OBJECTIVES: The aim of this study is to evaluate radiation exposure resulting from the comprehensive health examinations of selected university hospital programs and to present basic data for research and management strategies on the health effects of medical radiation exposure. METHODS: Radiation-based diagnostic studies of the comprehensive health examination programs of ten university hospitals in Seoul, Korea, as introduced in their websites, were analyzed. The medical radiation studies of the programs were reviewed by radiologists. Only the effective doses of the basic studies were included in the analysis. The optional studies of the programs were excluded. RESULTS: Among the 190 comprehensive health examination programs, 132 programs (69.5%) included computed tomography studies, with an average of 1.4 scans. The average effective dose of radiation by program was 3.62 mSv for an intensive program for specific diseases; 11.12 mSv for an intensive program for cancer; 18.14 mSv for a premium program; and 24.08 mSv for an overnight program. A higher cost of a programs was linked to a higher effective dose (r=0.812). The effective doses of the examination programs for the same purposes differed by as much as 2.1 times by hospital. Inclusion of positron emission tomography–computed tomography was the most critical factor in determining the level of effective dose. CONCLUSIONS: It was found that radiation exposure dose from comprehensive health exam programs targeted for an asymptomatic, healthy public reached between 3.6 and 24 times the annual dose limit for the general public. Relevant management policies at the national level should be provided to minimize medical radiation exposure.
Electrons ; Hospitals, University ; Korea* ; Mass Screening* ; Radiation Exposure ; Seoul

Sugammadex provides fast and safe recovery from neuromuscular blockade without causing major adverse effects, and its clinical use is increasing. However, there are some reports on the potential risks of sugammadex, such as severe bradycardia, interactions with steroids, coagulopathy, and neuronal damage. Although these potential risks are not clearly proven, they are considered to be dose-dependent and occur more frequently with the free-form of sugammadex. Until further pieces of evidence are accumulated, it is prudent to be aware of these potential risks and avoid an overdose of sugammadex.
Blood Coagulation Disorders ; Bradycardia ; Drug Interactions ; Neuromuscular Blockade ; Neurons ; Neurotoxicity Syndromes ; Steroids

To reduce the risk of residual neuromuscular blockade, neuromuscular monitoring must be performed. Acceleromyography (AMG)-based neuromuscular monitoring was regarded as “clinical gold standard” and widely applied. However, issues related to patient’s posture and overestimation of train-of-four ratio associated with AMG-based neuromuscular monitoring have increased. Recently, electromyography (EMG)-based neuromuscular monitoring is receiving renewed attention, since it overcomes AMG’s weaknesses. However, both AMG-based and EMG-based systems are useful when certain considerations are followed. Ultimately, to assure the patient’s good outcomes, the choice of monitoring system is not as important as the monitoring itself, which should be always implemented in such patients.

To reduce the risk of residual neuromuscular blockade, neuromuscular monitoring must be performed. Acceleromyography (AMG)-based neuromuscular monitoring was regarded as “clinical gold standard” and widely applied. However, issues related to patient’s posture and overestimation of train-of-four ratio associated with AMG-based neuromuscular monitoring have increased. Recently, electromyography (EMG)-based neuromuscular monitoring is receiving renewed attention, since it overcomes AMG’s weaknesses. However, both AMG-based and EMG-based systems are useful when certain considerations are followed. Ultimately, to assure the patient’s good outcomes, the choice of monitoring system is not as important as the monitoring itself, which should be always implemented in such patients.

