• Journal of Environmental Health Sciences
• /
• v.49 no.4
• /
• pp.218-227
• /
• 2023

Background: Since 2019, the Ministry of Environment has implemented a seasonal fine dust management system from December to March, targeting high PM_2.5 levels with the aim of reducing PM_2.5 concentrations and protecting public health. The focus of improving the seasonal management system lies in the atmospheric PM_2.5 levels. Considering the primary goal of protecting public health, it is necessary to analyze the policy effects from an exposure perspective rather than a concentration-based approach. Objectives: This study aims to quantitatively assess the improvement of indoor PM_2.5 levels and the health impacts of the seasonal management system by comparing the periods before and during its implementation in residential environments. Methods: PM_2.5 concentrations within residential environments in a metropolitan area were measured using an optical particle counter (IAQ-C7, K-weather, Ltd, Korea) at one-minute intervals during the pre-implementation period (November 21~25, 2022) and during the implementation period (December 19~23, 2022). Based on the measured PM_2.5 concentrations, a quantitative evaluation of cancer and mortality risks was conducted according to age and gender. Results: The results of comparing indoor and outdoor PM_2.5 concentrations before and during the implementation of the seasonal management system showed a decrease of approximately 56.6% and 47.9%, respectively. Health risk assessments revealed that both the safety-limit-based and safety-target-based Hazard Quotients (HQ) exceeded the threshold of 0.1 for children under 19 years of age, both before and after the implementation. The mortality risk decreased by approximately 47.9% after the implementation, with children aged 0-9 showing the highest mortality risk at 0.9%. Conclusions: The findings of this study confirmed the positive health impacts of the seasonal management system across all age groups, particularly children under 19 who are more vulnerable to fine dust exposure.

• Asian Pacific Journal of Cancer Prevention
• /
• v.13 no.6
• /
• pp.2523-2526
• /
• 2012

Introduction: Febrile neutropenia is a relatively frequent event in cancer patients treated with chemotherapy and improvement in absolute neutrophil count (ANC) has been linked directly to improved outcome. Evaluation of granulocyte colony stimulating factors (GCSFs) for treatment has shown reduced incidences of episodes of prolonged neutropenia and protracted hospitalization. To determine absolute neutrophil counts with GCSF in febrile neutropenic cancer patients admitted to a tertiary care centre and to co-relate the improvement in ANC with mortality and hospital discharge. Methods: A prospective cross sectional study was carried at an oncology ward at Aga Khan University hospital from January 2010 to June 2011. All adult patients who were admitted and treated with GCSF for chemotherapy induced febrile neutropenia were included. Multivariable regression was conducted to identify the factors related with poor outcomes. Results: A total of 131 patients with febrile neutropenia were identified with mean age of 43.2 (18-85) years, 79 (60%) being ${\leq}50$. Seventy-five (57%) had solid tumors and 56 (43%) hematological malignancies, including lymphoma. Fifty seven (43.5%) had an ANC less 100 cells/$mm^3$, 34 (26%) one between 100-300 cells/$mm^3$ and 40 (31%) an ANC greater than 300 cells/$mm^3$. Thirty (23%) patients showed ANC recovery in 1-3 days, and 74(56%) within 4-7 days. Thirteen (10%) patients showed no recovery. The overall mortality was 18 (13.7%) patients. The mean time for ANC recovery seen in hematological malignancies was 6.34 days whereas for solid tumors it was 4.88 days. Patients with ANC <100 cells/$mm^3$ were more likely to die than patients with ANC >300 cells/$mm^3$ by a factor of 4.3. Similarly patients >50 years of age were 2.7 times more likely to die than younger patients. Conclusion: Our study demonstrated that use of GCSF, in addition to intravenous antibiotics, in treatment of patients with chemotherapy induced febrile neutropenia accelerates neutrophil recovery, and shortens antibiotic therapy and hospitalization. We propose to risk classify the patients at the time of admission to evaluate the cost effectiveness of this approach in a resource constrained setup.

