Objective: We sought to compare the activity times of the 119 service ambulance units before and after the coronavirus disease 2019 (COVID-19) pandemic based on emergency medical service reports. Methods: This study analyzed the emergency medical service reports (1.26-10.31) of 69 ambulance units belonging to the Busan Fire Department in 2019 (before) and 2020 (after) the onset of the COVID-19 pandemic. This was a retrospective cross-sectional study to understand the changes in the activity times (response time, scene time interval, transport time interval, total prehospital time, turnaround time interval, and total activity time) according to the presence of fever or respiratory symptoms (symptom group). The data used for analysis included 150,771 cases, of which 79,121 were in 2019 and 71,650 in 2020, excluding incomplete transfer reports (128,082). Results: There was a total decrease of 7,471 cases in 2020. Compared to 2019, the dispatch and transport distance, outer dispatch jurisdiction, and transport to university hospitals increased. That was found to be greater in the symptom group than in the no symptom group. In the yearly comparison of activity times, there were significant differences in all the activity times and an overall increase in 2020. The increase in the active times was greater in the symptom group than in the no symptom group. Conclusion In this study, the activity times of the 119 service ambulance units after the COVID-19 showed an increase compared to the pre-COVID period. Therefore, the concerned people must identify the factors which lead to delays and prepare a plan to shorten the activity times, thereby reducing the fatigue of paramedics and providing the means to enhance assistance for the well-being of patients.

Objectives: The purpose of this study was to investigate the factors in which employee’s health beliefs affect their intention to get COVID-19 vaccines. Methods: The participants of this survey were 237 emlpoyees living in Busan. Data were collected using structured online questionnaires from April 26th to May 6th, 2021. The data were analyzed in SPSS WIN version 25.0 using descriptive statistics, t-test, chi-square test, multiple logistic regression analysis. Results: At the average score for each area of health beliefs regarding COVID-19, self-efficacy was 4.45 points, perceived sensitivity 4.71 points, perceived severity 3.59 points, perceived benefit 4.46 points, and perceived disability 2.19 points. Monthly income, perceived sensitivity, perceived severity, and perceived benefit were found to be factors affecting the intention to get COVID-19 vaccines. Conclusions In order to improve the vaccination intention of COVID-19, it is necessary for subjects to recognize the seriousness of the disease, increase their sensitivity to the disease, and actively promote and educate the community about the benefits of vaccination.

Background: This study aimed to analyze the prehospital process and reperfusion therapy process of acute ischemic stroke in Busan metropolitan area and examine the impact of living arrangement on the early management and functional outcomes of acute ischemic stroke (AIS). Methods: The patients who diagnosed with AIS and received reperfusion therapy at the Busan Regional Cardiovascular Center between September 2020 and May 2023 were selected. We investigated the patients’ hospital arrival time (onset to door time) and utilization of 119 emergency ambulance services. Additionally, various time matrices related to reperfusion therapy after hospital were examined, along with the functional outcome at the 90-day after treatment. Results: Among the 753 AIS patients who underwent reperfusion therapy, 166 individuals (22.1%) were living alone. AIS patients living alone experienced significant delays in symptom detection (p<0.05) and hospital arrival compared to AIS patients with cohabitants (370.1 minutes vs. 210.2 minutes, p<0.001). There were no significant differences between the two groups in terms of 119 ambulance utilization and time metrics related with the reperfusion therapy. Independent predictors of prognosis in AIS patients were found to be age above 70, National Institutes of Health Stroke Scale score at admission, tissue plasminogen activator, living alone (odds ratio [OR], 1.785; 95% confidence interval [CI], 1.155–2.760) and interhospital transfer (OR, 1.898; 95% CI, 1.152–3.127). Delay in identification of AIS was shown significant correlation (OR, 2.440; 95% CI, 1.070–5.561) at living alone patients. Conclusion This study revealed that AIS patients living alone in the Busan metropolitan region, requiring endovascular treatment, face challenges in the pre-hospital phase, which significantly impact their prognosis.

We experienced a case of nephropathy in chronic lead poisoning. The patient was 43-year-old male who has been working in secondary lead smelting plant for ]4 years. On admission, blood pressure was 160/90 mmHg and the others were non-specific. In past history, he received chelating agent administration for lead poisoning irregularly and medicated for gout, and the blood lead concentration was 180.0 microgram/dl on 2 months before admission. Smoking habit has been 1 pack per day for 15 years and drinking habit has been 1 bottle of Soju per day but less now. In liver function test, AT/ALT were 27/28 IU/l and gamma-GT was 456 IU/l. In blood test, Hb:11. 5 g/dl , Hct: 34.0% and basophilic stipplings were found in peripheral blood smear. Chest PA was normal and abdominal ultrasonographic finding was non-specific except fatty liver. In the test of lead exposure indices, pbB: 83.0 microgram/dl, pbU: 28.3 microgram/l, and blood ZPP was 300.0 microgram/dl. And in renal function test, BUN: 31.4 mg/dl, blood creatinine: 2.7mg/dl, blood uric acid: 9.1 mg/dl, urinary albumin: 100.0 mg/g creatinine, urinary a alpha 1-microglobulin: 120.5 mg/g creatinine, urinary beta2-mioroglobulin: 183.8 microgram/g creatinine, and 24 hours urinary creatinine clearance was 31.9 ml/min. The ultasonoguided renal biopsy showed the global sclerosis of glomerulus, moderate atrophy and loss of tubule, and interstitial fibrosis in light microscopy. There were diffuse losses of brush border of proximal tubule in electronmicroscopy.
Adult ; Atrophy ; Basophils ; Biopsy ; Blood Pressure ; Creatinine ; Drinking ; Fatty Liver ; Fibrosis ; Gout ; Hematologic Tests ; Humans ; Lead Poisoning* ; Liver Function Tests ; Male ; Microscopy ; Microvilli ; Osmeriformes ; Plants ; Sclerosis ; Smoke ; Smoking ; Thorax ; Uric Acid

