• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제45권3호
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• pp.135-140
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• 2019

Objectives: This study sought to investigate the association between the systemic intake of proton pump inhibitors (PPI) and the early failure of dental implants. Materials and Methods: A retrospective cohort study involving 1,918 dental implants in 592 patients (69 implants in 24 PPI users and 1,849 implants in 568 nonusers, respectively) was conducted. The effect of PPI intake on the osseointegration of dental implants was evaluated using patientand implant-level models. Results: Among 24 PPI users, two patients experienced implant failure, one of whom had three and the other of whom had one failed implant, respectively. Thus, the rate of failure for this population was 8.3%. Separately, 11 nonusers each experienced one implant failure, and the failure rate for these patients was 1.9%. Fisher's exact test revealed statistically significant differences between PPI users and nonusers at the implant level (P=0.002) but failed to show any significance at the patient level (P=0.094). The odds of implant failure were 4.60 times greater among PPI users versus nonusers. Dental implants that were placed in patients using PPIs were found to be 4.30 times more likely to fail prior to loading. Conclusion: The findings of this study suggest that PPI intake may be associated with an increased risk of early dental implant failure.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제24권1호
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• pp.100-108
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• 2021

Purpose: Percutaneous endoscopic gastrostomy (PEG) tube placements are commonly performed pediatric endoscopic procedures. Because of underlying disease, these patients are at increased risk for airway-related complications. This study compares patient characteristics and complications following initial PEG insertion with general endotracheal anesthesia (GETA) vs. anesthesia-directed deep sedation with a natural airway (ADDS). Methods: All patients 6 months to 18 years undergoing initial PEG insertion within the endoscopy suite were considered for inclusion in this retrospective cohort study. Selection of GETA vs. ADDS was made by the anesthesia attending after discussion with the gastroenterologist. Results: This study included 168 patients (GETA n=38, ADDS n=130). Cohorts had similar characteristics with respect to sex, race, and weight. Compared to ADDS, GETA patients were younger (1.5 years vs. 2.9 years, p=0.04), had higher rates of severe American Society of Anesthesiologists (ASA) disease severity scores (ASA 4-5) (21% vs. 3%, p<0.001), and higher rates of cardiac comorbidities (39.5% vs. 18.5%, p=0.02). Significant associations were not observed between GETA/ADDS status and airway support, 30-day readmission, fever, or pain medication in unadjusted or adjusted models. GETA patients had significantly increased length of stay (eβ=1.55, 95% confidence interval [CI]=1.11-2.18) after adjusting for ASA class, room time, anesthesia time, fever, and cardiac diagnosis. GETA patients also had increased room time (eβ=1.20, 95% CI=1.08-1.33) and anesthesia time (eβ=1.50, 95% CI=1.30-1.74) in adjusted models. Conclusion: Study results indicate that younger and higher risk patients are more likely to undergo GETA. Children selected for GETA experienced longer room times, anesthesia times, and hospital length of stay.

• Clinical and Experimental Reproductive Medicine
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• 제51권1호
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• pp.75-84
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• 2024

Objective: The purpose of this study was to evaluate the impact of preimplantation genetic testing for aneuploidy (PGT-A) on clinical outcomes among high-risk patients. Methods: This retrospective study involved 1,368 patients and the same number of cycles, including 520 cycles with PGT-A and 848 cycles without PGT-A. The study participants comprised women of advanced maternal age (AMA) and those affected by recurrent implantation failure (RIF), recurrent pregnancy loss (RPL), or severe male factor infertility (SMF). Results: PGT-A was associated with significant improvements in the implantation rate (IR) and the ongoing pregnancy rate/live birth rate (OPR/LBR) per embryo transfer cycle in the AMA (39.3% vs. 16.2% [p<0.001] and 42.0% vs. 21.8% [p<0.001], respectively), RIF (41.7% vs. 22.0% [p<0.001] and 47.0% vs. 28.6% [p<0.001], respectively), and RPL (45.6% vs. 19.5% [p<0.001] and 49.1% vs. 24.2% [p<0.001], respectively) groups, as well as the IR in the SMF group (43.3% vs. 26.5%, p=0.011). Additionally, PGT-A was associated with lower overall incidence rates of early pregnancy loss in the AMA (16.7% vs. 34.3%, p=0.001) and RPL (16.7% vs. 50.0%, p<0.001) groups. However, the OPR/LBR per total cycle across all PGT-A groups did not significantly exceed that for the non-PGT-A groups. Conclusion: PGT-A demonstrated beneficial effects in high-risk patients. However, our findings indicate that these benefits are more pronounced in carefully selected candidates than in the entire high-risk patient population.

