• Journal of Periodontal and Implant Science
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• v.49 no.5
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• pp.287-298
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• 2019

Purpose: The aim of this retrospective study was to determine the prevalence of early implant failure using a single implant system and to identify the factors contributing to early implant failure. Methods: Patients who received implant treatment with a single implant system ($Luna^{(R)}$, Shinhung, Seoul, Korea) at Dankook University Dental Hospital from 2015 to 2017 were enrolled. The following data were collected for analysis: sex and age of the patient, seniority of the surgeon, diameter and length of the implant, position in the dental arch, access approach for sinus-floor elevation, and type of guided bone regeneration (GBR) procedure. The effect of each predictor was evaluated using the crude hazard ratio and the adjusted hazard ratio (aHR) in univariate and multivariate Cox regression analyses, respectively. Results: This study analyzed 1,031 implants in 409 patients, who comprised 169 females and 240 males with a median age of 54 years (interquartile range [IQR], 47-61 years) and were followed up for a median of 7.2 months (IQR, 5.6-9.9 months) after implant placement. Thirty-five implants were removed prior to final prosthesis delivery, and the cumulative survival rate in the early phase at the implant level was 95.6%. Multivariate regression analysis revealed that seniority of the surgeon (residents: aHR=2.86; 95% confidence interval [CI], 1.37-5.94) and the jaw in which the implant was placed (mandible: aHR=2.31; 95% CI, 1.12-4.76) exerted statistically significant effects on early implant failure after adjusting for sex, age, dimensions of the implant, and type of GBR procedure (preoperative and/or simultaneous) (P<0.05). Conclusions: Prospective studies are warranted to further elucidate the factors contributing to early implant failure. In the meantime, surgeons should receive appropriate training and carefully select the bone bed in order to minimize the risk of early implant failure.

• Archives of Plastic Surgery
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• v.49 no.2
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• pp.158-165
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• 2022

Background Implant-based breast reconstruction has evolved tremendously in the last decades, mainly due to the development of new products and techniques that make the procedure safer and more reliable. The purpose of this study was to compare the outcomes in immediate one-stage breast reconstruction between acellular dermal matrix (ADM) and inferior dermal flap (IDF). Methods We conducted a retrospective comparative study of patients submitted to immediate breast reconstructions with an anatomical implant and ADM or IDF in a single center between 2016 and 2018. Outcomes evaluated included major complications, early complications, reinterventions, readmissions, and reconstruction failure. Simple descriptive statistics and univariate analysis were performed. Results A total of 118 breast reconstructions (85 patients) were included in the analysis. Patients in the IDF group had a higher body mass index (median = 27.0) than patients in the ADM group (median = 24). There were no statistically significant differences among both groups regarding immediate major complication, early complications, readmissions, and reinterventions. Conclusion There are no significant differences in complications between the ADM and IDF approach to immediate implant breast reconstruction. In patients with higher body mass index and large, ptotic breasts, we recommend an immediate implant reconstruction with IDF.

• Annals of Hepato-Biliary-Pancreatic Surgery
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• v.26 no.4
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• pp.333-338
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• 2022

Backgrounds/Aims: Bile duct stones (BDS) can be managed either prior to laparoscopic cholecystectomy (LC) using endoscopic retrograde cholangiopancreatography (ERCP) or with laparoscopic bile duct exploration (LBDE) at the time of LC. The latter is underutilised. The aim of this study was to use the dataset of the previously performed CholeS study to investigate LBDE hospital volumes, LBDE-to-LC rates, and LBDE outcomes. Methods: Data from 166 United Kingdom/Republic of Ireland hospitals were used to study the utilisation of LBDE in LC patients. Results: Of 8,820 LCs performed, 932 patients (10.6%) underwent preoperative ERCP and 256 patients (2.9%) underwent LBDE. Of the 256 patients who underwent LBDE, 73 patients (28.5%) had undergone prior ERCP and 112 patients (43.8%) had undergone prior magnetic resonance cholangiopancreatography. Fifteen (9.0%) of the 166 included hospitals performed less than five LBDEs in the two-month study period. LBDEs were mainly performed by upper gastrointestinal surgeons (84.4%) and colorectal surgeons (10.0%). Eighty-seven percent of the LBDEs were performed by consultants and 13.0% were performed by trainees. The laparoscopic-to-open conversion rate was 12.5%. The median operation time was 111 minutes (range: 75-155 minutes). Median hospital stay was 6 days (range: 4-11 days) for emergency LBDEs and 1 day (range: 1-4 days) for elective LBDEs. Overall morbidity was 21.5%. Bile leak rate was 5.3%. Thirty-day readmission and mortality rates were 12.1% and 0.4%, respectively. Conclusions: The single-stage approach to managing BDS was underutilised. An additional prospective study with a longer study period is needed to verify this finding.

