• Journal of Chest Surgery
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• 제57권2호
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• pp.169-177
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• 2024

Background: Pericardial effusion (PE) is a serious condition in cancer patients, primarily arising from malignant dissemination. Pericardial window formation is a surgical intervention for refractory PE. However, the long-term outcomes and factors associated with postoperative survival remain unclear. Methods: We retrospectively analyzed data from 166 oncology patients who underwent pericardial window formation at Samsung Medical Center between 2011 and 2023. We analyzed survival and PE recurrence regarding surgical approach, cancer type, and cytopathological findings. To identify factors associated with survival, we utilized Cox proportional-hazards regression. Results: All patients had tumors documented in accordance with the American Joint Committee on Cancer staging manual, including lung (61.4%), breast (9.6%), gastrointestinal (9.0%), hematologic (3.6%), and other cancers (16.4%). Surgical approaches included mini-thoracotomy (67.5%) and thoracoscopy (32.5%). Postsurgical cytopathology confirmed malignancy in 94 cases (56.6%). Over a median follow-up duration of 50.0 months, 142 deaths and 16 PE recurrences occurred. The 1-year overall and PE recurrence-free survival rates were 31.4% and 28.6%, respectively. One-year survival rates were significantly higher for thoracoscopy recipients (43.7% vs. 25.6%, p=0.031) and patients with negative cytopathology results (45.1% vs. 20.6%, p<0.001). No significant survival difference was observed between lung cancer and other types (p=0.129). Multivariate analysis identified New York Heart Association class, cancer stage, and cytopathology as independent prognostic factors. Conclusion: This series is the largest to date concerning window formation among cancer patients with PE. Patients' long-term survival after surgery was generally unfavorable. However, cases with negative cytopathology or earlier tumor stage demonstrated comparatively high survival rates.

• Journal of Periodontal and Implant Science
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• 제53권6호
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• pp.444-452
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• 2023

Purpose: The aim of this study was to retrospectively evaluate the survival and failure rates of RESTORE^® implants over a follow-up period of 10-15 years at a university dental hospital and to investigate the factors affecting the survival rate of these dental implants. Methods: A total of 247 RESTORE^® dental implants with a resorbable blast media (RBM) surface inserted in 86 patients between March 2006 and April 2011 at the Department of Periodontology of Seoul National University Dental Hospital were included. Patients with follow-up periods of less than 10 years were excluded, and data analysis was conducted based on dental records and radiographs. Results: Over a 10- to 15-year period, the cumulative survival rate of the implants was 92.5%. Seventeen implants (6.88%) were explanted due to implant fracture (n=10, 4.05%), peri-implantitis (n=6, 2.43%), and screw fracture (n=1, 0.4%). The results of univariate regression analysis using a Cox proportional hazards model demonstrated that implants placed in male patients (hazard ratio [HR], 4.542; 95% confidence interval [CI], 1.305-15.807; P=0.017) and implants that supported removable prostheses (HR, 15.498; 95% CI, 3.105-77.357; P=0.001) showed statistically significant associations with implant failure. Conclusions: Within the limitations of this retrospective study, the RESTORE^® dental implant with an RBM surface has a favorable survival rate with stable clinical outcomes.

• 대한간호학회지
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• 제54권1호
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• pp.18-31
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• 2024

