Mortality of Suicide and Cerebro-Cardiovascular Diseases by Occupation in Korea, 1997-2020.

Although studies on occupational mortality have been conducted in Korea, the results for occupations with high mortality around 2010 are inconsistent. This study aimed to examine occupational mortality from overwork-related suicide and cerebro-cardiovascular diseases (CCVD) from 1997 to 2020. We used microdata of the Causes of Death Statistics (CDS) and Economically Active Population Survey (EAPS) to obtain indirect standardized mortality ratio (SMR) and standardized proportional mortality ratio (PMR) of suicide (X60-X84) and CCVD deaths (I20-I25 and I60-I69) by gender and eight occupational categories. The trend of SMR of suicide and CCVD by occupation was similar within individual genders. The SMR of managers (MNG) was the highest for men and women in 2012-2017 and 2008-2020, respectively, whereas the SMR of professionals and related workers (PRF) was consistently low. Despite the similar socioeconomic status of MNG and PRF, we suggest that their mortality should be analyzed separately in Korea. SMR of suicide and CCVD in female MNG were consistently highest, although the PMR was low. Female MNG may have been more directly affected by the economic crisis. There is a need for work-related stress management, early intervention, and prevention policies in occupations vulnerable to mortality.

Epidemiology and cardiovascular comorbidities in patients with psoriasis: A Korean nationwide population-based cohort study.

There is a lack of nationwide studies examining the epidemiology and comorbidities of psoriasis vulgaris (PsV) and psoriatic arthritis (PsA) in Asian populations. The purpose of this study is to determine the demographics of psoriasis in Korea along with the incidence of cerebro-cardiovascular (CV) comorbidities and to compare these risks between populations with PsA and with PsV. This cohort study identified 15 484 patients with psoriasis among 855 003 subjects in the Korean National Health Insurance Database from 2002 through 2010. The cases were further classified into PsA and PsV. We used hazard ratios (HR) and 95% confidence intervals (CI) from the univariate and age-sex adjusted logistic regression model to assess the risk of comorbidities in patients with PsA and PsV. The annual prevalence of psoriasis increased from 313.2 to 453.5/100 000 people from 2002 through 2010; however, the overall incidence rate for psoriasis slightly decreased (252.7-212.6/100 000 population). Of psoriatic patients, 10.8% had PsA, and after adjusting for age and sex, PsA patients had a significantly higher risk of dyslipidemia than PsV patients (adjusted HR, 1.185; 95% CI, 1.049-1.338). When stratified by age group, subjects aged 20-39 years had a higher risk of stroke and many CV risk factors. In conclusion, the prevalence of psoriasis, while within the range of previous reports, tended to increase over time. Patients with PsA had higher burdens of specific comorbid diseases than those with PsV, especially at a comparatively early age.

Predictive factors for intractability to endoscopic hemostasis in the treatment of bleeding gastroduodenal peptic ulcers in Japanese patients.

BACKGROUND/AIMS: Despite improvements in endoscopic hemostasis and pharmacological therapies, upper gastrointestinal (UGI) ulcers repeatedly bleed in 10% to 20% of patients, and those without early endoscopic reintervention or definitive surgery might be at a high risk for mortality. This study aimed to identify the risk factors for intractability to initial endoscopic hemostasis. METHODS: We analyzed intractability among 428 patients who underwent emergency endoscopy for bleeding UGI ulcers within 24 hours of arrival at the hospital. RESULTS: Durable hemostasis was achieved in 354 patients by using initial endoscopic procedures. Sixty-nine patients with Forrest types Ia, Ib, IIa, and IIb at the second-look endoscopy were considered intractable to the initial endoscopic hemostasis. Multivariate analysis indicated that age ≥70 years (odds ratio [OR], 2.06; 95% confidence interval [CI], 1.07 to 4.03), shock on admission (OR, 5.26; 95% CI, 2.43 to 11.6), hemoglobin <8.0 mg/dL (OR, 2.80; 95% CI, 1.39 to 5.91), serum albumin <3.3 g/dL (OR, 2.23; 95% CI, 1.07 to 4.89), exposed vessels with a diameter of ≥2 mm on the bottom of ulcers (OR, 4.38; 95% CI, 1.25 to 7.01), and Forrest type Ia and Ib (OR, 2.21; 95% CI, 1.33 to 3.00) predicted intractable endoscopic hemostasis. CONCLUSIONS: Various factors contribute to intractable endoscopic hemostasis. Careful observation after endoscopic hemostasis is important for patients at a high risk for incomplete hemostasis.

Predictive Factors for Intractability to Endoscopic Hemostasis in the Treatment of Bleeding Gastroduodenal Peptic Ulcers in Japanese Patients

BACKGROUND/AIMS: Despite improvements in endoscopic hemostasis and pharmacological therapies, upper gastrointestinal (UGI) ulcers repeatedly bleed in 10% to 20% of patients, and those without early endoscopic reintervention or definitive surgery might be at a high risk for mortality. This study aimed to identify the risk factors for intractability to initial endoscopic hemostasis. METHODS: We analyzed intractability among 428 patients who underwent emergency endoscopy for bleeding UGI ulcers within 24 hours of arrival at the hospital. RESULTS: Durable hemostasis was achieved in 354 patients by using initial endoscopic procedures. Sixty-nine patients with Forrest types Ia, Ib, IIa, and IIb at the second-look endoscopy were considered intractable to the initial endoscopic hemostasis. Multivariate analysis indicated that age > or =70 years (odds ratio [OR], 2.06; 95% confidence interval [CI], 1.07 to 4.03), shock on admission (OR, 5.26; 95% CI, 2.43 to 11.6), hemoglobin or =2 mm on the bottom of ulcers (OR, 4.38; 95% CI, 1.25 to 7.01), and Forrest type Ia and Ib (OR, 2.21; 95% CI, 1.33 to 3.00) predicted intractable endoscopic hemostasis. CONCLUSIONS: Various factors contribute to intractable endoscopic hemostasis. Careful observation after endoscopic hemostasis is important for patients at a high risk for incomplete hemostasis.

Spontaneous Remission of Congenital Leukemia-One Case Report / 中华围产医学杂志

Objective To discuss the clinical features and possible mechanisms of congenrtal leuleemia spontaneous remission. Methods By means of literature review, 17 cases with spontaneous remission of congenital leukemia were retrospectively analyzed. Results Among the 17 patients, 8 were persistent remission(47%), 9 had late relapses(53%). Neither initial white cell count nor bone marrow involvement was associated with late relapses. 5 cases(29%) had abnormal karyotype and gene rearrangment,11q23 translocation indicated poor prognosis. Conclusions Conservative treatment can be given unless there was evidence of progressive leukemia. Because of occasional late relapses, long term follow-up was recommended. The detection of karyotype and gene rearrangment was a powerful prognostic tool available.