• 제목/요약/키워드: Cohort Method

검색결과 252건 처리시간 0.024초

Does Second-Generation Suspensory Implant Negate Tunnel Widening of First-Generation Implant Following Anterior Cruciate Ligament Reconstruction?

  • Sundararajan, Silvampatti Ramasamy;Sambandam, Balaji;Singh, Ajay;Rajagopalakrishnan, Ramakanth;Rajasekaran, Shanmuganathan
    • Knee surgery & related research
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    • 제30권4호
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    • pp.341-347
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    • 2018
  • Purpose: Tunnel widening following anterior cruciate ligament (ACL) reconstruction is commonly observed. Graft micromotion is an important contributing factor. Unlike fixed-loop devices that require a turning space, adjustable-loop devices fit the graft snugly in the tunnel. The purpose of this study is to compare tunnel widening between these devices. Our hypothesis is that the adjustable-loop device will create lesser tunnel widening. Materials and Methods: Ninety-eight patients underwent ACL reconstruction from January 2013 to December 2014. An adjustable-loop device was used in 54 patients (group 1) and a fixed-loop device was used in 44 patients (group 2). Maximum tunnel widening at 1 year was measured by the L'Insalata's method. Functional outcome was measured at 2-year follow-up. Results: The mean widening was 4.37 mm (standard deviation [SD], 2.01) in group 1 and 4.09 mm (SD, 1.98) in group 2 (p=0.511). The average International Knee Documentation Committee score was 78.40 (SD, 9.99) in group 1 and 77.11 (SD, 12.31) in group 2 (p=0.563). The average Tegner-Lysholm score was 87.25 (SD, 3.97) in group 1 and 87.29 in group 2 (SD, 4.36) (p=0.987). There was no significant difference in tunnel widening and functional outcome between the groups. Conclusions: The adjustable-loop device did not decrease the amount of tunnel widening when compared to the fixed-loop device. There was no significant difference in outcome between the two fixation devices. Level of Evidence: Level 3, Retrospective Cohort.

Reliability of Early Ambulation after Intradural Spine Surgery : Risk Factors and a Preventive Method for Cerebrospinal Fluid Leak Related Complications

  • Lee, Subum;Cho, Dae-Chul;Kim, Kyoung-Tae;Lee, Young-Seok;Rhim, Seung Chul;Park, Jin Hoon
    • Journal of Korean Neurosurgical Society
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    • 제64권5호
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    • pp.799-807
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    • 2021
  • Objective : Cerebrospinal fluid leakage related complications (CLC) occasionally occur after intradural spinal surgery. We sought to investigate the effectiveness of early ambulation after intradural spinal surgery and analyze the risk factors for CLC. Methods : For this retrospective cohort study, we enrolled 314 patients who underwent intradural spinal surgery at a single institution. The early group contained 79 patients who started ambulation after 1 day of bedrest without position restrictions, while the late group consisted of 235 patients who started ambulation after at least 3 days of bed rest and were limited to the prone position after surgery. In the early group, Prolene 6-0 was used as the dura suture material, while black silk 5-0 was used as the dura suture material in the late group. Results : The overall incidence rate of CLC was 10.8%. Significant differences between the early and late groups were identified in the rate of CLC (2.5% vs. 13.6%), surgical repair required (1.3% vs. 7.7%), and length of hospital stay (2.99 vs. 9.29 days) (p<0.05). Logistic regression analysis revealed that CLC was associated with practices specific to the late group (p=0.011) and the revision surgery (p=0.022). Conclusion : Using Prolene 6-0 as a dura suture material for intradural spinal surgery resulted in lower CLC rates compared to black silk 5-0 sutures despite a shorter bed rest period. Our findings revealed that suture - needle ratio related to dura defect was the most critical factor for CLC. One-day ambulation after primary dura closure using Prolene 6-0 sutures appears to be a costeffective and safe strategy for intradural spinal surgery.

