• Journal of Chest Surgery
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• v.42 no.6
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• pp.719-724
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• 2009

Background: As the patients who undergo heart transplantation have achieved better survival in recent years, growing number of recipients are at a risk for experiencing surgical complications in addition to rejection and infection. In this paper, we report on our experience with the surgical complications that occurred in heart transplant recipients. Material and Method: From April 1994 to September 2003, 37 heart transplantations were performed at our center by a single surgeon. The indications for transplantation were dilated cardiomyopathy, ischemic cardiomyopathy, valvular cardiomyopathy and familial hypertrophic cardiomyopathy. Result: Twenty postoperative complications required surgeries in 15 patients (41%). The types of operations required were; redo-sternotomy for bleeding (5), pericardiostomy for effusion (4), implantation of a permanent pacemaker (1), right lower lobe lobectomy for aspergilloma (1), removal of urinary stone (1), cholecystectomy for gall bladder stone (1), drainage of a perianal abscess (1), paranasal sinus drainage (1), total hip replacement (1), partial gingivectomy due to gingival hypertrophy (1), urethrostomy (1), herniated intervertebral disc operation (1) and total hysterectomy for myoma uteri (1). The locations of the complications were mediastinal in 10 (27%) cases and extramediastihalin 10 (27%) cases. Conclusion: The relatively high incidence of extrathoracic complications associated with heart transplantation emphasizes the importance of a multidisciplinary approach to the improve long-term survival when managing those complex patients.

• Journal of Trauma and Injury
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• v.20 no.1
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• pp.12-18
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• 2007

Purpose: Recently, trauma is more frequent due to the increases in the population, the number of traffic accident, and the incidence of violence. Especially, abdominal trauma is a leading cause of morbidity and mortality. We analyzed the clinical features and the factors associated with morbidity and mortality. Methods: We analyzed 136 patients of abdominal trauma who were admitted at the Department of Surgery, Chonnam National University Hospital, from January 2003 to June 2005. We analyzed the cause of trauma, the injured organ, combined injuries, mental status, blood pressure, laboratory findings, morbidity, and mortality. The relationships between by variable were assesed by using the independent samples test and the Kruskal?Wallis test. Results: The causes of trauma were traffic accidents (98 cases, 72%), falling accidents (9 cases, 6.6%), violence (6 cases, 4.4%), and stab injuries (6 cases, 4.4%). The injured organs were the small intestines (47 cases, 34.6%), the liver (35 cases, 25.7%), the spleen (26 cases, 19.1%), the mesentery (17 cases, 12.5%), the large intestines (15 cases, 11.0%), the pancreas (14 cases, 10.3%), etc. The most common combined injury was chest injury (53 cases, 39%). Comatose or semicomatose mental status and shock on admission (<60 mmHg in systolic) were related to high mortality (85.7%). In laboratory findings, decreased hemoglobin (<8 g/dL), and platelet count (<$50,000/mm^3$), and increased creatinine level (>1.6 mg/dL) were significant prognostic factors. The incidence of postoperative complications was 40.4%, and frequent complications were wound infection (8.1%) and re-bleeding (8.1%). The overall mortality rate was 18.4%, and most common cause was hypovolemic shock (18 cases, 13.2%), however, there was no statistical difference according to injurd organ. Conclusion: In the multivariate analysis, mental status, hemoglobin, and serum creatinine level were the most significant prognostic factors. When an abdominal trauma patient arrives at the emergency room, a rapid and accurate evaluation of the patient's status and risk factors, and resuscitation, if necessary, have to be performed to lower the morbidity and mortality.

• Childhood Kidney Diseases
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• v.9 no.1
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• pp.76-82
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• 2005

