• Journal of Radiation Industry
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• v.9 no.2
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• pp.69-75
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• 2015

Purpose: The gonad shielding is used to minimize the impact of the exposure to gonads when Abdomen, Pevis and Hip X-ray inspections are conducted on radiation impressionable pediatric patients. By the way, the gonad is palpable difficult and impossible to check visually because it's a sensitive area, so tests are conducted with the approximate location of shielding, thereby appearing problems of not shielding gonads accurately. Accordingly, this study produced shields by age and gender of pediatric patients and studied the method of positioning shields with ASIS as a reference point without palpable sensitive areas, and tried to evaluate its usability. Materials and methods: The study surveyed 30 pediatric patients by gender and age, who came and got inspected in Department of Radiology, our hospital from February 2012 to January 2014 and obtained the value of tolerance by measuring the average size of the pelvis using the distance measurement function of Infinitt Piview with the images stored in the PACS and producing shields by age and gender of pediatric patients and specifying the areas at random for the comparative analysis of pre- and post-using. It calculated the technology statistics($mean{\pm}SD$) with the value of tolerance measured the length using SPSS 12.0 statistical program. Results: As for boys, differences in the tolerance range of pre- and post-using shields were 2.69 mm in case of 1 year old, 2.58 mm in 2 years, 2.37 mm in 3 years, 2.815 mm in 4~5 years, 2.043 mm in 7~10 years, and as for girls, 1.92 mm in 1~2 years, 1.75 mm in 3~4 years, 2.52 mm in 5~6 years and 1.93 mm in 7~10. After analyzing the pre- and post-using shields for all of boys and girls, there were statistically significant differences(P<0.050). Conclusions: It is considered that we can minimize the exposure to gonads and get a better video for diagnosis in testing high biological impressionable pediatric, if we use shields correctly with ASIS as a reference point considering its shape and size by age and gender in Abdomen, Pevis and Hip X-ray inspections.

• Journal of The Korean Society of Clinical Toxicology
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• v.17 no.1
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• pp.21-27
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• 2019

Purpose: Mortality rate in the health services research field is frequently considered as a proxy for measuring healthcare quality. We compared the mortality rate and hospitalization levels among patients with poisoning. Methods: A population-based study of hospital size and level based on the Korean health insurance and assessment service was conducted to identify the impact of hospital level on patient mortality. Results: We analyzed a total of 16,416 patients, of which 7,607 were from tertiary hospitals, 8,490 were from general hospitals, and 319 were from hospitals. The highest mortality rate of diagnosis regarding poisoning was T60.31 (other herbicides and fungicides, 16%), followed by T60.0 (organophosphate and carbamate insecticides, 12.7%). There was no statistical difference in mortality among hospital levels for gender. Among age groups, tertiary hospitals had lower mortality than general hospitals and hospitals for patients aged more than 70 years (11.9% mortality at tertiary vs 14.2% at general and 23% at hospital; p=0.003, adjusted z score=-6.9), general hospitals had lower mortality than tertiary hospitals and hospitals for patients aged 18 to 29 (0.6% at general vs 2.4% at tertiary and 3.7% at hospital; p=0.01, adjusted z score=-4.3), and hospitals had lower mortality than tertiary hospitals and general hospitals for patients between 50 and 59 years of age (0% at hospital vs 6.4% at general and 8.3% at tertiary; p=0.004). Conclusion: Overall, there was no significant difference between mortality and hospital level among poisoned patients. However, to establish an efficient treatment system for patients with poisoning, further studies will be needed to identify the role of each facility according to hospital level.

• Journal of Climate Change Research
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• v.2 no.2
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• pp.79-91
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• 2011

In order to study interactions between climate change and air quality, a modeling system including the downscaling scheme has been developed in the integrated manner. This research focuses on the development of a downscaling method to utilize CCSM3 outputs as the initial and boundary conditions for the regional climate model, MM5. Horizontal/vertical interpolation was performed to convert from the latitude/longitude and hybrid-vertical coordinate for the CCSM3 model to the Lambert-Conformal Arakawa-B and sigma-vertical coordinate for the MM5 model. A variable diagnosis was made to link between different variables and their units of CCSM and MM5. To evaluate the dynamic downscaling performance of this study, spatial distributions were compared between outputs of CCSM/MM5 and NRA/MM5 and statistic analysis was conducted. Temperature and precipitation patterns of CCSM/MM5 in summer and winter showed a similar pattern with those of observation data in East Asia and the Korean Peninsula. In addition, statistical analysis presented that the agreement index (AI) is more than 0.9 and correlation coefficient about 0.9. Those results indicate that the dynamic downscaling system built in this study can be used for the research of interaction between climate change and air quality.

