• Journal of Chest Surgery
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• v.45 no.6
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• pp.404-407
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• 2012

Aortic dilatation and dissection are severe complications during pregnancy that can be fatal to both the mother and the fetus. The risks of these complications are especially high in pregnant patients with Marfan syndrome; however, incidents of descending aortic dissection are very rare. This case report involves a successful Bentall procedure for and recovery from a rare aortic dissection in a pregnant Marfan patient who developed acute type II aortic dissection with severe aortic regurgitation and chronic descending aortic dissection immediately after Cesarean section. Regular follow-up will be needed to monitor the descending aortic dissection.

• Industrial Engineering and Management Systems
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• v.13 no.4
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• pp.449-453
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• 2014

Chronic diseases including hypertension and its complications are major sources causing the national medical expenditures to increase. We aim to predict the risk of hypertension complications for hypertension patients, using the sample national healthcare database established by Korean National Health Insurance Corporation. We apply classification techniques, such as logistic regression, linear discriminant analysis, and classification and regression tree to predict the hypertension complication onset event for each patient. The performance of these three methods is compared in terms of accuracy, sensitivity and specificity. The result shows that these methods seem to perform similarly although the logistic regression performs marginally better than the others.

• Journal of Korean Neurosurgical Society
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• v.29 no.3
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• pp.420-425
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• 2000

Epidural steroid injection(ESI) has been a commonly applied conservative therapy for the management of chronic low back pain and sciatica. However, there are many reports concerning various local, systemic and neurological complications related to ESI. We report two cases with fatal complications after ESI for low back pain and sciatica. In both patients, ventriculitis and meningitis were causative factors to be fatal. Aseptic procedures and careful post-procedure assessment are essential to avoid serious complications following ESI.

• Journal of Oral Medicine and Pain
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• v.43 no.4
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• pp.136-141
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• 2018

Oral cancer is a malignant neoplasm of the lips or oral cavity. Surgery, radiotherapy and chemotherapy depending on the location and stage of the tumor can be considered as important treatment modalities of oral cancer. Unfortunately, all three treatments can have both acute and chronic complications. Among them, trismus and osteoradionecrosis (ORN), unique complications of radiotherapy in the orofacial region, are particularly difficult to treat once manifested. Therefore, these two complications of radiotherapy have devastating effects on the patient's oral health and furthermore, overall quality of life. In this study, we present a case of a patient showing trismus and ORN following radiotherapy for the treatment of maxillary squamous cell carcinoma and briefly discuss this matter of trismus and ORN in the perspective of a dentist.

• Journal of Chest Surgery
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• v.53 no.6
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• pp.392-399
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• 2020

Background: Surgical treatment of empyema thoracis in patients with chronic kidney disease is challenging, and few studies in the literature have evaluated this issue. In this study, we aim to report the surgical outcomes of empyema and to analyze factors predicting perioperative mortality in patients with chronic kidney disease. Methods: This retrospective study included data from 34 patients with chronic kidney disease (estimated glomerular filtration rate <60 mL/min/1.73 ㎡ for 3 or more months) who underwent surgery for empyema between 2012 and 2020. An analysis of demographic characteristics and perioperative variables, including complications, was carried out. Postoperative mortality was the primary outcome measure. Results: Patients' age ranged from 20 to 74 years with a 29-to-5 male-female ratio. The majority (n=19, 55.9%) of patients were in end-stage renal disease (ESRD) requiring maintenance hemodialysis. The mean operative time was 304 minutes and the mean intraoperative blood loss was 562 mL. Postoperative morbidity was observed in 70.5% of patients (n=24). In the subgroup analysis, higher values for operative time, blood loss, intensive care unit stay, and complications were found in ESRD patients. The mortality rate was 38.2% (n=13). In the univariate and multivariate analyses, poor performance status (Eastern Cooperative Oncology Group >2) (p=0.03), ESRD (p=0.02), and late referral (>8 weeks) (p<0.001) significantly affected mortality. Conclusion: ESRD, late referral, and poor functional status were poor prognostic factors predicting postoperative mortality. The decision of surgery should be cautiously assessed given the very high risk of perioperative morbidity and mortality in these patients.