Purpose : Regional anticoagulation with trisodium citrate for continuous renal replacement therapy(CRRT) is an effective and safe method, with lower bleeding risk. However it is not widely used because of complex current protocols used to prevent anticipated metabolic derangements. We evaluated simplified regional anticoagulation protocols with ACD-A(R) solution and commercially available calcium-containing dialysis solution. Methods : The medical records of twenty-eight patients who underwent CRRT were reviewed. Hemofilter life span according to the anticoagulation method used was compared, and laboratory findings at Pre- and 48 hours post-CRRT initiation were compared in the citrate-based CRRT group. Results : Of the twenty-eight Patients, five patients underwent citrate-based CRRT Hemofilter life span was 1.60 $\pm$ 0.72 days, showing no significant differences with the hemofilter life span in the heparin based and LMWH based CRRT group. No patients experienced hemorrhagic complications. PT, aPTT, sodium, t$CO_{2}$, iCa levels showed no difference in pre- and post-CRRT. Total calcium levels were increased. At the recommended postfilter iCa level, j.e., 0.25-0.39 mmol/L, all five patients needed increased amount of citrate infusion, and Ca infusion requirement was decreased. Conclusion : Simplified regional citrate anticoagulation with calcium-containing dialysate is an effective and safe method, and is not associated with increased hemofilter clotting. However, increased postfilter iCa level is recommended.

• Journal of the Korean Society of School Health
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• v.20 no.1
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• pp.91-101
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• 2007

Purpose: The present study intended to reveal the association between the physique of adolescent women and dysmenorrhea, and the factors related to the frequency of dysmenorrhea. Methods: The study subjects included 511 girls of a women's high school in Daejeon city and they were, during the period of March 1st through April 30th, 2005, given self-administered questionnaires about frequency of menstruation, age, physique, exercise, and such menstruation-related items as age of menarche, menstrual period and days, and amount. Results: As with the frequency of dysmenorrhea, 38.4% experienced it 「always」, 44.6% 「occasionally」, and 17.0% 「almost scarcely」, and those with dysmenorrhea accounted for 83.0% of the subjects. The frequency of dysmenorrhea was not significant difference according to the BMI and HPI. However, the lower the age of menarche and the greater the amount of menstrual flow, the more frequent dysmenorrhea. The symptoms of dysmenorrhea included the highest frequency of low back pain(68.5%) and it was followed by abdominal pain(65.9%), sensibility(54.0%), fatigue(51.7%), and nervousness(49.5%). These accompanied symptoms tended to be worse as the frequency of dysmenorrhea increased. The multiple logistic regression analysis revealed that the relative risk of frequency of dysmenorrhea is 2.2 times in age of 14, by a standard age of 15 as menarchial age, 2.2 in 13, and 3.1 in below 12. The menstrual days was 3.0 times in both below 2 days and over 8 days with the standard days of 3-7 days. The menstrual amount was 1.9 times in the group with a greater amount of menstrual bleeding and 1.5 times in the group with a less amount than the normal group, respectively. Conclusion: The above results suggest that the rate of experiencing dysmenorrhea was up to 83.0% and 38.4% from these had dysmenorrhea upon every menstruation. It is thought that dysmenorrhea could be a great disadvantage sufficient to impair optimal health to a larger body of school girls. Further, for quality of life, it is required that more fundamental strategies instead of pain killers or others for palliation of dysmenorrhea would be established among adolescents.

• Journal of Periodontal and Implant Science
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• v.48 no.6
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• pp.347-359
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• 2018

Purpose: Periodontitis and rheumatoid arthritis (RA) share a similar inflammatory pathogenesis. Porphyromonas gingivalis (Pg) can induce anticyclic-citrullinated peptide autoantibodies (anti-CCP antibodies), a key factor in the development of RA. This study aimed at evaluating the relationships between the 2 diseases and identifying the clinical implications thereof, with a focus on periodontal pathogens in Korean adults. Methods: A total of 260 RA patients and 86 age- and sex-matched control patients without arthritis were enrolled in this prospective cross-sectional study. Periodontal indices and the prevalence and amount of periodontal pathogens were compared between the groups. Correlations between periodontal and RA indices were examined, as were correlations between 9 periodontal pathogens and RA indices. Results: The RA group had significantly higher values than the control group for all investigated periodontal indices (P<0.05) except the number of teeth. The gingival index (GI) was correlated with the disease activity score 28 (DAS28) (r=0.125, P=0.049), RA disease duration (r=0.253, P<0.001), erythrocyte sedimentation rate (ESR) (r=0.162, P=0.010), and anti-CCP antibody titer (r=0.205, P=0.004). Probing pocket depth (PPD) was correlated with ESR (r=0.139, P=0.027) and anti-Pg antibody titer (r=0.203, P=0.001). Bleeding on probing (BOP) was correlated with DAS28 (r=0.137, P=0.030), RA disease duration (r=0.202, P=0.001), ESR (r=0.136, P=0.030), anti-Pg antibody titer (r=0.177, P=0.005), and anti-CCP antibody titer (r=0.188, P=0.007). Clinical attachment level (CAL) and periodontitis severity were correlated with anti-Pg antibody titer (the former r=0.201, P=0.002; the latter r=0.175, P=0.006). The quantity of Pg was positively correlated with the serum anti-Pg antibody titer (r=0.148, P=0.020). Conclusions: The GI, BOP, and PPD showed positive relationships with several RA indices. The anti-Pg antibody titer had positive relationships with PPD, BOP, CAL, and periodontitis severity. Thus, increasing values of periodontal indices could be used as a risk indicator of disease development in RA patients, and an increasing anti-Pg antibody titer could be considered as a warning sign in RA patients suffering with periodontitis.

