• Neonatal Medicine
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• v.25 no.3
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• pp.102-108
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• 2018

Purpose: Congenital diaphragmatic hernia (CDH) is rare but potentially fatal. The overall outcome is highly variable. This study aimed to identify a simple and dynamic parameter that helps predict the mortality of CDH patients in real time, without invasive tests. Methods: We conducted a retrospective chart review of 59 CDH cases. Maternal and fetal information included the gestational age at diagnosis, site of defect, presence of liver herniation, and lung-to-head ratio (LHR) at 20 to 29 weeks of gestational age. Information regarding postnatal treatment, including the number of days until surgery, the need for inhaled nitric oxide (iNO), the need for extracorporeal membrane oxygenation (ECMO), and survival, was collected. The highest respiratory severity score (RSS) within 24 hours after birth was also calculated. Results: Statistical analysis showed that a younger gestational age at the initial diagnosis (P<0.001), a lower LHR (P=0.001), and the presence of liver herniation (P=0.003) were prenatal risk factors for CDH mortality. The RSS and use of iNO and ECMO were significant factors affecting survival. In the multivariate analysis, the only remaining significant risk factor was the highest preoperative RSS within 24 hours after birth (P=0.002). The area under the receiver operating characteristic curve was 0.9375, with a sensitivity of 91.67% and specificity of 83.87% at the RSS cut-off value of 5.2. The positive and negative predictive values were 82.14% and 92.86%, respectively. Conclusion: Using the RSS as a prognostic predictor with simple calculations will help clinicians plan CDH management.

• The Journal of Korean Society for School & Community Health Education
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• v.14 no.2
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• pp.47-57
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• 2013

Backgrounds: According to a high interest in health these days, a bicycle is being highlighted as a means of leisure activity and auxiliary transportation means. Along with an increase in this interest, there is tendency that even the width of bicycle utilization gets diverse and that bicycle accident is also rapidly growing. Purpose: The purpose of this study was to suggest a prevention measure available for reducing occurrence of bicycle accidents by analyzing the Epidemiological characteristics according to age and injury severity in bicycle-injured patients. Methods: This study analyzed 115 materials suitable for this study by examining a medical record of patients, who received the hospitalized treatment owing to bicycle accident from January 1, 2011 to December 31 at one general hospital in S city. Results: The male-and-female ratio of bicycle-injured patients stood at about 7:3. The average age was 38.14(${\pm}21.59$) years old. The largest injury happened in 40-59 years old(31.3%). The averagely hospitalized period was 17.33(${\pm}18.12$) days. Injury severity was the ratio of 2:8 in a mild case versus a serious case. As for drinking and smoking characteristics according to age, the injury occurred the most in between 40 and 59 years old for people with drinking and smoking and in under 19 years for people without drinking and smoking. According to injury severity, the ratio of serious case got higher in the higher age. This was indicated(${\chi}^2$=15.675, p=0.001) to be statistically significant. Conclusion: In this study, a bicycle accident was indicated to have high injury risk in young children, adolescents, and old-age group. Prevention measure and publicity are demanded for reducing injury occurrence such as the prevention education for bicycle accident and wearing protective gear focusing on the ages of corresponding to groups with risk of injury occurrence. In addition, the security of safe movement route is necessarily demanded in order to increase application level as an auxiliary transportation means.

• Journal of Korean Neurosurgical Society
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• v.50 no.1
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• pp.1-5
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• 2011

Objective : There is no proven regimen to reduce the severity of stroke in patients with acute cerebral infarction presenting beyond the thrombolytic time window. Ozagrel sodium, a selective thromboxane A2 synthetase inhibitor, has been known to suppress the development of infarction. The antiplatelet effect is improved when aspirin is used together with a thromboxane synthetase inhibitor. Methods : Patients with non-cardiogenic acute ischemic stroke who were not eligible for thrombolysis were randomly assigned to two groups; one group received ozagrel sodium plus 100 mg of aspirin (group 1, n=43) and the other 100 mg of aspirin alone (group 2, n=43). Demographic data, cardiovascular risk factors, initial stroke severity [National Institute of Health Stroke Scale (NIHSS) and motor strength scale] and stroke subtypes were analyzed in each group. Clinical outcomes were analyzed by NIHSS and motor strength scale at 14 days after the onset of stroke. Results : There were no significant differences in the mean age, gender proportion, the prevalence of cardiovascular risk factors, stroke subtypes, and baseline neurological severity between the two groups. However, the clinical outcome for group 1 was much better at 14 days after the onset of stroke compared to group 2 (NIHSS score, p=0.007, Motor strength scale score, p<0.001). There was one case of hemorrhagic transformation in group 1, but there was no statistically significant difference in bleeding tendency between two groups. Conclusion : In this preliminary study, thromboxane A2 synthetase inhibitor plus a low dose of aspirin seems to be safe and has a favorable outcome compared to aspirin alone in patients with acute ischemic stroke who presented beyond the thrombolytic time window.

