• Health Policy and Management
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• v.29 no.3
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• pp.303-311
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• 2019

Background: Cerebrovascular disease is included in four major diseases and is a disease that has high rates of prevalence and mortality around the world. Moreover, it is a disease that requires a high cost for long-term hospitalization and treatment. This study aims to figure out the correlation between grip strength, which was presented as a simple, cost-effective, and relevant predictor of cerebrovascular disease, and cerebrovascular disease based on the results of a prior study. And furthermore, our study compared model suitability of the model to measuring grip strength and relative grip strength as a predictor of cerebrovascular disease to improve the quality of cerebrovascular disease's predictor. Methods: This study conducted an analysis based on the generalized linear mixed model using the data from the Korea Longitudinal Study of Ageing from 2006 to 2016. The research subjects consisted of 9,132 middle old age people aged 45 years or older at baseline with no missing information of education level, gender, marital status, residential region, type of national health insurance, self-related health, smoking status, alcohol use, and economic activity. The grip strength was calculated the average which measured 4 times (both hands twice), and the relative grip force was divided by the body mass index as a variable considering the anthropometric figure that affects the cerebrovascular disease and the grip strength. Cerebrovascular diseases, a dependent variable, were investigated based on experiences diagnosed by doctors. Results: An analysis of the association between grip strength and found that about 0.972 (odds ratio [OR], 0.972; 95% confidence interval [CI], 0.963-0.981) was the incidence of cerebral vascular disease as grip strength increased by one unit increase and the association between relative grip strength and cerebrovascular disease found that about 0.418 (OR, 0.418; 95% CI, 0.342-0.511) was the incidence of cerebral vascular disease as relative grip strength increased by unit. In addition, the model suitability of the model for each grip strength and relative grip strength was 11,193 and 11,156, which means relative grip strength is the better application to the predictor of cerebrovascular diseases, irrespective of other variables. Conclusion: The results of this study need to be carefully examined and validated in applying relative grip strength to improve the quality of predictors of cerebrovascular diseases affecting high mortality and prevalence.

• Journal of Korean Society of Occupational and Environmental Hygiene
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• v.29 no.3
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• pp.289-297
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• 2019

Objectives: To identify the positive rate of and the risk factors associated with latent tuberculosis infection(LTBI) in mine workers, the objectives of the present study evaluated those among former mine workers. Methods: Between January 2015 and May 2017, former male mine workers who had been subjects for epidemiology research for work-related chronic obstructive pulmonary disease(COPD) and had received QuantiFERON-$TB^{(R)}$ Gold In-Tube(QFT-GIT) from the Institute of Occupation and Environment(IOE) under Korea Workers' Compensation and Welfare Service(KCOMWEL) were selected as the study subjects. To identify significant variables for increased risk of LTBI, logistic regression analysis was performed. Results: A total of 736 male former mine workers were selected as study subjects. The positive rate of LTBI among subjects was 69.2%(509/736). The current smoking[odds ratio(OR), 2.3; 95% confidence interval(CI), 1.1-4.9], COPD(OR, 1.4; 95% CI, 0.9-2.3), department loading(OR, 1.8; 95% CI, 0.9-3.4) and mining(OR, 1.5; 95% CI, 0.9-2.5), and working duration of over 20(OR, 1.6; 95% CI, 0.9-3.1) and over 30 years(OR, 2.2; 95% CI, 0.9-4.9) were associated with increased risk of LTBI. The interferon-gamma(IFN-${\gamma}$) level after stimulation with Mycobacterium tuberculosis(MTB)-specific antigens showed a significantly negative correlation with age(r=-0.126). Conclusions: The present study determined that the high positive rate of LTBI among mine workers was associated with not only the host factors but also the occupational exposure to mine dust.

