• Journal of Korean Academy of Oral Health
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• v.41 no.4
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• pp.243-249
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• 2017

Objectives: Stress is a psychological reaction to stimuli such as anxiety or threat felt by a person either physically or mentally when placed in a difficult situation. Although a relationship between stress and dry mouth has been reported, it remains understudied. The purpose of this study was to investigate the association between stress and subjective dry mouth among the elderly living in a rural region. Methods: A total of 214 people aged ${\geq}60years$ living in a rural area were recruited with an informed consent for a cross-sectional analysis. Information about stress and subjective dry mouth was obtained by an interview survey with a constructed questionnaire. Data on other potential confounding factors (including oral factors) such as socio-demographic data, health-related behaviors, the number of remaining teeth, and subjective chewing ability were also gathered at the same time. Logistic regression models were used to analyze the relationship of stress and dry mouth using SPSS. Results: The Crude odds ratio (OR) of stress awareness affecting subjective dry mouth was 2.59 (95% confidence interval: 1.43-4.68). After adjusting for sex, education, income, smoking, and alcohol intake, the adjusted OR was 2.52 (95% confidence interval: 1.30-4.87) which was statistically significant. Conclusions: Elderly people who were stressed had an approximately 2-fold increase in experiencing subjective dry mouth when compared to their stress-free counterparts.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.19 no.11
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• pp.105-115
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• 2018

The purpose of this study was to clarify whether or not alcohol drinking patterns are associated with sleep quality. A cross-sectional study was carried out by self-administered questionnaire in May, 2017 among 553 male workers who employed in manufacturing industries in D city. Logistic regression analysis was used to evaluate whether or not alcohol drinking patterns (as measured by frequency, amount of alcohol per day, and amount of alcohol per week) were associated with poor sleep quality (as measured by Pittsburgh Sleep Quality Index). As a result, in comparison with male workers who did not drink, the adjusted odds ratio for poor sleep quality was 0.44 (95% CI=0.232-0.845) for those who drank alcohol once a week or more, 0.31 (95% CI=0.192-0.829) for those who drank less than 1 glass daily, and 0.28 (95% CI=0.167-0.762) for those who drank 1-3 glasses daily. The results of this study suggest that some alcohol drinking patterns may affect sleep quality among male workers.

• Journal of the Korea Convergence Society
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• v.10 no.1
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• pp.339-351
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• 2019

This study was conducted to identify the factors associated with the ruptured intracranial aneurysm (RIA) among demographic, admission to hospital, clinical, aneurysym itself and lifestyle characteristics. Medical records of RIA patients and un-RIA patients which had been admitted to undergo treatment including surgery (From January to December 2016) were included into data analysis. Multiple logistic regression showed that two and more than warning signs (14.14 (CI: 1.25-159.40)) indicated the greatest odds ratio with RIA, was followed by headache more than 3 scores (13.95 (CI: 3.68-52.83)), the admission via emergency room (13.62 (CI: 4.85-38.26)), single marital status (9.72 (CI: 2.22-42.49)), 1 mmHg increased systolic blood pressure (1.04 (CI: 1.01-1.08)), 1 score increased GCS (0.58 (CI: 0.37-0.90)), arrythmia finding in electrocardiogram (3.70 (CI: 1.22-11.22)) and increased age (0.95 (CI: 0.91-0.99)). The risk groups having factors associated with RIA were identified. Preventive activities including routine assessment should be done before developing the rupture and urgent care should be needed after developing the rupture for risk groups.

• Korean Journal of Psychosomatic Medicine
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• v.27 no.1
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• pp.69-76
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• 2019

Objectives : The purpose of this study was to examine the prevalence and clinical characteristics of nonsuicidal self-injury (NSSI), and its association with suicide attempts among clinically depressed adolescents in Korea. Methods : In total, 113 depressed adolescents aged 12-18 years in South Korea were enrolled in this study. We assessed sociodemographic and clinical characteristics including suicidality and non-suicidal self-injury (NSSI) using various self-reported scales and semi-structured interview for diagnosis of psychiatric disorders. Demographic and clinical characteristics of the subjects were compared between NSSI and non-NSSI groups. We examined significant predictors of suicide attempts using logistic regression analysis. Results : Among 113 depressed participants, 48 (42.1%) adolescents were classified into the NSSI group. In the NSSI group, there were significantly more females, showed higher depression, higher state-anxiety, and more suicide ideation. The most predictive factors of suicide attempts were history of NSSI, observed suicide/NSSI behaviors of their family or friends, and total state anxiety score. Conclusions : NSSI is more common problem among clinically depressed adolescents and history of NSSI is a significant predictor of present suicide attempts. To include the assessment of NSSI for clinically depressed adolescent may be crucial for intervention programs for high risk adolescents of suicide in Korea.