PURPOSE: Natural orifice transluminal endoscopic surgery (NOTES) is a new method of accessing intracavitary organs in order to minimize pain by avoiding incisions in the body wall. The aim of this study is to determine patients' acceptance of NOTES in Korea and to compare their views about laparoscopic surgery and NOTES for benign and malignant diseases. MATERIALS AND METHODS: The target number of total subjects was calculated to be 540. The subjects were classified into 18 sub-groups based on age groups, gender, and history of prior surgery. The questionnaire elicited information about demographic characteristics, medical check-ups, diseases, endoscopic and surgical histories, marital status and childbirth, the acceptance of NOTES, and the preferred routes for NOTES. In addition, the subjects chose laparoscopic surgery or NOTES for a hypothetical cholecystectomy and rectal cancer surgery, and responded to questions regarding the acceptable complication rate of NOTES, the appropriate cost of NOTES, and the reason(s) why they did not select NOTES. RESULTS: 486 of 540 patients (90.0%) who agreed to participate in this study completed the questionnaire. NOTES was preferred by the following patients: elderly; a history of treatment due to a disease; having regular check-ups; and a history of an endoscopic procedure (p<0.05). The most preferred route for NOTES was the stomach (67.1%). Eighty-four percent of the patients choosing NOTES responded that the complication rate of the new surgical method should be the same or lower than laparoscopic surgery. Vague anxiety over a new surgical method was the most common reason why NOTES was not selected in benign and malignant diseases (64% and 73%), respectively. CONCLUSION: Patients appear to be interested in the potential benefits of NOTES and would embrace it if their concerns about safety are met. We believe that qualified surgical endoscopists can meet these safety concerns, and that NOTES development has the potential to flourish.
Aged ; Anxiety ; Cholecystectomy ; Endoscopy* ; Humans ; Korea* ; Laparoscopy ; Marital Status ; Mass Screening* ; Methods ; Natural Orifice Endoscopic Surgery* ; Parturition ; Rectal Neoplasms ; Stomach

OBJECTIVE: The aim of this paper was to develop efficient and practical health promotion strategies in the workplace by investigating both the present status of health promotion and the barriers to its practice. METHODS: A questionnaire was administered to 20% of industrial workers in the workplaces which receives the health care agency enterprise or are supported by a grant from the national treasury, K University Hospital in Gyeong-Gi province, and C University Hospital in Seoul. RESULTS: According to the questionnaire survey, 51.3% workers were practicing health promotion activities and smoking cessation was the most common method among them. Regarding the factors that prompt workers to commence health promotion activities, TV or the mass media had a 33.4% effect, followed by a 22.1% effect for an abnormal finding at regular health screening. The most necessary health promotion activity in the workplace was exercise (41.9%), followed by stress management. When asked about their expectations of the health promotion program, 84.8% of the respondents answered that they expected it to be significantly or somewhat effective. Factors affecting the health promotion activities of workers were worker's health status and job control. CONCLUSIONS: This study demonstrated that workers evaluate health promotion activities positively and that some workers are unable to participate in these activities despite their willingness to do so due to the barrier of circumstances. To encourage worker's participation, the government and employers should remove barriers.
Community-Institutional Relations ; Data Collection ; Delivery of Health Care ; Financing, Organized ; Health Promotion* ; Mass Media ; Mass Screening ; Occupational Health ; Questionnaires ; Seoul ; Smoking Cessation

OBJECTIVES: The authors report a case of pneumonitis caused by methylene chloride (MC). METHODS: The patient was examined and diagnosed by clinical, radiologic, laboratorial and medical evaluation. The concentration of MC in the factory was measured to determine the exposure level. RESULTS: The patient had an infiltration in chest X-ray, which underwent rapid relief of radiological finding, respiratory acidosis and hypoxemia in arterial blood gas analysis, and a ground-glass opacity in high resolution computerized tomography. MC was the only exposed chemical compound in this case. The concentration of MC was 39.9 ppm in the factory. CONCLUSIONS: We diagnosed this to be a case of pneumonitis by MC based on clinical laboratory findings, exposure history to MC and MC concentration in the factory.
Acidosis, Respiratory ; Anoxia ; Blood Gas Analysis ; Humans ; Methylene Chloride* ; Pneumonia* ; Thorax

