• Journal of Korean Society of Occupational and Environmental Hygiene
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• v.29 no.1
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• pp.57-68
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• 2019

Objective: The purpose of this study is to propose the benefits of reduction measures according to the occupational radon reference level in order to present basic data for radon management guidelines considering domestic circumstances. Methods: This study uses radon data measured in the subway stations from 2015 to 2016. Of the total of 4,643 cases, 4,231 cases were analyzed excluding the 412 cases where the values were below $300Bq/m^3$. Results: Cost-Benefit analysis was done on the results of the field survey on subway work sites. At the exposure level of $400Bq/m^3$, the ratio between the cost and the benefit was highest at 1 : 1.81(the cost was KRW 1,398,568,032, while the benefit KRW 2,5248,772,841). At the exposure level of $600Bq/m^3$, the ratio of cost and benefit was 1: 1.80, at $300Bq/m^3$ it was 1.72, at $800Bq/m^3$ it was 1.71, at $200Bq/m^3$ it was 1.54, and at $100Bq/m^3$ it was 1.40. Conclusions: Radon management in the workplace provides economic benefits and appropriate reduction strategies are needed. In addition, it is necessary to establish and distribute radon exposure assessment procedures and guidelines for the safety and health of employees when exceeding the exposure standard, and guidelines for radon management in the workplace should be established.

• Journal of Preventive Medicine and Public Health
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• v.52 no.3
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• pp.161-169
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• 2019

Objectives: The objective of the present study was to validate a shortened transformational leadership (TL) scale (12 items) comprising core TL behaviour and to test the associations of this shortened TL scale with depressive symptoms. Methods: The study used cross-sectional data from 1632 employees of the overall workforce of a middle-sized German company (51.6% men; mean age, 41.35 years; standard deviation, 9.4 years). TL was assessed with the German version of the Transformational Leadership Inventory and depressive symptoms with the Hospital Anxiety and Depression Scale (HADS). The structural validity of the core TL scale was assessed with confirmatory factor analysis. Associations with depressive symptoms were estimated with structural equation modelling and adjusted logistic regression. Results: Confirmatory factor analysis and structural equation modelling showed better model fit for the core TL than for the full TL score. Logistic regression revealed 3.61-fold (95% confidence interval [CI], 2.20 to 5.93: women) to 4.46-fold (95% CI, 2.86 to 6.95: men) increased odds of reporting depressive symptoms (HADS score >8) for those in the lowest tertile of reported core TL. Conclusions: The shortened core TL seems to be a valid instrument for research and training purposes in the context of TL and depressive symptoms in employees. Of particular note, men reporting poor TL were more likely to report depressive symptoms.

• Journal of Gastric Cancer
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• v.19 no.2
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• pp.212-224
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• 2019

Purpose: Splenic hilar lymph node dissection (LND) during total gastrectomy is regarded as the standard treatment for proximal advanced gastric cancer (AGC). This study aimed to investigate whether splenic hilar LND or D2 LND is essential for proximal AGC of pT2- 4aN0M0 stage. Materials and Methods: Data of curative total gastrectomies (n=370) performed from 2000 to 2010 for proximal AGC of pT2-4aN0 stage were retrospectively reviewed. Clinicopathological characteristics and long-term outcomes were compared using propensity score matching between patients who underwent splenectomy (n=43) and those who did not (n=327) and between patients who underwent D2 LND (n=122) and those who underwent D1+ LND (n=248). Results: Tumors of larger size and a more advanced T stage and significantly lower overall and relapse-free survival (P<0.001) were observed in the splenectomy group than in the 2 spleen-preserving groups. Before propensity score matching, worse overall and relapse-free survival (P<0.001) was observed in the splenectomy group than in the non-splenectomy group. After matching, although the overall survival became similar (P=0.123), relapse-free survival was worse in the splenectomy group (P=0.021). Compared with D1+ LND, D2 LND had no positive impact on the overall (P=0.619) and relapse-free survival (P=0.112) after propensity score matching. Conclusions: Splenic hilar LND with or without splenectomy may not have an oncological benefit for patients with pathological AGC with no LN metastasis.

