• Neonatal Medicine
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• 제25권3호
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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.

• 한국학교ㆍ지역보건교육학회지
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• 제14권2호
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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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• 제50권1호
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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.

• 보건행정학회지
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• 제17권4호
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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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• 제36권4호
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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.

• 한국건설관리학회논문집
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• 제10권6호
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• pp.117-126
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• 2009

건설 산업에 내재된 위험은 작업환경, 작업의 종류, 작업자의 특성 등이 결합되어 발생한다. 건설 현장의 가변적이며 유동적인 특성을 고려한다면 동일 공종이라도 내재된 특성들의 조합에 따라 위험의 크기가 다르게 나타날 수 있다. 하지만 기존의 안전 관리 방식은 이러한 건설업의 특성을 반영하지 못한 체 타산업과 유사한 안전 관리를 수행하고 있다. 이에 본 연구는 건설현장의 다양한 위험 요소를 고려한 위험도 산정 방법을 제시하기 위해 선행연구 분석 및 설문을 통해 위험 영향 요소를 도출하고 가중치 체계를 구축하였다. 그리고 빈도와 강도 기반의 공종별 위험도를 구하였다. 위험 영향 요소와 공종별 위험도를 결합하여 건설 현장의 상황에 맞는 위험도 산정 방법을 마련하였다. 이로써 건설 현장의 특성을 고려한 위험도를 구할 수 있으며, 위험도를 바탕으로 보다 효과적인 안전관리활동을 펼칠 수 있을 것이다. 따라서 본 연구는 위험 영향 요소들을 고려하여 현장 특성을 반영한 위험도를 산정하였다는데 그 의미가 있다.

• Asian Pacific Journal of Cancer Prevention
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• 제16권8호
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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.

• 한국ITS학회 논문지
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• 제17권3호
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• pp.1-17
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• 2018

렌터카 차량의 교통사고 발생건수 및 사망자 수는 꾸준히 증가하는 추세를 보이며, 사고로 인한 사망률 또한 일반 승용차 및 영업용 택시보다 높다. 본 연구는 전국을 대상으로 2010년부터 2014년까지 발생한 렌터카 사고 데이터를 분석하여 사고 심각도에 영향을 미치는 요인들을 도출하였다. 사고 심각도와 관련된 17개 변수를 렌터카 사고 데이터로부터 추출하였으며 이를 4가지(인적, 차량, 도로 및 환경) 요인으로 구분한 후 순서형 로짓 모델을 적용하여 통계적으로 분석하였다. 분석 결과, 운전자 연령, 교차로 형태, 사고 발생 요일을 제외한 나머지 14개 변수가 렌터카 사고 심각도에 영향을 미치는 요인으로 통계적 유의성이 있는 것으로 분석되었다. 연구결과는 다음과 같이 요약될 수 있다. 첫째, 거주 지역이 아닌 곳에서 발생한 렌터카 사고의 심각도가 더 큰 것으로 나타났다. 둘째, 일반 도로 대비 고속도로 렌터카 사고, 과속 및 11대 중과실 위반 등 법규 위반 관련 렌터카 사고의 경우 사고 심각도가 더 큰 것으로 나타났다. 셋째, 지리적으로 익숙하지 않은 렌터카 운전자 특성상 도로 기하구조가 복잡하며, 운전자의 시야가 분산되는 커브구간 등에서의 사고 심각도가 높게 나타났다. 넷째, 지역별로 렌터카 사고 심각도에 차이가 있으나, 2010년 이후 사고 심각도는 전반적으로 감소하고 있는 것으로 나타났다. 본 연구의 결과는 향후 렌터카 사고 심각도를 줄이기 위한 기초자료로 활용될 수 있을 것으로 생각한다.

• 대한후두음성언어의학회지
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• 제31권1호
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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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• 제21권5호
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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.