• Title/Summary/Keyword: Risk Severity

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Risk Factors for Prevertebral Soft Tissue Swelling Following Single-level Anterior Cervical Spine Surgery

  • Junsang Park;Sang Mook Kang;Yu Deok Won;Myung-Hoon Han;Jin Hwan Cheong;Byeong-Jin Ha;Je Il Ryu
    • Journal of Korean Neurosurgical Society
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    • v.66 no.6
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    • pp.716-725
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    • 2023
  • Objective : Anterior cervical spine surgery (ACSS) is a common surgical procedure used to treat cervical spinal degenerative diseases. One of the complications associated with ACSS is prevertebral soft tissue swelling (PSTS), which can result in airway obstruction, dysphagia, and other adverse outcomes. This study aims to investigate the correlation between various cervical sagittal parameters and PSTS following single-level ACSS, as well as to identify independent risk factors for PSTS. Methods : A retrospective study conducted at a single institution. The study population included all patients who underwent single-level ACSS between January 2014 and December 2022. Patients with a history of cervical spine surgery or trauma were excluded from the study. The presence and severity of PSTS was assessed by reviewing pre- and postoperative imaging studies. The potential risk factors for PSTS that were examined include patient age, sex, body mass index, tobacco use, comorbidities, serum albumin levels, operative time, implant type, implanted level, and various cervical spine sagittal parameters. Multivariate linear regression analysis was performed to identify the independent risk factors for PSTS. Results : A total of 62 consecutive patients who underwent single-level ACSS over a 8-year period at a single institution were enrolled in this study. Only preoperative segmental angle showed positive correlation with PSTS among various cervical spine sagittal parameters (r=0.36, p=0.005). Artificial disc replacement showed a negative correlation with PSTS (β=-0.38, p=0.002), whereas the use of demineralized bone matrix (DBM) had a positive impact on PSTS (β=0.33, p=0.009). We found that male sex, lower preoperative serum albumin, and implantation of upper cervical level (above C5) were independent predictors for PSTS after single-level ACSS (β=1.21; 95% confidence interval [CI], 0.27 to 2.15; p=0.012; β=-1.63; 95% CI, -2.91 to -0.34; p=0.014; β=1.44; 95% CI, 0.38 to 2.49; p=0.008, respectively). Conclusion : Our study identified male sex, lower preoperative serum albumin levels, and upper cervical level involvement as independent risk factors for PSTS after single-level ACSS. These findings can help clinicians monitor high-risk patients and take preventive measures to reduce complications. Further research with larger sample sizes and prospective designs is needed to validate these findings.

Are Serum Vitamin D Levels Associated With Dry Eye Disease? Results From the Study Group for Environmental Eye Disease

  • Jeon, Da-Hye;Yeom, Hyungseon;Yang, Jaewon;Song, Jong Suk;Lee, Hyung Keun;Kim, Hyeon Chang
    • Journal of Preventive Medicine and Public Health
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    • v.50 no.6
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    • pp.369-376
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    • 2017
  • Objectives: Dry eye disease (DED) is an increasingly important public health problem in Korea. Previous studies conducted in Korea have reported inconsistent results regarding the protective effects of vitamin D on DED, and these discrepancies may be related to the relatively simple questionnaire that has been used. Thus, we evaluated the association of serum vitamin D levels with DED using the ocular surface disease index (OSDI). Methods: The present study evaluated data from participants in the Study Group for Environmental Eye Disease (2014-2015). This group included data from 752 participants, and data from 740 participants (253 men and 487 women) were analyzed in the present study. DED severity was evaluated using the OSDI. Results: Higher serum vitamin D levels were associated with a non-significantly reduced risk of DED in the crude analysis (odds ratio [OR], 0.991; 95% confidence interval [CI], 0.971 to 1.011) and in the adjusted analysis (OR, 0.988; 95% CI, 0.966 to 1.010). In the crude analysis of no/mild DED vs. moderate/severe DED, men exhibited a decreased risk with increasing serum vitamin D levels (OR, 0.999; 95% CI, 0.950 to 1.051), while women exhibited an increased risk (OR, 1.003; 95% CI, 0.979 to 1.027). In these analyses, we found no significant associations. Conclusions: The findings of the present study support previous reports that serum vitamin D levels are not associated with DED.