• Current Optics and Photonics
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• v.3 no.3
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• pp.256-262
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• 2019

Extensive tumor resection accompanied by radiotherapy and chemotherapy is the standard of care for malignant gliomas. However, there is a significant obstacle to the complete resection of the tumor due to the difficulty of distinguishing tumor and normal brain tissue with a conventional surgical microscope. Recently, multiple studies have shown the possibility of fluorescence-guided surgery in malignant gliomas. The most used fluorescence dyes for brain tumor surgery are 5-aminolevulinic acid (5-ALA) and indocyanine green (ICG). In this paper, a new fluorescence guided operation system, which can detect both 5-ALA and ICG fluorescent images simultaneously, is presented. This operation system consists of light emitting diodes (LEDs) which emits 410 nm and 740 nm wavelengths. We have performed experiments on rats in order to verify the operation of the newly developed operation system. Oral administration and imaging were performed to observe the fluorescence of 5-ALA and ICG fluorescence in rats. When LEDs at wavelengths of 410 nm and 740 nm were irradiated on rats, 628 nm wavelength with a violet fluorescence color and 825 nm wavelength with a red fluorescence color were expressed in 5-ALA and ICG fluorescent material, respectively, thus we were able to distinguish the tumor tissues easily. Previously, due to the poor resolution of the conventional surgical microscope and the fact that the color of the vein is similar to that of the tumor, the tumor resection margin was not easy to observe, thus increasing the likelihood for cancer recurrence. However, when the tumor is observed through the fluorescence guided operation system, it is possible to easily distinguish the color with the naked eye and it can be completely removed. Therefore, it is expected that surgical removal of cancerous tumors will be possible and surgical applications and surgical microscopes for cancer tumor removal surgery will be promising in the future.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.24 no.3
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• pp.279-287
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• 2021

Purpose: The clinical implications of bowel wall thickening (BWT) on abdominal computed tomography (CT) among children are unknown. We aimed to suggest a new method for measuring BWT and determining its clinical significance in children. Methods: We retrospectively analyzed 423 patients with acute abdomen who underwent abdominal CT; 262 were classified into the BWT group. For this group, the pediatric radiologist described the maximal bowel wall thickness (MT), normal bowel wall thickness (mm) (NT), and their ratios for each segment of the bowel wall. Results: In the thickened bowel walls, the thickness differed significantly between the small bowel (6.83±2.14 mm; mean±standard deviation) and the colon (8.56±3.46 mm; p<0.001). The ratios of MT to NT in the small bowel (6.09±3.17) and the colon (7.58±3.70) were also significantly different (p<0.001). In the BWT group, 35 of 53 patients had positive fecal polymerase chain reaction results; 6 patients infected with viruses predominantly had BWT in the small intestine, while the terminal ileum and the colon were predominantly affected in 29 patients with bacterial infections. In the initially undiagnosed 158 patients with BWT, the symptoms improved spontaneously without progression to chronic gastrointestinal disease. Conclusion: This study provides a clinical reference value for BWT in the small intestine and colon using a new method in children. The BWT on abdominal CT in children might indicate nonspecific findings that can be observed and followed up without additional evaluation, unlike in adults.

• Research in Community and Public Health Nursing
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• v.31 no.spc
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• pp.525-533
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• 2020

Purpose: Workers in special employment relationship (WSERs) are workers in nonstandard employment arrangements who lack worker protection accorded in standard employment arrangements. This study aimed to describe self-rated health (SRH) and depressive symptoms (DS) among Korean WSERs in comparison to regular wage workers (RWW) and identify associations between working conditions and those outcomes. Methods: In this study, secondary data analysis using the 5th Korean Working Conditions Survey was used. The sample totaled 29,120, including 1,538 WSERs and 27,564 RWWs. Sociodemographic and work-related characteristics were employed as explanatory variables and SRH and DS as dependent variables. Using multiple logistic regression, the determinants of fair/poor SRH and DS were identified. Results: The prevalence rates for fair/poor SRH and DS in WSERs were 25.2% and 28.3%, respectively, and 20.7% and 25.0% in RWWs, respectively. Compared to RWWs, WSERs had 31% (aOR=1.31, 95% CI=1.14~1.49) and 20% (aOR=1.20, 95% CI=1.06~1.36) higher odds of SRH and DS, respectively. Some factors, such as a lack of rest guarantee and sickness presenteeism, had a larger influence in the WSER than in the RWW group. Conclusion: Compared to RWWs, WSERs reported having poorer working conditions and were more likely to report poor general and mental health. Therefore, in Korea, public health policymakers should consider measures to protect the working conditions and health of WSERs, a growing segment of the working population. The study produced new epidemiological evidence regarding the relationships between employment arrangements and health.

• Quality Improvement in Health Care
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• v.26 no.2
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• pp.104-112
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• 2020

This study was done to investigate the independent organizations established for patient safety, related policies, and the duties of experts in other countries. Australia established an organization called the Commission in 2006, the United Kingdom established the National Patients Safety Agency in 2001, and the United States assigned its work to the Agency for Healthcare Research and Quality in 2005. This was done by law in all three countries. The experts for patient safety were mainly called the "patent safety and quality coordinator", and although there was no qualification system for carrying out patient safety work, all three countries had licenses in the health care field or required more than 4-5 years of practical experience. The main duties were planning on patient safety and quality of healthcare service, data collection and analysis, and education, etc. and for this, competencies such as communication, leadership, and teamwork were required.

