• Journal of agricultural medicine and community health
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• v.47 no.2
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• pp.109-120
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• 2022

Objectives: The purpose of this study was to identify the effectiveness of COVID-19 vaccinations on deaths of the COVID-19 cases in some elderly long-term care facilities (LTCF) in Gwangju Metropolitan City. Methods: The study subjects were 659 COVID-19 cases in residents of 7 elderly LTCF, Gwangju, from 21 Dec. 2021 to 28 Jan. 2022. The used variables were confirmed dates for COVID-19, demographic characteristics, co-morbidities, presentation of symptoms, death and vaccination related characteristics including type of vaccine, doses and dates. Vaccination status were classified as not vaccinated, partially and fully vaccinated. The associations of vaccination status and deaths of COVID-19 cases were tested by chi-square test and multiple logistic regression analysis. Results: The rates of not vaccinated, partially vaccinated and fully vaccinated were 19.4%, 10.2% and 70.4%, respectively. The mortality rate of the cases was 6.4%. The death rate by vaccination status was 16.4% in not vaccinated, 15.4% in partially vaccinated and 2.6% in fully vaccinated, showing a statistically significant difference. The adjusted odds ratios (ORs) (95% confidence intervals, CIs) of death compared to fully vaccinated were 7.64 (3.87-16.34) in non-vaccinated, and 6.97 (3.44-14.14) in partially vaccinated. Conclusions: COVID-19 vaccination seems to work effectively in preventing deaths of COVID-19 cases of elderly LTCF residents. This finding support that fully vaccinations in high risk group such as elderly LTCF residents is very important for one of strategies of COVID-19 management.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.34 no.1
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• pp.37-44
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• 2023

Objectives: Tic disorders are highly heritable; however, growing evidence suggests that environmental factors play a significant role in their pathogenesis. Studies on these factors have been inconsistent, with conflicting results. Therefore, this study aimed to examine the associations of pre- and perinatal exposure to Tourette syndrome (TS) or chronic tic disorders (CTD) in Korean school-aged children. Methods: This case-control study used data from a large prospective cohort study. The primary outcome was TS/CTD diagnosis according to the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5) criteria and Kiddie-Schedule for Affective Disorders and Schizophrenia-Present and Lifetime Version-Korean Version. Demographic, pre-, and perinatal information was obtained from the maternal questionnaires. Data between the TS/CTD and control groups were compared using the chi-squared or Student's t-test, as appropriate. Two-step logistic regression analyses were used to test the association between TS/CTD and pre- and perinatal risk factors. Results: We included of 223 children (78 with TS/CTD and 145 controls). Significant differences in the demographic data between the two groups were observed. The male sex ratio, mean parental age, parental final education level, and family history of tics were included as confounders. In the final adjusted multivariable model, TS/CTD was significantly associated with antiemetic exposure during pregnancy (odds ratio [OR]=16.61, 95% confidence interval [CI] 1.49-185.22, p=0.02) and medically assisted reproduction (OR=7.89, 95% CI 2.28-27.28, p=0.01). Conclusion: Antiemetic exposure and medically assisted reproduction are significantly associated with the risk of TS/CTD. These results should be replicated in future prospective and gene-by-environment studies.

• Journal of Dental Anesthesia and Pain Medicine
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• v.23 no.1
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• pp.29-37
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• 2023

