• Journal of Chest Surgery
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• v.57 no.3
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• pp.302-311
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• 2024

Background: Unexpected conversion to thoracotomy during planned video-assisted thoracoscopic surgery (VATS) can lead to poor outcomes and comparatively high morbidity. This study was conducted to assess preoperative risk factors associated with unexpected thoracotomy conversion and to develop a risk scoring model for preoperative use, aimed at identifying patients with an elevated risk of conversion. Methods: A retrospective analysis was conducted of 1,506 patients who underwent surgical resection for non-small cell lung cancer. To evaluate the risk factors, univariate analysis and logistic regression were performed. A risk scoring model was established to predict unexpected thoracotomy conversion during VATS of the lung, based on preoperative factors. To validate the model, an additional cohort of 878 patients was analyzed. Results: Among the potentially significant clinical variables, male sex, previous ipsilateral lung surgery, preoperative detection of calcified lymph nodes, and clinical T stage were identified as independent risk factors for unplanned conversion to thoracotomy. A 6-point risk scoring model was developed to predict conversion based on the assessed risk, with patients categorized into 4 groups. The results indicated an area under the receiver operating characteristic curve of 0.747, with a sensitivity of 80.5%, specificity of 56.4%, positive predictive value of 1.8%, and negative predictive value of 91.0%. When applied to the validation cohort, the model exhibited good predictive accuracy. Conclusion: We successfully developed and validated a risk scoring model for preoperative use that can predict the likelihood of unplanned conversion to thoracotomy during VATS of the lung.

• Asian Pacific Journal of Cancer Prevention
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• v.17 no.3
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• pp.1433-1436
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• 2016

Background: Cholangiocarcinoma (CCA), a major problem of health in Thailand, particularly in Northeastern and Northern regions, is generally incurable and rapidly lethal because of presentation in stage 3 or 4. Early diagnosis of stage 1 and 2 could allow better survival. Therefore, this study aimed to provide a distribution map of populations at risk for CCA in BuaYai district of Nakhon Ratchasima province, Northeast Thailand. Materials and Methods: A cross-sectional survey was carried out in 10 sub-districts and 122 villages, during June and November 2015. The populations at risk for CCA were screened using the Korat CCA verbal screening test (KCVST) and then risk areas were displayed by using Google map (GM). Results: A total of 11,435 individuals from a 26,198 population completed the KCVST. The majority had a low score of risk for CCA (1-4 points; 93.3%). High scores with 6, 7 and 8 points accounted for 1.20%, 0.13% and 0.02%. The population at risk was found frequently in sub-district municipalities, followed by sub-district administrative organization and town municipalities, (F=396.220, P-value=0.000). Distribution mapping comprised 11 layers: 1, district; 2, local administrative organization; 3, hospital; 4, KCVST opisthorchiasis; 5, KCVST praziquantel used; 6, KCVST cholelithiasis; 7, KCVST raw fish consumption; 8, KCVST alcohol consumption; 9, KCVST pesticide used; 10, KCVST relative family with CCA; and 11, KCVST naive northeastern people. Geovisual display is now available online. Conclusions: This study indicated that the population at high risk of CCA in Bua Yai district is low, therefore setting a zero model project is possible. Key success factors for disease prevention and control need further study. GM production is suitable for further CCA surveillance and monitoring of the population with a high risk score in this area.

• Journal of the Korea Safety Management & Science
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• v.26 no.2
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• pp.43-53
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• 2024

This study analyzes the importance-performance analysis (IPA) of the 10 dimensions of the smart construction safety management system, and analyzes which dimensions are important and which dimensions are performing to determine key improvement tasks, incremental improvement tasks, Maintenance and reinforcement tasks and continuous maintenance tasks were derived. Among the 10 dimensions of the smart construction safety management system, the dimensions that are recognized as important by all field managers and field workers and have high performance are the automatic risk displacement measurement system, smart environmental sensor system, and heavy equipment seizure prevention system. However, areas that were perceived as having high importance but low performance were worker location tracking systems, smart safety helmet chin muscles, and smart safety ring fastening. Among the smart construction safety management systems perceived by field managers, areas for key improvement with high importance and low performance included worker location tracking system and smart safety ring fastening. Among the smart construction safety management systems perceived by field workers, the area for key improvement with high importance and low performance was the automatic risk displacement measurement system.

