• 기본간호학회지
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• 제25권2호
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• pp.134-145
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• 2018

Purpose: The purpose of this study was to investigate gender related factors that influence regular exercise adherence in patients with coronary artery disease. Methods: This secondary analysis study used data from the 2013~2015 Korea National Health and Nutrition Examination Survey (KNHANES). Three hundred and eighty patients over 20 years of age and having coronary artery disease were selected for this study. Measures included questions about regular exercise, general characteristics, health behaviors, and health status. Data were analyzed using descriptive analysis, Rao-Scott $x^2$ statistic, and multiple logistic regression analysis with the SPSS 21.0 program. Results: The results were as follows. Men did more regular exercise than women (58.8% vs 40.1%). The multivariate-adjusted Odds Ratios (OR) for regular exercise adherence in men were 2.93 (95% CI: 1.39~6.17) for non smokers and 3.06 (95% CI: 1.53~6.13) for men with 0 to 1 comorbidities. Women had a high odds ratios of 0.38 (95% CI: 0.18~0.82) for not using alcohol and 2.10 (95% CI: 1.03~4.29) for no back pain. Conclusion: To improve regular exercise adherence in patients with coronary artery disease, it is necessary to develop different approaches considering gender.

• 대한치과마취과학회지
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• 제10권1호
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• pp.7-12
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• 2010

Background: This study was carried out to contribute to effective management of operated patients by analyzing cooperative details about patients who were taken elective operation and consulted to the department of anesthesiology. Patients and Methods: One thousand patients who have been consulted to department of Anesthesiology, Chonnam National University Hospital from 2008. November to 2009. March were analyzed. The gender, age, cooperative departments, cooperative reason, the number of cancelled cases and cancelled reason were evaluated. Results: Among 1000 patients, there were 470 females and 530 males. After adjusting for age, middle-aged people which range 45 to 64 year-old are 39.9% and over 65 year-old people are 30.3%. Cooperative department is distributed to orthopedics which is highest occupying 20.6%, neurosurgery, otorhinolaryngology, obstetrics and gynecology in order. Dentistry occupied 2.0%. By specifying reasons of cooperation, cardiovascular diseases distribute to 38.4% which is the highest, the respiratory diseases, 17.5% and the endocrine diseases including diabetes 13.2%. Arranging details, hypertension is 23.9%, ECG abnormality 14.5%, chronic bronchitis in chest radiographic interpretation 14.2%. Of 1,000 consulted patients, delayed or cancelled cases are 58. And the reasons were 26 cases of need of appropriate the blood-sugar level. 26 cases needed appropriate treatment for comorbidities and others 6. Conclusion: Thoroughly evaluating patients before operation and maintenace of active cooperative system between operative department and anesthesiology department can contribute to reduction of cancellation rate and effective management of both hospitalizing and operating rooms.

• Asian Pacific Journal of Cancer Prevention
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• 제14권10호
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• pp.6109-6114
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• 2013

Aim: To determine whether beta-blockers (BBs) improve the overall survival (OS) of patients with metastatic non-small cell lung cancer (NSCLC). Materials and Methods: The medical charts of 107 patients with metastatic NSCLC were retrospectively assessed. Thirty-five patients (BB group) using BBs during chemotherapy (CT) were compared with 72 controls [control=(C) group] who did not use BBs following the diagnosis of NSCLC. The histological tumor subtype, performance status (ECOG), age, gender, smoking status, comorbidities, other medications and chemotherapeutics that were received in any line of treatment were recorded. We compared the overall survival (OS) of the patients in the BB and C groups. Results: The mean age of the patients was 61 years (range 42-81 years) and all patients were administered CT. The BB group was more likely to have HT and IHD and was more likely to use RAS blockers (p<0.01 for all) compared with the C group, as expected. The mean follow-up time was 17.8 months (range 1-102 months) for the entire group. The most commonly prescribed BB agent was metoprolol (80% of cases). At the time of the analysis, 74 (69%) of all patients had died. In the univariate analysis the median overall survival (OS) was 19.25 (${\pm}2.87$) months (95%CI: 13.62-24.88) in the BB group and 13.20 (${\pm}2.37$) months (95%CI: 8.55-17.85) in the C group (p=0.017). However, the benefit of BBs on survival disappeared in the multivariate analysis. Conclusions: The use of BBs during CT may be associated with an improved OS for patients with metastatic NSCLC.

