1.Connective tissue disease is associated with the risk of posterior reversible encephalopathy syndrome following lung transplantation in Korea
Tae Jung KIM ; Hyun Joo LEE ; Samina PARK ; Sang-Bae KO ; Soo-Hyun PARK ; Seung Hwan YOON ; Kwon Joong NA ; In Kyu PARK ; Chang Hyun KANG ; Young Tae KIM ; Sun Mi CHOI ; Jimyung PARK ; Joong-Yub KIM ; Hong Yeul LEE
Acute and Critical Care 2025;40(1):79-86
Background:
Posterior reversible encephalopathy syndrome (PRES) is a rare complication of lung transplantation with poorly understood risk factors and clinical characteristics. This study aimed to examine the occurrence, risk factors, and clinical data of patients who developed PRES following lung transplantation.
Methods:
A retrospective analysis was conducted on 147 patients who underwent lung transplantation between February 2013 and December 2023. The patients were diagnosed with PRES based on the clinical symptoms and radiological findings. We compared the baseline characteristics and clinical information, including primary lung diseases and immunosuppressive therapy related to lung transplantation operations, between the PRES and non-PRES groups.
Results:
PRES manifested in 7.5% (n=11) of the patients who underwent lung transplantation, with a median onset of 15 days after operation. Seizures were identified as the predominant clinical manifestation (81.8%, n=9) in the group diagnosed with PRES. All patients diagnosed with PRES recovered fully. Patients with PRES were significantly associated with connective tissue disease-associated interstitial lung disease (45.5% vs. 18.4%, P=0.019, odds ratio=9.808; 95% CI, 1.064–90.386; P=0.044). Nonetheless, no significant variance was observed in the type of immunotherapy, such as the use of calcineurin inhibitors, blood pressure, or acute renal failure subsequent to lung transplantation.
Conclusions
PRES typically manifests shortly after lung transplantation, with seizures being the predominant initial symptom. The presence of preexisting connective tissue disease as the primary lung disease represents a significant risk factor for PRES following lung transplantation.
2.Feasibility of Circulating Tumor DNA Detection in the Cerebrospinal Fluid of Patients With Central Nervous System Involvement in Large B-Cell Lymphoma
Seok Jin KIM ; Jin Ju KIM ; Mi Ri PARK ; Bon PARK ; Kyung Ju RYU ; Sang Eun YOON ; Won Seog KIM ; Saeam SHIN ; Seung-Tae LEE
Annals of Laboratory Medicine 2025;45(1):90-95
We explored the utility of cerebrospinal fluid (CSF) circulating tumor DNA (ctDNA) sequencing as a noninvasive diagnostic tool for detecting central nervous system (CNS) involvement in patients with diffuse large B-cell lymphoma (DLBCL). Secondary CNS involvement in DLBCL, although rare (~5% of cases), presents diagnostic and prognostic challenges during systemic disease progression or relapse. Effective treatment is impeded by the blood–brain barrier. This was a prospective cohort study (Samsung Lymphoma Cohort Study III) involving 17 patients with confirmed CNS involvement. High-throughput sequencing was conducted using targeted gene panels designed to detect low-frequency variants and copy number alterations pertinent to lymphomas in ctDNA extracted from archived CSF samples. Despite challenges such as low DNA concentrations affecting library construction, the overall variant detection rate was 76%. Detected variants included those in genes commonly implicated in CNS lymphoma, such as MYD88. The study highlights the potential of CSF ctDNA sequencing to identify CNS involvement in DLBCL, providing a promising alternative to more invasive diagnostic methods such as brain biopsy, which are not always feasible. Further validation is necessary to establish the clinical utility of this method, which could significantly enhance the management and outcomes of DLBCL patients with suspected CNS involvement.
