• Journal of The Korean Society of Clinical Toxicology
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• v.21 no.2
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• pp.69-80
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• 2023

Purpose: Suicide ranks among the top causes of death among youth in South Korea. This study aimed to identify the characteristics of suicidal individuals treated at emergency departments between 2011 and 2020. Methods: A retrospective analysis was conducted using data from January 2011 to December 2020 in the Injury Surveillance Cohort, a prospective registry. Patients' sex, age, mortality, methods of self-harm, and previous suicide attempts were analyzed. The methods of self-harm were categorized into falls, asphyxiation, blunt injuries, penetrating injuries, poisoning, and others. Sub-groups with and without poisoning were compared. Results: The proportion of self-harm/suicide attempts increased from 2.3% (2011) to 5.0% (2020). The mortality rate decreased from 10.8% (2011) to 6.3% (2020). Poisoning was the most common method (61.7%). Mortality rates ranged from 42.0% for asphyxiation to 0.2% for blunt injuries. Individuals in their 20s showed a marked increase in suicide/self-harm attempts, especially in the last three years. A large proportion of decedents in their 70s or older (52.6%) used poisoning as a method of suicide. The percentage of individuals with two or more previous attempts rose from 7.1% (2011) to 19.7% (2020). The death rates by poisoning decreased from 7.7% (2011) to 2.5% (2020). Conclusion: Our findings underscore the urgent need for targeted interventions and suicide prevention policies. Managing and reducing suicide and self-harm in emergency settings will require a focus on poisoning, the 10-29 age group, and the elderly. This paper will be valuable for future policies aiming to reduce the societal burden of suicide and self-harm.

• Korean Journal of Radiology
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• v.20 no.8
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• pp.1300-1310
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• 2019

Objective: To measure the diagnostic accuracy of percutaneous transthoracic needle lung biopsies (PTNBs) on the basis of the intention-to-diagnose principle and identify risk factors for diagnostic failure of PTNBs in a multi-institutional setting. Materials and Methods: A total of 9384 initial PTNBs performed in 9239 patients (mean patient age, 65 years [range, 20-99 years]) from January 2010 to December 2014 were included. The accuracy, sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of PTNBs for diagnosis of malignancy were measured. The proportion of diagnostic failures was measured, and their risk factors were identified. Results: The overall accuracy, sensitivity, specificity, PPV, and NPV were 91.1% (95% confidence interval [CI], 90.6-91.7%), 92.5% (95% CI, 91.9-93.1%), 86.5% (95% CI, 85.0-87.9%), 99.2% (95% CI, 99.0-99.4%), and 84.3% (95% CI, 82.7-85.8%), respectively. The proportion of diagnostic failures was 8.9% (831 of 9384; 95% CI, 8.3-9.4%). The independent risk factors for diagnostic failures were lesions ≤ 1 cm in size (adjusted odds ratio [AOR], 1.86; 95% CI, 1.23-2.81), lesion size 1.1-2 cm (1.75; 1.45-2.11), subsolid lesions (1.81; 1.32-2.49), use of fine needle aspiration only (2.43; 1.80-3.28), final diagnosis of benign lesions (2.18; 1.84-2.58), and final diagnosis of lymphomas (10.66; 6.21-18.30). Use of cone-beam CT (AOR, 0.31; 95% CI, 0.13-0.75) and conventional CT-guidance (0.55; 0.32-0.94) reduced diagnostic failures. Conclusion: The accuracy of PTNB for diagnosis of malignancy was fairly high in our large-scale multi-institutional cohort. The identified risk factors for diagnostic failure may help reduce diagnostic failure and interpret the biopsy results.

• The korean journal of orthodontics
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• v.54 no.2
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• pp.79-88
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• 2024

Objective: Alveolar bone loss is a common adverse effect of intrusion treatment. Mandibular incisors are prone to dehiscence and fenestrations as they suffer from thinner alveolar bone thickness. Methods: Thirty skeletal class II patients treated with mandibular intrusion arch therapy were included in this study. Lateral cephalograms and cone-beam computed tomography images were taken before treatment (T1) and immediately after intrusion arch removal (T2) to evaluate the tooth displacement and the alveolar bone changes. Pearson's and Spearman's correlation was used to identify risk factors of alveolar bone loss during the intrusion treatment. Results: Deep overbite was successfully corrected (P < 0.05), accompanied by mandibular incisor proclination (P < 0.05). There were no statistically significant change in the true incisor intrusion (P > 0.05). The labial and lingual vertical alveolar bone levels showed a significant decrease (P < 0.05). The alveolar bone is thinning in the labial crestal area and lingual apical area (P < 0.05); accompanied by thickening in the labial apical area (P < 0.05). Proclined incisors, non-extraction treatment, and increased A point-nasion-B point (ANB) degree were positively correlated with alveolar bone loss. Conclusions: While the mandibular intrusion arch effectively corrected the deep overbite, it did cause some unwanted incisor labial tipping/flaring. During the intrusion treatment, the alveolar bone underwent corresponding changes, which was thinning in the labial crestal area and thickening in the labial apical area vice versa. And increased axis change of incisors, non-extraction treatment, and increased ANB were identified as risk factors for alveolar bone loss in patients with mandibular intrusion therapy.

