• Annals of Occupational and Environmental Medicine
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• v.34
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• pp.4.1-4.11
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• 2022

Background: Long working hours are known to account for approximately one-third of the total expected work-related diseases, and much interest and research on long working hours have recently been conducted. Additionally, as the prevalence of prediabetes and the high-risk group for diabetes are increasing worldwide, interest in prediabetes is also rising. However, few studies have addressed the development of type 2 diabetes and long working hours in prediabetes. Therefore, the aim of this longitudinal study was to evaluate the relationship between long working hours and the development of diabetes in prediabetes. Methods: We included 14,258 prediabetes participants with hemoglobinA1c (HbA1c) level of 5.7 to 6.4 in the Kangbuk Samsung Cohort Study. According to a self-reported questionnaire, we evaluated weekly working hours, which were categorized into 35-40, 41-52, and > 52 hours. Development of diabetes was defined as an HbA1c level ≥ 6.5%. Hazard ratios (HRs) and 95% confidence intervals (CIs) for the development of diabetes were estimated using Cox proportional hazards analyses with weekly working 35-40 hours as the reference. Results: During a median follow-up of 3.0 years, 776 participants developed diabetes (incidence density, 1.66 per 100 person-years). Multivariable-adjusted HRs of development of diabetes for weekly working > 52 hours compared with working 35-40 hours were 2.00 (95% CI: 1.50-2.67). In subgroup analyses by age (< 40 years old, ≥ 40 years old), sex (men, women), and household income (< 6 million KRW, ≥ 6 million KRW), consistent and significant positive associations were observed in all groups. Conclusions: In our large-scale longitudinal study, long working hours increases the risk of developing diabetes in prediabetes patients.

• Korean Circulation Journal
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• v.52 no.7
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• pp.529-540
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• 2022

Background and Objectives: Limited data are available regarding long-term clinical outcomes of iliac artery endovascular therapy (EVT) in real-world practice. This study investigated long-term outcomes according to Trans-Atlantic Inter-Society Consensus (TASC) classifications. Methods: We analyzed data from 1,705 limbs of 1,364 patients from the retrospective cohort of the multicenter Korean Vascular Intervention Society Endovascular Therapy in Lower Limb Artery Disease registry. The primary endpoint was target lesion revascularization (TLR)-free survival. Results: TASC A, B, C, and D lesions were present in 19.4%, 26.2%, 28.7%, and 25.7% of the treated limbs, respectively. The technical success rate was 96.2% and did not differ between TASC lesion types. Complications occurred in 6.8% of cases and more occurred in TASC D (11.8%). Iliac artery EVT showed a 5-year TLR-free survival of 89.2%. The TASC D group had the lowest TLR-free rate of 79.3%. TASC D (hazard ratio [HR], 1.75; 95% confidence interval [CI], 1.12-2.73; p=0.014), plain old balloon angioplasty (HR, 4.25; 95% CI, 2.03-8.88; p<0.001), current smoker (HR, 1.89; 95% CI, 1.26-2.83; p=0.002), previous bypass surgery (HR, 3.04; 95% CI, 1.28-7.19; p=0.011), combined femoropopliteal treatment (HR, 4.89; 95% CI, 3.19-7.50; p<0.001), combined below the knee treatment (HR, 2.20; 95% CI, 1.25-3.89; p=0.007), and complications (HR, 1.86; 95% CI, 1.07-3.24; p=0.028) were predictors for TLR. Conclusions: Iliac artery EVT achieved excellent technical success and 5-year TLR-free survival. TASC D showed a favorable but lower 5-year TLR-free survival rate and higher complication rate compared with other TASC groups.

