OBJECTIVES: This study was conducted in order to evaluate the prevalence of posttraumatic stress disorder (PTSD) and related factors in male firefighters in Daegu, Korea. METHODS: A total of 1,261 firefighters from fire stations in Daegu were the subjects of this study. Each firefighter completed a questionnaire on general and occupational matters, experience of traumatic events, and impact of event scale (IES). The IES questionnaire was administered to subjects in order to determine the high risk group for PTSD. We calculated the IES score and determined that an individual was abnormal if the IES score was over 26. RESULTS: The average IES score of the firefighters was 11.0+/-14.3, and the prevalence of high risk firefighters with PTSD was 15.1%. It was found that 40 years of age, fire sergeant, and emergency medical service personnel showed higher prevalence of PTSD than other groups. The most experienced event among traumatic events was 'witness death of victims or patients'. The results of multiple logistic regression analysis for the high risk PTSD group showed that fire sergeant (OR=2.28, 95% CI: 1.28~4.06), fire lieutenant (OR=2.47, 95% CI: 1.14~5.37), fire captain (OR=2.88, 95% CI: 1.11~7.45), firefighting department (OR=2.04, 95% CI: 1.00~4.17), emergency medical service personnel (OR=3.68, 95% CI: 1.47~9.23), total frequency of traumatic events experienced (OR=1.01, 95% CI: 1.00~1.02), and total type of traumatic event experienced (OR=1.35, 95% CI: 1.25~1.46) were significant variables with regards to the reference group (fire fighter and administration department). CONCLUSIONS: These findings indicate that the prevalence of PTSD in firefighters is higher than that in the general population, and fire sergeant, fire lieutenant, fire captain, emergency medical service personnel, firefighting department, total frequency of traumatic events experienced, and total type of traumatic event experienced were significant variables for the PTSD high risk group.
Emergency Medical Services ; Firefighters ; Fires ; Humans ; Logistic Models ; Male ; Prevalence ; Questionnaires ; Stress Disorders, Post-Traumatic

Purpose: To report a case of frosted branch angiitis associated with COVID-19-related multisystem inflammatory syndrome in children (MIS-C).Case summary: An 8-year-old boy was referred to the ophthalmology clinic with decreased visual acuity in his right eye. The initial best-corrected visual acuity (BCVA) was 20/63 in the right eye and 20/32 in the left eye. Upon fundus examination, bilateral frosted branch-like vascular sheathing and retinal hemorrhage were observed. Optical coherence tomography (OCT) demonstrated macular edema. Fluorescein angiography revealed late staining and leakage of affected retinal vessels. The patient exhibited persistent fever, rash, and gastrointestinal symptoms, accompanied by an increase in inflammatory markers in laboratory tests. Testing for SARS-CoV-2 immunoglobulin G (IgG) was positive, although there was no evidence of any other autoimmune diseases or viral infections. The patient was diagnosed with frosted branch angiitis associated with MIS-C. Treatment included systemic steroids and 1% prednisolone eye drops. After 2 weeks, the BCVA improved to 20/20 in both eyes, and all clinical signs resolved without recurrence. Conclusions In patients with frosted branch angiitis without any other apparent cause, the possibility of MIS-C should be considered. Testing for COVID-19 infection is recommended.

