• Asian Pacific Journal of Cancer Prevention
• /
• 제16권17호
• /
• pp.7765-7768
• /
• 2015

This study was conducted to determine the incidence of wound complications after laparotomy for endometrial cancer and significant predictors of risks. Medical records of patients with endometrial cancer undergoing laparotomy for surgical staging at Srinagarind Hospital, Khon Kaen University between January 2007 and December 2013 were reviewed. Intravenous antibiotic prophylaxis was routinely given 30 minutes before surgery. The primary endpoint was wound complications (including seroma, hematoma, separation, or infection) requiring additional medical and/or surgical management within 4 weeks of laparotomy. During the study period, 357 patients with complete medical records were reviewed. The mean age was 56.9 years. Wound complications were observed in 28 patients (7.84%, 95% CI, 5.27% to 11.14%). Body mass index (BMI) ${\geq}30kg/m^2$, diabetes mellitus (DM), and prior abdominal surgery were observed as significant independent factors predicting an increased risk of wound complications with adjusted odds ratios (95% CIs) of 2.96 (1.23-7.16), 2.43 (1.06-5.54), and 3.05 (1.03-8.98), respectively. In conclusion, the incidence of wound complications after laparotomy for endometrial cancer was 7.8%. Significant independent predictors of risk included BMI, DM and prior abdominal surgery.

• Journal of Preventive Medicine and Public Health
• /
• 제48권2호
• /
• pp.84-93
• /
• 2015

Objectives: The present study was conducted in order to examine the association between socioeconomic status (SES) and osteoporosis prevalence in Korea and to assess whether different associations are found in single-person households. Methods: A cross-sectional population-based study was conducted using the Korea National Health and Nutrition Examination Survey, from 2008 to 2011. The study subjects were people aged ${\geq}50$ years with osteoporosis as defined by bone mineral density. Multivariate logistic models were used to estimate prevalence odds ratios (pORs) and 95% confidence intervals (CIs). Gender differences in the likelihood of osteoporosis were analyzed based on household income, education level, and residential area. Results: There were 8221 osteoporosis patients aged ${\geq}50$ years, of whom 927 lived in single-person households. There was a gender-specific association between osteoporosis prevalence and all three SES factors that we analyzed: income, education, and residential area. After adjusting for age, SES, and health behaviors, including body mass index (BMI), low household income was only significantly associated with osteoporosis in men, whereas education level had an inverse relationship with osteoporosis only in women (p=0.01, p<0.001, respectively). However, after controlling for age and BMI, rural residency was only associated with osteoporosis in women living in single-person households (pOR, 1.59; 95% CI, 1.05 to 2.43). Conclusions: The Korean adult population showed a gender-specific relationship between SES and osteoporosis prevalence, with a different pattern found in single-person households.

• Journal of Medicine and Life Science
• /
• 제16권3호
• /
• pp.96-100
• /
• 2019

Postural tachycardia syndrome (POTS) is common, although not so well-known variant of cardiovascular autonomic disorder characterized by an excessive heart rate increase on standing. POTS is probably underdiagnosed due to the heterogeneity in both presentation and etiology. This study aimed to evaluate the clinical and autonomic features in patients with POTS. We reviewed the medical records of patients with POTS. Medical records include onset age, sex, presenting symptoms, body mass index (BMI) and prognosis. All patients had an autonomic function and laboratory tests. Ninety-nine patients met the inclusion criteria for POTS (51.5% male; mean±SD age, 20.0±9.7 years; mean±SD, BMI 21.9±3.9). Common presenting symptoms were a brief loss of consciousness, dizziness, blurred vision and headache. Autonomic function tests showed abnormal quantitative sudomotor axon reflex testing in 20 patients of 99 POTS patients. The abnormal post-ganglionic sympathetic sudomotor function is generally considered to reflect a neuropathic form of POTS. In treatments, 83 patients were treated by non-pharmacological management including lifestyle changes and 16 patients required the initiation of pharmacological therapies. Most patients with POTS showed a relatively favorable prognosis. POTS is a chronic disease with a substantial subset of patients recovering within a few years after the initial presentation. Future efforts should focus on better understanding of POTS pathophysiology and designing randomized controlled trials for the selection of more effective therapy.