Background: A high incidence (40-73%) of postoperative nausea and vomiting (PONV) has been reported following orthognathic surgery, and various risk factors have been associated with it. Identifying PONV risk factors based on initial onset time will help establish preventive measures. This study aimed to identify factors that are significantly related to PONV based on the initial onset time after orthognathic surgery. Methods: This study included 590 patients who underwent orthognathic surgery. Multivariate logistic regression analysis was performed to identify the risk factors that are significantly related to PONV. The objective variables were classified into three categories: no PONV, early PONV (initial onset time: 0-2 h after anesthesia), and late PONV (initial onset time: 2-24 h after anesthesia). The explanatory variables included relevant risk factors for PONV, as considered in previous studies. Results: Total intravenous anesthesia with propofol was a significant depressant factor for early PONV (adjusted odds ratio [aOR] = 0.340, 95% confidence interval [CI] = 0.209-0.555) and late PONV (aOR = 0.535, 95% CI = 0.352-0.814). The administration of a combination of intraoperative antiemetics (vs. no administration) significantly reduced the risk of early PONV (aOR = 0.464, 95% CI = 0.230-0.961). Female sex and young age were significant risk factors for late PONV (aOR = 1.492, 95% CI = 1.170-1.925 and unit aOR = 1.033, 95% CI = 1.010-1.057, respectively). Conclusion: We identified factors that are significantly related to PONV based on the initial onset time after orthognathic surgery. Total intravenous anesthesia with propofol significantly reduced the risk of PONV not only in the early period (0-2 h after anesthesia) but also in the late period (2-24 h after anesthesia).

• Journal of The Korean Society of Clinical Toxicology
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• v.20 no.2
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• pp.58-65
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• 2022

Purpose: Alcohol is one of the most commonly co-ingested agents in deliberate self-poisoning (DSP) cases presenting at the emergency department (ED). The increased impulsivity, aggressiveness, and disinhibition caused by alcohol ingestion may have different clinical features and outcomes in cases of DSP. This study investigates whether alcohol co-ingestion affects the clinical features and outcomes of DSP patients in the ED. Methods: This was a single-center retrospective study. We investigated DSP cases who visited our ED from January 2010 to December 2016. Patients were classified into two groups: with (ALC+) or without (ALC-) alcohol co-ingestion. The clinical features of DSP were compared by considering the co-ingestion of alcohol, and the factors related to discharge against medical advice (AMA) of DSP were analyzed. Results: A total of 689 patients were included in the study, with 272 (39.5%) in the ALC+ group. Majority of the ALC+ group patients were middle-aged males (45-54 years old) and arrived at the ED at night. The rate of discharge AMA from ED was significantly higher in the ALC+ group (130; 47.8%) compared to the ALC- group (p=0.001). No significant differences were obtained in the poisoning severity scores between the two groups (p=0.223). Multivariate analysis revealed that alcohol co-ingestion (odds ratio [OR]=1.42; 95% confidence interval [CI], 1.01-1.98), alert mental status (OR=1.65; 95% CI, 1.17-2.32), past psychiatric history (OR=0.04; 95% CI, 0.01-0.28), age >65 years (OR=0.42; 95% CI, 0.23-0.78), and time from event to ED arrival >6 hrs (OR=0.57; 95% CI, 0.37-0.88) were independent predictive factors of discharge AMA (p=0.043, p=0.004, p=0.001, p=0.006, and p=0.010, respectively). Conclusion: Our results determined a high association between alcohol co-ingestion and the outcome of discharge AMA in DSP patients. Emergency physicians should, therefore, be aware that DSP patients who have co-ingested alcohol may be uncooperative and at high risk of discharge AMA.

• Korean Journal of Clinical Laboratory Science
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• v.54 no.4
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• pp.256-264
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• 2022

Ischemic stroke is caused by an occlusion by a thrombus or embolus in a cerebral artery, preventing oxygenated blood from reaching the brain and causing the necrosis of nerve cells. This paper summarizes the serum candidate markers associated with cardiovascular disease and atrial fibrillation (AF) disease that enable an early diagnosis of ischemic stroke studied thus far and compares the odds ratio (OR) of each marker. This study examined the effect size of these serum candidate markers using meta-analysis techniques. The academic database search screening for articles containing the keywords "cardiovascular disease," "atrial fibrillation," "ischemic stroke," and "serum marker" was limited to results for patients with ischemic stroke. The most derived markers in this study were N-terminal pro-B-type natriuretic peptide (NT-pro-BNP), D-dimer, C-reactive protein (CRP), and glial fibrillary acidic protein (GFAP), the rest being investigated individually. In conclusion, NT-pro-BNP appears to be very useful for the early diagnosis of ischemic stroke. Primarily, it is a marker of AF, and more AF markers will be uncovered and studied in the future.

