• 한국산학기술학회논문지
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• 제11권6호
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• pp.2118-2123
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• 2010

국내의 경우 방사선작업종사자의 개인피폭관리는 선량한도를 초과한 피폭의 유무를 확인하여 사후 조치를 취하는 것에 초점이 맞추어져 있다. 그러나 의료기관 핵의학과의 경우 개봉선원을 사용하므로 작업환경이 방사선에 노출될 가능성이 많고, 방사성의약품 투여 후 수 시간 혹은 수 일 동안은 환자 자체가 방사선원이 되므로 방사선작업종사자나 수시출입자, 환자보호자들의 방사선 피폭 가능성이 매우 높다. 따라서 환자보호자 등 일반출입자의 방사선피폭을 방지하기 위해서는 환경방사선관리가 적절하게 실시되어야 한다. 일본에서는 "방사성동위원소등에 의한 방사선장해의 방지에 관한 법률" 등에 근거하여 방사선작업환경에 대한 환경방사선량을 정기적으로 측정, 보관하도록 하고 있다. 이에 대전시 소재 대학병원 핵의학과에서 일본에서 시행하고 있는 것과 같은 방법으로 핵의학과 내 8개소에 유리선량계를 설치하여 환경방사선을 측정한 결과 8개소 모두 "진단용 방사선 발생장치의 안전관리에 관한 규칙"에 규정된 방사선구역의 외부방사선량인 주당 0.3 mSv에는 훨씬 미치지 못하는 적은 선량이 측정되었다. 그러나 접수대에서는 3개월 누계 선량률이 0.51 mSv로서 접수대 종사자는 일반인 연간 유효선량한도인 1 mSv를 초과할 가능성이 높았으며, 환자 및 보호자 대기실에서도 0.23 mSv(3개월 누계치 0.69mSv)가 측정되어 유리선량계를 설치한 8개소 가운데 가장 높은 선량률을 보였다. 이것은 일반인의 연간 유효선량한도인 1 mSv를 초과하는 값이며, "방사선방호 등에 관한 기준 고시"에 환경상 위해방지를 위해 규정된 연간 유효선량 0.25 mSv를 초과하는 값이다. 따라서 접수대 근무자, 환자보호자 및 제3자 보호를 위해 핵의학과 내 환경방사선량 감소를 위한 적극적인 대책이 필요한 것으로 나타났다.

• Asian Pacific Journal of Cancer Prevention
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• 제15권7호
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• pp.3035-3039
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• 2014

Background: Lung cancer is one of the most prevalent malignancies in the world and both incidence and mortality rates are continuing to rise in Pakistan. However, epidemiological studies to identify common lung cancer determinants in the Pakistani population have been limited. Materials and Methods: In this retrospective case-control study, 400 cases and 800 controls were enrolled from different hospitals of all provinces of Pakistan. Information about socio-demographic, occupational, lifestyle and dietary variables was extracted by questionnaire from all subjects. Odd ratios (ORs) and 95% confidence intervals (CIs) were calculated. and dose-response associations were also assessed for suitable factors. Results: Strong associations were observed for smoking (OR=9.4, 95%CI=6.9-12.8), pesticide exposure (OR=5.1, 95%CI=3.1-8.3), exposure to diesel exhaust (OR=3.1, 95%CI=2.1-4.5), red meat consumption (OR=2.9, 95%CI=1.8-4.7) and chicken consumption (OR=2.8, 95%CI=1.7-49). Other associated factors observed were welding fumes (OR=2.5, 95%CI=1.0-6.5), sedentary living (OR=2.0, 95%CI=1.6-2.6), family history (OR=2.0, 95%CI=0.8-4.9), wood dust (OR=1.9, 95%CI=1.2-3.1), tea consumption (OR=1.8, 95%CI=1.2-2.6), coffee consumption (OR=1.8, 95%CI=1.1-2.8), alcoholism (OR=1.7, 95%CI=1.1-2.5) and asbestos exposure(OR=1.5, 95%CI=0.5-4.4). Consumption of vegetables (OR=0.3, 95%CI=0.2-0.4), juices (OR=0.3, 95%CI=0.3-0.4), fruits (OR=0.7, 95%CI=0.5-0.9) and milk (OR=0.6, 95%CI=0.5-0.8) showed reduction in risk of lung cancer. Strongest dose-response relationships were observed for smoking ($X^2=333.8$, $p{\leq}0.0000001$), pesticide exposure ($X^2=50.9$, $p{\leq}0.0000001$) and exposure to diesel exhaust ($X^2=51.8$, $p{\leq}0.0000001$). Conclusions: Smoking, pesticide exposure, diesel exhaust and meat consumption are main lung cancer determinants in Pakistan. Consuming vegetables, fruits, milk and juices can reduce the risk of lung cancer risk, as in other countries.

