PURPOSE: A circular stapler hemorrhoidectomy is widely used to treat hemorrhoids and has the advantages of less pain and an earlier return to work compared with a conventional excisional hemorrhoidectomy. This study examined the clinical significance and efficacy of a circular stapled hemorrhoidectomy. METHODS: One hundred eighty-six (186) patients with prolapsed hemorrhoids underwent surgery using a circular stapler. The patients' characteristics, the operation time, the postoperative course, the procedure- related factors, the pain, and the complications were analyzed. All the patients received a follow-up examination at the outpatient clinic, including the time to return to work, and the degree of satisfaction was analyzed. RESULTS: Grade-III hemorrhoids were the most common complaint (74.1%), followed by grade-IV hemorrhoids (23.7%). Twenty-one cases (11.3%) had undergone previous anal operations: hemorrhoids, fissure, and fistula. Regarding the anesthetic method, caudal anesthesia was used in 59.7% of the cases, and spinal or saddle anesthesia was used in 39.2%. The mean operation time was 19.1 minutes (range: 8~50). The postoperative pain scores were 3.4 on the operation day, 2.1 on the postoperative 3rd day, and 0.9 on the postoperative 7th day. During the operation, a hemostatic suture was made at the suture line in 72.0% of the cases. Muscle involvement was detected at a donut specimen grossly in 9% of cases and microscopically in 48.9%. The mean thickness of muscle involvement was 2.5 mm. In the postoperative course, the time for the first bowel movement was 1.2 days, and the mean hospital stay was 2.1 days. The mean time needed for the patient to return to work was 6.2 days. The most common complication encountered was urinary problems (34.9%). The incidence of postoperative bleeding was 2.2%. Postoperative follow- up revealed one case of a hemorrhoids recurrence and one case of temporary fecal incontinence. CONCLUSIONS: The circular stapler hemorrhoidectomy has no disadvantage in terms of operation time and operative course, and has an advantage in terms of operative pain and an earlier return to normal work without any significant or serious complications. Moreover, it has minimal long-term complications. Therefore, a circular stapler hemorrhoidectomy can be performed safely and is recommended as a useful method for treating hemorrhoids.
Ambulatory Care Facilities ; Anesthesia ; Anesthesia, Caudal ; Fecal Incontinence ; Fistula ; Follow-Up Studies ; Hemorrhage ; Hemorrhoidectomy* ; Hemorrhoids ; Humans ; Incidence ; Length of Stay ; Pain, Postoperative ; Recurrence ; Return to Work ; Sutures

BACKGROUND: Cleanroom air is extremely dry, as it is maintained within 1 % of relative humidity. Few studies have assessed the dermatologic life quality of workers in ultralow-humidity environments. Therefore, we aimed to evaluate the dermatologic life quality of cleanroom workers using the Skindex-29, compared to those of non-cleanroom workers. METHODS: Study participants were 501 cleanroom workers and 157 non-cleanroom workers from a secondary battery factory, who underwent an employee health examination at a single university hospital from September 2014 to September 2015. Results of the self-administered Skindex-29, and McMonnies questionnaire were analyzed. Other information and disease history were also collected during physician's medical examination. Descriptive and multivariate logistic regression analysis were performed. RESULTS: The Skindex-29 score was significantly higher in cleanroom workers than in non-cleanroom workers for all domains, Symptom (16.0 ± 15.9 vs. 6.3 ± 10.2, p < 0.001), Emotion (11.3 ± 17.4 vs. 2.5 ± 7.4, p < 0.001), Function (5.2 ± 11.1 vs. 1.6 ± 4.0, p < 0.001), and Overall (10.8 ± 13.4 vs. 3.5 ± 6.2, p < 0.001). The Skindex-29 score of cleanroom workers was similar to that of patients with skin diseases such as psoriasis, other dermatitis, corns, alopecia etc. Among the cleanroom workers, 37 workers had one or more skin diseases. Among the risk factors, ‘working at cleanroom’, ‘possessing skin disease’ and ‘McMonnies score’ had significant strong correlations with Skindex-29 score, meanwhile age, sex, smoking, drinking and exercise had weak correlations with it.‘Working at cleanroom’ and ‘possessing skin disease’ had highest odds ratios with overall 14.0 (C.I.: 5.9–33.1) and 13.4 (C.I.: 4.5–29.2), and the lowest odds ratios with function domain 3.5(C.I.: 1.7–7.1) and 4.5(C.I.: 2.1–9.5), respectively. The McMonnies score had the highest odds ratio with overall, 6.9(C.I.: 4.5–10.8) and lowest odd ratio with emotion domain 4.2 (C.I.: 2.7–6.4). CONCLUSIONS: Dermatologic life quality among cleanroom workers in the secondary battery factory is shown to be lower than that among non-cleanroom workers in this study. The study suggests that the Skindex-29 may provide helpful information on the dermatologic life quality of cleanroom workers. Therefore, regarding evaluation of dermatologic life quality using Skindex-29, preventive care is necessary for cleanroom workers in ultralow humidity environment.
Alopecia ; Callosities ; Dermatitis ; Drinking ; Humans ; Humidity ; Logistic Models ; Occupational Health ; Odds Ratio ; Psoriasis ; Quality of Life* ; Risk Factors ; Skin ; Skin Diseases ; Smoke ; Smoking ; Zea mays