• Journal of the Korean Society of Propulsion Engineers
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• v.4 no.4
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• pp.18-25
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• 2000

A two-color particle image velocimetry (PIV) has been developed for measuring two dimensional velocity flowfields and applied to a Mach 2.0 supersonic nozzle. This technique is similar to a single-color PIV technique except that two different color laser beams are used to solve the directional ambiguity problem. A green-color laser sheet (532 nm: 2nd harmonic beam of YAG laser) and a red-color laser sheet (619 nm: output beam from YAG pumped Dye laser using Rhodamine 640) are employed to illuminate the seeded particles. A high resolution (3060${\times}$2036) digital color CCD camera is used to record the particle positions. This system eliminates the photographic-film processing time and subsequent digitization time as well as the complexities associated with conventional image shifting techniques for solving directional ambiguity problem. The two-color PIV also has the advantage that velocity distributions in high speed flowfields can be measured simply and accurately by varying the time interval between two different laser beams due to its high signal-to-noise ratio and thereby less requirement of panicle pair numbers for a velocity vector in one interrogation spot. The velocity distribution in the Mach 2.0 supersonic nozzle has been measured and the over-expanded shock cell structure can be predicted by the strain rate field. These results are compared and analyzed with the schlieren photograph for the velocity distributions and shock location.

• Clinical and Experimental Reproductive Medicine
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• v.44 no.3
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• pp.152-158
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• 2017

Objective: To identify the associations between polymorphisms of the 3'-untranslated region (UTR) of methylenetetrahydrofolate reductase (MTHFR) gene, which codes for an important regulatory enzyme primarily involved in folate metabolism, and idiopathic recurrent pregnancy loss (RPL) in Korean women. Methods: The study population comprised 369 RPL patients and 228 controls. MTHFR 2572C > A, 4869C > G, 5488C > T, and 6685T > C 3'-UTR polymorphisms were genotyped by polymerase chain reaction-restriction fragment length polymorphism analysis or by TaqMan allelic discrimination assays. Natural killer cell proportions were determined by flow cytometry. Results: The MTHFR 2572-5488-6685 (A-C-T) haplotype had an adjusted odds ratio of 0.420 (95% confidence interval, 0.178-0.994; p= 0.048) for RPL. Analysis of variance revealed that MTHFR 4869C > G was associated with altered $CD56^+$ natural killer cell percentages (CC, $17.91%{\pm}8.04%$; CG, $12.67%{\pm}4.64%$; p= 0.024) and folate levels (CC, $12.01{\pm}7.18mg/mL$; CG, $22.15{\pm}26.25mg/mL$; p= 0.006). Conclusion: Variants in the 3'-UTR of MTHFR are potential biomarkers for RPL. However, these results should be validated in additional studies of ethnically diverse groups of patients.

• Journal of The Korean Society of Clinical Toxicology
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• v.12 no.2
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• pp.77-84
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• 2014

Purpose: Carbamate insecticides are potent cholinesterase inhibitors capable of causing severe cholinergic toxicity. Use of carbamate rather than organophosphate insecticides has been increasing. Compared with organophosphate poisoning, relatively few studies have investigated carbamate-associated acute pancreatitis. We investigated general characteristics and pancreatitis of carbamate poisoning and the predictors, among those readily assessed in the emergency department. Methods: We performed a retrospective review of consecutive patients, aged over 18 years, who were admitted between January 2008 and April 2012 to an emergency department (ED) of an academic tertiary care center for treatment of carbamate poisoning. Patients who exhibited poisoning by any other material, except alcohol, were excluded. After application of exclusion criteria, patients were divided according to carbamate-induced pancreatitis and non-pancreatitis groups. Results: A total of 41 patients were included in this study. Among these 41 patients, the prevalence of acute pancreatitis was 36.6% (15 patients). Initial blood chemistry tests showed a statistically higher glucose level in the pancreatitis group, compared with the non-pancreatitis group (222, IQR 189-284 vs. 137, IQR 122-175 mg/dL, P<0.05). Regarding clinical courses and outcomes, a significantly higher proportion of patients developed pneumonia [10 (66.7%) vs. 6 (23.1%), P<0.05] and had a longer hospital stay (7 days, IQR 6-12 vs. 5 days, IQR 2-11, P<0.05), but no difference in mortality, in the pancreatitis group vs. the non-pancreatitis group. In multivariate analysis, the initial glucose was showing significant association with the presentation of carbamate-induced acute pancreatitis (odds ratio 1.018, 95% confidence interval 1.001-1.035, P<0.05). Conclusion: Carbamate-induced acute pancreatitis is common, but not fatal. Initial serum glucose level is associated with acute pancreatitis.

