• Journal of the Korea Academia-Industrial cooperation Society
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• v.20 no.8
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• pp.494-502
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• 2019

Various international reports have shown strong proof that socioeconomic and sociodemographic variables are correlated with allergic diseases, yet little is known about how these variables affect Korean adolescents. This study was conducted to identify the socioeconomic and sociodemographic risk factors for allergic diseases of Korean adolescents, and to provide information for preventing and managing such conditions. Data from the 2018 Korean Youth Risk Behavior Survey (KYRBS) of 60,040 adolescents was used for this study. An anonymously administered online survey was conducted to collect information on the dependent variables. The independent variables were asthma, allergic rhinitis and atopic dermatitis. Multivariate logistic regression analysis was performed to analyze the correlations between the dependent variables and the independent variables. Low economic status, living with mother, high education level of parents, high school record, obesity, drinking and smoking were the risk factors for asthma. Low economic status, the place of residence, living with mother, high education level of the parents, gender, high school record, obesity, drinking and smoking were the risk factors for allergic rhinitis. Low economic status, living with mother, high education level of parents, genderhigh school record, obesity and drinking were the risk factors for atopic dermatitis. We found that low socioeconomic status and unhealthy behavior were the risk factor for allergic diseases of Korean adolescents. Balanced economic growth in the community and controlling unhealthy behavior can help reduce the prevalence of allergic diseases.

• Tuberculosis and Respiratory Diseases
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• v.82 no.3
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• pp.242-250
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• 2019

Background: Data on noninvasive ventilation (NIV) use in intensive care units (ICUs) are very limited in South Korea. Methods: A prospective observational study was performed in 20 ICUs of university-affiliated hospitals from June 2017 to February 2018. Adult patients (age>18 years) who were admitted to the ICU and received NIV treatment for acute respiratory failure were included. Results: A total of 156 patients treated with NIV were enrolled (mean age, $71.9{\pm}11.6years$). The most common indications for NIV were acute hypercapnic respiratory failure (AHRF, n=89) and post-extubation respiratory failure (n=44). The main device for NIV was an invasive mechanical ventilator with an NIV module (61.5%), and the majority of patients (87.2%) used an oronasal mask. After the exclusion of 32 do-not-resuscitate patients, NIV success rate was 68.5% (85/124); ICU and hospital mortality rates were 8.9% and 15.3%, respectively. However, the success rate was lower in patients with de novo respiratory failure (27.3%) compared to that of patients with AHRF (72.8%) or post-extubation respiratory failure (75.0%). In multivariate analysis, immunocompromised state, de novo respiratory failure, post-NIV (2 hours) respiratory rate, NIV mode (i.e., non-pressure support ventilation mode), and the change of NIV device were significantly associated with a lower success rate of NIV. Conclusion: AHRF and post-extubation respiratory failure were the most common indications for NIV in Korean ICUs. Overall NIV success was achieved in 68.5% of patients, with the lowest rate in patients with de novo respiratory failure.

• 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.

• 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.

• Journal of Korean Neurosurgical Society
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• v.64 no.5
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• pp.791-798
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• 2021

Objective : The period of mechanical ventilator (MV)-dependent respiratory failure after cervical spinal cord injury (CSCI) varies from patient to patient. This study aimed to identify predictors of MV at hospital discharge (MVDC) due to prolonged respiratory failure among patients with MV after CSCI. Methods : Two hundred forty-three patients with CSCI were admitted to our institution between May 2006 and April 2018. Their medical records and radiographic data were retrospectively reviewed. Level and completeness of injury were defined according to the American Spinal Injury Association (ASIA) standards. Respiratory failure was defined as the requirement for definitive airway and assistance of MV. We also evaluated magnetic resonance imaging characteristics of the cervical spine. These characteristics included : maximum canal compromise (MCC); intramedullary hematoma or cord transection; and integrity of the disco-ligamentous complex for assessment of the Subaxial Cervical Spine Injury Classification (SLIC) scoring. The inclusion criteria were patients with CSCI who underwent decompression surgery within 48 hours after trauma with respiratory failure during hospital stay. Patients with Glasgow coma scale 12 or lower, major fatal trauma of vital organs, or stroke caused by vertebral artery injury were excluded from the study. Results : Out of 243 patients with CSCI, 30 required MV during their hospital stay, and 27 met the inclusion criteria. Among them, 48.1% (13/27) of patients had MVDC with greater than 30 days MV or death caused by aspiration pneumonia. In total, 51.9% (14/27) of patients could be weaned from MV during 30 days or less of hospital stay (MV days : MVDC 38.23±20.79 vs. MV weaning, 13.57±8.40; p<0.001). Vital signs at hospital arrival, smoking, the American Society of Anesthesiologists classification, Associated injury with Injury Severity Score, SLIC score, and length of cord edema did not differ between the MVDC and MV weaning groups. The ASIA impairment scale, level of injury within C3 to C6, and MCC significantly affected MVDC. The MCC significantly correlated with MVDC, and the optimal cutoff value was 51.40%, with 76.9% sensitivity and 78.6% specificity. In multivariate logistic regression analysis, MCC >51.4% was a significant risk factor for MVDC (odds ratio, 7.574; p=0.039). Conclusion : As a method of predicting which patients would be able to undergo weaning from MV early, the MCC is a valid factor. If the MCC exceeds 51.4%, prognosis of respiratory function becomes poor and the probability of MVDC is increased.

