• Title/Summary/Keyword: Multicenter

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Multicenter survey of symptoms, work life, economic status, and quality of life of complex regional pain syndrome patients

  • Lee, Jaemoon;Lim, Yun Hee;Hong, Sung Jun;Jeong, Jae Hun;Choi, Hey Ran;Park, Sun Kyung;Kim, Jung Eun;Park, Eun Hi;Kim, Jae Hun
    • The Korean Journal of Pain
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    • v.34 no.3
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    • pp.288-303
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    • 2021
  • Background: Complex regional pain syndrome (CRPS) is an intractable pain disease with various symptoms. Here, we investigated the disease status, work life, sleep problems, medical insurance, economic status, psychological problems, and quality of life (QOL) of CRPS patients. Methods: CRPS patients from 37 university hospitals in South Korea were surveyed. The survey questionnaire consisted of 24 questions on the following aspects of CRPS patients: sex, age, occupation, cause of injury, activities of daily living (ADL), pain severity, sleep disturbance, level of education, economic status, therapeutic effect, and suicidal ideation. Additionally, the abbreviated World Health Organization Quality of Life (WHOQOL-BREF) questionnaire, consisting of 26 questions, was used to identify the status of QOL. Results: A total of 251 patients completed the questionnaire. According to the survey, 54.2% patients could not perform ADL on their own. Over the previous week, the mean pain score was 7.15 ± 1.78 (out of a total of 10 points); 92.1% of patients had sleep disorders and 80.5% had suicidal ideation, with most patients suffering from psychological problems. The average for each domain of WHOQOL-BREF was as follows: 21.74 ± 14.77 for physical, 25.22 ± 17.66 for psychological, 32.02 ± 22.36 for social relationship, and 30.69 ± 15.83 for environmental (out of a total of 100 points each). Occupation, ADL, sleep time, therapeutic effect, and suicidal ideation were statistically correlated with multiple domains. Conclusions: Most patients had moderate to severe pain, economic problems, limitations of their ADL, sleep problems, psychological problems, and a low QOL score.

Intravenous patient-controlled analgesia hydromorphone combined with pregabalin for the treatment of postherpetic neuralgia: a multicenter, randomized controlled study

  • Huang, Ying;Xu, Chenjie;Zeng, Tao;Li, Zhongming;Xia, Yanzhi;Tao, Gaojian;Zhu, Tong;Lu, Lijuan;Li, Jing;Huang, Taiyuan;Huai, Hongbo;Ning, Benxiang;Ma, Chao;Wang, Xinxing;Chang, Yuhua;Mao, Peng;Lin, Jian
    • The Korean Journal of Pain
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    • v.34 no.2
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    • pp.210-216
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    • 2021
  • Background: Postherpetic neuralgia (PHN) is the most common complication of acute herpes zoster. The treatment of PHN remains a challenge for clinical pain management. Despite the effectiveness of anticonvulsants, antidepressants, and lidocaine patches in reducing PHN, many patients still face intractable pain disorders. In this randomized controlled study, we evaluated whether hydromorphone through intravenous patient-controlled analgesia (IV PCA) was effective in relieving PHN. Methods: Patients with PHN were randomly divided into two groups, one group received oral pregabalin with IV normal saline, another group received oral pregabalin with additional IV PCA hydromorphone for two weeks. Efficacy was evaluated at 1, 4, and 12 weeks after the end of the treatments. Results: Two hundred and one patients were followed up for 12 weeks. After treatment, numerical rating scale (NRS) score of patients in the hydromorphone group was significantly lower than that of the control group, and the difference of NRS scores between the two groups was statistically significant at 4 and 12 weeks after treatment. The frequency of breakthrough pain in the hydromorphone group was significantly lower than that in the control group 1 and 4 weeks after treatment. After treatment, the quality of sleep in the hydromorphone group was significantly improved compared with the control group. The most common adverse reactions in the hydromorphone group were dizziness and nausea, with no significant respiratory depression. Conclusions: IV PCA hydromorphone combined with oral pregabalin provides superior pain relief in patients with PHN, which is worthy of clinical application and promotion.

