Background: To evaluate the health status of healthcare workers (doctors and nurses) compared to those in the general population based on the National Health Insurance Service database and the cause of death data from Statistics Korea. Methods: The subjects of this study were 104,484 doctors and 220,310 nurses working in healthcare facilities from 2002 to 2017, and who had undergone at least one general medical examination. Based on the subject definition, the subject data were extracted from the National Health Insurance healthcare facility database and qualification database. We collected medical use details included in the research database, general medical examination results, medical history included in the health examination database, and additional data on the cause of death from the National Statistics database to analyze the main cause of death and mortality. Results: In terms of the major causes of death and mortality among healthcare workers, the mortality rate associated with intentional self-harm, injury, transportation accident, heart disease, addiction, and falling was significantly higher than that in the general population. Further, the prevalence of respiratory and gastrointestinal diseases was high. When analyzing the proportional mortality ratio (PMR) by cause of death for healthcare workers, the PMR values for death related to malignant neoplasm was the highest. In terms of diseases, both doctors and nurses had higher rates of infectious diseases such as maternal sepsis, rubella, and measles. Conclusion The health status of healthcare workers differs from that of the general population. Thus, it is important to consider the occupational characteristics of healthcare personnel. This study is unique in that it was conducted based on medical use indicators rather than survey data.

Purpose: This study aimed to compare the clinical outcomes of laparoscopic appendectomy (LA) according to the method of appendiceal stump closure. Methods: Patients who underwent LA for appendicitis between 2010 and 2020 were retrospectively reviewed. Patients were classified into locking polymeric clip (LPC) and loop ligature (LL) groups. Clinical outcomes were compared between the groups. Results: LPC and LL were used in 188 (56.6%) and 144 patients (43.4%), respectively for appendiceal stump closure. No significant differences were observed in sex, age, comorbidities, and the severity of appendicitis between the groups. The median operative time was shorter in the LPC group than in the LL group (64.5 minutes vs. 71.5 minutes, P=0.027). The median hospital stay was longer in the LL group than in the LPC group (4 days vs. 3 days, P=0.020). Postoperative incidences of intraabdominal abscess and ileus were higher in the LL group than in the LPC group (4.2% vs. 1.1%, P=0.082 and 2.8% vs. 0%, P=0.035; respectively). The readmission rate was higher in the LL group than that in the LPC group (6.3% vs. 1.1%, P=0.012). Conclusion Using LPC for appendiceal stump closure during LA for appendicitis was associated with lower postoperative complication rate, shorter operative time, and shorter hospital stay compared to the use of LL. Operative time above 60 minutes and the use of LL were identified as independent risk factors for postoperative complications in LA. Therefore, LPC could be considered a more favorable closure method than LL during LA for appendicitis.

BACKGROUND: Thymoglobulin has been used for induction therapy to prevent acute rejection and delayed graft function (DGF) in kidney transplant patients. However, the usual dose of thymoglobulin is considered to be related with frequent infection. We compared the efficacy and safety of low-dose thymoglobulin to high-dose treatment in high risk recipients with kidney transplantation. METHODS: Twenty-one kidney transplant recipients underwent induction treatment with thymoglobulin and were divided into two groups: patients treated with low-dose (<6.0 mg/kg) and high-dose thymoglobulin (≥6.0 mg/kg). All patients showed one or more risk factors for acute rejection or DGF. The risk factors were re-transplantation, recipient or donor age over 60 years, human leukocyte antigen full mismatch, and panel-reactive antibody more than 50%. We compared incidence of acute rejection, infection, hematologic complications, and graft survival between two groups. RESULTS: The demographic characteristics of the two groups were comparable. Mean follow-up duration was 11.9±4.3 months, and cumulative thymoglobulin dosage was 6.3±1.6 mg/kg. The incidence rates of acute antibody-mediated rejection (AMR), DGF and infectious events as cytomegalovirus disease, or urinary tract infection were not significantly different between the two groups. Neutropenia occurred more frequently in the high-dose thymoglobulin group, but there was no statistically significant difference. The rate of graft loss were similar between the two groups. CONCLUSIONS: There were no differences in graft survival, infectious disease, and hematologic problems between the two groups. We suggest to lower the dose of thymoglobulin to less than 6 mg/kg for prevent acute AMR and DGF in high risk patients.
Communicable Diseases ; Cytomegalovirus ; Delayed Graft Function ; Follow-Up Studies ; Graft Survival ; Humans ; Immunosuppressive Agents ; Incidence ; Kidney Transplantation ; Kidney* ; Leukocytes ; Neutropenia ; Risk Factors ; Tissue Donors ; Transplant Recipients* ; Transplants ; Urinary Tract Infections

