• Title/Summary/Keyword: Incidence rates

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Concomitant open distal clavicle excision is associated with greater improvement in range of motion without increased risk of acromial stress fracture after reverse total shoulder arthroplasty: a retrospective cohort study

  • Ajay C. Kanakamedala;Dhruv S. Shankar;Neil Gambhir;Matthew R. Boylan;Michael Boin;Matthew G. Alben;Mandeep S. Virk;Young W. Kwon
    • Clinics in Shoulder and Elbow
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    • v.26 no.4
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    • pp.357-365
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    • 2023
  • Background: The purpose of this study was to evaluate the effect of concomitant open distal clavicle excision (DCE) on postoperative clinical outcomes and incidence of acromial and scapular stress fractures (ASFs) in patients with symptomatic acromioclavicular joint osteoarthritis (ACJ OA) undergoing reverse total shoulder arthroplasty (RTSA). Methods: A single-surgeon retrospective cohort study was conducted including patients who underwent primary elective RTSA with or without DCE from 2015 to 2019 with a minimum 6-month follow-up period. Shoulder active range of motion (AROM) and visual analog scale (VAS) pain were recorded preoperatively and postoperatively. ASFs and other adverse events were identified using postoperative notes and/or radiographs. Characteristics and outcomes were compared between the RTSA and RTSA-DCE groups. Results: Forty-six RTSA patients (mean age, 67.9±8.7 years; 60.9% male; mean follow-up, 24.9±16.6 months) and 70 RTSA-DCE patients (mean age, 70.2±8.9 years; 20.0% male; mean follow-up, 22.7±12.9 months) were included. There were no significant intergroup differences in rates of ASF (RTSA, 0.0% vs. RTSA-DCE, 1.4%; P=1.00), stress reactions (RTSA, 8.7% vs. RTSA-DCE, 11.4%; P=0.76), reoperation, revision, or infection (all P>0.05), or in pre-to-postoperative reduction in VAS pain (P=0.17) at latest follow-up. However, the RTSA-DCE group had greater pre-to-postoperative improvement in flexion AROM (RTSA, 43.7°±38.5° vs. RTSA-DCE, 59.5°±33.4°; P=0.03) and internal rotation (IR) AROM (P=0.02) at latest follow-up. Conclusions: Concomitant DCE in RTSA improves shoulder flexion and IR AROM, alleviates shoulder pain, and does not increase the risk of ASFs. Level of evidence: III.

Is antibiotic prophylaxis necessary after endoscopic ultrasound-guided fine-needle aspiration of pancreatic cysts?

  • Seifeldin Hakim;Mihajlo Gjeorgjievski;Zubair Khan;Michael E. Cannon;Kevin Yu;Prithvi Patil;Roy Tomas DaVee;Sushovan Guha;Ricardo Badillo;Laith Jamil;Nirav Thosani;Srinivas Ramireddy
    • Clinical Endoscopy
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    • v.55 no.6
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    • pp.801-809
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    • 2022
  • Background/Aims: Current society guidelines recommend antibiotic prophylaxis for 3 to 5 days after endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) of pancreatic cystic lesions (PCLs). The overall quality of the evidence supporting this recommendation is low. In this study, we aimed to assess cyst infection and adverse event rates after EUS-FNA of PCLs among patients treated with or without postprocedural prophylactic antibiotics. Methods: We retrospectively reviewed all patients who underwent EUS-FNA of PCLs between 2015 and 2019 at two large-volume academic medical centers with different practice patterns of postprocedural antibiotic prophylaxis. Data on patient demographics, cyst characteristics, fine-needle aspiration technique, periprocedural and postprocedural antibiotic prophylaxis, and adverse events were retrospectively extracted. Results: A total of 470 EUS-FNA procedures were performed by experienced endosonographers for the evaluation of PCLs in 448 patients, 58.7% of whom were women. The mean age was 66.3±12.8 years. The mean cyst size was 25.7±16.9 mm. Postprocedural antibiotics were administered in 274 cases (POSTAB+ group, 58.3%) but not in 196 cases (POSTAB- group, 41.7%). None of the patients in either group developed systemic or localized infection within the 30-day follow-up period. Procedure-related adverse events included mild abdominal pain (8 patients), intra-abdominal hematoma (1 patient), mild pancreatitis (1 patient), and perforation (1 patient). One additional case of pancreatitis was recorded; however, the patient also underwent endoscopic retrograde cholangiopancreatography. Conclusions: The incidence of infection after EUS-FNA of PCLs is negligible. Routine use of postprocedural antibiotics does not add a significant benefit.

