Background: We examined the relationship between average weekly work hours and glycated hemoglobin (HbA1c) levels in workers with diabetes. Methods: Data of 1,556 workers with diabetes mellitus (DM) from the Korea National Health and Nutrition Examination Survey spanning 2007–2016 were analyzed. Multiple regression analysis (SAS v9.4) was used to assess the correlation between average weekly work hours and HbA1c level. Results: Using 40–52 hours per week as the reference range, workers who worked more than 52 hours per week had significantly higher HbA1c levels (β: 0.2514; P=0.0087). This association remained significant (β: 0.2286; P=0.0308) among those working >52 hours in daytime shifts compared to than among those working standard 40–52 hour schedules. However, the correlation was not observed among other subgroup members who performed evening, night, regular, and irregular shifts. Conclusion Workers with DM who worked long hours were prone to significant increases in HbA1c levels. To mitigate this risk, workplaces should adhere to legal work-hour limitations and offer part-time options for employees with diabetes. Additionally, health education programs may help workers with diabetes manage their condition more effectively.

Background: We examined the relationship between average weekly work hours and glycated hemoglobin (HbA1c) levels in workers with diabetes. Methods: Data of 1,556 workers with diabetes mellitus (DM) from the Korea National Health and Nutrition Examination Survey spanning 2007–2016 were analyzed. Multiple regression analysis (SAS v9.4) was used to assess the correlation between average weekly work hours and HbA1c level. Results: Using 40–52 hours per week as the reference range, workers who worked more than 52 hours per week had significantly higher HbA1c levels (β: 0.2514; P=0.0087). This association remained significant (β: 0.2286; P=0.0308) among those working >52 hours in daytime shifts compared to than among those working standard 40–52 hour schedules. However, the correlation was not observed among other subgroup members who performed evening, night, regular, and irregular shifts. Conclusion Workers with DM who worked long hours were prone to significant increases in HbA1c levels. To mitigate this risk, workplaces should adhere to legal work-hour limitations and offer part-time options for employees with diabetes. Additionally, health education programs may help workers with diabetes manage their condition more effectively.

Background: We examined the relationship between average weekly work hours and glycated hemoglobin (HbA1c) levels in workers with diabetes. Methods: Data of 1,556 workers with diabetes mellitus (DM) from the Korea National Health and Nutrition Examination Survey spanning 2007–2016 were analyzed. Multiple regression analysis (SAS v9.4) was used to assess the correlation between average weekly work hours and HbA1c level. Results: Using 40–52 hours per week as the reference range, workers who worked more than 52 hours per week had significantly higher HbA1c levels (β: 0.2514; P=0.0087). This association remained significant (β: 0.2286; P=0.0308) among those working >52 hours in daytime shifts compared to than among those working standard 40–52 hour schedules. However, the correlation was not observed among other subgroup members who performed evening, night, regular, and irregular shifts. Conclusion Workers with DM who worked long hours were prone to significant increases in HbA1c levels. To mitigate this risk, workplaces should adhere to legal work-hour limitations and offer part-time options for employees with diabetes. Additionally, health education programs may help workers with diabetes manage their condition more effectively.

Background: We examined the relationship between average weekly work hours and glycated hemoglobin (HbA1c) levels in workers with diabetes. Methods: Data of 1,556 workers with diabetes mellitus (DM) from the Korea National Health and Nutrition Examination Survey spanning 2007–2016 were analyzed. Multiple regression analysis (SAS v9.4) was used to assess the correlation between average weekly work hours and HbA1c level. Results: Using 40–52 hours per week as the reference range, workers who worked more than 52 hours per week had significantly higher HbA1c levels (β: 0.2514; P=0.0087). This association remained significant (β: 0.2286; P=0.0308) among those working >52 hours in daytime shifts compared to than among those working standard 40–52 hour schedules. However, the correlation was not observed among other subgroup members who performed evening, night, regular, and irregular shifts. Conclusion Workers with DM who worked long hours were prone to significant increases in HbA1c levels. To mitigate this risk, workplaces should adhere to legal work-hour limitations and offer part-time options for employees with diabetes. Additionally, health education programs may help workers with diabetes manage their condition more effectively.

