PURPOSE: Indoor risk factors for allergic diseases in low-income households in Korea have been characterized only partially. We evaluated the prevalences of atopic dermatitis, asthma, and allergic rhinitis in Seoul, Korea, to identify key housing and behavioral risk factors of low-income households. METHODS: Statistical analysis of the prevalence of these diseases and various risk factors was conducted using data from a 2010 Ministry of Environment household survey. Logistic regression models were generated using data from 511 low-income household apartments in districts of Seoul. RESULTS: In general, housing factors such as renovation history (P<0.1) and crowding status (P<0.01) were associated with allergic rhinitis, whereas behavioral factors such as frequency of indoor ventilation (P<0.05) and cleaning (P<0.1) were inversely correlated with atopic dermatitis. Indoor smoking was a major trigger of asthma and atopic dermatitis in low-income households (P<0.05). The presence of mold and water leakage in houses were the most important risk factors for all three diseases (P<0.05). CONCLUSIONS: Various risk factors play a role in triggering allergic diseases among low-income households in Seoul, and health or environmental programs mitigating allergic diseases should be tailored to address appropriate housing or behavioral factors in target populations.
Asthma ; Crowding ; Dermatitis, Atopic ; Family Characteristics* ; Fungi ; Health Services Needs and Demand ; Housing ; Korea ; Logistic Models ; Poverty ; Prevalence* ; Rhinitis ; Risk Factors* ; Seoul ; Smoke ; Smoking ; Ventilation ; Water

PURPOSE: The role of PM10 in the development of allergic diseases remains controversial among epidemiological studies, partly due to the inability to control for spatial variations in large-scale risk factors. This study aims to investigate spatial correspondence between the level of PM10 and allergic diseases at the sub-district level in Seoul, Korea, in order to evaluate whether the impact of PM10 is observable and spatially varies across the subdistricts. METHODS: PM10 measurements at 25 monitoring stations in the city were interpolated to 424 sub-districts where annual inpatient and outpatient count data for 3 types of allergic diseases (atopic dermatitis, asthma, and allergic rhinitis) were collected. We estimated multiple ordinary least square regression models to examine the association of the PM10 level with each of the allergic diseases, controlling for various sub-district level covariates. Geographically weighted regression (GWR) models were conducted to evaluate how the impact of PM10 varies across the sub-districts. RESULTS: PM10 was found to be a significant predictor of atopic dermatitis patient count (P<0.01), with greater association when spatially interpolated at the sub-district level. No significant effect of PM10 was observed on allergic rhinitis and asthma when socioeconomic factors were controlled for. GWR models revealed spatial variation of PM10 effects on atopic dermatitis across the sub-districts in Seoul. The relationship of PM10 levels to atopic dermatitis patient counts is found to be significant only in the Gangbuk region (P<0.01), along with other covariates including average land value, poverty rate, level of education and apartment rate (P<0.01). CONCLUSIONS: Our findings imply that PM10 effects on allergic diseases might not be consistent throughout Seoul. GIS-based spatial modeling techniques could play a role in evaluating spatial variation of air pollution impacts on allergic diseases at the sub-district level, which could provide valuable guidelines for environmental and public health policymakers.
Air Pollution ; Asthma ; Dermatitis ; Dermatitis, Atopic ; Education ; Environmental Policy* ; Epidemiologic Studies ; Humans ; Inpatients ; Korea ; Outpatients ; Particulate Matter ; Poverty ; Public Health ; Rhinitis ; Risk Factors ; Seoul* ; Socioeconomic Factors ; Spatial Analysis

We describe a case of robot-assisted laparoscopic bilateral upper urinary tract surgery in a 4-month-old infant for complex bilateral upper urinary tract duplication anomalies.
Humans ; Infant* ; Pediatrics ; Robotics ; Urinary Tract*

INTRODUCTIONTo review the perioperative and short-term outcome of all laparoscopic partial nephrectomies (LPN) performed in a single institution.