Purpose: This study aimed to investigate the impact of anthropometric indices of obesity (body mass index [BMI], waist circumference, waist hip ratio, and body fat percentage) on the incidence of hypertension in adults with prehypertension. Methods: A longitudinal study design using secondary data form the Korean Genome and Epidemiology Study was employed. The study included 1,838 adults with prehypertension tracked every two years from 2001 to 2018. Statistical analyses, including frequency assessments, number of cases per 1,000 person-years, log-rank tests, Kaplan-Meier curves, and Cox's proportional hazards regression, were conducted using SPSS version 25. Results: Over the observation period (15,783.6 person-years), 1,136 individuals developed hypertension. The incidence of hypertension was significantly higher in the obesity groups defined by BMI (hazard ratio [HR] = 1.33), waist circumference (HR = 1.34), waist hip ratio (HR = 1.29), and body fat percentage (HR = 1.31) compared to the non-obese group. These findings indicate an increased risk of hypertension associated with obesity as measured by these indices. Conclusion: The study underscores the importance of avoiding obesity to prevent hypertension in individuals with prehypertension. Specifically, BMI, waist circumference, waist hip circumference, and body fat percentage were identified as significant risk factors for hypertension. The results suggest the need for individualized weight control interventions, emphasizing the role of health professionals in addressing the heightened hypertension risk in this population.

• Journal of Yeungnam Medical Science
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• 제41권2호
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• pp.86-95
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• 2024

Background: This study aimed to investigate the impact of coronavirus disease 2019 (COVID-19) on the development of major mental disorders in patients visiting a university hospital. Methods: The study participants were patients with COVID-19 (n=5,006) and those without COVID-19 (n=367,162) registered in the database of Keimyung University Dongsan Hospital and standardized with the Observational Medical Outcomes Partnership Common Data Model. Data on major mental disorders that developed in both groups over the 5-year follow-up period were extracted using the FeederNet computer program. A multivariate Cox proportional hazards model was used to estimate the hazard ratio (HR) and 95% confidence interval (CI) for the incidence of major mental disorders. Results: The incidences of dementia and sleep, anxiety, and depressive disorders were significantly higher in the COVID-19 group than in the control group. The incidence rates per 1,000 patient years in the COVID-19 group vs. the control group were 12.71 vs. 3.76 for dementia, 17.42 vs. 7.91 for sleep disorders, 6.15 vs. 3.41 for anxiety disorders, and 8.30 vs. 5.78 for depressive disorders. There was no significant difference in the incidence of schizophrenia or bipolar disorder between the two groups. COVID-19 infection increased the risk of mental disorders in the following order: dementia (HR, 3.49; 95% CI, 2.45-4.98), sleep disorders (HR, 2.27; 95% CI, 1.76-2.91), anxiety disorders (HR, 1.90; 95% CI, 1.25-2.84), and depressive disorders (HR, 1.54; 95% CI, 1.09-2.15). Conclusion: This study showed that the major mental disorders associated with COVID-19 were dementia and sleep, anxiety, and depressive disorders.

• 대한치과보철학회지
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• 제57권4호
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• pp.342-349
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• 2019

목적: 이 연구의 목적은 구치부 영역에서 임플란트 지지 고정 보철물의 재료에 따른 생존율과 성공률을 후향적으로 조사하는 것이다. 또한 임플란트 지지 고정성 보철물에서 발생하는 합병증의 양상을 관찰하고 실패에 영향을 주는 요인을 평가하는 것이다. 대상 및 방법: 2011년 1월부터 2018년 6월 사이에 전북대학교 치과병원 치과보철과에서 한 명의 보철전문의에 의해 구치부 임플란트 보철 수복을 시행한 환자를 대상으로 하였다. 의료기록을 통해 환자의 성별, 연령, 보철물의 재료, 위치, 유형 및 합병증을 조사하였다. 생존율 및 성공률 분석을 위해 Kaplan-Meier 분석법을 이용하였으며, 집단간 비교를 위해 Log-rank test를 사용하였다. 또한 Cox proportional hazards model을 이용하여 위험요소가 성공률에 미치는 영향을 분석하였다. 결과: 총 245명의 환자에서 364개의 임플란트 보철물이 관찰되었으며, 평균 추적관찰기간은 17.1개월이었다. 전체 임플란트 보철물의 3년, 5년 누적생존율은 각각 97.5%, 91.0%로 관찰되었으며, 총 5개의 임플란트 보철물이 실패하여 제거되었다. 임플란트 보철물의 3년, 5년 누적성공률은 각각 61.1%, 32.9%로 관찰되었으며, 재료, 성별, 연령, 보철물의 위치, 유형은 누적성공률에 영향을 미치지 않았다 (P > .05). 합병증은 인접면 접촉 상실 (53건), 유지력 상실 (17건), 임플란트 주위 점막염 (12건), 저위교합 (4건) 등의 순으로 발생하였다. 결론: 구치부에서 임플란트 지지 고정성 보철물의 높은 누적생존율을 고려할 때, 임플란트는 수복 재료와 상관없이 구치부에서 치아를 대체할 수 있는 신뢰할만한 치료방법으로 생각된다. 그러나 합병증이 빈번히 발생하기 때문에 정기적인 검사와 필요한 경우 수리 및 조정이 매우 중요하다.