Short-Term Outcomes of Laparoscopic Proximal Gastrectomy With Double-Tract Reconstruction Versus Laparoscopic Total Gastrectomy for Upper Early Gastric Cancer: A KLASS 05 Randomized Clinical Trial

  • Hwang, Sun-Hwi;Park, Do Joong;Kim, Hyung-Ho;Hyung, Woo Jin;Hur, Hoon;Yang, Han-Kwang;Lee, Hyuk-Joon;Kim, Hyoung-Il;Kong, Seong-Ho;Kim, Young Woo;Lee, Han Hong;Kim, Beom Su;Park, Young-Kyu;Lee, Young-Joon;Ahn, Sang-Hoon;Lee, In-Seob;Suh, Yun-Suhk;Park, Ji-Ho;Ahn, Soyeon;Han, Sang-Uk
    • Journal of Gastric Cancer
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    • v.22 no.2
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    • pp.94-106
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    • 2022
  • Purpose: Laparoscopic proximal gastrectomy with double-tract reconstruction (LPG-DTR) is a function-preserving procedure performed for treating upper early gastric cancer (EGC). However, few studies have compared the outcomes of LPG-DTR with those of laparoscopic total gastrectomy (LTG). This study aimed at comparing the short-term outcomes of LPG-DTR between LTG and upper EGC. Materials and Methods: For upper-third EGC, a multicenter, prospective, randomized trial was performed to compare those who underwent LPG-DTR with those who underwent LTG. Short-term outcomes, including clinicopathologic results, morbidity, mortality, and postoperative courses, were evaluated using a full analysis set based on the intention-to-treat principle and the per-protocol set. Results: Of the patients, 138 who fulfilled the criteria were randomized to each group. One patient in the LPG-DTR group withdrew consent. Sixty-eight patients underwent LPG-DTR and 69 underwent LTG. The operative time (LPG-DTR=219.4 minutes; LTG=201.8 minutes; P=0.085), estimated blood loss (LPG-DTR=76.0 mL; LTG=66.1 mL; P=0.413), and the morbidity rate (LPG-DTR=23.5%; LTG=17.4%; P=0.373) between the groups were not significantly different. No mortality occurred in either of the study groups. Two weeks post operation, the Visick scores for postprandial symptoms, including reflux symptoms, were not significantly different between the groups (P=0.749). Laboratory findings on postoperative day 5 were not significantly different between the groups. Conclusions: The short-term outcomes of LPG-DTR for upper EGC were comparable to those of LTG.

Effect of Non-contact Korean Medical Treatment for Patients Recovering at Home with Positive Coronavirus Disease 2019 Diagnostic Test Results at a Local Public Health Center: A Retrospective Chart Review (지역 보건소에서 시행한 코로나 바이러스 감염증-19 진단 검사상 양성인 재택치료 환자의 비대면 한의진료 효과: 후향적 차트 리뷰)

  • Jeon, Chaeheun;Choi, Daejun;Kim, Gyeongmuk;Kim, Hyejin;Leem, Jungtae;Chi, Gyoo-yong
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.36 no.4
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    • pp.130-137
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    • 2022
  • Due to the coronavirus disease 2019 (COVID-19) pandemic, appropriate management of sequelae and treatment of infectious symptoms became increasingly important healthcare issues. Although the practice guidelines and treatment cases based on the East Asian traditional medicine have been reported, there are rare studies on the use of Korean medicine in Korea. Therefore, this study aimed to present the progress of non-contact Korean medical treatment for infected patients at a local public health center using retrospective chart review. A total of 18 patients were prescribed with 5 days of herbal decoction and medicine extract covered by the national health insurance. With the questionnaire form, the progression and improvement of symptoms before and after treatment were evaluated using the numerical rating scale (NRS), and the treatment satisfaction and opinions were obtained. The symptoms such as cough (5.56±2.23 to 2.89±2.14), sputum (6.11±1,75 to 3.28±2.47), sore throat (6.06±2.70 to 1.47±1.62), anorexia (5.56±2.63 to 1.94±2.21), nausea (3.75±1.71 to 1.17±1.11), diarrhea (3.40±2.63 to 1.50±1.51), chest tightness (4.93±2.46 to 2.29±2.30) and fatigue (6.44±1.79 to 2.67±1.88) all improved according to the NRS, and the satisfaction with herbal medicine treatment on a 5-point Likert scale was 4.24±0.90. No side effects and adverse reactions were reported. Thereupon non-contact Korean medical treatment can be concluded that it effectively reduces the COVID-19 infection mild symptoms in restrictive extent. Since the retrospective data does not include a control group, the more confirmative data is needed by multicenter and large-scale controlled clinical study afterwards.