Surgeons occasionally encounter a patient with a gastric cancer invading an adjacent organ, such as the pancreas, liver, or transverse colon. Although there is no established guideline for treatment of invasive gastric cancer, combined resection with radical gastrectomy is conventionally performed for curative purposes. We recently treated a patient with a large gastric cancer invading the abdominal wall, which was initially diagnosed as a simple abdominal wall abscess. Computed tomography showed that an abscess had formed adjacent to the greater curvature of the stomach. During surgery, we made an incision on the abdominal wall to drain the abscess, and performed curative total gastrectomy with partial excision of the involved abdominal wall. The patient received intensive treatment and wound management postoperatively with no surgery-related adverse events. However, the patient could not receive adjuvant chemotherapy and expired on the 82nd postoperative day.
Abdominal Wall* ; Abscess* ; Chemotherapy, Adjuvant ; Colon, Transverse ; Gastrectomy ; Humans ; Liver ; Neoplasm Invasiveness ; Pancreas ; Stomach ; Stomach Neoplasms* ; Stomach Rupture ; Surgeons ; Wounds and Injuries

PURPOSE: The postoperative treatment after appendectomy is usually decided on the basis of the surgeons' intraoperative findings. Comparatively, the pathologic diagnosis of appendicitis is confirmed several days after the surgery; therefore, it usually does not affect the postoperative treatment strategy. The aim of this study was to investigate the discrepancies between the surgical and pathologic diagnoses of appendicitis and to identify their clinical implication. METHODS: A retrospective observational study was performed in 1,817 patients who underwent 3-port laparoscopic appendectomy for the final diagnosis of appendicitis. The clinical variables that could estimate the severity of appendicitis and the intensity of postoperative treatment were analyzed and compared according to the surgical and pathologic diagnoses. RESULTS: Of 1,321 cases of surgically simple appendicitis, 254 (29.3%) were pathologically complicated appendicitis. On the other hand, 221 of 496 cases (44.5%) of surgically complicated appendicitis were pathologically simple. Neither the surgical nor the pathologic diagnosis of appendicitis affected the development of postoperative intra-abdominal abscess (P = 0.079 for surgical diagnosis; P = 0.288 for pathologic diagnosis); however, the surgical diagnosis showed more correlation with the severity of disease and the intensity of the treatment pathway than did the pathologic diagnosis. CONCLUSION: There were discrepancies between the surgeons' intraoperative assessment and the pathologists' final histologic diagnosis of appendicitis. The surgeon's classification might be more predictive of the outcome than the pathologist's because only the surgeon's findings are available immediately after surgery.

Background and Objectives: Despite remarkable reduction in cardiovascular disease (CVD) mortality, the burden has remained the leading cause of death. Since little research has focused on regional disparity in CVD mortality, this study aims to investigate its spatiotemporal trends in Korea from 1983 to 2019. Methods: Using the causes of death statistics in Korea, we analyzed the geographic variation in deaths from CVDs from 1983 to 2019. The sex and age-standardized mortality rate was calculated according to the 17 administrative regions. The analyses include all diseases of the circulatory system (International Classification of Diseases-10 codes, I00–I99), along with the following 6 subcategories which were not mutually exclusive: total heart disease (I00–I13 and I20–I51), hypertensive heart disease (I10–I13), ischemic heart disease (I20–I25), myocardial infarction (I21–I23), heart failure (I50), and cerebrovascular disease (I60–I69). Results: Overall, heart failure death rate increased across all regions, and other CVD death rates showed a decreasing trend. Regional disparity in mortality was substantial in the early 1980s but converged over time. In all types of cardiovascular mortality, Busan, Ulsan and Gyeongnam remained the highest, although they showed a downward trend like other regions. Jeju continued to have a relatively low CVD mortality rate. Conclusions The regional disparity substantially decreased compared to the 1980s. However, the relatively high burden of CVD mortality in the southeastern region has not been fully resolved.