• Tuberculosis and Respiratory Diseases
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• 제46권1호
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• pp.25-35
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• 1999

연구배경: 다제내성폐결핵환자의 치료는 임상적으로 심각한 문제를 야기하고 있으나 이에 대한 보고는 거의 없는 상황이다. 이에 저자 등은 다제내성폐결핵환자의 치료처방에 따른 치료성적을 후향적으로 조사하여 보고하는 바이다. 방 법: 1993년 1월부터 1996년 1월까지 국립마산결핵병원에 입원하여 M. tuberculosis에 의한 폐결핵으로 치료를 받은 환자 중 INH와 RMP을 포함하는 항결핵제에 내성이 있는 63명의 임상적 경과를 조사하여 코호트분석(cohort retrospective study)을 시행하였다. 결 과: 환자의 평균 연령은 38.3세였고 이전에 투여받은 약제의 수는 평균 5가지였으며 내성약제의 수는 평균 4가지였다. 화학요법에 의하여 객담배양검사상 연속적으로 3개월이상 음성으로 나타난 치료성공군운 전체 63례 중 52례(82.5%)였고 11례(17.5%)에서는 반응이 없었다. Univariate analysis로 통계처리한 결과가 좋지 않았던 환자는 내성약제의 수와 밀접한 연관을 보였다.(비교위험도 21.5 ; 95% 신뢰구간, 1.2-3.0; p<0.05) 평균추적기간은 17개월이었고 치료에 반응을 보인 환자들중 재발은 없었으며 결핵으로 인한 사망은 없었다. 결 론: 저자의 연구에 의하면 다제내성결핵이라할지라도 잘 선택된 약제의 투여로 비교적 좋은 성적을 기대할 수 있다.

• Journal of Korean Neurosurgical Society
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• 제66권6호
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• pp.726-734
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• 2023

Objective : Chronic subdural hematoma (CSDH) patients using antithrombotic agents (AT) at high risk for cardiovascular disease are increasing. The authors aimed to analyze the factors influencing outcome by targeting patients using AT and to establish a desirable treatment strategy. Methods : A retrospective analysis was performed on data from 462 patients who underwent burr hole trephination (BHT) surgery for CSDH at five hospitals from March 2010 to June 2021. Outcomes included incidence of postoperative acute bleeding, recurrence rate, and morbidity or mortality rate. Patients were divided into the following four groups based on their history of AT use : no AT. Only antiplatelet agents (AP), only anticoagulants (AC), both of AP and AC. In addition, a concurrent literature review was conducted alongside our cohort study. Results : Of 462 patients, 119 (119/462, 25.76%) were using AT. AP prescription did not significantly delay surgery (p=0.318), but AC prescription led to a significant increase in the time interval from admission to operation (p=0.048). After BHT, AP or AC intake significantly increased the period required for an in-dwelling drain (p=0.026 and p=0.037). The use of AC was significantly related to acute bleeding (p=0.044), while the use of AP was not (p=0.808). Use of AP or AC had no significant effect on CSDH recurrence (p=0.517 and p=1.000) or reoperation (p=0.924 and p=1.000). Morbidity was not statistically correlated with use of either AP or AC (p=0.795 and p=0.557, respectively), and there was no significant correlation with mortality for use of these medications (p=0.470 and p=1.000). Conclusion : Elderly CSDH patients may benefit from maintenance of AT therapy during BHT due to reduced thromboembolic risk. However, the use of AC necessitates individualized due to potential postoperative bleeding. Careful post-operative monitoring could mitigate prognosis and recurrence impacts.

• Journal of Korean Neurosurgical Society
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• 제59권2호
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• pp.129-136
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• 2016

Objective : The purpose of this study was to figure out the radiologic findings and risk factors related to adjacent segment degeneration (ASD) after anterior cervical discectomy and fusion (ACDF) using 3-year follow-up radiography, computed tomography (CT), and magnetic resonance image (MRI). Methods : A retrospective matched comparative study was performed for 64 patients who underwent single-level ACDF with a cage and plate. Radiologic parameters, including upper segment range of motion (USROM), lower segment range of motion (LSROM), upper segment disc height (UDH), and lower segment disc height (LDH), clinical outcomes assessed with neck and arm visual analogue scale (VAS), and risk factors were analyzed. Results : Patients were categorized into the ASD (32 patients) and non-ASD (32 patients) group. The decrease of UDH was significantly greater in the ASD group at each follow-up visit. At 36 months postoperatively, the difference for USROM value from the preoperative one significantly increased in the ASD group than non-ASD group. Preoperative other segment degeneration was significantly associated with the increased incidence of ASD at 36 months. However, pain intensity for the neck and arm was not significantly different between groups at any post-operative follow-up visit. Conclusion : The main factor affecting ASD is preoperative other segment degeneration out of the adjacent segment. In addition, patients over the age of 50 are at higher risk of developing ASD. Although there was definite radiologic degeneration in the ASD group, no significant difference was observed between the ASD and non-ASD groups in terms of the incidence of symptomatic disease.

