• Journal of Environmental Health Sciences
• /
• v.50 no.1
• /
• pp.66-72
• /
• 2024

Background: Vibrio vulnificus is a serious opportunistic human pathogen that has a worldwide distribution in a variety of marine and estuarine environments. Objectives: For this reason, we investigated the distribution of Vibrio vulnificus in coastal areas of Gyeonggido Province from 2018 to 2022. Also, we analyzed the correlation between V. vulnificus leading to infection and two marine environmental factors (water temperature and salinity). Methods: We collected a total of 266 samples from six coastal area points (i.e., seawater, mudflats). Specimens were isolated using selective plating media and isolated strains were identified by a VITEK 2 system. To find the relevance of the isolation rates of V. vulnificus and number of cases of V. vulnificus infection, we summarized the data on 48 cases of V. vulnificus infection from the open data of the Korea Disease Control and Prevention Agency. Results: Among the 266 samples taken during the investigation period, 47 strains were isolated, and the separation rates of V. vulnificus were 17.7%. The monthly isolation rates of V. vulnificus were ranked in the order of August (53.8%), September (33.3%), June (28.6%), and July (21.1%). There was a positive correlation with the temperature of seawater, but salinity was not significant. The number of cases of V. vulnificus infection reported in Gyeonggi-do Province were 18 (37.5%) in September, 14 (29.2%) in August, and eight (16.7%) in October. The proportion was 83.3%. It was relevant to the isolation rates of V. vulnificus in the marine environmental sources. Conclusions: Our data showed that the number of V. vulnificus infection cases could be affected by changes in the distribution of V. vulnificus due to rise the temperature of seawater in the marine environment.

• Health Policy and Management
• /
• v.34 no.1
• /
• pp.17-25
• /
• 2024

Background: This study aimed to assess the appropriate allocation of emergency medical beds across 17 provinces and presume the economic benefits associated with such allocation. Methods: To estimate the optimal allocation of emergency medical beds by province, data from the Statistics Korea's "cause of death statistics (2014-2021)," regional statistics on "area, population, gender, age," and "population projections" were utilized. The "number of emergency beds by city and district" provided by the Health Insurance Review and Assessment Service was also used. In estimating the economic benefits of preventing avoidable emergency deaths due to the expansion of emergency medical facilities, guidelines from the Korea Development Institute and the Korea Transport Institute were referenced to calculate the wage loss costs associated with emergency deaths and estimate the economic benefits. Results: The optimal ratio of emergency medical beds allocation by region was highest in Gyeonggi, Seoul, Gyeongnam, Gyeongbuk, and Busan, while Daejeon, Jeju, and Sejong showed lower ratios. Additionally, the prevention of avoidable deaths and economic benefits resulting from the increase in emergency medical facilities were highest in Gyeonggi, Seoul, Gyeongbuk, Gyeongnam, and Busan. However, when standardized by population, the prevention of avoidable deaths and economic benefits were analyzed to be highest in Gyeongbuk, Chungnam, Jeonnam, Gyeongnam, and Busan. Conclusion: The results of this study can serve as foundational data for future policy measures aimed at addressing the imbalance in the supply of emergency medical facilities across regions. Considering regional characteristics in the distribution of emergency medical facilities is expected to ultimately increase the efficiency of national finances and yield economic benefits.

• Journal of Environmental Health Sciences
• /
• v.50 no.1
• /
• pp.6-15
• /
• 2024

Background: People's activities have been restricted due to the COVID-19 pandemic. These changes in activity patterns may lead to a decrease in fine particulate matter (PM_2.5) concentrations. Additionally, the level of population exposure to PM_2.5 may be changed. Objectives: This study aimed to analyze the impact of population movement and meteorological factors on the distribution of PM_2.5 concentrations before and after the outbreak of COVID-19. Methods: The study area was Guro-gu in Seoul. The research period was selected as January to March 2020, a period of significant population movement changes caused by COVID-19. The evaluation of the dynamic population was conducted by calculating the absolute difference in population numbers between consecutive hours and comparing them to determine the daily average. Ambient PM_2.5 concentrations were estimated for each grid using ordinary kriging in Python. For the population exposure assessment, the population-weighted average concentration was calculated by determining the indoor to outdoor population for each grid and applying the indoor to outdoor ratio to the ambient PM_2.5 concentration. To assess the factors influencing changes in the ambient PM_2.5 concentration, a statistical analysis was conducted, incorporating population mobility and meteorological factors. Results: Through statistical analysis, the correlation between ambient PM_2.5 concentration and population movement was positive on both weekends and weekdays (r=0.71, r=0.266). The results confirmed that most of the relationships were positive, suggesting that a decrease in human activity can lead to a decrease in PM_2.5 concentrations. In addition, when population-weighted concentration averages were calculated and the exposure level of the population group was compared before and after the COVID-19 outbreak, the proportion of people exceeding the air quality standard decreased by approximately 15.5%. Conclusions: Human activities can impact ambient concentrations of PM_2.5, potentially altering the levels of PM_2.5 exposure in the population.

