Background: We investigated the changing patterns of insulin secretion and resistance and risk factors contributing to the development of post-transplant diabetes mellitus (PTDM) in kidney recipients under tacrolimus-based immunosuppression regimen during 1 year after transplantation. Methods: This was a multicenter prospective cohort study. Of the 168 subjects enrolled in this study, we analyzed a total 87 kidney transplant recipients without diabetes which was assessed by oral glucose tolerance test before transplantation. We evaluated the incidence of PTDM and followed up the index of insulin secretion (insulinogenic index [IGI]) and resistance (homeostatic model assessment for insulin resistance [HOMA-IR]) at 3, 6, 9 months, and 1 year after transplantation by oral glucose tolerance test and diabetes treatment. We also assessed the risk factors for incident PTDM. Results: PTDM developed in 23 of 87 subjects (26.4%) during 1 year after transplantation. More than half of total PTDM (56.5%) occurred in the first 3 months after transplantation. During 1 year after transplantation, insulin resistance (HOMA-IR) was increased in both PTDM and no PTDM group. In no PTDM group, the increase in insulin secretory function to overcome insulin resistance was also observed. However, PTDM group showed no increase in insulin secretion function (IGI). Old age, status of prediabetes and episode of acute rejection were significantly associated with the development of PTDM. Conclusion In tacrolimus-based immunosuppressive drugs regimen, impaired insulin secretory function for reduced insulin sensitivity contributed to the development of PTDM than insulin resistance during 1 year after transplantation.

The Shprintzen–Goldberg syndrome (SGS) is an extremely rare genetic disorder caused by heterozygous variant in SKI . SGS is characterized by neurodevelopmental impairment with skeletal anomaly. Recognition of SGS is sometimes quite challenging in practice because it has diverse clinical features involving skeletal, neurological, and cardiovascular system. Here we report a case of a 6-month-old boy who initially presented with developmental delay and marfanoid facial features including prominent forehead, hypertelorism, high arched palate and retrognathia. He showed motor developmental delay since birth and could not control his head at the time of first evaluation. His height was above 2 standard deviation score. Arachnodactyly, hypermobility of joints, skin laxity, and pectus excavatum were also noted. Sequencing for FBN1 was negative, however, a novel missense variant, c.350G>A in SKI was identified by sequential whole exome sequencing. To our knowledge, this is the first case with SGS with phenotypic features of SGS overlapping with those of the Marfan syndrome, diagnosed by next generation sequencing in Korea.

BACKGROUND: The aim of this study was to evaluate the awareness of occupational hazards and personal protective equipment use among dental hygienists (DHs).METHODS: A total of 271 self-administered questionnaires were obtained from 280 DHs working at dental hospitals or clinics in Daegu and Gyeongsangbuk-do, Korea.RESULTS: The occupational hazards included work involving dust (94.1%), volatile substances (86.0%), noise (97.0%), and light-curing units (96.7%). The proportion of dental hygiene tasks that participants perceived as harmful were 42.4%, 51.7%, 9.2%, and 31.4% in the same order as above. The proportion of participants who used dust-proof masks during work involving dust was 1.1%. Those who wore gas-proof masks and gloves for work using volatile substances were 0.7% and 31.2%, respectively. Participants who used goggles for work involving light-curing units were 31.0%. None of the participants used ear plugs for work involving noise. A total of 22.9% of the participants recognized the Material Safety Data Sheet, while 79.7% had never been educated about harmful work environments.CONCLUSION: When compared to exposure status and perception of occupational hazards, the level of protective equipment use was very low. Extra measures to increase DHs’ use of personal protective equipment are necessary.
Daegu ; Dental Hygienists ; Dust ; Ear ; Eye Protective Devices ; Gyeongsangbuk-do ; Humans ; Korea ; Masks ; Material Safety Data Sheets ; Noise ; Occupations ; Oral Hygiene ; Personal Protective Equipment

