1.Morphometric Variations in Oblique Lumbar Interbody Fusion Corridors in Degenerative Lumbar Scoliosis:A Comparative Study of the Apex Direction
Ji Uk CHOI ; Dong-Ho LEE ; Chang Ju HWANG ; Sehan PARK ; Jae Hwan CHO
Clinics in Orthopedic Surgery 2026;18(1):96-106
Background:
Degenerative lumbar scoliosis (DLS) alters spinal anatomy, impacting the feasibility and dimensions of surgical corridors for oblique lumbar interbody fusion (OLIF). This study aimed to compare the morphometric characteristics of OLIF corridors between patients with left- and right-apex curves, focusing on corridor dimensions, psoas muscle asymmetry, and segmental artery positioning.
Methods:
A retrospective analysis of 80 patients with DLS (left apex: n = 43; right apex: n = 37) was conducted. Corridor angles and distances, psoas muscle cross-sectional areas, and segmental artery locations were measured at L2–3, L3–4, and L4–5 using T2-weighted magnetic resonance imaging (MRI). Multivariate regression analysis identified key anatomical predictors of corridor variation at L2–3.
Results:
Regardless of the apex direction, the left-sided corridor was consistently larger across all levels. Corridor angles were significantly greater on the left side in both groups (left apex: L2–3, 39.7° vs. 13.5°; L3–4, 38.3° vs. 11.9°; L4–5, 38.6° vs. 6.9°;right apex: L2–3, 53.7° vs. 18.1°; L3–4, 43.1° vs. 18.5°; L4–5, 28.6° vs. 11.9°). Psoas muscle areas were larger on the concave side of the curve (left apex: 125.7 mm2 vs. 67.9 mm2 ; right apex: 125.4 mm2 vs. 77.4 mm2 ). Segmental artery positioning exhibited curvedependent asymmetry at L2–3 (left apex: 8.8 mm vs. 7.9 mm; right apex: 9.6 mm vs. 8.0 mm). Multivariate regression analysis revealed that in the left apex group, the left psoas area (β = −0.132) and segmental artery distances were significant predictors of corridor angle variation (R2 = 0.517). In the right apex group, psoas asymmetry (β = 0.123) and sagittal alignment (β = −0.851) were associated with corridor differences.
Conclusions
OLIF corridors in DLS patients demonstrate consistent left-sided dominance, regardless of apex direction. Psoas muscle asymmetry and segmental artery positioning contribute to corridor variations. While the left-sided approach remains standard, right-sided access may be feasible in select cases, particularly at L4–5. These findings provide insights for optimizing preoperative planning and surgical decision-making in DLS patients.
2.Real-Time Assessment of Black Carbon Peaks Among Workers Exposed to Diesel Engine Exhaust Emissions
Ju-Hyun PARK ; Sangjun CHOI ; Kyung Ehi ZOH ; Seung Won KIM ; Dong-Hee KOH ; Won KIM ; Dong-Uk PARK
Safety and Health at Work 2026;17(1):142-150
Background:
Workers are commonly exposed to diesel engine exhaust (DEE) from diesel-powered engines and vehicles (DEVs), which contain harmful particulates such as black carbon (BC). This study aimed to characterize the peak BC exposures of workers operating or working near DEVs.
Methods:
BC levels were recorded every minute from workers driving or working near DEVs using a portable aethalometer and were categorized by job type and activity. Peak BC levels were characterized using the occupational exposure limits for DEE (measured as elemental carbon) of 10 μg/m 3 and 50 μg/ m3 as cut-off values.
Results:
Forklift operators, garbage collectors, and machine operators showed peak BC exposure levels surpassing 20 μg/m 3 , with average levels above 10 μg/m 3 . Despite their short exposure durations (<1 hour), these peaks contributed significantly (>60%) to the daily average BC exposure. The daily contribution rate of peak exposures above 10 μg/m 3 to the average daily BC exposure often exceeded 50%. The ratio of peak levels above 10 μg/m 3 and 50 μg/m 3 to the arithmetic mean was negatively correlated with exposure duration, the proportion of exposure duration, and the daily contribution of peak levels.
Conclusion
Drivers of diesel-engine vehicles often experienced significant spikes in BC exposure, highlighting the need for real-time monitoring, which is recommended as a best-practice approach to identify and mitigate short-term peak exposures.
3.Unhealed Anterolateral Ligament of the Knee is Associated with Residual Pivot-Shift Following Anterior Cruciate Ligament Reconstructions
Nam-Hong CHOI ; Dong-Min LEE ; Uk HUR ; Brian Nicholas VICTOROFF
The Journal of the Korean Orthopaedic Association 2025;60(1):30-37
Purpose:
The association between the healing of an injured anterolateral ligament (ALL) and residual pivot-shift following anterior cruciate ligament (ACL) reconstructions is rarely reported. This study analyzed the relationship between unhealed ALL and residual pivot-shift after an ACL reconstruction.