• Korean Journal of Radiology
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• v.25 no.9
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• pp.824-832
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• 2024

Objective: To determine the preventive effect of changing gadolinium-based contrast agents (GBCAs) to reduce the recurrence of GBCA-associated acute adverse drug reactions (ADRs). Materials and Methods: This retrospective, observational, single-center study-conducted between January 2016 and December 2021-included 238743 consecutive GBCA-enhanced MRI examinations. We focused on a subgroup of patients who experienced acute GBCA-associated ADRs during any of these examinations and subsequently underwent follow-up GBCA-enhanced MRI examinations up until July 2023. The follow-up examinations involved either the same (non-change group) or different (change group) GBCAs compared to the ones that initially caused the acute ADR. Baseline participant characteristics, generic profile of the GBCAs, administration of premedication, history of prior ADR to iodinated contrast media, and symptoms of GBCA-associated acute ADRs were retrospectively analyzed. Multivariable logistic regression with generalized estimating equations and propensity score matching were used. Results: A total of 1042 instances of acute ADRs (0.44%; 95% confidence interval [CI]: 0.41%-0.46%) were reported. Three-hundred and seventy-three patients underwent GBCA-enhanced MRI examinations after experiencing GBCA-associated acute ADRs within the study period; 31.9% (119/373) reexperienced acute ADRs at any of the follow-up examinations. The ADR recurrence was significantly lower in the GBCA change group than in the non-change group according to multivariable logistic regression (adjusted odds ratio [OR]: 0.35; 95% CI: 0.13-0.90; P = 0.03) and analysis with propensity score matching (14.3% [6/42] vs. 36.9% [31/84], respectively; OR: 0.32, 95% CI: 0.11-0.94; P = 0.04). A history of an ADR to iodinated contrast media (OR: 1.14, 95% CI: 0.68-1.90; P = 0.62) and premedication (adjusted OR: 2.09, 95% CI: 0.93-4.68; P = 0.07) were not significantly associated with GBCA-associated acute ADR recurrence. A separate analysis for recurrent allergic-like hypersensitivity reactions demonstrated similar results (adjusted OR: 0.20, 95% CI: 0.06-0.65; P < 0.01). Conclusion: Changing GBCAs may reduce the risk of GBCA-associated acute ADR recurrence.

• The Korean Nurse
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• v.29 no.1
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• pp.59-71
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• 1990

Although the usefulness and importance of clinical application of nursing diagnosis are well recognized by the academic circle, it is not yet generally practiced. In order to provide data for establishing a policy for clinical nursing diagnosis; a study was made at a seminar, sponsored by the Department of nursing, Severance Hospital, with participation of 190 nurses from 33 hospitals. The objective of the study was to find out; 1) if the nurses agree with the academic community in recognizing the benefits and problems of clinical application of nursing diagnosis; 2) how the nurses evaluate their ability to carry out nursing diagnosis; and 3) if educational programs would help enhance ability of nursing diagnosis among nurses. The summary of findings by the study is as follows; 1. While all nurses responded positively on the question of benefits improving science and quality of nursing, thus elevating credibility and position of nurses, some expressed concern on the practicality of the system in setting up nursing objectiveness, confirming the nursing problems and utilizing patient information. For the 20 questions and the scale of 1~5, the lowest average score was 3.223 and the highest 4.066. 2. The study attempted to find out the opinion of the nurses on the problems that 'would make difficult to adopt the nursing diagnosis in clinics. The result of the study indicates the nurses believe the major problems are the fact that the subject of nursing diagnosis are not well defined and that the form sheets do not match with the ones that are currently being used. However, comparing it with the result of the previous study on the same question (inadequate manpower and insufficienf time allocated for the job were two major problems pointed out then.), it can be said that the opinion of the nurses studied this time was much more positive and it suggests that they believe the system can be adopted without increasing manpower and only by giving additional training and by adjusting the format of nursing record sheets. It suggests that the future for adopting a clinical nursing diagnosis is very bright. 3. As the most urgent problem to be solved for adopting clinical nursing diagnosis, 38. 5% responded that it was "education of nurses, "and 34.2% responded that it was "staffing adequate number of nurses". 4. For the 10 questions asked for self-evaluation of ability to adopt the system, with the scale of 1~5, average score was lower than 3. This indicate that they evaluate their ability to adopt the system is low. 5. The results of study taken before and after the educational programs for clinical nursing diagnosis were compared with overall score in order to determine if such program would cause changes in the response to the effect of clinical application of nursing diagnosis, and it was found that there was statistically significant changes suggesting that the education contributed to positive change in the response. 6. The results of study taken before and after the educational programs for clinical nursing diagnosis were compared with overall score in order to determine how the proble~ ms for adopting nursing system would be effected by such educational programs, and it was found that those problems be not soived with a short course of training. 7. The results of study taken before and after the educational programs for clinical nursing diagnosis were compared with overall score in order to determine if such programs would bring changes in the self-evaluation of nurses on the ability of nursing diagno sis, and it was found that program improve score of self-evaluation their ability of the nursing diagnosis. As seen in the above reports, it was found that the nu'rses are very positive about the clinical nursing diagnosis, that educational program for the clinical nursing diagnosis helps nurses for positively changing their attitude for ,the nursing diagnosis, for their self-confidence on their ability to perform nursing diagnosis. With improved know-how and self"confictence of nurses gained through educational and .training programs, the future of clinical application of nursing diagnosis is very bright.diagnosis is very bright.

