clinical and laboratory features of rhabdomyolysis in a Korean pediatric population and highlighted the risk factors for AKI in these cases. Our findings will contribute to a greater understanding of pediatric rhabdomyolysis and may enable early intervention against rhabdomyolysis-induced AKI.

BACKGROUND: Menkes disease (MD) is a rare X-linked hereditary multisystemic disorder that is caused by dysfunction of copper metabolism. Patients with MD typically present with progressive neurodegeneration, some connective tissue abnormalities, and characteristic “kinky” hair. In addition, various types of urological complications are frequent in MD because of underlying connective tissue abnormalities. In this study, we studied the clinical features and outcomes of MD, focusing on urological complications. METHODS: A total of 14 unrelated Korean pediatric patients (13 boys and 1 girl) with MD were recruited, and their phenotypes and genotypes were analyzed by retrospective review of their medical records. RESULTS: All the patients had early-onset neurological deficit, including developmental delay, seizures, and hypotonia. The girl patient showed normal serum copper and ceruloplasmin levels as well as milder symptoms. Mutational analysis of the ATP7A gene revealed 11 different mutations in 12 patients. Bladder diverticula was the most frequent urological complication: 8 (57.1%) in the 14 patients or 8 (72.7%) in the 11 patients who underwent urological evaluation. Urological imaging studies were performed essentially for the evaluation of accompanying urinary tract infections. Four patients had stage II chronic kidney disease at the last follow-up. CONCLUSION: Urologic problems occurred frequently in MD, with bladder diverticula being the most common. Therefore, urological imaging studies and appropriate management of urological complications, which may prevent or reduce the development of urinary tract infections and renal parenchymal damage, are required in all patients with MD.
Ceruloplasmin ; Connective Tissue ; Copper ; Diverticulum ; Female ; Follow-Up Studies ; Genotype ; Hair ; Humans ; Medical Records ; Menkes Kinky Hair Syndrome* ; Metabolism ; Muscle Hypotonia ; Phenotype ; Renal Insufficiency, Chronic ; Retrospective Studies ; Seizures ; Urinary Bladder ; Urinary Tract Infections

The authors regret that there was an important error in the results in Table 1; the ATP7A mutations detected in Patients 2 and 14 were incorrectly noted.

BACKGROUND/AIMS: Due to advances in diagnostic techniques, clinicians are more frequently performing influenza diagnostic tests and referring to their test results ahead of the administration of neuraminidase inhibitors (NAIs). To investigate the clinical significance of the time from symptom onset to laboratory diagnosis, we reviewed the clinical characteristics of adult patients with influenza who had an early laboratory diagnosis (ED) or a late laboratory diagnosis (LD) at one of four tertiary care centers during a seasonal outbreak of influenza. METHODS: Clinical data were collected from 1,405 adults during the 2013 to 2014 influenza season. A patient was regarded as receiving an ED or LD if he/she received an influenza diagnostic test at 0 to 1 or 4 to 7 days after symptom onset, respectively. Early NAI therapy and late NAI therapy were defined as the administration of NAI ≤ 2 or > 2 days after symptom onset, respectively. RESULTS: Nearly half of the patients (47.0%) received an ED (n = 661), whereas 13.5% (n = 190) received a LD. Patients with a LD had initial symptoms of cough, sputum production, and dyspnea and experienced pneumonia, antibiotic therapy, hospitalization, and admission to the intensive care unit more often than those with an ED. NAI therapy and early NAI therapy were less frequent in patients with a LD than those with an ED. Of the analyzed baseline characteristics, age ≥ 50 years, influenza B infection, and diagnosis using a polymerase chain reaction test were significantly associated with a LD. CONCLUSIONS: LD was associated with inappropriate antiviral therapy and complicated presenting features in adult patients with seasonal influenza. ED of influenza should be emphasized, especially for older adults.
Adult* ; Antiviral Agents ; Clinical Laboratory Techniques ; Cough ; Delayed Diagnosis* ; Diagnosis ; Diagnostic Tests, Routine ; Dyspnea ; Hospitalization ; Humans ; Influenza, Human* ; Intensive Care Units ; Neuraminidase ; Pneumonia ; Polymerase Chain Reaction ; Seasons* ; Sputum ; Tertiary Care Centers

