• Journal of The Korean Society of Clinical Toxicology
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• v.17 no.1
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• pp.14-20
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• 2019

Purpose: This study estimated the incidence of delirium and associated risk factors and outcomes in ICU patients with acute poisoning. Methods: Data were collected from ICU patients over 18 years of age that were admitted via the emergency center after presenting with poisoning from 2010 to 2015. Delirium was assessed retrospectively using the Intensive Care Delirium Screening Checklist (ICDSC). Risk factors were evaluated by univariate and multivariate analysis. Results: A total of 199 patients participated in this study and 68 (34.2%) were diagnosed with delirium based on the ICDSC score. The delirium group showed a significantly higher association with prolonged length of stay in the hospital and ICU in comparison with the non-delirium group. The delirium group was associated with greater use of physical restraint. A statistically greater number of patients with pharmaceutical substance poisoning developed delirium over a short period of time than those with non-pharmaceutical substance poisoning. There was no significant difference between the two groups with respect to age, sex, past history, GCS score, vital signs, application of ventilator care and renal replacement therapy. Conclusion: The finding that the delirium group had a greater length of stay in both the hospital and the ICU is consistent with the results of previous worldwide studies of the effects of delirium on the prognosis of patients who were admitted to the ICU, suggesting the possibility for domestic application. Additionally, use of physical restraint was positively related to the incidence of delirium. Thus, interventions for minimizing the use of physical restraints and considering alternatives are needed.

• Korean Journal of Psychosomatic Medicine
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• v.29 no.2
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• pp.176-183
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• 2021

Objectives : The purpose of this study was to find out how demographic factors, suicide attempt patterns, psychiatric history and management of suicide attempters affect the completion of emergency department (ED) based case management program. Methods : Among the patients who attempted suicide and visited the emergency department of Chung-Ang University Hospital from June 1, 2018 to May 31, 2021, 661 patients who agreed to case management were studied. After being discharged from the emergency department, subjects were registered for an eight-week follow-up service program. Hierarchical logistic regression analysis was conducted with demographic factors, suicide attempt patterns, psychiatric history and management as independent variables, and completion of case management program as dependent variables. Results : Suicide attempt pattern had the most significant influence on the completion of case management program, followed by demographic factors, psychiatric history and management. Those who completed the case management program were significantly more likely to have suicide plans in the future, more authentic in suicide attempts, and had higher proportion of past suicide attempts than those who did not complete the program. Conclusions : To ensure that the subjects complete the follow-up project program and get connected to community services, an individualized approach with consideration of suicide attempt patterns, demographic factors, and psychiatric history is needed.

• Journal of Preventive Medicine and Public Health
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• v.34 no.2
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• pp.131-140
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• 2001

Objectives : During March-May, 2000, a measles outbreak occurred at Youngduk, Korea. This county is divided into two areas with different historical and socioeconomic background. The outbreak occurred in one of these areas. We conducted a comparative epidemiologic study on the two areas in order to evaluate the factors related to the epidemic. Materials and Methods : We selected two groups, grades 3 and 5 in a primary schools in each area. We investigated outbreak-related factors using parent-questionnaires, the vaccination history from the student's health record and the records concerning the recent measles-outbreak from the local health center. Serologic test on measles-IgG and -IgM antibody was done. Results : The infection rate was 31.5% for the epidemic area and 3.7% for non-the epidemic area according to clinical or serological criteria (p<0.001). No difference was seen in the measles vaccination rate, residence at the time of vaccination or past measles infection history between the two areas. In the epidemic area, the attack rate for the 4-6 year-old MMR booster group(20.5%) was higher than the non-booster group(32.4%), but was not found significantly. Vaccine efficacy was 29.6% in the epidemic area and 87.0% in the non-epidemic area (p<0.001). The IgG level and positive rate were significantly different between the two areas (median 10727 IU/ml, 98.9% in epidemic area; median 346 IU/ml, 85.9% in the non-epidemic area, p<0.001). However, the IgG level and positive rate between the measles-cases and non-cases were not significantly different. Conclusions : This outbreak took place in mostly vaccinated children. These results suggest that a reduction of herd immunity for immunity failure after vaccination may be one of the feasible factors related to the outbreak pattern in the two areas. The results of the IgG level and positive rate suggest that re-establishment of a normal value for IgG level and of a qualitative method for IgG are needed.