청년층 세대 비교로 살펴본 가족 건강성과 기능 요구도: 1차 및 2차 에코부머를 중심으로 (A generational comparison of young adults' needs for family strengths and functions : A study on 1st and 2nd echoboomers)

  • 강민지;유계숙
    • 한국가족관계학회지
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    • 제23권3호
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    • pp.131-152
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    • 2018
  • Objectives: The purpose of this study was to compare the first echo boomer to second in the needs for family strengths and family functions, after controlling the sociodemographic characteristics. Method: For this study, a survey was conducted with 406 never-married young adults, which has 182 first echo boomers and 224 seconds echo boomers as using the same self-report questionnaire. Results: First, the two echo boomer groups exhibited similar patterns in their perception of the three family strengths, positive family values, pursuit of coexistence, and spiritual value, in that order. On the other hand, in regard to family functions, groups' perceived emotion entertainment leisure function as core functions of the family, but the second echo boomers, unlike the first echo boomers, expressed a higher need for economic functions rather than functions for children generation. Second, the analysis of this study indicated that, even in cases where first and second echo boomers had the same social-demographic characteristics, the latter in contrast with the former tended not to regard spiritual values such love for shared ethical values, compassion, and religious beliefs as a family strength, and did not require functions for children generation of the family. Conclusions: From these findings, the differences in the needs for family strengths and functions expressed by the two generations belonging to two different birth cohorts were influenced by various changes in Korean society occurring between the two generations, such as the social divergence in the functions of care and nurture, the increase in one-person and childless households, and the weakening of kinship-centered or communitarian forms of familism.

청소년의 자아존중감이 삶의 만족도에 미치는 영향: 이타심과 자기통제에 의한 또래관계의 조절된 매개효과 검증 (The Influence of Adolescents' Self-Esteem on Life Satisfaction: Verifying Moderated Mediation of Peer Relations Mediated by Altruism and Self-Regulation)

  • 허미정;노미화;최연실
    • 한국가족관계학회지
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    • 제21권1호
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    • pp.29-49
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    • 2016
  • Objectives: The purpose of this study was aimed to examine the effect of self-esteem on life satisfaction and happiness among adolescents, and to verify moderated mediation of peer relations mediated by altruism and self-regulation. Method: The study referred to the 2015 Annual Report of the Korean Children and Youth Panel Survey. More precisely, report on the fourth year research process of the study cohort comprising 2,091 subjects was used to verify the research model. Overall data were analyzed by using SPSS 18.0 program and specifically, moderated mediation were verified by using SPSS Macro, as suggested by Preacher, etc. (2008). Results: As a result, firstly, the peer relations mediated the relationship between life satisfaction and self-esteem among adolescents. Secondly, altruism and self-regulation had moderated mediation effects between self-esteem and peer relations among adolescents. Conclusion: These results suggest that self-esteem affects on life satisfaction and happiness by mediation of peer relations among adolescents and altruism and self-regulation agent is applied positive adjustment to further promote the peer relations and increase life satisfaction among adolescents. Through these study results, the implications for counseling and suggestions for future research were discussed.

임신 여성의 적응에 관한 Giorgi의 기술적 현상학 연구 (Adaptation in pregnant women: a descriptive phenomenological study using Giorgi's approach)

  • 고민선;김지순;안숙희
    • 여성건강간호학회지
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    • 제26권4호
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    • pp.346-357
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    • 2020
  • Purpose: This descriptive phenomenological study aimed to explore the lived experience and meaning of pregnant women's adaptation. Methods: Ten pregnant women from an ongoing Pregnant Couples' Cohort Study agreed to participate in this study. The data were collected through telephone in-depth interviews regarding what they experienced and felt about pregnancy adaptation. The qualitative data were analyzed using Giorgi's method of descriptive phenomenology. Results: Five core situation components were extracted from the raw data, along with 12 themes and 33 focal meanings. The five core situations were 1) first recognizing the pregnancy, 2) pregnancy-related changes, (3) the upcoming birth, 4) the postpartum period, and 5) parenting. The 12 themes were as follows: "anxiety, pressure, and embarrassment due to pregnancy," "efforts to adapt to physical changes," "efforts to adapt to the psychological difficulties of pregnancy," "efforts to adapt to the financial burden and role changes caused by pregnancy," "connecting with the fetus," "adapting to a new marital relationship centering on the baby," "the frustration of childbirth," "fear of childbirth," "postpartum care, need help with lactation planning," "parenting beyond what I imagined," "dad's willingness to participate in parenting," and "career disconnect and consideration of workplace needs." Conclusion: We identified that pregnant women experience adaptation in physical, psychological, relational, and social aspects. The thematic clusters identified can be used to develop nursing interventions to promote women's adaptation to pregnancy.

