• The Korean Journal of Pain
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• v.34 no.4
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• pp.454-462
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• 2021

Background: This study was performed to reveal the relationships between the cross-sectional areas (CSAs) of the paraspinal muscles and the severity of low back pain (LBP), including the level of disability. Methods: This single-center cross-sectional study was conducted on 164 patients with chronic LBP. The effects of demographic characteristics, posture, level of physical activity, disc herniation type, and sarcopenia risk on the CSAs of paraspinal muscles were evaluated along with the relationship between the CSAs and severity of pain and disability in all patients. The CSAs of paraspinal muscles were evaluated using the software program Image J 1.53. Results: A negative significant correlation was found between age and the paraspinal muscle's CSA (P < 0.05), whereas a positive correlation was present between the level of physical activity and the CSA of the paraspinal muscle at the L2-3 and L3-4 levels. The CSAs of paraspinal muscles in patients with sarcopenia risk was significantly lower than those in patients without sarcopenia risk (P < 0.05). The CSAs of paraspinal muscles at the L2-3 and L3-4 levels in obese patients were significantly higher than those in overweight patients (P = 0.028, P = 0.026, respectively). There was no relationship between the CSAs of paraspinal muscles and pain intensity or disability. Conclusions: Although this study did not find a relationship between paraspinal CSAs and pain or disability, treatment regimens for preventing paraspinal muscles from atrophy may aid pain physicians in relieving pain, restoring function, and preventing recurrence in patients with chronic LBP.

• Journal of The Korean Society of Clinical Toxicology
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• v.17 no.1
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• pp.7-13
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• 2019

Purpose: Owing to the increased agricultural use of the herbicide glufosinate ammonium (GLA), the incidence of GLA poisoning has recently increased. Therefore, we investigated the possible predictive factors associated with severe complications following GLA poisoning. Methods: A retrospective analysis of medical records was conducted based on 76 patients who had visited our regional emergency medical center with GLA poisoning from 2006 to 2017. Severe complications were defined as respiratory failure requiring intubation, systolic blood pressure less than 90 mmHg, Glasgow Coma Scale (GCS) less than 8, and presence of seizure. Results: Age, ingested amount and ingested amount per weight were significantly greater in the severe group (p<0.001). PSS grade 2 or higher was more common in the severe group (p<0.001), and In addition, the APACHE II score was significantly higher in the severe group (p<0.001), as were the SOFA scores (p=0.002). Serum ammonia levels were significantly higher in the severe group (p=0.007), while MDRD-GFR was smaller in the severe group (p=0.002). The spot urine protein levels were significantly higher in the severe group (p=0.005), as was the urine protein to creatinine ratio (p=0.001). Upon multivariate analysis, the amount ingested per weight and PSS grade 2 or higher were identified as significant predictors. Conclusion: Our study showed that MDRD-GFR was significantly lower in the severe group after GLA poisoning. PSS grade 2 or higher and ingested amount per weight may be useful to evaluate the severity of complications after GLA poisoning.

• Clinics in Orthopedic Surgery
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• v.10 no.4
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• pp.433-438
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• 2018

Background: Cervical foraminal stenosis (CFS) is one of the degenerative changes of the cervical spine; however, correlations between the severity of stenosis and that of symptoms are not consistent in the literature. Studies to date on the prevalence of stenosis are based on images obtained from the departments treating cervical lesions, and thus patient selection bias may have occurred. The purpose of this study was to investigate the prevalence of CFS according to the site, extent, and morphology of stenosis using cervical computed tomography (CT) images obtained from patients who were visiting not because of symptoms related to the cervical spine, cervical pain, or upper limb pain. Methods: Among patients who underwent CT from January 2016 to March 2016 for reasons other than cervical spine symptoms, a total of 438 subjects were enrolled, and 2,628 cervical disc images (C4-5, C5-6, and C6-7; left and right sides) were examined. Three orthopedic surgeons performed two measurements each at 4-week intervals. Values were used for analysis if matched by more than two surgeons; if no match was found, the median values were used for analysis. The left and right sides on the same axial image were independently classified. Results: Left C5-6 stenosis was most common (24.66%) among patients. At the left C6-7, there were 20 focal types and 33 diffuse types. At bilateral C4-5 and right C6-7, the focal type was more common, whereas at bilateral C5-6 and left C6-7, the diffuse type was more common. Age and the severity of stenosis showed statistically significant correlation at all cervical levels. Conclusions: The prevalence of CFS was highest at the C5-6 level (19.06%). Compared to other levels, focal stenosis was more frequent at C4-5 and diffuse stenosis was more common at C5-6. At C6-7, the incidence of focal stenosis was higher on the right side and that of diffuse stenosis was higher on the left side.