MATERIALS AND METHODSThirteen consecutive patients who underwent LPN since the beginning of the programme in March 2002 to January 2008 were enrolled. Demographic, perioperative and follow-up data were retrospectively collected. Transperitoneal approach was used in all cases, and vascular control was achieved with the use of a laparoscopic Satinsky clamp or vascular tape. The tumour was excised using cold scissors. Transected intrarenal vessels were suture ligated and the parenchymal defect was closed primarily with absorbable suture over a bolster.

RESULTSThirteen patients underwent a total of 14 LPN. The median age of patients was 60 years (range, 41 to 77). The mean tumour size was 24 +/- 11.4 (2SD) mm. The mean operative time was 228 +/- 129 (2SD) minutes and median warm ischaemia time was 35 minutes (range, 24 to 68). Postoperatively, serum haemoglobin level decreased by a mean of 1.4 +/- 2.5 (2SD) gm/dL and serum creatinine increased by a mean of 22.5 +/- 25.8 (2SD) micromol/L. Twelve out of 13 (92%) patients achieved their baseline serum creatinine level within 1 month postoperatively. There was 1 open conversion (7%), and 2 patients (14%) required blood transfusion perioperatively. Two patients (14%) had transient fever postoperatively due to basal atelectasis. No other complications were encountered. Median patient hospital stay was 4 days (range, 2 to 10). Eleven out of 14 (79%) of the tumours were renal cell carcinoma (RCC). At a median follow-up of 12 months (range, 6 to 53), all except 1 patient with RCC were disease-free.

CONCLUSIONSOur experience has shown that laparoscopic partial nephrectomy is a safe, feasible technique in our centre for patients with small exophytic renal tumours. Patients can be discharged early with preservation of renal function and good early cancer control.

Adult ; Aged ; Carcinoma, Renal Cell ; surgery ; Female ; Hospitals, General ; Humans ; Kidney Neoplasms ; surgery ; Laparoscopy ; methods ; Length of Stay ; Male ; Middle Aged ; Nephrectomy ; methods ; Retrospective Studies ; Singapore

PURPOSE: During a laparotomy, the peritoneum is exposed to the cold, dry ambient air of the operating room (20℃, 0%–5% relative humidity). The aim of this review is to determine whether the use of humidified and/or warmed CO2 in the intraperitoneal environment during open or laparoscopic operations influences postoperative outcomes. METHODS: A review was performed in accordance with PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. The PubMed, OVID MEDLINE, Cochrane Central Register of Controlled Trials and Embase databases were searched for articles published between 1980 and 2016 (October). Comparative studies on humans or nonhuman animals that involved randomized controlled trials (RCTs) or prospective cohort studies were included. Both laparotomy and laparoscopic studies were included. The primary outcomes identified were peritoneal inflammation, core body temperature, and postoperative pain. RESULTS: The literature search identified 37 articles for analysis, including 30 RCTs, 7 prospective cohort studies, 23 human studies, and 14 animal studies. Four studies found that compared with warmed/humidified CO2, cold, dry CO2 resulted in significant peritoneal injury, with greater lymphocytic infiltration, higher proinflammatory cytokine levels and peritoneal adhesion formation. Seven of 15 human RCTs reported a significantly higher core body temperature in the warmed, humidified CO2 group than in the cold, dry CO2 group. Seven human RCTs found lower postoperative pain with the use of humidified, warmed CO2. CONCLUSION: While evidence supporting the benefits of using humidified and warmed CO2 can be found in the literature, a large human RCT is required to validate these findings.
Animals ; Body Temperature ; Carbon Dioxide ; Cohort Studies ; Humans ; Inflammation ; Insufflation* ; Laparotomy ; Operating Rooms ; Pain, Postoperative ; Peritoneum ; Pneumoperitoneum ; Prospective Studies ; Tissue Adhesions