Risk Factors for the Severity of Complications in Minimally Invasive Total Gastrectomy for Gastric Cancer: a Retrospective Cohort Study

  • Roh, Chul Kyu;Lee, Soomin;Son, Sang-Yong;Hur, Hoon;Han, Sang-Uk
    • Journal of Gastric Cancer
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    • 제21권4호
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    • pp.352-367
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    • 2021
  • Purpose: Minimally invasive gastrectomy is a promising surgical method with well-known benefits, including reduced postoperative complications. However, for total gastrectomy of gastric cancers, this approach does not significantly reduce the risk of complications. Therefore, we aimed to evaluate the incidence and risk factors for the severity of complications associated with minimally invasive total gastrectomy for gastric cancer. Materials and Methods: The study included 392 consecutive patients with gastric cancer who underwent either laparoscopic or robotic total gastrectomy between 2011 and 2019. Clinicopathological and operative characteristics were assessed to determine the features related to postoperative complications after minimally invasive total gastrectomy. Binomial and multinomial logistic regression models were used to identify the risk factors for overall complications and mild and severe complications, respectively. Results: Of 103 (26.3%) patients experiencing complications, 66 (16.8%) and 37 (9.4%) developed mild and severe complications, respectively. On multivariate multinomial regression analysis, independent predictors of severe complications included obesity (OR, 2.56; 95% CI, 1.02-6.43; P=0.046), advanced stage (OR, 2.90; 95% CI, 1.13-7.43; P=0.026), and more intraoperative bleeding (OR, 1.04; 95% CI, 1.02-1.06; P=0.001). Operation time was the only independent risk factor for mild complications (OR, 1.06; 95% CI, 1.001-1.13; P=0.047). Conclusions: The risk factors for mild and severe complications were associated with surgery, indicating surgical difficulty. Surgeons should be aware of these potential risks that are related to the severity of complications so as to reduce surgery-related complications after minimally invasive total gastrectomy for gastric cancer.

소아 성대결절의 음성치료 효과에 미치는 예후 인자 (Predictive Factors for the Efficacy of Voice Therapy for Pediatric Vocal Fold Nodule)

  • 윤창빈;김영모;최정석;김지원
    • 대한후두음성언어의학회지
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    • 제32권3호
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    • pp.130-134
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    • 2021
  • Background and Objectives Voice therapy (VT) is considered to be the gold standard of treatment of vocal fold nodule in children. This study was designed to analyze the success rate of pediatric VT and investigate the predictive factors for good response of periatic VT for vocal fold nodule. Materials and Method This was a retrospective cohort study of 23 patients under 18 years old who were diagnosed with vocal fold nodule and received pediatric VT. We divided the patients into responding and non-responding groups. We analyzed clinical and voice parameters related to the voice results. Results Twelve patients showed improved findings after VT. By univariate analysis, female patients (85.7%) and adolescence children (100%) showed a good response to VT. In multivariate analysis, female sex (p<0.05) and adolescence children (p<0.05) were significantly related to a successful voice response. Proton pump inhibitor or antihistamine, mucolytics treatment and pre-VT voice parameters did not significantly influence voice outcomes. Conclusion Pediatric VT is more effective in female and adolescence children.

The benefit of platelet-rich plasma injection over institution-based physical therapy program in adhesive capsulitis patients with diabetes mellitus: prospective observational cohort study

  • Barman, Apurba;Mukherjee, Somnath;Sinha, Mithilesh K;Sahoo, Jagannatha;Viswanath, Amrutha
    • Clinics in Shoulder and Elbow
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    • 제24권4호
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    • pp.215-223
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    • 2021
  • Background: The objective of this study was to compare the efficacy of platelet-rich plasma (PRP) injection with an institution-based physical therapy (PT) program for adhesive capsulitis (AC) of the shoulder in patients with diabetes mellitus (DM). Methods: A total of seventy diabetic patients with AC of the shoulder for <6 months were assigned to two groups: PRP group and PT group. In the PRP group, 35 patients were administered a single shot of PRP (4 mL) into the glenohumeral joint. In the PT group, 35 patients were given institution-based PT that included 10 30-minute sessions of planned PT over a 2-week period. After the interventions, all patients were prospectively followed for 12 weeks. Intensity of shoulder pain, function, and range of motion were assessed at baseline and then at 3, 6, and 12 weeks. Results: Thirty-three patients in the PRP group and 32 in the PT group completed the 12-week study. At 12 weeks, patients who received PRP injections showed greater improvement in shoulder pain (p<0.001) than those recruited to the PT group. In the range of motion and shoulder function activities, patients in the PRP group showed significant improvement compared with the institution-based PT group (p<0.001). No significant complications were reported from any groups. Conclusions: In a diabetic population, PRP injections significantly improved shoulder pain and function compared with an institution-based PT program for shoulder AC. Additionally, it is a safe and well-tolerated method for AC management for diabetic patients.