OBJECTIVES: To evaluate effects of lead on the central nervous system of children by measuring blood lead concentration, computerized neurobehavioral function and intelligence of elementary school students. METHODS: The study was conducted with 208 elementary school students living in the vicinity of Pohang Industrial Complex in October and November, 2005. Data on demographic characteristics, living environments and lifestyle habits were collected from subjects. RESULTS: Blood lead levels of elementary school students ranged from 0.76-4.97 microg/dl, which is below the 10 microg/dl recommended level of CDC. The blood lead levels were similar with those reported in other domestic and international studies. Neurobehavioral tests revealed that most third grade students reacted slowly and their speed declined in simple reaction time (p<0.05), choice reaction time (p<0.05), symbol digit substitution (p<0.01), finger tapping speed nondominant hand (p<0.05) as blood lead levels increased. Sixth grade students demonstrated significance in test performance, and displayed blood lead levels of 2.00-4.00 microg/dl. Results of intelligence testing showed significantly low performance in IQ (p<0.05), vocabulary ability (p<0.05), reasoning ability (p<0.05), mathematical ability (p<0.05) and perception ability (p<0.05) among third grade students who displayed high levels of blood lead concentration. Sixth grade students showed significantly low performance in vocabulary ability (p<0.05) at high level of blood lead concentration. The difference in mean IQ scores between the group with blood lead level of < or =2.00 microg/dl and the group with blood lead level > or =3.00 microg/ dl was 3.21 in third grade students and 4.28 in sixth grade students. Low academic achievement was observed among third grade students (p<0.05) and six grade students (p<0.05) as the average blood lead level increased. Correlation analysis on the association of blood lead concentration with neurobehavioral tests revealed a positive correlation between blood lead levels and reaction time of choice reaction time and symbol digit substitution in third grade students. A positive correlation was observed between blood lead levels and reaction time of symbol digit substitution and finger tapping speed in sixth grade students. There was a negative correlation between blood lead levels and reasoning ability of third grade students (r=-0.247) and vocabulary ability of six grade students (r=-0.255). CONCLUSION: There have been few studies on the effects of blood lead on the central nervous systems of children in Korea. The study supports the findings of earlier studies that blood lead has an impact on children. However, the study did not confirm significant association of blood lead concentration with each neurological and motor test conducted for this study due to a small sample size and relatively low blood lead levels of elementary school students. Further studies using a similar assessment methods would be helpful to evaluate the effects of low blood lead levels on the central nervous systems of children.
Achievement ; Centers for Disease Control and Prevention (U.S.) ; Central Nervous System ; Child ; Fingers ; Hand ; Humans ; Intelligence ; Intelligence Tests ; Korea ; Life Style ; Perception ; Reaction Time ; Sample Size ; Vocabulary

OBJECTIVES: To evaluate effects of lead on the central nervous system of children by measuring blood lead concentration, computerized neurobehavioral function and intelligence of elementary school students. METHODS: The study was conducted with 208 elementary school students living in the vicinity of Pohang Industrial Complex in October and November, 2005. Data on demographic characteristics, living environments and lifestyle habits were collected from subjects. RESULTS: Blood lead levels of elementary school students ranged from 0.76-4.97 microg/dl, which is below the 10 microg/dl recommended level of CDC. The blood lead levels were similar with those reported in other domestic and international studies. Neurobehavioral tests revealed that most third grade students reacted slowly and their speed declined in simple reaction time (p<0.05), choice reaction time (p<0.05), symbol digit substitution (p<0.01), finger tapping speed nondominant hand (p<0.05) as blood lead levels increased. Sixth grade students demonstrated significance in test performance, and displayed blood lead levels of 2.00-4.00 microg/dl. Results of intelligence testing showed significantly low performance in IQ (p<0.05), vocabulary ability (p<0.05), reasoning ability (p<0.05), mathematical ability (p<0.05) and perception ability (p<0.05) among third grade students who displayed high levels of blood lead concentration. Sixth grade students showed significantly low performance in vocabulary ability (p<0.05) at high level of blood lead concentration. The difference in mean IQ scores between the group with blood lead level of < or =2.00 microg/dl and the group with blood lead level > or =3.00 microg/ dl was 3.21 in third grade students and 4.28 in sixth grade students. Low academic achievement was observed among third grade students (p<0.05) and six grade students (p<0.05) as the average blood lead level increased. Correlation analysis on the association of blood lead concentration with neurobehavioral tests revealed a positive correlation between blood lead levels and reaction time of choice reaction time and symbol digit substitution in third grade students. A positive correlation was observed between blood lead levels and reaction time of symbol digit substitution and finger tapping speed in sixth grade students. There was a negative correlation between blood lead levels and reasoning ability of third grade students (r=-0.247) and vocabulary ability of six grade students (r=-0.255). CONCLUSION: There have been few studies on the effects of blood lead on the central nervous systems of children in Korea. The study supports the findings of earlier studies that blood lead has an impact on children. However, the study did not confirm significant association of blood lead concentration with each neurological and motor test conducted for this study due to a small sample size and relatively low blood lead levels of elementary school students. Further studies using a similar assessment methods would be helpful to evaluate the effects of low blood lead levels on the central nervous systems of children.
Achievement ; Centers for Disease Control and Prevention (U.S.) ; Central Nervous System ; Child ; Fingers ; Hand ; Humans ; Intelligence ; Intelligence Tests ; Korea ; Life Style ; Perception ; Reaction Time ; Sample Size ; Vocabulary

