• Journal of muscle and joint health
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• v.6 no.1
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• pp.37-50
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• 1999

The purpose of this study was to identify the risk factors of osteoporosis. The data were collected from women who visited Physical Examination Center of a university hospital located in Taejon during the period of September 1997-August 1998. The sample was divided into two groups(the osteoporosis group of 44 cases and the control group of 66 cases). The results were summarized as follows ; 1. Sociodemographic characteristics(education and family income) and BMI showed no significant difference between the osteoporosis group and the control group. 2. There was no significant difference in coffee, unbalanced diet, diet method and meal habit between the osteoporosis group and the control group. 3. The osteoporosis group reported more incidence of operative menopause due to hysterectomy and oophorectomy, but this was not statistically significant. There was no significant difference in use of oral pill use, past disease and family history of fracture between the osteoporosis group and the control group, but the odds ratio(OR 3.11, 95% CI : 1.30-7.41) of present illness was statistically significant in the osteoporosis group. 4. There was no significant difference in the reproductive history including number of delivery and abortion and feeding method between the osteoporosis group and the control group. 5. The osteoporosis group showed significant results of lower menopausal age, shorter duration of menstruation and longer duration after menopause compared to the control group. 6. The osteoporosis group reported significantly lower level of physical activity in such variables as work activity and walking time. 7. A logistic analysis showed that shorter period of menstruation, lower level of physical activity, non-alcohol drinking group, and presence of disease were related to the possibility of occurring of osteoporosis.

• Journal of Chest Surgery
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• v.50 no.3
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• pp.171-176
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• 2017

Background: In elderly patients who have atrial fibrillation (AF), surgical ablation of the arrhythmia during cardiac surgery may be challenging. Despite the reported advantages of ablating AF with the Cox maze procedure (CMP), the addition of the CMP may complicate other cardiac operations. We evaluated the effect of the CMP in elderly patients concurrent with other cardiac operations. Methods: From October 2007 to December 2015, we enrolled 27 patients aged >70 years who had AF and who underwent the CMP concurrently with other cardiac operations. The mean preoperative additive European System for Cardiac Operative Risk Evaluation score was $8{\pm}11$ (high risk). Results: Only 1 hospital death occurred (4%). The Kaplan-Meier method showed a high 5-year cumulative survival rate (92%). At mean follow‐up of 51 months, 23 patients (89%) had sinus rhythm conversion. The postoperative left atrial dimensions did not significantly differ between the 8 patients who had reduction plasty for giant left atrium ($53.4{\pm}7.5cm$) and the 19 patients who did not have reduction plasty ($48.7{\pm}5.7cm$). Conclusion: In patients aged >70 years, concurrent CMP may be associated with a high rate of sinus rhythm conversion without increased surgical risk, despite the added complexity of the main cardiac procedure.

• Journal of Korean Neurosurgical Society
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• v.43 no.3
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• pp.131-134
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• 2008

Objective: The surgical approach for anterior choroidal artery (AChA) aneurysm is typically similar to those used for other supraclinoid internal carotid artery (ICA) lesions. However, the surgical clipping of this aneurysm is complicated and as a result. can result in postoperative ischemic complications. The purpose of this study was to clarify the risk of clip-induced ischemic complication in AChA aneurysm and to get the benefits for helping decision making. Methods: We retrospectively investigated 53 cases (4.0%) of AchA aneurysm treated surgically. We divided the AChA aneurysm to 3 subtype according to the origin of aneurysmal neck; A type originating from the AChA itself. J type from junction of AChA and ICA and I type from the ICA itself. We evaluated brain CT about 1 week post-operative day to confirm the low density in AChA territory. Results: Ruptured aneurysm was 26 cases and unruptured aneurysm 27 cases. The aneurysmal subtype of A, J, and I was 13, 17, and 23 cases. Of the 53 cases who performed surgical neck clipping, twelve (22.6%) had postoperative AChA distribution infarcts. Increased infarct after neck clipping had statistic significance in non-I subtype (r=0.005) Conclusion: AChA aneurysm surgery carries a significant risk of postoperative stroke. Don't always stick to clipping only, especially in non-I type of incidental small aneurysm, which has high risk of post-clip ischemic complications.

• Archives of Plastic Surgery
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• v.40 no.1
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• pp.19-27
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• 2013

Background Acellular dermal matrix (ADM) allografts and their putative benefits have been increasingly described in prosthesis based breast reconstruction. There have been a myriad of analyses outlining ADM complication profiles, but few large-scale, multi-institutional studies exploring these outcomes. In this study, complication rates of acellular dermis-assisted tissue expander breast reconstruction were compared with traditional submuscular methods by evaluation of the American College of Surgeon's National Surgical Quality Improvement Program (NSQIP) registry. Methods Patients who underwent immediate tissue expander breast reconstruction from 2006-2010 were identified using surgical procedure codes. Two hundred forty tracked variables from over 250 participating sites were extracted for patients undergoing acellular dermis-assisted versus submuscular tissue expander reconstruction. Thirty-day postoperative outcomes and captured risk factors for complications were compared between the two groups. Results A total of 9,159 patients underwent tissue expander breast reconstruction; 1,717 using acellular dermis and 7,442 with submuscular expander placement. Total complications and reconstruction related complications were similar in both cohorts (5.5% vs. 5.3%, P=0.68 and 4.7% vs. 4.3%, P=0.39, respectively). Multivariate logistic regression revealed body mass index and smoking as independent risk factors for reconstructive complications in both cohorts (P<0.01). Conclusions The NSQIP database provides large-scale, multi-institutional, independent outcomes for acellular dermis and submuscular breast reconstruction. Both thirty-day complication profiles and risk factors for post operative morbidity are similar between these two reconstructive approaches.