Prevalence and Management of Venous Rupture Following Percutaneous Transluminal Angioplasty in Dysfunctional Arteriovenous Access: A Comparative Study of Primary Patency Rates with Non-Ruptured Access Circuits (동정맥루 기능 부전에서 경피적 혈관성형술 후 발생한 정맥 파열의 유병률 및 관리: 파열되지 않은 혈관과의 일차 개통 비교 연구)

  • Yoon Soo Park;Seung Boo Yang;Chae Hoon Kang;Dong Erk Goo
    • Journal of the Korean Society of Radiology
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    • v.85 no.4
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    • pp.746-753
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    • 2024
  • Purpose This study aims to evaluate the incidence and management of venous ruptures after percutaneous transluminal angioplasty (PTA) for dysfunctional arteriovenous (AV) access. Materials and Methods From January 1998 to December 2015, 13506 PTA, mechanical thrombectomy, and thrombolysis procedures were performed in 6732 patients. The venous rupture rate following PTA was obtained, and access circuit primary patency (ACPP) was compared according to the etiology (PTA, thrombotic occlusion, and treatment type) of the venous rupture present. Results Venous rupture developed in 604 of the 13506 procedures. Venous ruptures were more frequent in female, AV graft cases, and in cases accompanied by thrombosis. Balloon tamponade was performed in 604 rupture cases, and stents were deployed in 119 cases where contrast extravasation and flow stasis persisted. ACPP was significantly better in the non-ruptured AV access circuits than in the ruptured group. However, AV access type and thrombosis was not associated with primary patency. In ruptured cases, ACPP is 8.4 months for prolonged balloon tamponade and 11.2 months for bare-metal stent insertion, showing statistically significant difference. Conclusion Balloon tamponade and bare-metal stent placement are effective treatment for PTA-induced venous ruptures. In particular, stent placement showed a similar ACPP to that of non-ruptured AV access circuits.

A Study of the HI Antibody of the Koreans and Swine to Reovirus (한국인 및 가축(돼지)에 있어 Reovirus에 대한 HI 항체분석)

  • Lee, Yun-Tai;Lee, Chong-Hoon
    • The Journal of the Korean Society for Microbiology
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    • v.15 no.1
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    • pp.77-84
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    • 1980
  • The purpose of this paper is to study the incidence of humoral antibody to reovirus type 2 in the sera of the Koreans and animal(swine) at random. All the 614 of human beings and 877 of swine sera were collected during the period from June to December, 1979, from the healthy persons in the National Seoul Hospital and swine blood was collected from 25 different areas of June to 30th of September in 1977. The HI test was put with plastic plates according to the methods by Rosen(1960 a and 1974). The total 73.29% of the 614 cases in human and the 61.80% of the 877 in swine confirmed as a hemagglutination inhibition antibodies. In human the 76.47% of the 442 male cases and the 65.12% of the 172 female ones were confirmed to have humoral antibodies. The positive rate was widely shown in each age group. But the 31 to 50 old age groups showed a little higher than any other age group, which came to the 85.71% in 41-50 and the 78.72% in 31-40 old age groups. The monthly distribution of HI antibody was shown to reach the 93.22% of the 59 cases in June. This per cent was much higher than of any other distribution. Accordingly, the auther came to the conclusion that there is reovirus type 2 in all the parts of Korea and most of the Koreans have the higher rates of antibody. However, the positive rate of antibody was the 542 out of the 877 cases(61.8%) from the swine and antibodies was confirmed from the 25 different areas in Korea. The seasonal distribution of the antibody showed these high rates. In domestics animals; blood from the swine showed that distribution of HI antibodies to reoviras type 2. These antibody appears from the various areas of the province in Korea. For this reasons, reovirus was widely distributed in this country.