• Asian Spine Journal
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• v.12 no.6
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• pp.1043-1052
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• 2018

Study Design: Level III retrospective cross-sectional study. Purpose: To define and characterize the presentation, symptom duration, and patient/surgical risk factors associated with 'post-decompressive neuropathy (PDN).' Overview of Literature: PDN is characterized by lower extremity radicular pain that is 'different' from pre-surgical radiculopathy or claudication pain. Although it is a common constellation of postoperative symptoms, PDN is incompletely characterized and poorly understood. We hypothesize that PDN is caused by an intraoperative neuropraxic event and may develop early (within 30 days following the procedure) or late (after 30 days following the procedure) within the postoperative period. Methods: Patients who consented to undergo lumbar laminectomy with or without an instrumented fusion for degenerative lumbar spine disease were followed up prospectively from July 2013 to December 2014. Relevant data were extracted from the charts of the eligible patients. Patient demographics and surgical factors were identified. Patients completed postoperative questionnaires 3 weeks, 3 months, 6 months, and 1 year postoperatively. Questions were designed to characterize the postoperative pain that differed from preoperative pain. A diagnosis of PDN was established if the patient exhibited the following characteristics: pain different from preoperative pain, leg pain worse than back pain, a non-dermatomal pain pattern, and nocturnal pain that often disrupted sleep. A Visual Analog Scale was used to monitor the pain, and patients documented the effectiveness of the prescribed pain management modalities. Patients for whom more than one follow-up survey was missed were excluded from analysis. Results: Of the 164 eligible patients, 118 (72.0%) completed at least one follow-up survey at each time interval. Of these eligible patients, 91 (77.1%) described symptoms consistent with PDN. Additionally, 75 patients (82.4%) described early-onset symptoms, whereas 16 reported symptoms consistent with late-onset PDN. Significantly more female patients reported PDN symptoms (87% vs. 69%, p=0.03). Patients with both early and late development of PDN described their leg pain as an intermittent, constant, burning, sharp/stabbing, or dull ache. Early PDN was categorized more commonly as a dull ache than late-onset PDN (60% vs. 31%, p=0.052); however, the difference did not reach statistical significance. Opioids were significantly more effective for patients with early-onset PDN than for those with late-onset PDN (85% vs. 44%, p=0.001). Gabapentin was most commonly prescribed to patients who cited no resolution of symptoms (70% vs. 31%, p=0.003). Time to symptom resolution ranged from within 1 month to 1 year. Patients' symptoms were considered unresolved if symptoms persisted for more than 1 year postoperatively. In total, 81% of the patients with early-onset PDN reported complete symptom resolution 1 year postoperatively compared with 63% of patients with late-onset PDN (p=0.11). Conclusions: PDN is a discrete postoperative pain phenomenon that occurred in 77% of the patients who underwent lumbar laminectomy with or without instrumented fusion. Attention must be paid to the constellation and natural history of symptoms unique to PDN to effectively manage a self-limiting postoperative issue.

• Journal of the Korea Convergence Society
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• v.12 no.4
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• pp.95-103
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• 2021

This study was aimed to investigate the education needs for prevention and control of infectious diseases by lifecycle based on age group and to provide the fundamental data to develop the educational programs. A research was conducted with 328 adults over 19 years old for a month of February 2021 through online and mobile survey by Gallup Korea. Research contents include the general characteristics, personal hygiene practices related to infection, perceived risks related to infection, importance and level of knowledge on infectious diseases, and education needs for prevention and control of infectious diseases. For the research data analysis, PASW Statistics Ver 20.0 was used as a statistical program. Ranks from analysis upon conversion as the formula of Borich needs to sum up with importance and knowledge level showed first (Borich 3.11) with treatments for infectious diseases; second (Borich 2.15) with process in case of suspicion and diagnosis of infectious diseases; third (Borich 1.75) with transmission routes of infectious diseases; fourth (Borich 1.73) with preventive ways of infectious diseases; fifth (Borich 1.50) with diagnostic and test methods of infectious diseases; sixth (Borich 1.45) with characteristics of infectious diseases; and seventh (Borich1.38) with main symptoms of infectious diseases. It is anticipated that development of educational programs applying education needs for prevention and control of infectious diseases in this research can contribute to enhance the physical health, mental health, and psychological well-being of the subjects.