• Journal of Chest Surgery
• /
• v.57 no.1
• /
• pp.44-52
• /
• 2024

Background: Visceral pleural invasion (VPI) is a poor prognostic factor that contributes to the upstaging of early lung cancers. However, the preoperative assessment of VPI presents challenges. This study was conducted to examine intraoperative pleural carcinoembryonic antigen (pCEA) level and maximum standardized uptake value (SUVmax) as predictive markers of VPI in patients with clinical T1N0M0 lung adenocarcinoma. Methods: A retrospective review was conducted of the medical records of 613 patients who underwent intraoperative pCEA sampling and lung resection for non-small cell lung cancer. Of these, 390 individuals with clinical stage I adenocarcinoma and tumors ≤30 mm were included. Based on computed tomography findings, these patients were divided into pleural contact (n=186) and non-pleural contact (n=204) groups. A receiver operating characteristic (ROC) curve was constructed to analyze the association between pCEA and SUVmax in relation to VPI. Additionally, logistic regression analysis was performed to evaluate risk factors for VPI in each group. Results: ROC curve analysis revealed that pCEA level greater than 2.565 ng/mL (area under the curve [AUC]=0.751) and SUVmax above 4.25 (AUC=0.801) were highly predictive of VPI in patients exhibiting pleural contact. Based on multivariable analysis, pCEA (odds ratio [OR], 3.00; 95% confidence interval [CI], 1.14-7.87; p=0.026) and SUVmax (OR, 5.25; 95% CI, 1.90-14.50; p=0.001) were significant risk factors for VPI in the pleural contact group. Conclusion: In patients with clinical stage I lung adenocarcinoma exhibiting pleural contact, pCEA and SUVmax are potential predictive indicators of VPI. These markers may be helpful in planning for lung cancer surgery.

• Journal of Yeungnam Medical Science
• /
• v.40 no.4
• /
• pp.388-393
• /
• 2023

Background: Differentiating between bacterial and nonbacterial colitis remains a challenge. We aimed to evaluate the value of serum procalcitonin (PCT) and C-reactive protein (CRP) in differentiating between bacterial and nonbacterial colitis. Methods: Adult patients with three or more episodes of watery diarrhea and colitis symptoms within 14 days of a hospital visit were eligible for this study. The patients' stool pathogen polymerase chain reaction (PCR) testing results, serum PCT levels, and serum CRP levels were analyzed retrospectively. Patients were divided into bacterial and nonbacterial colitis groups according to their PCR. The laboratory data were compared between the two groups. The area under the receiver operating characteristic curve (AUC) was used to evaluate diagnostic accuracy. Results: In total, 636 patients were included; 186 in the bacterial colitis group and 450 in the nonbacterial colitis group. In the bacterial colitis group, Clostridium perfringens was the commonest pathogen (n=70), followed by Clostridium difficile toxin B (n=60). The AUC for PCT and CRP was 0.557 and 0.567, respectively, indicating poor discrimination. The sensitivity and specificity for diagnosing bacterial colitis were 54.8% and 52.6% for PCT, and 52.2% and 54.2% for CRP, respectively. Combining PCT and CRP measurements did not increase the discrimination performance (AUC, 0.522; 95% confidence interval, 0.474-0.571). Conclusion: Neither PCT nor CRP helped discriminate bacterial colitis from nonbacterial colitis.