• Journal of Cerebrovascular and Endovascular Neurosurgery
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• v.26 no.1
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• pp.85-96
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• 2024

Objective: Congenital intracranial pial arteriovenous fistula (PAVF) is a rare cerebral vascular pathology characterized by a direct shunt between one or more pial feeding arteries and a cortical draining vein. Transarterial endovascular embolization (TAE) is widely considered first line therapy. Curative TAE may not be achievable in the multi-hole variant due to the potential to harbor innumerable small feeding arteries. Transvenous embolization (TVE) may be considered to target the final common outlet of the lesion. Here, we present a series of four patients with complex multi-hole congenital PAVF treated with staged TAE followed by TVE. Methods: A retrospective review was conducted on patients who underwent treatment for congenital, multi-hole PAVFs treated by a combined TAE/TVE approach at our institution since 2013. Results: We identified four patients with multi-hole PAVF treated by a combined TAE/TVE. Median age was 5.2 (0-14.7) years. Median follow-up of 8 (1-15) months by catheter angiography and 38 (23-53) months by MRI/MRA was obtained. TVE achieved complete occlusion in three patients that proved durable on radiographic follow-up and demonstrated excellent clinical outcomes with a modified Rankin Score (mRS) of 0 or 1. Complete occlusion of the draining vein was not achieved by TVE in one case. This patient is graded as pediatric mRS=5 three years post-procedure. Conclusions: With thorough technical considerations, our series indicates that TVE of multi-hole PAVF that are refractory to TAE is feasible and effective in arresting the consequences of chronic, high-flow AV shunting produced by this pathology.

• Journal of Chest Surgery
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• v.57 no.5
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• pp.430-439
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• 2024

Background: This study investigated the incidence and clinical consequences of abnormal radiological and clinical findings during routinely performed 6-week outpatient visits in patients treated conservatively for multiple (3 or more) rib fractures. Methods: A retrospective analysis was conducted among patients with multiple rib fractures treated conservatively between 2018 and 2021 (Opvent database). The primary outcome was the incidence of abnormalities on chest X-ray (CXR) and their clinical consequences, which were categorized as requiring intervention or additional clinical/radiological examination. The secondary focus was the incidence of deviation from standard treatment in response to the findings (clinical or radiological) at the routine 6-week outpatient visit. Results: In total, 364 patients were included, of whom 246 had a 6-week visit with CXR. The median age was 57 years (interquartile range, 46-70 years) and the median Injury Severity Score was 17 (interquartile range, 13-22). Forty-six abnormalities (18.7%) were found on CXR. These abnormalities resulted in additional outpatient visits in 4 patients (1.5%) and in chest drain insertion in 2 (0.8%). Only 2 patients (0.8%) with an abnormality on CXR presented without symptoms. None of the 118 patients who had visits without CXR experienced problems. Conclusion: Routine 6-week outpatient visits for patients with conservatively treated multiple rib fractures infrequently revealed abnormalities requiring treatment modifications. It may be questioned whether the 6-week outpatient visit is even necessary. Instead, a more targeted approach could be adopted, providing follow-up to high-risk or high-demand patients only, or offering guidance on recognizing warning signs and providing aftercare through a smartphone application.

• Journal of Korean Neurosurgical Society
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• v.58 no.6
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• pp.499-503
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• 2015

Objective : The transradial catheterization (TRC) is becoming widespread, primarily for neurointerventions. Therefore, the evaluation of radial artery puncture in clinical practice and a better understanding of the anatomy are important to improve the safety of neuroendovascular surgery. Methods : Ten formalin-fixed adult Korean cadavers were dissected to expose radial artery (RA), brachial artery (BrA) and subclvian artery (ScA), bilaterally. Vessel lengths and diameters were meaured using a caliper and distance between the specific point of vessels and the anatomical landmarks including the radial styloid process, the medial epicondyle of the humerus, the sternoclavicular joint, and the vertebral artery orifice were also measured. Results : The average length between the radial (RAPS) and the BrA puncture sites (BrAPS) and between the vertebral artery orifice (VAO) and the BrA bifurcation (BrAB) did not differ between sides (p>0.05). The average length between the radial styloid process (RSP) and the RAPS was $13.41{\pm}2.19mm$, and the RSP was $26.85{\pm}2.47mm$ from the median nerve (MN). The mean length between the medial epicondyle (ME) and the BrAPS as $44.23{\pm}5.47mm$, whereas the distance between the ME and the MN was $42.23{\pm}4.77mm$. The average VAO-ScA angle was $70.94{\pm}6.12^{\circ}$, and the length between the ScA junction (SCJ) and the VAO was $60.30{\pm}8.48mm$. Conclusion : This study provides basic anatomical information about the radial artery and the brachial route and can help improving new techniques, selection of size and shape of catheters for TRC. This can help neurointerventionists who adopt a transradial neuroendovascular approach and offers comprehensive and safe care to their patients.