STUDY DESIGN: Retrospective cohort study. PURPOSE: To evaluate surgical outcomes and complications of cervical spine fractures in ankylosing spondylitis (CAS) patients who were treated using either the posterior (P) or combined approach (C). OVERVIEW OF LITERATURE: Ankylosing spondylitis typically causes progressive spinal stiffness that makes patients susceptible to spinal fractures. CAS is a highly unstable condition. There is contradictory evidence regarding which treatment option, the posterior or the combined approach, yields superior clinical results. METHODS: A single institution database was reviewed for data in the period 1999 to 2015. All CAS patients who underwent posterior or combined instrumented fusion were enrolled. We analyzed demographic data, radiographic results, perioperative complications, and postoperative results. RESULTS: Thirty-three patients were enrolled (23 in the P group, 10 in the C group). All patients presented with neck pain after a fall. In the P group, mean operative time was 161.1 minutes (100–327 minutes), and mean estimated blood loss (EBL) was 306.4 mL (50–750 mL). In the C group, 90% of patients underwent a staged procedure, typically with posterior surgery first. Mean EBL was 124 mL (25–337 mL). For posterior surgery, mean EBL was 458.3 mL (400–550 mL). EBL of posterior surgery in the C group was higher but this difference was not significant (p=0.16). Postoperative complication rate was higher in the C group but this difference was not significant (50% vs. 17.4%, p=0.09). In the follow-up period, no late reoperations were performed. Patients who underwent C surgery had a higher rate of neurological improvement but this difference was not significant (p=0.57). CONCLUSIONS: Both P and C provided good clinical results. P surgery had lower EBL, lower postoperative complication rate, and shorter length of stay than C surgery; none of these differences were statistically significant.
Cervical Vertebrae ; Cohort Studies ; Female ; Follow-Up Studies ; Humans ; Length of Stay ; Neck Pain ; Operative Time ; Postoperative Complications ; Reoperation ; Retrospective Studies ; Spinal Fractures ; Spine ; Spondylitis, Ankylosing

Background: This study characterized the risk of new-onset asthma among workers in Manitoba, Canada. Methods: Accepted time loss claims from the Workers' Compensation Board of Manitoba from 2006 to 2019, containing workers' occupations and industries, were linked with administrative health data from 1996 to 2020. After restricting the cohort to the first claim per person in an occupation and applying age and coverage exclusions, the cohort comprised 142,588 person–occupation combinations. Asthma cases were identified if workers had at least two medical records for asthma (International Classification of Diseases, Ninth Revision, 493) within a 12-month period, within the 2 years before 3 years after cohort entry. New-onset asthma was identified using a 3-year washout period. Asthma hazard ratios by occupation and industry were estimated using Cox proportional hazard models, adjusted for age, and stratified by sex. Results: Increased asthma risk was observed among workers with known asthmagen exposure, including male veterinary and animal health technologists and technicians (hazard ratio 3.97, 95% CI 1.78–8.86), male fish processing workers (3.40, 1.53–7.57), and male machining tool operators (2.91, 1.72–4.92). Increases were also observed for occupations with unknown or suspected allergens, including gas station attendants, drivers, mail/postal and related workers, public works and maintenance laborers, mine laborers and crane operators, and some indoor worker groups. Decreased risks were observed among nurses and residential and commercial installer and servicers. Conclusion This database linkage study successfully identified occupations and industries with known sensitizing agents or irritants, and several occupation and industries not typically associated with work-related asthma, warranting further investigation.