A cross-sectional study of 118 car painters and controls of 113 workers was performed to investigate the interrelation between self-reported neuropsychiatric symptom and neurobehavioral performance using Scandinavian Questionnaire 16, Zung anxiety, depression scale and Swedish performance evaluation system (simple reaction time, symbol digit, digit span, finger tapping speed). The typical symptoms characteristic of painter's syndrome were not found and no significant association was found between solvent exposure and !total score of neuropsychiatric symptom but neurobehavioral performance of simple reaction time, symbol digit and digit span had association with solvent exposure. No significant associations were found between total score of neurotoxic symptom, anxiety scale, depression scale and the neurobehavioral performance. In factor analysis, the factor of questionnaire 16 measuring function of memory demonstrated no significant association with the factor of neurobehavioral test items measuring short term memory.
Anxiety ; Cross-Sectional Studies ; Depression ; Fingers ; Memory ; Questionnaires ; Reaction Time ; Solvents*

Calcific myonecrosis is a rare condition in which hypoperfusion due to compartment syndrome causes soft tissue and muscle to become calcified. As calcific myonecrosis gradually deteriorates, secretions steadily accumulate inside the affected area, forming a cavity that is vulnerable to infection. Most such cases progress to chronic wounds that are unlikely to heal spontaneously. After removing the calcified tissue, the wound can be treated by primary closure, flap coverage, or a skin graft. In this case, a 72-year-old man had extensive calcific myonecrosis on his left lower leg, and experienced swelling and increasing tenderness. After removing the muscle calcification, we combined two anterolateral thigh free flaps, which were harvested from the patient’s right and left thigh, respectively, to reconstruct the wound with a dead-space filler and skin-defect cover at the same time. The patient recovered without revision surgery or major complications.

Calcific myonecrosis is a rare condition in which hypoperfusion due to compartment syndrome causes soft tissue and muscle to become calcified. As calcific myonecrosis gradually deteriorates, secretions steadily accumulate inside the affected area, forming a cavity that is vulnerable to infection. Most such cases progress to chronic wounds that are unlikely to heal spontaneously. After removing the calcified tissue, the wound can be treated by primary closure, flap coverage, or a skin graft. In this case, a 72-year-old man had extensive calcific myonecrosis on his left lower leg, and experienced swelling and increasing tenderness. After removing the muscle calcification, we combined two anterolateral thigh free flaps, which were harvested from the patient’s right and left thigh, respectively, to reconstruct the wound with a dead-space filler and skin-defect cover at the same time. The patient recovered without revision surgery or major complications.