Cardiac Complications Associated with Eating Disorders in Children: A Multicenter Retrospective Study

  • Choi, So Yoon;Lee, Kyung Jae;Kim, Soon Chul;Lee, Eun Hye;Lee, Yoo Min;Kim, Yu-Bin;Yi, Dae Yong;Kim, Ju Young;Kang, Ben;Jang, Hyo-Jeong;Hong, Suk Jin;Choi, You Jin;Kim, Hyun Jin
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.25 no.5
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    • pp.432-440
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    • 2022
  • Purpose: Eating disorders often result in somatic complications, including cardiac abnormalities. Cardiac abnormalities may involve any part of the heart, including the cardiac conduction system, and can lead to sudden cardiac death. The current study aimed to evaluate the incidence of cardiac complications in pediatric patients with eating disorders and their associated factors. Methods: We retrospectively analyzed patients aged 10-18 years who were diagnosed with DSM-V (Diagnostic and Statistical Manual of Mental Disorder-V) eating disorders and underwent electrocardiography (ECG) and/or echocardiography between January 2015 and May 2020. Results: In total, 127 patients were included, of whom 113 (89.0%) were female. The median body mass index (BMI) was 15.05±3.69 kg/m2. Overall, 74 patients (58.3%) had ECG abnormalities, with sinus bradycardia being the most common abnormality (91.9%). Patients with ECG abnormalities had significantly lower BMI (14.35±2.78 kg/m2 vs. 16.06± 4.55 kg/m2, p<0.001) than patients without ECG abnormalities, as well as lower phosphorus and higher cholesterol levels. Among the 46 patients who underwent echocardiographic evaluation, 23 (50.0%) had echocardiographic abnormalities, with pericardial effusion being the most common (60.9%). The median left ventricular mass (LVM) and ejection fraction were 67.97±21.25 g and 66.91±28.76%, respectively. LVM and BMI showed a positive correlation (r=0.604, p<0.001). After weight gain, the amount of pericardial effusion was reduced in 3 patients, and 30 patients presented with normal ECG findings. Conclusion: Cardiac abnormalities are relatively frequent in patients with eating disorders. Physicians should focus on this somatic complication and careful monitoring is required.

Fecal Calprotectin Levels Significantly Correlate with Polyp Size in Children and Adolescents with Juvenile Colorectal Polyps

  • Yu Bin Kim;Ju Young Kim;Sujin Choi;Yoo Min Lee;So Yoon Choi;Soon Chul Kim;Hyo-Jeong Jang;Yoon Lee;In Sook Jeong;Dae Yong Yi;Yunkoo Kang;Kyung Jae Lee;Byung-Ho Choe;Ben Kang
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.26 no.1
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    • pp.34-42
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    • 2023
  • Purpose: We aimed to investigate factors that correlate with fecal calprotectin (FC) levels in children and adolescents with colorectal polyps. Methods: Pediatric patients aged <19 years who underwent colonoscopic polypectomy for a juvenile polyps (JPs) and FC tests were simultaneously conducted in a multicenter, retrospective study. Baseline demographics, colonoscopic and histological findings, and laboratory tests, including FC levels, were investigated. Correlations between the factors were investigated, and linear regression analysis revealed factors that correlated with FC levels. FC levels measured after polypectomies were investigated and the FC levels pre- and post-polypectomies were compared. Results: A total of 33 patients were included in the study. According to Pearson correlation analysis, the polyp size was the only factor that showed a statistically significant correlation with FC levels (r=0.75, p<0.001). Furthermore, according to the multivariate linear regression analysis, polyp size was the only factor that showed a statistically significant correlation with FC levels (adjusted R2=0.5718, β=73.62, p<0.001). The median FC level was 400 mg/kg (interquartile range [IQR], 141.6-1,000 mg/kg), and the median polyp size was 14 mm (IQR, 9-20 mm). Nineteen patients underwent post-polypectomy FC tests. FC levels showed a significant decrease after polypectomy from a median of 445.2 mg/kg (IQR, 225-1,000) to 26.5 mg/kg (11.5-51) (p<0.001). Conclusion: FC levels significantly correlated with polyp size in children and adolescents with JPs.

