BACKGROUND: Primary hyperparathyroidism is a relatively frequent disease in western countries. The rate of occurrence in Korea is increasing due to increased concern of people and the development of imaging techniques. METHODS: The purpose of this study is to evaluate the clinical characteristics of patients with primary hyperparathyroidism by a retrospective analysis of their medical records. RESULTS: 19 patients with symptomatic hyperparathyroidism underwent a parathyroidectomy from Dec. 1987 to Aug. 1997 at the Department of Surgery, Korea University Hospital. The mean age of the patients was 44.6 years old, and the male-to-female ratio is 7:12. The major symptoms were generalized weakness (47.4%), polydipsia (36.8%), neck mass (36.8%), and arthralgia (15.8%) in order of frequency. Associated conditions during admission were urinary tract stones (21.1%), thyroid nodules (15.8%), degenerative osteoarthritis (10.5%), and pathologic fracture (10.5%). The mean duration of the major symptom of hyperparathyroidism was 20.6 months. The level of preoperative serum calcium was 13.2+/-2.1 mg, and that of the ionized calcium was 5.8+/-0.7 mg/dl. The level of serum parathormone was greatly higher than the standard value of hospital laboratory (687.2 pg/ml, reference value: 9~55 pg/ml). The true positive rates of imaging study were 78.9% of the hand and skull plain films, 71.4% of the neck CT scans, 40.0% of the neck sonograms, 80.0% of the Tl-c subtraction scans and 100% of the Sestamibi scans. One enlarged parathyroid gland was removed in each of 18 cases and two glands were removed in 1 case. The pathologic types of the enlarged glands were adenomas (16 cases), carcinomas (2 cases), and hyperplasia (1 case). The mean size of the parathyroid tumors was 2.2 cm X 1.7 cm X 1.2 cm, and the mean weight was 7.7 gram. Postoperative hypocalcemia developed in 15 patients and was the most severe on postoperative 3rd day. CONCLUSION: There was 20.6 months interval from the onset of patients' symtoms to the time of parathyroidectomy. Endocrine surgeons should pursue detecting the operable parathyroid tumors and remind medical endocrinologists that the best way of localizing parathyroid tumors is through an operation.
Adenoma ; Arthralgia ; Calcium ; Fractures, Spontaneous ; Hand ; Humans ; Hyperparathyroidism ; Hyperparathyroidism, Primary* ; Hyperplasia ; Hypocalcemia ; Korea ; Laboratories, Hospital ; Medical Records ; Neck ; Osteoarthritis ; Parathyroid Glands ; Parathyroid Hormone ; Parathyroidectomy ; Polydipsia ; Reference Values ; Retrospective Studies ; Skull ; Thyroid Nodule ; Tomography, X-Ray Computed ; Urinary Calculi

Purpose: This study analyzed the effects of a health policy capacity development education program as a publicprivate partnership (PPP) model in official development assistance (ODA) for health policy administrators. Methods: Between October 2015 and September 2017, 41 participants from underdeveloped countries completed the three-week education program at K university, following the official selection process of the Korea International Cooperation Agency (KOICA) and each country’s embassy. Results: The effects of the health policy capacity development education program differed significantly according to participants' age (p=.043), country region (p=.045), and academic or professional degree (p=.007). Academic or professional degree significantly predicted the effects of the program (β=.41, p=.007), explaining 21.7% of the variance in the regression model. Conclusion The current selection process for ODA program participants considers recommendations from each country’s embassy to determine eligible candidates. The hosting institution’s opinions or suggestions regarding participants’ professional expertise or work experience, country region, or demographic characteristics should also be considered in the participant selection process.

PURPOSE: The purpose of this study was to assess the psychosocial work environment of hospital nurses to identify influences of psychosocial work environment on stress, depression, sleep disorder, and burnout. METHODS: A total of 219 nurses working in one hospital were surveyed by using the Korean version of the Copenhagen Psychosocial Questionnaire (COPSOQ-K) mental health and psychosocial work environment. The impact of the psychosocial work environment on mental health was analyzed using multiple regression. RESULTS: Mental health variables are correlated with each other. The psychosocial work environment variables and mental health variables are mostly correlated. To assess the psychosocial work environment that affects mental health the most, multiple regression was used. Work-family conflict was the most powerful explanation of all the mental health variables. Work pace, social community at work, mutual trust among employees, predictability, and influence were found to be affecting some mental health variables. CONCLUSION: To improve the mental health of nurses, it is necessary to consider work pace, social community at work, mutual trust among employees, predictability, influence focus on work-family conflict.
Depression* ; Hospitals, General* ; Mental Health ; Surveys and Questionnaires

