• Journal of the Korean Society of Physical Medicine
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• v.19 no.1
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• pp.23-30
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• 2024

PURPOSE: The purpose of this study is to identify the incidence of chronic obstructive pulmonary disease (COPD) and risk factors for diseases in adults over 40 years of age in Korea, and to provide basic data for the prevention of COPD incidence through management. METHODS: Based on the 2019 data of the Korea National Health and Nutrition Examination Survey (KNHANES), 1,788 adults over the age of 40 who participated in pulmonary function test and health survey were selected as subjects. COPD incidence risk factors were analyzed using complex sample multiple logistic regression analysis. RESULTS: As a result of the analysis, the incidence of COPD in Korea was 11.5%, and the risk of developing COPD was higher in men, age, and current smokers. Compared to women, men had an increased risk of developing COPD by 2.369 times (95% CI 1.289-4.355). In age, the risk of COPD incidence increased by 3.702-fold (95% CI 1.923-7.124) in their 50s, 11.238-fold (95% CI 6.009-21.017) in their 60s, and 28.320-fold (95% CI 14.328-55.977) in their 70s compared to those in their 40s. In the smoking state, 2.302 times (95% CI 1.373-3.860) of past smokers and 4.542 times (95% CI 2.694-7.658) of current smokers were found to have a higher risk of developing COPD than non-smokers. CONCLUSION: To reduce the incidence of COPD, interventions are required to prevent disease development through lifestyle and smoking cessation education in subjects with COPD risk factors.

• Clinics in Shoulder and Elbow
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• v.26 no.4
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• pp.373-379
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• 2023

Background: The purpose of this study was to determine the association between smoking and clinical outcomes of hook plate fixation for acute acromioclavicular (AC) joint injuries. Methods: This study retrospectively investigated 82 patients who underwent hook plate fixation for acute AC joint dislocation between March 2014 to June 2022. The patients were grouped by smoking status, with 49 in group N (nonsmokers) and 33 in group S (smokers). Functional scores and active range of motion were compared among the groups at the 1-year follow-up. Coracoclavicular distance (CCD) was measured, and difference with the uninjured side was compared at initial injury and 6 months after implant removal. Results: No significant differences were observed between the two groups in demographic factors such as age and sex, as well as parameters related to initial injury status, which included time from injury to surgery, the preoperative CCD difference value, and the Rockwood classification. However, the postoperative CCD difference was significantly higher in group S (3.1±2.6 mm) compared to group N (1.7±2.4 mm). Multivariate regression analysis indicated that smoking and the preoperative CCD difference independently contributed to an increase in the postoperative CCD difference. Despite the radiographic differences, the postoperative clinical outcome scores and active range of motion measurements were comparable between the groups. Conclusions: Smoking had a detrimental impact on ligament healing after hook plate fixation for acute AC joint dislocations. This finding emphasizes the importance of smoking cessation to optimize reduction maintenance after AC joint injury. Level of evidence: III.

• Journal of The Korean Society of Clinical Toxicology
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• v.21 no.2
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• pp.128-134
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• 2023

Purpose: The Prescott nomogram has been utilized to forecast hepatotoxicity from acute acetaminophen poisoning. In developing countries, emergency medical centers lack the resources to report acetaminophen concentrations; thus, the commencement and cessation of treatment are based on the reported dose. This study investigated risk factors that can predict acetaminophen detection after 15 hours for safe treatment termination. Methods: Data were collected from an urban emergency medical center from 2010 to 2020. The study included patients ≥14 years of age with acute acetaminophen poisoning within 15 hours. The correlation between risk factors and detection of acetaminophen 15 hours after ingestion was evaluated using logistic regression, and the area under the curve (AUC) was calculated. Results: In total, 181 patients were included in the primary analysis; the median dose was 150.9 mg/kg and 35 patients (19.3%) had acetaminophen detected 15 hours after ingestion. The dose per weight and the time to visit were significant predictors for acetaminophen detection after 15 hours (odds ratio, 1.020 and 1.030, respectively). The AUCs were 0.628 for a 135 mg/kg cut-off value and 0.658 for a cut-off 450 minutes, and that of the combined model was 0.714 (sensitivity: 45.7%, specificity: 91.8%). Conclusion: Where acetaminophen concentrations are not reported during treatment following the UK guidelines, it is safe to start N-acetylcysteine immediately for patients who are ≥14 years old, visit within 15 hours after acute poisoning, and report having ingested ≥135 mg/kg. Additional N-acetylcysteine doses should be considered for patients visiting after 8 hours.