Comparison of Consumer Media Use Gratification for the Effective Delivery of Fine Dust Information: Applying the Niche Theory (효과적인 미세먼지 정보전달을 위한 소비자의 미디어 이용충족 비교 -적소이론을 적용하여 -)

  • Song, Eugene;Kwon, Seol A;Ryu, Sang Il
    • The Journal of the Korea Contents Association
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    • v.20 no.7
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    • pp.1-18
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    • 2020
  • Fine dust is one of the top ten causes of deaths globally. More than 95% of the world's population are endangered by it. However, as the fine dust problem is difficult to address immediately, people should be informed of its risk and prepared to deal with it. This study explores the methods used to define, efficiently provide, and manage the complementary relationships between various types of media providing risk information utilizing the competitive characteristics of media in niche theory. A survey consisting of 348 Korean university students was conducted over 12 days, to analyze three factors: consumer perception of fine dust, media usage, and media use gratification. The response value for media gratification was substituted in the equation to derive the niche breadth, niche overlap, and competitive superiority. It was found that 1) for providing fine dust forecast and fine dust response guidance information, a smartphone application was the most effective; 2) smartphone applications were limited in providing additional information such as the severity and origin of fine dust, and hence, it is necessary to establish the functionality of the Internet and TV to complement smartphone applications. Thus, a system considering the above should be developed.

Predictive Values of Magnetic Resonance Imaging Features for Tracheostomy in Traumatic Cervical Spinal Cord Injury

  • Jeong, Tae Seok;Lee, Sang Gu;Kim, Woo Kyung;Ahn, Yong;Son, Seong
    • Journal of Korean Neurosurgical Society
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    • v.61 no.5
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    • pp.582-591
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    • 2018
  • Objective : To evaluate the magnetic resonance (MR) imaging features that have a statistically significant association with the need for a tracheostomy in patients with cervical spinal cord injury (SCI) during the acute stage of injury. Methods : This study retrospectively reviewed the clinical data of 130 patients with cervical SCI. We analyzed the factors believed to increase the risk of requiring a tracheostomy, including the severity of SCI, the level of injury as determined by radiological assessment, three quantitative MR imaging parameters, and eleven qualitative MR imaging parameters. Results : Significant differences between the non-tracheostomy and tracheostomy groups were determined by the following five factors on multivariate analysis : complete SCI (p=0.007), the radiological level of C5 and above (p=0.038), maximum canal compromise (MCC) (p=0.010), lesion length (p=0.022), and osteophyte formation (p=0.015). For the MCC, the cut-off value was 46%, and the risk of requiring a tracheostomy was three times higher at an interval between 50-60% and ten times higher between 60-70%. For lesion length, the cut-off value was 20 mm, and the risk of requiring a tracheostomy was two times higher at an interval between 20-30 mm and fourteen times higher between 40-50 mm. Conclusion : The American Spinal Injury Association grade A, a radiological injury level of C5 and above, an MCC ${\geq}50%$, a lesion length ${\geq}20mm$, and osteophyte formation at the level of injury were considered to be predictive values for requiring tracheostomy intervention in patients with cervical SCI.

Diabetes Management and Hypoglycemia in Safety Sensitive Jobs

  • Lee, See-Muah;Koh, David;Chui, Winnie Kl;Sum, Chee-Fang
    • Safety and Health at Work
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    • v.2 no.1
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    • pp.9-16
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    • 2011
  • The majority of people diagnosed with diabetes mellitus are in the working age group in developing countries. The interrelationship of diabetes and work, that is, diabetes affecting work and work affecting diabetes, becomes an important issue for these people. Therapeutic options for the diabetic worker have been developed, and currently include various insulins, insulin sensitizers and secretagogues, incretin mimetics and enhancers, and alpha glucosidase inhibitors. Hypoglycemia and hypoglycaemic unawareness are important and unwanted treatment side effects. The risk they pose with respect to cognitive impairment can have safety implications. The understanding of the therapeutic options in the management of diabetic workers, blood glucose awareness training, and self-monitoring blood glucose will help to mitigate this risk. Employment decisions must also take into account the extent to which the jobs performed by the worker are safety sensitive. A risk assessment matrix, based on the extent to which a job is considered safety sensitive and based on the severity of the hypoglycaemia, may assist in determining one's fitness to work. Support at the workplace, such as a provision of healthy food options and arrangements for affected workers will be helpful for such workers. Arrangements include permission to carry and consume emergency sugar, flexible meal times, selfmonitoring blood glucose when required, storage/disposal facilities for medicine such as insulin and needles, time off for medical appointments, and structured self-help programs.