• Journal of Medicine and Life Science
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• 제21권2호
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• pp.40-48
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• 2024

Understanding the effectiveness of statin treatment is essential for developing tailored stroke prevention strategies. We aimed to evaluate the efficacy of statin treatment in preventing recurrent stroke among patients with various ischemic stroke subtypes. Using data from the Clinical Research Collaboration for Stroke-Korea-National Institute for Health (CRCS-K-NIH) registry, we included patients with acute ischemic stroke admitted between January 2011 and July 2020. To evaluate the differential effects of statin treatment based on the ischemic stroke subtype, we analyzed patients with large artery atherosclerosis (LAA), cardio-embolism (CE), and small vessel occlusion (SVO). The primary outcomes were recurrent ischemic stroke and recurrent stroke events. The hazard ratio for outcomes between statin users and nonusers was compared using a Cox proportional hazards model adjusted for covariates. A total of 46,630 patients who met the inclusion criteria were analyzed. Statins were prescribed to 92%, 93%, and 78% of patients with LAA, SVO, and CE subtypes, respectively. The hazards of recurrent ischemic stroke and recurrent stroke in statin users were reduced to 0.79 (95% confidence interval [CI], 0.63-0.99) and 0.77 (95% CI, 0.62-0.95) in the LAA subtype and 0.63 (95% CI, 0.52-0.76) and 0.63 (95% CI, 0.53-0.75) in CE subtype compared to nonusers. However, the hazards of these outcomes did not significantly decrease in the SVO subtype. The effectiveness of statin treatment in reducing the risk of recurrent stroke in patients with LAA and CE subtypes has been suggested. Nonetheless, no significant effect was observed in the SVO subtype, suggesting a differential effect of statins on different stroke subtypes.

• Radiation Oncology Journal
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• 제19권4호
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• pp.327-334
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• 2001