Materials and Methods:
The inclusion criteria were patients who underwent autologous hamstring ACL reconstructions within 6 weeks after injury from January 2008 to March 2021. Preoperative ALL injuries and postoperative ALL healing were graded according to the magnetic resonance imaging classification, with postoperative magnetic resonance imaging performed 7.8 months after surgery on average. The patients were categorized based on postoperative ALL healing, and the clinical scores (Lysholm score and Tegner activity scale) and knee stability (Lachman test and pivot-shift test) were assessed at the 1-year postoperative follow-up.
Results:
One hundred and forty-five patients were enrolled in this study. One hundred and twenty-eight (88.3%) patients had a concomitant ALL injury. Among 86 patients with preoperative grade B, 16 (18.6%) patients showed grade 1 (good), and 70 (81.4%) showed grade 2 (partial) ALL postoperatively. Among the 42 patients with preoperative grade C (complete tear), 1 (2.4%) patient showed grade 1 (good), 21 (50.0%) showed grade 2 (partial), and 20 (47.6%) showed grade 3 (non-visualized) ALL. Preoperative grade C was significantly associated with a higher incidence of grade 3 (non-visualized) postoperatively than the other groups (p<0.001). Postoperatively, the Lachman test, KT-1000 (MEDmetric Corp.) arthrometer (side-to-side difference), Lysholm score, and Tegner activity scales did not show a significant difference among the intact, grade 1, grade 2, and grade 3 ALL groups. The pivot-shift test showed a significant difference between the ALL grades (p=0.001). Grade 3 ALL group showed a higher incidence of pivot-shift than the intact, grade 1, and grade 2 ALL groups.
Conclusion
Patients with preoperative grade C had a higher rate of grade 3 postoperatively compared to the other groups. In addition, the grade 3 group had a significantly higher incidence of a pivot-shift. Therefore, in cases of ACL injuries with concomitant complete ALL tears, ALL reconstruction should be considered during ACL reconstruction.
4.Roots of the Large-Scale Household Humidifier Disinfectant Poisoning Tragedy: Regulatory and Surveillance Shortcomings in Korea
Dong-Uk PARK ; Kyung Ehi ZOH ; Dae Hwan CHO ; Soyoung PARK ; Jeonghwa HWANG ; Cheong-Hak CHOI ; Dong-Hee KOH ; Yeyong CHOI ; Jinyoung PARK
Journal of Korean Medical Science 2025;40(15):e144-
The multi-decade household humidifier disinfectant poisoning tragedy (HHDT) in South Korea highlights the importance of investigating government failures. This study aims to identify and discuss key failures and shortcomings in the South Korean authorities’ approach to regulating humidifier disinfectants (HDs) and monitoring cases of chemical poisoning. We reviewed both the HD risk prevention measures that the South Korean Ministry of Environment (KME) should have implemented under the Toxic Chemicals Control Act (TCCA) (1991–2013).Polyhexamethylene guanidine phosphate (PHMG), a new chemical, was approved for use as a disinfectant under the TCCA. KME declared PHMG non-hazardous based solely on preproduction documentation provided by the industry. In addition, the Korea Disease Control and Prevention Agency (KDCPA) failed to detect the HHDT that had accumulated each year for more than a decade. KME’s neglect of its responsibilities, coupled with KDCPA’s lack of chemical poisoning surveillance systems, led to the accumulation of widespread HHDT.
5.Roots of the Large-Scale Household Humidifier Disinfectant Poisoning Tragedy: Regulatory and Surveillance Shortcomings in Korea
Dong-Uk PARK ; Kyung Ehi ZOH ; Dae Hwan CHO ; Soyoung PARK ; Jeonghwa HWANG ; Cheong-Hak CHOI ; Dong-Hee KOH ; Yeyong CHOI ; Jinyoung PARK
Journal of Korean Medical Science 2025;40(15):e144-
The multi-decade household humidifier disinfectant poisoning tragedy (HHDT) in South Korea highlights the importance of investigating government failures. This study aims to identify and discuss key failures and shortcomings in the South Korean authorities’ approach to regulating humidifier disinfectants (HDs) and monitoring cases of chemical poisoning. We reviewed both the HD risk prevention measures that the South Korean Ministry of Environment (KME) should have implemented under the Toxic Chemicals Control Act (TCCA) (1991–2013).Polyhexamethylene guanidine phosphate (PHMG), a new chemical, was approved for use as a disinfectant under the TCCA. KME declared PHMG non-hazardous based solely on preproduction documentation provided by the industry. In addition, the Korea Disease Control and Prevention Agency (KDCPA) failed to detect the HHDT that had accumulated each year for more than a decade. KME’s neglect of its responsibilities, coupled with KDCPA’s lack of chemical poisoning surveillance systems, led to the accumulation of widespread HHDT.