• Journal of Chest Surgery
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• v.53 no.1
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• pp.1-7
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• 2020

Background: The aim of this study was to evaluate the short-term and long-term results of surgical treatment for native valve endocarditis (NVE) and to investigate the risk factors associated with mortality. Methods: Data including patients' characteristics, operative findings, postoperative results, and survival indices were retrospectively obtained from Hallym University Sacred Heart Hospital. Results: A total of 29 patients underwent surgery for NVE (affecting the mitral valve in 20 patients and the aortic valve in 9) between 2003 and 2017. During the follow-up period (median, 46.9 months; interquartile range, 19.1-107.0 months), the 5-year survival rate was 77.2%. In logistic regression analysis, body mass index (p=0.031; odds ratio [OR], 0.574; 95% confidence interval [CI], 0.346-0.951), end-stage renal disease (ESRD) (p=0.026; OR, 24.0; 95% CI, 1.459-394.8), and urgent surgery (p=0.010; OR, 34.5; 95% CI, 2.353-505.7) were significantly associated with in-hospital mortality. Based on Cox proportional hazard regression analysis, the statistically significant predictors of long-term outcomes were hypertension, ESRD, and urgent surgery. Conclusion: Surgical treatment for NVE is associated with considerable mortality. The in-hospital mortality and 5-year survival rates of this study were 13.8% and 77.2%, respectively. Underlying conditions, including hypertension and ESRD, and urgent surgery were independent risk factors for unfavorable outcomes.

• Archives of Plastic Surgery
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• v.38 no.5
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• pp.621-626
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• 2011

Purpose: Implant-based breast reconstruction has multiple advantages such as decreased morbidity, shorter operative time and faster recovery. However, postoperative infection with tissue expander increases medical cost and causes a delay in concurrent antineoplastic treatment. To reduce tissue expander infection, it is important to identify related risk factors and minimize them when possible. Methods: A retrospective review of patient records in a single breast cancer center was performed. Eighty-six tissue expanders were placed in 80 women for postmastectomy breast reconstruction. Variables including patients'age, body mass index (BMI), preoperative breast volume, operation time, drain indwelling time, postoperative seroma/hematoma formation, chemotherapy, and radiation therapy were evaluated. Infection was defined as the status that shows any symptom of local inflammation and identification of pathogens. Representative values were compared through Student's t-test and univariate and multivariate analyses. Results: We examined 86 postmastectomy tissueexpanders which were placed between June 2004 and April 2010. Seven cases of tissue expander infection (8.1%) were identified. The infected tissue expander was removed in three of the cases. The relationship between BMI, and preoperative breast volume and that between infection and non-infection groups were significant ($p$ <0.05). Univariate analysis showed significant association between BMI ($p$=0.023) and preoperative breast volume ($p$=0.037). Multivariate analysis revealed that BMI and preoperative breast volume were independent variables regarding tissue expander infection. Conclusion: Certain characteristics of implant-based breast reconstruction patients increase infection rate of tissue expander. These risk factors should be monitored and evaluated before surgeries for more successful outcome.

• Journal of Korean Medicine Rehabilitation
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• v.31 no.1
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• pp.149-163
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• 2021

Objectives This study is to review the effectiveness of exercise after lung cancer surgery. Methods Relevant randomized controlled trials (RCTs) were searched in PubMed database. The systematic review was conducted through flow diagram. The risk of biases were assessed through the Cochrane guideline. Characteristics and outcomes were extracted from each study. Meta-analyses of forced expiratory volume in one second (FEV1), 6-minute walk test (6MWT), quality of life (QoL), pulmonary complications were conducted. Results 14 RCTs were selected. In meta-analysis, exercise improved FEV1 (mean difference [MD] 0.14; 95% confidence interval [CI] 0.04 to 0.25; p=0.009; I2=55%) and mean change of FEV1 (MD 0.11; 95% CI 0.02 to 0.20; p=0.02; I2=0%). Exercise increased the distance of 6MWT, but there was considerable heterogeneity (MD 45; 95% CI 21.16 to 68.83; p=0.0002, I2=89%). There was no differences in QoL scores by 2 questionnaires (European Organisation for Research and Treatment of Cancer quality of life questionnaire, short form-36). Exercise reduced the duration of hospital stay (MD -3.32; 95% CI -5.27 to -1.36; I2=0%; 2 studies) but not duration of chest tube intubation (MD -1.37; 95% CI -2.81 to 0.06; I2=0%) and incidence of pulmonary complications (pooled risk ratio 0.54; 95% CI 0.23 to 1.30; I2=0%). Conclusions Exercise might reduce the duration of hospital stay after lung surgery. There was not enough evidence to prove improvement of lung function, aerobic capacity, muscle strength, QoL, and decline of pulmonary complications. Low-quality risk of bias, different units or estimation of outcome, different exercise type and duration, heterogeneity among studies make the evidence of effectiveness weak. Future researches are required to redeem these defects.

