• Journal of The Korean Society of Clinical Toxicology
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• v.18 no.2
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• pp.130-135
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• 2020

Purpose: Taking large amounts of glyphosate is life-threatening, but the amounts of glyphosate taken by patients for suicide are not known precisely. The purpose of this study was to find the predictors of large amounts of glyphosate ingestion. Methods: This retrospective study analyzed patients presenting to an emergency department with glyphosate intoxication between 2010 and 2019, in a single tertiary hospital. The variables associated with the intake amounts were investigated. The parameters were analyzed by multivariate variate logistic regression analyses and the receiver operating characteristic (ROC) curve. Results: Of the 28 patients with glyphosate intoxication, 15 (53.6%) were in the large amounts group. Univariate analysis showed that metabolic acidosis, lactic acid, and corrected QT (QTc) interval were significant factors. In contrast, multivariate analysis presented the QTc interval as the only independent factor with intoxication from large amounts of glyphosate. (odds ratio, 95% confidence interval: 1.073, 1.011-1.139; p=0.020) The area under the ROC curve of the QTc interval was 0.838. Conclusion: The QTc interval is associated significantly with patients who visit the emergency department after being intoxicated by large amounts of glyphosate. These conclusions will help in the initial triage of patients with glyphosate intoxication.

• Korean Journal of Clinical Laboratory Science
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• v.54 no.3
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• pp.167-172
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• 2022

In clinical practice, the diagnosis of tuberculosis (TB) continues to be a challenge. The goal of this study was to evaluate the reliability and impact of adenosine deaminase (ADA) enzyme testing as a biochemical marker in the continued management of suspected tuberculosis in a limited resource setting hospital. The retrospective data were collected from 2018 to 2021 and comprised the results of all ADA test assays done in the laboratory. All types of body fluids received for ADA testing were analyzed. Over the course of two years, 1461 samples for ADA assay testing were received. The average age of the study population was 56.69±11.7 years, with males accounting for the majority of the subjects (55.72%). Pleural fluid (N=817, 55.92%) was the most common type of sample received for the ADA assay. 114 (13.95%) of the 817 pleural fluid samples were found to be positive. A survey was conducted to obtain physician's response regarding reliability on ADA testing. 100% of them reported the supportive role of ADA levels in the workup of patients with suspected tuberculosis. In a limited resource setting, the ADA test, in conjunction with clinical and other laboratory findings, can help physicians to initiate early treatment in hospitals for the benefit of patients.

• Women's Health Nursing
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• v.29 no.2
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• pp.91-103
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• 2023

Purpose: This study aimed to construct a structural equation model to explain and predict factors affecting the health-related quality of life (QoL) in female rheumatoid arthritis (RA) patients based on the health-related QoL model by Ferrans et al. (2005) and a literature review. Methods: Patients (N=243) who were either registered members of an internet cafe composed of patients with RA or rheumatology outpatients at two tertiary general hospitals in Busan, Korea, were recruited via convenience sampling. Data were collected from July 2 to September 9, 2021, and the survey was conducted using a web-based questionnaire. The data were analyzed by SPSS and AMOS 26.0. Results: The goodness-of-fit statistics of the final model exhibited good results (χ²/degree of freedom=2.68, Turker-Lewis index=.94, comparative fit index=.96, standardized root mean-squared residual=.04, root mean- square error of approximation=.08), and 11 out of 14 paths of the model were supported. The squared multiple correlation, which reflected the explanatory power of the environmental characteristics, symptoms, functional status, and perceived health status on health-related QoL, was 80%. In the hypothesis model, 10 paths had significant direct effects, 6 paths had significant indirect effects, and 12 paths had significant total (direct and indirect) effects. Conclusion: Considering that factors directly affecting the health-related QoL of female patients with RA were social support, symptoms (fatigue and depression), resilience, and perceived health status, and that resilience was the most influential factor, clinicians can encourage resilience. Hence, to improve the health-related QoL of female patients with RA, continuing management is necessary, using various intervention methods that focus on enhancing resilience from the early stage to the end of treatment for RA.

• Safety and Health at Work
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• v.14 no.2
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• pp.229-236
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• 2023

Background: In workers with moderate to severe work-related traumatic brain injury (wrTBI), this study aimed to investigate the effect of the timing of rehabilitation therapy initiation on the length of hospital stay and the factors that can influence this timing. Methods: We used data obtained from the Republic of Korea's nationwide Workers' Compensation Insurance. In the Republic of Korea, between the years 2010 and 2019, a total of 26,324 workers filed a claim for compensation for moderate to severe wrTBI. Multiple regression modeling was performed to compare the length of hospital stay according to the timing of rehabilitation therapy initiation following wrTBI. According to the timing of the initiation of rehabilitation therapy following TBI, the proportions of healthcare institutions that provided medical care during each admission step were compared. Results: The length of hospital stay for workers who started rehabilitation therapy within 90 days was significantly shorter than that for workers who started rehabilitationment were first admitted to tertiary hospitals. Approximately 39% of patients who received delayed rehabilitation treatment were first admitted to general hospitals, and 28.5% were first admitted to primary hospitals. Conclusions: Our findings demonstrate the importance of early rehabilitation initiation and that the type of healthcare institution that the patient is first admitted to after wrTBI may influence the timing of rehabilitation initiation. The results of this study also emphasize the need to establish a Worker's Compensation Insuranceespecialized rehabilitation healthcare delivery system.