BACKGROUND: Research on the emotional labor of firefighters is actively being carried out, but studies that analyze emotional labor separately by job types, working departments, and other conditions of firefighters are insufficient. The purpose of this study is to investigate the difference in emotional labor level between departments and other conditions of firefighters. METHODS: A total of 287 Korean firefighters were included for analysis. The demands of emotional labor and emotional damage were measured using the Korean Emotional Labor Scale. To analyze the conditions and factors affecting the emotional labor level of the firefighters, logistic regression analysis was performed using the emotional labor high risk group as a dependent variable. RESULTS: The average score of overall emotional labor level of the firefighters was 47.2 ± 17.3, and the prevalence of high risk firefighters with emotional labor was 27.1%. It was found that the emergency medical service and administration departments showed a higher prevalence of high risk emotional labor firefighters than did other departments. The result of multiple logistic regression analysis for the high risk emotional labor firefighters showed that the adjusted odds ratio of emergency medical service department compared to the reference group (the rescue department) was 2.89 (95% confidence interval [CI]: 1.02–8.24). CONCLUSIONS: Among the firefighters, the emergency medical service department is a high risk factor for emotional labor. Therefore, education and prevention training on emotional labor should be more thorough before work shifts.
Daegu ; Education ; Emergency Medical Services ; Firefighters ; Humans ; Logistic Models ; Male ; Odds Ratio ; Prevalence ; Risk Factors

BACKGROUND AND PURPOSE: To investigate whether appointing a full-time neurointensivist to manage a closed-type neurological intensive care unit (NRICU) improves the quality of critical care and patient outcomes. METHODS: This study included patients admitted to the NRICU at a university hospital in Seoul, Korea. Two time periods were defined according to the presence of a neurointensivist in the preexisting open-type NRICU: the before and after periods. Hospital medical records were queried and compared between these two time periods, as were the biannual satisfaction survey results for the families of patients. RESULTS: Of the 15,210 patients in the neurology department, 2,199 were admitted to the NRICU (n=995 and 1,204 during the before and after periods, respectively; p<0.001). The length of stay was shorter during the after than during the before period in both the NRICU (3 vs. 4 days; p<0.001) and the hospital overall (12.5 vs. 14.0 days; p<0.001). Neurological consultations (2,070 vs. 3,097; p<0.001) and intrahospital transfers from general intensive care units to the NRICU (21 vs. 40; p=0.111) increased from the before to after the period. The mean satisfaction scores of the families of the patients also increased, from 78.3 to 89.7. In a Cox proportional hazards model, appointing a neurointensivist did not result in a statistically significant change in 6-month mortality (hazard ratio, 0.82; 95% confidence interval, 0.652–1.031; p=0.089). CONCLUSIONS: Appointing a full-time neurointensivist to manage a closed-type NRICU had beneficial effects on quality indicators and patient outcomes.
Critical Care Outcomes ; Critical Care ; Humans ; Intensive Care Units ; Korea ; Length of Stay ; Medical Records ; Mortality ; Neurology ; Proportional Hazards Models ; Referral and Consultation ; Seoul

BACKGROUND: The aim of this study was to evaluate the awareness of occupational hazards and personal protective equipment use among dental hygienists (DHs). METHODS: A total of 271 self-administered questionnaires were obtained from 280 DHs working at dental hospitals or clinics in Daegu and Gyeongsangbuk-do, Korea. RESULTS: The occupational hazards included work involving dust (94.1%), volatile substances (86.0%), noise (97.0%), and light-curing units (96.7%). The proportion of dental hygiene tasks that participants perceived as harmful were 42.4%, 51.7%, 9.2%, and 31.4% in the same order as above. The proportion of participants who used dust-proof masks during work involving dust was 1.1%. Those who wore gas-proof masks and gloves for work using volatile substances were 0.7% and 31.2%, respectively. Participants who used goggles for work involving light-curing units were 31.0%. None of the participants used ear plugs for work involving noise. A total of 22.9% of the participants recognized the Material Safety Data Sheet, while 79.7% had never been educated about harmful work environments. CONCLUSION When compared to exposure status and perception of occupational hazards, the level of protective equipment use was very low. Extra measures to increase DHs’ use of personal protective equipment are necessary.