BACKGROUND: Harassment means systemic and repeated unethical acts. Research on workplace harassment have been conducted widely and the NAQ-R has been widely used for the researches. But this tool, however the limitations in revealing differended in sub-factors depending on the culture and in reflecting that unique characteristics of the Koren society. So, The workplace harassment questionnaire for Korean finace and service workers has been developed to assess the level of personal harassment at work. This study aims to develop a tool to assess the level of personal harassment at work and to test its validity and reliability while examining specific characteristics of workplace harassment against finance and service workers in Korea. METHODS: The framework of survey was established based on literature review, focused-group interview for the Korean finance and service workers. To verify its reliability, Cronbach’s alpha coefficient was calculated; and to verify its validity, items and factors of the tool were analyzed. The correlation matrix analysis was examined to verify the tool’s convergent validity and discriminant validity. Structural validity was verified by checking statistical significance in relation to the BDI-K. RESULTS: Cronbach’s alpha coefficient of this survey was 0.93, which indicates a quite high level of reliability. To verify the appropriateness of this survey tool, its construct validity was examined through factor analysis. As a result of the factor analysis, 3 factors were extracted, explaining 56.5 % of the total variance. The loading values and communalities of the 20 items were 0.85 to 0.48 and 0.71 to 0.46. The convergent validity and discriminant validity were analyzed and rate of item discriminant validity was 100 %. Finally, for the concurrent validity, We examined the relationship between the WHI-KFSW and pschosocial stress by examining the correlation with the BDI-K. The results of chi-square test and multiple logistic analysis indicated that the correlation with the BDI-K was satatisctically significant. CONCLUSION: Workplace harassment in actual workplaces were investigated based on interviews, and the statistical analysis contributed to systematizing the types of actual workplace harassment. By statistical method, we developed the questionare, 20 items of 3 categories.
Humans ; Korea ; Methods ; Reproducibility of Results*

OBJECTIVE: This paper examines the possible toxicity to immune system in farmers chronically exposed to pesticides. METHODS: We compared 43 male farmers exposed to pesticides with 29 male residents who had neither past nor current pesticides exposure. The selected variables for studying immunotoxicity were WBC, CD3, CD4, CD8, CD19, CD56, IgG, IgA, IgM, and IL-2. As part of the baseline questionnaires for the immunotoxicity, subjects were asked about kinds of farming, pesticides exposure and medical history. RESULTS: None of the variables for studying immunotoxicity showed statistically significant difference between the two groups. Although the results were not statistically significant, CD4 and the CD4/CD8 ratio decreased and CD8 increased. These effects showed a dose response change with exposure level. In the exposed group, the values of CD3, CD4, CD4/CD8 and CD19 decreased and those of the CD8 and CD56 increased compared to the non-exposed group. Also there was higher prevalence of self-reported disease in the exposed group compared to the non-exposed group. CONCLUSIONS: Although statistically significant differences in indices of immunotoxicity in farmers exposed to pesticides were not shown, the results suggest that pesticides may decrease immune function. More advanced test methods for immunotoxicity need to be developed and tested in larger population to detect immunotoxic effects of pesticides.
Humans ; Immune System ; Immunoglobulin A ; Immunoglobulin G ; Immunoglobulin M ; Interleukin-2 ; Male ; Pesticides* ; Prevalence ; Surveys and Questionnaires

OBJECTIVE: This study investigated the driving habits of taxi drivers, in order to examine the characteristics of human factors causing traffic accidents and unsafe driving behavior and to determine any relevancy among them. METHOD: Taxi drivers (N=335) answered a questionnaire investigating various measures of human factors, unsafe driving behaviors, and number of traffic accident experiences in the previous year. In factor analysis, the characteristics of human factors were classified into 5 common factors: job, mental health, age, health habit and sleep factor. A contextual mediated model was proposed to distinguish the distal (5 common factors) and proximal (unsafe driving behaviors) factors in predicting traffic accident involvement by hierarchical multiple regression. RESULT: In hierarchical multiple regression, job factor(beta: 0.122), sleep factor (beta: 0.114) and unsafe driving behaviors (beta: 0.018) yielded a direct effect on the rate of traffic accidents. Mental health factor beta: 6.429), job factor (beta: 1.319) and health habit factor(beta: 1.177) yielded a indirect effect on the rate of traffic accidents by unsafe driving behaviors. CONCLUSION: Various human factors co-related by the unique characteristics that exist in the taxi service industry have significant effects on the rate of traffic accidents mediated by unsafe driving behaviors. Therefore a proper countermeasure against these factors should be established in order to effectively reduce the rate of taxi accidents.
Accidents, Traffic* ; Humans* ; Mental Health ; Questionnaires

