• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.19 no.4
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• pp.269-275
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• 2016

Purpose: Undernutrition during hospitalization increases the risk of nosocomial infection and lengthens the disease courses. The aim of this study was to evaluate the risk factors of weight loss during hospitalization in children. Methods: All the patients who were admitted in general wards between April and May 2014 were enrolled. Patients aged >18 years and discharged within 2 days were excluded. Weight loss during hospitalization was defined as a decrease in body weight of >2% in 8 hospital days or on the day of discharge. Patients who lost body weight during hospitalization were compared with patients who maintained their body weights. Significant parameters were evaluated by using the multivariate logistic regression analysis. Results: We enrolled 602 patients, of whom 149 (24.8%) lost >2% of their body weight. Complaint of pain (p=0.004), admission to the surgical department (p=0.001), undergoing surgery (p=0.044), undergoing abdominal surgery (p=0.034), and nil per os (NPO) durations (p=0.003) were related to weight loss during hospitalization. The patients who had high weight-for-age tended to lose more body weight (p=0.001). Admission to the surgical department (odds ratio [OR], 1.668; 95% confidence interval [CI], 1.054-2.637; p=0.029) and long NPO durations (OR, 1.496; 95% CI, 1.102-2.031; p=0.010) were independent risk factors of weight loss during hospitalization. The patients with high weight-for-age tended to lose more weight during hospitalization (OR, 1.188; 95% CI, 1.029-1.371; p=0.019). Conclusion: Greater care in terms of nutrition should be taken for patients who are admitted in the surgical department and have prolonged duration of nothing by mouth.

• Journal of Korean Neurosurgical Society
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• v.50 no.4
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• pp.363-369
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• 2011

Objective : We investigated the clinical and radiological advantages of unilateral laminectomy in posterior lumbar interbody fusion (PLIF) procedure comparing with bilateral laminectomy, under the same procedural condition including bilateral instrumentation and insertion of two cages, in patients with degenerative lumbar disease with unilateral leg symptoms. Methods : We retrospectively reviewed 124 consecutive cases of PLIF via unilateral or bilateral approach between January 2006 and April 2010. In 80 cases (bilateral group), two cages were inserted via bilateral laminectomy, and in 44 cases (unilateral group), via unilateral laminectomy. The average follow-up duration was 29.5 months. The clinical outcomes were evaluated with the Visual Analogue Scale (VAS) and the Oswestry disability index (ODI). The fusion rates and disc space heights were determined by dynamic standing radiographs and/or computed tomography. Operative times, intra-operative and post-operative blood losses and hospitalization periods were also evaluated. Results : In clinical evaluation, the VAS and ODI scores showed excellent outcomes in both groups. There were no significant differences in term of fusion rate, but the perioperative blood loss and the operative time of the unilateral group were lower than that of the bilateral group. Conclusion : Unilateral laminectomy can minimize the operative time and perioperative blood loss in PLIF procedure. However, the different preoperative disc height between two groups is a limitation of this study. Despite this limitation, solid fusion and satisfactory symptomatic improvement could be achieved uniquely by our surgical method. This surgical method can be an alternative surgical technique in patients with unilateral leg pain.

• Journal of Gastric Cancer
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• v.14 no.3
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• pp.156-163
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• 2014