• Archives of Plastic Surgery
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• v.46 no.4
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• pp.336-343
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• 2019

Background Sternal rigid plate fixation (RPF) has been adopted in recent years in high-risk cases to reduce complications associated with steel wire cerclage, the traditional approach to sternal closure. While sternal RPF has been associated with lower complication rates than wire cerclage, it has its own complication profile that requires evaluation, necessitating a critical examination from a national perspective. This study will report the outcomes and associated risk factors of sternal RPF using a national database. Methods Patients undergoing sternal RPF from 2005 to 2016 in the American College of Surgeons-National Surgical Quality Improvement Program were identified. Demographics, perioperative information, and complication rates were reviewed. Logistic regression analysis was performed to identify risk factors for postoperative complications. Results There were 381 patient cases of RPF identified. The most common complications included bleeding (28.9%), mechanical ventilation >48 hours (16.5%), and reoperation/readmission (15.2%). Top risk factors for complications included dyspnea (odds ratio [OR], 2.672; P<0.001), nonelective procedure (OR, 2.164; P=0.010), congestive heart failure (OR, 2.152; P=0.048), open wound (OR, 1.977; P=0.024), and operating time (OR, 1.005; P<0.001). Conclusions Sternal RPF is associated with increased rates of three primary complications: blood loss requiring transfusion, ventilation >48 hours, and reoperation/readmission, each of which affected over 15% of the study population. Smokers remain at an increased risk for surgical site infection and sternal dehiscence despite RPF's purported benefit to minimize these outcomes. Complications of primary versus delayed sternal RPF are roughly equivalent, but individual patients may perform better with one versus the other based on identified risk factors.

• Journal of Trauma and Injury
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• v.32 no.3
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• pp.143-149
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• 2019

Purpose: No previous study has assessed elderly pedestrian traffic accidents based on a nationwide database. This study aimed to help primary physicians who examine patients in emergency departments to determine and make prompt and accurate treatment decisions. Methods: This study used data from the Emergency Department-based Injury Indepth Surveillance from 2013 to 2017, managed by the Korea Centers for Disease Control and Prevention. Pedestrians aged ${\geq}65years$ were included, and using multivariate logistic regression multiple factors were analyzed to determine their relationship with injury severity. Results: Of 227,695 subjects, 6,498 were included, of whom 2,065 (31.8%) were severely injured. There were more female than male patients in all severity groups. Most accidents occurred in the afternoon and on general roads. In the multivariate analysis, the odds ratio (OR) of injury severity for male pedestrians was 1.165 (95% confidence interval: 1.034-1.313, p=0.012). Older age of patients and the use of ambulances were associated with greater injury severity. The accident time affected the degree of injury severity; i.e., compared to dawn, injury severity increased in the morning (OR: 1.246, p=0.047) and decreased at night (OR: 0.678, p<0.001). A significant difference was noted in the correlation between the type of vehicle causing the accident and the accident severity; i.e., motorcycle accidents had lower severity than bicycle accidents (OR: 0.582, p=0.047). Conclusions: Injury severity was correlated with sex, age, transportation to the ED, TA onset time, and type of vehicle. The study results suggest that injury severity may be positively reflected in initial assessments and overall integrated treatments by physicians and in the related policies.

• Epidemiology and Health
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• v.39
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• pp.36.1-36.8
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• 2017

OBJECTIVES: To investigate the screening rates for gastric, breast, and cervical cancer in people with diabetes compared with people without diabetes. METHODS: Data from the Korea National Health and Nutrition Examination Survey (2007-2009) were used. Cancer-free men who were 40 years old and over and cancer-free women who were 30 years old and over were included. The lifetime screening rate and regular screening rate were compared in people with and without diabetes. RESULTS: Fewer people with diabetes than people without diabetes had ever received cancer screening (53.5 vs. 59.5%, p<0.001 for gastric cancer; 60.5 vs. 71.5%, p<0.001 for breast cancer; and 49.1 vs. 59.6%, p<0.001 for cervical cancer). Fewer people with diabetes than people without diabetes received the recommended screenings for gastric cancer (38.9 vs. 42.9%, p<0.001), breast cancer (38.8 vs. 44.6%, p<0.001), and cervical cancer (35.1 vs. 51.2%, p<0.001). In subgroup analyses according to socioeconomic factors, the lifetime and recommended screening rates were lower in the diabetic population in most socioeconomic subgroups. In the multivariate analysis adjusted for socioeconomic factors, people with diabetes showed lower lifetime screening rates for gastric and cervical cancer (odds ratio [OR], 0.8; 95% confidence interval [CI], 0.7 to 0.9 and OR, 0.7; 95% CI, 0.6 to 0.9), and lower regular screening rates for breast and cervical cancer (OR, 0.7; 95% CI, 0.6 to 0.9 and OR, 0.7; 95% CI, 0.5 to 0.9). CONCLUSIONS: The cancer screening rate in people with diabetes was lower than in people without diabetes. Considering the higher cancer risk in people with diabetes, efforts to increase the screening rate in this high-risk population should be implemented.