• Korean Journal of Psychosomatic Medicine
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• v.24 no.2
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• pp.217-226
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• 2016

Objectives : To investigate changes in, and predictors of, metabolic syndrome(MetS) status over a 5-year period in chronic schizophrenic patients and to identify factors associated with the prevention of or recovery from MetS. Methods : In total, 107 patients, all of whom provided written informed consent, were followed from 2011 to 2016 at Naju National Hospital for this study. MetS was defined according to the revised National Cholesterol Education Program-Adult Treatment Panel III guidelines. Results : During follow-up period, 22(20.5%) patients were newly diagnosed to MetS, 14(13.1%) were disappeared, 77(66.4%) were not changed[MetS : 34(31.8%), No MetS 37(34.6%)]. Common significant factors in the two changed groups were triglyceride and waist circumference, not dose and type of antipsychotic medication. Multiple logistic regression analysis revealed that female gender(odds ratio[OR]=2.846, 95% confidence interval[CI] : 1.020-7.942), attending two or more outpatient visits per month(OR=3.155, 95% CI : 1.188-8.379) and taking antidepressant medication(OR=3.991, 95% CI : 1.048-15.205) were significantly associated with MetS after controlling for other confounding variables. Type and dose of antipsychotic medication were not significantly associated with MetS. Conclusions : Triglyceride and waist circumference were important manageable indicator of MetS. Adoption of a healthy lifestyle is more important than adjusting the dose or type of antipsychotic medication in the treatment of chronic schizophrenia patients with MetS.

• Tuberculosis and Respiratory Diseases
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• v.84 no.4
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• pp.282-290
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• 2021

Background: Radial probe endobronchial ultrasound-guided transbronchial lung biopsy (RP-EBUS-TBLB) has improved the diagnostic yield of bronchoscopic biopsy of peripheral pulmonary lesions (PPLs). The diagnostic yield and complications of RP-EBUS-TBLB for PPLs vary depending on the technique, such as using a guide sheath (GS) or fluoroscopy. In this study, we investigated the utility of RP-EBUS-TBLB using a GS without fluoroscopy for diagnosing PPLs. Methods: We retrospectively reviewed data from 607 patients who underwent RP-EBUS of PPLs from January 2019 to July 2020. TBLB was performed using RP-EBUS with a GS without fluoroscopy. The diagnostic yield and complications were assessed. Multivariable logistic regression analyses were used to identify factors affecting the diagnostic yields. Results: The overall diagnostic accuracy was 76.1% (462/607). In multivariable analyses, the size of the lesion (≥20 mm; odds ratio [OR], 2.06; 95% confidence interval [CI], 1.27-3.33; p=0.003), positive bronchus sign in chest computed tomography (OR, 2.30; 95% CI, 1.40-3.78; p=0.001), a solid lesion (OR, 2.40; 95% CI, 1.31-4.41; p=0.005), and an EBUS image with the probe within the lesion (OR, 6.98; 95% CI, 4.38-11.12; p<0.001) were associated with diagnostic success. Pneumothorax occurred in 2.0% (12/607) of cases and chest tube insertion was required in 0.5% (3/607) of patients. Conclusion: RP-EBUS-TBLB using a GS without fluoroscopy is a highly accurate diagnostic method in diagnosing PPLs that does not involve radiation exposure and has acceptable complication rates.

• Journal of Korean Neurosurgical Society
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• v.64 no.6
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• pp.950-956
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• 2021

Objective : Psoas and masseter muscles are known markers of sarcopenia. However, the relative superiority of either muscle as a marker is unclear. Therefore, this study analyzed the two muscles in patients with a prognosis of traumatic brain injury (TBI). Methods : Patients with TBI visiting a regional trauma center between January 2017 and December 2018 were selected, and their medical records were reviewed. TBI patients with an abbreviated injury score (AIS) of 4 or 5 were selected. Patients with an AIS of 4 or 5 at the chest, abdomen, and extremity were excluded. Patients with a hospital stay of 1 to 2 days were excluded. Both muscle areas were measured based on the initial computed tomography. The psoas muscle index (PMI) and the masseter muscle index (MMI) were calculated by dividing both muscle areas by height in meters squared (cm²/m²). These muscle parameters along with other medical information were used to analyze mortality and the Glasgow outcome scale (GOS). Results : A total of 179 patients, including 147 males (82.1%), were analyzed statistically. The mean patient age was 58.0 years. The mortality rate was 16.8% (30 patients). The mean GOS score was 3.7. Analysis was performed to identify the parameters associated with mortality, which was a qualitative study outcome. The psoas muscle area (16.9 vs. 14.4 cm², p=0.028) and PMI (5.9 vs. 5.1 cm²/m², p=0.004) showed statistical differences between the groups. The PMI was also statistically significant as a risk factor for mortality in logistic regression analysis (p=0.023; odds ratio, 0.715; 95% confidence interval, 0.535-0.954). Quantitative analyses were performed with the GOS scores. Bivariate correlation analysis showed a statistically significant correlation between PMI and GOS scores (correlation coefficient, 0.168; p=0.003). PMI (p=0.004, variation inflation factor 1.001) was significant in multiple regression analysis. The masseter muscle area and MMI did not show significance in the study. Conclusion : Larger PMI was associated with statistically significant improved survival and GOS scores, indicating its performance as a superior prognostic marker. Further analyses involving a larger number of patients, additional parameters, and more precise settings would yield a better understanding of sarcopenia and TBI.