• Journal of agricultural medicine and community health
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• v.49 no.1
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• pp.50-58
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• 2024

Objective: The purpose of this study is to examine the factors influencing the health status of first-year high school students leisure activity time, considering of the city size. Methods: This study utilized the first cohort survey of the Korean Children and Youth Panel Survey. The analysis was used data from survey targeting first-year high school students of 2021. The city size was divided into large cities and medium and small-sized cities, and T-test was conducted to examine differences in factors by city size, and multiple regression analysis was conducted to identify factors influencing health status according to leisure activity time on weekdays and weekends by city size. Results: In large cities, exercise and physical activity time and other than that, Time to play with friends had a positive effect(+), Time to play with a smartphone had a negative effect(-) on both weekdays and weekends. In medium and small-sized cities, Exercise and physical activity time and Time to play while watching TV had a positive influence(+) on both weekdays and weekends, while Time to play with a smartphone had a negative influence(-). Conclusion: There were the same questions for factors influencing health status, but other questions also appeared. Leisure activities that have a positive(+) impact on health status by city size are supported so that leisure activities can be actively carried out, while leisure activities that have a negative(-) impact are participate in other leisure activities together to improve health. It is believed that this plan should be considered.

• Journal of the Korean Society of Radiology
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• v.83 no.1
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• pp.138-148
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• 2022

Purpose This study evaluated the rates and annual trends of pediatric CT scans in South Korea using a nationwide population-based database. Materials and Methods Data regarding pediatric CT scan usage between 2012 and 2017 were retrieved from the health insurance review and assessment service. Data on the age, sex, diagnosis, and the anatomical area of involved patients were also extracted. Results A total of 576376 CT examinations were performed among 58527528 children aged below 18 years (9.8 scans/1000 children), and the number of CT examinations per 1000 children was noted to have increased by 23.2% from 9.0 in 2012 to 11.0 in 2017. Specifically, the number of CT examinations increased by 32.9% for the 6-12 years of age group (7.4/1000 to 9.8/1000) and by 34.0% for the 13-18 years of age group (11.4/1000 to 15.3/1000). Moreover, majority of the CT scans were limited to the head (39.1%), followed by the extremities (32.5%) and the abdomen (13.7%). Notably, the number of extremity CT scans increased by 83.6% (2.3/1000 to 4.2/1000), and its proportion as compared to other scans increased from 25.3% to 37.7%. Conclusion CT scans in the pediatric population increased continuously from 2012 to 2017 at an annual rate of 4.4%. Therefore, physicians should balance the benefits of CT with its potential harms from associated radiation exposure in pediatric patients.

• Korean Circulation Journal
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• v.53 no.11
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• pp.744-755
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• 2023

Background and Objectives: Aortic valve replacement (AVR) is considered a class I indication for symptomatic severe aortic stenosis (AS). However, there is little evidence regarding the potential benefits of early AVR in symptomatic patients diagnosed with normal-flow, low-gradient (NFLG) severe AS. Methods: Two-hundred eighty-one patients diagnosed with symptomatic NFLG severe AS (stroke volume index ≥35 mL/m², mean transaortic pressure gradient <40 mmHg, peak transaortic velocity <4 m/s, and aortic valve area <1.0 cm²) between January 2010 and December 2020 were included in this retrospective study. After performing 1:1 propensity score matching, 121 patients aged 75.1±9.8 years (including 63 women) who underwent early AVR within 3 months after index echocardiography, were compared with 121 patients who received conservative care. The primary outcome was a composite of all-cause death and heart failure (HF) hospitalization. Results: During a median follow-up of 21.9 months, 48 primary outcomes (18 in the early AVR group and 30 in the conservative care group) occurred. The early AVR group demonstrated a significantly lower incidence of primary outcomes (hazard ratio [HR], 0.52; 95% confidence interval [CI], 0.29-0.93; p=0.028); specifically, there was no significant difference in all-cause death (HR, 0.51; 95% CI, 0.23-1.16; p=0.110), although the early AVR group showed a significantly lower incidence of hospitalization for HF (HR, 0.43; 95% CI, 0.19-0.95, p=0.037). Subgroup analyses supported the main findings. Conclusions: An early AVR strategy may be beneficial in reducing the risk of a composite outcome of death or hospitalization for HF in symptomatic patients with NFLG severe AS. Future randomized studies are required to validate and confirm our findings.