• Journal of Nutrition and Health
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• v.36 no.10
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• pp.1052-1060
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• 2003

Poor dietary habits and inadequate nutrient intakes are of concern in the elderly, even it is worse in rural areas. In the present study, we conducted the anthropometric measurement and the dietary intakes including macronutrients, minerals and vitamins to assess the nutrient intakes and nutritional risk in elderly people in rural kyungpook province in South Korea. Subjects (n = 168, mean age, 67.3 yrs) were interviewed using d general questionnaire and 3 days of 24-hours recall for dietary intake. Nutrient intakes were analyzed using CAN-pro soft program and compared to Korean RDA and nutrition reference values (NRV). The anthropometric measurement showed that the weight and the height of the subjects in the rural area were below the average of the same age of Korean elderly people. The energy and protein intakes were 85％ and 90％ of Korean RDA, respectively. The intakes of lipid, cholesterol and dietary fiber were 62％, 40％ and 22％ of NRV for Korean adults. Main sources for protein and lipid intakes came from the vegetable sources and this pattern was more prominent in female elderly people. Ca intake was half of Korean RDA (56％), while P intake was 132％ of Korean RDA. For the antioxidant trace mineral (Fe, Cu, Mn, Zn, and Se) intakes, Fe and Zn intakes were 78％ and > 103％ of Korean RDA. Cu, Mn and Se intakes were > 113％, > 275％, and > 185％ of Korean NRV. Thiamin, niacin and vitamin C intakes were above Korean RDA, but the intakes of vitamin A and riboflavin were 88％ and 63％ of Korean RDA, respectively. On summarizing the results of the present study, the elderly people in rural area consume less lipid, cholesterol, Ca, and dietary fiber. Ca intake is lower, while P intake is higher, and this would be the potential risk for bone health. Also, Na intake was high, which can be the potential risk for the cardiovascular disease prevailance. Vitamin intakes were fairly good status, excepting riboflavin. Antioxidant mineral intakes were much higher than Korean NRV, unexpectedly. The results suggest that the elderly people in rural area have inadequate intakes of protein, lipid, dietary fiber and Ca, which mainly should be supplied from animal products. Recommendations to increase diet variety would be emphasized for this nutritionally poor-conditioned subjects, specially including animal food products and high dietary fiber food.

• Journal of the Korean Wood Science and Technology
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• v.43 no.1
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• pp.104-111
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• 2015

The three-year inspection of 20 tree stumps in the fire prevention area around the wooden building confirmed that termite colonies had been rapidly spread. In particular, four buildings among thirty one wooden buildings of Songgwang-sa temple were infected by the termite, indicating that the habitate of termite has been spread across the fire prevention area over the temple area. However, a non-destructive microwave diagnosis showed that internal damages have been progressed until now, suggesting a high risk to the building. These results suggest that the fire prevention area should be properly maintained to have harmful element controlled. Therefore, effective methods are required to eliminate tree stumps or wood materials used to establish fire prevention area near wooden buildings.

• Journal of Preventive Medicine and Public Health
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• v.53 no.5
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• pp.313-322
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• 2020

Objectives: This study was conducted to determine the incidence and risk factors of myocardial infarction (MI) and stroke in farmers compared to the general population and to establish 5-year prediction models. Methods: The farmer cohort and the control cohort were generated using the customized database of the National Health Insurance Service of Korea database and the National Sample Cohort, respectively. The participants were followed from the day of the index general health examination until the events of MI, stroke, or death (up to 5 years). Results: In total, 734 744 participants from the farmer cohort and 238 311 from the control cohort aged between 40 and 70 were included. The age-adjusted incidence of MI was 0.766 and 0.585 per 1000 person-years in the farmer and control cohorts, respectively. That of stroke was 0.559 and 0.321 per 1000 person-years in both cohorts, respectively. In farmers, the risk factors for MI included male sex, age, personal history of hypertension, diabetes, current smoking, creatinine, metabolic syndrome components (blood pressure, triglycerides, and high-density lipoprotein cholesterol). Those for stroke included male sex, age, personal history of hypertension, diabetes, current smoking, high γ-glutamyl transferase, and metabolic syndrome components (blood pressure, triglycerides, and high-density lipoprotein cholesterol). The prediction model showed an area under the receiver operating characteristic curve of 0.735 and 0.760 for MI and stroke, respectively, in the farmer cohort. Conclusions: Farmers had a higher age-adjusted incidence of MI and stroke. They also showed distinct patterns in cardiovascular risk factors compared to the general population.

• Journal of Korean Society for Atmospheric Environment
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• v.8 no.4
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• pp.247-256
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• 1992