6.Roots of the Large-Scale Household Humidifier Disinfectant Poisoning Tragedy: Regulatory and Surveillance Shortcomings in Korea
Dong-Uk PARK ; Kyung Ehi ZOH ; Dae Hwan CHO ; Soyoung PARK ; Jeonghwa HWANG ; Cheong-Hak CHOI ; Dong-Hee KOH ; Yeyong CHOI ; Jinyoung PARK
Journal of Korean Medical Science 2025;40(15):e144-
The multi-decade household humidifier disinfectant poisoning tragedy (HHDT) in South Korea highlights the importance of investigating government failures. This study aims to identify and discuss key failures and shortcomings in the South Korean authorities’ approach to regulating humidifier disinfectants (HDs) and monitoring cases of chemical poisoning. We reviewed both the HD risk prevention measures that the South Korean Ministry of Environment (KME) should have implemented under the Toxic Chemicals Control Act (TCCA) (1991–2013).Polyhexamethylene guanidine phosphate (PHMG), a new chemical, was approved for use as a disinfectant under the TCCA. KME declared PHMG non-hazardous based solely on preproduction documentation provided by the industry. In addition, the Korea Disease Control and Prevention Agency (KDCPA) failed to detect the HHDT that had accumulated each year for more than a decade. KME’s neglect of its responsibilities, coupled with KDCPA’s lack of chemical poisoning surveillance systems, led to the accumulation of widespread HHDT.
7.Unhealed Anterolateral Ligament of the Knee is Associated with Residual Pivot-Shift Following Anterior Cruciate Ligament Reconstructions
Nam-Hong CHOI ; Dong-Min LEE ; Uk HUR ; Brian Nicholas VICTOROFF
The Journal of the Korean Orthopaedic Association 2025;60(1):30-37
Purpose:
The association between the healing of an injured anterolateral ligament (ALL) and residual pivot-shift following anterior cruciate ligament (ACL) reconstructions is rarely reported. This study analyzed the relationship between unhealed ALL and residual pivot-shift after an ACL reconstruction.
Materials and Methods:
The inclusion criteria were patients who underwent autologous hamstring ACL reconstructions within 6 weeks after injury from January 2008 to March 2021. Preoperative ALL injuries and postoperative ALL healing were graded according to the magnetic resonance imaging classification, with postoperative magnetic resonance imaging performed 7.8 months after surgery on average. The patients were categorized based on postoperative ALL healing, and the clinical scores (Lysholm score and Tegner activity scale) and knee stability (Lachman test and pivot-shift test) were assessed at the 1-year postoperative follow-up.
Results:
One hundred and forty-five patients were enrolled in this study. One hundred and twenty-eight (88.3%) patients had a concomitant ALL injury. Among 86 patients with preoperative grade B, 16 (18.6%) patients showed grade 1 (good), and 70 (81.4%) showed grade 2 (partial) ALL postoperatively. Among the 42 patients with preoperative grade C (complete tear), 1 (2.4%) patient showed grade 1 (good), 21 (50.0%) showed grade 2 (partial), and 20 (47.6%) showed grade 3 (non-visualized) ALL. Preoperative grade C was significantly associated with a higher incidence of grade 3 (non-visualized) postoperatively than the other groups (p<0.001). Postoperatively, the Lachman test, KT-1000 (MEDmetric Corp.) arthrometer (side-to-side difference), Lysholm score, and Tegner activity scales did not show a significant difference among the intact, grade 1, grade 2, and grade 3 ALL groups. The pivot-shift test showed a significant difference between the ALL grades (p=0.001). Grade 3 ALL group showed a higher incidence of pivot-shift than the intact, grade 1, and grade 2 ALL groups.
Conclusion
Patients with preoperative grade C had a higher rate of grade 3 postoperatively compared to the other groups. In addition, the grade 3 group had a significantly higher incidence of a pivot-shift. Therefore, in cases of ACL injuries with concomitant complete ALL tears, ALL reconstruction should be considered during ACL reconstruction.
8.Roots of the Large-Scale Household Humidifier Disinfectant Poisoning Tragedy: Regulatory and Surveillance Shortcomings in Korea
Dong-Uk PARK ; Kyung Ehi ZOH ; Dae Hwan CHO ; Soyoung PARK ; Jeonghwa HWANG ; Cheong-Hak CHOI ; Dong-Hee KOH ; Yeyong CHOI ; Jinyoung PARK
Journal of Korean Medical Science 2025;40(15):e144-
The multi-decade household humidifier disinfectant poisoning tragedy (HHDT) in South Korea highlights the importance of investigating government failures. This study aims to identify and discuss key failures and shortcomings in the South Korean authorities’ approach to regulating humidifier disinfectants (HDs) and monitoring cases of chemical poisoning. We reviewed both the HD risk prevention measures that the South Korean Ministry of Environment (KME) should have implemented under the Toxic Chemicals Control Act (TCCA) (1991–2013).Polyhexamethylene guanidine phosphate (PHMG), a new chemical, was approved for use as a disinfectant under the TCCA. KME declared PHMG non-hazardous based solely on preproduction documentation provided by the industry. In addition, the Korea Disease Control and Prevention Agency (KDCPA) failed to detect the HHDT that had accumulated each year for more than a decade. KME’s neglect of its responsibilities, coupled with KDCPA’s lack of chemical poisoning surveillance systems, led to the accumulation of widespread HHDT.
