• Journal of Environmental Science International
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• v.22 no.2
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• pp.151-161
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• 2013

The assessment of personal exposure is a critical component in population-based epidemiologic studies of air pollution. This study was conducted to apply and compare the four exposure estimation methods of individual-level to air pollution concentration in a cohort including 2,283 subjects in Gwangyang, Korea. Individual-level exposure of air pollution were estimated using multiple approaches, including average across all monitors, nearest monitor, and spatial interpolation by inverse distance weighting and kriging. The mean concentrations of $PM_{10}$, $NO_2$, $SO_2$, CO, $O_3$ by four exposure estimation methods were slightly different but not significantly different from each other. Cross-validation showed that kriging was more accurate than other exposure estimation methods because kriging has probably predicted individual exposure levels equivalent to residential locations after estimating the parameters of a model according to the spatial surface of air pollution concentration. These data support that spatial interpolation methods may provide better estimates than selecting the value from the nearest monitor and averaging across values from all monitors by reflecting spatial attributes of air pollution on personal level.

• Korea journal of population studies
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• v.29 no.2
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• pp.27-51
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• 2006

In this paper, I have tested various kinds of methods for mortality projection and chose Lee-Carter method for projection of Korean mortality by age and sex. I reviewed the trends of life tables and life expectancies by age and sex from 2005 to 2050 projected by Lee-Carter method and found that the method was very applicable for Korean mortality projection. The differences between reported and estimated data for the period of 1971-2003 were small enough for both sexes and for all of the age groups. The projected life expectancies in 2051 were 82.73 years for males and 89.41 for females, and the differences decreased from 7.06 years in 2005 to 6.68 years. Because of the limitation of Korean infant mortality rate, I adopted the Japanese estimated IMR in 2050 as Korean object level in 2051. When the time series of IMR become long enough, we can use Korean IMR directly for the mortality projection. In addition, if we can estimate the changes of the main cause of death correctly in future, the mortality projection will be more correct and reliable. This will be available when we can produce a long series of life tables by cause of deaths.

• Journal of Oral Medicine and Pain
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• v.45 no.3
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• pp.56-64
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• 2020

Purpose: Temporomandibular disorders (TMD) is a mosaic of clinical signs and symptoms that can be regarded as a set of phenotypes that are affected by various factors including pain sensitivity, pain disability, sleep and psychological functioning. The aims of this study were to evaluate association of pain experience, sleep quality and psychological distress with different phenotypes of TMD patients. Methods: This retrospective study included a cohort (n=1,858; 63.8% for female, mean age=34.9±15.9 years) of patients with TMD. A set of self-administered questionnaires concerning pain interference (Brief Pain Inventory), pain disability (Graded Chronic Pain Scale), sleep quality (Pittsburg Sleep Questionnaire Index), psychological distress (Symptom Checklist-90 revised), and pain catastrophizing (Pain Catastrophizing Scale) were administered to all participants at the first consultation. All TMD patients were classified into four groups including TMD with internal derangement without pain (TMD_ID, n=370), TMD with joint pain (TMD_J, n=571), TMD with muscle pain (TMD_M, n=541) and TMD with muscle-joint combined pain (TMD_MJ, n=376). Results: The female ratio was particularly high in the group with TMD_MJ (p=0.001). The patients with muscle pain and both muscle and joint pain had longer symptom duration (p=0.004) and presented significantly higher scores in pain experience (p<0.001), subjective sleep quality (p<0.001), pain catastrophizing (p<0.001) and psychological distress (p<0.05) except for paranoid-ideation than the groups with only joint problems. Conclusions: The results of this study highlight the importance of multi-dimensional approach that consider pain disability, sleep quality, and psychological functioning in the management of TMD with muscle component. This study would contribute to a better understanding of interaction between heterogeneous TMD and multiple risk factors in order to build tailored treatment based on different phenotypes.