• Journal of Chest Surgery
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• v.41 no.3
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• pp.354-359
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• 2008

Background: Warfarin is used as an anticoagulant and it is mainly excreted by the liver metabolism (the R-form is mainly metabolized by cytochrome p450 3A4, and the S form by cytochrome p450 2C9). Rifampin is usually used for tuberculosis or endocarditis, and it is a representative drug that induces the CYP families, including 3A4 and 2C9. The anticoagulation effect of warfarin decreases through the increased metabolism that's due to the induction of enzymes, and this iscaused by rifampin when patients take these two medicines together. No one has suggested appropriate guidelines regarding this drug interaction even though an appropriate adjustment of warfarin's dosage is needed. We examined the drug interaction in patients who received warfarin-rifampin combination therapy according to the time interval, and the factors affecting drug interaction were analyzed. Based on the data, we tried to determine the clinically available warfarin dosage guidelines before and after taking this drug combination. Material and Method: We reviewed the OO University Hospital anticoagulation service team's follow up sheets that were filled out from Jan '1998 to Sep 2006 for the patient who took warfarin - rifampin combination therapy (n=15). Result: The average INR of all the patient before rifampin administration was $2.25{\pm}0.52$ $(mean{\pm}SD)$, and that value for the first 100 days after rifampin administration was $1.98{\pm}0.28$. The p value for these two sets of data showed no correlation (paired t-test, p>0.05). The average INR of all the patient before rifampin cessation was $2.19{\pm}0.34$, and the value after rifampin cessation was $2.49{\pm}0.43$. The p value of these two showed correlation (paired t-test, p<0.05) but the average INR falls between the therapeutic INR range. Conclusion: The warfarin dose adjustment equation of before and after warfarin-rifampin combination therapy was derived based on this study's results because the warfarin dosage adjustment of the anticoagulation service team was considered appropriate.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.1 no.1
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• pp.100-106
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• 1998

Purpose: Ceftriaxone, a potent parenteral third-generation semisynthetic cephalosporin is widely used for the treatment of a variety of bacterial infections in both children and adult. Review of recent data indicates that ceftriaxone treatment has been associated with the development of reversible biliary pseudolithiasis and that is thought by many to be a benign process. Despite, several reports describe patients with ceftriaxone pseudolithiasis who required cholecystectomy for presumed acute cholecystitis. In this study we evaluated the incidence, risk factors, and prognosis of gallbladder pseudolithiasis after ceftriaxone treatment. Methods: Between march, 1997 and January, 1998, any child admitted to the Children's hospital of National University of Seoul and prescribed ceftriaxone for probable or definite bacterial infection were eligible for the study. 21 of them had ultrasound examination on the 2~12 days later after the start of ceftriaxone treatment, 8 of whom documented gallbladder precipitates or pseudolithiasis during treatment by serial abdominal ultrasound. Repeat abdominal ultrasound was performed 10~80 days later after the end of ceftriaxone treatment. The children with underlying liver disease or decreased renal function were excluded in this study. Results: 1) 21 children had ultrasound examinations of gallbladder during ceftriaxone treatment and 8 (38%) of them acquired pseudolithiasis. 2) The patients who developed gallbladder pseudolithiasis were significantly older ($6.3{\pm}2.9$ yr. vs $2.2{\pm}3.1$ yr.)(p<0.05), and older than 24 months were probably the significant risk associated with this phenomenon (p<0.05). However, no significant differences in sex, type of infection, fasting, and ceftriaxone treatment regimen (dose, duration of therapy). 3) The abnormality found on gallbladder ultrasonography was a strikingly hyperechogenic material with post-acoustic shadowing in 5 patients without post-acoustic shadowing in 3 patients 4) Follow up of gallbladder ultrasound was performed in 6 patients after cessation of ceftriaxone treatment. Sonographic abnormalities completely resolved within 14 days post cessation of therapy in 2 patients; 30 days, 1 patient; 80 days, 3 patients. Conclusions: We suggest that routine abdominal ultrasound should be considered in all children who received high dose ceftriaxone in more than 24 months of age and developed hepatobiliary symptoms during or just after ceftriaxone treatment.