PURPOSE: This study aims to determine the association between psychosocial work environment and self-rated health among general hospital nurses. METHODS: A total of 195 nurses working in one general hospital were eligible for data analysis by multivariate logistic regression. The psychosocial work environment was measured with the Korean version of the Copenhagen Psycosocial Questionnaire version II (COPSOQ-K). Self-rated health was recoded as good (excellent/good) and not good (fair/poor/bad) to the question, "In general, how would you rate your health status?" RESULTS: 40% of nurses rated their health positively. Commitment to the workplace (OR=1.27), predictability (OR=1.32), recognition and reward (OR=1.41), role clarity (OR=1.32), and social support from colleagues (OR=1.25) were positively associated with self-rated health of nurse participants. Work-family conflict (OR=0.82) was negatively associated with self-rated health. CONCLUSION: The findings suggest that psychological work environment predicts self-rated health of hospital nurses. Good psychological work environment may be helpful in improvement of nurses' health.
Hospitals, General* ; Logistic Models ; Surveys and Questionnaires ; Reward ; Statistics as Topic

PURPOSE: The purpose of this study was to investigate the effects of emergency setting visitors' knowledge and behavior patterns in relation to prevention of respiratory tract infections. METHODS: A descriptive survey was used. The participants were visitors to the emergency service in ‘D’ general hospital in ‘D’ city, and the data were collected from July 1 to September 1, 2016. The collected data were analyzed using frequency analysis, t-test, ANOVA, Scheffé test, Pearson correlation coefficients, and multiple regression analysis. RESULTS: Factors influencing prevention of respiratory tract infections were visitors' education level, methods of dissemination of prevention information, and participants' knowledge with regard to preventive methods. The explanatory power was found to be 35% in the regression model. CONCLUSION: The findings indicate that visitors' education level, knowledge of infection prevention, and the dissemination of information regarding infection prevention by the hospital play an important role in the prevention of respiratory tract infections in emergency services in the hospital. These results highlight the need for a customized education program for prevention of respiratory tract infections in emergency settings. Programs should take into consideration the educational background of visitors, and provide them with appropriate information regarding infection prevention.
Education ; Emergencies* ; Emergency Service, Hospital* ; Hospitals, General ; Respiratory System* ; Respiratory Tract Infections*

The purpose of this study was to investigate the relationship between hormone replacement therapy (HRT) and periodontal disease in postmenopausal women using data from the 4th and 5th Korea National Health and Nutrition Examination Survey. A total of 5,482 postmenopausal women aged 45~75 years were included as study subjects in the final analysis. The HRT group comprised 1,035 postmenopausal women who had received HRT for at least one month, and the non-HRT group comprised 4,447 postmenopausal women who did not receive HRT. The chi-square test was used to confirm the bivariate relationship between the variables. Multinomial logistic regression analysis was used to adjust for covariance (age, education, family income, body mass index, age of menopause, alcohol, smoking, dental visit < 1 per year, use of oral care products, and frequency of tooth brushing per day). After adjusting for all covariates, HRT was found to be associated with periodontal disease. In particular, the relationship between HRT and periodontal disease was more evident in older women and women younger than 45 years of menopausal age. The relationship between HRT and periodontal disease was stronger in women who brushed their teeth less than 3 times per day, women without regular oral examination, and women who did not use oral hygiene products. The results of this study confirmed the importance of actively considering hormone therapy when determining policy recommendations for postmenopausal women. Especially, health programs such as HRT, regular dental examination, and oral care are needed for older women who have undergone premature menopause.
Body Mass Index ; Diagnosis, Oral ; Education ; Female ; Hormone Replacement Therapy ; Humans ; Korea ; Logistic Models ; Menopause ; Menopause, Premature ; Nutrition Surveys ; Oral Hygiene ; Periodontal Diseases ; Smoke ; Smoking ; Tooth

PURPOSE: This study aims to determine the association between psychosocial work environment and self-rated health among general hospital nurses. METHODS: A total of 195 nurses working in one general hospital were eligible for data analysis by multivariate logistic regression. The psychosocial work environment was measured with the Korean version of the Copenhagen Psycosocial Questionnaire version II (COPSOQ-K). Self-rated health was recoded as good (excellent/good) and not good (fair/poor/bad) to the question, "In general, how would you rate your health status?" RESULTS: 40% of nurses rated their health positively. Commitment to the workplace (OR=1.27), predictability (OR=1.32), recognition and reward (OR=1.41), role clarity (OR=1.32), and social support from colleagues (OR=1.25) were positively associated with self-rated health of nurse participants. Work-family conflict (OR=0.82) was negatively associated with self-rated health. CONCLUSION: The findings suggest that psychological work environment predicts self-rated health of hospital nurses. Good psychological work environment may be helpful in improvement of nurses' health.
Hospitals, General ; Logistic Models ; Surveys and Questionnaires ; Reward ; Statistics as Topic