A prospective multicenter clinical study on the efficiency of detachable ball- and spring-retained implant prosthesis

  • Min-Jung Kim;Won-Tak Cho;Su-Hyun Hwang;Ji-Hyeon Bae;Eun-Bin Bae;June-Sung Shim;Jong-Eun Kim;Chang-Mo Jeong;Jung-Bo Huh
    • The Journal of Advanced Prosthodontics
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    • v.15 no.4
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    • pp.202-213
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    • 2023
  • PURPOSE. This prospective clinical study was conducted to evaluate the clinical usefulness of the freely detachable zirconia ball- and spring-retained implant prosthesis (BSRP) through a comparative analysis of screw- and cement-retained implant prosthesis (SCRP). MATERIALS AND METHODS. A multi-center, randomized, prospective clinical study evaluating the clinical usefulness of the detachable zirconia ball- and spring-retained implant prostheses was conducted. Sixty-four implant prostheses in 64 patients were examined. Periodic observational studies were conducted at 0, 3, 6, and 12 months after delivery of the implant prosthesis. Factors such as implant success rate, marginal bone resorption, periodontal pocket depth, plaque and bleeding index, and prosthetic complications were evaluated, respectively. RESULTS. During the 1-year observation period, all implants survived without functional problems and clinical mobility, showing a 100% implant success rate. Marginal bone resorption was significantly higher in the SCRP group than in the BSRP group only at the time of implant prosthesis delivery (P = .043). In all observation periods, periodontal pocket depth was slightly higher in the BSRP group than in the SCRP group, but there was no significant difference (P > .05). The modified plaque index (mPI) scores of both groups were moderate. Higher ratio of a score 2 in modified sulcus bleeding index (mBI) was observed in the BSRP group in the 6- and 12-months observation. CONCLUSION. Within the limitations of this study, the newly developed zirconia ball- and spring-retained implant prosthesis could be considered as an applicable and predictable treatment method along with the existing screw- and cement-retained prosthesis.

Severity of grinder injuries and related factors compared with other high-rotation cutting tool injuries: a multicenter retrospective study from 2011 to 2018

  • Juni Song;Yang Bin Jeon;Jae Ho Jang;Jin Seong Cho;Jae Yeon Choi;Woo Sung Choi
    • Journal of Trauma and Injury
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    • v.36 no.1
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    • pp.32-38
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    • 2023
  • Purpose: This study aimed to identify the characteristics of patients injured by high-rotation cutting tools and the factors related to the severity of their injuries. Methods: Adult patients (≥18 years), who presented to the emergency department (ED) after a high-rotation cutting tool injury and who were registered in the Korean Emergency Department-based Injury In-Depth Surveillance (2011-2018) database, were included. Patients' demographic characteristics, injury-related factors, and Injury Severity Scores were collected. All included cases were categorized into two groups according to the tool that caused the injury: grinder versus nongrinder. The characteristics of the two groups were compared, and the factors associated with the severity of injuries were investigated. Results: Among 8,697 ED visits, 4,603 patients had been using a grinder and 4,094 had been using a nongrinder tool. The most frequently injured body part while using a grinder was the hand (46.4%), followed by the head (23.0%). While using a nongrinder tool, the most frequently injured body part was also the hand (64.0%), followed by the lower leg (11.4%). The odds of a severe injury were affected by patient age (odds ratio [OR], 1.024; 95% confidence interval [CI], 1.020-1.028) and using a grinder (OR, 2.073; 95% CI, 1.877-2.290). The odds of a severe injury using a grinder were higher in arm injuries (OR, 1.60; 95% CI, 1.40-1.83) and multiple-part injuries (OR, 1.998; 95% CI, 1.639-2.437). The odds of a severe injury using a grinder were lower for head injuries (OR, 0.481; 95% CI, 0.297-0.781). Conclusions: Injuries from grinders were more likely to affect the head and neck than nongrinder injuries, despite the lower severity. The current lack of regulations on grinders in occupational safety and health standards warrants relevant legislation and the development of applicable safety equipment.