• Health Policy and Management
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• v.17 no.4
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• pp.99-112
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• 2007

The purpose of this study was to analyze the effect of fire fighters' duty type on occurrence and severity of low back pain. Data were collected with questionnaire to 450 fire fighters working at 119 safety center and rescue unit of 30 fire stations in Gyeonggi-do. Finally the study was analyzed for 360 persons among them. The risk of experiencing of lower back pain occurred in the order of Rescue[odds ratio(OR) 3.36, 95% confidence interval(95% CI) 1.18-9.52], Vehicle operation(OR 2.63, 95% CI 1.26-5.50), First aid(OR 2.18, 95% CI 1.03-4.59), and Putting out a fire. The risk on severity of lower back pain occurred in the order of Vehicle operation(OR 4.00, 95% CI 1.57-9.80), First aid(OR 1.88, 95% CI 1.00-4.81), Putting out a fire, and Rescue. These result suggest that duty type of fire fighters may be a prognostic factor for occurrence and severity of low back pain. The potential implications of these findings are discussed about different approach for primary and secondary prevention by duty type of fire fighters.

• Journal of Trauma and Injury
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• v.36 no.4
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• pp.329-336
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• 2023

Purpose: In this study, we aimed to compare the characteristics of patients with trauma by age group in a single center in Korea to identify the clinical characteristics and analyze the risk factors affecting mortality. Methods: Patients aged ≥18 years who visited the Chungbuk National University Hospital Regional Trauma Center between January 2016 and December 2022 were included. The accident mechanism, severity of the injury, and outcomes were compared by classifying the patients into group A (18-64 years), group B (65-79 years), and group C (≥80 years). In addition, logistic regression analysis was performed to identify factors affecting death. Results: The most common injury mechanism was traffic accidents in group A (40.9%) and slipping in group B (37.0%) and group C (56.2%). Although group A had the highest intensive care unit admission rate (38.0%), group C had the highest mortality rate (9.5%). In the regression analysis, 3 to 8 points on the Glasgow Coma Scale had the highest odds ratio for mortality, and red blood cell transfusion within 24 hours, intensive care unit admission, age, and Injury Severity Score were the predictors of death. Conclusions: For patients with trauma, the mechanism, injured body region, and severity of injury differed among the age groups. The high mortality rate of elderly patients suggests the need for different treatment approaches for trauma patients according to age. Identifying factors affecting clinical patterns and mortality according to age groups can help improve the prognosis of trauma patients in the future.

• Korean Journal of Construction Engineering and Management
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• v.10 no.6
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• pp.117-126
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• 2009

Many work-related risk factors can cause construction site hazards. Considering variable and changeable characteristics of construction site, risk of same trade can be different by combination of inherent characteristics. But established safety management has performed like other industries not reflecting characteristics of construction. So, to suggest risk assessment methodology considering risk influence factors in construction site, this study extracts risk influence factors by literature reviews and surveys, builds the weighting system for classification of factors. And risk of trade is calculated based on frequency and severity of risk. Risk assessment methodology is suggested by integrating risk influence factors and risk of trade. From this, risk considering the conditions of construction sites can be derived and based on the derived risk, safety management can be performed more effectively. This study has meaning for assessing the risk which can reflect characteristics of construction site considering risk influence factors.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.8
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• pp.3173-3181
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• 2015

Background: It has been hypothesized that IL-18 (pro-) and IL-10 (anti-) inflammatory genetic variants at -607 C/A-137G/C and -819C/T,-592C/A, respectively, may generate susceptibility and severity risk with various modes of tobacco exposure in prostate carcinoma (PCa) patients. IL-18 is a pro-inflammatory cytokine expressed on various cells including prostate gland elements, and is a key mediator of immune responses with anti-cancerous properties. IL-10 is an anti-inflammatory cytokine that is associated with tumour malignancy which causes immune escape. Materials and Methods: The present study was conducted with 540 subjects, comprising 269 prostate carcinoma patients and 271 controls. Genotyping was performed by PCR-RFLP and confirmed by real time PCR probe-based methods. Results: The findings indicated that the mutant heterozygous and homozygous genotype CC and GC+CC showed significant negative associations (p=0.01, OR=0.21; 95% CI: 0.08-0.51 and p=0.011, OR=0.43; 95% CI: 0.22-0.81, respectively) thus, less chance to be diagnosed as cancer against GG genotype of tobacco smoking patients. In addition, a heterozygous GC genotype at the same locus of IL-18 pro-inflammatory cytokine may aggravate the severity (OR=2.82; 95%CI 1.09-7.29 :p=001) so that patients are more likely to be diagnosed in advanced stage than with the GG wild homozygous genotype. Our results also illustrated that anti-inflammatory cytokine (IL-10) genetic variants, although showing no significant association with susceptibility to cancer of the prostate, may gave profound effects on severity of the disease, as -819 TC (OR=4.60; 95%CI 1.35-15.73), and -592 AC (OR=5.04; 95%CI 1.08-25.43) of IL-10 in tobacco chewers and combined users (both chewers and smokers) respectively, are associated with diagnosis in more advanced stage than with other variants. Conclusions: We conclude that promoter genetic variants of IL-18 and IL-10 with various modes of tobacco exposure may affect not only susceptibility risk but also severity in prostate cancer.

