• Journal of Korean Neurosurgical Society
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• v.61 no.4
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• pp.450-457
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• 2018

Objective : Very large (20-25 mm) and giant (${\geq}25mm$) intracranial aneurysms have an extremely poor natural course, and treatment of these aneurysms remains a challenge for endovascular and surgical strategies. This study was undertaken to describe our experiences of endosaccular treatment of very large and giant intracranial aneurysms with parent artery preservation. Methods : From January 2005 to October 2016, twenty-four very large or giant aneurysms in 24 patients were treated by endosaccular coil embolization with parent artery preservation. Nine (37.5%) aneurysms were ruptured and 15 were unruptured, and of these 15, 11 were symptomatic cases and 4 were incidentally discovered. The cohort comprised 17 women and 7 men of mean age 58.5 years (range, 26-82). Mean aneurysm size was 26.0 mm (range, 20-39) and 13 of the 24 aneurysms were giant. Results : Immediate angiographic results were complete occlusion in nine (37.5%) cases, remnant neck in six (25.0%), and remnant sac in nine (37.5%). Overall procedural related morbidity and mortality rates were 12.5% and 4.2%, respectively. Angiographic follow-up was available in 16 patients (66.7%). Mean and median follow-up periods were 27.2 (range, 2-77) and 10.5 months, respectively. In 12 cases (12/16, 75%) stable occlusion was achieved, four cases (4/16, 25%) had recanalized, and two of these were retreated with additional coiling. At clinical follow-up of the nine ruptured cases, three patients (33.3%) achieved a good clinical outcome (Glasgow outcome scale [GOS] score of 4 or 5), two (22.2%) a poor outcome (GOS score of 2 or 3), and four patients (44.4%) expired (GOS 1). On the other hand, of the 15 unruptured cases, 13 patients (86.7%) achieved a good clinical outcome (GOS 4 or 5), one patient a poor outcome (GOS score of 2 or 3), and one patient expired (GOS 1). Conclusion : The present study shows endosaccular treatment of very large or giant intracranial aneurysms with parent artery preservation is both feasible and effective with acceptable morbidity and mortality.

• Clinical and Experimental Pediatrics
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• v.56 no.1
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• pp.26-31
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• 2013

Purpose: Lymphocyte subset recovery is an important factor that determines the success of hematopoietic stem cell transplantation (HSCT). Temporal differences in the recovery of lymphocyte subsets and the factors influencing this recovery are important variables that affect a patient's posttransplant immune reconstitution, and therefore require investigation. Methods: The time taken to achieve lymphocyte subset recovery and the factors influencing this recovery were investigated in 59 children who had undergone HSCT at the Department of Pediatrics, The Catholic University of Korea Seoul St. Mary's Hospital, and who had an uneventful follow-up period of at least 1 year. Analyses were carried out at 3 and 12 months post-transplant. An additional study was performed 1 month post-transplant to evaluate natural killer (NK) cell recovery. The impact of pre- and post-transplant variables, including diagnosis of Epstein-Barr virus (EBV) DNAemia posttransplant, on lymphocyte recovery was evaluated. Results: The lymphocyte subsets recovered in the following order: NK cells, cytotoxic T cells, B cells, and helper T cells. At 1 month post-transplant, acute graft-versus-host disease was found to contribute significantly to the delay of $CD16^+/56^+$ cell recovery. Younger patients showed delayed recovery of both $CD3^+/CD8^+$ and $CD19^+$ cells. EBV DNAemia had a deleterious impact on the recovery of both $CD3^+$ and $CD3^+/CD4^+$ lymphocytes at 1 year post-transplant. Conclusion: In our pediatric allogeneic HSCT cohort, helper T cells were the last subset to recover. Younger age and EBV DNAemia had a negative impact on the post-transplant recovery of T cells and B cells.