• Journal of Preventive Medicine and Public Health
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• v.37 no.4
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• pp.381-389
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• 2004

Objective : To compare the efficacy between SKI306X and Diclofenac by using generalized estimating equations (GEE) methodology in the analysis of correlated bivariate binary outcome data in Osteoarthritis (OA) diseases. Methods : A randomized, double-blind, active comparator-controlled, non-inferiority clinical trial was conducted at 5 institutions in Korea with the random assignment of 248 patients aged 35 to 75 years old with OA of the knee and clinical evidence of OA. Patients were enrolled in this study if they had at least moderate pain in the affected knee joint and a score larger than 35mm as assessed by VAS (Visual Analog Scale). The main exposure variable was treatment (SKI 306X vs. Diclofenac) and other covariates were age, sex, BMI, baseline VAS, center, operation history (Yes/No), NSAIDS (Y/N), acupuncture (Y/N), herbal medicine (Y/N), past history of musculoskeletal disease (Y/N), and previous therapy related with OA (Y/N). The main study outcome was the change of VAS pain scores from baseline to the 2nd and 4th weeks after treatment. Pain scores were obtained as baseline, 2nd and 4th weeks after treatment. We applied GEE approach with empirical covariance matrix and independent(or exchangeable) working correlation matrix to evaluate the relation of several risk factors to the change of VAS pain scores with correlated binary bivariate outcomes. Results : While baseline VAS, age, and acupuncture variables had protective effects for reducing the OA pain, its treatment (Joins/Diclofenac) was not statistically significant through GEE methodology (ITT:aOR=1.37, 95% CI=(0.8200, 2.26), PP:aOR=1.47, 95% CI=(0.73, 2.95)). The goodness-of-fit statistic for GEE (6.55, p=0.68) was computed to assess the adequacy of the fitted final model. Conclusions : Both ANCOVA and GEE methods yielded non statistical significance in the evaluation of non-inferiority of the efficacy between SKI306X and Diclofenac. While VAS outcome for each visit was applied in GEE, only VAS outcome for the fourth visit was applied in ANCOVA. So the GEE methodology is more accurate for the analysis of correlated outcomes.

• Health Policy and Management
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• v.24 no.2
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• pp.136-142
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• 2014

Background: This study is to research on how hypertension control is associated with adherence in newly diagnosed hypertension patients. Methods: The study is based on 255,916 patients who were diagnosed with hypertension in 2009 and didn't have any previous medical history of hypertension or associated complication for the past year using data collected by National Health Insurance Corporation. Newly diagnosed hypertension patients are divided into two group by visiting medical center numbers (more than 300 days was adherence group, if not non-adherence group). Patients are considered to have successfully controlled their hypertension based on blood pressure measured by health examination. Chi-square test and logistic regression, repeated measured analysis of variance was used to analyze. Results: The relations between adherence and hypertension control show that 1.12 times of patients in adherence group was able to control their hypertension. The additional analysis proves that adherence group are more decreased level of blood pressure than non-adherence group except for patients who are over 70. Comparison of the average of systolic blood pressure and diastolic blood pressure between adherence and non-adherence groups shows that the blood pressure has been significantly among the adherence group. Conclusion: The study proves that constant treatment for hypertension could control the blood pressure and encourages patients to put more effort for persistent treatment. It also shows that hypertension treatment are more effective in younger patients than the elderly and strategies of approaching are different depending on age.

• Journal of Korean Society for Atmospheric Environment
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• v.25 no.5
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• pp.382-391
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• 2009

The aim of the study was to assess the levels in typical central borough of phthalate exposure by monitoring children's facilities (19 kindergartens and 21 elementary schools) and households (17 old apartments and 22 new apartments) via sampling indoor floor dust. A vacuum cleaner specifically prepared for sampling dust was attached to a filter of a vacuum cleaner dust collecting container. During the sample preparation process, containers made of glass were used and analysis was performed using GC-MSD. The mean concentration of DEHP was $412{\mu}g/g$, DnBP was $24{\mu}g/g$, and BBzP was $10{\mu}g/g$ dust. The indoor characteristics including floor, wall materials, years after construction, water leakage history for the past three years, and ventilation were also examined to categorize phthalate esters from the dust samples. From the flooring and wallpaper materials of kindergartens and elementary schools, DEHP in the dust sample appeared at a statistically significant level (p<0.05) when PVC materials were present. DEHP in the indoor dust also increased significantly (p<0.01) during the construction period. The daily intake of DEHP measured from indoor dust was 0.08~$19.7{\mu}g/kg/day$ for children and 0.02~$1.1{\mu}g/kg/day$ for adults (women). The results clearly revealed that phthalate exposure is greater in children than in adults (women) due to the indoor dust.

• Journal of Genetic Medicine
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• v.4 no.2
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• pp.200-203
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• 2007

Niemann-Pick type C is an inborn error of metabolism that affects lipid degradation and storage, which is characterized by hepatosplenomegaly and progressive neurological symptoms. A 7-month-old girl with jaundice was presented cholestasis and hepatosplenomegaly. Laboratory study showed elevated acid phosphatase, angiotensin converting enzyme and mild decrease of cholesterol. Characteristic foamy cell and sea-blue histiocytes in bone marrow biopsy consistent with Niemann-Pick disease. Niemann-Pick type C was suspected by past medical history and findings of physical examination. Therefore, molecular analysis was performed and found mutations of NPC1 gene. We report the first Korean case of type C Niemann-Pick disease confirmed by mutation analysis.