BACKGROUND: Glycopyrrolate given as reversing agents of muscle relaxants has been reported to be effective in reducing postoperative catheter-related bladder discomfort (CRBD). However, it remains unclear whether glycopyrrolate as premedication is also effective. This study aims to investigate the effectiveness of glycopyrrolate as premedication on preventing CRBD in the post-anesthesia care unit (PACU). METHODS: Eighty-three patients who received elective ureteroscopic removal of ureteral stone were randomly assigned to the control (n = 43) or the glycopyrrolate group (n = 40). The glycopyrrolate group was treated with glycopyrrolate 0.3 mg as premedication while the control group received 0.9% saline 1.5 ml. The incidence and severity of CRBD and pain score using numerical rating scale (NRS) were measured in the PACU. RESULTS: The incidence of CRBD (26 of 40 patients vs. 41 of 43 patients, relative risk [RR] = 0.68, 95% Confidence interval [CI] = 0.53–0.86, P = 0.001) and the moderate to severe CRBD incidence (6 of 40 patients vs. 20 of 43 patients, RR = 0.32, 95% CI = 0.14–0.72, P = 0.002) were lower in the glycopyrrolate group than in the control group. Also, postoperative pain NRS score was found to be lower in the glycopyrrolate group (median = 1 [Q1 = 0, Q3 = 2]) compared to the control group (3 [1, 5], median difference = 1.00, 95% CI = 0.00–2.00, P = 0.002). CONCLUSIONS: The use of glycopyrrolate 0.3 mg as premedication in patients receiving ureteroscopic removal of ureteral stone reduced the incidence and severity of CRBD, and decreased postoperative pain in the PACU.
Glycopyrrolate* ; Humans ; Incidence ; Pain, Postoperative ; Premedication* ; Ureter* ; Ureteroscopy ; Urinary Bladder* ; Urinary Catheterization

BACKGROUND: Kidney transplantation (KT) is the treatment of choice for end-stage renal disease patients. The spouse is a major donor in living KT. Clinical outcomes of spousal donor KT are not inferior to those of living related donor KT. In this study, we compared clinical outcomes between ABO-compatible (ABOc) and ABO-incompatible (ABOi) spousal donor KTs. METHODS: Thirty-two cases of spousal donor KT performed from January 2011 to August 2013 were analyzed retrospectively. Twenty-one ABOc KTs and 11 ABOi KTs were performed. We investigated patient survival, graft survival, acute rejection, graft function, and complications. RESULTS: During follow-up, patient and graft survival rates were 100% in both groups. There were no significant differences in the incidence of delayed graft function, acute rejection, and the change in graft function between the 2 groups. Medical and surgical complications were not significantly different between the groups. CONCLUSION: The clinical outcomes of ABOc and ABOi spousal donor KTs were equivalent. In ABOi KT, an emotionally motivated spousal donor KT may be a good alternative to the problem of the absolute shortage of kidney donations.
Blood Group Incompatibility ; Delayed Graft Function ; Follow-Up Studies ; Graft Rejection ; Graft Survival ; Humans ; Incidence ; Kidney Failure, Chronic ; Kidney Transplantation* ; Kidney* ; Retrospective Studies ; Spouses ; Tissue Donors* ; Transplants