• Archives of Plastic Surgery
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• v.47 no.5
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• pp.460-466
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• 2020

Background Sternoclavicular joint (SCJ) osteomyelitis is a rare pathology requiring urgent intervention. Several operative approaches have been described with conflicting reports. Here, we present a multi-institutional study utilizing multiple surgical pathways for SCJ reconstruction. Methods A multi-institutional retrospective cohort study was conducted to identify patients who underwent surgical repair for sternoclavicular osteomyelitis between 2008 and 2019. Patients were stratified according to reconstruction approach: single-stage reconstruction with advancement flap and delayed-reconstruction with flap following initial debridement. Demographics, operative approach, type of reconstruction, and postoperative outcomes were analyzed. Results Thirty-two patients were identified. Mean patient age was 56.2±13.8 years and 68.8% were male. The average body mass index (BMI) was 30.0±8.8 kg/㎡. The most common infection etiologies were intravenous drug use and bacteremia (both 25%). Fourteen patients (43.8%) underwent one-stage reconstruction and 18 (56.2%) underwent delayed two-staged reconstruction. Both single and delayed-stage groups had comparable rates of reinfection (7.1% vs. 11.1%, respectively), surgical site complications (21.4% vs. 27.8%), readmissions (7.1% vs. 16.6%), and reoperations (7.1% vs. 5.6%; all P>0.05). The single-stage reconstruction group had a significantly lower BMI (26.2±5.7 kg/㎡ vs. 32.9±9.1 kg/㎡; P<0.05) and trended towards shorter hospital length of stay (11.3 days vs. 17.9 days; P=0.01). Conclusions Both single and delayed-stage approaches are appropriate methods with comparable outcomes for reconstruction for SCJ osteomyelitis. When clinically indicated, a single-stage reconstruction approach may be preferable in order to avoid a second operation as associated with the delayed phase, and possibly shortening total hospital length of stay.

• Journal of Preventive Medicine and Public Health
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• v.50 no.6
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• pp.401-410
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• 2017

Objectives: The purpose of this study was to examine the associations of childbirth, breastfeeding, and their interaction with breast cancer (BC) risk reduction, and to evaluate the heterogeneity in the BC risk reduction effects of these factors by menopause, hormone receptor (HR) status, and pathological subtype. Methods: BC patients aged 40+ from the Korean Breast Cancer Registry in 2004-2012 and controls from the Health Examinee cohort participants were included in this study after 1:1 matching (12 889 pairs) by age and enrollment year. BC risk according to childbirth, breast-feeding, and their interaction was calculated in logistic regression models using odds ratios (ORs) and 95% confidence intervals (CIs). Results: BC risk decreased with childbirth (3+ childbirths relative to 1 childbirth: OR, 0.66; 95% CI, 0.56 to 0.78 and OR, 0.80; 95% CI, 0.68 to 0.95 in postmenopausal and premenopausal women, respectively); and the degree of risk reduction by the number of children was heterogeneous according to menopausal status (p-heterogeneity=0.04), HR status (p-heterogeneity<0.001), and pathological subtype (p-heterogeneity<0.001); whereas breastfeeding for 1-12 months showed a heterogeneous association with BC risk according to menopausal status, with risk reduction only in premenopausal women (p-heterogeneity<0.05). The combination of 2 more childbirths and breastfeeding for ${\geq}13$ months had a much stronger BC risk reduction of 49% (OR, 0.51; 95% CI, 0.45 to 0.58). Conclusions: This study suggests that the combination of longer breastfeeding and more childbirths reduces BC risk more strongly, and that women who experience both 2 or more childbirths and breastfeed for ${\geq}13$ months can reduce their BC risk by about 50%.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.15 no.11
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• pp.6694-6701
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• 2014