• Korean Journal of Radiology
• /
• v.24 no.11
• /
• pp.1142-1150
• /
• 2023

Objective: To evaluate ^99mtechnetium-three polyethylene glycol spacers-arginine-glycine-aspartic acid (^99mTc-3PRGD₂) single-photon emission computed tomography (SPECT)/computed tomography (CT) imaging for diagnosing lymph node metastasis of primary malignant lung neoplasms. Materials and Methods: We prospectively enrolled 26 patients with primary malignant lung tumors who underwent ^99mTc-3PRGD₂ SPECT/CT and ¹⁸F-fluorodeoxyglucose (¹⁸F-FDG) positron emission tomography (PET)/CT imaging. Both imaging methods were analyzed in qualitative (visual dichotomous and 5-point grades for lymph nodes and lung tumors, respectively) and semiquantitative (maximum tissue-to-background radioactive count) manners for the lymph nodes and lung tumors. The performance of the differentiation of lymph nodes with and without metastasis was determined at the per-lymph node station and per-patient levels using histopathological results as the reference standard. Results: Total 42 stations had metastatic lymph nodes and 136 stations had benign lymph nodes. The differences between metastatic and benign lymph nodes in the visual qualitative and semiquantitative analyses of ^99mTc-3PRGD₂ SPECT/CT and ¹⁸F-FDG PET/CT were statistically significant (all P < 0.001). The area under the receiver operating characteristic curve (AUC) in the semi-quantitative analysis of ^99mTc-3PRGD₂ SPECT/CT was 0.908 (95% confidence interval [CI], 0.851-0.966), and the sensitivity, specificity, positive predictive value, and negative predictive value were 0.86 (36/42), 0.88 (120/136), 0.69 (36/52), and 0.95 (120/126), respectively. Among the 26 patients (including two patients each with two lung tumors), 15 had pathologically confirmed lymph node metastasis. The difference between primary lung lesions in patients with and without lymph node metastasis was statistically significant only in the semi-quantitative analysis of ^99mTc-3PRGD₂ SPECT/CT (P = 0.007), with an AUC of 0.807 (95% CI, 0.641-0.974). Conclusion: ^99mTc-3PRGD₂ SPECT/CT imaging may notably perform in the direct diagnosis of lymph node metastasis of primary malignant lung tumors and indirectly predict the presence of lymph node metastasis through uptake in the primary lesions.

• Archives of Plastic Surgery
• /
• v.51 no.2
• /
• pp.251-257
• /
• 2024

Background Plastic surgery has developed to benefit in a variety of challenging areas formerly handled by other disciplines. Medical students do not have a clear picture of plastic surgery as a career due to lacking scope, clinical practice, and understanding of plastic surgery as a clinical area of expertise, including general practitioners, nursing staff, medical trainees, and the general public, and misconceptions about the extent of reconstructive and plastic surgery. Methods A cross-sectional observational study was conducted on Kuwait University Medical students (2nd-7th Years) over a period of 1 month. A questionnaire and a consent form were provided to eligible students. The inclusion criteria were Kuwait University Medical students from 2nd to 7th Years with signed consent form. The response was collected via email sent in coordination with the Vice Dean of Student Affairs in the Faculty of Medicine. Using statistical package for the social sciences, responses were statistically analyzed. Pearson's chi-square test was used to calculate p-values, where p < 0.05 was considered statistically significant. Results A total of 244 eligible medical students, 121 males and 123 females, were included in the study, with a mean age of 21 (±2) years. Similarly, 126 (51.6%) were preclinical students (2nd-4th-year students), while 118 (48.4%) were clinical students (5th-7th-year students). About 79.8% of medical students believed that plastic surgery plays an essential role in trauma management, whereas 9.2% did not consider plastic surgery significant for trauma management. This study found that only 15.5% of medical students were interested in enrolling in plastic surgery residency after graduation, while 47.1% of students did not consider plastic surgery residency after graduation. However, 37.4% were uncertain. The two most driving factors in deciding on plastic surgery residency were expected income (61.8%) and lifestyle (14.3%). Conclusion Improving medical students' education quality can enhance their perception and awareness of plastic surgery. Students should be taught the broader scope of plastic surgery. The inclusion of formal training during undergraduation is the essence of time and should be added to or improved during plastic surgery rotations with more emphasis on reconstructive and hand/peripheral nerve surgery. Student-led interest groups can be a useful tool for educating students about their specialty.

