Proper seat belt use saves lives; however, the use rate decreased in Korea. This study aimed to measure the magnitude of the preventive effect of seat belt on case-fatality across drivers and passengers. We used the Emergency Department based Injury In-depth Surveillance (EDIIS) database from 17 EDs between 2011 and 2012. All of adult injured patients from road traffic injuries (RTI) in-vehicle of less than 10-seat van were eligible, excluding cases with unknown seat belt use and outcomes. Primary and secondary endpoints were in-hospital mortality and intracranial injury. We calculated adjusted odds ratios (AORs) of seat belt use and driving status for study outcomes adjusting for potential confounders. Among 23,698 eligible patients, 15,304 (64.6%) wore seat belts. Driver, middle aged (30-44 yr), male, daytime injured patients were more likely to use seat belts (all P < 0.001). In terms of clinical outcome, no seat belt group had higher proportions of case-fatality and intracranial injury compared to seat belt group (both P < 0.001). Compared to seat belt group, AORs (95% CIs) of no seat belt group were 10.43 (7.75-14.04) for case-fatality and 2.68 (2.25-3.19) for intracranial injury respectively. In the interaction model, AORs (95% CIs) of no seat belt use for case-fatality were 11.71 (8.45-16.22) in drivers and 5.52 (2.83-14.76) in non-driving passengers, respectively. Wearing seat belt has significantly preventive effects on case-fatality and intracranial injury. Public health efforts to increase seat belt use are needed to reduce health burden from RTIs.
Accidents, Traffic/mortality/*prevention & control ; Adult ; Aged ; Craniocerebral Trauma/prevention & control ; Databases, Factual ; Emergency Service, Hospital ; Female ; Humans ; Logistic Models ; Male ; Middle Aged ; Motor Vehicles ; Odds Ratio ; Republic of Korea/epidemiology ; Seat Belts/*utilization ; Young Adult

Eugenol (4-allyl-2-methoxyphenol) is a naturally occurring phenolic compound that is widely used in dentistry as a component of zinc oxide eugenol cement that is commonly applied to the mouth environment. Cisplatin is one of the most potent known anticancer agents and shows significant clinical activity against a variety of solid tumors. This study was undertaken to investigate the synergistic apoptotic effects of co-treatments with eugenol and cisplatin on human melanoma (G361) cells. To investigate whether this co-treatment efficiently reduces the viability of G361 cells compared with each single treatment, an MTT assay was conducted. The induction and augmentation of apoptosis were confirmed by DNA electrophoresis, Hoechst staining and an analysis of DNA hypoploidy. Western blot analysis and immunofluorescent staining were also performed to evaluate the expression levels and the translocation of apoptosis-related proteins following this co-treatment. Furthermore, proteasome activity and mitochondrial membrane potential (MMP) changes were also assayed. The results indicated that a co-treatment with eugenol and cisplatin induced multiple pathways and processes associated with an apoptotic response in G361 cells including nuclear condensation, DNA fragmentation, a reduction in MMP and proteasome activity, the increase and decrease of Bax and Bcl-2, a decreased DNA content, the release of cytochrome c into the cytosol, the translocation of AIF and DFF40 (CAD) into the nucleus, and the activation of caspase-9, caspase-7, caspase-3, PARP and DFF45 (ICAD). In contrast, separate treatments of 300 microM eugenol or 3 microM cisplatin for 24 h did not induce apoptosis. Our present data thus suggest that a combination therapy of eugenol and cisplatin is a potential treatment strategy for human melanoma.
Antineoplastic Agents ; Apoptosis ; Blotting, Western ; Caspase 3 ; Caspase 7 ; Caspase 9 ; Cisplatin ; Cytochromes c ; Cytosol ; Dentistry ; DNA ; DNA Fragmentation ; Electrophoresis ; Eugenol ; Humans ; Melanoma ; Membrane Potential, Mitochondrial ; Mouth ; Phenol ; Proteasome Endopeptidase Complex ; Proteins ; Zinc Oxide-Eugenol Cement