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Prevalence Report of Transovarian Transmitted Diseases in the Breeder Chickens, Korea (국내 종계에서 난계대 전염병 감염 실태 보고)

  • Kwon, Yong-Kuk;Kang, Min-Soo;Oh, Jae-Young;Jung, Byeong-Yeal;Kim, Hye-Ryoung;Kim, Ha-Young;Shin, So-Yeon;Kwon, Jun-Hun;Chung, Gab-Soo
    • Korean Journal of Poultry Science
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    • v.37 no.3
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    • pp.237-245
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    • 2010
  • A survey of transovarially transmitted diseases, including salmonellosis [(pullorum disease; PD)/(fowl typhoid; FT)], mycoplasmosis, avian infectious anemia (CIA), and fowl adenovirus infection was conducted in the breeder chickens from August to December in 2009. The numbers of flocks sampled out were: Grand Parents Stock (GPS), 45; Parents Stock (PS) 1,018, Baeksemi breeder (BSB) 54. The seroprevalence of salmonellosis (PD/FT) were 0% (GPS), 3.2% (PS), and 3% (BSB), respectively. A total of 983 chicken farms were affected with FT outbreaks between 2000 and 2008. The incidence of FT in commercial broilers, Baeksemi, commercial layers, native chickens, and broiler breeders was 44.3%, 26.2%, 15.7%, 12.6% and 1.08%, respectively. Of the affected broilers, over 90% birds were under 2 weeks of age, indicating it was possible that they were infected with S. gallinarum via vertical transmission. The sero-positive flocks against Mycoplasma gallisepticum (MG) were 71.1% (GPS), 88.7% (PS), 88.7% (BSB), while the rates of positive flocks against Mycoplasma synoviae (MS) were 86.0% (GPS), 77.0% (PS), and 98.0% (BSB). In GP and parent farms, the detection rates on specific genes of CIA virus were 19/45 (42.2%), and 169/1039 (18.0%), respectively, whereas the seroprevalence of CIA were 86.0% in GPS and 93.7% in PS flocks. In addition, positive flocks of fowl adenoviruses were 4.4% (GPS), 2.7% (PS) and 9.35% (BSB), respectively. As the results, avian mycoplasmosis and CIA have been more prevailing in chicken breeder than avian salmonellosis and fowl adenovirus infection in Korea.

Comparision of Maternal Charcteristics and Birth Weight among Five Different Categories of Medical Facility for Delivery in Taegu (대구시내 각급 의료기관에서 분만하는 산모들의 특성 및 출산결과의 비교 분석)

  • Song, Jung-Hup;Park, Jung-Han;Kim, Gui-Yeon;Kim, Jang-Rak
    • Journal of Preventive Medicine and Public Health
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    • v.21 no.1 s.23
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    • pp.10-20
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    • 1988
  • This study was conducted to compare the maternal charactristics, and birth weight of infants delivered at five different categories of medical facility in Taegu to examine the risk level of pregnant women and children by the medical facility for delivery. The study population included 1,410 pregnant women who delivered a baby at one of nine medical facilities (3 university hospitals, 2 general hospitals, 2 private clinics, 1 midwife clinic, 1 MCH center) in Taegu in April, 1987(April and May, 1987 for K university hospital), Pregnant women were interviewed to ask the age and educational level of woman, payment of medical fee, birth order, delivery method. Birth weight of infant was obtained from medical record. Mean ages of the women delivering at the university hospitals(27.5 years) and at general hospitals(26.7 years) were higher than those at midwife clinic(25.4 years) and at MCH center(26.1 years). Also, mean years of school education were higher in women of university hospitals(12.7 years) and general hospitals (12.2 years) than in women of midwife clinic(9.2 years) and MCH center (9.3 years). The percentages of women covered by the medical insurance were far greater in the university hospitals(78.1%) and general hospitals(82.9%) than in private clinics(44.3%) , midwife clinic(29.1%) and MCH center (5.4%). Infants born at the MCH center were mostly the second birth (47.3%) while 56.0% to 61.7% of infants born at all the other medical facilities were the first birth more women delivering at the university hospitals had history of spontaneous abortion as well as still birth than the women delivering at the other medical facilities. The preform birth rate (11.4%) and low birthweight incidence rates(5.8-13.0%) in university hospitals were significantly higher than those of other medical facilities. Accordingly, c-section rates showed a wide variation among the medical facilities. Study findings revealed that most of women delivering at the university hospitals and general hospitals are in the middle of or upper socio-economic class and obstetrically high risk group regardless of socioeconomic class while the wome delivering at the midwife clinic and MCH center are low risk group of low socioeconomic class. Therefore, the data of a specific medical facility are highly limited in interpretation and can not be generalized.