Human Telomerase Gene and High-Risk Human Papillomavirus Infection are Related to Cervical Intraepithelial Neoplasia

  • Zhao, Xu-Ye;Cui, Yongm;Jiang, Shu-Fang;Liu, Ke-Jun;Han, Hai-Qiong;Liu, Xiao-Su;Li, Yali
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.2
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    • pp.693-697
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    • 2015
  • Our aims were to evaluate the clinical performance of human telomerase RNA gene component (hTERC gene) amplification assay with high-risk human papillomavirus (HR-HPV) DNA test of Hybrid Capture 2 DNA test (HC2), for the detection of high grade cervical precancerous lesions and cancer (CIN 2+). In addition, the association shown between hTERC gene amplification and HPV DNA test positive in women with and without cervical neoplasia was assessed. There were 92 women who underwent cytology, HR-HPV DNA test, hTERC gene amplification test, colposcopy and biopsy. We compared the clinical performance of hTERC gene test along with HR-HPV DNA test of women with colposcopy and routine screening. The samples were histology-confirmed high-grade cervical intraepithelial neoplasia (CIN 2) or worse (CIN2+) as the positive criterion. The test of hTERC gene showed the hTERC gene amplification positivity increased with the severity of histological abnormality and cytological abnormality. The test of hTERC gene showed higher specificity than HR-HPV DNA test for high-grade lesions (84.4% versus 50%) and also higher positive predictive value (90.4% versus 76.5%). Our results predicted that hTERC gene amplification demonstrated more specific performance for predicting the risk of progression and offer a strong potential as a tool for triage in cervical cancer screening, with the limited sensitive as HR-HPV DNA test.

The Incidence Rates and Risk Factor of Mild Injury for Two Weeks - Using Korea National Health and Nutrition Examination Survey 2001 - (2주간 경미손상의 발생률과 위험요인 - 2001년 국민건강영양조사자료를 이용하여 -)

  • Lee, Je-Suk;Kim, Soon-Duck;Lee, Dong-Ki;Lee, Ji-Sung
    • Journal of Preventive Medicine and Public Health
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    • v.41 no.4
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    • pp.279-286
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    • 2008
  • Objectives: This study was performed to provide the basic data for establishing countermeasures for preventing injury by analyzing the incidence rates, the risk factors, the characteristics of the injury and the utilization of medical care for mild injury that lasted for two weeks. Methods: We examined the injury survey data among the National Health and Nutrition Survey data. The definition of mild injury that lasted for two weeks was that the injury that caused pain at least once a day for two weeks or the injury for which the usual daily activity of the injured person was severely affected. We used statistical analysis methods such as chi-square test and multiple logistic regression analysis. Results: The incidence rate of injury that lasted for two weeks was 4.7 per 1,000 persons. On the multiple logistic regression, the children and adolescents (OR=3.80, 95%CI=1.63-8.84) had higher rates of injuries than the adults, and the middle and high school (OR=0.51, 95%CI=0.31-0.85) and college(OR=0.34, 95%CI=0.17-0.68) students had lower rates of injuries than the elementary school students. The unemployed (OR=0.39, 95%CI=0.20-0.73) and others (OR=0.38, 95%CI=0.21-0,70) had lower rates of injuries than the blue collar workers. The major causes of injuries were found to be falling and slipping, and the most prevalent place of occurrence was near or at home. Conclusions: A prevention program needs to be developed and continuous education must be offered to the children, adolescents and blue collar workers.

The Effect of Voice Disorders on Quality of Life(QOL) in the Korean (한국인의 음성질환이 삶의 질에 미치는 영향)