• Asian Pacific Journal of Cancer Prevention
• /
• v.17 no.11
• /
• pp.4999-5003
• /
• 2016

The testicular cancer (TCa) incidence is increasing in many countries, with age-standardized incidence rates up to 7.8/100,000 men in the Western world, although reductions in mortality and increasingly high cure rates are being witnessed at the same time. In Africa, where rates are lower, presentation is often late and morbidity and mortality high. Given this scenario, awareness of testicular cancer and practice of testicular self-examination among future first response doctors is very important. This study was conducted to determine knowledge and attitude to testicular cancer, and practice of testicular self-examination (TSE) among final (6th) year medical students. In addition, the effect of an intervention in the form of a single PowerPoint(R) lecture, lasting 40 minutes with image content on testicular cancer and testicular self examination was assessed. Pre and post intervention administration of a self-administered structured pre tested questionnaire was performed on 151 medical students, 101 of whom returned answers (response rate of 66.8%). In the TC domain, there was a high level of awareness of testicular cancer, but poor knowledge of the age group most affected, with significant improvement post intervention (p<0.001). Notable also was the poor awareness of the potential curability of TC, this also being improved following the intervention (p<0.001). A poor level of awareness and practice of testicular self-examination pre-intervention was found considering the nature of the study group..Respondents had surprisingly weak/poor responses to the question "How important to men's health is regular testicular self-examination?" Answers to the questions "Do you think it is worthwhile to examine your testis regularly?" and "Would you be interested in more information on testicular cancer and testicular self-examination?" were also suboptimal, but improved post intervention p<0.001, p<0.001 and p=0.037. Age, gender and marital status were without specific influence. In conclusion, this study showed poor levels of knowledge regarding epidemiology of TCa and its potential curability when detected early. There was also a poor awareness of, practice of, and poor attitudes to TSE. The significant improvement in these parameters post intervention indicates value in educational intervention. We recommend inclusion of TCa coverage and TSE teaching in the secondary school curriculum (targeting adolescents). Greater emphasis should also be given to testicular cancer in the curricula of medical schools and other training institutions for health care personnel.

• Clinical and Experimental Pediatrics
• /
• v.52 no.2
• /
• pp.194-198
• /
• 2009

Purpose : Active perioperative intervention and improvement on surgical technique has decreased the mortality rate of total anomalous pulmonary venous connection (TAPVC); however, when complicated with pulmonary venous obstruction, operative mortality is still high. The purpose of this study was to investigate the clinical course of TAPVC. Methods : Twenty-seven patients who were diagnosed with TAPVC (without other complex heart anomalies) by echocardiogram at Kyungpook National University Hospital from January 1994 to February 2008 were included. Results : Mean age at diagnosis was $28.1{\pm}33.4$ days (1-126 days). Sites of drainage were supracardiac type (15), cardiac (6), infracardiac (5), and mixed (1). Seven patients had pulmonary venous obstruction: 5 with supracardiac type, 1 with cardiac, and 1 with infracardiac. Intraoperative trans-esophageal echocardiograms were performed in 14 patients (58.3%). The operative mortality was 16.7% (4 of 24) and overall hospital mortality (including deaths without operation) was 22.2% (6 of 27). There were 5 postoperative pulmonary venous obstructions. The sites of obstruction were anastomotic in 3 of 5 (60%) patients, and ostial pulmonary vein in the other 2 (40%) patients. Three patients who presented with anastomotic pulmonary venous obstruction underwent reoperation, but all the patients were found to have pulmonary venous anastomotic obstruction. The other 2 patients with ostial pulmonary vein obstruction who had no significant symptoms were diagnosed by routine echocardiographic examination during follow-up. Conclusion : In TAPVC patients, early diagnosis and aggressive surgical management will improve prognosis, and we must pay attention to early and late pulmonary vein restenosis through intraoperative trans-esophageal echocardiogram and peri- and post-operative echocardiographic follow-up examinations.