• Asian Pacific Journal of Cancer Prevention
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• 제16권11호
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• pp.4699-4704
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• 2015

Medical diagnostic X-ray workers are one occupational group that expose to the long-term low-dose external radiation over their working lifetime, and they may under risk of different cancers. This study aims to determine the relationship between the occupational X-ray radiation exposure and cancer risk among these workers in Jiangsu, China. We conducted Nested case-control study to investigate the occupational X-ray radiation exposure and cancer risk. Data were collected through self-administered questionnaire, which includes but not limits to demographic data, personal behaviors and family history of cancer. Retrospective dose reconstruction was conducted to estimate the cumulative doses of the x-ray workers. Inferential statistics, t-test and 2 tests were used to compare the differences between each group. We used the logistic regression model to calculate the odds ratio (OR) and 95% confidence interval (CI) of cancer by adjusting the age, gender. All 34 breast cancer cases and 45 esophageal cancer cases that detected in a cohort conducted among health workers between 1950~2011 were included in this presented study, and 158 cancer-free controls were selected by frequency-matched (1:2). Our study found that the occupational radiation exposure was associated with a significantly increased cancer risk compared with the control, especially in breast cancer and esophageal cancer (adjusted OR=2.90, 95% CI: 1.19-7.04 for breast cancer; OR=4.19, 95% CI: 1.87-9.38 for esophageal cancer, and OR=3.43, 95% CI: 1.92-6.12 for total cancer, respectively). The occupational X-ray radiation exposure was associated with increasing cancer risk, which indicates that proper intervention and prevention strategies may be needed in order to bring down the occupational cancer risk.

• Journal of Preventive Medicine and Public Health
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• 제51권4호
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• pp.205-212
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• 2018

Objectives: The main purpose of this study was to quantify the risk of mortality linked to various regimens of hypertonic peritoneal dialysis (PD) solution. Methods: A retrospective cohort study of patients using home-based PD was carried out. The prescribed regimen of glucose-based PD solution for all patients, determined on the basis of their individual conditions, was extracted from their medical chart records. The primary outcome was death. The treatment regimens were categorized into 3 groups according to the type of PD solution used: original PD (1.5% glucose), shuffle PD (1.5 and 2.5% glucose), and serialized PD (2.5 and 4.5% glucose). Multivariate analysis (using the Weibull model) was applied to comprehensively examine survival probabilities related to the explanatory variable, while adjusting for other potential confounders. Results: Of 300 consecutive patients, 38% died over a median follow-up time of 30 months (interquartile range: 15-46 months). Multivariate analysis showed that a treatment regimen with continued higher-strength PD solution (serialized PD) resulted in a lower survival rate than when the conventional strength solution was used (adjusted hazard ratio, 2.6; 95% confidence interval, 1.6 to 4.6, p<0.01). Five interrelated risk factors (age, length of time on PD, hemoglobin levels, albumin levels, and oliguria) were significant predictors contributing to the outcome. Conclusions: Frequent exposure to high levels of glucose PD solution significantly contributed to a 2-fold higher rate of death, especially when hypertonic glucose was prescribed continuously.

• Journal of Acupuncture Research
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• 제31권4호
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• pp.71-79
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• 2014

Objectives : The aim of this study is to evaluate the safety of acupuncture therapy when applied to patients who are undergoing anticoagulants / antiplatelet medication therapy combined with herbal medicine using a retrospective, case-control study. Methods : 428 charts of patients were reviewed in this study. Odds ratio between case of bleeding-related adverse event and control was calculated as main analysis. Exposures were anticoagulants / antiplatelet medication, Hwalhyeolgeoeo herbal medicine and combination of both drugs. Additionally, odds ratios were calculated according to the severity of bleeding-related adverse events. Results : The results were as following: 1. Analysis of all bleeding-related adverse events showed there was no increased risk of combined therapy compared with other exposures and control group. 2. Analysis of only clinically significant adverse events showed there was no increased risk of combined therapy compared with other exposure and control group. 3. Hwalhyeolgeoeo herbal medicine group showed a tendency of increased risk of bleeding-related adverse events in all analysis but was not statistically significant. Conclusions : The results suggest that Hwalhyeolgeoeo herbal medicine-anticoagulant / antiplatelet medication combined therapy may not increase risk of bleeding-related adverse events in acupuncture therapy. By executing various modules of analysis, it was possible to acquire useful data for possible future studies. Further research is needed to confirm such results.