• Journal of Periodontal and Implant Science
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• 제50권6호
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• pp.379-391
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• 2020

Purpose: The aims of this study were to evaluate the 5-year cumulative survival rate (CSR) of implants placed with guided bone regeneration (GBR) compared to implants placed in native bone, and to identify factors contributing to implant failure in regenerated bone. Methods: This retrospective cohort study included 240 patients who had implant placement either with a GBR procedure (regenerated bone group) or with pristine bone (native bone group). Data on demographic features (age, sex, smoking, and medical history), location of the implant, implant-specific features, and grafting procedures and materials were collected. The 5-year CSRs in both groups were estimated using Kaplan-Meier analysis. Risk factors for implant failure were analyzed with a Cox proportional hazards model. Results: In total, 264 implants in the native bone group and 133 implants in the regenerated bone group were analyzed. The 5-year CSRs were 96.4% in the regenerated bone group and 97.5% in the native bone group, which was not a significant difference. The multivariable analysis confirmed that bone status was not an independent risk factor for implant failure. However, smoking significantly increased the failure rate (hazard ratio, 10.7; P=0.002). Conclusions: The 5-year CSR of implants placed in regenerated bone using GBR was comparable to that of implants placed in native bone. Smoking significantly increased the risk of implant failure in both groups.

• Journal of Yeungnam Medical Science
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• 제40권2호
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• pp.164-171
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• 2023

Background: The study aimed to evaluate the effect of prehydration solution on hearing thresholds after cisplatin chemotherapy. Methods: In this retrospective cohort study, we reviewed the data of patients who underwent ≥3 courses of cisplatin-based chemotherapy for locally advanced head and neck cancers at a tertiary referral center (n=64). The dextrose solution (DW) group (n=26) received 2 L of normal saline and 1 L of 5% dextrose. The Hartmann solution (HS) group (n=38) received 2 L of normal saline and 1 L of HS. Hearing data were measured 1 day before starting the first course of chemotherapy, and again 20 days after the first, second, and third courses of chemotherapy. The severity of hearing loss was evaluated using the Common Terminology Criteria for Adverse Events (CTCAE). Results: Thresholds at all frequencies after chemotherapy were greater in the DW group than in the HS group. The increase in thresholds in 1 to 4 kHz after the third course of chemotherapy was greater in the DW group than in the HS group. CTCAE grades after the second and third courses of chemotherapy were greater in the DW group than in the HS group. Logistic regression showed that the odds ratio for CTCAE grade 3 or 4 after the third course of chemotherapy in the DW group was 4.84 on univariate analysis. Conclusion: Prehydration using a solution with salt was associated with a decrease in change in hearing thresholds after cisplatin chemotherapy in patients with head and neck cancers.

• Clinical Endoscopy
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• 제56권5호
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• pp.658-665
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• 2023

Background/Aims: We aimed to study the effects of sedation on endoscopic ultrasound-guided tissue acquisition. Methods: We conducted a retrospective study evaluating the role of sedation in endoscopic ultrasound-guided tissue acquisition by comparing two groups: anesthesia care provider (ACP) sedation and endoscopist-directed conscious sedation (CS). Results: Technical success was achieved in 219/233 (94.0%) in the ACP group and 114/136 (83.8%) in the CS group (p=0.0086). In multivariate analysis, the difference in technical success between the two groups was not significant (adjusted odds ratio [aOR], 0.5; 95% confidence interval [CI], 0.234-1.069; p=0.0738). A successful diagnostic yield was present in 146/196 (74.5%) in the ACP group and 66/106 (62.3%) in the CS group, respectively (p=0.0274). In multivariate analysis, the difference in diagnostic yield between the two groups was not significant (aOR, 0.643; 95% CI, 0.356-1.159; p=0.142). A total of 33 adverse events (AEs) were observed. The incidence of AEs was significantly lower in the CS group (5/33 CS vs. 28/33 ACP; OR, 0.281; 95% CI, 0.095-0.833; p=0.022). Conclusions: CS provided equivalent technical success and diagnostic yield for malignancy in endoscopic ultrasound-guided tissue acquisition. Increased AEs were associated with anesthesia for the endoscopic ultrasound-guided tissue acquisition.

• 보건교육건강증진학회지
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• 제29권2호
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• pp.1-12
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• 2012

Objectives: Several practice guidelines recommended both medication and behavior modification to control hypertension. The objective of this study was to analyze ambulatory care utilization pattern and related factors. Methods: A retrospective cohort study was conducted among 45,267 new users who initiated treatment with hypertensive drugs in 2003. Korean National Health Insurance Claims Data was used to study the medical care utilization behavior and related factors after treatment initiation for up to four years. Taking prescription was considered as medical care utilization. Results: More than 20% of patients discontinued visiting physicians for prescription after initiating antihypertensive drug therapy. The average number of institutions visited by patients was about 1.3 annually. Clinic was the most frequently visited institution by patients. In GEE analysis, probability of continuous visit one institution after initiating antihypertensive drug treatment increased in patients who were women, old, have comorbidity, visited clinic or hospital mainly in previous year. Conclusions: Young hypertensive male patients who have no major comorbidity showed high possibility to discontinue medical service utilization. It is necessary to educate these targeted patients about importance of hypertension management in early stage after treatment initiation.