PURPOSE: To review and determine the complications in 76 child abuse cases recorded by a multidisciplinary hospital-based child protection team between 1987 and 2007. METHODS: We retrospectively reviewed the reports and medical records of child abuse cases maintained by a university hospital-based child protection team. We devised a questionnaire for standardized interviews with the victims' guardians to determine the current physical and mental status of the children; questionnaires were answered by social workers of the child protection team who interviewed the present fosterers of 24 (35.8%) children. RESULTS: Of the 76 children, 6 were infants, 10 were 1-3 years old, were 3-10 years old, and 19 were over 10 years old. Seven children (9.2%) were neglected and 27 (35.5%) and 44 (57.9%) were sexually and physically abused, respectively. In more than half of the cases, the perpetrators were the father or mother of the children. Most children (41 cases, 53.9%) were abused at their homes. The mean follow-up duration from the time of abuse infliction was 54.3+/-49.2 months, and the current mean age of the children was 8.3+/-6.4 years. Moderate and severe developmental delay and physical disability were observed in 6 (25.0%) and 3 (12.5%) cases, respectively. In 13 children (54.2%), the Global Assessment of Functioning Scale (GAF) score was less than 60, which indicates mild mental disability. CONCLUSION: A hospital-based child protection team may witness the different proportion of abuse types and patterns by conducting a nation-wide survey of child abuse cases.
Child ; Child Abuse ; Child Advocacy ; Fathers ; Follow-Up Studies ; Humans ; Infant ; Korea ; Medical Records ; Mothers ; Surveys and Questionnaires ; Retrospective Studies ; Social Workers ; Wit and Humor as Topic

PURPOSE: To review and determine the complications in 76 child abuse cases recorded by a multidisciplinary hospital-based child protection team between 1987 and 2007. METHODS: We retrospectively reviewed the reports and medical records of child abuse cases maintained by a university hospital-based child protection team. We devised a questionnaire for standardized interviews with the victims' guardians to determine the current physical and mental status of the children; questionnaires were answered by social workers of the child protection team who interviewed the present fosterers of 24 (35.8%) children. RESULTS: Of the 76 children, 6 were infants, 10 were 1-3 years old, were 3-10 years old, and 19 were over 10 years old. Seven children (9.2%) were neglected and 27 (35.5%) and 44 (57.9%) were sexually and physically abused, respectively. In more than half of the cases, the perpetrators were the father or mother of the children. Most children (41 cases, 53.9%) were abused at their homes. The mean follow-up duration from the time of abuse infliction was 54.3+/-49.2 months, and the current mean age of the children was 8.3+/-6.4 years. Moderate and severe developmental delay and physical disability were observed in 6 (25.0%) and 3 (12.5%) cases, respectively. In 13 children (54.2%), the Global Assessment of Functioning Scale (GAF) score was less than 60, which indicates mild mental disability. CONCLUSION: A hospital-based child protection team may witness the different proportion of abuse types and patterns by conducting a nation-wide survey of child abuse cases.
Child ; Child Abuse ; Child Advocacy ; Fathers ; Follow-Up Studies ; Humans ; Infant ; Korea ; Medical Records ; Mothers ; Surveys and Questionnaires ; Retrospective Studies ; Social Workers ; Wit and Humor as Topic

BACKGROUND: Stigma may affect the interpersonal relationship and coping ability of epilepsy patients. This study was aimed to evaluate the degree of stigma and the relationship between the clinical factors, quality of life (QOL) and the stigma in epilepsy patients. METHODS: One hundred and sixty-three patients with epilepsy were included. The research instruments were questionnaires for collecting demographic and disease-specific data, the stigma and quality of life. The modified Kim Eun Ja's stigma scale (1997) was used. It consists of two domains (enacted stigma, felt stigma) and has 10 items. The quality of life was evaluated by QOLIE-31. To test the correlation between the clinical factors, QOL and the stigma, Pearson correlation coefficient and ANCOVA were used. RESULTS: 51.5% of all patients had stigma. There was a significant negative correlation (r=-0.585, p<0.01) between the total score of stigma and the QOL. Two domains of stigma were also negatively correlated with QOL as follows : felt stigma vs. QOL (r=-0.429, p<0.01) and enacted stigma vs. QOL (r=-0.542, p<0.01). The patients with higher seizure frequency had lower QOL (F=4.834, p=0.03). The clinical factors that could predict the degree of stigma were the seizure frequency (F=7.86, p=0.006), duration of seizure disorder (F=7.34, p=0.008), seizure pattern (F=4.48, p=0.036) and the number of AED (F=2.51, p=0.045). CONCLUSIONS: The felt stigma and the enacted stigma affected the QOL of epilepsy patients. These results suggest that psychosocial interventions are necessary to treat the negative reaction and depressed self-esteems of epilepsy patients in order to improve their QOL.
Epilepsy* ; Humans ; Quality of Life* ; Surveys and Questionnaires ; Seizures

