• Korean Journal of Clinical Laboratory Science
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• v.55 no.1
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• pp.52-64
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• 2023

This study aimed to examine the types and characteristics of otorhinolaryngology examinations performed by clinical laboratory technologists and to investigate the working environment and scope of work of otorhinolaryngology laboratory personnel using online questionnaires. Based on the research results, constructive policy measures for the University-Association-Society were also presented. Most of the survey respondents were in their 40s (34.1%). Females accounted for 80.2% of respondents and 30.8% of them had a career spanning 15 years or more. We found that laboratory personnel had a wide scope of work, high work stress and frequently suffered occupational diseases. We observed that, to reduce stress and increase satisfaction, an expansion of the workforce was necessary. Compared to other occupations, 72% of clinical laboratory technologists occupied more senior positions, occupational distribution depended on senior positions (P<0.001). Clinical laboratory technologists performed about 26 types of otorhinolaryngology examinations. The most frequent test performed daily was pure tone audiometry, and polysomnography took the longest test time, with an average of 8 hours. In conclusion, clinical laboratory technologists were in charge of various specialized otorhinolaryngology examinations. Considering the importance of clinical laboratory technologists in otorhinolaryngology, the University-Association-Society should put in additional effort into nurturing otorhinolaryngology examination experts.

• Journal of the Korean Society of Radiology
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• v.17 no.2
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• pp.249-255
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• 2023

In this study, radiation exposure doses were measured in the course of clinical practice of radiation workers, radiological technologists in the radiation-related worker group, and preliminary-radiological technologists who were classified as frequent visitors. Radiological technologists who worked in the radiation area of C University Hospital in Incheon for a year from January 2021 and 121 students who completed clinical practice at the same medical institution from July 1 to August 31 were the subjects of the study. The nominal risk factor based on ICRP 103 was used to evaluate the probability of side effects due to the exposure dose to the lungs, which are organs at risk of damage due to radiation exposure dose. During the clinical practice period, radiology students, who were classified as frequent visitors, had a surface dose of 0.98 ± 0.14 mSv and a deep dose of 0.93 ± 0.14 mSv. In other words, 6.7 per 1,000,000 for shallow dose and 6.4 per 1,000,000 for deep dose were found to have side effects due to exposure to the lungs. This is a value in terms of exposure dose in one year. Considering that the radiation (science) education course is 3 or 4 years, systematic management and attention to prospective radiation workers who are going to clinical practice are required, and the stochastic effect of radiation In relation to this, it is considered that it will be used as basic data for radiation safety management.

• Therapeutic Science for Rehabilitation
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• v.12 no.3
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• pp.33-44
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• 2023

Objective : The purpose of this study was to identify the risk factors for shoulder pain in manual wheelchair users with spinal cord injuries and to explore the correlation between shoulder pain and quality of life. Methods : Out of 182 participants initially included, 168 were selected for analysis. The questionnaire had 41 questions, with 15 on the Wheelchair User's Shoulder Pain Index (WUSPI) and 26 on the World Health Organization Quality of Life-BREF (WHOQOL-BREF). Results : It was found that participants' scored 50.75 in the WUSPI, whereas they scored higher in mobility and overhead activity. In addition, participants' WHOQOL-BREF scored 70.48, with a mean score of 2.71, which was lower than ordinary adults' WHOQOL-BREF (mean: 3.11) and that of older people suffering from chronic musculoskeletal system pain (total score: 77.92). Conclusion : The participants' WUSPI showed negative correlations with all items, including the total scores on the WHOQOL-BREF. This suggests that the participants' shoulder pain had a negative impact on their quality of life. Therefore, clinical experts, including occupational therapists, should provide manual wheelchair users with spinal cord injuries with programs aimed at preventing and managing shoulder pain, thereby contributing to improving their quality of life.

• Journal of Korean Neurosurgical Society
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• v.66 no.5
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• pp.543-551
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• 2023