  • 송윤경;심현섭;권기환;이경철;이용배;진성민
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.11 no.1
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    • pp.51-60
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    • 2000
  • Background and Objectives : Quality of life(QOL) is a construct representing physical, mental and social well-being. QOL has been used as a device for measuring the severity of health-related condition and treatment outcomes. As the social welfare system develops, the attention to QOL increases as well. The aims of this study was to examine whether the patients with voice disorder perceived significantly more the effects of voice disorder on QOL than nonpatient group did and if any, identify the sociodemographic risk factors influencing QOL of patients. Materials and Methods : This study asked 113 adults with voice disorders who were enrolled in Voice Clinic in the Department of Otolaryngology, Kangbuk Samsung Hospital between lune 1998 and January 1999 and 111 nonpatients to complete a questionnaire designed to elicit information about the effete of voice disorders on quality of lift. The questionnaire included items concerning sociodemographic areas, voice symptoms, job, effects of voice disorders on QOL domains(work, social, psychological, physical, and communication areas), potential risk factors to exposures, familial and medical history of voice disorders. Results : The sociodemographic characteristics of the patient group are as follows : (1) 75.2% of total patient group were female and the rest were male. (2) Age of total patient group ranged from 20 to 65 years. Hoarseness was the most commonly reported complaints, followed by complaints of high note difficulties during singing and voice fatigue. The patient group perceived effects of voice disorders on the areas of work, social, psychological, physical and communication more adversely than the comparison group did (p<0.05). QOL impairments were evaluated as a function of age, gender, education, and income, controlling other independent effects. The results were that (1) age was significantly associated with work problems and (2) gender and income were significantly associated with psychological problems. Conclusions : The findings indicated that the patients with voice disorders would perceive markedly adverse effect on all QOL domains, that is, work, social, psychological, physical, communicational areas. Therefore, the results of study suggest that lurker investigations about the nature of voice disorders, the prevention, treatment, and coping strategies are needed in the future.

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Is the Neutrophil-Lymphocyte Ratio an Indicator of Progression in Patients with Benign Prostatic Hyperplasia?

  • Tanik, Serhat;Albayrak, Sebahattin;Zengin, Kursad;Borekci, Hasan;Bakirtas, Hasan;Imamoglu, M. Abdurrahim;Gurdal, Mesut
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.15
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    • pp.6375-6379
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    • 2014
  • Purpose: The aim of this study was to evaluate inflammation parameters and assess the utility of the neutrophil-lymphocyte ratio (NLR) as a simple and readily available predictor for clinical disease activity in patients with nenign prostate hyperplasia BPH. We also aimed to investigate the relationship between inflammatory parameters with ${\alpha}$-blocker therapy response, and evaluate the potential association between NLR and the progression of benign prostatic hyperplasia (BPH). Materials and Methods: We examined 320 consecutive patients (July 2013-December 2013) admitted to our outpatient clinic with symptoms of the lower urinary tract at Bozok University. The mean age was 60 (range, 51-75) years. Complete blood count (CBC), prostate-specific antigen (PSA), erythrocyte sedimentation rate (ESR), and C-reactive protein (CRP) were assessed. Correlations between PSA, CRP, ESR, prostate volume, International Prostate Symptom Score (IPPS), maximum urinary flow rate (Qmax), and NLR were assessed statistically. Patients were divided into two groups: high and low risk of progression. Results: NLR was positively correlated with IPSS (p=0.001, r=0.265), PSA (p=0.001, r=0.194), and negatively correlated with Qmax (p<0.001, r=-0.236). High-risk patients a had a higher NLR compared with low-risk patients, based on IPSS (p<0.001), PSA (p=0.013), and Qmax (p<0.001); however, there were no significant differences between the groups in terms of age (p>0.05), and prostate volume (p>0.05). Conclusions: NLR can predict BPH progression. We propose that increased inflammation is negatively associated with clinical status in BPH patients and suggest that NLR can give information along with LUTS severity which may be used as a readikly accessible marker for patient follow-up.

Risk factors of fisher on stow net fishing vessel using analysis of adjudication (재결서 분석을 통한 안강망어선에 승선하는 선원의 위험요인)

  • KIM, Wook-Sung;HYUN, Yun-Ki;LEE, Yoo-Won
    • Journal of the Korean Society of Fisheries and Ocean Technology
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    • v.56 no.2
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    • pp.155-162
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    • 2020
  • The adjudication of Korean Maritime Safety Tribunal (KMST) was analyzed to collect basic data to identify the cause of the risk that did not appear in the current data provided by the fishermen's occupational accidents of the National Federation of Fisheries Cooperative (NFFC) in stow net fishing vessel from 2015 to 2019. The personnel's carelessness was the most common in 29 out of 33 accidents (87.9%), followed by 25 cases (75.8%) of inadequacy of instructions, 24 cases (72.7%) of inadequacy of education on hazard factor, 20 cases (60.6%) of no personal protection equipment, 18 cases (54.5%) of poor guard, 17 cases (51.5%) of inadequacy of work method, 16 cases (48.5%) of absence of emergency stop button, 14 cases (42.4%) of work practice of poor safety precautions that affected more than 40% of all accidents as accident causes. These causes had a strong influence on each other, and the ratio of accident causes is high. With this relationship, accidents can be prevented or the severity of human injury can be reduced if types of accident process can be estimated with a scenario, and the key points before the accident in the scenario are switched to safe points.