BACKGROUND: The Korean Computerized Neurobehavioral Test (KCNT) is a psychological assessment tool used as part of Workers’ Special Health Examinations in Korea. Due to the spread of mobile technology, this study aimed to compare results of the KCNT administered on a tablet PC versus a desktop computer, and, therefore, assess the clinical applicability of mobile devices. METHODS: A total of 72 participants enrolled in this study. Their age, sex, and years of formal education were collected during an interview, as well as their typing speed. The test battery comprised five subtests: Simple Reaction Time test, Choice Reaction Time test, Digit Addition test, Symbol-Digit Substitution test, and Finger Tapping Speed test. Participants repeated the KCNT test battery in a randomly assigned order using four different testing systems: a desktop computer equipped with a conventional 106-key keyboard (System 1), a desktop computer equipped with a simplified keyboard (System 2), a tablet PC with a simplified 17-key on-screen keyboard (System 3), and a tablet PC equipped with a simplified keyboard (System 4). RESULTS: Results of the Digit Addition test did not differ significantly for different testing systems. In contrast, results of the Simple Reaction Time test, Choice Reaction Time test, Symbol-Digit Substitution test, and Finger Tapping test were lower for the tablet PC (Systems 3 and 4) compared to the desktop computer (Systems 1 and 2). Systems 1 and 2 did not show significantly different results. Performance on System 3 was inferior to that on System 4, only for the Choice Reaction Time test and Finger Tapping Speed test. There were also significant differences in performance by computer familiarity when adjusted for age and education; however, the performance of each group on the test systems showed similar patterns. CONCLUSIONS: It is not recommended to use a tablet PC to administer the KCNT to evaluate neurobehavioral performance for the Simple Reaction Time test and Choice Reaction Time test; however, tablet PCs with an on-screen keyboard may be used to perform the Digit Addition test, and the Symbol-Digit Substitution test and Finger Tapping Speed test to a limited degree.
Education ; Fingers ; Korea ; Reaction Time ; Recognition (Psychology)

BACKGROUND: Shark meat is used as sacrificial food in Gyeongsangbuk-do, and is a major source of dietary mercury. This study aimed to evaluate the effects of shark meat intake or the ritual of Jesa on blood mercury levels within workers living in Gyeongsangbuk-do. METHODS: This study was conducted from September 2016 to October 2016 in two cities of Gyeongsangbuk-do. To compare the differences between urban and rural areas, two workplaces each in Daegu as the urban area and Yeongcheon as the rural area were selected. General characteristics and characteristics related to shark meat consumption of the workers were acquired by personal interviews during their health examination. Blood mercury concentrations were analyzed by the gold amalgamation method using a direct mercury analyzer (DMA-80; Milestone Inc., Shelton, CT, USA). RESULTS: The shark consumption group had a higher blood mercury concentration than the non-consumption group. The levels of blood mercury increased with the frequency, annual intake, as well as most recent date of shark meat consumption. Moreover, the levels of mercury in blood increased according to the annual frequency of participation in Jesa (times per year) and the annual frequency of shark meat consumption during Jesa (times per year). CONCLUSIONS: Shark meat intake and the ritual of Jesa contributed to an increase in the blood mercury levels of workers in Gyeongsangbuk-do. Therefore, it is necessary to evaluate dietary exposure, occupational as well as other factors that may influence blood mercury concentrations in workers during their health examination, particularly in regions with high mercury exposures.
Daegu ; Gyeongsangbuk-do* ; Humans ; Meat* ; Methods ; Occupational Exposure ; Sharks*