• The Journal of Pediatrics of Korean Medicine
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• v.35 no.2
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• pp.11-20
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• 2021

Objectives The purpose of the study is to evaluate the safety of the Allium Fistulosum extract in children and its effectiveness in height growth. Methods This study is randomized, double-blind, placebo-controlled trial. The participants are children between the 3rd and 25th percentiles in height, and between the ages of 5 and 12 years. They are randomly assigned to treatment group or control group. The treatment group will take 5 g (1 g as Allium Fistulosum extract) for 24 weeks, 1 time a day. The control group will take the 5 g (0 g as Allium Fistulosum extract) of placebo for 24 weeks, 1 time a day. The primary outcome is change in height, and the secondary outcomes are growth rate, height standard deviations, Insulin-like growth factor-1 (IGF-1), Insulin-like growth factor binding protein-3 (IGFBP-3), IGF1-1/IGFBP-3 ratio, growth hormone, bone age, osteocalcin, and Z-score for growth. Results This protocol has been approved by the institutional review board (IRB) of Daejeon Korean Medicine Hospital of Daejeon University (IRB No. DJDSKH-20-BM-15), and registered in the Clinical Research Information Service (CRIS) (Registry No. KCT0005981). Conclusions This study will provide clinical information about the effectiveness and safety of Allium Fistulosum extract in children for their growth.

• Journal of the Korean society of biological therapies in psychiatry
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• v.24 no.3
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• pp.218-229
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• 2018

Objectives : Antipsychotic-induced hyperprolactinemia causes physical symptoms, such as amenorrhea, galactorrhea, gynecomastia, sexual dysfunction, and bone density loss, as well as psychiatric symptoms, such as depression and cognitive impairments. This study aimed to clarify the associations among hyperprolactinemia caused by antipsychotics in patients with schizophrenia, psychiatric pathology, and psychosocial factors. Methods : Ninety-nine patients with schizophrenia in the psychiatry department of a university hospital were registered between 2015 and 2017. All participants were assessed using structured questionnaires to elucidate psychopathology, social function, quality of life, and hyperprolactinemia-related side effects. The standard levels for hyperprolactinemia were 24ng/mL for women and 20ng/mL for men. Results : The average prolactin levels were $73.45{\pm}49.37ng/mL$ in patients with hyperprolactinemia and $9.16{\pm}6.42ng/mL$ in those without hyperprolactinemia. The average prolactin level in women was significantly higher than that in men(p=0.04). Risperidone was most commonly administered in patients with hyperprolactinemia(58.1%, p<0.01), while aripiprazole was most commonly administered in those without hyperprolactinemia(44.7%, p<0.01). Patients with hyperprolactinemia had significantly higher Positive and Negative Syndrome Scale(p=0.03) and Patient Health Questionnaire-9(p=0.05) scores and had significantly lower Social and Occupational Functioning Assessment Scale(p=0.04) and Strauss-Carpenter Levels of Functioning Scale(p=0.03) scores than patients without hyperprolactinemia. There were no significant differences in side effects or quality of life between the two groups. Conclusion : These findings demonstrate that hyperprolactinemia confers negative effects on depression and social function, but does not directly affect the quality of life. These results suggest that patients with schizophrenia who take antipsychotics that increase prolactin or cause side effects of hyperprolactinemia need to be assessed and receive interventions for depression.

• Journal of Trauma and Injury
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• v.33 no.4
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• pp.207-218
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• 2020

The following recommendations are presented herein: All trauma patients admitted to the resuscitation room should be constantly (or periodically) monitored for parameters such as blood pressure, heart rate, respiratory rate, oxygen saturation, body temperature, electrocardiography, Glasgow Coma Scale, and pupil reflex (1C). Chest AP and pelvic AP should be performed as the standard initial trauma series for severe trauma patients (1B). In patients with severe hemodynamically unstable trauma, it is recommended to perform extended focused assessment with sonography for trauma (eFAST) as an initial examination (1B). In hemodynamically stable trauma patients, eFAST can be considered as the initial examination (2B). For the diagnosis of suspected head trauma patients, brain computed tomography (CT) should be performed as an initial examination (1B). Cervical spine CT should be performed as an initial imaging test for patients with suspected cervical spine injury (1C). It is not necessary to perform chest CT as an initial examination in all patients with suspected chest injury, but in cases of suspected vascular injury in patients with thoracic or high-energy damage due to the mechanism of injury, chest CT can be considered for patients in a hemodynamically stable condition (2B). CT of the abdomen is recommended for patients suspected of abdominal trauma with stable vital signs (1B). CT of the abdomen should be considered for suspected pelvic trauma patients with stable vital signs (2B). Whole-body CT can be considered in patients with suspicion of severe trauma with stable vital signs (2B). Magnetic resonance imaging can be considered in hemodynamically stable trauma patients with suspected spinal cord injuries (2B).