Background: Bacterial skin infections are commonly observed in dermatological practice. After the coronavirus disease (COVID-19) pandemic, individuals have become concerned about personal hygiene. It is expected that infectious diseases will decrease, and there will be differences in the characteristics of isolated microorganisms, including antibiotic susceptibility. Objective: This study aimed to analyze the differences in the characteristics of bacterial skin infections before and after the COVID-19 pandemic. Methods: We retrospectively reviewed patients who underwent bacterial culture and susceptibility tests at Chosun University Hospital for the treatment of bacterial skin infections. The period before the COVID-19 pandemic is from January 2018 to December 2019, and the period after the COVID-19 pandemic is from January 2020 to December 2021. We analyzed the antibiotic susceptibility of Staphylococcus aureus in the patients. Results: Overall, 578 patients were included in this study. The age of the patients increased from 39.9 years before the COVID-19 pandemic to 44.2 years (p=0.03). The number of hospitalized patients decreased from 0.2% before the pandemic to 0.1% after the pandemic (p＜0.001). The most commonly isolated microorganism in both groups was S. aureus, followed by coagulase-negative staphylococci. The methicillin resistance rate of S. aureus increased from 34.8% to 36.4% between 2018 and 2021, although no significant association was found between the pre- and post-COVID-19 pandemic. Conclusion This study showed that although there was no significant difference in the types of bacteria and antibiotic resistance, the age of the patients increased, and the rate of admission decreased.

OBJECTIVES: The present study evaluated the effects of job stress, including organisational system to self-rated depression through a panel study of male municipal firefighters in the Republic of Korea. METHODS: A panel of 186 municipal firefighters reported self-rated depressive symptoms according to the Beck Depression Inventory (BDI). The effects of job stress were evaluated using the Korea Occupational Stress Scale, taken one year earlier and classified by the median value. Panel members were classified into Depression or Control groups according to BDI scores, with a cut-off level of \'over mild depression' in a follow-up survey. RESULTS: The Depression group included 17 (9.1%) workers. Firefighters who scored high on occupational system had an 8.3 times greater risk of being assigned to the Depression group than those who had not (adjusted odds ratio [OR] = 8.03, 95% confidence interval (CI) = [1.73-37.22]). In contrast, job stress from a \'difficult physical environment' revealed negative risks related to being classified in the Depression group (AOR = 0.20, 95% CI = [0.04-0.92]). CONCLUSIONS: Although the healthy worker effect may be involved, job stress based on perceptions of organisational system was a strong risk factor for depression. A comprehensive approach should be considered that encompasses social issues when assessing or mental health in high-risk groups, as well as the practical issue of physiochemical hazards.
Depression* ; Firefighters* ; Follow-Up Studies ; Healthy Worker Effect ; Humans ; Korea ; Male* ; Mental Health ; Odds Ratio ; Republic of Korea ; Risk Factors