Purpose: Information regarding antimicrobial prophylaxis (AMP) for gastric cancer surgery is limited. The present study investigated the efficacy of single-dose AMP for the prevention of surgical site infection (SSI) in patients undergoing gastrectomy for gastric carcinoma. Materials and Methods: Between 2011 and 2013, 1,330 gastric carcinoma surgery patients were divided into two AMP administration groups depending on the duration of treatment. Postoperative outcomes including morbidity and SSI were compared between the two groups overall and in matched patients. Risk factors for SSI were analyzed. Results: The extended group (n=1,129) received AMP until postoperative day 1 and the single-dose group (n=201) received single-dose AMP only during an operation. Postoperatively, there were no significant differences between the two groups with respect to overall morbidity, mortality, or length of hospital stay. The SSI rate of the single-dose group was not significantly different from that of the extended group overall (4.5% vs. 5.5%, respectively, P=0.556) or in matched patients (4.5% vs. 4.0%, respectively, P=0.801). There was no increase in the SSI rate of the single-dose group compared to the extended group in subgroups based on different clinicopathological and operative factors. Univariate and multivariate analyses revealed male gender, open surgery, and operating time (${\geq}180$ minutes) as independent risk factors for SSI. Conclusions: Single-dose AMP showed no increase in the postoperative SSI rate compared to postoperative extended use in patients undergoing gastrectomy for gastric carcinoma. The efficacy of single-dose AMP requires further investigation in randomized clinical trials specific to gastric cancer surgery.

• Journal of Korean Foot and Ankle Society
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• v.12 no.2
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• pp.203-209
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• 2008

Purpose: To emphasize the importance of considering tuberculosis in atypical cases of foot and ankle by reporting clinical results of those cases. Materials and Methods: Seven cases which were diagnosed as tuberculosis around foot and ankle from March 1996 to June 2007 were included. We reviewed initial impressions, the time to be diagnosed, clinical symptoms, laboratory findings, radiological findings and the clinical results and complications. Results: We followed up at least 6 months ($6{\sim}24$ months) after surgery in all cases. Initially 2 cases had been diagnosed as cellulitis, 4 cases as chronic osteomyelitis, and 1 case as an ankle instability. Tuberculosis was diagnosed after biopsy in all cases. Mean duration of symptom was 15 months ($6{\sim}36$ months) except in infants. There were various radiologic manifestations such as osteopenia, bony erosion or destruction and cystic changes. Symptoms were relieved in all cases within 4 months with chemotherapy followed by surgical biopsy, except one ankle which had been misdiagnosed as ankle instability and joint destruction was developed after modified Brostrom surgery. Conclusion: It is important to perform a surgical biopsy for diagnosis and proper management even with a faint suspicion on tuberculosis in foot and ankle. And in case of need, when surgical biopsy is performed, curettage procedure may help to improve clinical result.

• Korean Journal of Head & Neck Oncology
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• v.9 no.2
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• pp.234-243
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• 1993

The thyroid nodules are the most common endocrine disease requiring surgical management. Up to date, various diagnostic techniques and surgical management have been developed. Authors analysed 2285 cases of thyroid nodules who were treated at Department of Surgery, Pusan National University for the duration of 10 years from January 1980 to December 1989 and the results obtained were summerized as follows: 1) Patients were composed of 1727 cases(75.8%) of benign nodule and 558 cases(24.5%) of malignant nodule. Benign nodule was prevalent in forth and fifth decade comparing with malignant nodule was sixth and fifth decade. The sexual distribution revealed female preponderance with 1:10.8 in benign nodule and 1:9.3 in malignant nodule. 2) The histopathologic classfication of benign nodule in decreasing order of frequency were follicular adenoma 1009 cases(54.8%), adenomatous goiter 573 cases(33.3%), simple cyst 65 cases(3.8%), and Hashimoto's thyroiditis 52 cases(3.0%). The malignant disease were papillary adenocarcinoma 460 cases(82.4%), follicular adenocarcinoma 69 cases(12.4%), undifferentiated carcinoma 13 cases (2.0%), and medullary carcinoma 7 cases(1.0%). 3) Fine needle aspiration cytology was performed in 1758 cases and it showed 80.5% of sensitivity, 96.5% of specificity, 19.5% of false negative and 80% of accuracy. 4) The location of nodule was 87.7%, in unilateral, 12.2% in bilateral. 5) On the radioiodine scanning, the incidence of benign nodule with cold nodule was 83.9% and the incidence of benign nodule with hot nodule was 7.5%. The incidence of thyroid carcinoma with cold nodule was 88.3% and the incidence of thyroid carcinoma with hot nodule was 4.6%. 6) Most cases of benign nodules were treated with lobectomy 82.6%, subtotal thyroidectomy 10.1% and subtotal lobectomy 3.0%. Malignant nodules were treated with lobectomy and/or isthmusectomy 37.6%, total thyroidectomy 17.7%, subtotal thyroidectomy 15.4%, and any thyroidectomy and neck dissection 13.5%. 7) Postoperative complications were developed in 3.8% of benign nodules and 13.8% of malignant nodules.