Calf losses have an economic impact on larger Korean native cattle (KNC) breeding farms due to replacement, productivity, and marketing. However, little research on KNC calf mortality or causes of calf death on large-scale breeding farms has been conducted. Based on medical records and autopsy findings from the Hanwoo experimental station of the National Institute of Animal Science, calf death records from 2002 to 2011 were used to identify the causes of mortality. Mortality rate of KNC calves was 5.7%. Large differences (1.8~12.6%) in year-specific mortalities were observed. Calf deaths were due to digestive diseases (68.7%), respiratory diseases (20.9%), accidents (6.0%), and other known diseases (2.2%). The main cause of calf death was enteritis followed by pneumonia, rumen indigestion, and intestinal obstruction. The greatest number of calf deaths occurred during the fall followed by summer. These results indicated that enteritis and pneumonia were the main reasons for calf death. However, autopsy findings demonstrated that other factors also caused calf death. This study suggested that seasonal breeding and routine vaccinations are the most important factors for preventing calf death, and improving calf health in high land areas with low temperature.
Animals ; Autopsy ; Breeding* ; Cattle ; Death Certificates ; Dyspepsia ; Efficiency ; Enteritis ; Intestinal Obstruction ; Marketing ; Medical Records ; Mortality* ; Pneumonia ; Rumen ; Seasons ; Vaccination

STUDY DESIGN: This is a retrospective study. OBJECTIVES: The purpose of this study is to confirm the clinical usefulness of utilizing ProSet imaging for checking the nerve root compression and swelling in extraforaminal disc herniation. SUMMARY OF LITERATURE REVIEW: Diagnosing extraforaminal disc herniations can be neglected with using a conventional MRI. MATERIALS AND METHODS: A retrospective analysis was performed on 25 patients, who underwent both conventional & Principles of the selective excitation technique (ProSet) MR imaging for the evaluation of extraforaminal disc herniation, from April 2008 to October 2010. Radiographic analysis was based on the notion that the degree of nerve root compression and swelling was decided by Pfirrmann's classification. RESULTS: Severe compression in the ProSet 3D rendering image was observed in 21 subjects, as compared with 8 subjects in the conventional axial image. Especially, nothing was ever detected in the conventional sagittal image. Severe compression in the ProSet 3D rendering image was observed in 4 subjects, while their nerve root compression was not clear in the conventional axial image. Severe compression and severe swelling in the ProSet 3D & coronal image was observed in 15 subjects, while their nerve root compression was none or not clear in the conventional sagittal image. The swelling degree of the ProSet coronal image turned out bigger than the swelling degree of conventional axial image, and the signal intensity change was also obvious. CONCLUSIONS: ProSet imaging is regarded useful to investigate the symptom triggering nerves, because ProSet image not only observes better nerve root compression, but also identifies the swelling degree more easily than that of the conventional magnetic resonance imaging (MRI).
Humans ; Magnetic Resonance Imaging ; Radiculopathy ; Retrospective Studies