BACKGROUND: Aircraft noise is a major environmental noise problem. This study was conducted in order to investigate the relationship between sleep disturbance and exposure to aircraft noise on the residents who are living near an airport. METHODS: There were 3308 residents (1403 in the high exposure group, 1428 in the low exposure group, and 477 in the non-exposure group) selected as the subjects for this study. The Insomnia severity Index (ISI) and Epworth Sleepiness Scale (ESS) questionnaires were used to evaluate sleep disturbance. RESULTS: The mean ISI and ESS scores were 6.9 ± 6.4 and 5.5 ± 3.7, respectively, and the average scores were significantly greater in the aircraft noise exposure group, as compared to the non-exposure group. The percentage of the abnormal subjects, which were classified according to the results of the ISI and ESS, was also significantly greater in the noise exposure group, as compared to the control group. The odd ratios for insomnia and daytime hypersomnia were approximately 3 times higher in the noise exposure group, as compared to the control group. CONCLUSIONS: The prevalence of insomnia and daytime hypersomnia was higher in the aircraft noise exposure group, as compared to the control group. Further study is deemed necessary in order to clarify the causal relationship.
Aircraft* ; Airports* ; Cross-Sectional Studies* ; Disorders of Excessive Somnolence ; Noise* ; Prevalence ; Sleep Initiation and Maintenance Disorders

BACKGROUNDS/AIMS: Identifying pancreatic cancer patients at high risk of early mortality following surgical resection for pancreatic cancer is important to make optimal treatment decisions in multidisciplinary setting. The purpose of this study was to identify the factors related to early mortality in patients who underwent pancreatic resection for pancreatic adenocarcinoma. METHODS: We reviewed our institution's experience with all consecutive patients who underwent pancreatectomy for pancreatic adenocarcinoma from January 2000 to December 2010. One thousand patients were eligible for our study. Fifty-three patients who did not meet the study criteria were excluded. Based on 12 months after surgery, patients were divided into early mortality group or the remaining group. We performed logistic regression analysis to identify predictors of early mortality. RESULTS: Among 947 patients who met our study criteria, 302 (31.9%) early mortality (defined as experiencing death within 12 months after surgery) occurred. Multivariate analysis revealed that patient age and surgery time period were statistically significant predictors of early mortality within six months after surgery. Poorly differentiated tumor and adjuvant chemotherapy were statistically significant predictors of early mortality within 12 months after surgery. Total pancreatectomy and lymphovascular invasion were significant (p<0.05) prognostic factors of early mortality within 6 or 12 months after surgery. CONCLUSIONS: We suggest followings to avoid early mortality after pancreatic resection: patients with multiple risk factors related to early mortality after pancreatectomy should be considered for alternative treatment; patient's general condition and surgical technique improvement are important; and adjuvant therapy should be taken into consideration.
Adenocarcinoma* ; Chemotherapy, Adjuvant ; Humans ; Logistic Models ; Mortality* ; Multivariate Analysis ; Pancreas ; Pancreatectomy ; Pancreatic Neoplasms ; Prognosis ; Risk Factors

Because doxylamine is an antihistamine commonly used as over-the counter sleep preparation, it may bring out overdose. The usual clinical course of the overdose is dominated by the anticholinergic effect of these agents; it include significant autonomic and central nervous system effect. The most frequent symptom included impaired consciousness, seizure, tachycardia, mydriasis and a psychosis similar to that in catatonic stupor. A serious complications may be rhadbomyolysis with subsequent impairment of renal function and acute renal failure. Though the exact mechaism is not clear yet, it seems likely that doxylamine has a direct toxic effect on striated muscle. We report a case of a 22-year-old man who was complicated by rhabdomyolysis and impairment of renal function after doxylamine overdose. He was transported due to reddish urine from other hospital. According to transfer note, when he arrived at emergency room, he had slight drowsy mental state without tonic clonic seizure. He developed a elevated muslce enzyme and showed generalized, multiple uptake in damages muscle with the image of 99MTc-MDP bone scan. He was managed with hydration, urine alkalinization and supportive care during hospitalization. If doxylamine overdose are suspected, we should obtain creatine kinase level. Recognition of the potential for rhabdomyolysis and institution of vigorous treatment may prevent acute renal failure in patients who have taken an overdose of the drug.
Acute Kidney Injury ; Central Nervous System ; Consciousness ; Creatine Kinase ; Doxylamine* ; Emergency Service, Hospital ; Hospitalization ; Humans ; Muscle, Striated ; Mydriasis ; Psychotic Disorders ; Rhabdomyolysis* ; Seizures ; Stupor ; Tachycardia ; Technetium Tc 99m Medronate ; Young Adult