Objective : This study aimed to investigate the current status of intracranial pressure (ICP) monitoring in patients with severe traumatic brain injury (sTBI) in Korea and the association between ICP monitoring and prognosis. In addition, a survey was administered to Korean neurosurgeons to investigate the perception of ICP monitoring in patients with sTBI. Methods : This study used data from the second Korea Neurotrauma Databank. Among the enrolled patients with sTBI, the following available clinical data were analyzed in 912 patients : Glasgow coma scale score on admission, ICP monitoring, mortality, and extended Glasgow outcome scale score at 6 months. In addition, we administered a survey, entitled "current status and perception of ICP monitoring in Korean patients with sTBI" to 399 neurosurgeons who were interested in traumatic brain injury. Results : Among the 912 patients, 79 patients (8.7%) underwent ICP monitoring. The mortality and favorable outcome were compared between the groups with and without ICP monitoring, and no statistically significant results were found. Regarding the survey, there were 61 respondents. Among them, 70.4% of neurosurgeons responded negatively to performing ICP monitoring after craniectomy/craniotomy, while 96.7% of neurosurgeons responded negatively to performing ICP monitoring when craniectomy/craniotomy was not conducted. The reasons why ICP monitoring was not performed were investigated, and most respondents answered that there were no actual guidelines or experiences with post-operative ICP monitoring for craniectomy/craniotomy. However, in cases wherein craniectomy/craniotomy was not performed, most respondents answered that ICP monitoring was not helpful, as other signs were comparatively more important. Conclusion : The proportion of performing ICP monitoring in patients with sTBI was low in Korea. The outcome and mortality were compared between the patient groups with and without ICP monitoring, and no statistically significant differences were noted in prognosis between these groups. Further, the survey showed that ICP monitoring in patients with sTBI was somewhat negatively recognized in Korea.

• Journal of Korean Neurosurgical Society
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• v.66 no.5
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• pp.536-542
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• 2023

Objective : Surgical site infection is the most detrimental complication following cranioplasty. In other surgical fields, intrawound vancomycin powder application has been introduced to prevent surgical site infection and is widely used based on results in multiple studies. This study evaluated the effect of intrawound vancomycin powder in cranioplasty compared with the conventional method without topical antibiotics. Methods : This retrospective study included 580 patients with skull defects who underwent cranioplasty between August 1, 1998 and December 31, 2021. The conventional method was used in 475 (81.9%; conventional group) and vancomycin powder (1 g) was applied on the dura mater and bone flap in 105 patients (18.1%; vancomycin powder group). Surgical site infection was defined as infection of the incision, organ, or space that occurred after cranioplasty. Surgical site infection within 1-year surveillance period was compared between the conventional and vancomycin powder groups with logistic regression analysis. Penalized likelihood estimation method was used in logistic regression to deal with zero events. All local and systemic adverse events associated with topical vancomycin application were also evaluated. Results : Surgical site infection occurred in 31 patients (5.3%) and all were observed in the conventional group. The median time between cranioplasty and detection of surgical site infection was 13 days (range, 4-333). Staphylococci were the most common organisms and identified in 25 (80.6%) of 31 cases with surgical site infections. The surgical site infection rate in the vancomycin powder group (0/105, 0.0%) was significantly lower than that in the conventional group (31/475, 6.5%; crude odds ratio [OR], 0.067; 95% confidence interval [CI], 0.006-0.762; adjusted OR, 0.068; 95% CI, 0.006-0.731; p=0.026). No adverse events associated with intrawound vancomycin powder were observed during the follow-up. Conclusion : Intrawound vancomycin powder effectively prevented surgical site infections following cranioplasty without local or systemic adverse events. Our results suggest that intrawound vancomycin powder is an effective and safe strategy for patients undergoing cranioplasty.

• Journal of Korean Neurosurgical Society
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• v.66 no.5
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• pp.582-590
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• 2023

Objective : Trauma is a leading causes of death and disability in all ages. The aim of this study was to describe the demography and characteristics of paediatric head trauma in our institution and examine the predictors of outcome and incidence of injury related mortality. Methods : We examined our institutional Trauma Registry over a 2 year period. Results : A total of 1100 trauma patients were seen over the study period. Of the 579 patients who had head injury 99 were in the paediatric age group. Of the paediatric head trauma patients 79 had documented Glasgow coma score (GCS), 38 (48.1%), 17 (21.5%) and 24 (30.4%) had mild, moderate and severe head injury respectively. The percentage mortality of head injury in the paediatric age group was 6.06% (6/99). There is an association between mortality and GCS (p=0.008), necessity for intensive care unit (ICU) admission (p=0.0001), associated burns (p=0.0001) and complications such as aspiration pneumonia (p=0.0001). The significant predictors of outcome are aspiration (p=0.004), the need for ICU admission (p=0.0001) and associated burns (p=0.005) using logistic binary regression. During the study period 46 children underwent surgical intervention with extradural haematoma 16 (34.8%), depressed skull fracture 14 (30.4%) and chronic subdural haematoma five (10.9%) being the commonest indication for surgeries. Conclusion : Paediatric head injury accounted for 9.0% (99/1100) of all trauma admissions. Majority of patients had mild or moderate injuries. Burns, aspiration pneumonitis and the need for ICU admission were important predictors of outcome in children with traumatic brain injury.