• Tuberculosis and Respiratory Diseases
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• v.79 no.2
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• pp.91-97
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• 2016

Background: Chronic obstructive pulmonary disease (COPD) is sometimes complicated with pneumonia, but little is known about the risk factors that promote the development of pneumonia in COPD. These risk factors were evaluated in the present study. Methods: The data of 324 patients with COPD from a prospective multi-center observational cohort with obstructive lung disease were evaluated retrospectively. To identify risk factors for the development of pneumonia in COPD, the clinical and radiological data at enrollment and the time to the first episode of pneumonia were analyzed by Cox proportional hazard analysis. Results: The median follow-up time was 1,099 days and 28 patients (8.6%) developed pneumonia. The Cox analysis showed that post-bronchodilator forced expiratory volume in one second ($FEV_1$, % of predicted) and the computed tomography (CT) emphysema extent (inspiratory V950) were independent risk factors for the development of pneumonia (post-bronchodilator $FEV_1$: hazard ratio [HR], 0.97; 95% confidence interval [CI], 0.94-1.00; p=0.048 and inspiratory V950: HR, 1.04; 95% CI, 1.01-1.07; p=0.01). Conclusion: Emphysema severity measured by CT and post-bronchodilator $FEV_1$ are important risk factors for the development of pneumonia in COPD.

• Restorative Dentistry and Endodontics
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• v.36 no.6
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• pp.465-476
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• 2011

In current endodontic practice, introduction of operating microscope, ultrasonic instruments, and microinstruments has induced a big change in the field of surgical retreatment. In this study, we aimed to offer key steps of endodontic microsurgery procedure compared with traditional root-end surgery, and to evaluate factors influencing success and failure based on published articles. Endodontic microsurgery is a surgical procedure performed with the aid of a microscope, ultrasonic instruments and modern microsurgical instruments. The microscope provides magnification and illumination - essential for identifying minute details of the apical anatomy. Ultrasonic instruments facilitate the precise root-end preparation that is within the anatomical space of the canal. Modern endodontics can therefore be performed with precision and predictability, thus eliminating the disadvantages inherent in traditional periapical surgery such as large osteotomy, beveled apicoectomy, inaccurate root-end preparation and the inability to observe isthmus. Factors influencing the outcomes of endodontic microsurgery may be diverse, but standardization of procedures can minimize its range. Among patient and tooth-related factors, periodontal status and tooth position are known to be prognostic, but there are only few articles concerning this matter. High-evidence randomized clinical trials or prospective cohort studies are needed to confirm these findings.

• Journal of Preventive Medicine and Public Health
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• v.49 no.1
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• pp.45-52
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• 2016

Objectives: Previous large-scale cohort studies conducted in Korea have found a positive association between diabetes mellitus (DM) and colorectal cancer (CRC) in men only, in contrast to studies of other populations that have found significant associations in both men and women. Methods: A total of 1070 CRC cases and 2775 controls were recruited from the National Cancer Center, Korea between August 2010 and June 2013. Self-reported DM history and the duration of DM were compared between cases and controls. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated by binary and polytomous logistic regression models. Results: DM was associated with an elevated risk of CRC in both men (OR, 1.47; 95% CI, 1.13 to 1.90) and women (OR, 1.92; 95% CI, 1.24 to 2.98). This association remained when we controlled for age, body mass index, alcohol consumption, and physical activity level. In sub-site analyses, DM was associated with distal colon cancer risk in both men (multivariate OR, 2.04; 95% CI, 1.39 to 3.00) and women (multivariate ORs, 1.99; 95% CI, 1.05 to 3.79), while DM was only associated with rectal cancer risk in women (multivariate OR, 2.05; 95% CI, 1.10 to 3.82). No significant association was found between DM and proximal colon cancer risk in either men (multivariate OR, 1.45; 95% CI, 0.88 to 2.41) or women (multivariate OR, 1.79; 95% CI, 0.78 to 4.08). Conclusions: Overall, DM was associated with an increased risk of CRC in Koreans. However, potential over-estimation of the ORs should be considered due to potential biases from the case-control design.

• Journal of Preventive Medicine and Public Health
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• v.36 no.4
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• pp.303-313
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• 2003

General information is summarized, that is necessary to introduce a scientific assessment of the human health and exposure issue concerning dioxin and dioxin-like compound. Scientific literatures were reviewed to assess the background exposures to the dioxin-like compounds for normal residents. Epidemiologic studies were also reviewed to assess malignant and nonmalignant sweets of dioxins. In 1997, the International Agency for Research on Cancer classified 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD) as a human carcinogen, primarily based on occupational cohort studies. The US Environmental Protection Agency made the same decision in it's Draft Dioxin Reassessment. Epidemiologic evidences point to a generalized excess of all cancers, without any pronounced excess at specific sites. Reported non-cancer effects included a range of conditions affecting most systems. Among them, chloracne, elevation in gamma glutamyl transferase(GGT), and alterations in reproductive hormones are related to TCDO, Other adverse outcomes, such as lipid concentrations, diabetes, circulatory and heart diseases, immunologic disorders, neurobehavioral effects, and developmental outcomes require further study before their respective relationships to TCDD can be more definitively assessed.