• Geophysics and Geophysical Exploration
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• v.9 no.1
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• pp.60-66
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• 2006

Three differing sandstones, two synthetic and one field sample, have been tested ultrasonically under a range of confining pressures and pore pressures representative of in-situ reservoir pressures. These sandstones include: a synthetic sandstone with calcite intergranular cement produced using the CSIRO Calcite In-situ Precipitation Process (CIPS); a synthetic sandstone with silica intergranular cement; and a core sample from the Otway Basin Waarre Formation, Boggy Creek 1 well, from the target lithology for a trial $CO_2$ pilot project. Initial testing was carried on the cores at "room-dried" conditions, with confining pressures up to 65 MPa in steps of 5 MPa. All cores were then flooded with $CO_2$, initially in the gas phase at 6 MPa, $22^{\circ}C$, then with liquid-phase $CO_2$ at a temperature of $22^{\circ}C$ and pressures from 7 MPa to 17 MPa in steps of 5 MPa. Confining pressures varied from 10 MPa to 65 MPa. Ultrasonic waveforms for both P- and S-waves were recorded at each effective pressure increment. Velocity versus effective pressure responses were calculated from the experimental data for both P- and S-waves. Attenuations $(1/Q_p)$ were calculated from the waveform data using spectral ratio methods. Theoretical calculations of velocity as a function of effective pressure for each sandstone were made using the $CO_2$ pressure-density and $CO_2$ bulk modulus-pressure phase diagrams and Gassmann effective medium theory. Flooding the cores with gaseous phase $CO_2$ produced negligible change in velocity-effective stress relationships compared to the dry state (air saturated). Flooding with liquid-phase $CO_2$ at various pore pressures lowered velocities by approximately 8% on average compared to the air-saturated state. Attenuations increased with liquid-phase $CO_2$ flooding compared to the air-saturated case. Experimental data agreed with the Gassmann calculations at high effective pressures. The "critical" effective pressure, at which agreement with theory occurred, varied with sandstone type. Discrepancies are thought to be due to differing micro-crack populations in the microstructure of each sandstone type. The agreement with theory at high effective pressures is significant and gives some confidence in predicting seismic behaviour under field conditions when $CO_2$ is injected.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.23 no.1
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• pp.49-62
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• 2020