• The Journal of Internal Korean Medicine
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• v.41 no.6
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• pp.1066-1077
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• 2020

Objective: This study was conducted to evaluate the effect of herbal medicine on blood glucose in diabetic patients. Methods: The subjects were patients with diabetes mellitus (DM) who had been admitted to Kyung Hee University Korean Medicine Hospital for more than 8 weeks for a primary diagnosis other than DM and who had taken herbal medicine for more than 8 weeks from January 2010 to February 2020. The medical records were analyzed retrospectively to confirm the characteristics of the subjects, and examination results included hemoglobin A1c (HbA1c), total cholesterol, triglyceride, low-density lipoprotein cholesterol (LDL), high-density lipoprotein cholesterol (HDL), aspartate aminotransferase (AST), alanine aminotransferase (ALT), blood urea nitrogen (BUN), and creatinine. Changes in HbA1c before and after taking herbal medicine and changes according to subgroups were analyzed. Results: A total of 149 subjects with type 2 DM were selected as participants. After taking the herbal medicine, the HbA1c value was significantly decreased, and the statistical significance was maintained even when the effect of controlling antidiabetic agents was excluded. The decrease in HbA1c was higher in the poor glycemic control group. Liver and kidney functions did not show any significant changes after taking the herbal medicine. Conclusions: Administration of herbal medicine for a long period of 8 weeks or longer did not increase HbA1c in patients with DM complicated by other various diseases.

• Journal of the Korean Society of Safety
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• v.35 no.6
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• pp.15-24
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• 2020

With the development of the chemical industry, the chemical accident is increasing every year, thereby increasing the risk of accidents caused by chemicals. The Ministry of Environment provides the criteria for determining shelter-in-place or outdoor evacuation by material, duration of accident, and distance from the toxic substance leak. However, it is hard to say that the criteria for determining the transition point are not clear. Transition point mean the time that evacuation method is switched from shelter-in-place to outdoor evacuation. So, the purpose of this study was to calculate appropriate transition point by comparing the cumulative toxic load. Namdong-gu in Incheon Metropolitan City was finally selected as the target area, considering the current status of the population of Incheon Metropolitan City in 2016 and the statistical survey of chemicals in 2016. The target materials were HCl, HF, and NH₃. Modeling was simulated by ALOHA and performed assuming that the entire amount would be leaked for 10 min. Residents' evacuation scenarios were assumed to be shelter-in-place, immediate outdoor evacuation, and outdoor evacuation at an appropriate time after shelter-in-place. Based on the above method, the appropriate transition point from residents located in A(800 m away), B(1,200 m away), C(1,400 m away) and D(2,200 m away) was identified. In HCl, appropriate transition point was after 15 min, after 16 min, after 17 min, after 20 min in order by A, B, C and D. In HF, appropriate transition point was before 1 min or after 16 min, before 4 min or after 19 min, before 5 min or after 20 min, before 14 min or after 26 min in order by A, B, C and D. In NH₃, appropriate transition point at A was before 4 min or after 16. Others are not in chemical cloud. This study confirmed the transition point to minimize the cumulative toxic load can be obtained by quantitative method. Through this, it might be possible to select evacuation method quantitatively that cumulative toxic load are minimal. In addition, if the shelter-in-place is maintained without transition to outdoor evacuation, the cumulative toxic load will increase more than outdoor evacuation. Therefore, it was confirmed that actions to reduce the concentration of chemicals in the room were necessary, such as conducting ventilation after the chemical cloud passed through the site.

• Journal of Chest Surgery
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• v.55 no.5
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• pp.378-387
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• 2022

