Objective: To investigate the diagnostic yield of contrast-enhanced computed tomography (CT) in Crohn's disease (CD) patients presenting with acute severe lower gastrointestinal bleeding (LGIB), and the role of CT in predicting the risk of rebleeding. Materials and Methods: A consecutive series of 110 CD patients presenting with acute severe LGIB between 2005 and 2016 were analyzed. Among them, 86 patients who had undergone contrast-enhanced CT constituted the study cohort. The diagnostic yield of CT for detecting contrast extravasation was obtained for the entire cohort and compared between different CT techniques. In a subgroup of 62 patients who had undergone CT enterography (CTE) and showed a negative result for extravasation on CTE, the association between various clinical and CTE parameters and the risk of rebleeding during subsequent follow-up was investigated using Cox regression analysis. Results: The diagnostic yield of CT was 10.5% (9 of 86 patients). The yield did not significantly differ between single-phase and multiphase examinations (p > 0.999), or between non-enterographic CT and CTE (p = 0.388). Extensive CD (adjusted hazard ratio [HR], 3.27; 95% confidence interval [CI], 1.09-9.80; p = 0.034) and bowel wall-to-artery enhancement ratio (adjusted HR, 2.81; 95% CI, 1.21-6.54; p = 0.016) were significantly independently associated with increased rebleeding risks, whereas anti-tumor necrosis factor-${\alpha}$ therapy after the bleeding independently decreased the risk of rebleeding (adjusted HR, 0.26; 95% CI, 0.07-0.95; p = 0.041). Conclusion: The diagnostic yield of contrast-enhanced CT was not high in CD patients presenting with acute severe LGIB. Nevertheless, even a negative CTE may be beneficial as it can help predict the risk of later rebleeding.
Oh, In Mok;Hong, Minseok;Lee, Soo Yeon;Yoon, Ga Hee;Lee, Ho;Kim, Myung Jin;Kim, Hyun Mi;Lee, Sang Don
Anxiety and mood
/
v.15
no.2
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pp.115-121
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2019
Objective : The purpose of this study was to investigate prevalence of psychiatric symptoms and determine predictors of emotional distress of military hospital surgical patients. Methods : This study examined 104 orthopedic patients admitted to the Armed Forces Military Hospital September-November 2018. For the study, every subject completed self-assessment inventories regarding depressive and anxiety symptoms (Hospital Anxiety and Depression Scale), sleep problems (Pittsburgh Sleep Quality Index), problematic alcohol and tobacco use (Cut off, Annoyed, Guilty, Eye-opener screening), and psychiatric history. We performed the Student's t-test and the chi-square test for the collected data to investigate the prevalence of psychiatric symptoms, including emotional distress. Logistic regression analysis was used to examine the risk factors related to emotional distress of hospitalized military personnel. Results : There were no significant differences in socio-demographic and psychiatric symptoms between soldiers and officers. The prevalence of depressive and/or anxiety symptoms (emotional distress) was 21.2% (n=21). In the logistic regression analysis, psychiatric history [Adjusted Odds Ratio (AOR)=18.99 ; 95% Confidence Interval (CI)=1.42-253.57 ; p=0.026] and low military life satisfaction (AOR=15.67; 95% CI=1.46-168.11 ; p=0.023) correlated with emotional distress. Conclusion : Soldiers admitted to the military hospital showed similar prevalence of emotional distress as those at general hospitals. Considering military circumstances, it is necessary to detect and intervene regarding soldiers with a psychiatric history and low military life satisfaction to promote mental health at military hospitals.