OBJECTIVES: In establishing policies for agricultural safety, evaluating injury burdens as well as investigating the rates and characteristics of work injury is important. This study investigated the types and characteristics of agricultural injury subjective burdens. METHODS: By analyzing the injured farmers identified in the 2013 Korean Farmers' Occupational Injury Survey, the burdens caused by injuries were categorized using one direct cost item (medical costs) and five indirect cost items (including productivity decreases and wage increases). Statistical differences among the burden items were analyzed using logistic regression analysis according to the characteristics of the farmers and their farm injuries. RESULTS: Among the subjective burdens indicated by the 457 injured farmers, disruption to work was most common. The major influences on each subjective burden item are as follows: for the item of disruption to work, age, time of injury occurrence, treatment period, and farming machine use were influential; for an increased family member's burden of farm works, the number of family members and treatment period were influential. Regarding cost burden of treatment, the results varied according to whether or not the patient was hospitalized and annual income. CONCLUSION: Subjective burdens induced by indirect costs rather than those induced by direct costs were found to be higher in ratio. In regard to each burden item, the results varied according to the characteristics of the farmers and their farm injuries. To support injured farmer, setting goals to reduce indirect cost burdens and preparing concrete methods is necessary.
Efficiency ; Humans ; Logistic Models ; Occupational Injuries ; Salaries and Fringe Benefits

Glia have been known for its pivotal roles in physiological and pathological conditions in the nervous system. To study glial biology, multiple approaches have been applied to utilize glial cells for research, including stem cell-based technologies. Human glial cells differentiated from pluripotent stem cells are now available, allowing us to study the structural and functional roles of glia in the nervous system, although the efficiency is still low. Direct conversion is an advanced strategy governing fate conversion of diverse cell types directly into the desired lineage. This novel strategy stands as a promising approach for preliminary research and regenerative medicine. Direct conversion employs genetic and environmental cues to change cell fate to that with the required functional cell properties while retaining maturity-related molecular features. As an alternative method, it is now possible to obtain a variety of mature cell populations that could not be obtained using conventional differentiation methods. This review summarizes current achievements in obtaining glia, particularly oligodendrocytes and Schwann cells.

Capnography is commonly used to monitor respiration during general anesthesia. However, it has limited utility in patients with respiratory distress during sedation. This case report examines capnography use in a transcatheter aortic valve replacement procedure performed on an elderly woman with severe aortic stenosis. A 73-year-old woman with a history of non-ST-elevation myocardial infarction and congenital heart failure presented with severe dyspnea caused by severe aortic stenosis. Transcatheter aortic valve replacement was preferred over surgery due to her comorbidities. Monitored anesthesia care was administered with a capnogram. During the procedure, the patient was sedated with remimazolam, maintaining a bispectral index range of 60–80 and a score of 2 on the Modified Observer’s Assessment of Alertness/Sedation scale. Although irregular breathing patterns and a gradual decrease in oxygen saturation were observed following remimazolam infusion, the patient’s respiration eventually stabilized. However, the patient experienced cardiovascular collapse 45 minutes after sedation began. The arterial carbon dioxide pressure measured by arterial blood gas analysis performed just before resuscitation was 68.4 mmHg. After one cycle of resuscitation, the patient recovered. The procedure was successfully performed under general anesthesia, which was replaced with monitored anesthesia care during resuscitation. Although most monitoring devices have similar utility for both general anesthesia and sedation, capnography has limitations for evaluating respiration during sedation, especially for patients with respiratory distress. Therefore, anesthesiologists or medical staff who provide sedation should not neglect periodical arterial carbon dioxide pressure observations via other methods, such as arterial blood gas analysis.