The aim of this study was to identify the correlation between low density lipoprotein (LDL) cholesterol and the pulmonary function. This study enrolled premenopausal women in their aged 40s, who visited the health promotion center of a general hospital more than two times. A total of 384 subjects were classified into four groups based on their LDL-cholesterol levels; A, LDL(mg/dL)<100 at both initial and follow-up; B, LDL<100 at initial but ${\geq}100$ at follow-up; C, $LDL{\geq}100$ at initial but <100 on follow-up; and D, $LDL{\geq}100$ at both the initial and follow-up test. The result showed no significant differences in the pulmonary function between the four groups. Multiple linear regression analysis, which was adjusted for age, body mass index, smoking, exercise, and follow-up duration, showed a significant negative relationship between the changes in the LDL and the changes in the $FEV_1/FVC$ (${\beta}=-0.109$, S.E.=0.029, P<0.001), but not in the $FEV_1$ and FVC. In conclusion, there was a significant but weak relationship between the LDL and pulmonary function. Further larger studies will be needed.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.23
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• pp.10505-10508
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• 2015

Background: Breast cancer is an important cause of death among women. One way of classifying different forms of breast cancer is by molecular features, usually in terms of the four subtypes: luminal A, luminal B, HER2-enriched, and triple negative. Objectives: This study aimed to investigate the association between molecular subtypes and survival among breast cancer patients treated with radiotherapy. Materials and Methods: A retrospective cohort study was conducted. The subjects were 272 breast cancer patients who had received treatment in the radiotherapy unit at Srinagarind Hospital, Thailand, between 1 January, 1999, and 31 May, 2009. The end of the study was 1 June, 2014. Overall survival was defined as the time elapsing between initial registration at the radiotherapy unit and death or the end of the study. Survival curves were estimated by the Kaplan-Meier method, and a multivariate analysis was performed using Cox's proportional hazard regression model. Results: The patient mean age was $47.5{\pm}10.4$ at the time of diagnosis. Of the 272 patients, 146 (53.7%) were classified as luminal A, 12 (4.4%) as luminal B, 30 (11.0%) as HER2-enriched, and 84 (30.9%) as triple negative. The overall survival rates at 1, 3 and 5 years were 87.1%, 68.4% and 59.2%, respectively. According to molecular subtypes, HER2-enriched patients had the lowest 5-year survival rate (30.0 %, 95%CI: 15.02-46.55). The median follow-up time was 8.37 years. In the Cox model analysis a higher risk of death was found for patients with HER2-enriched ($HR_{adj}=3.34$, 95%CI:1.96-5.67), triple negative ($HR_{adj}=2.17$, 95%CI: 1.44-3.27), and stage IIlB ($HR_{adj}=2.20$, 95%CI: 1.16-4.17) cancers. Conclusions: The worst survival rates were among patients classified as HER2-enriched, triple negative and at stage IIIB. Early detection and an advanced treatment modality are needed to help these patients.

• Journal of Nutrition and Health
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• v.53 no.4
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• pp.406-415
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• 2020

Purpose: This study examined the association of fruit and vegetable consumption with asthma in Korean adults. Methods: Data on 16,528 adults aged 19-64 were collected from the Korea National Health and Nutrition Examination Survey (KNHANES). The general characteristics of the subjects, daily food intake, and daily energy and nutrients intake were investigated according to fruit and vegetable consumption. All statistical analyses were conducted based on SAS software version 9.4. Results: The prevalence of doctor-diagnosed asthma was 2.6%, and ranged between 1.8% and 3.1% depending on fruit and vegetable consumption. As fruit and vegetable consumption increased, the individuals showed a higher average age and household income, but a lower educational level, smoking rate, and frequency of alcohol consumption. The group with higher fruit and vegetable consumption had higher intakes of all food groups without milk and dairy products and energy and nutrients than the counterpart group. For the intake rate of energy, the group with higher consumption of fruit and vegetables had a higher intake rate of carbohydrate and protein and a lower intake rate of fat. The risk rate of asthma with the third quartile group regarding fruit and vegetable consumption was 35%-40% lower than that of the first quartile group. Conclusion: The results suggest that adequate consumption of fruit and vegetable will help to improve the risk of asthma. Moreover, prospective cohort studies and clinical test research are necessary to measure the effects of fruit and vegetable consumption on the occurrence of asthma.