• Restorative Dentistry and Endodontics
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• v.45 no.4
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• pp.48.1-48.11
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• 2020

Objectives: This systematic review aimed to identify mean oxygen saturation values (SpO₂) using pulse oximetry in permanent maxillary anterior teeth. Materials and Methods: The MEDLINE, Scientific Electronic Library Online, Cochrane Central Register of Controlled Trials, EMBASE, and Literatura Latino Americana em Ciências da Saúde electronic databases were searched. Combinations and variations of "oximetry" AND "dental pulp test" were used as search terms. Studies reporting means and standard deviations of SpO₂ values were included. Two reviewers independently extracted data following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses checklist. Heterogeneity was assessed using the I² statistic, and all analyses were performed using R software. Study quality was assessed using the Quality Assessment of Diagnostic Accuracy Studies-2 tool and the Newcastle-Ottawa scale. Results: Of the 251 studies identified, 19 met the eligibility criteria and were included (total sample, 4,541 teeth). In the meta-analysis, the mean SpO₂ values were 84.94% (95% confidence interval [CI], 84.85%-85.04%) for the central incisors, 89.29% (95% CI, 89.22%-89.35%) for the lateral incisors, and 89.20% (95% CI, 89.05%-89.34%) for the canines. The studies were predominantly low-quality due to the high risk of bias associated with the index test, unclear risk regarding patient selection, and concerns about outcome assessment. Conclusions: Although most studies were low-quality, the oxygen saturation levels in normal pulp could be established (minimum saturation, 77.52%). Despite the risk of bias of the included studies, the reference values reported herein are clinically relevant for assessments of changes in pulp status.

• Archives of Reconstructive Microsurgery
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• v.8 no.1
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• pp.22-27
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• 1999

While the conventional end-to-end anastomotic technique is accepted as 'the golden standard' for microvascular anastomosis, it is time-consuming and tedious. In an effort to offer faster and safer ways of performing microvascular anastomoses, numerous anastomotic techniques have been proposed, but further refinements in microvascular techniques are still necessary. A 'continuous suture with interrupted knot' technique was devised for faster and safer anastomosis. It has been successfully used in microanastomoses of both artery and vein for free tissue transfer. It is a combination of the interrupted suturing technique and the continuous suturing technique. First, a continuous suture is made with the size of loop decreasing in order, and then the sutures are tied individually from the first loop to the last one as in the conventional interrupted suturing technique. It was applied clinically to fourteen patients over the past ten months and found to be a highly efficient technique that satisfied our needs. This 'continuous suture with interrupted knot' technique has several advantages over other techniques : The operative time is reduced comparing conventional interrupted suture technique. By delaying the tie and with the vessel walls kept separated, the risk of through-stitch can be reduced. Tying all the sutures at one time not only speed up the procedures, but also reduced the surgeon's fatigue. In addition, it has no problem of anastomotic stenosis which is a disadvantage of continuous suture technique. This technique proved to be faster and safer, and has patency equal to that of the conventional end-to-end anastomosis. It is of great help to the surgeon in reducing operative time, especially in clinical situations when many anastomoses are required, or lengthy grafting procedures are undertaken.

• Archives of Plastic Surgery
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• v.35 no.3
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• pp.295-302
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• 2008

Purpose: The lower leg often has poor vascularity, proximity to bone, and insufficient soft tissue. The island flaps offer a feasible one stage reconstruction and has a remarkable vascularization and high quality results for soft tissue defect with or without bony problems to occur on regions below the knee. So we reported our experience of island flaps with review of the literatures. Methods: We reconstructed 29 cases of soft tissue and 2 cases of bony defect on regions below the knee by using various island flaps at our hospital from December, 1991 to January, 2006. We used 2 fibular osteocutaneous island flaps, 15 reverse sural island flaps, 6 extensor digitorum brevis muscular island flaps, 2 medial plantar island flaps, 5 saphenous island flaps, and a dorsalis pedis island flap. Results: Partial necrosis was developed in 4 out of 15 reverse sural island flaps and 1 out of 5 saphenous island flaps, but they were healed with secondary skin graft. There was partial loss of skin graft on the donor sites in 2 cases. Conclusion: Island flaps are very useful for reconstruction of regions below the knee because island flaps have good vascularity and less risk of infection. Generous flap size, easy operative technique, lower cost, shorter operative time, and minimal morbidity at the donor site are other advantages. We attained satisfactory results.