• Tuberculosis and Respiratory Diseases
• /
• v.45 no.6
• /
• pp.1252-1264
• /
• 1998

Background : Patients with established ARDS have a mortality rate that exceeds 50 percent despite of intensive care including artificial ventilation modality, Mortality has been associated with sepsis and organ failure preceding or following ARDS ; APACHE II score ; old age and predisposing factors. Revised ventilator strategy over last 10 years especially at ARDS appeared to improve the mortality of it. We retrospectively investigated 40 ARDS patients of respiratory-care unit to examine how these factors influence outcome. Methods : A retrospective investigation of 40 ARDS patients in respiratory-care unit with ventilator management over 46 months was performed. We investigated the clinical characteristics such as a risk factor, cause of death and mortality, and also parameters such as APACHE II score, number of organ dysfunction, and hypoxia score (HS, $PaO_2/FIO_2$) at day 1, 3, 7 of severe acute lung injury, and simultaneously the PEEP level and tidal volume. Results : Clinical conditions associated with ARDS were sepsis 50%, pneumonia 30%, aspiration pneumonia 20%, and mortality rate based on the etiology of ARDS was sepsis 50%, pneumonia 67%(p<0.01 vs sepsis), aspiration pneumonia 38%. Overall mortality rate was 60%. In 28 day-nonsurvivors, leading cause of death was severe sepsis(42.9%) followed by MOF(28.6%), respiratory failure(19.1 %), and others(9.5%). There were no differences in variables of age, sex, APACHE II score, HS, and numbers of organ dysfunction at day 1 of ARDS between 28-days survivor and nonsurvivors. In view of categorized variables of age(>70), APACHE II score(>26), HS(<150) at day 1 of ARDS, there were significant differences between 28-days survivor and nonsurvivors(p<0.05). After day 1 of ARDS, the survivors have improved their APACHE II score, HS, numbers of organ dysfunction over the first 3d to 7d, but nonsurvivors did not improve over a seven-day course. There were significant differences in APACHE II score and numbers of organ dysfunction of day 3, 7 of ARDS, and HS of day 7 of ARDS between survivors and nonsurvivors(p<0.05). Fatality rate of ARDS has been declined from 68% to less than 40% between 1995 and 1998. There were no differences in APACHE II score, HS, numbers of organ dysfunction, old age at presentation of ARDS. In last years, mean PEEP level was significantly higher and mean tidal volume was significantly lower than previous years during seven days of ARDS(p<0.01). Conclusions : Improvement of HS, APACHE II score, organ dysfunction over the first 3d to 7d is associated with increased survival Decline in ARDS fatality rates between 1995 and 1998 seems that this trend must be attributed to improved supportive therapy including at least high PEEP instead of conventional-least PEEP approach in ventilator management of acute respiratory distress syndrome.

• Korean Journal of Construction Engineering and Management
• /
• v.17 no.5
• /
• pp.108-119
• /
• 2016

Since the introduction of the converted accident rate in Pre-Qualification(PQ) process in 1992, the safety evaluation system has contributed to a reduction of construction accidents and development of the safety management system in public construction projects. As the comprehensive evaluation method the government plans to introduce includes the indicators 'accident rate' and 'death rate per 10,000 workers', the influences on the safety evaluation in the bidding process would be broader in public sector construction projects. However, the current safety evaluation system is operated by different estimating standards in the bidding process. At this point, a study of improvement on the safety evaluation index is required to review its current conditions and to propose its efficient operating method. Therefore, the purpose of this study is to analyze problems of the current safety evaluation system through the questionnaire survey on the qualified workers in construction safety management and to propose an improvement plan for the problems noticed. Our results suggest the standards of the unified process for the safety evaluation index, the size of construction firms needed for accident rate estimation, and the improvement plan for unreported accidents. The proposed improvement plan enables the reasonable estimation and efficient operation of the safety evaluation index, and further, it would contribute to reducing construction accidents through the activation of voluntary safety management by construction firms.

• KSCE Journal of Civil and Environmental Engineering Research
• /
• v.35 no.4
• /
• pp.969-975
• /
• 2015

In this paper, we review the regulations relating to railway safety and station workers interviewed, eight urban rail accidents decreased operating agencies through the prevention research currently being conducted into the (Seoul Metropolitan Rapid Transit Corporation City, Seoul Metro, Incheon traffic mortality, etc.) the root cause for the lack of aggressive prevention measures performed on the difficulties related regulations, organizational culture and work environment, prevention of negative operating authority derived in three improvements were obtained through this direction. First proposed urban railway safety ever buy Conduct production, utilization and operating agencies college safety assistant suggests directions for safety training, organizational culture and work environment improvements in senior management. Finally, active accident prevention campaigns, and provide direction to increase the educational participation of guests. Improvement for such accidents would decrease is thought to play a role in the prevention of future operating agency established when the guidelines.