• Korean Journal of Ophthalmology
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• v.32 no.6
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• pp.451-458
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• 2018

Purpose: To investigate the efficacy, safety, and anatomical outcomes associated with intravitreal anti-vascular endothelial growth factor (VEGF) treatment of retinopathy of prematurity (ROP). Methods: We performed a retrospective review of intravitreal anti-VEGF (bevacizumab or ranibizumab) treatment of 153 eyes (83 infants) diagnosed with ROP at two tertiary hospitals from June 2011 to January 2017. The primary outcome was the rate of recurrence requiring additional treatment; secondary outcomes included incidence of major complications and final refractive error. Results: A total of 101 eyes were treated with bevacizumab, and 52 with ranibizumab. The bevacizumab and ranibizumab groups were characterized by mean birthweights of $941.8{\pm}296.1$ and $1,257.7{\pm}514.5g$, gestational ages at birth of $26.9{\pm}1.9$ and $28.1{\pm}3.2$ weeks, and postmenstrual ages at treatment of $40.4{\pm}2.4$ and $39.2{\pm}2.3$ weeks, respectively. The two groups differed significantly in birthweights and gestational ages at birth, but not in postmenstrual ages at treatment. The mean follow-up duration was $30.9{\pm}18.4$ months for the bevacizumab group, and $13.9{\pm}12.5$ months for ranibizumab. More cases were classified as zone 1 ROP in the ranibizumab group (44.2% vs. 11.9%, p < 0.001). Major surgical interventions included scleral encircling and vitrectomy (one and two eyes, respectively, both in the bevacizumab group). Retinal detachment was noted in one eye treated with bevacizumab. There was no significant difference in the most recent spherical equivalence for the two groups ($+0.10{\pm}3.66$ and $+0.22{\pm}3.00$ diopters for bevacizumab and ranibizumab, respectively). Univariable analysis revealed that only ROP stage influenced the occurrence of major complications (odds ratio, 9.046; p = 0.012). Conclusions: Intravitreal anti-VEGF treatment of ROP with both bevacizumab and ranibizumab achieved stable retinal vascularization with a low rate of complications and recurrence. Ranibizumab achieved similar anatomical outcomes as bevacizumab, without additional risk for major complications.

• Journal of Korean Neurosurgical Society
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• v.62 no.5
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• pp.519-525
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• 2019

Objective : The circadian pattern of the onset time of aneurysmal subarachnoid hemorrhage (aSAH) has been reported by various authors. However, the effect of the degree of physical exertion on the circadian pattern has not been studied in detail. Therefore, we conducted this study to investigate the effect of physical exertion on the circadian pattern of aSAH. Methods : Of the 335 patients presenting with aSAH from January 2012 to December 2017, 234 patients with identifiable onset time and metabolic equivalent (MET) values were enrolled. The onset time of aSAH was divided into 4-hour intervals. The patient's physical exertion was then assessed on a scale between 1 and 8 METs using generally accepted MET values, and categorized into two groups-light exertion (1 to 4 METs) and moderate to heavy exertion (5 to 8 METs)-to determine the effect of the degree of physical exertion on the onset time distribution of aSAH. Multivariate analysis was used to calculate the odds ratio (OR) between the two groups to determine the effect of the degree of physical exertion on each set of time periods. Results : There was a definite bimodal onset pattern that peaked at 08:00-12:00 hours followed by 16:00-20:00 hours (p<0.001). MET values at all time intervals were found to be significantly higher than the night time (00:00-04:00 hours) values (p<0.031). The MET value distribution showed a unimodal pattern that slightly differed from the bimodal distribution of the onset time of aSAH. There were no significant differences in the ORs of each time interval according to the degree of the MET value. Conclusion : This study reaffirmed that aSAH occurs in a bimodal pattern, especially showing the highest prevalence in the morning. Although aSAH could be related to daily activity, there were no significant changes in diurnal variations affected by the degree of physical exertion.

• Tuberculosis and Respiratory Diseases
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• v.82 no.4
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• pp.328-334
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• 2019

Background: Although the frequency of respiratory viral infection in patients with pulmonary acute respiratory distress syndrome (ARDS) is not uncommon, clinical significance of the condition remains to be further elucidated. The purpose of this study was to compare characteristics and outcomes of patients with pulmonary ARDS infected with influenza and other respiratory viruses. Methods: Clinical data of patients with pulmonary ARDS infected with respiratory viruses January 2014-June 2018 were reviewed. Respiratory viral infection was identified by multiplex reverse transcription-polymerase chain reaction (RT-PCR). Results: Among 126 patients who underwent multiplex RT-PCR, respiratory viral infection was identified in 46% (58/126): 28 patients with influenza and 30 patients with other respiratory viruses. There was no significant difference in baseline and clinical characteristics between patients with influenza and those with other respiratory viruses. The use of extracorporeal membrane oxygenation (ECMO) was more frequent in patients with influenza than in those with other respiratory viruses (32.1% vs 3.3%, p=0.006). Co-bacterial pathogens were more frequently isolated from respiratory samples of patients with pulmonary ARDS infected with influenza virus than those with other respiratory viruses. (53.6% vs 26.7%, p=0.036). There were no significant differences regarding clinical outcomes. In multivariate analysis, acute physiology and chronic health evaluation II was associated with 30-mortality (odds ratio, 1.158; 95% confidence interval, 1.022-1.312; p=0.022). Conclusion: Respiratory viral infection was not uncommon in patients with pulmonary ARDS. Influenza virus was most commonly identified and was associated with more co-bacterial infection and ECMO therapy.