• Safety and Health at Work
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• v.10 no.4
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• pp.445-451
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• 2019

Objective: The objective of this study was to evaluate the prevalence and incidence of accidents with biological material, the level of knowledge, and compliance to standard precautions (SPs) among dentists, physicians, nurses, and dental and medical students. Methods: A closed cohort study with a prospective and retrospective component was conducted between August 2014 and September 2015. The participants were contacted in two moments during the follow-up period, during which a structured questionnaire divided into six sections was used; the interviews were conducted during the follow-up period (Month 6) and at the end of the observation period (Month 12). Results: The global prevalence of accidents in the previous 12 months was 10.2%, with a difference between professionals and students (13.0% vs. 5.1%, respectively; p < 0.003). The incidence rate was 6.49 per 100 person/year, with difference between the groups (6.09 per 100 person/year in professionals and 7.26 per 100 person/year in students), type of specialization (hazard ratio, 3.27), and hours worked per week (hazard ratio, 2.27). The mean of compliance to SP was 31.99 (±3.85) points, with a median of 33 (30, 35) points against the expected 27.75 points. Adherence to SP was associated with the accident report (p < 0.020). Conclusion: We conclude that the proportion/incidence rate of accidents with biological material was high in relation to that in the literature, being higher in professionals and especially among physicians. The levels of knowledge and adherence to SP were good, with the best found in dentists and dental students.

• Archives of Plastic Surgery
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• v.45 no.1
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• pp.58-61
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• 2018

Background Venous anastomosis is an important component of digital replantation, but is not always feasible, as some cases require external bleeding to treat venous congestion in the replanted tissue. In the present study, we evaluated the relationship between the number of vein anastomoses and the survival rate of Tamai zone I replantations. Methods A retrospective review was performed of all patients who underwent replantation of a fingertip amputation between 2014 and 2016. Patient charts were reviewed for demographic information, the mechanism of injury, the number of venous anastomoses, and the use of anticoagulation, external bleeding, and/or leeches. The cohort was divided into 3 groups depending on the number of venous anastomoses: no veins (group 1), a single vein (group 2), and 2 or more veins (group 3). Survival rates and external bleeding rates were analyzed across the groups. Results The review identified 143 fingertip replantations among 134 patients. The overall survival rate was 94% (135 of 143). Failures were due equally to venous complications (n=4, 50%) and to arterial complications (n=4, 50%). Our analysis did not identify any correlation between the number of veins anastomosed and the replant survival rate (P=0.689). However, a greater number of anastomoses was associated with a significantly lower frequency of external bleeding (P=0.017). Conclusions The number of venous anastomoses was not correlated with the survival rate. However, a greater number of venous anastomoses was associated with a decreased need for external bleeding, corresponding to a significant decrease in the need for postoperative monitoring and leech therapy.

• Journal of Periodontal and Implant Science
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• v.52 no.4
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• pp.298-311
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• 2022

Purpose: The aim of this study was to evaluate the clinical outcomes of periodontal granulation tissue preservation (PGTP) in access flap periodontal surgery. Methods: Twenty patients (stage III-IV periodontitis) with 42 deep periodontal pockets that did not resolve after non-surgical treatment were consecutively recruited. Access flap periodontal surgery was modified using PGTP. The clinical periodontal parameters were evaluated at 9 months. The differences in the amount of granulation tissue width (GTw) preserved were evaluated and the influence of smoking was analyzed. Results: GTw >1 mm was observed in 97.6% of interproximal defects, and the granulation tissue extended above the bone peak in 71.4% of defects. At 9 months, probing pocket depth reduction (4.33±1.43 mm) and clinical attachment gain (CAG; 4.10±1.75 mm) were statistically significant (P<0.001). The residual probing depth was 3.2±0.89 mm. When GTw extended above the interproximal bone peak (i.e., the interproximal supra-alveolar granulation tissue thickness [iSUPRA-GT] was greater than 0 mm), a significant CAG was recorded in the supra-alveolar component (1.67±1.32 mm, P<0.001). Interproximal gingival recession (iGR) was significant (P<0.05) only in smokers, with a reduction in the interdental papillary tissue height of 0.93±0.76 mm. In non-smokers, there was no increase in the iGR when the iSUPRA-GT was >0 mm. The clinical results in smokers were significantly worse. Conclusions: PGTP was used to modify access flap periodontal surgery by preserving affected tissues with the potential for recovery. The results show that preserving periodontal granulation tissue is an effective and conservative procedure in the surgical treatment of periodontal disease.