• Archives of Craniofacial Surgery
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• v.19 no.2
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• pp.108-113
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• 2018

Background: The aim of our retrospective study is to evaluate the management of isolated orbital floor fractures considering the clinical, functional and aesthetic results according to the surgical approach and the type of materials used. Methods: Retrospectively, clinical, radiological, surgical, and ophthalmological data from 79 patients were collected from January 2010 to December 2016. Furthermore, included patients were interrogated on functional and aesthetic satisfaction. Results: The main causes of trauma were physical aggression followed by accidents. The median time between trauma and surgery was 4 days. The most common surgical approaches were the subciliary and the transconjunctival ones. Alloplastic materials were used in 75 patients. In two patients, we used a combination of two grafts. Patients experienced minor immediate complications. On follow-ups, none of our patients suffered from ocular movement restrictions. Patients treated by subciliary approach had higher risk of retractile scaring compared to other surgical approaches. In our study, patients agreed to complete a questionnaire assessing functional and aesthetic outcomes with a high satisfaction score. No association between the implant material used and the results has been assessed. Conclusion: This study describes the results of orbital floor reconstructions. Despite a variety of materials used and surgical approaches performed, we believe that the transconjunctival approach is the most suitable option with a high satisfaction score.

• Research in Community and Public Health Nursing
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• v.29 no.3
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• pp.359-370
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• 2018

Purpose: The purpose of this study is to identify effects of the variables of Health Action Process Approach (HAPA) Model on physical activity. Methods: This study has conducted a systematic literature review and meta-analysis. Sixteen articles were searched through electronic databases (PsycINFO, PubMed, CINAHL, Web of science, Science Direct, RISS, KMBASE, KoreaMed, KISS, DBpia) and additional journals from 2000 to July, 2017. To estimate the effect size (ES), the meta-analysis of the studies was performed by using Comprehensive Meta-Analysis programs. Results: The overall effect size of the variables of HAPA on physical activity was median (ES=.28). Of the core variables of HAPA model, action control (ES=.43) showed the largest effect size, followed by coping self-efficacy (ES=.31) and planning (ES=.31).Additional variables were identified as preparatory behavior (ES=.39) and past physical activity (ES=.24). Through the moderator effect analysis, the effect size was higher in the volitional phase than in the motivational phase, and higher in the healthy group than in the patient group. The higher the proportion of males and the lower the age, the larger the effect size. Conclusion: This finding shows empirical evidence that all core variables of the HAPA model are useful for predicting physical activity. We propose the use of the HAPA model to develop physical activity promotion intervention.

• Journal of the Korean Home Economics Association
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• v.34 no.4
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• pp.327-343
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• 1996

The objective of this study were 1) to determine the stages of concern of HE teachers about the practical problem-based curriculum approach, as illustrated by the Ohio's Work and Family Life Curriculum (W&FLC); 2) to determine the relationships between home economics (HE) teacher's stages of concern about W&FLC and personal and professional characteristics of HE teachers; and 3) to determine aspects of interest about the practical problem-based curriculum approach, such as the Ohio W&FLC. Respondents in this study were 225 HE teachers. The data were collected during the in-service teacher training sessions after presentation about W&FLC. Concerns Based Adoption Model (CBAM) was modified to provide a conceptual framework for this study. Frequencies, SD, mean, mode, range were used to determine the stages of concern of HE teachers. To determine the relationships between stages of concerns and personal and professional characteristics of HE teachers, coefficient of Chi-Square contingency tables was used. Content analysis was used to determine aspects of interest about the practical problem-bsed curriculum approach, such as W&FLC. The median of the stages of HE teachers' concerns about W&FLC was Stage 1, Information Stage. About 60% of HE teachers were interested in learning more details about W&FLC. Chi-square revealed no statistically significant relationships between stages of concerns about W&FLC and characteristics of HE teachers. Content analysis was used to determine aspects of interest about W&FLC of HE teachers. Nine categories were found: content, teaching strategies, implementation of the curriculum, philosophical framework, how to adopt W&FLC, resource materials, students' outcomes, in-service teacher training, and HE teacher organization. The majority of HE teachers were interested in relationships with family and others, resource management, family relationships, personal development, communication skill, family life, creating a self-identity, life planning, roles of family members, homemaking management, child care, and parenting.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.18 no.3
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• pp.249-257
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• 2017

Filtering the data for travel time records obtained from DSRC probes is essential for a better estimation of the link travel time. This study addresses the major deficiency in the performance of TRANSGUIDE in removing anomalous data. This algorithm is unable to handle unstable traffic flow conditions for certain time intervals, where fluctuations are observed. In this regard, this study proposes an algorithm that is capable of overcoming the weaknesses of TRANSGUIDE. If TRANSGUIDE fails to validate sufficient number of observations inside one time interval, another process specifies a new validity range based on the median absolute deviation (MAD), a common statistical approach. The proposed algorithm suggests the parameters, ${\alpha}$ and ${\beta}$, to consider the maximum allowed outlier within a one-time interval to respond to certain traffic flow conditions. The parameter estimation relies on historical data because it needs to be updated frequently. To test the proposed algorithm, the DSRC probe travel time data were collected from a multilane highway road section. Calibration of the model was performed by statistical data analysis through using cumulative relative frequency. The qualitative evaluation shows satisfactory performance. The proposed model overcomes the deficiency associated with the rapid change in travel time.