• 한국환경보건학회지
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• 제38권4호
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• pp.277-290
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• 2012

Objectives: Diesel engine exhaust (DE) accounts for a significant percentage of air pollutants that are associated with various health outcomes including mortality, asthma, chronic bronchitis, respiratory tract infection, etc. In June, 2012, the International Agency for Research on Cancer (IARC) released the assessment results that classified DE as "carcinogenic to humans" (Group 1). This review is therefore focused on the lung cancer risks of DE. Methods: Literatures were searched using PubMed with key words of "diesel exhaust", "lung cancer", and other related terms for the period between 1990 and 2012. A total of 295 articles were searched and sixteen epidemiologic studies were identified as potentially relevant. Results: Sixteen epidemiologic studies about the lung cancer risks of workers exposed to DE in various occupations were summarized in two tables, 1) retrospective cohort studies and 2) case-control studies. Increased lung cancer risk, although not always smoking adjusted, was observed in 6 out of 8 retrospective cohort studies and 4 of 8 case-control studies. Conclusions: Diesel fuel is widely used in Korea. Exposure to DE is confirmed to be a human carcinogen by IARC. Noncancer health risks of DE also need careful attention as DE is a major source of fine-particle pollution. Along with the efforts for reducing the DE emission through improvements of diesel engines and fuel, and the use of alternative fuels, comprehensive health risk assessment of DE should be conducted to minimize the adverse health effects.

• Journal of Periodontal and Implant Science
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• 제45권3호
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• pp.82-93
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• 2015

Purpose: This retrospective study evaluated the relationship between the timing of peri-implantitis diagnosis and marginal bone level after a 5-year follow-up of non-surgical peri-implantitis treatment. Methods: Thirty-three patients (69 implants) were given peri-implantitis diagnosis in 2008-2009 in Seoul National University Bundang Hospital. Among them, 31 implants from 16 patients were included in this study. They were treated non-surgically in this hospital, and came for regular maintenance visits for at least 5 years after peri-implantitis treatment. Radiographic marginal bone levels at each interval were measured and statistical analysis was performed. Results: Timing of peri-implantitis was one of the significant factors affecting initial bone loss and total bone loss not additional bone after peri-implantitis diagnosis. Patients with cardiovascular disease and diabetic mellitus were positively influenced on both initial bone loss and total bone loss. Patients who needed periodontal treatment after implant placement showed a negative effect on bone loss compared to those who needed periodontal treatment before implant placement during entire periods. Implant location also significantly influenced on amounts of bone loss. Mandibular implants showed less bone loss than maxillary implants. Among surgical factors, combined use of autogenous and xenogenic bone graft materials showed a negative effect on bone loss compared to autogenous bone graft materials. Use of membrane negatively affected on initial bone loss but positively on additional bone loss and total bone loss. Thread exposure showed positive effects on initial bone loss and total bone loss. Conclusions: Early peri-implantitis diagnosis led to early non-surgical intervention for peri-implantitis treatment, which resulted in the maintenance of the bone level as well as preservation of the implant.

• Journal of Korean Biological Nursing Science
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• 제25권4호
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• pp.285-294
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• 2023