• Journal of Gastric Cancer
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• v.23 no.3
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• pp.451-461
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• 2023

Purpose: Endoscopic submucosal dissection (ESD) is an effective treatment for early gastrointestinal neoplasms. However, this is a time-consuming procedure requiring various devices. This study aimed to evaluate the efficacy and safety of the ClearCut^TM Knife H-type, which is an integrated needle-tipped and insulated-tipped (IT) knife. Materials and Methods: Between July 2020 and September 2021, 99 patients with gastric epithelial neoplasms scheduled for ESD at three tertiary care hospitals were randomly assigned to H-knife (ClearCut^TM Knife H-type) or IT-knife (conventional IT knife) groups. Procedure times, therapeutic outcomes, and adverse events were analyzed. Results: A total of 98 patients (50 in the H-knife group and 48 in the IT-knife group) were analyzed. The median total procedure time was 11.9 minutes (range, 4.4-47.2 minutes) in the H-knife group and 12.7 minutes (range, 5.2-137.7 minutes) in the IT-knife group (P=0.209). Unlike the IT-knife group, which required additional devices in all cases, no additional devices were used in the H-knife group (P<0.001). En-bloc resection was performed for all lesions in both groups. The incidence of adverse events was not significantly different between groups (4.0% in the H-knife group vs. 8.3% in the IT-knife group; P=0.431). Conclusions: The newly developed hybrid device, the ClearCut^TM Knife H-type, had comparable efficacy to the conventional IT knife for gastric ESD.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.27 no.1
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• pp.43-52
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• 2024

Purpose: In this study, we investigated the clinical profile, survival at discharge, and proportion of children with acute liver failure (ALF) meeting the criteria for, yet surviving without, liver transplantation (LT). Methods: Medical case records of children aged >28 days to ≤15 years over a period of 7 years, identified from pediatric admission and discharge registers, were screened. Children satisfying the criteria for ALF were included in this study. Results: A total of 71 records meeting the pediatric ALF (PALF) criteria were included. The survival rate at discharge was 61% (n=44). A considerable proportion of children satisfied the King's College Criteria (KCC) (56.3%) and the European Association for the Study of the Liver (EASL) criteria (7%) for LT at admission. Nonetheless, the survival rate in the absence of LT was 42.5% in children who satisfied the KCC and 20% in those who met the EASL criteria. Infection (29.5%) and paracetamol overdose (19.7%) were the major identifiable causes of PALF. Hepatitis A was the most common infection identified. No significant predictors of poor outcomes were identified in multivariable analysis. Conclusion: Our study highlights the changing survival rates and the clinical and etiological profiles of patients with PALF. In areas with poor access to LT services, survival in these children could be improved through early referral to centers with adequate intensive care facilities. Preventing ALF and referring patients to LT services are paramount to reducing mortality.

• Hip & pelvis
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• v.35 no.4
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• pp.233-237
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• 2023

Purpose: The objective of this study was to analyze the results from a cohort of patients who underwent a revision total hip arthroplasty (THA) using a dual mobility cup (DMC) implant. Materials and Methods: A retrospective review of revised THAs was conducted using the database from a single tertiary referral hospital. A total of 91 revision THAs from 91 patients were included in the study. There were 46 male hips and 45 female hips. The mean age was 56.3±14.6 years, and the mean follow-up period was 6.4±5.9 years. In performance of revision THAs, the DMC implants were used in 18 hips (19.8%), and the conventional implants were used in 73 hips (80.2%). Results: During the follow-up period, three dislocations were identified, and the overall dislocation rate was 3.3%. Early dislocation (at one month postoperatively) occurred in one patient, while late dislocation (at a mean of 7.5 years) occurred in two patients. There was no occurrence of dislocation in the DMC group (0%), and three dislocations were detected in the conventional group (4.1%). However, no significant difference in the rate of dislocation was observed between the two groups (P=0.891). Conclusion: Although the rate of dislocation was higher in the conventional group, there were no statistically significant differences between the two groups due to the small number of patients. Nevertheless, we believe that the dual mobility design is advantageous in terms of reducing dislocation rate and can be recommended as an option for a revision THA.

