• Title/Summary/Keyword: Hazard Factor

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Association Between Atrial Fibrillation and the Risk of Dementia in the Korean Elderly: A 10-Year Nationwide Cohort Study

  • Nah, Min-Ah;Lee, Kyeong Soo;Hwang, Tae-Yoon
    • Journal of Preventive Medicine and Public Health
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    • v.53 no.1
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    • pp.56-63
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    • 2020
  • Objectives: The objective of this study was to determine the effect of atrial fibrillation (AF) on the risk of dementia in the Korean elderly. Methods: A 10-year retrospective cohort study was conducted using the National Health Insurance Service-Senior Cohort database. We excluded those who were under 65 years of age as of January 2006 (n=46 113), those who were diagnosed with dementia between 2002 and 2005 (n=9086), and those with a history of stroke prior to AF diagnosis (n=8392). We used a Cox proportional hazards model with a time-varying covariate to determine whether AF is associated with the risk of dementia after adjusting for potential confounders. Results: In univariable Cox regression, the hazard ratio (HR) of dementia according to AF status was 1.28 (95% confidence interval [CI], 1.23 to 1.33). After adjusting for potential confounders, AF was found to increase the risk of dementia (HR, 1.12; 95% CI, 1.07 to 1.17), Alzheimer dementia (HR, 1.12; 95% CI, 1.07 to 1.17), and vascular dementia (HR, 1.10; 95% CI, 1.03 to 1.18). In patients diagnosed with AF, the incidence of dementia was lower (HR, 0.50; 95% CI, 0.47 to 0.52) in patients who were treated with oral anticoagulants. Conclusions: Investigating the potential risk factors of dementia in an aged society is important. We found a slightly higher risk of dementia in those with AF than in those without AF, and we therefore concluded that AF is a potential risk factor for dementia.

Keratinization of Lung Squamous Cell Carcinoma Is Associated with Poor Clinical Outcome

  • Park, Hye Jung;Cha, Yoon-Jin;Kim, Seong Han;Kim, Arum;Kim, Eun Young;Chang, Yoon Soo
    • Tuberculosis and Respiratory Diseases
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    • v.80 no.2
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    • pp.179-186
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    • 2017
  • Background: Although the World Health Organization (WHO) classification of lung squamous cell carcinoma (SCC) was revised in 2015, its clinical implications for lung SCC subsets remain unclear. We investigated whether the morphologic characteristics of lung SCC, including keratinization, were associated with clinical parameters and clinical outcome of patients. Methods: A total of 81 patients who underwent curative surgical resection of diagnosed lung SCC, were enrolled in this study. Attributes such as keratinization, tumor budding, single cell invasion, and nuclear size within the tumor, as well as immunohistochemistry of Bcl-xL and pS6 expressions, were evaluated. Results: The keratinizing and nonkeratinizing subtypes did not differ with respect to age, sex, TNM stage, and morphologic parameters such as nuclear diameter, tumor budding, and single cell invasion at the tumor edge. Most patients with the keratinizing subtype (98.0%) had a history of smoking, whereas the nonkeratinizing group had a relatively higher proportion of never-smokers relative to the keratinizing group (24.0% vs. 2.0%; p=0.008, chi-square test). Expression of pS6 (a surrogate marker of mammalian target of rapamycin complex 1 [mTORC1] signaling that regulates keratinocyte differentiation), and Bcl-xL (a key anti-apoptotic molecule that may inhibit keratinization), did not correlate significantly with the presence of keratinization. Patients with the keratinizing subtype had a significantly shorter overall survival (85.2 months vs. 135.7 months, p=0.010, log-rank test), and a multivariate analysis showed that keratinization was an independent, poor prognostic factor (hazard ratio, 2.389; 95% confidence interval, 1.090-5.233; p=0.030). Conclusion: In lung SCC, keratinization is associated with a poor prognosis, and might be associated with smoking.