• Journal of Preventive Medicine and Public Health
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• v.24 no.3 s.35
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• pp.373-389
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• 1991

In order to develop the measuring tool of VDT syndrome and investigate the variables affecting the development of VDT syndrome, a questionnaire study accompanied with the evaluation of working environment was performed with 138 VDT users from six public organs in Kwangju area. The results were summarized as follows. 1. As a result of analysis with data collected by newly developed questionnaire, VDT syndrome included five factors named as eye-related component, psychological component, general body component, musculoskeletal component, and skin-related component and the estimates of the internal consistency of five factors were 0.877, 0.820, 0.796, 0.791, 0.593 respectively. 2. Variables affecting the level of eye-related symptoms were the type of main b using VDT, the total time of VDT operation per day, and the use of external filter on CRT. 3. The level of eye-related symptoms in the group using external filter was higher significantly than that in the group not using filter. 4. The past history of severe illness affected the level of psychological symptoms significantly. 5. Variables affecting the level of general body symptoms were b satisfaction and income satisfaction. 6. Variables affecting the level of musculoskeletal symptoms were the type of main job using VDT, whether majored in EDPS, the level of typewriting, b satisfaction, and the total time of VDT operation per day. 7. Age and the use of external filter were significantly related to the level of skin-related symptoms.

• The Journal of Korean Medicine
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• v.25 no.3
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• pp.78-89
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• 2004

Background : A report published by the National Institute of Toxicological Research (NITR) in January 2004 about toxic hepatitis in Korea contained the result of analysis on 55 cases of severe toxic hepatitis from 7 university hospitals for 8 months. NITR claimed that the extrapolated annual frequency of severe toxic hepatitis in Korea was 1904 cases per year. They also claimed that the most frequent etiology of severe toxic hepatitis were herbal medications and similar plant preparations (61.7%), contrasted with traditional therapeutic preparations and healthy foods (29.1%). I have investigated that report to be certain of the result because it is a very important subject for public health and society in Korea. Results : The NITR report has too many problems to have faith in its results. They include the following: 1. The report uses only 55 cases to estimate annual prevalence rate of severe toxic hepatitis in Korea. 2. There was a large regional preponderancy in the NITR report (2 cases in Seoul from a population of 10.17 million, 19 cases in Gwangju from a population of 1.4 million) 3. There was another preponderancy that selected much fewer cases caused by western medication (9.1%) than other reasons. 4. The NITR report used a modified scale than that officially recognized to diagnose toxic hepatitis. 5. There was a mistake using the scale to adapt the right indications. 6. They collected cases before beginning the study, although it was a prospective study. There was also not any questionnaire or other materials concerned with alcohol, drugs, or history of past liver disease. Conclusions : NITR is one of the important official arms of the government of Korea. Nevertheless, there is a severe problem in validity because of selection bias, uncertain accuracy, and insufficiency of raw materials in the report. Therefore it seems incorrect to generalize the results of the report and there is a lack of confidence in it as a national study publishing by the NITR.

• The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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• v.20 no.1 s.32
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• pp.218-227
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• 2007

Objective : The purpose of this study is to investigate outpatients of hypersensitive rhinitis including allergic rhinitis who had visited to Hospital of Oriental Medicine. Method : We analyzed statistics study in 580 patients, who had visited to the Dept. of dermatology, ophthalmology & otorhinolayngology Hospital of Oriental Medicine Dongeui University from March, 1998 to December, 2006. Results : The results were as follows. 1. There is more male(53.28%) than femal(46.72%). The age distributions of patients showed highest in 20-29 years, followed by 10-19 years, 30-39 years in order. 2. The yearly distributions of patients showed highest in 2004, followed by 2001, 2005 in order. The seasonal distributions of patients showed highest in fall, followed by winter, summer, spring in order. The monthly distributions of patients showed highest in September, followed by August, October in order. 3. The distributions of number of times in treatment showed highest in 1-5 times. The distributions of duration of treatment showed highest in 1 week. In the treatment method, a major portion of treatment methods was acupuncture, followed by herbal medicine treatment, aroma therapy in order. 4. The Frequency of use of Prescriptions showed highest in Bojungikgi-Tanggami. The Frequency of use of Extract showed highest in Sochungryong-Tang. 5. The distribution of past history showed highest in Atopic dermatitis. The distribution of Rhinologic Complication showed highest in Paranasal sinusitis.