BACKGROUND: This study was conducted in order to evaluate the propriety of expanded donor criteria in Korea and to identify the preoperative factors influencing allograft survival and function. METHODS: We studied 404 patients who received deceased renal transplants from five transplantation centers of 2, 3 territory from 2000 to 2010. Differences in 1-year graft function, delayed graft function (DGF) rate, and graft survival rate between the standard criteria donor (SCD) and expanded criteria donor (ECD) were compared retrospectively. The preoperative factors influencing graft function and graft survival were analysed. RESULTS: SCD showed significantly better 1-year graft function than ECD (P=0.011). No differences in 1-year acute rejection rate were observed between SCD (13.2%) and ECD (16.9%) (P=0.449). Significantly higher DGF rate was observed for ECD (25.4%) than for SCD (14.1%) (P=0.022). Graft type had no significant influence on 5-year graft survival (SCD 94.5% vs. ECD 93.7%) (P =0.835). Advanced donor age (P=0.001), donor hypertension history (P=0.047), high serum creatinine (P=0.002), and cerebral infarction as cause of death (P=0.004) had a negative influence on 1-year allograft function. Significantly low graft survival was observed for advanced donor age (P =0.002). CONCLUSIONS: Graft function, DGF rates of ECD were poorer than those of SCD. Graft survival rate of ECD was comparable to that of SCD kidney. Korean Network for Organ Sharing expanded criteria may underestimate the organ quality of deceased kidney and modification may be needed in order to expand the potential donor pool through nationwide study.
Cause of Death ; Cerebral Infarction ; Creatinine ; Delayed Graft Function ; Graft Survival ; Humans ; Hypertension ; Kidney ; Kidney Transplantation* ; Korea ; Retrospective Studies ; Survival Rate ; Tissue Donors* ; Transplantation, Homologous ; Transplants

PURPOSE: To compare clinical outcomes of the tumor prosthetic replacement and osteosynthetic fixation for pathologic fracture of skeletal metastatic lesion of the proximal femur. MATERIALS AND METHODS: From 1994 May to 2009 May, medical records of 22 patients who underwent tumor prosthetic replacement with tumor resection (group 1) and 15 others (16 hips) who underwent osteosynthetic fixation without tumor resection (group 2) were reviewed. The mean age of overall patients were 59 (group 1) and 60 (group 2). Mean follow up periods were 23 and 11 months. The oncological and functional results were evaluated with Kaplan-Meier methods and Musculoskeletal Tumor Society (MSTS) scoring system, 1993. The statistical evaluation was assessed with Log rank test and t-test. RESULTS: The mean survival periods were 24 months in group 1 and 11months in group 2. The 1 year survival rates were 86% in group 1 and 50 % in group 2, and 2 year survival rates were 29.7% in group 1 and 9.4% in group 2. The mean MSTS functional score were 26.4 (19-30), 87.9% in group 1 and 15.3 (10-23), 51.0% in group 2. CONCLUSION: The results of tumor resection and prosthetic replacement in selected cases was better than osteosynthetic fixation without tumor resection for metastatic bone tumors around proximal femur in oncological and functional aspects.
Femur ; Follow-Up Studies ; Fractures, Spontaneous ; Humans ; Joints ; Medical Records ; Survival Rate

PURPOSE: This study was designed to evaluate the treatment results of malignant melanoma and to analyze the factors influencing prognosis. MATERIALS AND METHODS: Thirty one cases of malignant melanoma were included in this study. They were treated in our hospital surgically, medically and immunologically from January 1996 to December 2005, and were followed more than 5 years. We compared 5 year survival rate (5YSR) according to the age, gender, anatomical site, depth of tumor, TNM stage, involvement of lymph node and immuno-chemotherapy. RESULTS: Overall 5YSR was 80.6%. 5YSR of the age group below 65 years was 89.7% and 66.7% for the age group over 65 (p=0.033). 5YSR for men was 75% and 90.9% for women. 5YSR according to the site of occurrence showed 66.7% in upper extremities, 89.5% in lower extremities, and 66.7% in other site. 5YSR was 100% for the Clark level below III and 62.5% for the level above IV (p=0.032). 5YSR was 53.8% for lymph node metastasis group and 100% for non-lymph node metastasis group (p=0.021). CONCLUSION: We concluded that early diagnosis and wide excision was the most important in treatment of malignant melanoma. The prognostic fractors of malignant melanoma were age, depth of tumor (Clark's stage) and metastasis of lymph node.
Early Diagnosis ; Female ; Humans ; Lower Extremity ; Lymph Nodes ; Male ; Melanoma ; Neoplasm Metastasis ; Survival Rate ; Upper Extremity