3.Alternative strategy for handling portal vein tearing around chronic calcification in living donor liver transplantation
Yi Ping SNG ; Jae-Yoon KIM ; YoungRok CHOI ; Suk Kyun HONG ; Jiyoung KIM ; Gayoung KIM ; Min Kyoung KIM ; Sang Hyuk PARK ; Kwang-Woong LEE
Annals of Liver Transplantation 2025;5(2):147-153
Portal vein preparation for inflow anastomosis is a critical step in liver transplantation. Although portal vein thrombosis is well documented and classified according to Yerdel grading, calcification or sclerosis of the portal vein is rarely reported. Segmental or diffuse calcification of portal vein compromises its structural integrity and may even result in flow obstruction, rendering it unsuitable for reconstruction and necessitating alternative inflow strategies. This case report describes a patient with portal vein tearing around chronic calcification who underwent successful living donor liver transplantation using a cryopreserved iliac vein graft anastomosed to gastric varices.
4.Corrigendum: Correction of Funding in the Article “List of occupational diseases among farmers in Korea: a literature review”
Hansoo SONG ; Seok-Ju YOO ; Won-Ju PARK ; Seunghyeon CHO ; Ki Soo PARK ; Joo Hyun SUNG ; Sang Jin PARK ; Seong-yong YOON ; Kyeongsoo KIM ; Dong-phil CHOI ; Hye-min KIM ; Bounggyun JU ; Kanwoo YOUN
Annals of Occupational and Environmental Medicine 2025;37(1):e16-
5.Occupational stress (KOSS®19): scale development and validation in the Korean context
Hansoo SONG ; Hyoung Ryoul KIM ; Inah KIM ; Jin-Ha YOON ; Sang-Baek KOH ; Sung-Soo OH ; Hee-Tae KANG ; Da-Yee JEUNG ; Dae-Sung HYUN ; Chunhui SUH ; Sei-Jin CHANG
Annals of Occupational and Environmental Medicine 2025;37(1):e12-
Background:
The Korean Occupational Stress Scale (KOSS) was developed in 2004. During this time, industrial structures have evolved, and societal awareness of occupational stress has changed. This study aims to develop and validate a revised version of the Korean Occupational Stress Scale (KOSS®19), tailored for workers, reflecting these changes.
Methods:
The KOSS®19 was developed based on the 26-item KOSS–short form (SF) through a review by eight experts. A survey was conducted including 359 service industry workers, comprising the KOSS®19, Burnout, and Depression scales. The KOSS®19 subscales were restructured, and their reliability and validity were evaluated.
Results:
The KOSS®19 composed of eight subscales: hazardous physical environment (2 items), high job demand (3 items), insufficient job control (2 items), low social support (2 items), job insecurity (2 items), organizational injustice (4 items), lack of reward (2 items), and work-life imbalance (2 items). The reliability and validity of the KOSS®19 were found to be satisfactory.
Conclusions
The KOSS®19 is a suitable tool for assessing occupational stress, effectively replacing the original KOSS and KOSS-SF.
6.Emotional labor (KELS®11): scale development and validation in the Korean context
Da-Yee JEUNG ; Hyoung Ryoul KIM ; Hansoo SONG ; Inah KIM ; Jin-Ha YOON ; Sang-Baek KOH ; Sung-Soo OH ; Hee-Tae KANG ; Dae-Sung HYUN ; Chunhui SUH ; Sei Jin CHANG
Annals of Occupational and Environmental Medicine 2025;37(1):e13-
Background:
Emotional labor refers to the management of emotions and expressions to meet the emotional requirements of a job role. This study aimed to develop a revised version of the Korean Emotional Labor Scale (KELS®11), based on the first edition (KELS-24) introduced in 2014, and to provide practical applications and guidelines for its use in the Korean workplace through a validation process.
Methods:
The revised version of KELS®11 was derived from the 24-item KELS, following a review process involving eight experts. To validate the scale’s reliability and validity, a self-administered survey was conducted among 359 service industry workers using KELS®11, burnout, and depression scales. KELS®11 was reclassified, and its reliability and validity were evaluated. Receiver operating characteristic curve analysis was conducted to establish sex-specific cutoff values (normal vs. high-risk groups).
