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

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

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.

Traditional removable partial denture is a successful treatment for partial edentulous patients. When the abutment is formed with unilateral minority teeth, satisfaction with the use of removable partial denture may be lowered due to patient's discomfort and damage of the abutment. Recently, it has been reported that the unilateral posterior extension partial denture is used as a bilateral posterior extension partial denture using implant fixed prostheses as abutments. In this case, by using implant surveyed crown prostheses, bilateral posterior extension partial denture is fabricated in site that is predicted to have a poor prognosis. This resulted in improved support, maintenance, and stabilization of the removable partial denture, which were economically beneficial to patient and satisfied with use.
Crowns ; Denture, Partial ; Denture, Partial, Removable ; Humans ; Prognosis ; Prostheses and Implants ; Tooth

In the case of complete edentulous patients, as the mandibular alveolar bone absorption progresses, the maintenance and stability of the existing dentures, which had satisfactory functions in the past, are deteriorated. Despite of the need to fabricate new dentures, they often hesitate due to physical burdens on the duration and intensity of future treatment progress due to the effects of aging and systemic diseases. In the case of these completely edentulous patients, it is necessary to consider the treatment goals that can reduce the number of visits and the adaptation period for new dentures before starting the treatment. This case is a case of producing complete dentures of elderly patients with deteriorated physical ability. In addition to producing suction dentures through preliminary and definitive closed mouth functional impression suggested by Sato, CAD / CAM technique was used to transfer occlusal functional information of existing dentures to facilitate adaptation to new dentures.

Background: This clinical trial was conducted to determine whether combined use of magnesium sulfate and vitamin C more significantly reduced postoperative fentanyl consumption and pain than magnesium sulfate or vitamin C alone. Methods: The prospective, double-blinded, randomized controlled study enrolled 132 patients scheduled for laparoscopic gynecologic surgery. The patients were randomly allocated to one of the four groups (n = 33 for each group; Group M [magnesium sulfate 40 mg/kg], Group V [vitamin C 50 mg/kg], Group MV [magnesium sulfate 40 mg/kg and vitamin C 50 mg/kg] and Group C [isotonic saline 40 ml]). Cumulative postoperative fentanyl consumption (primary endpoint measure), postoperative pain score by numeric rating scale, and postoperative nausea and vomiting were recorded at 1, 6, 24, and 48 h after discharge from the postanesthesia care unit. Results: Cumulative postoperative fentanyl consumption was significantly less in Groups M, V, and MV than in Group C at all time points. Group MV showed significantly less cumulative postoperative fentanyl consumption than Group M at postoperative 24 h (mean ± standard deviation, 156.6 ± 67.5 vs. 235.6 ± 94.6 μg, P = 0.001), as well as significantly less consumption than Groups M and V at postoperative 48 h (190.8 ± 74.6 vs. 301.0 ± 114.8 or 284.1 ± 128.6 μg, P < 0.001, P = 0.003, respectively). Conclusions Combined use of magnesium sulfate and vitamin C provides an additional benefit in postoperative pain management after laparoscopic gynecologic surgery in comparison to single administration of magnesium sulfate or vitamin C.

OBJECTIVES: We aimed to assess the radiation exposure for epidemiologic investigation in residents exposed to radiation from roads that were accidentally found to be contaminated with radioactive cesium-137 (137Cs) in Seoul. METHODS: Using information regarding the frequency and duration of passing via the 137Cs contaminated roads or residing/working near the roads from the questionnaires that were obtained from 8875 residents and the measured radiation doses reported by the Nuclear Safety and Security Commission, we calculated the total cumulative dose of radiation exposure for each person. RESULTS: Sixty-three percent of the residents who responded to the questionnaire were considered as ever-exposed and 1% of them had a total cumulative dose of more than 10 mSv. The mean (minimum, maximum) duration of radiation exposure was 4.75 years (0.08, 11.98) and the geometric mean (minimum, maximum) of the total cumulative dose was 0.049 mSv (<0.001, 35.35) in the exposed. CONCLUSIONS: An individual exposure assessment was performed for an epidemiological study to estimate the health risk among residents living in the vicinity of 137Cs contaminated roads. The average exposure dose in the exposed people was less than 5% of the current guideline.
Epidemiologic Studies* ; Humans ; Korea* ; Radiation Exposure* ; Seoul*

