Background: Perioperative patients are potentially at risk for pressure injuries due to anesthetic agents and surgical positioning. Pressure injury increases discomfort and pain in patients and causes complications, which lead to an increase in mortality and hospitalization duration. Most previous studies did not focus on specific types of surgery or surgical positioning. We tried to identify the incidence of perioperative pressure injury during spinal surgery and perioperative risk factors that contribute to pressure injury. Methods: We retrospectively analyzed electronic medical records of 663 patients who underwent spinal surgery between March 2016 and May 2018. The primary outcome was occurrence of pressure injury. Potential risk factors of pressure injury were selected based on previous studies and expert opinion, and divided into two sub-categories: preoperative and intraoperative risk factors. We compared the clinical characteristics of patients in the pressure injury and non-injury groups. Perioperative risk factors for pressure injury were analyzed by logistic regression. Results: Among 663 patients, the incidence of all stages of pressure injury was 5.9%. The face and inguinal regions were the most injured sites (both 28.6%). The pressure injury group showed a 13% longer hospitalization period. Preoperative plasma concentration of protein was associated with 0.5-fold lower pressure injury (OR: 0.50; 95% CI: 0.27 to 0.95; P = 0.034). Conclusions The incidence of pressure injury was similar to that previously reported and occurred in the direct weight-bearing areas, which led to longer hospitalization. We found that a lower preoperative serum protein level is significantly associated with intraoperative pressure injury occurrence during spinal surgery.

Objective: Emergency department-based interventions are known to be effective at reducing the risk of repeat suicide attempts among patients admitted to emergency departments after attempting suicide. However, the factors that influence loss to follow-up after emergency department-based interventions are not well known. Methods: This study investigated suicide attempt patients who registered with an emergency department-based intervention and received counseling at least once from January 2019 to December 2020. Patients were allocated to a follow-up group or a loss-to-follow-up group depending on whether emergency department-based interventions had been performed more than three times. Clinical factors and socioeconomic status were considered independent variables. Logistic regression analysis was performed to identify factors that influenced loss to emergency department-based interventions. Results: Of 339 patients enrolled, 210 (61.9%) were lost to follow-up. Time taken to initiation of intervention after discharge (adjusted odds ratio [aOR]=2.42; 95% confidence interval [CI], 1.38-4.30) and suicide attempt associated with physical illness (aOR=0.31; 95% CI, 0.14-0.68) independently influenced loss to emergency department-based interventions. Conclusion Initiation of intervention after discharge significantly influenced emergency department-based intervention follow-up loss of suicide attempt patients. The study suggests initiation of intervention prior to discharge might reduce the risk of repeat suicide attempts.

BACKGROUND: We studied the clinical significance of nontuberculous mycobacteria (NTM) recovered from respiratory specimens for six months in a tertiary referral center. METHODS: We identified all NTM isolates from sputum or bronchial washing from October, 2001 to March, 2002, using polymerase chain reaction-restriction fragment length polymorphism analysis method amplifying the rpoB gene. Patients were classified as having definite, probable, or unlikely NTM disease as defined by the American Thoracic Society and the British Thoracic Society guidelines. RESULTS: 261 isolates of NTM recovered from 162 patients. In 162 patients, M. avium complex (MAC) was the most common species comprising 29.6% (n=48), which was followed by M. fortuitum complex (n=46, 28.4%), M. abscessus (n=26, 16.0%). 29 (17.9%) patients had definite NTM disease, and 13 (8.0%) had probable NTM disease. The common organisms involved in NTM diseases were MAC (n=23, 54.8%), M. abscessus (n=12, 28.6%). In a univariate analysis, predictive factors that were related to NTM disease were BMI <18.5 kg/m2, presence of symptoms, previous history of antituberculous treatment, positive sputum smear, presence of infiltrative, nodular or cavitary lesions at chest radiography, and isolation of MAC or M. abscessus. In a multivariate analysis, isolation of MAC or M. abscessus (OR 16.3, 95% CI 4.2~62.7, p<0.001), cavity at chest radiography (OR 4.8, 95% CI 1.4~16.6, p=0.012), and positive sputum smear (OR 4.3, 95% CI 1.4~13.3, p=0.012) were found to be variables independently associated with pulmonary disease. CONCLSUION: Epidemiology of NTM pulmonary disease in Korea is different from that in other countries. A high index of clinical suspicion as well as an accurate identification of the isolates would be required for the diagnosis of NTM pulmonary disease.
Diagnosis ; Epidemiology ; Humans ; Korea ; Lung Diseases ; Multivariate Analysis ; Mycobacterium avium Complex ; Mycobacterium chelonae ; Nontuberculous Mycobacteria* ; Radiography ; Sputum ; Tertiary Care Centers ; Thorax