Releasing of asbestos fibers from the weathered asbestos cement slate roofing (슬레이트 지붕 노후화에 따른 석면 섬유 방출량)

  • Kim, Hyun-Wook;Park, Gye-Young;Han, Jin-Gu;Han, Young-Sun;Hwang, Bum-Gu;Lee, Jun-Hyuk
    • Journal of Korean Society of Occupational and Environmental Hygiene
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    • v.20 no.2
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    • pp.88-93
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    • 2010
  • To confirm and quantify asbestos fibers released from the asbestos-cement slate roofs due to weathering, three houses, selected based on the year of built - 60's, 70, and 80's, were investigated. All of them were located in the downtown of Seoul. Rain or snow-melt water was collected from the roof in a 3.5 liter plastic bottle. A known amount of collected water was filtered on the 37 mm membrane filter, ashed in a muffle furnace, and subsequently treated with HCl to remove organic material. The treated remaining was refiltered on a 25mm membrane filter for PLM and PCM analyses. The NIOSH 7400 method was utilized for PCM counting. In addition, SEM/EDX was used to confirm the asbestos types. The results of this study showed that chrysotile fibers were confirmed by PLM in all samples analyzed. A significant amount of asbestos fibers were found in the water samples. The ranges of asbestos fibers counted from the samples collected in the 60's, 70's, and 80's were; 10,406.3~55,575.6 f/L, 5,218.8~38,126.2 f/L, and 2,906.3~7,798.6 f/L, respectively. As anticipated, concentrations of asbestos fibers increased with time of installment of the roofing material. We conclude that weathering can be a significant factor on the release of asbestos fibers from the asbestos cement products. Since asbestos fibers released into environment can be a source of significant health hazard, countermeasures, such as replacement, removal, and encapsulation of weathered asbestos slate, should be initiated immediately.

Treatment Outcomes with Selective Coil Embolization for Large or Giant Aneurysms : Prognostic Implications of Incomplete Occlusion

  • Jo, Kyung Il;Yang, Na-Rae;Jeon, Pyoung;Kim, Keon Ha;Hong, Seung-Chyul;Kim, Jong Soo
    • Journal of Korean Neurosurgical Society
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    • v.61 no.1
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    • pp.19-27
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    • 2018
  • Objective : The objectives of this study were to evaluate the immediate and long-term efficacy and safety of coil embolization for large or giant aneurysms. Methods : One hundred and fifty large or giant aneurysm cases treated with endovascular coil embolization between January 2005 and February 2014 at a single institute were included in this study. Medical records and imaging findings were reviewed. Statistical analysis was performed to evaluate prognostic factors associated with major recurrence (major recanalization or rupture) and delayed thromboembolism after selective coil embolization. Results : Procedure-related symptomatic complications occurred in five (3.3%) patients. The mean clinical and radiological follow-up periods were 38 months (range, 2-110) and 26 months (range, 6-108), respectively. During the follow-up period, the estimated recurrence rate was 4.6% per year. Multivariate analysis using Cox regression showed the degree of occlusion to be the only factor associated with recurrence (p=0.008, hazard ratio 3.15, 95% confidence interval 1.34-7.41). The patient's history of rupture in addition to the size and location of the aneurysm were not associated with recurrence in this study. Delayed infarction occurred in eight cases, and all were incompletely occluded. Conclusion : Although immediate postprocedural safety profiles were reasonable, longterm results showed recanalization and thromboembolic events to occur continuously, especially in patients with incomplete occlusion. In addition, incomplete occlusion was associated with delayed thromboembolic complications. Patients with incomplete occlusions should be followed carefully for delayed recurrence or delayed thromboembolic events.

A Study on the Fire Risk of Black Box Wiring in Motor Vehicle (자동차의 블랙박스 와이어링 화재 위험성에 관한 연구)

  • Kang, Sin-Dong;Kim, Ju-Hee;Choi, Jun-Pyo;Kim, Jae-Ho
    • Journal of the Korean Society of Safety
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    • v.32 no.6
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    • pp.22-28
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    • 2017
  • According to the National Fire Data System (NFDS), more than 5,000 vehicle fires have occurred every year for the last 10 years. Vehicle fires are primarily caused by mechanical (breaking system and engine), electrical (wiring and battery), and chemical (oil and fuel gas leakage) problems. The electrical factor has increased with the installation of driver convenience equipment. For example, today, the black box is widely used to provide video data recording of motor vehicle accidents. The black box consists of a front camera, rear camera, and wires. The black box wires are directly connected to the junction box or fuse box from the start battery that operates to provide normal on power supplying for engine stop. It is extremely dangerous when the wires short circuit due to insulation aging, mechanical and electrical stress, etc. In this study, the black box wiring fire risk have been analyzed and investigated when the steady state and abnormal operations, and under the following conditions: wiring arrangements with a high temperature condition, insulation aging, poor contact, and short circuits. The results showed that black box wiring short circuits had a higher fire risk than the other fire hazard elements. To prevent fire hazards caused by black box wiring, the black boxes must be installed by qualified service personnel. Do not modify the wiring, remove the fuse and secure the wiring using cable ties or insulation tape.

