Analysis of causes of injuries among children in Daegu, Korea

PurposeThe purpose of this study was to determine the mechanisms and exact causes of injuries to children by analyzing the medical records of children who visited emergency medical centers.MethodsWe reviewed the medical records of 7,114 pediatric patients (aged below 15 years) who visited the emergency care center (ECC) of a Yeungnam university hospital in Daegu between January 2007 and December 2009.ResultsAmong the pediatric patients who visited the ECC, 1,526 (27.2%) were admitted for injuries (boys, 979 [64.2%] and girls, 547 [35.8%]); the boy-to-girl ratio in this study population was 1.8:1. The proportion of boys was higher than that of girls over all age ranges, except for children aged less than 1 year. The highest incidence of injury due to slipping (20.5%) was noted in the 1-year-old group, and nearly half the total number of cases (49.3%) involved children who were under 4 years of age. Of the sites of injury, 999 involved the head and face (73.7%) and 134 involved the hand and wrist (9.9%). Seventy-one injuries (5.7%) occurred on the bed, 70 (5.6%) at the door, and 67 (5.3%) on the stairs. Of the approximately 250 types of injuries classified by cause, 17 accounted for 50.4% of all the injuries.ConclusionThe cause of injury could be attributed to approximately 20 causes in more than half the cases of pediatric injuries. A classification of the types of injuries and the development of appropriate preventive strategies can help avoid such injuries

Rates and subsequent clinical course of fetal congenital anomalies detected by prenatal targeted ultrasonography of 137 cases over 5 years in a single institute: a retrospective observational study

Background With the establishment of international guidelines and changes in insurance policies in Korea, the role of targeted ultrasonography has increased. This study aimed to identify the rates and clinical course of anomalies detected using prenatal targeted ultrasonography. Methods This study was a retrospective analysis of all pregnancies with targeted ultrasonography performed in a single secondary medical center over 5 years. Results Fetal anomalies were detected by targeted ultrasonography in 137 of the 8,147 cases (1.7%). The rates of anomalies were significantly higher in female fetuses (2.0% vs. 1.3%). In cases of female fetuses, the rate of anomalies was significantly higher in the advanced maternal age group (2.4% vs. 1.2%). In cases of male fetuses, the rate of anomalies was significantly higher in nulliparous (2.4% vs. 1.5%) and twin (5.7% vs. 1.9%) pregnancies. Pulmonary anomalies were significantly more common in the multiparity group (17.6% vs. 5.8%). Among the 137 cases, 17.5% terminated the pregnancy, 16.8% were diagnosed as normal after birth, and 42.3% were diagnosed with anomalies after birth or required follow-up. Conclusion Through the first study on the rates and clinical course of anomalies detected by targeted ultrasonography at a single secondary center in Korea, we found that artificial abortions were performed at a high rate, even for relatively mild anomalies or anomalies with good prognosis. We suggest the necessity of a nationwide study to establish clinical guidelines based on actual incidences or prognoses

Prefrontal functional connectivity analysis of cognitive decline for early diagnosis of mild cognitive impairment: A functional near-infrared spectroscopy study

Cognitive decline (CD) is a major symptom of mild cognitive impairment (MCI). Patients with MCI have an increased likelihood of developing Alzheimer's disease (AD). Although a cure for AD is currently lacking, medication therapies and/or daily training in the early stage can alleviate disease progression and improve patients' quality of life. Accordingly, investigating CD-related biomarkers via brain imaging devices is crucial for early diagnosis. In particular, “portable” brain imaging devices enable frequent diagnostic checks as a routine clinical tool, and therefore increase the possibility of early AD diagnosis. This study aimed to comprehensively investigate functional connectivity (FC) in the prefrontal cortex measured by a portable functional near-infrared spectroscopy (fNIRS) device during a working memory (WM) task known as the delayed matching to sample (DMTS) task. Differences in prefrontal FC between healthy control (HC) (n = 23) and CD groups (n = 23) were examined. Intra-group analysis (one-sample t-test) revealed significantly greater prefrontal FC, especially left- and inter-hemispheric FC, in the CD group than in the HC. These observations could be due to a compensatory mechanism of the prefrontal cortex caused by hippocampal degeneration. Inter-group analysis (unpaired two-sample t-test) revealed significant intergroup differences in left- and inter-hemispheric FC. These attributes may serve as a novel biomarker for early detection of MCI. In addition, our findings imply that portable fNIRS devices covering the prefrontal cortex may be useful for early diagnosis of MCI. © 2020 Optical Society of America under the terms of the OSA Open Access Publishing Agreement1

Refined prefrontal working memory network as a neuromarker for Alzheimer’s disease

Detecting Alzheimer’s disease (AD) is an important step in preventing pathological brain damage. Working memory (WM)-related network modulation can be a pathological feature of AD, but is usually modulated by untargeted cognitive processes and individual variance, resulting in the concealment of this key information. Therefore, in this study, we comprehensively investigated a new neuromarker, named “refined network,” in a prefrontal cortex (PFC) that revealed the pathological features of AD. A refined network was acquired by removing unnecessary variance from the WM-related network. By using a functional near-infrared spectroscopy (fNIRS) device, we evaluated the reliability of the refined network, which was identified from the three groups classified by AD progression: healthy people (N=31), mild cognitive impairment (N=11), and patients with AD (N=18). As a result, we identified edges with significant correlations between cognitive functions and groups in the dorsolateral PFC. Moreover, the refined network achieved a significantly correlating metric with neuropsychological test scores, and a remarkable three-class classification accuracy (95.0%). These results implicate the refined PFC WM-related network as a powerful neuromarker for AD screening. © 2021 Optical Society of America1