OBJECTIVES: We aimed to assess the radiation exposure for epidemiologic investigation in residents exposed to radiation from roads that were accidentally found to be contaminated with radioactive cesium-137 (137Cs) in Seoul. METHODS: Using information regarding the frequency and duration of passing via the 137Cs contaminated roads or residing/working near the roads from the questionnaires that were obtained from 8875 residents and the measured radiation doses reported by the Nuclear Safety and Security Commission, we calculated the total cumulative dose of radiation exposure for each person. RESULTS: Sixty-three percent of the residents who responded to the questionnaire were considered as ever-exposed and 1% of them had a total cumulative dose of more than 10 mSv. The mean (minimum, maximum) duration of radiation exposure was 4.75 years (0.08, 11.98) and the geometric mean (minimum, maximum) of the total cumulative dose was 0.049 mSv (<0.001, 35.35) in the exposed. CONCLUSIONS: An individual exposure assessment was performed for an epidemiological study to estimate the health risk among residents living in the vicinity of 137Cs contaminated roads. The average exposure dose in the exposed people was less than 5% of the current guideline.
Epidemiologic Studies* ; Humans ; Korea* ; Radiation Exposure* ; Seoul*

BACKGROUND/AIMS: Hepatoduodenal ligament lymph node (LN) dissection has been performed as a part of extended LN dissection during the operation for gastric cancer. And additional cholecystectomy has been performed for more radical node dissection and prevention of cholelithiasis in some centers. There are rare studies and reports about the injury of bile duct system with the operation for gastric cancer. The aim of this study is to evaluate the risk of biliary tree injury with LN dissection for gastric cancer. METHODS: 254 patients of gastric cancer were treated with gastrectomy with LN dissection at Kangnam general hospital between January 1996 and December 2001. Among this group, 151 patients of advanced gastric cancer underwent extended LN dissection of D2+alpha or D3 including hepatoduodenal ligament LN and 69 patients of early gastric cancer underwent D2. And we routinely conducted cholecystectomy for advanced and early gastric cancer. Of these patients, 5 cases without remained or recurred tumor of bile leakage after operation were reviewed. And we analyzed the changes of liver function tests (LFT) of 15 patients of early gastric cancer and 21 patients of advanced gastric cancer whose LFT follow-up data were available. RESULTS: The rate of bile leakage was 2.3% (5 patients) after LN dissection of hepatoduodenal ligament for gastric cancer. Among this group, 3 patients underwent reoperation due to unexpected bile leakage and 2 patients underwent T tube choledochostomy due to minor injury to common hepatic duct on operation. One patient died of sepsis with continued bile leakage after T tube removal on the postoperative 41st day. The serum alkaline phosphatase was increased after operation especially in advanced gastric cancer without clinical significance and there was no other significant abnormality in LFT after hepatoduodenal LN dissection and cholecystectomy in non-recurrent cases. CONCLUSION: Extended lymph node dissection including hepatoduodenal ligament LN and cholecystectomy may have the possibility of increasing the risk of bile duct injury. It is important to select the patients who will benefit from hepatoduodenal ligament LN dissection and cholecystectomy. And meticulous surgical technique to operate biliary tract and adequate management of biliary injury are needed.
Alkaline Phosphatase ; Bile Ducts* ; Bile* ; Biliary Tract ; Cholecystectomy ; Choledochostomy ; Cholelithiasis ; Follow-Up Studies ; Gastrectomy ; Hepatic Duct, Common ; Hospitals, General ; Humans ; Ligaments ; Liver Function Tests* ; Liver* ; Lymph Node Excision ; Lymph Nodes ; Reoperation ; Sepsis ; Stomach Neoplasms*

Vancomycin is a frequently used antibiotic in intensive care units, and the patient’s renal clearance affects the pharmacokinetic characteristics of vancomycin. Several advantages have been reported for vancomycin continuous intravenous infusion, but studies on continuous dosing regimens based on patients’ renal clearance are insufficient. The aim of this study was to develop a vancomycin serum concentration prediction model by factoring in a patient’s renal clearance. Children admitted to our institution between July 1, 2021, and July 31, 2022 with records of continuous infusion of vancomycin were included in the study. Sex, age, height, weight, vancomycin dose by weight, interval from the start of vancomycin administration to the time of therapeutic drug monitoring sampling, and vancomycin serum concentrations were analyzed with the linear regression analysis of the mixed effect model. Univariable regression analysis was performed using the vancomycin serum concentration as a dependent variable. It showed that vancomycin dose (p < 0.001) and serum creatinine (p = 0.007) were factors that had the most impact on vancomycin serum concentration. Vancomycin serum concentration was affected by vancomycin dose (p < 0.001) and serum creatinine (p = 0.001) with statistical significance, and a multivariable regression model was obtained as follows: Vancomycin serum concentration (mg/l) = –1.296 + 0.281 × vancomycin dose (mg/kg) + 20.458 × serum creatinine (mg/dl) (adjusted coefficient of determination, R2 = 0.66). This prediction model is expected to contribute to establishing an optimal continuous infusion regimen for vancomycin.