Purpose: This study aimed to identify the colonization rate of carbapenem-resistant Enterobacteriaceae (CRE), the characteristics of CRE isolates, and risk factors for CRE colonization in patients transferred to the general wards of a small/medium-sized hospital. Methods: This retrospective study was conducted on patients who underwent CRE culture tests within 24 hours of admission among patients transferred to a small/medium-sized hospital. Forty-seven patients confirmed as positive for CRE were classified as belonging to the patient group. For the control group, 235 patients (five times the number of the patient group) were matched by sex, age, and diagnosis, and then selected at random. Data were analyzed using descriptive analysis and multiple logistic regression analysis. Results: The CRE colonization rate was 5% (47 out of 933 patients), and Klebsiella pneumoniae (68.0%) was the most common isolate of CRE. The positivity rate of carbapenemase-producing Enterobacteriaceae was 61.7%. The risk factors for CRE colonization included renal disease (odds ratio [OR]=4.93; 95% confidence interval [CI], 1.49-16.31), heart disease (OR=3.86; 95% CI, 1.35-11.01), indwelling urinary catheters (OR=4.43; 95% CI, 1.59-12.36), and cephalosporin antibiotic use (OR=8.57; 95% CI, 1.23-59.60). Conclusion: Having a comorbid renal or cardiac disease, an indwelling urinary catheter, or a history of exposure to cephalosporin antibiotics could be classified as risk factors for CRE colonization in patients transferred to small and medium-size hospitals. It is necessary to perform active infection control through proactive CRE culture testing of patients with risk factors.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제42권
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• pp.10.1-10.9
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• 2020

Background: The aim of this study was to evaluate the long-term clinical stability of implants with acid-etched surfaces sandblasted with alumina using retrospective analyses of the survival rate, success rate, primary and secondary stability, complications, and marginal bone loss of the implants. Methods: Patients who had implants placed (TS III SA, SS II SA, SS III SA, and U III SA) with SA surfaces from Osstem (Osstem Implant Co., Busan, Korea) at the Seoul National University Bundang Hospital, from January 2008 to December 2010 were selected for the study. Patients' medical records and radiographs (panorama, periapical view) were retrospectively analyzed to investigate sex, age, location of implantation, diameter, and length of the implants, initial and secondary stability, presence of bone grafting, types of bone grafting and membranes, early and delayed complications, marginal bone loss, and implant survival rate. Results: Ninety-six implants were placed in 45 patients. Five implants were removed during the follow-up period for a total survival rate of 94.8%. There were 14 cases of complications, including 6 cases of early complications and 8 cases of delayed complications. All five implants that failed to survive were included in the early complications. The survival of implants was significantly associated with the occurrence of complications and the absorption of bone greater than 1 mm within 1 year after prosthetic completion. In addition, the absorption of bone greater than 1 mm within 1 year after prosthetic completion was significantly associated with the occurrence of complications, primary stability, and implant placement method. Five cases that failed to survive were all included in the early complications criteria such as infection, failure of initial osseointegration, and early exposure of the fixture. Conclusions: Of the 96 cases, 5 implants failed resulting in a 94.8% survival rate. The failed implants were all cases of early complications such as infection, failure of initial osseointegration, and early exposure of the fixtures. Periimplantitis was mostly addressed through conservative and/or surgical treatment and resulted in very low prosthetic complications. Therefore, if preventive measures are taken to minimize initial complications, the results can be very stable.

• 대한임상독성학회지
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• 제4권1호
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• pp.32-43
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• 2006

Purpose: Toxic Exposure Surveillance System (TESS) is widely used for poisoning data collection and making a counterplan. But, there were few reports about poisoning data collection using TESS in Korea. The aim was to collect poisoning data using TESS report form and investigate the recognition of emergency physician about the necessity of TESS as preliminary survey. Methods: Retrospectively, we gathered data from hospital records about the patient who admitted hospital emergency room due to poisoning. Date were gathered by paper and/or web client system report form in patients recruited by ICD-10 codes Results: From Jun 2004 to May 2005,3,203 patients were enrolled in 30 hospitals and their mean age was $44.9{\pm}20.3years$ old(male: female = 1,565: 1,638). The most frequent site of exposure was their own residence (73.2%, 2,345/3,203) and most of reported patients were older than 20 years(89.7%, 2,871/3,203). Frequent substances involved in poisoning were medication(41.9%) and pesticide(33.3%). Intentional poisoning was 60.7%(1,954). In fatality, overall frequency was 5.1%(162/3,203) and the most frequent route of exposure was ingestion(96.3%, 156/162) and the most frequent substance was pesticide(85.2%, 138/ 162). Antidotes were administered in 202 patients(2-PAM, atropine, antivenin, N-acetylcystein, vitamin K, flumazenil, ethanol, methylene blue, naloxone, calcium compound). 19 of 20 emergency physicians agreed with necessity of TESS. Conclusion: Data collection using TESS report form showed preliminary poisoning events in Korea. Frequent poisoning substance were medication and pesticide. The fatality was mainly related with pesticide ingestion. Many doctors in emergency room recognized the necessity of TESS.