We experienced a case of occupational lead poisoning employed in a secondary lead smelting plant for 12 years. The patient was 39-year-old male and had been felt dizziness, recent memory impairment and intermittent severe abdominal pain for 2 years. On admission, blood lead level was 92.9 microgram/dl, urinary lead level was 19,9 microgram/l and zinc protoporphyrin level was 226.0 microgram/dl. On the blood test, hemoglobin was 10.6 g/dl and showed normocytic normochromic anemia. There were no abnormal findings in the biochemical and hormonal tests. Decrease of I.Q. and use of words in speaking were found in the psychiatric and psychologic examinations. We observed the finding of motor polyneuropathy in the nerve conduction velocity test. Computed tomographic finding showed calcification lesions in the basal ganglia, dentate nuclei, caudate nuclei, and especially characteristic multiple calcifications were located in the subcortical white matter.
Abdominal Pain ; Adult ; Anemia ; Basal Ganglia ; Brain* ; Dizziness ; Hematologic Tests ; Humans ; Lead Poisoning* ; Male ; Memory ; Neural Conduction ; Osmeriformes ; Plants ; Polyneuropathies ; Zinc

BACKGROUND: The present study aims to compare the pulmonary function of residents of Seoul special city (Seoul) and Jeju special self-governing province including Jeju city and Seogwipo city (Jeju), characterized by vastly different annual average airborne particulate matter with an aerodynamic diameter less ≤10 μm (PM10) concentrations, with the annual average PM10 concentration in Seoul being significantly higher than that in Jeju. METHODS: This cross-sectional study analyzed the pulmonary function test results and sociodemographic data of Korean adults ≥19 years of age derived from the 4th KNHANES, 2007–2009. A total of 830 individuals residing in Seoul or Jeju were included in this study. T-tests were used to analyze predicted values of forced expiratory volume in 1 sec (FEV1p), predicted values of forced vital capacity (FVCp) and FEV1/FVC ratio (FEV1/FVC), as dependent variables, to examine the differences in the subjects’ pulmonary function according to the city of residence. Stratified analysis was then performed to adjust for variables potentially affecting pulmonary function. The analysis was performed on subjects as a group and also following stratification according to sex and other variables. RESULTS: Seoul residents had a significantly lower FVCp than that of the Jeju residents (difference: 3.48%, p = 0.002). FEV1p, FVCp and FEV1/FVC of male Seoul residents were significantly lower than those of male Jeju residents (difference: 6.99, 5.11% and 0.03, respectively; p < 0.001, p = 0.001, p = 0.001). In male subjects, statistically significant results were obtained even after adjusting the influence of other variables through stratified analysis. CONCLUSION: The present analysis was based on cross-sectional data collected at one point in time. Therefore, unlike longitudinal studies, it does not establish a clear causal association between the variables. Nevertheless, this study found that pulmonary function among subjects residing in Seoul was significantly decreased compared to that of subjects residing in Jeju.
Adult ; Cross-Sectional Studies ; Forced Expiratory Volume ; Humans ; Korea ; Longitudinal Studies ; Male ; Nutrition Surveys ; Particulate Matter ; Respiratory Function Tests ; Seoul ; Vital Capacity

Background: The decreased use of cord blood units (CBU) due to improvements in haploidentical transplantation is a financial burden for public cord blood banks. Currently, there is no guidance regarding the length of cryopreservation of CBU in Korean public banks. The relative quality of long-term storage CB (LTCB) and short-term storage CB (STCB) needs to be evaluated to establish a storage policy. Methods: Thirty-four and thirty-one units of CB cryopreserved for less than one year and up to 14∼15.5 years, respectively, in the Busan Gyeongnam Public Cord Blood Bank were assessed. The total nucleated cells (TNCs), CD34+ cell counts, and colony-forming units-granulocyte monocyte (CFU-GM) were examined. The cell viabilities were evaluated by Eosin-Y exclusion staining and 7-aminoactinomycin D flow cytometry. The number of stored Korean public CB units from 2000 to 2016 was determined and categorized according to TNCs. Results: The post-thawing viability of the STCBs measured by flow cytometry was consistently higher than that of the LTCBs (TNCs, 62.5% vs 57.3%; MNCs, 93.1% vs 88.9%; CD34+ cells 95.7% vs 94.0%). The CD34+ cell viability was significantly higher in STCB (P=0.03). The CFU-GM after thawing was higher in STCBs (61.5±23.4 vs 49.9±22.8 [0.95 mm 2 ] P=0.05). Of the 48,161 CB units stored until 2016, Dec, 9,493 (19.7%), which were stored until 2006, had been stored for more than 10 years. Conclusion LTCB with a low number of cells (＜0.7×10 9 cells) should be considered to exclude from storage for therapeutic purposes to improve the storage efficiency.