• Journal of the Korean Society of Radiology
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• v.17 no.4
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• pp.581-587
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• 2023

In this study, we tried to provide basic data for radiation safety management by comparing and analyzing the exposure doses of radiation workers and frequent workers at C University Hospital in Incheon. From January 2021 to December 2022, surface dose and deep dose were analyzed for 30 radiation workers and 8 frequent workers who worked at C university hospital in Incheon. Radiation workers were targeted at radiation technicians and nurses working in the radiation oncology department and nuclear medicine department, and frequent visitors were targeted at frequent workers who manage and clean facilities in the same radiation management area. In the radiation worker group, 3.1 per 10,000 radiation technologist, 1.2 per 100,000 nurses, and 4.5 per 1,000,000 frequent workers showed the possibility of developing side effects on the lungs. The probability of radiation oncology was 1.1 per 10,000 for radiation technologist and 5.2 per 1,000,000 for nurses, and the probability of radiation technologist in nuclear medicine was 2.9 per 10,000 and for nurses was 7.1 per 1,000,000. It is hoped that this study can be used as basic data in future revisions on frequent workers, and it is considered that it will be used as basic data in the field of obstacles in relation to the stochastic effect of radiation in the future.

• Journal of the Korean Society of Radiology
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• v.17 no.2
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• pp.243-248
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• 2023

This study aims to analyze the secondary carcinogenesis rate caused by exposure of organs at risk of damage using a glass dosimeter during radiosurgery in vestibular schwannoma disease. Using a pediatric phantom of human tissue equivalent material, the volume of the tumor was set to a total of three volumes: 0.506 cm³, 1.008 cm³, and 2.032 cm³, and a radiosurgery plan was established with an average dose of 18.4 ± 3.4 Gy. After mounting the human body phantom on the table of surgical equipment, glass dosimeters were placed on the right eye, left eye, thyroid gland, thymus, right lung, and left lung to measure the exposure dose, respectively. In this study, the incidence of secondary cancer due to exposure to damaged organs during gamma knife radiosurgery in vestibular schwannoma disease with the largest tumor volume of 2.032 cm³ was measured with a glass dosimeter. This study studies the risk of secondary radiation exposure dose that can occur during stereotactic radiosurgery, and it is considered that it will be used as basic data in the field of radiation damage related to the stochastic effect of radiation in the future.

• Safety and Health at Work
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• v.13 no.4
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• pp.493-499
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• 2022

Background: The purpose of this study is to construct a job-exposure matrix for lead that accounts for industry and work processes within industries using a nationwide exposure database. Methods: We used the work environment measurement data (WEMD) of lead monitored nationwide from 2015 to 2016. Industrial hygienists standardized the work process codes in the database to 37 standard process and extracted key index words for each process. A total of 37 standardized process codes were allocated to each measurement based on an automated key word search based on the degree of agreement between the measurement information and the standard process index. Summary statistics, including the arithmetic mean, geometric mean, and 95th percentile level (X95), was calculated according to industry, process, and industry process. Using statistical parameters of contrast and precision, we compared the similarity of exposure groups by industry, process, and industry process. Results: The exposure intensity of lead was estimated for 583 exposure groups combined with 128 industry and 35 process. The X95 value of the "casting" process of the "manufacture of basic precious and non-ferrous metals" industry was 53.29 ㎍/m³, exceeding the occupational exposure limit of 50 ㎍/m³. Regardless of the limitation of the minimum number of samples in the exposure group, higher contrast was observed when the exposure groups were by industry process than by industry or process. Conclusion: We evaluated the exposure intensities of lead by combination of industry and process. The results will be helpful in determining more accurate information regarding exposure in lead-related epidemiological studies.

• Korean Journal of Clinical Laboratory Science
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• v.54 no.1
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• pp.61-67
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• 2022

Intraoperative neurophysiological monitoring (INM) ensures the stability and safety of specific surgeries in high-risk groups. As part of INM, intensive tests are conducted during the surgical process. When INM tests are applied during surgery, a delay in notifying the operating surgeon in cases of neurological defects can cause serious irreversible sequelae to the patient. Aortic replacement, which is necessitated due to aortic aneurysms and aortic dissection, is a complicated procedure that blocks the blood flow to the heart. When arteries that branch out from the aorta and supply blood to the spinal cord are replaced, blood flow to the spinal cord decreases, resulting in spinal ischemia. In aortic surgery, INM plays an important role in preventing spinal ischemia and serious complications by quickly detecting the early signs of spinal ischemia during cross-clamping and reporting it to the surgeon. Therefore, this paper was prepared to help examiners who conduct INM by detailing the process, method, time, and warning criteria for INM. This paper identifies the need for INM in aortic surgery and the process flow for a smooth test, accurate and rapid examination, and subsequent reporting.