목적 : 직장암에 대한 수술 단독 또는 수술후 방사선치료를 받은 환자를 대상으로 골반종양제어율과 생존율, 합병증 발생률, 예후인자 등을 후향적으로 비교 분석하여 방사선치료의 역할을 평가한다. 대상 및 방법 : 1982년 2월부터 1996년 12월까지 총 212명의 환자가 modified Astler-Coiler 병기 $B2\~C3$ 직장암으로 진단되어 근치적목적의 수술단독 또는 수술후 방사선치료를 시행하였는데, 이중 39.6 Gy 미만의 방사선치료를 받은 18명을 제외한 194명을 대상으로 하였다. 104명은 수술후 방사선치료를 받았고 90명은 수술 단독을 시행하였다. 방사선치료는 일일 조사량 $1.8\~2.0\;Gy$로 주 5회씩 전골반강에 $39.6\~55.8\;Gy$ (평균:49.9 Gy)를 조사하였고 필요시 원발 종양 절제부위에 $5.4\~10\;Gy$를 추가 조사하였다. 생존율과 골반종양제어율의 산출은 Kaplan-Meier방법으로, 이들의 통계적 유의성검증은 Log-rank test로 하였다. 다요인 분석은 Cox proportional hazards model을 이용하였다. 결과 : 전체 환자의 5년 생존율 및 무병 생존율은 각각 $53\%,\;49\%$이었다. 수술단독군과 방사선치료 추가군의 5년 생존율은 각각 $63\%$와 $45\%$로 유의한 차이를 보였다(p=0.03). 그러나 이러한 차이는 방사선치료 추가군에서 진행된 병기의 환자가 더 많이 분포함에 기인한 것으로 생각되었다(p<0.05 by $\chi^2-test$). 수술단독군과 방사선치료 추가군의 5년생존율은 병기 B2+3, C1, C2+3 군에서 각각 $68\%$ 대 $55\%$ (p=0.09), $100\%$ 대 $100\%,\;40\%$ 대 $33\%$ (p=0.71)로 두 군간의 유의한 차이는 없었다. 위의 병기별 5년 무병생존율은 각각 $65\%$ 대 $49\%$ (p=0.14), $100\%$ 대 $100\%,\;33\%$ 대 $31\%$ (p=0.46)로 역시 유의한 차이는 없었다. 전체 환자의 5년 골반종양제어율은 $72.5\%$이었다. 수술단독군과 방사선치료 추가군의 골반종양제어율은 각각 $71\%,\;74\%$이었다(p=0.41). 병기 B2+3, C1, C2+3군에서 수술달독군과 방사선치료 추가군의 골반종양제어율은 각각 $79\%$ 대 $75\%$ (p=0.88), $100\%$ 대 $100\%,\;44\%$ 대 $68\%$ (p=0.01)이었다. 전체 환자를 대상으로 다요인 분석을 시행한 결과 생존율과 무병생존율에 병기만이 유의하였고 두 치료 군에서도 역시 병기가 유의한 인자로 나타났다. 전체환자에서 골반종양제어율에 유의한 예후인자로 다요인분석을 시행한 결과 병기와 수술방법이 유의하였다. 수술단독군에서는 병기만이 유의하였고 방사선치료 추가군에서는 수술방법만이 유의하여 복부회음절제술군의 골반종양재발률이 높았다. 결론 : 본 후향적 연구에서 수술 후 보조적 방사선치료를 시행하여 수술단독군에 비해 병기 C2+3군에서 골반종양제어율이 향상되었음을 알 수 있었다. 그러나 병기 B2이상의 모든 환자에서 골반종양제어율 뿐만 아니라 생존율의 향상을 가져오기 위해서는 최근 효용성이 널리 입증된 연속주사법의 5-FU를 포함한 동시적 항함화학방사선 병용요법이 시도되어야 할 것으로 생각된다.

• Journal of Korean Neurosurgical Society
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• 제30권11호
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• pp.1263-1270
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• 2001

Objective : To analyze the radiosurgical results of intracranial meningiomas after Gamma Knife radiosurgery (GKS) and to assess the possible factors related to the outcome and complications in treating meningiomas. Patients and Methods : We retrospectively reviewed the clinical and radiological data in 179 patients(194 lesions) treated with GKS for intracranial meningiomas between May 1992 and October 2000. Radiosurgical responses were categorized as shrinkage, stasis and enlargement, and we defined the shrunken and static group as a radio-logical control. A Cox proportional hazards model was used to evaluate the correlation between the radiosurgical outcomes and various factors such as location and size of tumor, age and gender of patients, relation to venous sinus, pre-GKS degree of edema, treatment modality, radiosurgical parameters, and pathologic findings. Results : Patients were grouped into skull base meningiomas(57.7%), non-skull base tumor including convexity, parasagittal, and falx meningiomas(37.1%), and others(5.2%) according to the location of tumors. The mean maximum dose and the margin dose of tumor was 30.0Gy(19-45Gy) and 15.1Gy(9.5-24.5Gy), respectively. The mean volume of the tumors was 9.4cc(0.003-45.0cc). The radiologic control rate was 97.1%. The radiation induced imaging change with or without neurologic deficit was the most common complication(23.6%). There were seen mostly in convexity, parasagittal, and falx meningiomas which were deeply embedded in cortex. Conclusion : GKS for intracranial meningioma seems to be safe and effective treatments. However, GKS should be considered very cautiously in non-skull base tumor such as convexity, parasagittal, or falx meningiomas with regards to patient's age and general condition, size and location of tumor, pattern of embedding into cortex, presenting symptoms and patient's preference.