• Annals of Occupational and Environmental Medicine
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• v.35
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• pp.32.1-32.10
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• 2023

Background: Although many studies have been conducted on worker fatigue and sickness absence, the association between fatigue and sickness absence is unclear in Korean workers. This study was conducted to investigate the effect of worker fatigue on future sickness absence. Methods: The study was conducted on workers who received medical check-ups at a university hospital for two consecutive years (2014-2015). During check-ups in the first year, the Fatigue Severity Scale (FSS) was used to assess fatigue levels, and during check-ups in the second year, sickness absence was surveyed to determine whether they had been absent from work due to physical or mental illness during previous 12 months. The χ² test was used to analyze relationships between sociodemographic and occupational characteristics, fatigue levels, and sickness absence. Odds ratios (ORs) were calculated by logistic regression analysis controlled for confounding factors. Results: A total of 12,250 workers were included in the study, and 396 (3.2%) workers experienced more than one day of sickness absence during the study period. Adjusted ORs for sickness absence were 3.35 (95% confidence interval [CI]: 2.64-4.28) in the moderate-fatigue group and 6.87 (95% CI: 4.93-9.57) in the high-fatigue group versus the low-fatigue group. For men in the moderate- and high-fatigue groups, adjusted ORs for sickness absence were 3.40 (95% CI: 2.58-4.48) and 8.94 (95% CI: 6.12-13.07), and for women in the moderate- and high-fatigue groups, adjusted ORs for sickness absence were 2.93 (95% CI: 1.68-5.10) and 3.71 (95% CI: 1.84-7.49), respectively. Conclusions: Worker fatigue is associated with sickness absence during the following 12 months, and this association appears to be stronger for men than women. These results support the notion that sickness absence can be reduced by evaluating and managing work-related fatigue.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.2
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• pp.613-619
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• 2015

Background: Hepatocellular carcinoma (HCC) is the commonest primary malignant cancer of the liver in the world. Insulin-like growth factor-1 (IGF-1) levels reflect hepatic function and are inversely correlated with the severity of background chronic liver disease. Objective: This study evaluated whether basal serum IGF-1 levels can predict prognosis of HCC patients according to different risks of disease progression. Materials and Methods: A total of 89 patients with hepatocellular carcinoma (HCC) were recruited in 3 groups: Group I, 30 HCC patients receiving sorafinib; Group II, 30 HCC patients with best supportive care; and Group III include 29 patients undergoing transcatheter arterial chemoembolization (TACE). All patients were investigated for serum levels of AST, ALP, Bb, Cr, BUN, AFP and IGF-I. Results: Patients with disease control had significantly higher baseline IGF-1 levels 210 (185-232.5) ng/mL (p value<0.01) than did patients without disease control. Low basal IGF-1 levels were associated with advanced HCC, such as multiple tumors and advanced stage, and low IGF-1 levels predicted shorter TTP and overall survival in patients treated with TACE. Conclusions: The levels of serum IGF-1, expressed as continuous values, may be helpful for accurately assessing hepatic function and the prognostic stratification of patients with HCC.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.21 no.4
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• pp.321-328
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• 2018

Purpose: Feeding children is a problem in pediatric intensive care units (PICU) and it is difficult to know the correct amount. The purpose of this study is to evaluate if prealbumin or retinol binding proteins (RBP) are effective relative to daily enteral nutrition, without being affected by severity of diseases or infections and can be used to follow up nutritional amount. Methods: This is a prospective observational study that includes 81 patients admitted to PICU in Akdeniz University with estimated duration >72 hours, age between 1 month and 8 years. Daily calorie and protein intake were calculated and prealbumin, RBP and C-reactive protein (CRP) levels were measured on the first, third, fifth and seventh mornings. Results: We find moderate correlation between daily calorie intake and prealbumin levels (r=0.432, p<0.001), RBP levels and daily protein intake (r=0.330, p<0.001). When we investigated the relationship between changes of prealbumin, RBP, CRP, calorie and protein intake during intensive care stay, we found that increase of Prealbumin and RBP levels are explained by decrease of CRP levels (r=-0.546 and -0.645, p<0.001) and not with increase of nourishment. Conclusion: Even adjusted for PRISM3, age and CRP, prealbumin and RBP are correlated with last 24 hours' diet. However, it is not convenient to use as a follow up biomarker because increase of their levels is related with decrease of CRP levels.