Results:
KELS®11 was designed to account for individual, organizational, and cultural contexts. It consists of four subscales and 11 items: “emotional regulation” (2 items), “emotional dissonance” (3 items), “organizational monitoring” (2 items), and “organizational protective system for emotional labor” (4 items). KELS®11 demonstrated good validity (content validity ratio: 0.84; item convergence/discriminant validity success rates: 100%; correlation with burnout: r = 0.185–0.436, p < 0.01; correlation with depression: r = 0.128–0.339, p < 0.05) and reliability (Cronbach’s alpha: 0.597–0.795). Additionally, sex-specific reference values were established to determine risk groups based on the intensity of emotional labor exposure.
Conclusions
KELS®11 is a validated and reliable measurement tool designed to assess the intensity and magnitude of emotional labor in the workplace. The revised tool reflects critical considerations in the development of emotional labor measurement scales.
7.Workplace Violence (KWVS®13): scale development and validation in the Korean context
Da-Yee JEUNG ; Hyoung Ryoul KIM ; Hansoo SONG ; Inah KIM ; Jin-Ha YOON ; Sang-Baek KOH ; Sung-Soo OH ; Hee-Tae KANG ; Dae-Sung HYUN ; Chunhui SUH ; Sei-Jin CHANG
Annals of Occupational and Environmental Medicine 2025;37(1):e14-
Background:
Workplace violence refers to any act or threat of physical violence, verbal abuse, harassment, intimidation, bullying, mobbing, or other aggressive and disruptive behaviors that occur at work. This study aims to develop and validate a revision of the Korean Workplace Violence Scale (KWVS®13), based on the first edition of the Korean Workplace Violence Scale (KWVS-24), and to provide practical applications and guidelines for the Korean workplace environment.
Methods:
The revised KWVS®13 was developed by restructuring the 24-item KWVS through a review process involving eight experts. To validate the reliability and validity of KWVS®13, a self-administered survey comprising KWVS®13, burnout, and depression scales was conducted among 359 service industry workers. KWVS®13 was reclassified, and its reliability and validity were assessed. Receiver operating characteristic curve analysis was performed to establish sex-specific cutoff values (normal vs. risk) of the scale.
Results:
KWVS®13 consists of 13 items across four subscales: “psychological and sexual violence from customers” (4 items), “psychological and sexual violence from supervisors or coworkers” (4 items), “physical assault from customers, supervisors, or coworkers” (2 items), and “organizational protective system for workplace violence” (3 items). We found that KWVS®13 shows relatively good validity (content validity ratio for content validity: 0.888; success rate of item convergent and discriminant validity: 100%, and significant correlation coefficient with burnout (r = 0.115–0.83, p < 0.05) and depression (r = 0.098–0.348, p < 0.05) with the exception of Organizational Violence Protection System for Workplace Violence) and reliability (Cronbach’s alpha: 0.827–0.860). The reference values for determining risk groups according to the intensity of exposure to workplace violence are presented separately by sex.
Conclusions
KWVS®13 is a robust and useful measurement tool to objectively and quantitatively assess the intensity and magnitude of workplace violence. It incorporates important considerations for workplace violence assessment and provides a reliable framework for evaluating workplace violence in various professional settings.
8.Development of standard job classification codes for building a job-exposure matrix for police officers
Sangjun CHOI ; Ju-Hyun PARK ; Inah KIM ; Jungwon JANG ; Jeehee MIN ; Sang Baek KOH ; Seongwon KIM ; Yeji SUNG ; Kyoung Yoon KO ; Su Min OH ; Un-Yeol JEON
Annals of Occupational and Environmental Medicine 2025;37(1):e10-
Background:
This study aimed to develop standard job categories for constructing a job-exposure matrix (JEM) for police officers in South Korea and to evaluate their applicability.
Methods:
We examined standard job codes related to police personnel management and compared them with job classifications from police publications. Using R Shiny, we developed a web-based search tool for standard codes. A pilot survey of 130 police officers assessed the codes' applicability and relevance to health-related hazardous factors.
Results:
Eighty-seven standard functional codes used in the police personnel management system POOL were organized into minor categories as the basic units of standard jobs. These were grouped into 20 sub-major categories and further consolidated into 10 major categories to develop the standard job codes. The responses to the standard job codes in the pilot survey were 75% accurate compared with the final expert evaluation results and 99.2% accurate compared with the algorithm-based automatic allocation results. The results of the job-hazardous factor network analysis revealed that the most frequently reported hazardous factor was emotional labor, followed by night shifts and electromagnetic waves. Emotional labor was identified as the top hazardous factor in six out of the nine standard job categories.