• Journal of Environmental Health Sciences
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• v.48 no.6
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• pp.306-314
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• 2022

Background: Due to the rapid aging of the South Korean population, neurological diseases such as dementia are increasing. Many studies have reported that the incidence of dementia is associated with environmental factors along with age. Objectives: This study analyzed the association between cognitive function and ten heavy metals in the body: arsenic, aluminum, chromium, manganese, cobalt, nickel, iron, copper, zinc, and lead. Methods: From 2018 to 2019, a total of 120 participants who suffered from cognitive impairment were recruited for this study. Blood and urine samples were collected and analyzed for heavy metal concentrations using an inductively coupled plasma mass spectrometer. Demographic information was obtained through face-to-face questionnaires completed by a trained investigator. Cognitive function was evaluated with the Korean version of the Mini-Mental State Examination and the Korean version of the Boston Name Waiting Test. The associations between cognitive function scores and heavy metal concentrations were analyzed using multiple logistic regression analysis. Results: The average age of the 120 participants was 72.7 years, and 69.2% were female. The mean of the MMSE-K and K-BNT scores were 22.9 and 37.9, respectively. The geometric mean of aluminum (Al) was 8.42 ㎍/L. MMSE-K was associated with iron (Fe), but the significance was removed in the logistic regression based on 24 points. K-BNT was significantly associated with aluminum and the odds ratio for K-BNT above 38 decreased by 45% as the aluminum concentration increased. Conclusions: The association between aluminum and the K-BNT score indicated that aluminum is associated with language-related cognitive decline. Based on this result, further study will be conducted by considering co-exposure effects of heavy metals including aluminum.

• Journal of Chest Surgery
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• v.56 no.3
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• pp.162-170
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• 2023

Background: Extracorporeal cardiopulmonary resuscitation (E-CPR) plays an indispensable role when resuscitation fails; however, extracorporeal life support (ECLS) in infants is different from that in adults. The objective of this study was to evaluate the outcomes of E-CPR in infants. Methods: A single-center retrospective study was conducted, analyzing 51 consecutive patients (age <1 year) who received E-CPR for in-hospital cardiac arrest between 2010 and 2021. Results: The median age and body weight was 51 days (interquartile range [IQR], 17-111 days) and 3.4 kg (IQR, 2.9-5.1 kg), respectively. The cause of arrest was cardiogenic in 45 patients (88.2%), and 48 patients (94.1%) had congenital cardiac anomalies. The median conventional cardiopulmonary resuscitation (C-CPR) time before the initiation of ECLS was 77 minutes (IQR, 61-103 minutes) and duration of ECLS was 7 days (IQR, 3-12 days). There were 36 in-hospital deaths (70.6%), and another patient survived after heart transplantation. In the multivariate analysis, single-ventricular physiology (odds ratio [OR], 5.05; p=0.048), open sternum status (OR, 8.69; p=0.013), and C-CPR time (OR, 1.47 per 10 minutes; p=0.021) were significant predictors of in-hospital mortality. In a receiver operating characteristic curve, the optimal cut-off of C-CPR time was 70.5 minutes. The subgroup with early E-CPR (C-CPR time <70.5 minutes) showed a tendency for lower in-hospital mortality tendency (54.5% vs. 82.8%, p=0.060), albeit not statistically significant. Conclusion: If resuscitation fails in an infant, E-CPR could be a life-saving option. It is crucial to improve C-CPR quality and shorten the time before ECLS initiation.