Vitamin D intake and bone mineral density in Korean adults: analysis of the 2009-2011 Korea National Health and Nutrition Examination Survey

  • Hyejin, You;Hye Ran, Shin;SuJin, Song;Sun Yung, Ly
    • Nutrition Research and Practice
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    • 제16권6호
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    • pp.775-788
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    • 2022
  • BACKGROUND/OBJECTIVES: The prevalence of vitamin D deficiency in Koreans is quite high; however, until recently, Korean National Health and Nutrition Survey (KNHANES) had not analyzed the vitamin D intake among Koreans. Additionally, the Korean Dietary Reference Intake for vitamin D was established based on insufficient evidence. Therefore, we investigated vitamin D intake and its relationship with bone mineral density (BMD) in Korean adults using the combined data from the 2009-2011 KNHANES. MATERIALS AND METHODS: This study was conducted in 11,949 healthy adults. Vitamin D intake was assessed using a 24-h recall method, and the BMD was measured using dual-energy X-ray absorptiometry. RESULTS: The prevalence of vitamin D deficiency (< 20 ng/mL) was 64% in men and 77% in women. In women aged ≥ 50 yrs and men aged < 50 yrs, there was a significant positive correlation between vitamin D intake and serum 25-hydroxyvitamin D level after sun exposure adjustment. The BMD of postmenopausal women aged ≥ 50 yrs with a vitamin D intake of 5 ㎍/day or more was significantly higher than that of women with intake less than 5 ㎍/day. After adjusting for age, energy, and calcium intake, the vitamin D intake of the osteoporotic group was significantly lower than that of the osteopenia group in women. CONCLUSIONS: Since the relationship between vitamin D intake and BMD was observed in women aged ≥ 50 yrs, further research is needed to clarify these findings using cohort or randomized controlled trials.

Traditional Korean Medicine Usage and Perception: a comparative study between the general population and the disabilities

  • Han, Ji-Eun;Kim, Jihye;Kim, Kyeong Han;Lee, Ji-Yeon;Sung, Soo-Hyun
    • 대한약침학회지
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    • 제25권1호
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    • pp.24-36
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    • 2022
  • Objectives: This study is a comparative analysis of the satisfaction and recognition characteristics for traditional Korean medicine (TKM) in people with disabilities and the general population of Korea. Methods: Here, 5,000 subjects were categorized into two groups based on a disability rating using the data from the 2017 National Survey for the Usage of Korean Medicine. The relationships among the sociodemographic characteristics, TKM usage status, recognition of TKM usage, and recognition of the effectiveness of the TKM treatment were analyzed based on the disease. The response reliability was verified using the chi-square test analysis method. Results: Disabilities corresponded with low rates of high school or higher education (44%, 83.5%) and no jobs (56.9%, 33.5%), mostly the status of the low-income class with a monthly household income of < 1,500 USD (50.9%, 10.5%), poor health conditions (55.2%, 9.8%), high chronic disease prevalence rate (69.0%, 19.9%), high medical care rate (11.2%, 0.5%), and low commercial health insurance subscription rate (44%, 74.2%). Furthermore, people with disabilities visited TKM institutions more often (88.8%, 74.1%) with a high frequency TKM usage rate of ≥ 1-2 times a month (26.2%, 15.3%). They also reported that the cost of using the TKM was very high (14.7%, 8.8%) and that primarily the application of insurance benefits should be improved (52.6%, 47.5%). The treatment effectiveness for diseases was high for musculoskeletal disorders for both people with disabilities and the general population. Conclusion: Preferential application of insurance benefits for musculoskeletal diseases must be extended to the TKM treatment as well, as people with disabilities have a high recognition for these conditions with TKM. It is difficult to perform randomized controlled trials on people with disability. Therefore, large-scale observational and cohort studies should be conducted. We hope this study will help establish a suitable TKM policy for people with disabilities.