• Journal of The Korean Society of Clinical Toxicology
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• v.18 no.2
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• pp.110-115
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• 2020

Purpose: Acute kidney injury (AKI) in patients with glyphosate poisoning has a poor prognosis. This study aimed to predict the risk factors for AKI in patients with glyphosate poisoning at the emergency department (ED). Methods: Clinical data on glyphosate poisoning patients at ED who were older than 18 years were collected retrospectively between January 2013 and December 2019. The clinical characteristics and clinical outcomes of the AKI group in patients with glyphosate poisoning were compared with the non-AKI (NAKI) group. Results: Of 63 glyphosate poisoning patients, AKI was observed in 15 (23.8%). The AKI patients group showed the following: old age (p=0.038), low systolic blood pressure (p=0.021), large amount of ingestion (p=0.026), delayed hospital visits (p=0.009), high white blood cells (WBC) (p<0.001), high neutrophil counts (p<0.001), high neutrophil-lymphocyte (LN) ratios (p<0.001), high serum potassium (p=0.005), low arterial blood pH (p=0.015), and low pO2 (p=0.021), low bicarbonate (p=0.009), and high Poisoning Severity Score (PSS) (p<0.001). AKI patients required hemodialysis, ventilator care (p<0.001, p=0.002), and inotropics (p<0.001). They also showed more intensive care unit admission (p<0.001), longer hospitalization (p<0.001), and high mortality (p<0.001). Logistic multivariate regression analysis showed that high WBCs (OR, 1.223) and increased LN ratios (OR, 1.414) were independently associated with the occurrence of AKI. Conclusion: In patients with glyphosate poisoning at ED, high WBCs and increased LN ratios can help predict the occurrence of AKI.

• Quality Improvement in Health Care
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• v.27 no.2
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• pp.18-29
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• 2021

Purpose: Patients with hematologic malignancy (HM) typically have a high mortality rate when their condition deteriorates. The chronic progressive course of the disease makes it difficult to assess the effect of intervention on acute events. We investigated the effectiveness of a rapid response team (RRT) on in-hospital mortality in patients with HM. Methods: We retrospectively analyzed the data of patients with HM who admitted to the medical intensive care unit between 2006 and 2015. Clinical outcomes before and after RRT implementation were evaluated. Results: A total of 228 patients in the pre-RRT period and 781 patients in the post-RRT period were included. The overall in-hospital mortality was 55.4%. Patients in the post-RRT period had improved survival; however, they required more vasopressor therapy, continuous renal replacement therapy, and extracorporeal membrane oxygenation. Multivariate analysis revealed that in-hospital mortality was associated with RRT activation (hazard ratio [HR], 0.634; 95% confidence interval [CI], 0.498-0.807; p < .001), neurological disease (HR, 2.007; 95% CI, 1.439-2.800; p < .001), sequential organ failure assessment score (HR, 1.085; 95% CI, 1.057-1.112; p < .001), need for continuous renal replacement therapy (HR, 1.608; 95% CI, 1.206-1.895; p< .001), mechanical ventilation (HR, 1.512; 95% CI, 1.206-1.895; p< .001), vasopressor (HR, 1.598; 95% CI, 1.105-2.311; p = .013), and extracorporeal membrane oxygenation (HR, 1.728; 95% CI, 1.105-2.311; p = .030). Conclusion: RRT activation may be associated with improved survival in patients with HM.