Development and Validation of AI Image Segmentation Model for CT Image-Based Sarcopenia Diagnosis (CT 영상 기반 근감소증 진단을 위한 AI 영상분할 모델 개발 및 검증)

  • Lee Chung-Sub;Lim Dong-Wook;Noh Si-Hyeong;Kim Tae-Hoon;Ko Yousun;Kim Kyung Won;Jeong Chang-Won
    • KIPS Transactions on Computer and Communication Systems
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    • v.12 no.3
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    • pp.119-126
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    • 2023
  • Sarcopenia is not well known enough to be classified as a disease in 2021 in Korea, but it is recognized as a social problem in developed countries that have entered an aging society. The diagnosis of sarcopenia follows the international standard guidelines presented by the European Working Group for Sarcopenia in Older People (EWGSOP) and the d Asian Working Group for Sarcopenia (AWGS). Recently, it is recommended to evaluate muscle function by using physical performance evaluation, walking speed measurement, and standing test in addition to absolute muscle mass as a diagnostic method. As a representative method for measuring muscle mass, the body composition analysis method using DEXA has been formally implemented in clinical practice. In addition, various studies for measuring muscle mass using abdominal images of MRI or CT are being actively conducted. In this paper, we develop an AI image segmentation model based on abdominal images of CT with a relatively short imaging time for the diagnosis of sarcopenia and describe the multicenter validation. We developed an artificial intelligence model using U-Net that can automatically segment muscle, subcutaneous fat, and visceral fat by selecting the L3 region from the CT image. Also, to evaluate the performance of the model, internal verification was performed by calculating the intersection over union (IOU) of the partitioned area, and the results of external verification using data from other hospitals are shown. Based on the verification results, we tried to review and supplement the problems and solutions.

Quantitative Research Trends for Critical Care Survivors' Health related Quality of Life after Intensive Care Unit Discharge (중환자실 생존 환자의 퇴원 후 건강관련 삶의 질에 관한 국내·외 양적연구 동향)

  • Son, Youn-Jung;Song, Hyo-Suk
    • Asia-pacific Journal of Multimedia Services Convergent with Art, Humanities, and Sociology
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    • v.6 no.12
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    • pp.55-67
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    • 2016
  • Purpose: The aims of this were to analyse the quantitative research trends and describe the factors influencing health related to quality of life (HRQoL) and instruments used to HRQoL after Intensive care units (ICU) discharge. Methods: This study were included 84 published papers regarding HRQoL after ICU discharge from initial data to December 2015. Results: The majority of papers were performed abroad. Only 4 papers with regard to HRQoL of ICU survivors were performed by nurses. 36 studies (42.8%) were used to measure HRQoL ICU survivors using the SF-36. 29 studies (34.5%) were used to measure HRQoL at 3~6 months after ICU discharge. Older age, longer length of stay at ICU, severity of illness, anxiety and depression were main risk factors to lower HRQoL in ICU patients. Conclusions: This study provides a better understanding of quality of life follwing critical illness. Therefore, further stduy is needed to develop patient centered intervention considered patients'health status and recovery phase. Additionally, large prospective multicenter cohort studies should be required.