• Archives of Plastic Surgery
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• v.40 no.6
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• pp.721-727
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• 2013

Background One of the main concerns in orbital blowout fracture repair is a narrow operation field, due mainly to the innate complex three dimensions of the orbit; however, a deep location and extensive area of the fracture and soft tissue edema can also cause concern. Swelling of the orbital contents progresses as the operation continues. Mannitol has been used empirically in glaucoma, cerebral hemorrhage, and orbital compartment syndrome for decompression. The authors adopted mannitol for the control of intraorbital edema and pressure in orbital blowout fracture repair. Methods This prospective study included 108 consecutive patients who were treated for a pure blowout fracture from January 2007 to October 2012. For group I, mannitol was administered during the operation. Under general anesthesia, all patients underwent surgery by open reduction and insertion of an absorbable mesh implant. The authors compared postoperative complications, the reoperation rate, operation time, and surgical field improvement between the two groups. Results In patients who received intraoperative administration of mannitol, the reoperation rate and operation time were decreased; however, the difference was not statistically significant. The total postoperative complication rates did not differ. Panel assessment for the intraoperative surgical field video recordings showed significantly improved vision in group I. Conclusions For six years, mannitol proved itself an effective, reliable, and safe adjunctive drug in the repair of orbital blowout fractures. With its rapid onset and short duration of action, mannitol could be one of the best methods for obtaining a wider surgical field in blowout fracture defects.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.20
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• pp.8673-8678
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• 2014

Purpose: This study aimed to determine the association between tobacco consumption (kretek) and betel quid chewing with oral cancer risk. Materials and Methods: A total of 81 cases of oral cancers were matched with 162 controls in this hospital-based study. Information on sociodemographic characteristics and details of risk habits (duration, frequency and type of tobacco consumption and betel quid chewing) were collected. Association between smoking and betel quid chewing with oral cancer were analysed using conditional logistic regression. Results: Slightly more than half of the cases (55.6%) were smokers where 88.9% of them smoked kretek. After adjusting for confounders, smokers have two fold increased risk, while the risk for kretek consumers and those smoking for more than 10 years was increased to almost three-fold. Prevalence of betel quid chewing among cases and controls was low (7.4% and 1.9% respectively). Chewing of at least one quid per day, and quid combination of betel leaf, areca nut, lime and tobacco conferred a 5-6 fold increased risk. Conclusions: Smoking is positively associated with oral cancer risk. A similar direct association was also seen among betel quid chewers.

• Journal of Korean Neurosurgical Society
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• v.59 no.5
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• pp.485-491
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• 2016

Objective : The aims of the Korean Neuro-Trauma Data Bank System (KNTDBS) are to evaluate and improve treatment outcomes for brain trauma, prevent trauma, and provide data for research. Our purpose was to examine the mortality rates following traumatic brain injury (TBI) in a retrospective study and to investigate the sociodemographic variables, characteristics, and causes of TBI-related death based on data from the KNTDBS. Methods : From 2010 to 2014, we analyzed the data of 2617 patients registered in the KNTDBS. The demographic characteristics of patients with TBI were investigated. We divided patients into 2 groups, survivors and nonsurvivors, and compared variables between the groups to investigate variables that are related to death after TBI. We also analyzed variables related to the interval between TBI and death, mortality by region, and cause of death in the nonsurvivor group. Results : The frequency of TBI in men was higher than that in women. With increasing age of the patients, the incidence of TBI also increased. Among 2617 patients, 688 patients (26.2%) underwent surgical treatment and 125 patients (4.7%) died. The age distributions of survivors vs. nonsurvivor groups and mortality rates according the severity of the brain injury, surgical treatment, and initial Glasgow Coma Scale (GCS) scores were statistically significantly different. Among 125 hospitalized nonsurvivors, 70 patients (56%) died within 7 days and direct brain damage was the most common cause of death (80.8%). The time interval from TBI to death differed depending on the diagnosis, surgical or nonsurgical treatment, severity of brain injury, initial GCS score, and cause of death, and this difference was statistically significant. Conclusion : Using the KNTDBS, we identified epidemiology, mortality, and various factors related to nonsurvival. Building on our study, we should make a conscious effort to increase the survival duration and provide rapid and adequate treatment for TBI patients.