Woo, Joon-Bum;Son, Dong-Wuk;Lee, Su-Hun;Lee, Jun-Seok;Lee, Sang Weon;Song, Geun Sung
Journal of Korean Neurosurgical Society
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v.62
no.4
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pp.450-457
/
2019
Objective : Anterior cervical discectomy and fusion (ACDF) is commonly used surgical procedure for cervical degenerative disease. Among the various intervertebral spacers, the use of allografts is increasing due to its advantages such as no harvest site complications and low rate of subsidence. Although subsidence is a rare complication, graft collapse is often observed in the follow-up period. Graft collapse is defined as a significant graft height loss without subsidence, which can lead to clinical deterioration due to foraminal re-stenosis or segmental kyphosis. However, studies about the collapse of allografts are very limited. In this study, we evaluated risk factors associated with graft collapse. Methods : We retrospectively reviewed 33 patients who underwent two level ACDF with anterior plating using allogenous bone graft from January 2013 to June 2017. Various factors related to cervical sagittal alignment were measured preoperatively (PRE), postoperatively (POST), and last follow-up. The collapse was defined as the ratio of decrement from POST disc height to follow-up disc height. We also defined significant collapses as disc heights that were decreased by 30% or more after surgery. The intraoperative distraction was defined as the ratio of increment from PRE disc height to POST disc height. Results : The subsidence rate was 4.5% and graft collapse rate was 28.8%. The pseudarthrosis rate was 16.7% and there was no association between pseudarthrosis and graft collapse. Among the collapse-related risk factors, pre-operative segmental angle (p=0.047) and intra-operative distraction (p=0.003) were significantly related to allograft collapse. The cut-off value of intraoperative distraction ${\geq}37.3%$ was significantly associated with collapse (p=0.009; odds ratio, 4.622; 95% confidence interval, 1.470-14.531). The average time of events were as follows: collapse, $5.8{\pm}5.7months$; subsidence, $0.99{\pm}0.50months$; and instrument failure, $9.13{\pm}0.50months$. Conclusion : We experienced a higher frequency rate of collapse than subsidence in ACDF using an allograft. Of the various preoperative factors, intra-operative distraction was the most predictable factor of the allograft collapse. This was especially true when the intraoperative distraction was more than 37%, in which case the occurrence of graft collapse increased 4.6 times. We also found that instrument failure occurs only after the allograft collapse.
Journal of the Korean society of biological therapies in psychiatry
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v.24
no.3
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pp.184-193
/
2018
Objectives : This study investigated the effects of social support and chronic medical conditions on depressive symptoms in elderly people living alone in a rural community. Methods : Sociodemographic information on 173 subjects aged 65 years or older who lived alone in a rural community and were recipients of National Basic Livelihood Security was collected and analyzed. All participants completed the Korean Form of the Geriatric Depression Scale and the Lubben Social Network Scale. Additionally, the current prevalence of chronic medical conditions that interfere with the activities of daily living was examined. Multiple logistic regression analysis was conducted to analyze the associations of social support and chronic medical conditions with depressive symptoms. Results : Social support(odds ratio: OR, 0.96; 95% confidence interval: 95% CI, 0.92-0.99) and chronic medical conditions(OR, 1.59; 95% CI, 1.23-2.05) were significantly associated with depressive symptoms in all subjects. When analyzed by gender, social support served as a protective factor against depressive symptoms in elderly men only(OR, 0.91; 95% CI, 0.83-0.99), and chronic medical conditions increased the risk of depressive symptoms in elderly women only(OR, 1.74; 95% CI, 1.26-2.40). Furthermore, osteoarthritis and lumbar pain were risk factors for depressive symptoms in all subjects(OR, 2.24; 95% CI, 1.10-4.56 and OR, 2.10; 95% CI, 1.08-4.12) and in elderly women(OR, 4.07; 95% CI, 1.68-9.84 and OR, 3.34; 95% CI, 1.47-7.57), respectively. Conclusion : This study indicates that improving the social support and managing the chronic medical conditions of elderly people living alone are important for the prevention of depression in this population. Additionally, the present results suggest that it is necessary to establish different depression-prevention strategies for elderly men and women living alone.