• Korean Journal of Veterinary Research
• /
• v.37 no.4
• /
• pp.755-763
• /
• 1997

Recently new technologies for the establishment of high health herds are becoming efficient tools in the control of PRRS virus and secondary infections. Medicated early weaning(MEW) and nursery depopulation(ND) have shown to be one of the most successful procedures in the eradication and control of pathogens. Indirect evidence of the role of PRRSV in precipitating secondary infection comes from successful improvement in growth and in decreasing mortality on farms that have eliminated PRRSV through ND. Hence the present experiments were conducted in an effort to compare ND with MEW procedures as a means of eliminating PRRSV controlling secondary pathogens and improving performance of pigs in endemically infected swine herds. Following MEW and ND procedures practiced in the farms, some benefits obtained were as follows: 1. A decrease in PRRSV circulation in the nursery, but no entire elimination. 2. Decrease in the frequency of secondary bacteria and in the use of antibiotics. 3. Mycoplasma hyopneumoniae infection was prevented during the nursery stage. 4. ND protocol had a lower cost and management changes than MEW techniques. 5. Nursery performance was improved after the depopulation, cleaning and disinfection procedures, even though PRRSV still being cycled in the old nursery rooms. These studies revealed that the MEW and ND protocols are not always successful for PRRS virus elimination but it's great effect on control of secondary pathogens and improvement of performance make MEW and ND an efficient tools for the establishment of healthier and more efficient herds.

• The Korean Journal of Pain
• /
• v.18 no.2
• /
• pp.187-191
• /
• 2005

Background: Discogenic leg pain is a major cause of health problems, often due to herniation of the intervertebral disc, and has traditionally been treated conservatively or with an open surgical discectomy. Conventional open surgery has many complications, such as nerve root injury, discitis and a relatively high mortality rate; failure of conservative treatments is also common. Recently, the $Dekompressor^{(R)}$ Percutaneous Lumbar Discectomy probe was developed. Herein, we present the early results for a percutaneous lumbar discectomy in herniated lumbar disc disease. Methods: Eleven patients, including 8 men and 3 women, with ages ranging from 22 to 78 years, were enrolled in this study. Those patients with a previous history of back surgery were not excluded from the study. All patients were postoperatively evaluated for their clinical outcomes, such as visual analogue scale (VAS) for pain after 1 and 3 months, reduction in analgesics, functional improvement and overall satisfaction. Results: The percutaneous lumbar discectomy was completed in 11 patients (17 levels), with average reductions in pre-VAS of 61.3 and 60.2% at 1 and 3 months, respectively. Also, 72.7% of patients reported functional improvement, with 81.1% expressing overall satisfaction. There were no procedural related complications. Conclusions: We concluded that a percutaneous lumbar discectomy is a safe and effective treatment modality for a herniated lumbar disc.

• Korean Parent-Child Health Journal
• /
• v.16 no.1
• /
• pp.11-16
• /
• 2013

Purpose: Ethiopia is one of the sub-Saharan countries most affected by high maternal and infant mortality. The government has trained health extension workers (HEWs), the community health workers, to deliver preventive and basic curative health services to community residents in Ethiopia. Very few studies have investigated on-the-job educational effects for HEWs on improvement of their knowledge and performance confidence in maternal and child health care (MCH). This study aimed at identifying the educational effects for HEWs in one health center in Tigray, Ethiopia on improvement of their knowledge in MCH. Methods: Twelve HEWs from 6 health posts participated in this study. A health center officer provided a total of 5 educational sessions on antenatal and postnatal care, family planning, and newborn care from August, 2012 to April, 2013. Ten to 12 items regarding the topics were tested before and after each education. Wilcoxon signed rank test was used to analyze the data. Results: All the HEWs were female with average 4-year working experience. Their knowledge significantly increased after education, except the first session. Their satisfaction on education was greater than 45 points out of 50. Conclusion: This study suggests a focused education for HEWs should continue to improve their capacity on MCH.