• Journal of Korean Society of Occupational and Environmental Hygiene
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• v.32 no.2
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• pp.116-128
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• 2022

Objectives: The aim of this study was to examine the association of working posture with headache/eye strain in Korean waged workers. Methods: Data were collected from the 5th Korean Working Condition Survey. A total of 30,955 workers participated in this study. A four-items of working postures were measured using a 7-point Likert scale, and we categorized them into three groups ('normal', 'moderate', and 'severe') each 4 items. Headache/eye strain were measured using a self-administrative questionnaire ('yes' vs. 'no'). To examine the relationship between the total working postures score and headache/eye strain, we summed a 4-items of working postures. It was categorized into five groups according to the severity of exposures('normal', 'mild', 'moderate', 'severe', and 'very severe'). The multivariate logistic regression analysis was performed using the IBM SPSS(Ver. 25), and a p<.05 was considered significant. Results: The results show that 'fatiguing and painful posture' and 'posture repetitively using hands or arms' were associated with headache/eye strain after controlling for control variables. The total working posture score was positively associated with headache/eye strain. People with higher levels of the total working posture score were more likely to increase the risk of headache/eye strain compared to those of normal(OR: 1.844, 95% CI: 1.549~2.195 for 'mild'; OR: 2.564, 95% CI: 2.152~3.503 for 'moderate'; OR: 4.140, 95% CI: 3.432~4.994 for 'severe'; OR: 7.613, 95% CI: 5.625~10.304 for 'very severe') (p<.05 for trend). Conclusions: These results indicate that inappropriate working postures might play a crucial role in developing headache/eye strain. It is needed to improve the working environment, especially focusing on reducing inappropriate working posture at the organizational level.

• The Journal of the Korea Contents Association
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• v.22 no.6
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• pp.530-540
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• 2022

The aim of this study was to analyze the impacts of perceived economic instability on drinking frequency in the mist of exercising the strong social distancing in the early phase of COVID19 pandemic. The data were collected from 1,117 adults aged between 19 and 70 across the nation from May 13 to May 19 in 2020 by Embrain, an on-line research company. We used only 820(73.4%) out of 1,117 who answered that they had a drinking in 2020. Bi-variate analysis and multivariate multinomial logistic regression were performed using STATA16. Multinomial logistic regression results showed that the increase of employment instability was related to the increase of drinking frequency, whereas the increase of income instability was related to the decrease of drinking frequency. In sum, the impact of perceived economic instability during the early phase of pandemic may be presented as an increase or decrease of drinking frequency depending on the effect of employment instability and income instability.

• Journal of Korean Society of Occupational and Environmental Hygiene
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• v.32 no.4
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• pp.287-301
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• 2022

Objectives: This study compared the characteristics of the work environment between agricultural and general workers and analyzed the effects of agricultural working characteristics on work-related health problems. Methods: The participants of this study were 2,347 agricultural workers and 48,042 general workers who were selected by applying standardized weights to the raw data of 50,538 respondents from the 6th Korean Working Condition Survey (KWCS). Variables applicable to both worker groups and related to exposure to hazardous risk factors in the working environment, working hours and intensity of work, health problems and work-related status, and satisfaction with the work environment were selected. Chi-square tests and independent sample t-tests were performed to evaluate the differences in the variables between the two groups. Multivariate logistic regression analysis was conducted to analyze the effects of work environment characteristics on work-related health problems. Results: Compared to general workers, agricultural workers were more exposed to hazardous environments, irregular work patterns such as working on Saturday/Sunday, and short repetitive tasks. They reported more work-related and general health problems, including back pain, upper extremity muscle pain, lower extremity muscle pain, and general fatigue. Agricultural workers showed lower satisfaction with their work environment than general workers. Factors affecting one or more work-related health problems included gender, working years, hazardous factors, irregular work pattern, working hours, and labor intensity. Conclusions: Our findings showed that agricultural workers were relatively more vulnerable to safety issues compared to other occupational groups. Therefore, it is necessary to establish standardized safety and health standards and strengthen systematic safety and health management policies and services for agriculture.