Representative levels of blood lead, mercury, and urinary cadmium in youth: Korean Environmental Health Survey in Children and Adolescents (KorEHS-C), 2012–2014

AbstractBackgroundThis study examined levels of blood lead and mercury, and urinary cadmium, and associated sociodemographic factors in 3–18 year-old Korean children and adolescents.Materials and methodsWe used the nationally representative Korean Environmental Health Survey in Children and Adolescents data for 2012–2014 and identified 2388 children and adolescents aged 3–18 years. The median and 95th percentile exposure biomarker levels with 95% confidence intervals (CIs) were calculated. Multivariate regression analyses were performed on log transformed exposure biomarker levels adjusted for age, sex, area, household income, and father’s education level. The median exposure biomarker levels were compared with data from Germany, the US, and Canada, as well as the levels of Korean children measured at different times.ResultsThe median levels of blood lead and mercury, as well as urinary cadmium were 1.23μg/dL, 1.80μg/L, and 0.40μg/L (95% CIs, 1.21–1.25, 1.77–1.83, and 0.39–0.41, respectively). The blood lead levels were significantly higher in boys and younger children (p<0.0001) and children with less educated fathers (p=0.004) after adjusting for covariates. Urinary cadmium level increased with age (p<0.0001). The median levels of blood mercury and urinary cadmium were much higher in Korean children and adolescents than those in their peers in Germany, the US, and Canada. Blood lead levels tended to decrease with increasing age and divergence between the sexes, particularly in the early teen years. Median levels of blood lead and urinary cadmium decreased since 2010.ConclusionSociodemographic factors, including age, sex, and father’s education level were associated with environmental exposure to heavy metals in Korean children and adolescents. These biomonitoring data are valuable for ongoing surveillance of environmental exposure in this vulnerable population

Estimation of Mercury Emission from Incineration of Extracted Teeth with Dental Amalgam Fillings in South Korea

This study is aimed to estimate the levels of mercury emission related to amalgam fillings at dental institutions in order to provide basic data for establishing a management protocol for extracted mercury-containing amalgam fillings. We conducted a cross-sectional study at a dental clinic of a general hospital (City of Daegu), a dental hospital (City of Daegu), and five private dental clinics (one in the South and four in the North Gyeongsang Province). The extracted anterior and posterior teeth (N = 1208) were separated, and the amalgam filling rate of the posterior teeth was assessed. After cutting out the amalgam from filled posterior teeth, the weight of the amalgam was measured, and the estimated mercury emission was calculated based on the equation, where annual number of extracted posterior teeth &times; amalgam filling rate (%) &times; mean amalgam weight (g) &times; 0.5 (the proportion of mercury in amalgam). We found that 48.86 kg (95% confidence interval [CI] 41.53&ndash;58.63 kg) of mercury had been incinerated along with the extracted teeth. After applying the dental institution weights, the estimated amount of mercury was 42.53 kg (95% CI 34.11&ndash;52.17 kg). The amount of mercury incinerated with extracted posterior teeth at Korean dental institutions is therefore about 42.53&ndash;48.86 kg/year

An outbreak of neurologic symptoms among patients exposed to an unknown stench in a high school near an industrial complex: an epidemiological investigation

OBJECTIVES Seven students at a high school in Korea visited the emergency room with non-specific neurological symptoms after a stench was noticed during a school entrance ceremony. In relation to this incident, 105 patients visited medical institutions over 5 days. A team of environmental and epidemiological experts was assembled to investigate the incident. METHODS Our team of experts participated in the investigation 1 month post-incident. Previously, only air samples had been analyzed. We received results of air samples analyzed by other investigators, medical records of some students, and data from police interviews of patients. Additional investigation and interviews were conducted, and the events were reconstructed in spatial and temporal order. RESULTS A cluster of patients was observed on the south side and parts of the north side of the upper floor. A stench like that reported during the incident had been noticed for about 2 years near the school. Students consistently described a similar stench occurring frequently in the vicinity of the school. According to student statements, the odor mainly resembled something burning. The carboxyhemoglobin levels of some students were observed to be >1.5%. CONCLUSIONS In the investigation, 2 suspected sources were identified: a science room storing chemicals downstairs from the auditorium and various industrial facilities near the school. Combining the scattered evidence, we considered a toxic puff of gas, perhaps from brief incineration or leakage in a specific area, to be the likely cause of the incident. We describe our approach and the limitations encountered during the investigation

Association of Blood Mercury Level with Liver Enzymes in Korean Adults: An Analysis of 2015–2017 Korean National Environmental Health Survey

Increased liver enzymes as a result of exposure to mercury and their toxic effects are not well understood in Korea at the population level. The effect of blood mercury concentration on alanine aminotransferase (ALT) and aspartate aminotransferase (AST) was evaluated after adjusting for sex, age, obesity, alcohol consumption habit, smoking, and exercise parameters in 3712 adults. The risk of abnormal liver function was measured using a multiple logistic regression analysis. Blood mercury concentration was divided into quartiles, and liver enzyme levels were compared for each quartile. ALT and AST levels were 10–20% higher in the second, third, and fourth quartiles compared to the first quartile. The risk of liver dysfunction or elevated liver enzymes was significantly higher in the second, third, and fourth quartiles than in the first quartile. As blood mercury levels increased, liver enzymes and mercury-induced hepatotoxicity increased. The increase in liver enzymes caused by mercury was more pronounced in the low-mercury concentration range. To reduce the long-standing problem of abnormal liver enzymes and liver function in Korea and other similar settings, it is important to decrease exposure to mercury through effective implementation of specific health and environmental strategies