The Absence of Atrial Contraction as a Predictor of Permanent Pacemaker Implantation after Maze Procedure with Cryoablation

  • Jeon, Chang-Seok;Shim, Man-shik;Park, Seung-Jung;Jeong, Dong Seop;Park, Kyoung-Min;On, Young Keun;Kim, June Soo;Park, Pyo Won
    • Journal of Chest Surgery
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    • v.50 no.3
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    • pp.163-170
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    • 2017
  • Background: The absence of atrial contraction (AC) after the maze procedure has been reported to cause subsequent annular dilatation and to increase the risk of embolic stroke. We hypothesized that the lack of AC could increase the risk of permanent pacemaker (PPM) implantation in patients undergoing the maze procedure. Methods: In 376 consecutive patients who had undergone a cryo-maze procedure and combined valve operation, recovery of AC was assessed at baseline and at immediate (${\leq}2$ weeks), early (${\leq}1$ year, $4.6{\pm}3.8$ months), and late (>1 year, $3.5{\pm}1.1$ years) postoperative stages. Results: With a median follow-up of 53 months, 10 patients underwent PPM implantation. Seven PPM implants were for sinus node dysfunction (pauses of $9.6{\pm}2.4$ seconds), one was for marked sinus bradycardia, and two were for advanced/complete atrioventricular block. The median (interquartile range) time to PPM implantation was 13.8 (0.5-68.2) months. Our time-varying covariate Cox models showed that the absence of AC was a risk factor for PPM implantation (hazard ratio, 11.92; 95% confidence interval, 2.52 to 56.45; p=0.002). Conclusion: The absence of AC may be associated with a subsequent risk of PPM implantation.

Level of Safety Awareness of Construction Workers (건설현장 작업자의 내면적 안전의식 수준)

  • Lee, Wang Gi;Park, Seong Yong;Son, Ki Sang
    • Journal of the Korean Society of Safety
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    • v.32 no.3
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    • pp.48-53
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    • 2017
  • Many construction accidents can be lead to a death occurring at construction sites. These are considerably due to potentially-hazardous equipment and machine or unexpected collapsion at earth work due to land slide and so on. Almost 50% of the total death and injury, occurred in construction sites in 2015. 66% of those serious accidents are due to falling occurring from construction sites when they work. Therefore, causes and recommendations of each accident should be deeply thought and analysed The indirect causes are directly related to safe consciousness of the construction workers. Actually, their safety consciousness are not high, even very low, it is thought. Questionnaire survey sheets have been distributed to Seoul, Incheon, and Gyunggi-Do area, first. And then, the authors have collected those directly at sites, in order to increase collection rate of the sheets. The totally, collected sheets are 295 sheets. And, they are analysed using SPSS version 19 package program. Workers internal consciousness has been investigated and reviewed and analysed by statistical method such as frequency rate, crossed, and correlated analysis. And finally the conclusions for the above analyses are as follows; Heavy weight worth a crew of more than two workers should be necessarily considered for the advanced safety plan and needed for making a highly potential hazard group at construction sites. Safety consciousness, earing p.p.e, workman ship should be mainly considered for investing safety costs with an aspect of human factor.

The Technique of Landslide Hazard Prediction Using Vegetation Interpretation of Aerial Photo (항공사진의 식생 판독에 의한 재해 예측 기법)

  • 강인준;곽재하;정재형
    • Journal of the Korean Society of Surveying, Geodesy, Photogrammetry and Cartography
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    • v.11 no.1
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    • pp.29-35
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    • 1993
  • The vegetation such as grass, shrub, tree has been used to control the erosion and stabilize the slope for a long time. But the effects of vegetation on slope area is usually neglected in traditional stability analyses. There are many errors in slope analyses in thin soil mantles. Therefore the effects of vegetation is an important factor. But it is difficult and complex to represent the vegetation influence quantitatively in stability analysis. In this study, authors choose the landslide region at the Kum sung dong Kum-jung ku Pusan as a model area. Authors analyzed the degree of slope with the aerial photo interpretation and DTM data extracted from the topographic map, and the relationship of D.B.H. (diameter of breast height), height, and age of tree in field investigation data. Finally authors know the fact that landslide take place approximately 10 or 20 years later in arbitrary afforestable area where the degree of slope is 27. The prevention effect must be considered in the control of vegetation.