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Clinical Analysis of Disease Recurrence for the Patients with Secondary Spontaneous Pneumothorax (이차성 자연기흉 환자의 재발양상에 관한 분석)

  • Ryu, Kyoung-Min;Kim, Sam-Hyun;Seo, Pil-Won;Park, Seong-Sik;Ryu, Jae-Wook;Kim, Hyun-Jung
    • Journal of Chest Surgery
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    • v.41 no.5
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    • pp.619-624
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    • 2008
  • Background: Secondary spontaneous pneumothorax is caused by various underlying lung diseases, and this is despite that primary spontaneous pneumotherax is caused by rupture of subpleural blebs. The treatment algorithm for secondary pneumothorax is different from that for primary pneumothorax. We studied the recurrence rate, the characteristics of recurrence and the treatment outcomes of the patients with secondary spontaneous pneumothorax. Material and Method: Between March 2005 to March 2007, 85 patients were treated for their first episodes of secondary spontaneous pneumothorax. We analyzed the characteristics and factors for recurrence of secondary spontaneous pneumothorax by conducting a retrospective review of the medical records. Result: The most common underlying lung disease was pulmonary tuberculosis (49.4%), and the second was chronic obstructive lung disease (27.6%), The recurrence rate was 47.1% (40/85). The second and third recurrence rates were 10.9% and 3.5%, respectively. The mean follow up period was $21.1{\pm}6.7$ months (range: $0{\sim}36$ month). For the recurrence cases, 70.5% of them occurred within a year after the first episode. The success rates according to the treatment modalities were thoracostomy 47.6%, chemical pleurodesis 74.4%, blob resection 71% and Heimlich valve application 50%. Chemical pleurodesis through the chest tube was the most effective method of treatment. The factor that was most predictive of recurrence was 'an air-leak of 7 days or more' at the first episode. (p=0.002) Conclusion: The patients who have a prolonged air-leak at the first episode of pneumothorax tend to have a higher incidence of recurrence. Further studies with more patients are necessary to determine the standard treatment protocol for secondary spontaneous pneumothorax.

Radiotherapy for Nasopharyngeal Carcinoma (비인강암의 방사선치료 성적)

  • Lee, Myung-Za;Chun, Ha-Chung
    • Radiation Oncology Journal
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    • v.21 no.4
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    • pp.269-275
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    • 2003
  • Purpose: To evaluate the results of radiation management on recurrence, survival and prognostic factors of patients with nasopharyngeal cancer Materials and Methods: Forty-nine patients, treated for nasopharyngeal cancer by radiotherapy between January 1984 and June 2000, were retrospectively studied. All patients were followed up for at least 2.5 years. Their median age was 52 years (range 17$\~$78). The histological types were 21 squamous cell carcinoma, 25 undifferentiated carcinoma, and 3 adenoid cystic carcinoma. The tumor stages were as follows: T1 in 14 patients, T2 in 24, T3 in 3, and T4 in 8, and N0 in 17 patients, Nl in 15, N2 in 4 and N3 in 13. Stages I, IIa, IIb ,III, IV and IVb were 4, 7, 12, 5, 8, and 13 patients respectively. Radiation doses of 58$\~$70 Gy (median 68.7 Gy) were given to the nasopahryngeal and involved lymphatic areas and of 46 $\~$ 50 Gy to the uninvolved neck areas. Results: The overall 5 and 10-year actuarial and disease free survival rates were 54.53$\%$ and 47$\%$ and 55.7$\%$ and 45.3$\%$, respectively The overall five-year survival rates were 100$\%$ in stage I , 80$\%$ in stage IIa, 59.5$\%$ in stage IIIb, 40$\%$ in stage III, and 42.2$\%$ in stage IV tumors. Twenty-three patients fatted either loco-regionally or distantly. Incidences of local failure, regional failure and distant metastasis for the first failure were 20.4$\%$, 8.2$\%$ and 20.4$\%$, respectively. Local recurrences were 4.3$\%$ in T1, 12.5$\%$ in T2, 0$\%$ in T3, and 62.5$\%$ in T4 lesions. Distant metastasis was seen in 41.2$\%$ of N2-3 lesions. Fifty percent of local recurrence appeared within 2 years of treatment at the primary lesion, whereas 70$\%$ of distant metastasis appeared within 2 years following treatment. Young age, female, early T stage, N0 stage; and poorly differentiated carcinoma were all related with good survival. However only stage showed statistically significance. Conclusionn: Based on the results of this study, radiation therapy to nasopharyngeal cancer showed high local recurrence in T4 and increased metastasis in N2-3 lesions. To improve local failure, further radiation doses, such as stereotactic radiation or IMRT radiation, are necessary especially in T4 lesions. The high incidence of distant metastasis in positive lymph node patients, indicates that combined radiation and effective chemotherapeutic agents with appropriated schedule are necessary.