Airborne suspended particulates were collected at Shinchon by a high volume cascade impactor from Sep. 1990 to Aug. 1991. Organic matter was extracted from particulates and fractionated by liquid-liquid extraction and thin layer chromatography. Substances in the PAHs and nitroarenes'subfraction of neutral fraction were determined by capillary gas chromatography. Based on unit risk estimates by multi-stage model of benzo[a]pyrene and the results of exposure estimates, cancer risk was assessed. The annual average concentration of total suspended particulates was 201.77g/$m^3$. The percentage of fine particulates was 57.40. The concentration of total suspended particulates showed seasonal variations and was high in winter and spring. The average concentration of extractable organic matter was 8.12g/$m^3$. In all, 21 PAHs were identified and quantified. The annual concentration of fluoranthene was 2.38ng/$m^3$, and that was the highest value of all PAHs. A carcinogenic compound, benzo[a]pyrene, was at a concentration of 1.84ng/$m^3$. All the 10 nitroarenes were also identified and quantified. The major nitroarene in the Shinchon area was 2,7-dinitrofluorene. The annual concentration of 1-nitropyrene was 1.56ng/$m^3$. Concentrations of PAHs and nitroarenes were high in winter and low in summer. The life time excess risk estimates of benzo[a]pyrene was calculated as 0.96 persons/a million population in this experiment. In the rank of relative potenties, carcinogenic effects of the other PAHs were calculated as 0.004-0.108 persons/a million population.

• Clinical Endoscopy
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• v.57 no.4
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• pp.476-485
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• 2024

Background/Aims: Sedation has become a standard practice for patients undergoing gastrointestinal (GI) endoscopy. However, considering the serious cardiopulmonary adverse events associated with sedatives, it is important to identify patients at high risk. Machine learning can generate reasonable prediction for a wide range of medical conditions. This study aimed to evaluate the risk factors associated with sedation during GI endoscopy and develop a predictive model for hypoxia during endoscopy under sedation. Methods: This prospective observational study enrolled 446 patients who underwent sedative endoscopy at the Korea University Ansan Hospital. Clinical data were used as predictor variables to construct predictive models using the random forest method that is a machine learning algorithm. Results: Seventy-two of the 446 patients (16.1%) experienced life-threatening hypoxia requiring immediate medical intervention. Patients who developed hypoxia had higher body weight, body mass index (BMI), neck circumference, and Mallampati scores. Propofol alone and higher initial and total dose of propofol were significantly associated with hypoxia during sedative endoscopy. Among these variables, high BMI, neck circumference, and Mallampati score were independent risk factors for hypoxia. The area under the receiver operating characteristic curve for the random forest-based predictive model for hypoxia during sedative endoscopy was 0.82 (95% confidence interval, 0.79-0.86) and displayed a moderate discriminatory power. Conclusions: High BMI, neck circumference, and Mallampati score were independently associated with hypoxia during sedative endoscopy. We constructed a model with acceptable performance for predicting hypoxia during sedative endoscopy.

• Journal of Korean Society for Atmospheric Environment
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• v.8 no.1
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• pp.29-37
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• 1992

The risk of benzo(a)pyrene for cancer in the ambient air of Seoul was assessed by using the extrapolation methods. The average daily lifetime exposure of benzo(a)pyrene in the ambient air of Seoul was calculated at 6.97-24.30ng/$m^2$/day, which was based on the occurrence analysis of benzo(a)pyrene in the residential(Bull Kwang Dong) and traffic areas(Shin Chon) of Seoul. Using the dose scaling based on body surface area in comparisons of toxicity for extrapolation from animal to human and mathematical models from the high dose region, the low-dose risk was estimated. The response probabilities were estimated by the tolerance distribution models; Probit, Logit and Weibull model. They were consistent with the observed ones at experimental dose region. The unit risk estimates of these models were too low to be used. One-hit and multistage model to prove more conservative risk was selected. As a redult, the lifetime unit risk of benzo(a)pyrene for cancer and virtually safe dose were calculated; One-hit model provided the risk 2.8 $\times 10^{-7}$ and 3.4ng/$m^3$, respectively and multistage model provided 5.2 $\times 10^{-7}$ and 1.9ng/$m^3$ as the more conservatives. The lifetime excess risk estimates of benzo(a)pyrene for cancer were calculated at 0.37-1.30 persons/million persons by one-hit model and 0.69-2.41 persons/million persons by multistage model, which was considered in without virtual risk.

• Safety and Health at Work
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• v.3 no.3
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• pp.235-240
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• 2012

The objectives are to compare the airborne asbestos concentrations resulted from mitering of abestos cement roof sheets by a high-speed motor and a hand saw, and to monitor whether other workers near the test sites are vulnerable to the fibers exceeding the occupational exposure limit. Four test cases were carried out and altogether 7 personal and 4 area air samples were collected. The NIOSH method 7400 was employed for the air samplings and analysis. Using the phase contrast microscopy, fiber counting was conducted under Rule A. The study showed that the fiber concentration medians for personal air samples gathered from the two tools were 4.11 fibers/cc (ranged: 1.33-12.41 fibers/cc) and 0.13 fibers/cc (ranged: 0.01-5.00 fibers/cc) respectively. The median for the area samples was 0.59 fibers/cc (ranged: 0.14-3.32 fibers/cc). Comparing each study case, the concentration level caused by the high-speed motor saw was more than twice that of the hand saw. According to the area samples, the workers nearby the test site are at risk from high exposure to asbestos.