• Journal of Nutrition and Health
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• v.24 no.4
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• pp.366-377
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• 1991

A retrospective cohort study of low- income households was carried out on 679 mother-infant pairs to see the effect of weaning practices on growth between March, 1987 and January, 1988 in one rural area, one small city, and one big city, by measuring weight and height of children and intervewing mothers. The sample children showed a linear growth retardation from around 7 or 8 month based on WAZ and HAZ using the Korea Growth Standard. After adjusting both for birth-weight/length and morbidity effect, the ANCOVA test showed that :1) infants who were given supplements were not greater than those of not given. 2) infants who were eating supplements more frequently did not show a larger WAZ or HAZ than those of not eating or sometimes eating them. 3) The caloric intake rates of those of higher food frequencies were not greater than those of lower food frequencies. The context of nutrition education about weaning practices has to be changed stressing not only the early introduction of supplements but also the adequate amount of food intake to secure the rapid growth at this critical age.

• Korea journal of population studies
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• v.19 no.1
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• pp.5-44
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• 1996

Wornen's lahor market participation as well as the policy concern for wider utilization of married women, have continuously grown up. However, research efforts on the determinants of women's labor market participation, in the context of the relationship hetween life courses and active entry into lahor market, has been far behind the growing interest in this field. This study has conducted an event histoiry analysis of women's labor market transition utilizing personal occupational history data collected by the Korea Institute for Women's Development in 1991. The analysis is divided into tow parts: First part introduces logit regression to analyze the determinants of women's labor market participation and exit. The second part employs Cox regression to see the variation of transition rate between employment and non-employment. The result shows that there is a wide variation in women's labor market participation according to age, cohort, and family formation. Special note is needed for the significantly negative effect of marriage and child birth on labor market participation. The transition pattern of lower class women with less education fits well to the prediction of neo-classical economics; but the tendency of highly educated women's regression to non-employment reveals the strong influence of the unfavorable labor market structure, which can be better explained by the neo-structuralist perspective. There is a strong trade-off between productive and reproductive labor of women, which can only be corrected by strong policy implementation, such as extended child care facilities, abolition of discriminatory employment practices, and expansion of flexible part-time employment.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.40 no.4
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• pp.169-172
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• 2014

Objectives: The purpose of this retrospective study was to compare the amount of postoperative drainage via closed suction drainage system after intraoral vertical ramus osteotomy (IVRO) and sagittal split ramus osteotomy (SSRO). Materials and Methods: We planned a retrospective cohort study of 40 patients selected from a larger group who underwent orthognathic surgery from 2007 to 2013. Mean age (range) was 23.95 (16 to 35) years. Patients who underwent bilateral IVRO or SSRO were categorized into group I or group II, respectively, and each group consisted of 20 patients. Closed suction drainage system was inserted in mandibular osteotomy sites to decrease swelling and dead space, and records of drainage amount were collected. The data were compared and analyzed with independent t-test. Results: The closed suction drainage system was removed at 32 hours postoperatively, and the amount of drainage was recorded every 8 hours. In group I, the mean amount of drainage was 79.42 mL in total, with 31.20 mL, 19.90 mL, 13.90 mL, 9.47 mL, and 4.95 mL measured at 0, 8, 16, 24, and 32 hours postoperatively, respectively. In group II, the mean total amount of drainage was 90.11 mL, with 30.25 mL, 25.75 mL, 19.70 mL, 8.50 mL, and 5.91 mL measured at 0, 8, 16, 24, and 32 hours postoperatively, respectively. Total amount of drainage from group I was less than group II, but there was no statistically significant difference between the two groups (P=0.338). There was a significant difference in drainage between group I and group II only at 16 hours postoperatively (P=0.029). Conclusion: IVRO and SSRO have different osteotomy design and different extent of medullary exposure; however, our results reveal that there is no remarkable difference in postoperative drainage of blood and exudate.