• Asian Pacific Journal of Cancer Prevention
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• 제16권4호
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• pp.1355-1360
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• 2015

Background: The number of cancer survivors is increasing globally and recently, higher rates of comorbidities in cancer survivors have been reported. However, no studies have investigated whether cancer survivors have a higher risk of chronic kidney disease (CKD). Accordingly, our study evaluated the association between cancer survivors and the risk of CKD using the 2010-2012 Korean National Health and Nutrition Examination Survey. Materials and Methods: A total of 11,407 participants aged 40 years and over were categorized into two groups according to cancer experience. Multiple variables were compared and the odds ratios (ORs) for CKD prevalence were calculated using a weighted logistic regression analysis between the two groups. Results: Cancer survivors were older than were those in the non-cancer group, on average, the percentages of glomerular filtration rate(GFR) lower than $60mL/min/1.73m^2$, proteinuria, and CKD were significantly higher in cancer survivors when compared to controls. Weighted logistic regression analyses demonstrated that cancer survivors had a higher risk for CKD after adjusting for multiple variables (OR (95% confidence interval), 2.88 (1.48-5.59)). Conclusions: Our study demonstrated a possible association between CKD and cancer survival in Korean adults. Identifying and correcting risk factors for cancer survivors would positively affect prevention of CKD and result in a better cancer prognosis.

• Journal of Korean Neurosurgical Society
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• 제57권3호
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• pp.192-196
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• 2015

Objective : Tremor is a common movement disorder that interferes with daily living. Since the medication for tremor has some limitations, surgical intervention is needed in many patients. In certain patients who cannot undergo aggressive surgical intervention, Gamma Knife thalamotomy (GKT) is a safe and effective alternative. Methods : From June 2012 to August 2013, 7 patients with an intractable tremor underwent GKT. Four of these 7 patients had medical comorbidities, and 3 patients refused to undergo traditional surgery. Each patient was evaluated with the modified Fahn-Tolosa-Marin tremor rating scale (TRS) along with analysis of handwriting samples. All of the patients underwent GKT with a maximal dose of 130 Gy to the left ventralis intermedius (VIM) nucleus of the thalamus. Follow-up brain MRI was performed after 3 to 8 months of GKT, and evaluation with the TRS was also performed. Results : Six patients showed objective improvement in the TRS score. Excluding one patient who demonstrated tremor progression, there was 28.9% improvement in the TRS score. However, five patients showed subjective improvement in their symptoms. On comparing the TRS scores between follow-up periods of more and less than 4 months, the follow-up TRS score at more than 4 months of GKT was significantly improved compared to that at less than 4 months of GKT. Follow-up MRI showed radiosurgical changes in 5 patients. Conclusion : GKT with a maximal dose of 130 Gy to the VIM is a safe procedure that can replace other surgical procedures.

• Journal of Korean Neurosurgical Society
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• 제59권5호
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• pp.498-504
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• 2016

Objective : Although subdural hematoma (SDH) is commonly treatable by burr hole surgery in the late subacute or chronic stage, there is no clear consensus regarding appropriate management and exact predictive factors for postoperative recurrence also remain unclear. The aim of this study was to evaluate risk factors associated with recurrence of SDH that requires burr hole surgery in the late subacute or chronic stage. We also identified the appropriate timing of surgery for reducing the recurrence. Methods : We retrospectively reviewed 274 patients with SDH in the late subacute or chronic stage treated with burr hole surgery in our hospital between January 2007 and December 2014. Excluding patients with acute intracranial complications or unknown time of trauma onset left 216 patients included in the study. Results : Of 216 patients with SDH in the late subacute or chronic stage, recurrence was observed in 36 patients (16.7%). The timing of the operation in patients with late subacute stage (15-28 days) resulted in a significant decrease in recurrence (RR, 0.33; 95% CI, 0.17-0.65; p=0.001) compared to chronic stage (>28 days). Otherwise, no significant risk factors were associated with recurrences including comorbidities and surgical details. Conclusion : The results indicated that time from trauma onset to burr hole surgery may be important for decreasing the risk of recurrence. Therefore, unless patients can be treated conservatively without surgery, prompt surgical management is recommended in patients diagnosed as having late subacute or chronic subdural hematoma treatable by burr hole surgery, even when neurological deficits are unclear.

• Journal of Korean Neurosurgical Society
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• 제60권2호
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• pp.239-249
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• 2017

Objective : The purpose of this study is to evaluate the associations between 30-day mortality and various radiological and clinical factors in patients with traumatic acute subdural hematoma (SDH). During the 11-year study period, young patients who underwent surgery for SDH were followed for 30 days. Patients who died due to other medical comorbidities or other organ problems were not included in the study population. Methods : From January 1, 2004 to December 31, 2014, 318 consecutive surgically-treated traumatic acute SDH patients were registered for the study. The Kaplan-Meier method was used to analyze 30-day survival rates. We also estimated the hazard ratios of various variables in order to identify the independent predictors of 30-day mortality. Results : We observed a negative correlation between 30-day mortality and Glasgow coma scale score (per 1-point score increase) (hazard ratio [HR], 0.60; 95% confidence interval [CI], 0.52-0.70; p<0.001). In addition, use of antithrombotics (HR, 2.34; 95% CI, 1.27-4.33; p=0.008), history of diabetes mellitus (HR, 2.28; 95% CI, 1.20-4.32; p=0.015), and accompanying traumatic subarachnoid hemorrhage (hazard ratio, 2.13; 95% CI, 1.27-3.58; p=0.005) were positively associated with 30-day mortality. Conclusion : We found significant associations between short-term mortality after surgery for traumatic acute SDH and lower Glasgow Coma Scale scores, use of antithrombotics, history of diabetes mellitus, and accompanying traumatic subarachnoid hemorrhage at admission. We expect these findings to be helpful for selecting patients for surgical treatment of traumatic acute SDH, and for making accurate prognoses.