• Journal of Oral Medicine and Pain
• /
• 제42권1호
• /
• pp.1-7
• /
• 2017

Purpose: The aims of this study were to evaluate the clinical characteristics and polysomnographic results of patients visited the Seoul National University Dental Hospital (SNUDH) and to suggest guidelines for the management of sleep disordered-breathing patients in a dental clinic. Methods: Five hundred sixty-two patients who visited the Snoring and Sleep Apnea Clinic of SNUDH were evaluated for clinical characteristics including associated comorbidities, age, gender, body mass index (BMI), neck circumference, and daytime sleepiness and among them 217 patients were performed nocturnal polysomnography for evaluating respiratory disturbance index, apnea-hypopnea index (AHI), oxygen saturation levels, and sleep stages. The associations among clinical characteristics, sleep parameters, and positional and rapid eye movement (REM) dependencies of the patients were analyzed. Results: The most common co-morbidities of the patients were cardiovascular (30.2%), endocrine (10.8%), and respiratory diseases (7.9%). Age (${\beta}=0.394$), total AHI (${\beta}=0.223$), and lowest $O_2$ saturation levels (${\beta}=0.205$) were significantly associated with the number of co-morbidities in patients with obstructive sleep apnea (OSA). Mean $O_2$ saturation was not significantly associated with number of co-morbidities. Non-positional OSA patients had higher BMI, longer neck circumferences, more severe AHI values, and lower mean and lowest $O_2$ saturation levels compared to positional OSA patients. Not-REM-related patients were older and had more severe AHI values compared to REM-related patients. Not-REM-related patients have longer duration of stage I sleep and shorter stage II, III, and REM sleep than REM-related patients. There were no significant differences in each sleep stage between positional and non-positional patients. Neck circumference, positional dependency, REM dependency, and percentage of supine position were significantly associated with severity of OSA. Conclusions: Age, total AHI, and lowest $O_2$ saturation level were significantly associated with the number of co-morbidities in patients with OSA. Neck circumference, positional dependency, REM dependency, and percentage of supine position were significantly associated with severity of OSA.

• 수면정신생리
• /
• 제29권1호
• /
• pp.4-8
• /
• 2022

Obesity hypoventilation syndrome (OHS) is defined as the triad of obesity (body mass index, [BMI] ≥ 30 kg/m²), daytime hypercapnia (PaCO2 ≥ 45 mm Hg), and sleep breathing disorder, after excluding other causes for hypoventilation. As the obese population increases worldwide, the prevalence of OHS is also on the rise. Patients with OHS have poor quality of life, high risk of frequent hospitalization and increased cardiopulmonary mortality. However, most patients with OHS remain undiagnosed and untreated. The diagnosis typically occurs during the 5th and 6th decades of life and frequently first diagnosed in emergency rooms as a result of acute-on-chronic hypercapnic respiratory failure. Due to the high mortality rate in patients with OHS who do not receive treatment or have developed respiratory failure, early recognition and effective treatment is essential for improving outcomes. Positive airway pressure (PAP) therapy including continuous PAP (CPAP) or noninvasive ventilation (NIV) is the primary management option for OHS. Changes in lifestyle, rehabilitation program, weight loss and bariatric surgery should be also considered.