• Tuberculosis and Respiratory Diseases
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• v.49 no.3
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• pp.353-364
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• 2000

Background : Bronchoscopy is a useful diagnostic tool, for accurate localization of the bleeding site and the management of hemoptysis. However, there is some controversy about the optimal timing of bronchoscopy. Method : To determine the optimal timing of bronchoscopy in hemoptysis, we reviewed the medical records of 118 patients and analyzed the following relationships amongst simple chest PA findings, namely, the duration and amount of hemoptysis, and the timing of bronchoscopy retrospectively. Results : The major causes of hemoptysis were active tuberculosis(28.8%), inactive tuberculosis(10.2%), bronchiectasis(17.0%), lung cancer(7.6%), and aspergilloma(7.6%). Localization of the bleeding focus by bronchoscopy was possible in 87.5% (21/24 cases) during active bleeding, and it was possible in 40.4% after bleeding had stopped(p<0.05). The localization rate of bleeding focus was 59.8% when the chest PA showed certain abnormalities, but it decreased to 27.8% when the chest PA finding was normal(p<0.05). When chest PA showed diffuse abnormalities or its finding was normal, the localization rate of bleeding focus significantly increased if bronchoscopy was performed during bleeding or within 48 hours of the cessation of active bleeding. The localization rate was higher as the amount of hemoptysis became larger(p<0.05). The localization rate of early bronchoscopy(during bleeding or within 48 hours of the cessation of active bleeding) was significantly higher when the duration of hemoptysis was less than 1 week, but there was no advantage if the duration was 1 week or longer. Early bronchoscopy was also necessary to localize the bleeding focus for surgical resection in 4 patients, and the bronchoscopy itself was therapeutic in 1 patient whose bleeding was successfully managed with thrombin-application via bronchoscope. Conclusion : It is concluded that flexible bronchoscopy is useful at not only localizing the bleeding focus but also in preparing a therapeutic plan, and early bronchoscopy is more favorable in hemoptysis.

• Korean Journal of Environmental Biology
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• v.32 no.2
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• pp.138-152
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• 2014

The objective of the study survey was to determine the effect of marine sand extraction on community composition and rate of recolonization of the meiobenthos following cessation of mining activities. Because of meiobenthic distribution in nature, high abundance, intimate association with sediments, fast reproduction, benthic larva period, sensitivity to pollution and rapid life histories, meiobenthos are widely regarded as ideal organisms to study the potential ecological indicator of natural and anthropogenic stresses. The community structure of meiobenthos was studied at seven stations within sandy tidal and sub tidal zones in Jangbongdo in the Yellow Sea, Korea from Aug. 2006 to Dec. 2007. Meiobenthic samples were collected by three core samples, with a 3.6 cm in diameter, from each sediment sample taken with a Smith-McIntyre Grab. It was found that sand mining often causes complete removal of the sediment and the damage to the habitats of meiobenthos. This study in the effect showed that sand mining resulted in a reduction in total abundance and biomass of meiobenthos in mining area. The finding of this study further showed that initial restoration of abundance and biomass within one year of the cessation of sand mining.

• Horticultural Science & Technology
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• v.32 no.3
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• pp.279-288
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• 2014

To understand changes in composition and distribution of nutrients during early shoot growth of persimmon, organic compounds and inorganic elements of terminal shoots were analyzed for about 40 days from the time of foliation. Sample shoots were collected from mature 'Fuyu' trees for this three-year experiment and they were divided to stem, leaves, and the fruits including flower buds at the earliest stage. During shoot growth, concentration of soluble sugars increased in both leaves and fruits, but that of starch increased only in leaves. Those of amino acids tended to decrease in all the parts but there was no consistent change in proteins. As shoots grew, contents of all the organic compounds in a shoot increased, and they were especially higher in May leaves accounting for more than 60% of the shoot total for each nutrient. Along with shoot growth, concentrations of N and P gradually decreased in all three parts, while K decreased only in stem. However, those of Ca and Mg did not show notable changes in all the parts with wide variations depending on the year. Due to the quantitative increase in growth, contents of inorganic elements in a shoot increased in all the parts and the leaves accounted for 54-82% of the shoot total. At the cessation time of extension growth, a shoot contained 526-768 mg of soluble sugars, 245-844 mg of starch, 26-31 mg of amino acids, and 66-103 mg of proteins for three years. On the other hand, a shoot contained 203-388 mg of K, the greatest among the inorganic elements, followed by 132-159 mg of N. Changes of the nutrients in a shoot were much greater during the earlier stage of growth after foliation than during the later stage toward growth cessation, suggesting the importance of mobilizing reserve nutrients for the early growth of the shoots. The results of this study also suggested that the rate of nutrient changes, especially during the earlier stage of shoot growth, could be affected by environmental and cultural conditions.