• Annals of Hepato-Biliary-Pancreatic Surgery
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• v.28 no.2
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• pp.220-228
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• 2024

Backgrounds/Aims: Postoperative pancreatic fistula is the key worry in the ongoing debate about the safety and effectiveness of total laparoscopic pancreaticoduodenectomy (TLPD). Laparoscopic-assisted pancreaticoduodenectomy (LAPD), a hybrid approach combining laparoscopic resection and anastomosis with a small incision, is an alternative to TLPD. This study compares the short-term outcomes and oncological efficacy of LAPD vs. open pancreaticoduodenectomy (OPD). Methods: A retrospective analysis of data of all patients who underwent LAPD or OPD for periampullary carcinoma at a tertiary care center in Northeast India from July 2019 to August 2023 was done. A total of 30 LAPDs and 30 OPDs were compared after 1:1 propensity score matching. Demographic data, intraoperative and postoperative data (30 days), and pathological data were compared. Results: The study included a total of 93 patients, 30 underwent LAPD and 62 underwent OPD. After propensity score matching, the matched cohort included 30 patients in both groups. The LAPD presented several advantages over the OPD group, including a shorter incision length, reduced postoperative pain, earlier initiation of oral feeding, and shorter hospital stays. LAPD was not found to be inferior to OPD in terms of pancreatic fistula incidence (Grade B, 30.0% vs. 33.3%), achieving R0 resection (100% vs. 93.3%), and the number of lymph nodes harvested (12 vs. 14, p = 0.620). No significant differences in blood loss, short-term complications, pathological outcomes, readmissions, and early (30-day) mortality were observed between the two groups. Conclusions: LAPD has comparable safety, technical feasibility, and short-term oncological efficacy.

• Korean Circulation Journal
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• v.54 no.2
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• pp.78-90
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• 2024

Background and Objective: We aimed to investigate long-term clinical and echocardiographic outcomes, including tricuspid valve durability, annular growth, and left ventricular reverse remodeling, after modified cone reconstruction in patients with Ebstein's anomaly. Methods: This was a retrospective analysis of all pediatric patients who underwent modified cone reconstruction for Ebstein's anomaly at a single tertiary center between January 2005 and June 2021. Results: A total of 14 pediatric patients underwent modified cone reconstruction for Ebstein's anomaly; the median age was 5.8 years (range, 0.01-16.6). There were three patients (21.4%) with Carpentier type B, ten patients with Carpentier type C (71.4%), and one patient with Carpentier type D (7.1%). There was no early or late mortality, arrhythmia, or readmission for heart failure at a 10-year follow-up. There were no cases of more than mild tricuspid stenosis or more than moderate tricuspid regurgitation during the study period, except for one patient with severe tricuspid regurgitation who underwent reoperation. The z value for tricuspid valve annular size significantly decreased immediately after the operation (2.46 vs. -1.15, p<0.001). However, from 1 year to 7 years after surgery, the z values were maintained between -1 and +1. Left ventricular end-systolic volume, end-diastolic volume, and stroke volume increased after surgery and remained elevated until seven years postoperatively. Conclusions: Ebstein's anomaly in children can be repaired by modified cone reconstruction with low mortality and morbidity, good tricuspid valve durability, and annular growth relative to somatic growth.

• The Korean Journal of Petroleum Geology
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• v.3 no.1 s.4
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• pp.1-15
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• 1995

Seismic reflection profiles and exploratory drilling well samples from the southern marginal-continental shelf basin of Korea delineate that the Tertiary sedimentary sequences can be grouped into five sequences (Sequence A, Sequence B, Sequence C, Sequence D and Sequence E, in descending order). Paleontologic data, K-Ar age datings, correlation with tuff layers and sequence stratigraphic analysis reveal that the sequences A, B, C, D and E can be considered as the deposits of Holocene $\~$ Pleistocene, Pliocene, Late Miocene, Early $\~$ Middle Miocene and Oligocene, respectively. The sequence stratigraphic and structural analyses suggest that the southern part of the Cheju Basin had experienced severe folding and faulting. NE-SW trending strike-slip movement is responsible for the deformation. The sinistral movement of strike-slip fault ceased before the deposition of Sequence B. Age dating and rare-earth elements analysis of volvanic rocks reveal+ that the Sequence D was deposited during the Early $\~$ Middle Miocene and the Sequence I was deposited earlier than the deposition of the Green Tuff Formation. Sedimentary petrological studies indicate that sediments of the Sequence I came from the continental block provenance. After the deposition of the Sequence E, uplift of the source area resulted in increase of sediment supply, subsidence and volcanic activities. The Sequence D show these factors and the sediments of the Sequence D are considered to be transported from the recycled orogenic belt.