• 한국방사선학회논문지
• /
• 제10권7호
• /
• pp.477-482
• /
• 2016

유방촬영검사(Mammography)에서 선량지표를 분석하여 한국식품의약품안전처(Korea Food & Drug Administ ration)에서 제시하는 가이드라인과 비교분석하여 의료방사선의 관리가 잘 이루어지고 있는지 파악하고자 하였다. 방법으로는 유방촬영검사를 시행한 후 의료영상저장정보시스템(Picture Archiving Communication System, PACS)으로 전송되어진 선량 보고서(dose report)와 의료전자차트(Electronic Medical Record, EMR)를 참고하여 양쪽 유방 상하방향촬영(cranio-caudal, CC), 내외 사방향 촬영(medio-lateral oblique, MLO)검사에서 관전압(kVp), 조사시간(exposure time), 관전류량(mAs), 유방압박두께(compressed breast thickness), 평균유선선량(average glandular dose), 체질량지수(Body Mass Index, BMI)를 분류하여 분석하였다. 결과적으로 연령별에 따른 검사부위 CC, MLO에서 유방압박두께는 50-59세에서 45.6 mm, 49.6 mm로 가장 두껍게 나타났으며 전체적인 평균유방압박두께는 CC에서 44.2 mm, MLO 48.9 mm로 MLO가 4.7 mm 더 두껍게 나타났다. 평균유선선량은 CC에서 1.05 mGy, MLO에서 1.14 mGy로 CC보다 MLO에서 0.09 mGy가 더 높게 나타났으며 유방압박두께가 10 mm 증가할수록 CC와 MLO에서는 0.15 mGy, 0.17 mGy가 증가하는 것으로 나타났다. 한국식품의약품안전처에서 제시하는 유방 CC에서 1매 촬영 시 환자가 받는 평균유선선량 1.16 mGy 평가와 비교했을 시 1.05 mGy로 나타났으나 60 mm이상에서는 1.30 mGy로 초과하는 것으로 나타났다. 또한 유방압박두께가 높을수록 체질량지수가 높게 나타났으며 체질량지수에 따른 비만기준 25이상인 경우는 유방압박두께가 50 mm 이상일 경우에 비만인 것으로 나타났다.

• 보건교육건강증진학회지
• /
• 제31권5호
• /
• pp.81-95
• /
• 2014

Objectives: The purpose of this study was to apply participatory action-oriented training (PAOT) principle for the management of metabolic syndrome and to assess its effectiveness in the workplace. Methods: The metabolic syndrome management program applying participatory action-oriented training (PAOT) principle is constructed action checklist, Group discussion, self-creation of an action plan, after 3 months, 6 months, 1 year, the practice carried out check up and encourage practice activity. Results: The seventy-seven workers who participated in the metabolic syndrome management program made a total of 246 action plans, 3.8 action plans per person and 234 action plans were achieved after one year, so that 81.0% of action plans have been achieved. After 1 year, in the intervention group, systolic blood pressure (SBP) and diastolic blood pressure (DBP), body mass index (BMI), the risk factors score decreased statistically significant, and metabolic syndrome prevalence decreased 54.8%. whereas the control group also showed a significant decreased in the mean systolic and diastolic blood pressure, the risk factors score. but, low-density lipoprotein (LDL) was significantly increased. Conclusions: To improve the effectiveness of metabolic syndrome management program applying participatory action-oriented training (PAOT) principle, the need to continues implementing programs and analysis of the long-term effects are required. Participatory action-oriented training (PAOT) principle can applying without cost and time, the human burden for the prevention and management of chronic diseases such as metabolic syndrome.