• Annals of Occupational and Environmental Medicine
• /
• v.35
• /
• pp.24.1-24.15
• /
• 2023

Background: The construction workers are vulnerable to fatigue due to high physical workload. This study aimed to investigate the relationship between overwork and heart rate in construction workers and propose a scheme to prevent overwork in advance. Methods: We measured the heart rates of construction workers at a construction site of a residential and commercial complex in Seoul from August to October 2021 and develop an index that monitors overwork in real-time. A total of 66 Korean workers participated in the study, wearing real-time heart rate monitoring equipment. The relative heart rate (RHR) was calculated using the minimum and maximum heart rates, and the maximum acceptable working time (MAWT) was estimated using RHR to calculate the workload. The overwork index (OI) was defined as the cumulative workload evaluated with the MAWT. An appropriate scenario line (PSL) was set as an index that can be compared to the OI to evaluate the degree of overwork in real-time. The excess overwork index (EOI) was evaluated in real-time during work performance using the difference between the OI and the PSL. The EOI value was used to perform receiver operating characteristic (ROC) curve analysis to find the optimal cut-off value for classification of overwork state. Results: Of the 60 participants analyzed, 28 (46.7%) were classified as the overwork group based on their RHR. ROC curve analysis showed that the EOI was a good predictor of overwork, with an area under the curve of 0.824. The optimal cut-off values ranged from 21.8% to 24.0% depending on the method used to determine the cut-off point. Conclusion: The EOI showed promising results as a predictive tool to assess overwork in real-time using heart rate monitoring and calculation through MAWT. Further research is needed to assess physical workload accurately and determine cut-off values across industries.

• Journal of Cardiovascular Imaging
• /
• v.31 no.1
• /
• pp.18-23
• /
• 2023

BACKGROUND: Three-dimensional (3D) transesophageal echocardiogram (TEE) is the gold standard for the diagnosis of degenerative mitral regurgitation (dMR) and preoperative planning for transcatheter mitral valve repair (TMVr). TEE is an invasive modality requiring anesthesia and esophageal intubation. The severe acute respiratory syndrome coronavirus 2 pandemic has limited the number of elective invasive procedures. Multi-detector computed tomographic angiography (MDCT) provides high-resolution images and 3D reconstructions to assess complex mitral anatomy. We hypothesized that MDCT would reveal similar information to TEE relevant to TMVr, thus deferring the need for a preoperative TEE in certain situations like during a pandemic. METHODS: We retrospectively analyzed data on patients who underwent or were evaluated for TMVr for dMR with preoperative MDCT and TEE between 2017 and 2019. Two TEE and 2 MDCT readers, blinded to patient outcome, analyzed: leaflet pathology (flail, degenerative, mixed), leaflet location, mitral valve area (MVA), flail width/gap, anterior-posterior (AP) and commissural diameters, posterior leaflet length, leaflet thickness, presence of mitral valve cleft and degree of mitral annular calcification (MAC). RESULTS: A total of 22 (out of 87) patients had preoperative MDCT. MDCT correctly identified the leaflet pathology in 77% (17/22), flail leaflet in 91% (10/11), MAC degree in 91% (10/11) and the dysfunctional leaflet location in 95% (21/22) of patients. There were no differences in the measurements for MVA, flail width, commissural or AP diameter, posterior leaflet length, and leaflet thickness. MDCT overestimated the measurements of flail gap. CONCLUSIONS: For preoperative TMVr planning, MDCT provided similar measurements to TEE in our study.

• The Journal of the Convergence on Culture Technology
• /
• v.10 no.1
• /
• pp.281-287
• /
• 2024

In general, design education related to transportation has been recognized as a department specialized in transportation design or as an area of detailed transportation majors within industrial design majors. However, as technological, social, and environmental factors change, the concept of mobility and the ecosystem related to the mobility industry are diversifying, and accordingly, the category of mobility-related design is expanding further. Based on this background, this study is not a mobility design major, but it aims to find implications by analyzing the trend and type of topic selection related to the mobility ecosystem among the last five years of graduation design topics conducted in the design engineering major. As a result of the study, of a total of 131 graduation design works conducted over the past five years, about 30 works were highly related to mobility, and their types were very diverse. In conclusion, it was confirmed that the change and expansion of the mobility ecosystem expanding from products to services and systems were also reflected in the selection of graduation works in that various topics approached from user-centered and user experience were proposed and made into works.