• The Journal of The Korea Institute of Intelligent Transport Systems
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• v.17 no.3
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• pp.1-17
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• 2018

Over the past five years (2010-2014), the total number of traffic accidents has decreased from 226,878 to 223,552 with decrease of 0.37 percent each year. The death toll has also decreased from 5,505 to 4,762. However, the number of rental car accidents and fatalities has been steadily increased. Despite of its growth, no previous study has been conducted on rental car accident severity. This study analyzed data of 18,050 rental car accidents in South Korea collected from 2010 to 2014 and then processed in order to identify which factors could affect the accident severity. Seventeen factors related to rental car accident severity were grouped into four categories: driver, vehicle, roadways and environment. As a result of the ordered probit model analysis, fourteen variables excluding age, intersection, and day of week were found to affect the severity of rental car accidents. The results of the study summarized as follows. First of all, violation of traffic regulations such as speeding increase the severity of rental car accidents. Secondly, rental accident severity is higher at curved sections of complicated roadway, which the driver's field of view is impaired. The results of this study can be used to reduce the severity of rental car accidents in transportation safety.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.31 no.1
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• pp.19-26
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• 2020

Background and Objective Endoscopic airway dilation is the primary treatment for pediatric subglottic stenosis (SGS) due to its feasibility and non-invasiveness. The aim of this study is to evaluate the risk factors for the failure of endoscopic airway dilation in pediatric patients with SGS. Materials and Methods This study reviewed medical records of 38 pediatric patients had endoscopic dilation from a single and tertiary referral center, retrospectively. The success of the endoscopic dilation procedure was defined as no dyspneic symptom without tracheostomy or laryngotracheal reconstruction. Demographic profiles, underlying disease, and Myer-Cotton SGS severity grade were recorded. Success rates and risk factors for the failure of treatment were analyzed. Results The SGS patients with severity grade I was most common. After mean 1.8 numbers of procedures, there were 23 patients (60.5%) in the success group and 15 patients (39.5%) in the failure group. Age, sex, underlying diseases, and SGS severity grade were not significantly different between two groups. In patients who had multiple endoscopic procedures, the failure group showed SGS deteriorated after procedures in 66.7%, compared to 11.1% of the success group. In multivariable analysis, a long-term intubation (≥1 month) was identified as an independent risk factor for failure of endoscopic dilation procedure. Conclusion Although endoscopic dilation procedure is safe and effective for the management, repetitive endoscopic dilation may not give clinical benefit in patient with long-term intubation. Other airway procedures must be considered in those group of patients.

• Journal of Dental Anesthesia and Pain Medicine
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• v.21 no.5
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• pp.413-429
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• 2021

Background: Migraine headaches are the second leading cause of disability worldwide and are responsible for significant morbidity, reduction in the quality of life, and loss of productivity on a global scale. The purpose of this systematic review and meta-analysis was to evaluate the efficacy of ketamine on migraines and other primary headache disorders compared to placebo and other active interventions, such as midazolam, metoclopramide/diphenhydramine, and prochlorperazine/diphenhydramine. Methods: An electronic search of databases published up to February 2021, including Medline via PubMed, EMBASE, Web of Science, and Cochrane Library, a hand search of the bibliographies of the included studies, as well as literature and systematic reviews found through the search was conducted to identify randomized controlled trials (RCTs) investigating ketamine in the treatment of migraine/headache disorders compared to the placebo. The authors assessed the risk of bias according to the Cochrane Handbook guidelines. Results: The initial search strategy yielded 398 unduplicated references, which were independently assessed by three review authors. After evaluation, this number was reduced to five RCTs (two unclear risk of bias and three high risk of bias). The total number of patients in all the studies was 193. Due to the high risk of bias, small sample size, heterogeneity of the outcomes reported, and heterogeneity of the comparison groups, the quality of the evidence was very low. One RCT reported that intranasal ketamine was superior to intranasal midazolam in improving the aura attack severity, but not duration, while another reported that intranasal ketamine was not superior to metoclopramide and diphenhydramine in reducing the headache severity. In one trial, subcutaneous ketamine was superior to saline in migraine severity reduction; however, intravenous (I.V.) ketamine was inferior to I.V. prochlorperazine and diphenhydramine in another study. Conclusion: Further double-blind controlled studies are needed to assess the efficacy of ketamine in treating acute and chronic refractory migraines and other primary headaches using intranasal and subcutaneous routes. These studies should include a long-term follow-up and different ketamine dosages in diagnosed patients following international standards for diagnosing headache/migraine.