Temporomandibular joint (TMJ) pain is characterized by persistent jaw pain associated with dysfunction and tenderness of the temporomandibular muscles and joints. The aim of this study was to investigate whether treatment with red or black ginseng extract helps in the modulation of inflammatory TMJ pain. Male Sprague-Dawley rats weighing 220~260 g were used. The experimental group was subdivided into 4 groups based on the treatment method (n=6, each group): formalin (5%, 30 µl), formalin after distilled water (vehicle), formalin after red or black ginseng extract (per oral, single or repeated, respectively). To induce TMJ pain, 30 µl of formalin was injected into the articular cavity under ether inhalation anesthesia. The number of noxious behavioral responses of scratching the facial region proximal to the injection site was recorded for 9 successive 5-min intervals following formalin injection. Repeated treatment with red or black ginseng extract reduced the nociceptive responses in the second phase (11~45 min). Nuclear factor erythroid 2-related factor 2 (Nrf2) is an oxidative stress-mediated transcription factor. Both ginsengs significantly down-regulated the increased Nrf2 level compared to the vehicle group. In the test for liver and kidney functions, repeated treatment with red or black ginseng was not different compared to the vehicle group. These results indicate that red and black ginseng extract might be promising analgesic agents in the treatment of inflammatory TMJ pain.
Analgesics ; Anesthesia, Inhalation ; Animals ; Ether ; Formaldehyde ; Humans ; Jaw ; Joints ; Kidney ; Liver ; Male ; Methods ; Models, Animal* ; Muscles ; Panax* ; Rats* ; Rats, Sprague-Dawley ; Temporomandibular Joint* ; Transcription Factors ; Water

OBJECTIVES: The purpose of this study was to suggest factors related with the job satisfaction of interviewers who participated in Community Health Survey (CHS) in Jeonbuk province. METHODS: An interview survey was carried out, targeting all 70 interviewers who were working at Jeonbuk CHS from Oct. 20 to Oct. 31. 2011. RESULTS: As a result of carrying out a univariate analysis of job satisfaction factors by general characteristics, this study found out that interviewers at the age below 40 showed a higher emotional factor-related score than interviewers at the age over 40, and interviewers having participated a statistic survey more than 6 times showed a higher emotional factor-related score than interviewers having participated a statistic survey less than 5 times. As a result of carrying out a multiple regression analysis of factors by general characteristics, this study found out that as interviewers were older, they showed a lower emotional factor-related satisfaction score and job performance factor-related satisfaction score, and their job satisfaction score was higher when a single interviewer conducts a survey than when more than 2 interviewers conduct a survey. CONCLUSIONS: The interviewer's job satisfaction score was relatively low. This results strongly suggest that it is necessary to understand their job performance environment and work environment most of all. It is expected that the results of this study will be used as basic data needed to increase the job satisfaction of interviewers from CHS and improve the quality of survey data.
Health Surveys* ; Interviews as Topic ; Jeollabuk-do ; Job Satisfaction*

This study attempted to calculate and investigate the incidence of hospitalized acute myocardial infarction (AMI) and stroke in Korea. Using the National Health Insurance claim data, we investigated patients whose main diagnostic codes included AMI or stroke during 2006 to 2010. As a result, we found out that the number of AMI hospitalized patients had decreased since 2006 and amounted to 15,893 in 2010; and that the number of those with stroke had decreased since 2006 and amounted to 73,501 in 2010. The age-standardized incidence rate of hospitalized AMI, after adjustment for readmission, was 41.6 cases per 100,000-population in 2006, and had decreased to 29.4 cases in 2010 (for trend P < 0.001). In the case of stroke was estimated at 172.8 cases per 100,000-population in 2006, and had decreased to 135.1 cases in 2010 (for trend P < 0.001). In conclusion, the age-standardized incidence rates of both hospitalized AMI and stroke in Korea had decreased continuously during 2006 to 2010. We consider this decreasing trend due to the active use of pharmaceuticals, early vascular intervention, and the national cardio-cerebrovascular disease care project as the primary and secondary prevention efforts.
Acute Disease ; Adolescent ; Adult ; Age Factors ; Aged ; Aged, 80 and over ; Child ; Child, Preschool ; Female ; Hospitalization/*trends ; Humans ; Incidence ; Infant ; Infant, Newborn ; Male ; Middle Aged ; Myocardial Infarction/*epidemiology ; Patient Readmission ; Republic of Korea/epidemiology ; Sex Factors ; Stroke/*epidemiology ; Young Adult