• Journal of Gastric Cancer
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• v.21 no.3
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• pp.268-278
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• 2021

Purpose: While several prognostic models for the stratification of death risk have been developed for patients with advanced gastric cancer receiving first-line chemotherapy, they have seldom been tested in the Chinese population. This study investigated the performance of these models and identified the optimal tools for Chinese patients. Materials and Methods: Patients diagnosed with metastatic or recurrent gastric adenocarcinoma who received first-line chemotherapy were eligible for inclusion in the validation cohort. Their clinical data and survival outcomes were retrieved and documented. Time-dependent receiver operating characteristic (ROC) and calibration curves were used to evaluate the predictive ability of the models. Kaplan-Meier curves were plotted for patients in different risk groups divided by 7 published stratification tools. Log-rank tests with pairwise comparisons were used to compare survival differences. Results: The analysis included a total of 346 patients with metastatic or recurrent disease. The median overall survival time was 11.9 months. The patients were different into different risk groups according to the prognostic stratification models, which showed variability in distinguishing mortality risk in these patients. The model proposed by Kim et al. showed relative higher predicting abilities compared to the other models, with the highest χ² (25.8) value in log-rank tests across subgroups, and areas under the curve values at 6, 12, and 24 months of 0.65 (95% confidence interval [CI]: 0.59-0.72), 0.60 (0.54-0.65), and 0.63 (0.56-0.69), respectively. Conclusions: Among existing prognostic tools, the models constructed by Kim et al., which incorporated performance status score, neutrophil-to-lymphocyte ratio, alkaline phosphatase, albumin, and tumor differentiation, were more effective in stratifying Chinese patients with gastric cancer receiving first-line chemotherapy.

• Journal of Korean Neurosurgical Society
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• v.64 no.3
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• pp.437-446
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• 2021

Objective : To investigate the radiographic characteristics of the uppermost instrumented vertebrae (UIV) and UIV+1 compression fractures that are predictive of revision surgery following long-segment spinal fixation. Methods : A total 27 patients who presented newly developed compression fracture at UIV, UIV+1 after long segment spinal fixation (minimum 5 vertebral bodies, lowest instrumented vertebra of L5 or distal) were reviewed retrospectively. Patients were divided into two groups according to following management : revisional surgery (group A, n=13) and conservative care (group B, n=14). Pre- and postoperative images, and images taken shortly before and after the occurrence of fracture were evaluated for radiologic characteristics Results : Despite similar degrees of surgical correction of deformity, the fate of the two groups with proximal junctional compression fractures differed. Immediately after the fracture, the decrement of adjacent disc height in group A (32.3±7.6 mm to 23.7±8.4 mm, Δ=8.5±6.9 mm) was greater than group B (31.0±13.9 mm to 30.1±15.5 mm, Δ=0.9±2.9 mm, p=0.003). Pre-operative magnetic resonance imaging indicated that group A patients have a higher grade of disc degeneration adjacent to fractured vertebrae compared to group B (modified Pfirrmann grade, group A : 6.10±0.99, group B : 4.08±0.90, p=0.004). Binary logistic regression analysis indicated that decrement of disc height was the only associated risk factor for future revision surgery (odds ratio, 1.891; 95% confidence interval, 1.121-3.190; p=0.017). Conclusion : Proximal junctional vertebral compression fractures with greater early-stage decrement of adjacent disc height were associated with increased risk of future neurological deterioration and necessity of revision. The condition of adjacent disc degeneration should be considered regarding severity and revision rate of proximal junctional kyphosis/proximal junction failures.