• Radiation Oncology Journal
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• v.28 no.2
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• pp.85-90
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• 2010

Purpose: To evaluate the rate of tumor response, local control, and treatment-related complications after hypofractionated radiotherapy for recurrent hepatocelluar carcinoma (HCC) less than 5 cm in size. Materials and Methods: Among the HCC patients who were treated by radiotherapy (RT) between 2006 and 2007 after the failure of previous treatment, a total of 12 patients were treated with hypofractionated RT. The criteria for hypofractionated RT was as follows: 1) HCC less than 5 cm, 2) HCC not adjacent to a critical organ, 3) HCC without portal vein tumor thrombosis, and 4) less than 15% of normal liver volume that irradiated 50% of the prescribed dose. Hypofractionated RT was performed with 50 Gy delivered in 10 fractions, at a rate of 5 fractions per week. The evaluation of tumor response was determined by CT scans performed at 3 months after the cessation of RT, followed by the evaluation of toxicity by Common Terminology Criteria for Adverse Events version 3.0. The median follow-up period after radiotherapy was 18 months. Results: A complete response (CR) was achieved in 5 of 12 lesions (41.7%) at CT performed at 3 months after the cessation, whereas the overall complete response was observed in 7 of 12 cases (58.3%). In-field local control rate was sustained in 83.3% of patients. All patients developed intra-hepatic metastases except for 2 patients. The overall survival rate was 90.0% at 1 year and 67.5% at 2 years, respectively. Three patients developed Grade 1 nausea during RT and 1 patient showed a progression of ascites after RT. There was no grade 3 or greater treatment-related toxicities. Conclusion: Hypofractionated RT for small-sized HCC as a salvage therapy showed a 58.3% CR rate and 83.3% of local control. Fifty Gy administered in 10 fractions of partial liver irradiation is considered as a tolerable dose that does not cause severe complications.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.20 no.8
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• pp.47-55
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• 2019

This study was conducted to investigate the factors associated with electronic cigarette use by Korean adults. To accomplish this, data collected from 228,477 individuals during a community health survey conducted by the Korean Centers for Disease Control and Prevention in 2015 were analyzed by descriptive analysis, the Chi-squared test, and logistic regression analysis. The lifetime prevalence of electronic cigarette smoking was 11.1% for men and 0.8% for women. The current prevalence for electronic cigarettes smoking was 24.2% for men and 26.1% for women among lifetime users of electronic cigarettes. The lifetime experience rate of electronic cigarette smoking was significantly associated with age, educational attainment, occupation, income status and current smoking status, respectively. The current universal smoking e-cigarette is significantly related to the current smoking status, which shows a significantly higher number of current smokers than groups that have smoked in the past. The preference for electronic cigarette smoking was high. E-cigarettes were perceived by those who aimed to quit smoking as having a smoking cessation effect compared to regular cigarettes while also providing the pleasure of smoking and addressing the addiction. Therefore, e-cigarettes were highly favored because they were reflected as a solution to the dilemma of smoking. In 2014, electronic cigarette imports tripled from the previous year, and interest in electronic cigarettes is increasing worldwide. Accordingly, measures related to the prevention and discontinuation of e-cigarettes should be considered. Strengthening anti-smoking education and active promotion of anti-smoking risks is needed to improve smokers' wrong perception of smoking-related health. The WHO also reports that there is a lack of grounds to ensure or acknowledge that e-cigarettes are effective. Accordingly, it is important to identify environmental factors influencing the use of electronic cigarettes and explore the relationship between electronic cigarette recognition and use.