Background and Objectives: Understanding the trends in cardiovascular disease (CVD) mortality is important for developing burden reduction strategies. Based on the Cause of Death Statistics, we examined the changing patterns of CVD mortality in Korea between 1983 and 2018. Methods: Causes of death were coded according to the International Classification of Disease, 10th revision. Deaths from all diseases of circulatory system (I00-I99) and the following 6 subcategories were analyzed: total heart diseases (I00-I13 and I20-I51), hypertensive heart diseases (I10-I13), ischemic heart diseases (I20-I25), myocardial infarction (I21-I23), heart failure (I50), and cerebrovascular diseases (I60-I69). Crude, age-standardized, and age-stratified rates were calculated to assess temporal trends in CVD mortality. Results: The number of deaths and crude mortality rate for all diseases of circulatory system increased recently mainly due to the population ageing. Specifically, total heart diseases showed increasing trend, whereas cerebrovascular diseases showed decreasing trend. Between 1983 and 2018, age-standardized mortality rates significantly declined for all diseases of circulatory system, total heart diseases, hypertensive heart diseases, and cerebrovascular diseases. Age-standardized mortality rates for ischemic heart diseases and myocardial infarction peaked in the early 2000s then decreased thereafter. However, agestandardized mortality rate for heart failure rapidly increased, especially in recent years. Conclusions CVD mortality in Korea has remarkably decreased over the last 36 years.However, the recent rise in the absolute number of deaths from heart diseases, especially from heart failure, calls for attention in prevention and management of CVD and its sequelae.

Background and Objectives: Understanding the trends in cardiovascular disease (CVD) mortality is important for developing burden reduction strategies. Based on the Cause of Death Statistics, we examined the changing patterns of CVD mortality in Korea between 1983 and 2018. Methods: Causes of death were coded according to the International Classification of Disease, 10th revision. Deaths from all diseases of circulatory system (I00-I99) and the following 6 subcategories were analyzed: total heart diseases (I00-I13 and I20-I51), hypertensive heart diseases (I10-I13), ischemic heart diseases (I20-I25), myocardial infarction (I21-I23), heart failure (I50), and cerebrovascular diseases (I60-I69). Crude, age-standardized, and age-stratified rates were calculated to assess temporal trends in CVD mortality. Results: The number of deaths and crude mortality rate for all diseases of circulatory system increased recently mainly due to the population ageing. Specifically, total heart diseases showed increasing trend, whereas cerebrovascular diseases showed decreasing trend. Between 1983 and 2018, age-standardized mortality rates significantly declined for all diseases of circulatory system, total heart diseases, hypertensive heart diseases, and cerebrovascular diseases. Age-standardized mortality rates for ischemic heart diseases and myocardial infarction peaked in the early 2000s then decreased thereafter. However, agestandardized mortality rate for heart failure rapidly increased, especially in recent years. Conclusions CVD mortality in Korea has remarkably decreased over the last 36 years.However, the recent rise in the absolute number of deaths from heart diseases, especially from heart failure, calls for attention in prevention and management of CVD and its sequelae.

Objectives: We compared the associations of 3 computed tomography (CT)-based abdominal adiposity indexes with non-alcoholic fatty liver disease (NAFLD) among middle-aged Korean men and women. Methods: The participants were 1366 men and 2480 women community-dwellers aged 30-64 years. Three abdominal adiposity indexes—visceral fat area (VFA), subcutaneous fat area (SFA), and visceral-to-subcutaneous fat ratio (VSR)—were calculated from abdominal CT scans. NAFLD was determined by calculating the Liver Fat Score from comorbidities and blood tests. An NAFLD prediction model that included waist circumference (WC) as a measure of abdominal adiposity was designated as the base model, to which VFA, SFA, and VSR were added in turn. The area under the receiver operating characteristic curve (AUC), integrated discrimination improvement (IDI), and net reclassification improvement (NRI) were calculated to quantify the additional predictive value of VFA, SFA, and VSR relative to WC. Results: VFA and VSR were positively associated with NAFLD in both genders. SFA was not significantly associated with NAFLD in men, but it was negatively associated in women. When VFA, SFA, and VSR were added to the WC-based NAFLD prediction model, the AUC improved by 0.013 (p<0.001), 0.001 (p=0.434), and 0.009 (p=0.007) in men and by 0.044 (p<0.001), 0.017 (p<0.001), and 0.046 (p<0.001) in women, respectively. The IDI and NRI were increased the most by VFA in men and VSR in women. Conclusions Using CT-based abdominal adiposity indexes in addition to WC may improve the detection of NAFLD. The best predictive indicators were VFA in men and VSR in women.