• Journal of Periodontal and Implant Science
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• v.51 no.3
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• pp.147-162
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• 2021

Purpose: This systematic review and meta-analysis was conducted to assess the effects of glycine powder air-polishing (GPAP) in patients during supportive periodontal therapy (SPT) compared to hand instrumentation and ultrasonic scaling. Methods: The authors searched for randomized clinical trials in 8 electronic databases for relevant studies through November 15, 2019. The eligibility criteria were as follows: population, patients with chronic periodontitis undergoing SPT; intervention and comparison, patients treated by GPAP with a standard/nozzle type jet or mechanical instrumentation; and outcomes, bleeding on probing (BOP), patient discomfort/pain (assessed by a visual analogue scale [VAS]), probing depth (PD), gingival recession (Rec), plaque index (PI), clinical attachment level (CAL), gingival epithelium score, and subgingival bacteria count. After extracting the data and assessing the risk of bias, the authors performed the meta-analysis. Results: In total, 17 studies were included in this study. The difference of means for BOP in patients who received GPAP was lower (difference of means: -8.02%; 95% confidence interval [CI], -12.10% to -3.95%; P<0.00001; I²=10%) than that in patients treated with hand instrumentation. The results of patient discomfort/pain measured by a VAS (difference of means: -1.48, 95% CI, -1.90 to -1.06; P<0.001; I²=83%) indicated that treatment with GPAP might be less painful than ultrasonic scaling. The results of PD, Rec, PI, and CAL showed that GPAP had no advantage over hand instrumentation or ultrasonic scaling. Conclusions: The findings of this study suggest that GPAP may alleviate gingival inflammation more effectively and be less painful than traditional methods, which makes it a promising alternative for dental clinical use. With regards to PD, Rec, PI, and CAL, there was insufficient evidence to support a difference among GPAP, hand instrumentation, and ultrasonic scaling. Higher-quality studies are still needed to assess the effects of GPAP.

• The Journal of Korean Academy of Prosthodontics
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• v.60 no.3
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• pp.283-292
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• 2022

For fixed prosthetic treatment using implants, implants must be placed in a suitable location for prosthetic treatment. During surgery, minimally invasive prosthetic restoration is possible using a flapless method using a surgical guide. The patient in this case was an 86-year-old male patient who wanted treatment due to discomfort when using conventional dentures. Due to systemic disease, the patient had difficulty using removable local dentures, so full dentures for the maxilla and fixed implants for the mandible were restored. Because there is a high risk of bleeding due to systemic disease, the implant was placed in a flapless method using a surgical guide. Finally, prostheses were fabricated with maxillary full denture and mandibular screw-retained zirconia, and this report shows satisfactory esthetic and functional recovery.

• Journal of Periodontal and Implant Science
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• v.50 no.6
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• pp.368-378
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• 2020