• Journal of Korean Foot and Ankle Society
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• v.26 no.2
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• pp.78-83
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• 2022

Purpose: The purpose of this study was to evaluate the surgical outcome of split-thickness skin graft (STSG) for chronic diabetic wounds of the foot and ankle. Materials and Methods: The medical records of 20 patients who underwent surgery for chronic diabetic wounds of the foot and ankle between October 2013 and May 2018 were reviewed. Surgical management consisted of consecutive debridement, followed by negative-pressure wound therapy and STSG. We used an acellular dermal matrix between the wound and the overlying STSG in some patients with wide or uneven wounds. Patient satisfaction, comorbidities, wound size and location, length of hospital stay, wound healing time, and complications were investigated. Results: Of 20 patients, 17 (85.0%) were satisfied with the surgical outcome. Eight patients had diabetic wounds associated with peripheral vascular disease (PVD), 7 patients had diabetic wounds without PVD, and 5 patients had acute infection superimposed with necrotizing abscesses. The mean size of the wound was 49.6 cm². The mean length of hospital stay was 33.3 days. The mean time to wound healing was 7.9 weeks. The mean follow-up period was 25.9 months. Complications included delayed wound healing (4 cases) and recurrence of the diabetic wounds (2 cases), which were resolved by meticulous wound dressing. Conclusion: STSG remains a good treatment strategy for chronic diabetic wounds of the foot and ankle.

• Journal of Korean Foot and Ankle Society
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• v.28 no.1
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• pp.15-20
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• 2024

Purpose: Achilles tendon rupture is a frequently encountered ankle pathology associated with a substantial burden of intense pain and functional deficits. Chronic Achilles tendon ruptures with considerable defects pose intricate repair challenges that are often marred by complications such as re-rupture and persistent pain. Various treatment methods, including allograft transplantation, have been proposed, but the literature on this technique is limited. In this study, we propose a surgical approach utilizing allotendon transplantation and a calcaneal tunneling technique and provide clinical evaluation details. Materials and Methods: Fifteen patients with chronic Achilles tendon ruptures treated with allotendon between 2020 and 2022 were included in the study. Patients were evaluated at 1, 3, and 6 months postoperatively using Visual Analog Scale (VAS) scores and Achilles Tendon Total Rupture Scores (ATRSs). Complications were assessed postoperatively. Results: The average VAS score was 7 before surgery, 7.3 immediately after surgery, and 4.3 at 1 month, 2.5 at 3 months, and 1.3 at 6 months after surgery. Because the sample was limited to 15 individuals and distributions were non-normal, the analysis was conducted using the non-parametric Wilcoxon's signed-rank test, and statistical significance was accepted for p-values<0.05. Results showed a significant improvement in ATRS and VAS scores versus preoperative and immediate postoperative values. VAS scores showed a decreasing trend after surgery, whereas average ATRS scores increased from 14 before surgery, 33.8 at 1 month, 82.7 at 3 months, and 93.9 at 6 months. Conclusion: This study suggests that allograft transplantation using the described calcaneal tunnel technique provides an effective treatment for chronic Achilles tendon ruptures. However, extensive research and long-term clinical trials are required to validate and better understand the technique's efficacy.

• Journal of Korean Neurosurgical Society
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• v.55 no.3
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• pp.178-180
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• 2014

Despite significant advances in the treatment of all forms of chronic otitis media (COM), complications still can and do occur, with intracranial complications representing the most life-threatening cases, often requiring immediate therapeutic intervention. Herein, we present a rare case of rapidly progressing facial paralysis with concomitant severe headache and ipsilateral hearing loss secondary to an otogenic brain abscess, treated with the transmastoid approach, drainage, and facial nerve decompression.

• Archives of Plastic Surgery
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• v.48 no.5
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• pp.494-497
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• 2021

Bronchopleural fistula is a severe complication with a high mortality rate that occurs after pulmonary resection. Several treatment options have been suggested; however, it is a challenge to treat this condition without recurrence or other complications. In this case report, we describe the successful performance of a pedicled latissimus dorsi myocutaneous flap transfer, with no recurrence or donor site morbidity.

• Research in Community and Public Health Nursing
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• v.32 no.2
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• pp.131-139
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• 2021

Purpose: In adults with chronic diseases, unmet healthcare needs are likely to increase the risk of worsening the illness and complications. This study was conducted to explore factors affecting unmet healthcare needs among adults with chronic diseases. Methods: A cross sectional study was performed using the data from the seventh Korea National Health and Nutrition Examination Survey (KNHANES VII), 2016-2017. The sample of this study consisted of 6,104 adults with chronic diseases. The data were analyzed by Rao-Scott 𝑥² test and logistic regression using complex samples analysis. Results: The proportion of subjects who experienced unmet healthcare needs was 10.9% of adults with chronic diseases. The factors affecting unmet healthcare needs of adults with chronic diseases were age, gender, employment status, household income, subjective health status, activity limitation, and perceived stress. Conclusion: The findings of this study suggest that various factors may be associated with their unmet healthcare needs. Finally, the development of strategies to reduce unmet healthcare needs for people with chronic diseases should consider the associated factors presented in the study.