• Clinics in Shoulder and Elbow
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• v.26 no.4
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• pp.380-389
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• 2023

Background: Total shoulder arthroplasty (TSA) with a nonspherical humeral head component and inlay glenoid is a successful bone-preserving treatment for glenohumeral arthritis. This study aimed to describe the 90-day complication profile of TSA with this prosthesis and compare major and minor complication and readmission rates between inpatient- and outpatient-procedure patients. Methods: A retrospective review was performed of a consecutive cohort of patients undergoing TSA with a nonspherical humeral head and inlay glenoid in the inpatient and outpatient settings by a single surgeon between 2017 and 2022. Age, sex, body mass index, American Society of Anesthesiologists (ASA) score, Charlson Comorbidity Index (CCI), and 90-day complication and readmission rates were compared between inpatient and outpatient groups. Results: One hundred eighteen TSAs in 111 patients were identified. Mean age was 64.9 years (range, 39-90) and 65% of patients were male. Ninety-four (80%) and 24 (20%) patients underwent outpatient and inpatient procedures, respectively. Four complications (3.4%) were recorded: axillary nerve stretch injury, isolated ipsilateral arm deep venous thrombosis (DVT), ipsilateral arm DVT with pulmonary embolism requiring readmission, and gastrointestinal bleed requiring readmission. There were no reoperations or other complications. Outpatients were younger with lower ASA and CCI scores than inpatients; however, there was no difference in complications (1/24 vs. 3/94, P=1.00) or readmissions (1/24 vs. 1/94, P=0.37) between these two groups. Conclusions: TSA with a nonspherical humeral head and inlay glenoid can be performed safely in both inpatient and outpatient settings. Rates of early complications and readmissions were low with no difference according to surgical setting. Level of evidence: IV.

• The Journal of Internal Korean Medicine
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• v.45 no.3
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• pp.342-357
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• 2024

Background: Cold hypersensitivity (CH) and sleep disorders are not limited to patients with specific diseases, as they are also commonly observed in the general population. The objective of this study was to investigate the relationship between CH and sleep quality. Methods: This cross-sectional study analyzed data from a cohort of 5,052 individuals living in South Korea. Based on the results of a questionnaire on CH, the participants were classified into four groups: non-CH, CH in the hands (CHH), CH in the feet (CHF), and CH in the hands and feet (CHHF). Sleep quality was evaluated using the Pittsburgh Sleep Quality Index (PSQI). Multiple regression was used for groupwise comparisons of total PSQI scores and the scores for each component, and logistic regression was used to find the odds ratios of being a "poor sleeper" (PSQI≥8.5). Results: The CHF and CHHF groups showed significantly higher scores than the non-CH group on the overall PSQI as well as on the following sleep components: subjective sleep quality, sleep latency, habitual sleep efficiency, sleep disturbance, and sleep medication use. The odds ratios for being a "poor sleeper" were significant in the CHF (1.84; CI=1.38-2.43) and CHHF groups (1.54; CI=1.25-1.89), but the CHH group did not show any difference from the non-CH group. We identified a correlation between CH in the feet and poor sleep quality. Conclusions: These findings help to elucidate the relationship between sleep and CH and highlight the need to clarify the underlying mechanism.