• Journal of Korean Neurosurgical Society
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• v.60 no.2
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• pp.165-173
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• 2017

Objective : To explore and analyze the influencing factors of facial nerve function retainment after microsurgery resection of acoustic neurinoma. Methods : Retrospective analysis of our hospital 105 acoustic neuroma cases from October, 2006 to January 2012, in the group all patients were treated with suboccipital sigmoid sinus approach to acoustic neuroma microsurgery resection. We adopted researching individual patient data, outpatient review and telephone followed up and the House-Brackmann grading system to evaluate and analyze the facial nerve function. Results : Among 105 patients in this study group, complete surgical resection rate was 80.9% (85/105), subtotal resection rate was 14.3% (15/105), and partial resection rate 4.8% (5/105). The rate of facial nerve retainment on neuroanatomy was 95.3% (100/105) and the mortality rate was 2.1% (2/105). Facial nerve function when the patient is discharged from the hospital, also known as immediate facial nerve function which was graded in House-Brackmann : excellent facial nerve function (House-Brackmann I-II level) cases accounted for 75.2% (79/105), facial nerve function III-IV level cases accounted for 22.9% (24/105), and V-VI cases accounted for 1.9% (2/105). Patients were followed up for more than one year, with excellent facial nerve function retention rate (H-B I-II level) was 74.4% (58/78). Conclusion : Acoustic neuroma patients after surgery, the long-term (${\geq}1year$) facial nerve function excellent retaining rate was closely related with surgical proficiency, post-operative immediate facial nerve function, diameter of tumor and whether to use electrophysiological monitoring techniques; while there was no significant correlation with the patient's age, surgical approach, whether to stripping the internal auditory canal, whether there was cystic degeneration, tumor recurrence, whether to merge with obstructive hydrocephalus and the length of the duration of symptoms.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.40 no.5
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• pp.206-210
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• 2014

Objectives: To identify post-treatment prognostic factors for medication-related osteonecrosis of the jaw (MRONJ). Materials and Methods: We evaluated 54 MRONJ patients who visited the Department of Dentistry, Ajou University Hospital, from May 2007 to March 2014. Twenty-one patients were surgically managed with debridement or sequestrectomy and 33 patients were conservatively managed using antibiotics. Correlations of age, sex, stage, bisphosphonate duration and type, and drug holiday with the prognosis of MRONJ were investigated. Correlations were verified by logistic regression analysis and t-tests with a significance level of 0.05. Results: Clinical outcomes were evaluated on the basis of both clinical and radiographic findings. Twelve out of 21 surgically managed patients showed a favorable prognosis and nine patients relapsed. Thirty-one of the 33 conservatively managed patients showed no specific change in prognosis, and two patients worsened. Statistical analyses of the conservative management group did not reveal any correlation of the above factors with the prognosis of conservative management. Drug holiday was the only prognostic factor in the surgical management group (P=0.031 in logistic regression analysis, P=0.004 in t-test). Conclusion: Drug holiday is a prognostic factor in the surgical management of MRONJ. Because the drug holiday in the patients of the poor prognosis group occurred 1.5 to 4 months prior to surgical management, we recommend a drug holiday more than 4 months before surgery.