Background: Atrial fibrillation (Afib) is a marker of increased cardiovascular morbidity and mortality. Owing to the increased prevalence of Afib in patients undergoing cardiac surgery, assessing the effect of Afib on postsurgical outcomes is important. We aimed to analyze the effect of preoperative Afib on clinical outcomes in patients undergoing cardiac surgery using a large surgical database. Methods: This retrospective cohort study was based on the national health claims database established by the National Health Insurance Service of the Republic of Korea from 2009 to 2015. Diagnosis and procedure codes were used to identify diseases according to the International Statistical Classification of Diseases, 10th revision. Results: We included 1,037 patients (0.1%) who had undergone cardiac surgery from a randomized 1,000,000-patient cohort, and 15 patients (1.5%) treated with isolated surgical Afib ablation were excluded. Of these 1,022 patients, 412 (39.7%), 303 (29.2%), and 92 (9.0%) underwent coronary artery bypass, heart valve surgery, and Cox-maze surgery, respectively. Preoperative Afib was associated with higher patient mortality (p=0.028), regardless of the surgical procedure. Patients with preoperative Afib (n=190, 18.6%) experienced a higher cumulative risk of overall mortality (hazard ratio [HR], 1.435; 95% confidence interval [CI], 1.263-2.107; p=0.034). Subgroup analysis revealed a reduced risk of overall mortality with Cox-maze surgery in Afib patients (HR, 0.500; 95% CI, 0.266-0.938; p=0.031). Postoperative cerebral ischemia or hemorrhage events were not related to Afib. Conclusion: Preoperative Afib was independently associated with worse long-term postoperative outcomes after cardiac surgery. Concomitant Cox-maze surgery may improve the survival rate.

• Journal of Acupuncture Research
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• v.39 no.4
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• pp.297-303
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• 2022

Background: This retrospective study aimed to determine whether there were correlations between the number and type of accompanying symptoms of peripheral facial nerve palsy, and surface electromyography (SEMG) and clinical assessment scales to help diagnosis. Methods: There were 30, cases of peripheral facial nerve palsy at Visit 1 to the Korean Medicine Hospital, Dong-eui University, 22 cases at Visit 2 and 10 cases at Visit 3. The study period was from July 19, 2021 to November 31, 2021. Symptoms were evaluated three times (with two-week intervals which began 7 days from onset) using SEMG, clinical assessment scales and accompanying symptoms. In this study, the House-Brackmann grading system (HBGS), and the Yanagihara's unweighted grading system (Y-score) clinical assessment scales were used. The Pearson or Spearman correlation was used for statistical analysis. Results: On Visit 1, the number of accompanying symptoms of peripheral facial nerve palsy had no significant correlation with other measures. On Visits 1-3, the HBGS score had a significant negative correlation with the Y-score. On Visit 2, most of the mean values measured had significant correlations with each other although not between SEMG-Z and SEMG-O that Z means a zygomaticus muscle and O means a orbicularis oris muscle. On Visit 3, the number of accompanying symptoms significantly correlated with the clinical assessment scales. The HBGS score, Y-score, and SEMG measurements (except SEMG-Z) had significant correlations with each other. A significant positive correlation between SEMG-Z and SEMG-T was noted. Conclusion: We predict accompanying symptoms can be used to diagnose the peripheral facial nerve palsy including both clinical assessment scales and SEMG measurements at 2-5 weeks after onset.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.34 no.1
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• pp.37-44
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• 2023

Objectives: Tic disorders are highly heritable; however, growing evidence suggests that environmental factors play a significant role in their pathogenesis. Studies on these factors have been inconsistent, with conflicting results. Therefore, this study aimed to examine the associations of pre- and perinatal exposure to Tourette syndrome (TS) or chronic tic disorders (CTD) in Korean school-aged children. Methods: This case-control study used data from a large prospective cohort study. The primary outcome was TS/CTD diagnosis according to the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5) criteria and Kiddie-Schedule for Affective Disorders and Schizophrenia-Present and Lifetime Version-Korean Version. Demographic, pre-, and perinatal information was obtained from the maternal questionnaires. Data between the TS/CTD and control groups were compared using the chi-squared or Student's t-test, as appropriate. Two-step logistic regression analyses were used to test the association between TS/CTD and pre- and perinatal risk factors. Results: We included of 223 children (78 with TS/CTD and 145 controls). Significant differences in the demographic data between the two groups were observed. The male sex ratio, mean parental age, parental final education level, and family history of tics were included as confounders. In the final adjusted multivariable model, TS/CTD was significantly associated with antiemetic exposure during pregnancy (odds ratio [OR]=16.61, 95% confidence interval [CI] 1.49-185.22, p=0.02) and medically assisted reproduction (OR=7.89, 95% CI 2.28-27.28, p=0.01). Conclusion: Antiemetic exposure and medically assisted reproduction are significantly associated with the risk of TS/CTD. These results should be replicated in future prospective and gene-by-environment studies.