Purpose: We aimed to investigate the disease phenotype of Korean pediatric Crohn's disease (CD) patients at diagnosis according to the Paris classification by comparison with patients from the European multicenter 5-years recruitment of children with newly developed IBD (EUROKIDS registry). Methods: Korean children and adolescents who had been newly diagnosed with CD at the age of <18 years during 2013-2016 were included in this multicenter retrospective study. Disease phenotype at diagnosis was classified according to the Paris classification, and compared with the published data from the EUROKIDS study. Results: A total of 255 patients were included. The median diagnosis age was 14.7 years (range, 0.8-17.9 years). No significant difference was observed in male-to-female ratio with EUROKIDS (1.9:1 vs. 1.45:1, p=0.062). The proportion of children aged <10 years was significantly lower in Koreans (7.1% vs. 19.6%, p<0.001). Colonic disease was less prominent (10.0% vs. 27.3%, p<0.001), while upper GI involvement was more prominent in Korean children (59.3% vs. 46.2%, p<0.001). The proportion with perianal fistulizing disease at diagnosis was significantly higher in Korean patients (44.8% vs. 8.2%, p<0.001). A separate analysis of Korean patients revealed that perianal fistulizing disease at diagnosis was positively associated with male sex and body mass index z-score (odds ratio [OR]=2.12, 95% confidence interval [CI]=1.20-3.76, p=0.010; and OR=1.29, 95% CI=1.05-1.58, p=0.015, respectively). Conclusion: Approximately half of pediatric CD patients in Korea present with perianal fistulas and/or abscesses at diagnosis, which is a distinct feature of CD in Korean children and adolescents compared to their European counterparts. An underlying genetic difference between ethnicities may play a role in this expression of different phenotypes in pediatric CD.

• The Journal of Korean Orthopaedic Ultrasound Society
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• v.4 no.2
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• pp.77-83
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• 2011

Purpose: We compared with USG-guided steroid injection group and blind steroid injection group for the treatment of calcific tendinitis to evaluate the effectiveness of the treatment modalities. Materials and Methods: We reviewed two groups of calcific tendinitis treated with steroid injection and follow up upto 6 month after injection. Group I was blind injection for 88 patient with average age of 53years old and female gender in 77%. Group II was USG- guided injection for 102 patients with average age of 54years old and female gender in 85%. We compared follow up results according to age, gender, size of tendon involvement, initial VAS score, and phase of the calcific tendinitis between two groups. Results: At 6 month's follow up period, USG-guided injected group was more prevalent compared to blind injection group with 92%(94/102) and 72%(64/88) (P<0.05). In Group I, 77%(49/64) patients have improved symptom. And in Group II, 92%(86/94) patients have improved symptom in formative or resorptive phase. Despite of symptom improvement, calcium deposit is remained 47%(30/64) in Group I, and 20%(19/94) in Group II. Conclusion: Conservative treatment of Shoulder calcific tendinitis patients through USG-guided injection is more effective than Blind injection in pain relief & calcium decrease. The patients USG-guided injected group was more prevalent in follow up at outpatient clinic, throughout more accurate injection with improved confidence.

• The Korean Journal of Nuclear Medicine Technology
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• v.15 no.1
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• pp.58-64
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• 2011

Objective: The 3-dimensional reconstruction method with resolution recovery modeling has advantages of high spatial resolution and contrast because of its precise modeling of spatial blurring according to the distance from detector plane. The aim of this study was to evaluate one of the resolution recovery reconstruction methods (Astonish, Philips Medical), compare it to other iterative reconstructions, and verify its clinical usefulness. Materials and Methods: NEMA IEC PET body phantom and Flanges Jaszczak ECT phantom (Data Spectrum Corp., USA) studies were performed using Skylight SPECT (Philips) system under four different conditions; short or long (2 times of short) radius, and half or full (40 kcts/frame) acquisition counts. Astonish reconstruction method was compared with two other iterative reconstructions; MLEM and 3D-OSEM which vendor supplied. For quantitative analysis, the contrast ratios obtained from IEC phantom test were compared. Reconstruction parameters were determined by optimization study using graph of contrast ratio versus background variability. The qualitative comparison was performed with Jaszczak ECT phantom and human myocardial data. Results: The overall contrast ratio was higher with Astonish than the others. For the largest hot sphere of 37 mm diameter, Astonish showed about 27.1% and 17.4% higher contrast ratio than MLEM and 3D-OSEM, in short radius study. For long radius, Astonish showed about 40.5% and 32.6% higher contrast ratio than MLEM and 3D-OSEM. The effect of acquired counts was insignificant. In the qualitative studies with Jaszczak phantom and human myocardial data, Astonish showed the best image quality. Conclusion: In this study, we have found out that Astonish can provide more reliable clinical results by better image quality compared to other iterative reconstruction methods. Although further clinical studies are required, Astonish would be used in clinics with confidence for enhancement of images.