PURPOSE: A hospital-based case-control study was conducted to find out risk factors for developing breast cancer in Korea. MATERIALS AND METHODS: Histologically confirmed incident cases of breast cancer(n=280) were selected from inpatients at the Department of General Surgery, Seoul National University Hospital during 1994 to 1997. Women with free of self-reporting past history of any malignancies were regarded as controls who were selected from the inpatients at the Department of Obstetrics and Gynecology of the same hospital during 1992 to 1994(n=930). Information on life-styles including reproductive factors were obtained by direct interview using questionnaire. Age- and education-adjusted odds ratio and 95% confidence interval were estimated by unconditional linear logistic regression. RESULTS: Based on the risk factors identified by both this study and other epidemiologic studies previously performed in Korea, high risk group for female breast cancer in Korea was established as follows. (1) women with age over 50, (2) women who have a family history of breast cancer, (3) women with age at menarche before 14-year old, (4) women with age at menopause after 50-year old, (5) women who were not experienced a full term pregnancy, (5) nulliparous women (6) women with age at her first fullterm pregnancy after 35-year old (7) women who were not experienced breast feeding, (8) women with body mass index more than 25 kg/m2 or with body weight more than 64 kg. CONCLUSION: Life-time risk of breast cancer, as an indicator of absolute risk, according to the risk factors should be pursued in further prospective studies with community population.
Adolescent ; Adult ; Body Mass Index ; Body Weight ; Breast Feeding ; Breast Neoplasms* ; Breast* ; Case-Control Studies ; Epidemiologic Studies ; Female* ; Gynecology ; Humans ; Inpatients ; Korea* ; Logistic Models ; Menarche ; Menopause ; Middle Aged ; Obstetrics ; Odds Ratio ; Pregnancy ; Surveys and Questionnaires ; Reproduction ; Risk Factors ; Seoul

OBJECTIVES: Recent genetic studies have suggested a preferential transmission of the Dopamine D5 receptor gene (DRD5) 148bp marker allele. The aim of this study is to test the association between DRD5 and ADHD. METHODS: 106 Korean children with ADHD and their parents were analyzed using the transmission disequilibrium test (TDT) and haplotype-based haplotype relative risk test (HHRR). And also the ADHD children were compared with 212 age and gender matched normal controls. RESULTS: We found the evidence for an association of short alleles of DRD5 dinucleotide repeat polymorphism in both case control and family based studyies. Additionally, we observed some evidence for biased transmission of allele 152 bp and 144 bp. CONCLUSION: Our results lend credence to the notion that the relationship between ADHD and DRD5 is complex. The number of cases and informative transmissions in our study were small, therefore it would be premature to make any conclusions concerning the role of DRD5 in ADHD. Further work is needed to support these findings.
Alleles ; Attention Deficit Disorder with Hyperactivity* ; Bias (Epidemiology) ; Case-Control Studies* ; Child ; Dinucleotide Repeats ; Dopamine* ; Haplotypes ; Humans ; Parents ; Receptors, Dopamine D5*

OBJECTIVES: Recent genetic studies have suggested a preferential transmission of the Dopamine D5 receptor gene (DRD5) 148bp marker allele. The aim of this study is to test the association between DRD5 and ADHD. METHODS: 106 Korean children with ADHD and their parents were analyzed using the transmission disequilibrium test (TDT) and haplotype-based haplotype relative risk test (HHRR). And also the ADHD children were compared with 212 age and gender matched normal controls. RESULTS: We found the evidence for an association of short alleles of DRD5 dinucleotide repeat polymorphism in both case control and family based studyies. Additionally, we observed some evidence for biased transmission of allele 152 bp and 144 bp. CONCLUSION: Our results lend credence to the notion that the relationship between ADHD and DRD5 is complex. The number of cases and informative transmissions in our study were small, therefore it would be premature to make any conclusions concerning the role of DRD5 in ADHD. Further work is needed to support these findings.
Alleles ; Attention Deficit Disorder with Hyperactivity* ; Bias (Epidemiology) ; Case-Control Studies* ; Child ; Dinucleotide Repeats ; Dopamine* ; Haplotypes ; Humans ; Parents ; Receptors, Dopamine D5*

BACKGROUND: Hepatitis B virus (HBV) infection leads to hepatic and extrahepatic manifestations including chronic kidney disease (CKD). However, the association between HBV and CKD is not clear. This study investigated the association between chronic HBV infection and CKD in a nationwide multicenter study. METHODS: A total of 265,086 subjects who underwent health-check examinations in 33 hospitals from January 2015 to December 2015 were enrolled. HBV surface antigen (HBsAg) positive cases (n = 10,048), and age- and gender-matched HBsAg negative controls (n = 40,192) were identified. CKD was defined as a glomerular filtration rate (GFR) < 60 mL/min/1.73 m² or proteinuria as at least grade 2+ of urine protein. RESULTS: HBsAg positive cases showed a significantly higher prevalence of GFR < 60 mL/min/1.73 m² (3.3%), and proteinuria (18.9%) than that of the controls (2.6%, P < 0.001, and 14.1%, P < 0.001, respectively). In the multivariate analysis, HBsAg positivity was an independent factor associated with GFR < 60 mL/min/1.73 m² along with age, blood levels of albumin, bilirubin, anemia, and hemoglobin A1c (HbA1c). Likewise, HBsAg positivity was an independent factor for proteinuria along with age, male, blood levels of bilirubin, protein, albumin, and HbA1c. A subgroup analysis showed that HBsAg positive men but not women had a significantly increased risk for GFR < 60 mL/min/1.73 m². CONCLUSION: Chronic HBV infection was significantly associated with a GFR < 60 mL/min/1.73 m² and proteinuria (≥ 2+). Therefore, clinical concern about CKD in chronic HBV infected patients, especially in male, is warranted.
Anemia ; Antigens, Surface ; Bilirubin ; Case-Control Studies* ; Female ; Glomerular Filtration Rate ; Hepatitis B Surface Antigens ; Hepatitis B virus ; Hepatitis B, Chronic* ; Hepatitis, Chronic* ; Humans ; Male ; Multivariate Analysis ; Prevalence ; Proteinuria ; Renal Insufficiency, Chronic*