• Asian Spine Journal
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• v.12 no.6
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• pp.1010-1016
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• 2018

Study Design: Retrospective cohort study. Purpose: To report on spinal fusion assessment using computed tomography (CT) after adult spinal deformity (ASD) surgery using ultra-low dose recombinant human bone morphogenetic protein 2 (RhBMP-2). Overview of Literature: The reported dose of RhBMP-2 needed for successful spinal posterolateral fusion in ASD ranges from 10 to 20 mg per spinal level. This study reports the use of ultra-low dose of RhBMP-2 (0.07 mg per facet) to achieve spinal fusion in multilevel ASD surgery. Methods: Consecutive patients who underwent ASD surgery using ultra-low dose RhBMP-2 were recruited. Routine postoperative CT analysis for spinal fusion was performed by two spine surgeons. Inter-observer agreement was calculated for facet fusion (FF) and interbody fusion (IBF) at 6 and 12 months after the procedure. Results: Six consecutive ASD patients with a mean age of 62 years (28-72 years) were examined. Each patient received a total dose of 12 mg with an average dose of $0.69{\pm}0.2mg$ (0.42-1 mg) per single FF and $1.38{\pm}0.44mg$ (0.85-2 mg) for IBF. Total 131 FF and 15 IBF were examined in the study, with 88 FFs and nine IBFs being analyzed specifically at 6 months after the surgery. FF and IBF reported by surgeons A and B at 6 months were 97.7% vs. 91.9% FF, respectively (${\kappa}=0.95$) and 100% vs. 100% IBF, respectively (${\kappa}=1$). Two patients underwent longitudinal follow-up CT at 12 months, and the FF rates reported by surgeons A and B were 100% vs. 95.8%, respectively (${\kappa}=0.96$). Five out of nine facet (56%) non-unions were identified at the cross-links. The remaining four facet pseudarthrosis were noted at 1-2 spinal levels caudal to the cross-links. At the final clinical follow-up, there was no rod breakage, deformity progression, neurological deficit, or symptom recurrence. The Oswestry Disability Index improved by an average of $32.8{\pm}6.3$, while the mental component summary of the 36-item Short-Form Health Survey improved by an average of $4.7{\pm}2.1$, and physical component summary improved by an average of $10.5{\pm}2.1$. Conclusions: To our knowledge, this is the first study to report a CT that defined 92%-98% FF and 100% IBF using the lowest reported dose of RhBMP-2 in multilevel ASD surgery. The use of ultra-low dose RhBMP-2 reduces the RhBMP-2 related complications and healthcare costs.

• Tuberculosis and Respiratory Diseases
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• v.60 no.2
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• pp.205-214
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• 2006

Background : Acute exacerbations form a major component of the socioeconomic burden of COPD. As yet, little information is available about the long-term outcome of patients who have been hospitalized with acute exacerbations, although high mortality rates have been reported. The aim of this study was to determine predictors of long-term mortality after hospitalization for acute exacerbation of COPD. Methods : We performed a retrospective cohort study of consecutive patients admitted to the hospital for COPD exacerbation between 2000 through 2004. Patients who had died in hospital or within 6-months after discharge, had tuberculosis scar, pleural thickening or bronchiectasis by chest radiography or had been diagnosed with malignancy during follow-up periods were excluded. Results : Mean age of patients was 69.5 years, mean follow-up duration was 49 months, and mean $FEV_1$ was 1.00L (46% of predicted). Mortality was 35% (17/48). In the multivariate Cox regression analysis, heart rate of 100/min or more (p=0.003; relative risk [RR], 11.99; 95% confidence interval [CI], 2.34-61.44) and right ventricular systolic pressure (RVSP) of 35mmHg or more (p=0.019; RR, 6.85; 95% CI, 1.38-34.02) were independent predictors of mortality. Conclusion : Heart rate and RVSP in stable state may be useful in predicting long-term mortality for COPD patients admitted to hospital with acute exacerbation.