• Journal of Gastric Cancer
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• v.23 no.2
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• pp.355-364
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• 2023

Background: There are no clear guidelines to determine whether to perform D1 or D1+ lymph node dissection in early gastric cancer (EGC). This study aimed to develop a nomogram for estimating the risk of extraperigastric lymph node metastasis (LNM). Materials and Methods: Between 2009 and 2019, a total of 4,482 patients with pathologically confirmed T1 disease at 6 affiliated hospitals were included in this study. The basic clinicopathological characteristics of the positive and negative extraperigastric LNM groups were compared. The possible risk factors were evaluated using univariate and multivariate analyses. Based on these results, a risk prediction model was developed. A nomogram predicting extraperigastric LNM was used for internal validation. Results: Multivariate analyses showed that tumor size (cut-off value 3.0 cm, odds ratio [OR]=1.886, P=0.030), tumor depth (OR=1.853 for tumors with sm2 and sm3 invasion, P=0.010), cross-sectional location (OR=0.490 for tumors located on the greater curvature, P=0.0303), differentiation (OR=0.584 for differentiated tumors, P=0.0070), and lymphovascular invasion (OR=11.125, P<0.001) are possible risk factors for extraperigastric LNM. An equation for estimating the risk of extraperigastric LNM was derived from these risk factors. The equation was internally validated by comparing the actual metastatic rate with the predicted rate, which showed good agreement. Conclusions: A nomogram for estimating the risk of extraperigastric LNM in EGC was successfully developed. Although there are some limitations to applying this model because it was developed based on pathological data, it can be optimally adapted for patients who require curative gastrectomy after endoscopic submucosal dissection.

• Journal of agricultural medicine and community health
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• v.48 no.3
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• pp.178-188
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• 2023

Objective: Self perceived health status dose not only reflects an individual's perception of their overall well-being but is also known to be influenced by various aspects of life. Rural areas tend to have relatively lower quality of life compared to urban areas. Therefore, this study aims to investigate factors related to Self perceived health status among farmers. Methods: In the subjective health status questionnaire, responses of "very healthy" and "healthy" are classified as 'good', whereas "average", "unhealthy" or "very unhealthy" are classified as indicative of a 'poor' subjective health status. Logistic regression analysis was conducted to calculate odds ratios(OR), aiming to investigate factors related to self perceived health status. Results: The OR for self perceived health status as poor was statistically significant for females at 2.32(95% CI 1.47-3.67), for individuals working in greenhouses at 1.43(95% CI 1.01-1.98), for current smoker at 1.50(95% CI 1.02-2.08), and for those who experienced symptoms after pesticide exposure at 1.74(95% CI 1.13-2.67). An annual income of 50 million won or more had a statistically significant OR of 0.51(95% CI 0.28-0.91), education level of high school and above had an OR of 0.45(95% CI 0.32-0.63), and engaging in physical exercise had an OR of 0.61(95% CI 0.42-0.89). Conclusions: The factors related to self perceived health status were identified as sex, smoking, cultivation type, presence of symptoms after pesticide exposure, annual income, education level, and exercise status. The significance of this study lies in providing foundational data for the development of health management programs for farmers.

• Journal of the korean academy of Pediatric Dentistry
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• v.50 no.1
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• pp.24-34
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• 2023

The aim of this study was to retrospectively analyze the effects of pulp treatment on exfoliation of primary teeth and its related factors. In this study, 167 teeth of 97 patients aged 6 months to 12 years who were treated with pulp treatment at Dankook Dental Hospital were selected, and information related to pulp treatment and tooth loss was collected. The included subjects were 72 primary anterior teeth (43.1%) and 95 primary posterior teeth (56.9%), of which 56 were males (57.7%) and 41 females (42.3%). The mean follow-up period was 106.1 ± 38.7 months, and the mean age at pulp treatment was 34.8 ± 15.4 months for primary anterior teeth and 69.1 ± 25.1 months for primary posterior teeth. Unilaterally pulpectomized teeth were significantly exfoliated earlier than the same tooth on the opposite side (p < 0.05). Also, in the case of teeth with periapical lesions, despite pulp treatment, the probability of extraction due to infection has been increased on primary anterior teeth (p < 0.05), but not on posterior teeth (p > 0.05). Pulpectomized teeth were lost earlier, an average of 7.8 months for primary anterior teeth and 8.5 months for primary posterior teeth. Early loss of the primary tooth can lead to space loss and premature eruption of the successor, so this can be considered when planning or performing treatment of the primary tooth.