• 제목/요약/키워드: Comprehensive Risk Analysis

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Assessment of the Quality of Esophago-gastric Anastomosis by Endoscopic Examination -Cervical Versus Intrathoracic Anastomosis- (내시경을 통한 식도-위 문합술의 질 평가-경부와 흉부 문합의 비교-)

  • Shim, Jae-Hoon;Kim, Hyun-Koo;Baek, Man-Jong;Kim, Hark-Jei;Choi, Young-Ho
    • Journal of Chest Surgery
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    • v.39 no.12 s.269
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    • pp.920-926
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    • 2006
  • Background: Mortality and morbidity of anastomotic complications after esophagectomy have gradually decreased in recent years. However, swallowing difficulties and reflux symptoms after esophagogastrostomy continue to be a burden jeopardizing the quality of life. In the present study, we evaluated the quality of esophagogastrostomy by analyzing anastomotic stenosis and reflux esophagitis. Material and Method: A retrospective analysis was made in 74 patients who underwent esophagogastrostomy after esophagectomy by one surgeon between January 1995 and December 2004. 53 patients of them received endoscopic examination during follow-up($29{\pm}23.6$ months, range $5{\sim}111$ months). Reflux esophagitis and stenosis at anastomostic site were analyzed according to the techniques and locations of esophagogastrostomy. Result: The median age at the time of repair was $60.3{\pm}8.87$ years(range $39{\sim}81$ years). 23 patients received a hand-sewn esophagogastric anastomosis and 30 patients a circular stapled one. There was no significant statistical difference in terms of anastomotic stenosis(p=0.64) and reflux esophagitis(p=0.41) between the two groups. Cervical anastomosis was peformed in 26 patients and intrathoracic anastomosis in 27 patients. No significant statistical difference in anastomotic stenosis between the two groups was found(p=0.44), but reflux esophagitis was noted in 3 patients in the cervical anastomosis group and 14 patients in the intrathoracic anastomosis group(p=0.003). Conclusion: Cervical anastomosis was supposed to have a better quality of esophagogastrostomy by lowering the risk of reflux esophagitis. In the future, the comprehensive study including a patient's subjective symptom and Barrett's metaplasia should be performed in larger cases.

Development of evaluation items for adolescents' dietary habits and nutritional practices reflecting eating behaviors and food environment (식행동, 식생활 환경을 반영한 청소년의 식생활·영양 실천 평가 항목 개발)

  • Jimin Lim;Hye Ji Seo;Jieun Oh
    • Journal of Nutrition and Health
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    • v.57 no.1
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    • pp.136-152
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    • 2024
  • Purpose: A comprehensive evaluation item was developed to assess adolescent dietary habits and nutritional practices, considering food intake, eating behaviors, and food culture, such as social support and food environment. Methods: The 59 candidate items of the evaluation checklist were obtained based on the results of the eighth Korea National Health and Nutrition Examination Survey data, Korea Dietary Reference Intakes, dietary guidelines for adolescents, Youth Risk Behavior Survey data, national nutrition policies and dietary guidelines, and literature reviews. Four hundred and three middle and high school students residing in metropolitan areas participated in a survey using the 58-item checklist, which was selected through expert evaluation and content validity ratio analysis. The construct validity of the assessment tool for the quality of adolescent diets was assessed by exploratory factor analyses to determine if the checklist items were organized properly and whether the responses to each item were distributed adequately. Results: The Bartlett sphericity test was significant for each area (p <0.001), and the eigen values were greater than one. The Kaiser-Meyer-Olkin and cumulative proportions by areas were food intake (0.765 and 56.8%, respectively), eating behaviors (0.544 and 64.8%, respectively), and food environment (0.699 and 62.4%, respectively). Twenty-two checklists were determined for the final evaluation items for the adolescents' dietary habits and nutritional practices and were categorized into three distinct factors: food intake (10 items), eating behaviors (4 items), and food environment (8 items). Conclusion: The evaluation items for adolescent dietary habits and nutritional practices is a useful checklist for easily and quickly assessing the dietary qualities and reflecting Korean adolescents and their food environmental factors related to a sustainable diet.