BACKGROUND: Formaldehyde is used to preserve cadaver in medical schools, and students are exposed to formaldehyde during cadaver dissection classes. When humans are exposed to formaldehyde, it induces mucosal inflammation, skin inflammation, and declining of neurobehavioral function including attention and memory executive functions. The purpose of this study is to identify the effects of formaldehyde exposure on student's neurobehavioral performance during cadaver dissection classes. METHODS: The level of formaldehyde was measured in a cadaver dissection class. A total of 16 students were randomly divided into two groups. One group wore respiratory protection masks, while the other group did not. Among many subtests in Korean Computerized Neurobehavioral test, backward digit span was tested on all subjects before and after the class. RESULTS: The length of memorized digit span between the two groups was not significant; however there was a greater decrease in neurobehavioral function after formaldehyde exposure in the non-mask group than the mask group. CONCLUSION: Formaldehyde exposure during cadaver dissection may likely decrease neurobehavioral performance of students. Therefore, proper ventilation system and respiratory protective equipment are necessary to protect medical school students from adverse effects of formaldehyde exposure.
Cadaver* ; Executive Function ; Formaldehyde* ; Humans ; Inflammation ; Masks ; Memory ; Schools, Medical ; Skin ; Ventilation

Background: Lip lifting is a widely accepted and efficient surgical procedure for volumizing the upper lip to achieve a more youthful appearance. A previous study by Hwang et al. identified the lip-related ratios most preferred by Koreans: a lip height-to-width ratio (LTW) of 0.4, an upper-to-lower vermilion ratio (ULR) of 0.8, and an upper vermilion thickness-to-upper lip height ratio (VUL) of 0.5. The current study investigated whether the attractive lip ratio favored by Koreans could be obtained with central upper lip lift surgery. Methods: This retrospective chart review included South Korean patients who underwent central lip lifts between 2015 and 2019 at a single center. The LTW, ULR, VUL, and columellar-labial angle were measured using the patients’ preoperative and postoperative clinical photographs. Results: A total of 87 patients underwent central lip lifts. Before surgery, the mean LTW was 0.34, the mean ULR was 0.76, and the mean VUL was 0.30. After surgery, the LTW increased to an average of 0.39, the ULR increased to 0.84, and the VUL increased to 0.393. The patients’ postoperative ratio values were close to the attractive lip ratio values proposed by Hwang et al. The average columellar-labial angle decreased from 101.59° to 95.04°, and therefore did not interfere with the aesthetic relationship between the nose and lips. Conclusions The central lip lift was an efficient cosmetic technique that provided the Korean ideal shape for attractive lips.

OBJECTIVE: The purpose of this investigation was to identify distinctive clinical correlates of psychotic major depression (PMD) as compared with non-psychotic major depression (NPMD) in a large cohort of Korean patients with major depressive disorder (MDD). METHODS: We recruited 966 MDD patients of age over 18 years from the Clinical Research Center for Depression of South Korea (CRESCEND) study. Diagnoses of PMD (n=24) and NPMD (n=942) were made with the DSM-IV definitions and confirmed with SCID. Psychometric scales were used to assess overall psychiatric symptoms (BPRS), depression (HAMD), anxiety (HAMA), global severity (CGI-S), suicidal ideation (SSI-Beck), functioning (SOFAS), and quality of life (WHOQOL-BREF). Using independent t-tests and chi2 tests, we compared clinical characteristics of patients with PMD and NPMD. A binary logistic regression model was constructed to identify factors independently associated with increased likelihood of PMD. RESULTS: PMD subjects were characterized by a higher rate of inpatient enrollment, and higher scores on many items on BPRS (somatic concern, anxiety, emotional withdrawal, guilt feelings, tension, depression, suspiciousness, hallucination, motor retardation, blunted affect and excitement) global severity (CGI-s), and suicidal ideation (SSI-Beck). The explanatory factor model revealed that high levels of tension, excitement, and suicidal ideation were associated with increased likelihood of PMD. CONCLUSION: Our findings partly support the view that PMD has its own distinctive clinical manifestation and course, and may be considered a diagnostic entity separate from NPMD.
Anxiety ; Cohort Studies ; Depression* ; Depressive Disorder, Major ; Diagnosis ; Diagnostic and Statistical Manual of Mental Disorders ; Guilt ; Hallucinations ; Humans ; Inpatients ; Korea ; Logistic Models ; Psychometrics ; Quality of Life ; Suicidal Ideation ; Weights and Measures