• Journal of the Korean Society of Food Science and Nutrition
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• v.46 no.7
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• pp.868-875
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• 2017

The aim of the present study was to investigate antioxidant nutrient intake and risk of metabolic syndrome based on stress level in rural Korean women. Subject were participants from the Multi-Rural Communities Cohort Study, which was a part of the Korean Genome and Epidemiology Study. According to scores of the Psychosocial Well-Being Index Short-Form, a total of 10,111 subjects were classified into 'low stress group (n=8,015)' from 0 to 26 points and 'high stress group (n=2,096)' above 27 points. Data were collected using self-administered questionnaires, anthropometric measurements, and blood chemical analysis. Dietary nutrient consumption was assessed by a semi-quantitative food frequency questionnaire. High stress group showed lower intake of antioxidant nutrients, such as vitamin A, vitamin C, vitamin E, folate, zinc, and carotene compared to the low stress group. Intake of fruits and vegetable was lower in the high stress group compared to the low stress group. Subjects with high stress showed higher risk of hypertension [odd ratio (OR), 95% confidence interval (CI)=1.226 (1.112~1.351)] and hypertriglyceridemia [OR, 95% CI=1.227 (1.110~1.356)] than subjects with low stress. High stress group had a significantly greater odds ratio for metabolic syndrome compared with the low stress group [OR, 95% CI=1.216 (1.101~1.342]). Thus, the present study suggests that high stress might be associated with low intake of antioxidant nutrients and high risk of metabolic syndrome in rural Korean women.

• Journal of Gynecologic Oncology
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• v.29 no.6
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• pp.100.1-100.13
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• 2018

Objective: To investigate survival outcomes in endometrioid endometrial cancer (EEC) patients with single vs. multiple positive pelvic lymph nodes. Methods: We performed a retrospective evaluation of all consecutive patients with histologically proven International Federation of Gynecology and Obstetrics (FIGO) stage IIIC1 EEC who underwent primary surgical treatment between 2004 and 2014 at seven Italian gynecologic oncology referral centers. Patients with pre- or intra-operative evidence of extra-uterine disease (including the presence of bulky nodes) and patients with stage IIIC2 disease were excluded, in order to obtain a homogeneous population. Results: Overall 140 patients met the inclusion criteria. The presence of >1 metastatic pelvic node was significantly associated with an increased risk of recurrence and mortality, compared to only 1 metastatic node, at both univariate (recurrence: hazard ratio [HR]=2.19; 95% confidence interval [CI]=1.2-3.99; p=0.01; mortality: HR=2.8; 95% CI=1.24-6.29; p=0.01) and multivariable analysis (recurrence: HR=1.91; 95% CI=1.02-3.56; p=0.04; mortality: HR=2.62; 95% CI=1.13-6.05; p=0.02) and it was the only independent predictor of prognosis in this subset of patients. Disease-free survival (DFS) and disease-specific survival (DSS) were significantly longer in patients with only 1 metastatic node compared to those with more than 1 metastatic node (p=0.008 and 0.009, respectively). Conclusion: The presence of multiple metastatic nodes in stage IIIC1 EEC represents an independent predictor of worse survival, compared to only one positive node. Our data suggest that EEC patients may be categorized according to the number of positive nodes.