Purpose: Vitamin D deficiency may cause bone loss and increased inflammation, which are well-known symptoms of periodontal disease. This study investigated whether serum 25-hydroxyvitamin D (25(OH)D) levels are associated with periodontal disease status and tooth loss. Methods: Cross-sectional data from 5,405 individuals aged ≥50 years (2,253 males and 3,152 females) were obtained from the 2008-2010 Dong-gu study, a prospective cohort study of risk factors for chronic diseases. Periodontal examinations were conducted to evaluate the number of remaining teeth, the periodontal probing depth (PPD), the clinical attachment level (CAL), and bleeding on probing. The percentages of sites with PPD ≥4 mm and CAL ≥4 mm were recorded for each participant. The severity of periodontitis was classified using the Centers for Disease Control and Prevention and the American Academy of Periodontology case definitions. Serum 25(OH)D levels were classified as reflecting severe deficiency, deficiency, insufficiency, or sufficiency. Multivariate linear regression analysis was performed to assess the associations of serum 25(OH)D levels with periodontal parameters and the number of remaining teeth after adjusting for confounders including age, smoking status, alcohol consumption status, month of blood collection, and physical activity. Multivariate logistic regression was used to evaluate the association between serum vitamin D levels and severe periodontitis. An overall statistical analysis and a stratified analysis by sex were performed. Results: Overall, the rates of severe deficiency, deficiency, insufficiency, and sufficiency were 6.5%, 67.9%, 22.4%, and 3.2%, respectively. After adjustment for confounders, vitamin D levels were directly associated with the number of remaining teeth, an association that was significant in males, but not in females. Sufficient serum 25(OH)D was associated with a low frequency of severe periodontitis. Conclusions: This population-based cross-sectional study indicates that low serum 25(OH) D is significantly associated with tooth loss and severe periodontitis in Koreans aged 50 years and older.

• Journal of Korean Clinical Nursing Research
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• v.29 no.1
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• pp.24-41
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• 2023

Purpose: This study aimed to update the previously published nursing practice guideline for prevention of venous thromboembolism (VTE). Methods: The guideline was updated according to the manuals developed by National Institute for Health and Care Excellence (NICE) and Scottish Intercollegiate Guidelines Network (SIGN), and a Handbook for Clinical Practice Guideline Developer Version 10. Results: The updated nursing practice guideline for prevention of VTE was consisted of 16 domains, 46 subdomains, and 216 recommendations. The recommendations in each domain were: 4 general issues, 8 assessment of risk and bleeding factors, 5 interventions for prevention of VTE, 18 mechanical interventions, 36 pharmacological interventions, 36 VTE prevention starategies for medical patients, 25 for cancer patients, 13 for pregnancy, 8 for surgical patients, 7 for thoractic and cardiac surgery, 16 for orthopedic surgery, 10 for cranial and spinal surgery, 5 for vascular surgery, 13 for other surgery, 3 educations and information, and 2 documentation and report. For these recommendations, the level of evidence was 32.1% for level I, 51.8% for level II, and 16.1% for level III according to the infectious diseases society of America (IDSA) rating system. A total of 112 new recommendations were developed and 49 previous recommendations were deleted. Conclusion: The updated nursing practice guideline for prevention of VTE is expected to serve as an evidence-based practice guideline for prevention of VTE in South Korea. It is recommended that this guideline will disseminate to clinical nursing settings nationwide to improve the effectiveness of prevention of VTE practice.

• The Korea Journal of Herbology
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• v.39 no.1
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• pp.31-38
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• 2024

Objectives : Ulcerative colitis is a chronic recurrent inflammatory disease of the gastrointestinal tract. However, there are some drawbacks to long-term drug therapy such as the risk of opportunistic infections. Recently, there was an increasing interest on the use of khorasan Kamut wheat because of their higher value of selenium and fiber than modern wheat. The present study was aimed to investigate the effect of Kamut brand wheat enzyme (Kamut WE) diet on colon health in dextran sulfate sodium (DSS)-induced colitis mice. Methods : Female C57BL/6J mice were divided into 6 groups. (1) normal (Water and AIN-93G diet), (2) control (1.25% DSS and AIN-93G diet), (3) Kamut WE (1.25% DSS and Kamut WE diet), (4) normal (Water and AIN-93G diet), (5) control (2.50% DSS and AIN-93G diet), (6) Kamut WE (2.50% DSS and Kamut WE diet). Dietary intake, body weight change, disease activity index (DAI), colon length and spleen weight were monitored. Results : Kamut WE group alleviated colitis symptom, including dietary intake loss, DAI (weight loss, loose stools, bleeding), colon length shortening and spleen swelling. Further, Kamut WE diets showed a significant effect against pathological damage by the increased colon length, decreased DAI and spleen weight in DSS 1.25% as well as DSS 2.50%. Conclusions : Our study provides evidence that Kamut WE diet increased colon length, decreased DAI and spleen weight in intestinal inflammation.