Background: This study characterized the risk of new-onset asthma among workers in Manitoba, Canada. Methods: Accepted time loss claims from the Workers' Compensation Board of Manitoba from 2006 to 2019, containing workers' occupations and industries, were linked with administrative health data from 1996 to 2020. After restricting the cohort to the first claim per person in an occupation and applying age and coverage exclusions, the cohort comprised 142,588 person–occupation combinations. Asthma cases were identified if workers had at least two medical records for asthma (International Classification of Diseases, Ninth Revision, 493) within a 12-month period, within the 2 years before 3 years after cohort entry. New-onset asthma was identified using a 3-year washout period. Asthma hazard ratios by occupation and industry were estimated using Cox proportional hazard models, adjusted for age, and stratified by sex. Results: Increased asthma risk was observed among workers with known asthmagen exposure, including male veterinary and animal health technologists and technicians (hazard ratio 3.97, 95% CI 1.78–8.86), male fish processing workers (3.40, 1.53–7.57), and male machining tool operators (2.91, 1.72–4.92). Increases were also observed for occupations with unknown or suspected allergens, including gas station attendants, drivers, mail/postal and related workers, public works and maintenance laborers, mine laborers and crane operators, and some indoor worker groups. Decreased risks were observed among nurses and residential and commercial installer and servicers. Conclusion This database linkage study successfully identified occupations and industries with known sensitizing agents or irritants, and several occupation and industries not typically associated with work-related asthma, warranting further investigation.

Background: This study characterized the risk of new-onset asthma among workers in Manitoba, Canada. Methods: Accepted time loss claims from the Workers' Compensation Board of Manitoba from 2006 to 2019, containing workers' occupations and industries, were linked with administrative health data from 1996 to 2020. After restricting the cohort to the first claim per person in an occupation and applying age and coverage exclusions, the cohort comprised 142,588 person–occupation combinations. Asthma cases were identified if workers had at least two medical records for asthma (International Classification of Diseases, Ninth Revision, 493) within a 12-month period, within the 2 years before 3 years after cohort entry. New-onset asthma was identified using a 3-year washout period. Asthma hazard ratios by occupation and industry were estimated using Cox proportional hazard models, adjusted for age, and stratified by sex. Results: Increased asthma risk was observed among workers with known asthmagen exposure, including male veterinary and animal health technologists and technicians (hazard ratio 3.97, 95% CI 1.78–8.86), male fish processing workers (3.40, 1.53–7.57), and male machining tool operators (2.91, 1.72–4.92). Increases were also observed for occupations with unknown or suspected allergens, including gas station attendants, drivers, mail/postal and related workers, public works and maintenance laborers, mine laborers and crane operators, and some indoor worker groups. Decreased risks were observed among nurses and residential and commercial installer and servicers. Conclusion This database linkage study successfully identified occupations and industries with known sensitizing agents or irritants, and several occupation and industries not typically associated with work-related asthma, warranting further investigation.

Background: This study characterized the risk of new-onset asthma among workers in Manitoba, Canada. Methods: Accepted time loss claims from the Workers' Compensation Board of Manitoba from 2006 to 2019, containing workers' occupations and industries, were linked with administrative health data from 1996 to 2020. After restricting the cohort to the first claim per person in an occupation and applying age and coverage exclusions, the cohort comprised 142,588 person–occupation combinations. Asthma cases were identified if workers had at least two medical records for asthma (International Classification of Diseases, Ninth Revision, 493) within a 12-month period, within the 2 years before 3 years after cohort entry. New-onset asthma was identified using a 3-year washout period. Asthma hazard ratios by occupation and industry were estimated using Cox proportional hazard models, adjusted for age, and stratified by sex. Results: Increased asthma risk was observed among workers with known asthmagen exposure, including male veterinary and animal health technologists and technicians (hazard ratio 3.97, 95% CI 1.78–8.86), male fish processing workers (3.40, 1.53–7.57), and male machining tool operators (2.91, 1.72–4.92). Increases were also observed for occupations with unknown or suspected allergens, including gas station attendants, drivers, mail/postal and related workers, public works and maintenance laborers, mine laborers and crane operators, and some indoor worker groups. Decreased risks were observed among nurses and residential and commercial installer and servicers. Conclusion This database linkage study successfully identified occupations and industries with known sensitizing agents or irritants, and several occupation and industries not typically associated with work-related asthma, warranting further investigation.