BACKGROUND: The health of the economically active population contributes to increased corporate productivity by reducing the productivity loss caused by disease and increasing job efficiency, which in turn is a national benefit. Since the economically active population is a concept encompassing workers and a source of economic development for a country, that population's health should be treated with importance not only from a personal standpoint but also at a national level. METHODS: In this study, data of 11,007 adults aged 20 years and older who participate in economic activities were analyzed in the five-year Korea Health Panel Study from 2010 to 2014 including the number of dental visits and dental medical expenses. RESULTS: Factors related to “gender,” “education level,” “age,” “duty category,” “income level,” “employment type,” “national health insurance,” and “chronic disease status” of the economically active population are affected in relation to the number of visits and dental medical expenses. The number of dental visits increased with higher education levels (p<0.001), and the number of visits to the dentist increased with older age (p <0.001). Dental medical expenses were 91,806 Korean won (KRW) more for “white-collar workers” than for “blue-collar workers” (p<0.03), and 127,674 KRW more for “regular workers” than for “atypical workers” (p<0.02). CONCLUSION: When it is necessary to improve policies to enhance the efficiency of the distribution of health and medical resources in the overall balance of the dental health sector, we should try to identify various factors of oral health disorder due to income inequality among the classes according to the country's employment type in order to find ways to reduce the health gap among the social classes.
Adult ; Dentists ; Economic Development ; Education ; Efficiency ; Employment ; Humans ; Korea ; Oral Health ; Social Class ; Socioeconomic Factors

The diagnostic accuracy of fine needle aspiration cytology (FNAC) had been reported about 88-99% in the preoperative diagnosis of breast cancer. High false negative results were reported in the diagnosis of breast cancers, which were small size desmoplastic type, infiltrating lobular cancer, tubular cancer and mucinous cancer. The purpose of this study is to define the possible histopathologic characteristics of breast cancer affecting the results of fine needle aspiration cytology. From Jan. 1997 to Dec. 1998, we performed 622 cases of FNAC at the department of surgery, Korea University Hospital. Among these aspirate, 246 cases were followed by subsequent pathological confirmation and were included in this study. The results of fine needle aspiration cytololgy were classified as benign, suspicious and malignant cells. Pathological reports for breast specimens were reviewed for the size, the location, grade or pathological subtypes and presence or fibrosis in the breast lesions. The pathological characteristics were compared statistically with the results of fine needle aspiration cytology. The likelihood ratios for malignant, suspicious, atypical, benign and unsatisfactory cytological diagnosis were 98.7, 5.5, 1.1 and 0.6, respectively. Absolute and complete sensitivities for the malignant lesions were 64.5% and 90.3%. The specificity was 71.9%. False negative and positive rates were 4.3% and 0.7%. The predictive value for malignant cytology in malignancy was 98.4%. The rate of unsatisfactory diagnosis was 9.3%. The range of tumor size is from 0.6 cm to 6.5 cm. The concordance rates of FNAC results wee 75% of less than 1 cm, 60.7% of 1-2 cm, 76.5% of 2-5 cm, and 50% of greater than 5cm of tumor, respectively (p=0.01). The location of tumor also affect the FNAC result and the highest concordant rate was found in the tumor of lower outer quadrant of breast (73.3%, p=0.001). The Bloom-Richardson grade histologic type of breast cancer also affect the FNAC result. Low grade tumor, medullary carcinoma, metaplastic, carcinoma, lobular carcinoma, adenoid cystic carcinoma and mucinous carcinoma usually showed discordant FNAC results. The presence or absence of fibrotic pathology did not affect the FNAC result (p=0.39) In conclusion, the sensitivity of FNAC was 90.3% in the diagnosis of breast cancer and the false negative rate was 4.3%. The great concordance of FNAC diagnosis was found in the patients with tumor of less than 5cm and located in the axilla and locoregional recurrent area. The FNAC results of breast cancer were frequently incorrect in the low grade tumor and cancer of rare pathological type such as lobular, medullary, mucinous and adenoid cystic carcinoma of breast.
Adenocarcinoma, Mucinous ; Axilla ; Biopsy, Fine-Needle* ; Brain Stem Neoplasms ; Breast Neoplasms* ; Breast* ; Carcinoma, Adenoid Cystic ; Carcinoma, Lobular ; Diagnosis* ; Fibrosis ; Humans ; Korea ; Mucins ; Pathology ; Sensitivity and Specificity

PURPOSE: The purpose of this study is to predict industrial accident rate using time series analysis. METHODS: The rates of industrial accident and occupational injury death were analyzed using industrial accident statistics analysis system of the Korea Occupational Safety and Health Agency from 2001 to 2014. Time series analysis was done using the most recent data, such as raw materials of Economically Active Population Survey, Economic Statistics System of the Bank of Korea, and e-National indicators. The best-fit model with time series analysis to predict occupational injury was developed by identifying predictors when the value of Akaike Information Criteria was the lowest point. Variables into the model were selected through a series of expertises' consultations and literature review, which consisted of socioeconomic structure, labor force structure, working conditions, and occupational accidents. RESULTS: Indexes at the meso- and macro-levels predicting well occurrence of occupational accidents and occupational injury death were labor force participation rate for ages 45-49 and budget for small scaled work-place support. The rates of industrial accident and occupational injury death are expected to decline. CONCLUSION: For reducing industrial accident continuously, we call for safe employment policy of economically active middle aged adults and support for improving safety work environment of small sized workplace.
Accidents, Occupational* ; Adult ; Budgets ; Employment ; Humans ; Korea* ; Middle Aged ; Occupational Health ; Occupational Injuries ; Referral and Consultation