9.Unhealed Anterolateral Ligament of the Knee is Associated with Residual Pivot-Shift Following Anterior Cruciate Ligament Reconstructions
Nam-Hong CHOI ; Dong-Min LEE ; Uk HUR ; Brian Nicholas VICTOROFF
The Journal of the Korean Orthopaedic Association 2025;60(1):30-37
Purpose:
The association between the healing of an injured anterolateral ligament (ALL) and residual pivot-shift following anterior cruciate ligament (ACL) reconstructions is rarely reported. This study analyzed the relationship between unhealed ALL and residual pivot-shift after an ACL reconstruction.
Materials and Methods:
The inclusion criteria were patients who underwent autologous hamstring ACL reconstructions within 6 weeks after injury from January 2008 to March 2021. Preoperative ALL injuries and postoperative ALL healing were graded according to the magnetic resonance imaging classification, with postoperative magnetic resonance imaging performed 7.8 months after surgery on average. The patients were categorized based on postoperative ALL healing, and the clinical scores (Lysholm score and Tegner activity scale) and knee stability (Lachman test and pivot-shift test) were assessed at the 1-year postoperative follow-up.
Results:
One hundred and forty-five patients were enrolled in this study. One hundred and twenty-eight (88.3%) patients had a concomitant ALL injury. Among 86 patients with preoperative grade B, 16 (18.6%) patients showed grade 1 (good), and 70 (81.4%) showed grade 2 (partial) ALL postoperatively. Among the 42 patients with preoperative grade C (complete tear), 1 (2.4%) patient showed grade 1 (good), 21 (50.0%) showed grade 2 (partial), and 20 (47.6%) showed grade 3 (non-visualized) ALL. Preoperative grade C was significantly associated with a higher incidence of grade 3 (non-visualized) postoperatively than the other groups (p<0.001). Postoperatively, the Lachman test, KT-1000 (MEDmetric Corp.) arthrometer (side-to-side difference), Lysholm score, and Tegner activity scales did not show a significant difference among the intact, grade 1, grade 2, and grade 3 ALL groups. The pivot-shift test showed a significant difference between the ALL grades (p=0.001). Grade 3 ALL group showed a higher incidence of pivot-shift than the intact, grade 1, and grade 2 ALL groups.
Conclusion
Patients with preoperative grade C had a higher rate of grade 3 postoperatively compared to the other groups. In addition, the grade 3 group had a significantly higher incidence of a pivot-shift. Therefore, in cases of ACL injuries with concomitant complete ALL tears, ALL reconstruction should be considered during ACL reconstruction.
10.Management and Collection of Occupational Data for Health (ODH) in National Public Health Statistics: Evaluation and Recommendations for Korea
Dong-Uk PARK ; Kyung Ehi ZOH ; Yun-Keun LEE ; Hoekyeong SEO ; Sangjun CHOI ; Dong-Hee KOH ; Jin-Ha YOON ; Kanwoo YOUN ; Mo-Yeol KANG ; Eun Suk CHOI ; Jungwon KIM ; Yangho KIM ; Domyung PAEK
Safety and Health at Work 2025;16(1):60-68
Background:
The aims of this study are to examine how occupation-related data and information for health (ODH) are collected and managed from census-based surveys and potential occupational illness and injuries (POIS) statistics, and to propose a national strategy for the systematic collection, analysis, and management of ODH by building on the Korean Standard Classification of Occupation (KSCO) and using a job exposure matrix (JEM).
Methods:
The status of the collection and management of ODH registered as national statistics, drawn not only from the census-based general population and workforce, but also from POIS statistics was reviewed and evaluated.
Results:
ODH from the Republic of Korea's Census of Population and Labor Force are collected and classified according to the KSCO. In contrast, national statistics on POIS are not systematically collected for KSCO coding, reflecting the lack of an KSCO and related guidelines on how to collect ODH. Key frameworks for the construction of both an KSCO and a reference JEM for public health surveillance are proposed.
Conclusions
Further research is needed to develop a national system for collecting and managing ODH, which will ultimately contribute to the use of a national KSCO and the construction of JEM for public health surveillance.

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