• Archives of Plastic Surgery
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• 제42권5호
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• pp.619-625
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• 2015

Background The reconstruction of ankle and heel defects remains a significant problem for plastic surgeons. The following options exist for reconstructing such defects: local random flaps, reverse flow island flaps, and free flaps. However, each of these methods has certain drawbacks. Peroneal artery perforators have many advantages; in particular, they are predictable and reliable for ankle and heel reconstructions. In this study, we report our clinical experience with peroneal artery perforator-based pedicled flaps in ankle and heel reconstructions. Methods From July 2005 to October 2012, 12 patients underwent the reconstruction of soft tissue defects in the ankle and heel using a peroneal artery perforator-based pedicled flap. These 12 cases were classified according to the anatomical area involved. The cause of the wound, comorbidities, flap size, operative results, and complications were analyzed through retrospective chart review. Results The mean age of the patients was 52.4 years. The size of the flaps ranged from $5{\times}4$ to $20{\times}8cm^2$. The defects were classified into two groups based on whether they occurred in the Achilles tendon (n=9) or heel pad (n=3). In all 12 patients, complete flap survival was achieved without significant complications; however, two patients experienced minor wound dehiscence. Nevertheless, these wounds healed in response to subsequent debridement and conservative management. No patient had any functional deficits of the lower extremities. Conclusions Peroneal artery perforator-based pedicled flaps were found to be a useful option for the reconstruction of soft tissue defects of the ankle and heel.

• 대한한방내과학회지
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• 제34권3호
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• pp.240-255
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• 2013

Objectives : This study was performed to research trends in Korean medicine treatment of diabetes mellitus (DM). Methods : We reviewed 73 studies about diabetes mellitus, which had been published from 2008 to 2013. The article search was performed on the Korean institute of oriental medicine (KIOM) database. Results : 1. Patterns of study design were as follows : 14 review studies, 44 experimental studies, 7 clinical studies, 8 case reports. 2. From the 14 review studies, we noted that literature studies about definition, pathologic mechanism, treatment, pathologic pattern identification of DM and previous study analyses were done. 3. From the 44 experimental studies that are the most common type of DM studies, various Korean medicine treatments such as single medicinal herbs, herbal complexes, diets and pharmacopuncture were used. Anti-diabetic effects were demonstrated in most of the studies. 4. 7 clinical studies about acupuncture, electroacupuncture, herbal medicine, etc. were reported. 5. 8 cases about DM complications and comorbidities were reported. Clinical symptoms improved in all of studies, blood sugar level decreased in four studies. Conclusions : Further clinical and case study based on experimental researches should be performed.

• Journal of Preventive Medicine and Public Health
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• 제48권4호
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• pp.188-194
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• 2015

Objectives: The goal of this study was to identify association between the continuity of ambulatory care of diabetes patients in South Korea (hereafter Korea) and the incidence of macrovascular complications of diabetes, using claims data compiled by the National Health Insurance Services of Korea. Methods: This study was conducted retrospectively. The subjects of the study were 43 002 patients diagnosed with diabetes in 2007, who were over 30 years of age, and had insurance claim data from 2008. The macrovascular complications of diabetes mellitus were limited to ischemic heart disease and ischemic stroke. We compared the characteristics of the patients in whom macrovascular complications occurred from 2009 to 2012 to the characteristics of the patients who had no such complications. Multiple logistic regression was used to assess the effects of continuity of ambulatory care on diabetic macrovascular complications. The continuity of ambulatory diabetes care was estimated by metrics such as the medication possession ratio, the quarterly continuity of care and the number of clinics that were visited. Results: Patients with macrovascular complications showed statistically significant differences regarding sex, age, comorbidities, hypertension, dyslipidemia and continuity of ambulatory diabetes care. Visiting a lower number of clinics reduced the odds ratio for macrovascular complications of diabetes. A medication possession ratio below 80% was associated with an increased odds ratio for macrovascular complications, but this result was of borderline statistical significance. Conclusions: Diabetes care by regular health care providers was found to be associated with a lower occurrence of diabetic macrovascular complications. This result has policy implications for the Korean health care system, in which the delivery system does not work properly.