• 정신신체의학
• /
• 제14권1호
• /
• pp.47-52
• /
• 2006

연구목적 : 우울증상은 여성에게 흔하며 적절한 혈당 조절은 당뇨병 치료에 있어 매우 중요하다. 당뇨병 환자에서 우울증은 상대적으로 흔히 발견된다. 그러나 아직 우울증과 혈당조절의 상호관계에 대해서는 명확히 밝혀진 바가 없다. 본 연구는 한국 여성 당뇨병 환자의 혈당 조절과 우울증상 사이의 상호관계를 평가하려 한다. 방법: 여성 당뇨병 환자 216명을 포함한 연구 대상자 4,567명을 대상으로 Beck 우울 척도와 장기 혈당조절 지표인 $HbA_{1c}$ 수치를 측정하여 우울증과 혈당조절간의 연관성을 분석하였다. 공복 혈당 수치와 비만도 지표인 체질량지수도 함께 측정하여 분석하였다. 임상적으로 우울증을 의심할 수 있는 분할점은 16점으로 하였다. 결과: 당뇨병 보유 여성군에서 우울 여성군이 유의미하게 많았고(P<0.001), Beck우울 척도 평균치도 통계적으로 유의하게 높았다(p<0.001). 우울 여성군에서 $HbA_{1c}$, 평균치 (p<0.01)와 공복 혈당 평균치 (p<0.05)가 유의미하게 높았고, 혈당 조절의 장애가 심할 수록 우울 여성군의 비율이 증가하는 경향을 보였다(p=0.001). 결론: 본 연구는 한국 여성에서 우울증상과 당뇨병 및 혈당 조절간 연관성이 존재함을 지지하는 결과를 보였다. 향후 종적 연구를 통한 우울장애와 당뇨병간 상호작용에 대한 원인-결과론적 이해가 요구된다.

• Tuberculosis and Respiratory Diseases
• /
• 제70권6호
• /
• pp.474-481
• /
• 2011

Background: Chronic obstructive pulmonary disease (COPD) is characterized by air low limitation, which is one of the leading causes of mortality worldwide. There have been many studies on survival rates in the world literature, but there have been few reports regarding the survival rate in Korean patients with COPD. Acute exacerbation is regarded as a risk factor for mortality in patients with COPD. The purpose of this study was to investigate the survival rate and the effect of acute exacerbations on the survival rate of Korean patients with COPD. Methods: A total of 502 COPD patients who were diagnosed on the basis of history and lung function tests were enrolled in this study. The frequency of acute exacerbations, body mass index (BMI), C-reactive protein (CRP) and pulmonary hypertension were analyzed. Results: The 3- and 5-year survival rates were 98% and 83%, respectively. The median survival time was 78 months. The median survival time was 55 months in 322 patients with one or more acute exacerbations. The 3- and 5-year survival rates were significantly lower in the 322 patients with one or more acute exacerbations than in those without any. The mortality rate was significantly higher in patients with CRP>3 mg/L than in those with CRP ${\leq}3$ mg/L (p<0.005); it was significantly higher in patients with pulmonary hypertension than in those without it (p<0.01). Conclusion: Because the 5-year survival rate is 83% in Korean patients with COPD, the management of stable patients with COPD should focus on the prevention of acute exacerbations.

• 한국산학기술학회논문지
• /
• 제20권4호
• /
• pp.320-328
• /
• 2019

본 연구는 출산한 산모를 대상으로 골밀도와 골밀도에 영향을 미치는 특성을 조사하여 출산 후 골다공증 예방을 위한 기초자료를 제공하고자 한다. 최종 137명의 의무기록을 분석한 서술적 조사연구이다. 대상자의 일반적, 산과적 특성에 따른 T-score의 차이는 independent t-test와 one way ANOVA로, 사후분석은 Scheffe test로 실시하였다. 연구 대상자들의 평균 연령은 32.4세였고 T-score 평균값은 0.34였다. 출산 후 4주째 측정한 BMI에서 저체중군은 정상군과 과체중군에 비해 골밀도가 유의하게 높게 나타났고(F=11.935, p<.001). 비타민 D가 충분한 대상자는 부족한 대상자보다 부족한 대상자는 결핍인 대상자보다 골밀도가 유의하게 높은 것으로 나타났다(F=4.906, p=0.009). 유산경험이 없는 경우가 1회 이상인 경우보다 골밀도가 유의하게 높은 것으로 나타났고(t=4.264, p<.001) 자연분만을 한 경우가 제왕절개수술을 한 경우보다 골밀도가 유의하게 높은 것으로 나타났다(t=2.019, p=.046). 본 연구 결과를 바탕으로 임신과 출산과정 중 골밀도에 영향을 미치는 특성을 바탕으로 출산한 산모의 골다공증 관리 예방프로그램개발이 필요할 것이다.