Yoon, Bo Ra;Park, Ji Eun;Kim, Chi Young;Park, Moo Suk;Kim, Young Sam;Chung, Kyung Soo;Song, Joo Han;Paik, Hyo-Chae;Lee, Jin Gu;Kim, Song Yee
Yonsei Medical Journal
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v.59
no.9
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pp.1088-1095
/
2018
Purpose: Post-operative pulmonary function is an important prognostic factor for lung transplantation. The purpose of this study was to identify factors affecting recovery of forced expiratory volume in 1 second (FEV1) at the first year after lung transplantation. Materials and Methods: We retrospectively reviewed the medical records of lung transplantation patients between October 2012 and June 2016. Patients who survived for longer than one year and who underwent pulmonary function test at the first year of lung transplantation were enrolled. Patients were divided into two groups according to whether they recovered to a normal range of FEV1 (FEV1 ${\geq}80%$ of predicted value vs. <80%). We compared the two groups and analyzed factors associated with lung function recovery. Results: Fifty-eight patients were enrolled in this study: 28 patients (48%) recovered to a FEV1 ${\geq}80%$ of the predicted value, whereas 30 patients (52%) did not. Younger recipients [odds ratio (OR), 0.92; 95% confidence interval (CI), 0.87-0.98; p=0.010], longer duration of mechanical ventilator use after surgery (OR, 1.14; 95% CI, 1.03-1.26; p=0.015), and high-grade primary graft dysfunction (OR, 8.08; 95% CI, 1.67-39.18; p=0.009) were identified as independent risk factors associated with a lack of full recovery of lung function at 1 year after lung transplantation. Conclusion: Immediate postoperative status may be associated with recovery of lung function after lung transplantation.
The purpose of this study is to examine the necessity of providing new perspectives by conveying the various psychological changes and realities experienced by victims of incest sexual violence after the incident, And it is meaningful to understand and record it through. The results of the analysis through the phenomenological methodology are as follows: First, participants were disturbed by the emotional neglect of their parents and forced violence, threats, and silence by their family members, resulting in disbelief in interpersonal relationships and low self-esteem and suffered constant difficulties in daily life. Second, the suffering and aftereffects of sexual violence experienced the conflict of roles by repeating the real maladjustment and social activity avoidance as the fear of being informed about the event, the negative thought about oneself, and the difficulty of interpersonal relationship. Third, the aftereffects of incest sexual violence in childhood·adolescence were found to be extreme with regard to PTSD. The PTSD experience has become a factor that forces participants to rely on substances, such as psychiatric medications and alcohol, and further avoids external activities with hallucinations and delusions. Fourth, the change through the adaptation process is a new perspective on life, facing and separating the events. During the adaptation program, they tried to express their words and feelings that they could not express because of the past hurts, to set goals for living their life, and to move forward. The experience of overcoming reality has enhanced participants' confidence in self-esteem, self-efficacy, and healthy self-control ability. In this study, it is meaningful to suggest a model in which the incest sexual violence trauma is reexperienced through the new daily crisis and the new adaptation process is repeated for each process.
Investment in public sector information services has been on the rise in recent years. The supply of high-speed Internet and smartphones has become more common, and the stability of the information system provided to the public in the public sector has become an important management factor. In other words, tasks such as handling civil complaints and issuing certificates by public institutions, financial transactions by banks, customs clearance work, and e-commerce by individuals or institutions are mostly done online. Therefore, how to deal with obstacles arising from the information system, which is in charge of important civil service affairs, is becoming a very important issue. In other words, in the case of a disability that does not function normally even for a short period of time, various problems can occur when the work is delayed, as well as causing serious financial damage to the civil petitioner. This could be accompanied by a decline in public confidence and various other damages such as filing civil complaints. The reasons for the occurrence of information system failures are very diverse and realistically difficult to predict when. Among the various measures to cope with disability, this paper proposed a plan to establish a disability situation notification system that can minimize confusion caused by disability in the event of a homepage malfunction. The proposed disability situation notification system was established in the public IDC environment to show the possibility of utilization.