• Asian Pacific Journal of Cancer Prevention
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• 제13권2호
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• pp.559-562
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• 2012

Serum alpha-fetoprotein (AFP) is a significant marker for clinical diagnosis and prognosis evaluation in hepatocellular carcinoma (HCC) patients. However, some proportion of liver cancer patients are AFP-negative (AFP ${\leq}$20ng/ml). In order to study the differences between clinicopathological factors and prognosis of alpha-fetoprotein negative and positive patients, a total of 114 cases (41 AFP-negative and 73 AFP-positive) were selected for our research. By systematically statistical analysis, the results demonstrated that compared with AFP-negative patients, AFP-positive examples were more likely to feature cirrhosis nodules, non-complete neoplasm capsules, and a poor Edmondson-steiner grade. Furthermore, AFP-negative patients demonstrated a favorable long-term prognosis. By univariate analysis and multivariate analysis with Cox's proportional hazards model, multiple tumors were found to be independent risk factors for worse survival of AFP negative patients; however, less tumor-free margins, multiple tumors and Edmondson-steiner grades III/IV, proved to be independent risk factors leading to a poor prognosis of AFP positive cases. Finally, we can infer that high levels of AFP signify a highly malignant tumor and unfavorable prognosis.

• Asian Pacific Journal of Cancer Prevention
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• 제13권1호
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• pp.147-155
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• 2012

Aboriginal and Torres Strait Islander people comprise about 2.5% of the Australian population. Cancer registry data indicate that their breast cancer survivals are lower than for other women but the completeness and accuracy of Indigenous descriptors on registries are uncertain. We followed women receiving mammography screening in BreastScreen to determine differences in screening experiences and survivals from breast cancer by Aboriginal and Torres Strait Islander status, as recorded by BreastScreen. This status is self-reported and used in BreastScreen accreditation, and is considered to be more accurate. The study included breast cancers diagnosed during the period of screening and after leaving the screening program. Design: Least square regression models were used to compare screening experiences and outcomes adjusted for age, geographic remoteness, socio-economic disadvantage, screening period and round during 1996-2005. Survival of breast cancer patients from all causes and from breast cancer specifically was compared for the 1991-2006 diagnostic period using linked cancer-registry data. Cox proportional hazards regression was used to adjust for socio-demographic differences, screening period, and where available, tumour size, nodal status and proximity of diagnosis to time of screen. Results: After adjustment for socio-demographic differences and screening period, Aboriginal and Torres Strait Islander women participated less frequently than other women in screening and re-screening although this difference appeared to be diminishing; were less likely to attend post-screening assessment within the recommended 28 days if recalled for assessment; had an elevated ductal carcinoma in situ but not invasive cancer detection rate; had larger breast cancers; and were more likely than other women to be treated by mastectomy than complete local excision. Linked cancer registry data indicated that five-year year survivals of breast cancer cases from all causes of death were 81% for Aboriginal and Torres Strait Islander women, compared with 90% for other women, and that the former had larger breast cancers that were more likely to have nodal spread at diagnosis. After adjusting for socio-demographic factors, tumour size, nodal spread and time from last screen to diagnosis, Aboriginal and Torres Strait Islander women had approximately twice the risk of death from breast cancer as other women. Conclusions: Aboriginal and Torres Strait Islander women have less favourable screening experiences and those diagnosed with breast cancer (either during the screening period or after leaving the screening program) have lower survivals that persist after adjustment for socio-demographic differences, tumour size and nodal status.