BACKGROUND: Arsenic is a carcinogenic heavy metal that has a species-dependent health effects and abandoned metal mines are a source of significant arsenic exposure. Therefore, the aims of this study were to analyze urinary arsenic species and their concentration in residents living near abandoned metal mines and to monitor the environmental health effects of abandoned metal mines in Korea. METHODS: This study was performed in 2014 to assess urinary arsenic excretion patterns of residents living near abandoned metal mines in South Korea. Demographic data such as gender, age, mine working history, period of residency, dietary patterns, smoking and alcohol use, and type of potable water consumed were obtaining using a questionnaire. Informed consent was also obtained from all study subjects (n = 119). Urinary arsenic species were quantified using high performance liquid chromatography (HPLC) and inductively coupled plasma mass spectrometry (ICP/MS). RESULTS: The geometric mean of urinary arsenic (sum of dimethylarsinic acid, monomethylarsonic acid, As3+, and As5+) concentration was determined to be 131.98 μg/L (geometric mean; 95% CI, 116.72–149.23) while urinary inorganic arsenic (As3+ and As5+) concentration was 0.81 μg/L (95% CI, 0.53–1.23). 66.3% (n = 79) and 21.8% (n = 26) of these samples exceeded ATSDR reference values for urinary arsenic (>100 μg/L) and inorganic arsenic (>10 μg/L), respectively. Mean urinary arsenic concentrations (geometric mean, GM) were higher in women then in men, and increased with age. Of the five regions evaluated, while four regions had inorganic arsenic concentrations less than 0.40 μg/L, one region showed a significantly higher concentration (GM 15.48 μg/L; 95% CI, 7.51–31.91) which investigates further studies to identify etiological factors. CONCLUSION: We propose that the observed elevation in urinary arsenic concentration in residents living near abandoned metal mines may be due to environmental contamination from the abandoned metal mine. TRIAL REGISTRATION: Not Applicable (We do not have health care intervention on human participants).
Arsenic* ; Cacodylic Acid ; Chromatography, Liquid ; Delivery of Health Care ; Drinking Water ; Environmental Health ; Female ; Humans ; Informed Consent ; Internship and Residency ; Korea* ; Male ; Mass Spectrometry ; Plasma ; Reference Values ; Smoke ; Smoking

BACKGROUND: It is thought that computer familiarity has increased significantly since 2004 as well as the use of computers. This study aimed to evaluate the effects of computer familiarity and types of keyboard and computer on the performance of the Korean computerized neurobehavioral test (KCNT), and to identify which parameters of KCNT were affected by aforementioned factors. METHODS: A total of 85 subjects were classified into three groups of computer familiarity by Korean typing speed. Their age, gender and the level of education were also collected. The parameters of KCNT included simple reaction time, choice reaction time, addition, symbol digit, and finger tapping speed. The test was conducted using three types of computers: a laptop computer, a laptop computer with a simplified keyboard, and a desktop computer with a simplified keyboard. RESULTS: Parameters including the simple reaction time, choice reaction time, addition, and symbol digit, and the finger tapping speed of non-dominant hand showed no significant differences in the results among the three groups by computer familiarity after age and educational years were controlled as covariates. The mean reaction time of the simple reaction time and the choice reaction time with a simplified keyboard was significantly shorter compared to that with a typical keyboard. With regard to type of computer, the mean reaction time of the simple reaction time and the choice reaction time was significantly reduced when performed with the desktop computer with a simplified keyboard. CONCLUSIONS: Unlike previous study results, the choice reaction time, the addition, and the finger tapping speed of dominant hand were the only parameters affected by the computer familiarity. Both the type of keyboard and the type of computer significantly influenced the simple reaction time and the choice reaction time. Therefore, it is recommended to use a desktop computer with a simplified keyboard for such parameters.
Education ; Fingers ; Hand ; Reaction Time ; Recognition (Psychology)*