Clinical Analysis of Arteriovenous Fistulas for Hemodialysis (혈액 투석을 위한 동정맥루 조성술의 임상적 고찰)

  • 손영상;조원민;류세민;황재준;조성준;최영호;김학제;허영숙
    • Journal of Chest Surgery
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    • v.35 no.5
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    • pp.369-374
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    • 2002
  • Background: Proper construction of vascular access and adequate maintenance are essential for the prognosis of the hemodialysis patients. Though arteriovenous fistula using autogenous vessel is the first of choice, the incidence of arteriovenous fistula using artificial graft is gradually increasing. The aim of this study was to analyse the patency rates between autogenous and artificial fistula, among artificial graft types, according to the accompanied disease. Material and Method: A retrospective study was conducted on 186 patients who underwent 292 arteriovenous fistula operations for hemodialysis at Korea University Guro Hospital between 1996 and 2000. Mean age of the patients was 54.37 $\pm$ 12.79years, and the male: female ratio 99:87. Result: Among 292 operations, there were 156 autogenous fistula and 116 graft fistula. The other 20 operations were thrombectomy, takedown of graft, revision, and balloon dilatation. Patency rates of autogenous fistula were 92.78 $\pm$ 2.35% at 1 year and 39.03$\pm$9.08% at 5 years, and those of graft fistula were 96.09 $\pm$ 2.22% at 1 year and 16.45 $\pm$ 10.15% at 5 scars. However, there was no statistical significance between the two operations. The patients who had hypertension, diabetes or both had no statistical significance in the patency rate compared to that of patients without underlying disease. In addition, the type of graft used did not affect the patency rate. Second operation was needed in 62 patients and third operation in 31 patients, but their patency rate again had no statistical significance compared to that of the first operation. Conclusion: The patency of the artificial graft fistula was comparable to the autogenous fistula, but the patency according to types of graft need to be studied further. Furthermore, the underlying diseases did not affect the fistula patency.

A Survey of Disease Occurrence in Korean Black Goats (흑염소 사육농가의 질병발생 실태조사)

  • Choe, Chang-Yong;Kang, Da-Won;Choi, Sun-Ho;Cho, Chang-Yeon;Jung, Byeong-Yeal;Son, Jun-Kyu;Ryu, Il-Sun;Hu, Tai-Young;Jung, Young-Hun;Kang, Seog-Jin;Do, Youn-Jeong;Kim, Ui-Hyung;Park, Yong-Sang;Son, Dong-Soo
    • Journal of Veterinary Clinics
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    • v.29 no.2
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    • pp.160-164
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    • 2012
  • The goat industry has been developing for many years in Korea to meet demands for food and medicine. However, many complicated patterns of disease have arisen in goat farms as this industry has developed. In this study, disease occurrence patterns in Korean black goats were surveyed in six professional farming households in Imsil and Soonchang in the Jeonbuk province and in Hamyang and Sachon in the Gyeongnam province to understand and extend the goat disease database. We observed morbidity rates between 2.0% and 9.8% for adult goats and between 2.9% and 68.3% for kids. Kids showed a markedly higher incidence of disease when compared to adults. The rate of disease occurrence was 40.0% for floppy kid syndrome (FKS), 37.7% for diarrhea, 16.0% for respiratory disease, and 1.9% for skin disease. The observed mortality rates were 0.7% ~ 10.0%, and 2.2% ~ 24.9% for adult goats and kids, respectively. In addition, FKS, diarrhea, and respiratory disease were observed in 38.3%, 28.9%, and 10.0%, respectively, of dead goats. In conclusion, the majority of diseases in goats occur during the neonatal period, and FKS is the highest single cause of mortality in Korean black goats. Thus careful attention must be paid to kids to reduce the goat mortality rate.