Background: It is getting important to improve the oral health status of the elderly because oral health status may affect their health status of the whole body. In this respect, we aimed to explore the association of oral health status and behavior factors with self-rated health status by sex. Methods: Using the data from the 7th Korea National Health and Nutrition Examination Survey for health surveys and oral examinations (2016-2018), we analyzed a total of 3,070 people aged 65 or older (men: 1,329; women: 1,741). Our dependent variable, self-rated health status, was divided into two groups: not good (bad and very bad) and good (very good, good, and fair), whereas our independent variables of interest were oral health status and behavior factors. In addition to descriptive analysis and the Rao-Scott chi-square test, reflecting survey characteristics, we conducted hierarchical multivariable logistic regression analyses adjusted for socio-demographics and health status and behavior factors. All analyses were stratified by sex. Results: The proportion of people having 'not good' self-rated health was 36.5% in women but 24.5% in men. In a model adjusted for all covariates, the self-rated health status showed significant association with the self-rated oral health status. For example, in men, the risk of having 'not good' self-rated health was high in people having 'poor' (odds ratio [OR], 5.31; 95% confidence interval [CI], 2.34-12.03) self-rated oral health status and in those having 'fair' (OR, 4.03; 95% CI, 1.68-9.70) in comparison with those having 'good' self-rated oral health status. Dental status regarding speaking difficulty seemed to be very important in influencing self-rated health status. For instance, in women, compared to people having 'no discomfort' speaking difficulty, the risk of having 'not good' self-rated health was high in people having 'not bad' (OR, 1.60; 95% CI, 1.14-2.24) and 'discomfort' (OR, 1.79; 95% CI, 1.30-2.47) speaking difficulty. The covariates significantly associated with the risk of having 'not good' self-rated health were: physical activity, chronic disease, stress, and body mass index in both sexes; health insurance type and drinking only in men; and economic activity only in women. Conclusion: Oral health status and behavioral factors were associated with self-rated health status among the elderly, differently by sex. This suggests that public health policies toward better health in the elderly should take their oral health status and oral health behaviors into account in a sex-specific way.
Purpose: Frailty is a clinical syndrome in older adults, and adequate nutrition is a modifiable factor in preventing the condition. The current study aims to investigate the association between frailty and dietary intake in the Korean elderly. Methods: This cross-sectional study included data from the 2018 Korean National Health and Nutrition Examination Survey of 1,268 subjects (535 men and 733 women) aged 65 years or older. Frailty was defined as having more than three of the following 5 modified Fried frailty phenotype criteria: unintentional weight loss, exhaustion, walking difficulties, weakness, and low physical activity. Dietary intake was assessed by applying the one-day 24-hour dietary recall. The association between frailty and dietary intakes were analyzed by multiple logistic regression. Results: Totally, 9.7% men and 21.9% women were classified as the frail group. Increasing levels of frailty were proportional to a decreased mean nutrient adequacy ratio in both genders. Moreover, the total food intake was significantly low in the frail elderly. In male subjects, multiple logistic regression analyses after adjusting covariates showed that the odds ratio (OR) of frailty in the highest tertile of the consumption of fruits (OR [95% confidence interval, CI] = 0.34 [0.13-0.93], p-trend = 0.021) were significantly lower than values obtained in the lowest tertile. In females, the highest tertile of fish and shellfish intake showed a significantly lower OR for frailty (OR [95% CI] = 0.55 [0.30-0.99], p-trend = 0.045), as compared with the lowest tertile. Conclusion: The present study indicates that high intake of fruits for men, and fish and shellfish for women, are probably linked with lowering the risk of frailty in the elderly.
Journal of the Korean Applied Science and Technology
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v.38
no.6
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pp.1667-1677
/
2021
In this study, we tried to investigate the relationship between the cosmetology major student's major satisfaction and the professionals by analyzing the effect of the cosmetology major student's major satisfaction on the beauty professional hall. Research Results It was found that there is a correlation (p <0.001) between the degree of satisfaction of college students in the hair beauty department and the beauty professionals (p <0.001), and the satisfaction of the department is "specialty" t = 4.625 (p =). .000),'Occupational recognition' t = 3.152 (p = .002), major value is'specialty' t = 2.330 (p = .021),'professional activity' t = 2.438 (p = .015), 'Occupation recognition' t = 4.843 (p = .000), university student activity adaptation is a subordinate factor of the cosmetology profession, "professional activity" t = 2.746 (p = .006), "occupation recognition" t = 4.303 ( Appearing as p = .000), it was found that the degree of satisfaction of college students in the hair beauty department has a significant effect on beauty professionals. For cosmetology college students, major satisfaction not only leads to satisfaction with the university and department, but also to self-satisfaction and cosmetology job confidence, allowing them to adapt to social life with a positive impact, and cosmetologists are hair With the values and attitude toward the beauty profession, you will be able to become a professional officer when you are a university student majoring in cosmetology. Through the research results, the formation of a positive professional hall for college students majoring in hair beauty and the satisfaction of the major will be enhanced, and the self-development of students, as well as professors and educational relations, will be established so that beauty professionals can be established through correct theory and practical education. Education and continued guidance on the professional ethics and values of the person is considered necessary.
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