• Journal of Preventive Medicine and Public Health
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• v.51 no.3
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• pp.163-168
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• 2018

Objectives: Due to their developmental characteristics, adolescents have a higher probability than other age groups of experiencing injuries caused by accidents, violence, and intentional self-harm. The severity and characteristics of injuries vary by the intentionality and mechanism of injury; therefore, there is a need for a national-level estimate of the scale and the severity of injuries in adolescents that takes these factors into account. Methods: By using data from the Emergency Department-based Injury In-depth Surveillance Data, National Emergency Department Information System, the Korean National Hospital Discharge In-depth Injury Survey, and cause of death statistics, we calculated the emergency department (ED) visit rate, hospitalization rate, and death rate of injuries per 100 000 adolescents for each injury mechanism. The calculated rates were used to generate the injury pyramid ratio (ratio of death rate to hospitalization rate to ED visit rate) to visualize the scale and the severity of the injury. Results: The mortality rate in adolescents due to injury was 10/100 000; the corresponding rates for hospitalization and ED visits were 1623 and 4923, respectively, resulting in an injury pyramid ratio with the general pyramid form, with a 1:162:492 ratio of deaths to hospitalizations to ED visits. The mortality rate due to suicide/intentional self-harm was 5/100 000, while 35 were hospitalized for this reason and 74 made ED visits. The pyramid ratio of 1:7:15 for intentional self-harm/suicide showed a steep pyramidal form, indicating considerable lethality. The mortality rate due to motor vehicle collisions (MVCs) was 3/100 000; 586 were hospitalized for this reason, while 1023 made ED visits. The pyramid ratio of 1:195:341 for MVCs showed a gradual pyramid form, indicating that the lethality was low and the scale of injury was high. Conclusions: The main categories of injuries in adolescents were visualized in pyramid form, contributing to an understanding of the scale of each injury by mechanism in terms of levels of death, hospitalization, and ED visits. These findings will be helpful for understanding how to prioritize injuries in adolescents.

• Journal of Oriental Neuropsychiatry
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• v.28 no.2
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• pp.49-59
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• 2017

Objectives: To measure the quality of life in patients according to virtual cerebral palsy severity by using the Korean version of EQ-5D-Y proxy, Visual Analogue Scale (VAS), and Time Trade-Off method (TTO). Methods: The study was conducted in parents of children and adolescents aged 4 to 15 years in Seoul. We analyzed the difference in the utility value according to five levels of cerebral palsy severity in the Gross Motor Function Classification System (GMFCS) and test-retest reliability. Results: 1. There were significant differences in VAS, TTO, and EQ-5D-Y proxy according to the cerebral palsy severity (p<.001). 2. VAS was significantly different according to the respondent's visit to the medical institution, the presence of disease in the respondent, a visit to the child's medical institution, the age of the child, and the sex of the child. The value of TTO was significantly different according to the respondent's visit to the medical institution, respondent's sex, and the age of the child. Also, EQ-5D-Y proxy was significantly different according to the age of the child. 3. Intraclass correlation coefficient values were more than 0.6 for both VAS and TTO at all stages. But for the EQ-5D-Y proxy, the value was less than 0.6 at all stages. Conclusions: The quality of life assessment using EQ-5D-Y proxy showed significant differences in the severity of cerebral palsy. However, large-scale studies using EQ-5D-Y proxy are needed because of low test-retest reliability.

• Korean Journal of Psychosomatic Medicine
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• v.26 no.2
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• pp.194-200
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• 2018

Objectives : The significance of leukoaraiosis on brain magnetic resonance imaging (MRI) is uncertain, but it is often seen with vascular risk factors or in the context of cognitive impairment. We aimed to investigate the effect of leukoaraiosis on the severity and course of delirium. Methods : Periventricular hyperintensity and deep white matter hyperintensity on brain MRI were rated in 42 patients with delirium by semiquantative visual rating scale. Correlations between their grades and the scores of Korean version of Delirium Rating Scale-Revised-98 (K-DRS-R-98) were analyzed, and the interaction effects between the groups according to the levels of leukoaraiosis and two evaluation points were also analyzed. Results : The grade of deep white matter hyperintensity in the occipital lobe was positively correlated with the scores on the total, severity items, cognitive items, and non-cognitive items of K-DRS-R-98. The cognitive items scores of K-DRS-R-98 in the low grade group of periventricular hyperintensity showed significantly steeper decrease than the high grade group. Conclusions : A difference in severity or recovery speed of delirium according to the level of leukoaraiosis may result from disruption in brain functional connectivity. Our results have a clinical implication in that the severity and course of delirium can be possibly predicted using the level of leukoaraiosis.

• Therapeutic Science for Rehabilitation
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• v.11 no.2
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• pp.63-76
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• 2022

Objective : The purpose of this study is to examine the relationship with employment of the disabled considering the severity and the type of disability. Methods : Data from the 4th data of the 2nd wave Panel Survey of Employment for the Disabled (PSED) by Korea Employment Agency for Persons with Disabilities (KEAD) were used. The odds ratio of employment in disability types according to severity of disability was calculated by logistic regression analysis. Results : When the related variables were adjusted, the employment of internal disability type was significantly lower than that of external disability type by 0.413(95% CI:0.271-0.629) times in the group with severe disability. On the other hand, in the group with less severe disability, internal disability was 0.475(95% CI:0.327-0.690) times lower than that of external disability (p=<.001). Conclusions : Employment may vary depending on the type of disability, even if the disability severity level is the same. It is necessary to prepare judgment criteria that can reduce the variation in employment by considering both the type and severity of the disability.