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Socio Demographic and Reproductive Risk Factors for Cervical Cancer - a Large Prospective Cohort Study from Rural India

  • Thulaseedharan, Jissa V.;Malila, Nea;Hakama, Matti;Esmy, Pulikottil O.;Cheriyan, Mary;Swaminathan, Rajaraman;Muwonge, Richard;Sankaranarayanan, Rengaswami
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.6
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    • pp.2991-2995
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    • 2012
  • Background: India shows some of the highest rates of cervical cancer worldwide, and more than 70% of the population is living in rural villages. Prospective cohort studies to determine the risk factors for cervical cancer are very rare from low and medium resource countries. The aim of this study was to quantify the effect of risk factors related to cervical cancer in a rural setting in South India. Material and methods: Sociodemographic and reproductive potential risk factors for cervical cancer were studied using the data from a cohort of 30,958 women who constituted the unscreened control group in a randomised screening trial in Dindigul district, Tamilnadu, India. The analysis was accomplished with the Cox proportional hazard regression model. Results: Women of increasing age (HR=2.4; 95% CI: 1.6, 3.8 in 50-59 vs 30-39), having many pregnancies (HR=7.1; 1.0, 52 in 4+ vs 0) and no education (HR=0.6; 0.2, 0.7 in high vs none) were found to be at significantly increased risk of cervical cancer. Conclusion: This cohort study gives very strong evidence to say that education is the fundamental factor among the sociodemographic and reproductive determinants of cervical cancer in low resource settings. Public awareness through education and improvements in living standards can play an important role in reducing the high incidence of cervical cancer in India. These findings further stress the importance of formulating public health policies aimed at increasing awareness and implementation of cervical cancer screening programmes.

Elevated PIVKA-II is Associated with Early Recurrence and Poor Prognosis in BCLC 0-A Hepatocellular Carcinomas

  • Wang, Bei-Li;Tan, Qi-Wen;Gao, Xing-Hui;Wu, Jiong;Guo, Wei
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.16
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    • pp.6673-6678
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    • 2014
  • Background: To investigate the prognostic value of serum PIVKA-II (prothrombin induced by the absence of vitamin K or antagonist-II) in BCLC (Barcelona Clinic Liver Cancer) 0-A hepatocellular carcinoma (HCC) patients after curative resection. Materials and Methods: Preoperative sera were collected from 140 patients with BCLC 0-A HCCs undergoing curative resection during 2011-2012 in Zhongshan Hospital. Follow-up ended on November 2013. ELISA was used to detect the serum concentrations of preoperative PIVKA-II. The prognostic value of PIVKA-II and other clinicopathological factors was analyzed by the Kaplan-Meier method and the multivariate Cox proportional hazards model. Results: During follow-up, 39 of 140 patients suffered recurrence and the 1-year recurrence rate was 27.9%. The high-PIVKA-II expression group had lower 1-year time to progression (TTP) compared with the low-expression group (54.8% vs 20.2%, p<0.001). Patients with high preoperative PIVKA-II expression showed a relatively higher risk of developing postoperative recurrence than those with low expression in the low-recurrence-risk subgroups, including ${\alpha}$-fetoprotein ${\leq}400ng/mL$ (45.4% vs 16.7%; p=0.006), tumor size ${\leq}5cm$ (54.2% vs 18.1%; p<0.001), single tumor (56.0% vs 19.1%; p<0.001), absence of satellite lesions (53.3% vs 19.8%; p=0.001), absence of vascular invasion (52.6% vs 14.9%; p=0.002), and Edmondson stage I/II (60.9% vs 20.3%; p<0.001). PIVKA-II was the strongest independent prognostic factor for TTP (hazard ratio, 2.877; 95% CI 1.524-5.429; p=0.001). Conclusions: Elevated PIVKA-II is associated with early recurrence of BCLC 0-A HCC after curative resection and can be considered a novel prognostic predictor.