Conclusions
The standard job codes developed in this study were designed in connection with the personnel management system for police officers, making them well-suited for constructing a comprehensive JEM for the entire police force.
9.List of occupational diseases among farmers in Korea: a literature review
Hansoo SONG ; Seok-Ju YOO ; Won-Ju PARK ; Seunghyeon CHO ; Ki Soo PARK ; Joo Hyun SUNG ; Sang Jin PARK ; Seong-yong YOON ; Kyeongsoo KIM ; Dong-phil CHOI ; Hye-min KIM ; Bounggyun JU ; Kanwoo YOUN
Annals of Occupational and Environmental Medicine 2025;37(1):e2-
A comprehensive list of occupational diseases among farmers is crucial for both compensation and prevention efforts. In Korea, most farmers are self-employed, and some occupational diseases are compensated through farmer safety insurance. However, it is not harmonized with industrial accident compensation insurance and does not adequately reflect the true burden of occupational diseases among farmers. To address this gap, the authors compiled a list of occupational diseases tailored to Korean farmers by reviewing the International Labor Organization’s list of occupational diseases, the Korean Industrial Accident Compensation Insurance List, the occupational disease lists of other countries, and relevant literature on farmers’ work-related diseases.
10.A Study on the Healthcare Workforce and Care for Acute Stroke: Results From the Survey of Hospitals Included in the National Acute Stroke Quality Assessment Program
Jong Young LEE ; Jun Kyeong KO ; Hak Cheol KO ; Hae-Won KOO ; Hyon-Jo KWON ; Dae-Won KIM ; Kangmin KIM ; Myeong Jin KIM ; Hoon KIM ; Keun Young PARK ; Kuhyun YANG ; Jae Sang OH ; Won Ki YOON ; Dong Hoon LEE ; Ho Jun YI ; Heui Seung LEE ; Jong-Kook RHIM ; Dong-Kyu JANG ; Youngjin JUNG ; Sang Woo HA ; Seung Hun SHEEN
Journal of Korean Medical Science 2025;40(16):e44-
Background:
With growing elderly populations, management of patients with acute stroke is increasingly important. In South Korea, the Acute Stroke Quality Assessment Program (ASQAP) has contributed to improving the quality of stroke care and practice behavior in healthcare institutions. While the mortality of hemorrhagic stroke remains high, there are only a few assessment indices associated with hemorrhagic stroke. Considering the need to develop assessment indices to improve the actual quality of care in the field of acute stroke treatment, this study aims to investigate the current status of human resources and practices related to the treatment of patients with acute stroke through a nationwide survey.
Methods:
For the healthcare institutions included in the Ninth ASQAP of the Health Insurance Review and Assessment Service (HIRA), data from January 2022 to December 2022 were collected through a survey on the current status and practice of healthcare providers related to the treatment of patients with acute stroke. The questionnaire consisted of 19 items, including six items on healthcare providers involved in stroke care and 10 items on the care of patients with acute stroke.
Results:
In the treatment of patients with hemorrhagic stroke among patients with acute stroke, neurosurgeons were the most common providers. The contribution of neurosurgeons in the treatment of ischemic stroke has also been found to be equivalent to that of neurologists. However, a number of institutions were found to be devoid of healthcare providers who perform definitive treatments, such as intra-arterial thrombectomy for patients with ischemic stroke or cerebral aneurysm clipping for subarachnoid hemorrhage. The intensity of the workload of healthcare providers involved in the care of patients with acute stroke, especially those involved in definitive treatment, was also found to be quite high.
Conclusion
Currently, there are almost no assessment indices specific to hemorrhagic stroke in the ASQAP for acute stroke. Furthermore, it does not reflect the reality of the healthcare providers and practices that provide definitive treatment for acute stroke. The findings of this study suggest the need for the development of appropriate assessment indices that reflect the realities of acute stroke care.

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