BACKGROUND: Lead and cadmium have been identified as risk factors for hearing loss in animal studies, but large-scale studies targeting the general human population are rare. This study was conducted to investigate the link between heavy metal concentrations in blood and hearing impairment, using a national population-based survey. METHODS: The study participants comprised 6409 Koreans aged 20 or older, who were included in the Fifth and Sixth Korea National Health and Nutrition Examination Surveys (KNHANES 2010–2013). Hearing impairment was categorized into two types, low- and high-frequency hearing impairment, using pure tone audiometry. Low-frequency hearing impairment was defined as having a binaural average of hearing thresholds for 0.5, 1, and 2 kHz exceeding 25 dB, and high-frequency hearing impairment was defined as having a binaural average of hearing thresholds for 3, 4, and 6 kHz exceeding 25 dB. The blood levels of heavy metals (lead and cadmium) were classified into quartiles. Cross-sectional association between hearing impairment and the level of heavy metals (lead and cadmium) was examined in both sexes. Multivariate logistic regression was used to obtain adjusted odds ratios (ORs) and 95% confidence intervals (CIs). RESULTS: Among men, the prevalence of low- and high- frequency hearing impairment was 13.9% and 46.7%, respectively, which was higher than the prevalence among women (11.8% and 27.0%, respectively). Regarding lead, the adjusted OR of high-frequency hearing impairment for the highest blood level group versus the lowest group was significant in both men (OR = 1.629, 95% CI = 1.161–2.287) and women (OR = 1.502, 95% CI = 1.027–2.196), after adjusting for age, body mass index, education, smoking, alcohol consumption, exercise, diagnosis of diabetes mellitus, hypertension, and noise exposure (occupational, loud, firearm noises). No links were found between blood lead levels and low-frequency hearing impairment, or between blood cadmium levels and low- or high-frequency hearing impairment in either sex. CONCLUSIONS: The present study findings suggest that even exposure to low-level lead is a risk factor for high-frequency hearing loss. A prospective epidemiologic study should be conducted to identify the causal relationship between human health and exposure to heavy metals, and efforts to reduce heavy metal exposure in the general population should continue.
Alcohol Drinking ; Animals ; Audiometry ; Body Mass Index ; Cadmium ; Diabetes Mellitus ; Diagnosis ; Education ; Environmental Exposure ; Epidemiologic Studies ; Female ; Hearing Loss ; Hearing Loss, High-Frequency ; Hearing ; Humans ; Hypertension ; Korea ; Logistic Models ; Male ; Metals, Heavy ; Noise ; Nutrition Surveys ; Odds Ratio ; Prevalence ; Prospective Studies ; Risk Factors ; Smoke ; Smoking

BACKGROUND: Shift work disturbs workers' biological clocks and this condition can cause various health problems including cardiovascular disease. The elevated albuminuria level has been significantly associated with the risk of the cardiovascular disease even within a normal reference range. Therefore, this study aimed to investigate the association between shift work and microalbuminuria. METHODS: Workers aged over 20 years from the fifth and sixth Korea National Health and Nutrition Examination Survey(KNHANES 2012–2014; n = 3000) were included in this analysis. The multiple logistic regression analysis was performed to determine the association between shift work and microalbuminuria stratified by gender. RESULTS: The prevalence of microalbuminuria in male subjects was higher among day workers, but the difference was not significant. However, the prevalence of microalbuminuria among females was higher in shift workers with statistical significance. For female, the Odds ratio of microalbuminuria in shift workers was significantly higher with 1.86 (95% CI 1.02–3.39) compared with day workers. After dividing into 5 subgroups of the shift work pattern, the odds ratio of microalbuminuria for fixed night shift was significantly higher at 4.68 (95% CI 1.29–17.00) compared with day workers. CONCLUSIONS: This study showed that shift work was associated with microalbuminuria in female workers. Especially we found out the association between fixed night shift and microalbuminuria in female workers.
Albuminuria ; Biological Clocks ; Cardiovascular Diseases ; Female ; Humans ; Korea ; Logistic Models ; Male ; Odds Ratio ; Prevalence ; Reference Values