• Archives of Plastic Surgery
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• 제46권5호
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• pp.462-469
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• 2019

Background Incisional hernia is a common complication following visceral organ transplantation. Transplant patients are at increased risk of primary and recurrent hernias due to chronic immune suppression and large incisions. We conducted a retrospective review of patients with a history of liver or kidney transplantation who underwent hernia repair to analyze outcomes and hernia recurrence. Methods This is a single center, retrospective review of 19 patients who received kidney and/or liver transplantation prior to presenting with an incisional hernia from 2011 to 2017. All hernias were repaired with open component separation technique (CST) with biologic mesh underlay. Results The mean age of patients was $61.0{\pm}8.3years\;old$, with a mean body mass index of $28.4{\pm}4.8kg/m^2$, 15 males (78.9%), and four females (21.1%). There were seven kidney, 11 liver, and one combined liver and kidney transplant patients. The most common comorbidities were hypertension (16 patients, 84.2%), diabetes (9 patients, 47.4%), and tobacco use (8 patients, 42.1%). Complications occurred in six patients (31.6%) including hematoma (1/19), abscess (1/19), seroma (2/19), and hernia recurrence (3/19) at mean follow-up of $28.7{\pm}22.8months$. With the exception of two patients with incomplete follow-up, all patients healed at a median time of 27 days. Conclusions This small, retrospective series of complex open CST in transplant patients shows acceptable rates of long-term hernia recurrence and healing. By using a multidisciplinary approach for abdominal wall reconstruction, we believe that modified open CST with biologic mesh is a safe and effective technique in the transplant population with complex abdominal hernias.

• 한국식생활문화학회지
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• 제35권4호
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• pp.363-370
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• 2020

This study analyzed the health characteristics and comorbidity of adult men aged 40 years by dividing them into a control group of those without any disease related to fine dust and a patient group with one or more diseases related to fine dust in areas with high levels of fine dust pollution using the sixth and seventh Korea National Health and Nutrition Examination Survey (2013-2017). Among the general characteristics, the mean age of the patient group was significantly older than that of the control group (p<0.001), and in terms of the health-related characteristics, the frequency of breakfast consumption in the patient group was higher than in the control group (p<0.043). The body measurements were similar in the patient and control groups. Regarding the prevalence of comorbidity, the patient group showed a higher prevalence of hypertension, dyslipidemia, stroke, myocardial infarction, heart failure, and diabetes than the control group, but the differences were not statistically significant. On the other hand, the prevalence of other cancers (except stomach cancer, liver cancer, colorectal cancer, breast cancer, and cervical cancer) in the patient group was higher than in the control group (p<0.05). In terms of the clinical characteristics, the glycated hemoglobin levels in the patient group were significantly higher than in the control group (p<0.048). Information on nutrition and health in areas with frequent occurrences of fine dust was obtained through the study results, which can be used as basic data for measures of health and diet management against diseases that will increase in relation to fine dust.

• Journal of Nutrition and Health
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• 제46권1호
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• pp.61-71
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• 2013

The aim of this study was to examine the relationship between dietary variables and the prevalence of insulin resistance (IR) in middle-aged Korean adults using data from the 2007-2009 Korea National Health and Nutrition Examination Survey. Because IR is closely linked with metabolic syndrome, subjects were divided into three groups according to symptoms of metabolic syndrome: the 'Normal group' without any symptoms, the 'Risk group' with one or two symptoms, and the Metabolic syndrome (MetS) group' with three or more symptoms. Subjects between the ages of 30 and 65 years with no prior diagnosis or treatment for diabetes, hypertension, or dyslipidemia were selected. The number of subjects per group was as follows: 2,085 adults in the Normal group, 3,699 adults in the Risk group, and 1,160 adults in the MetS group. Metabolic syndrome was defined according to Adult Treatment Panel III criteria with modified waist circumference cutoff values (men ${\geq}$ 90 cm, women ${\geq}$ 85 cm). Subjects with HOMA-IR > 2.0 were classified as IR. Homeostasis Model Assessment of Insulin Resistance (HOMA-IR) was calculated using the following formula: (fasting plasma glucose ${\times}$ fasting plasma insulin)/22.5. Nutrients and food groups intake were obtained from a single 24-hour recall. Subjects with IR in the Normal group were more obese and less physically active than non-IR subjects. In the MetS group, subjects with IR were more obese and had a lower prevalence of smoking and drinking, compared with non-IR subjects. Men with IR in the Normal group had a tendency to consume more oils and sugars than non-IR men, while women with IR in the same group had higher intake of carbohydrate, dietary glycemic index, and dietary glycemic load than non-IR women. Women with IR in the Risk group had lower energy intake but higher intake of oils and sugars than non-IR women. In the MetS group, consumption of fruits was higher in subjects with IR than in non-IR subjects. In conclusion, findings of this study suggest that dietary carbohydrate intake, including glycemic index, may be associated with IR in healthy women. Further research in prospective cohort studies in order to examine the effects of dietary carbohydrate on IR incidence will be necessary.

• The Journal of Korean Physical Therapy
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• 제11권1호
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• pp.23-43
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• 1999

A study on severity of cerebro-vascular accident patients in Korea was conduced in order to determine the risk factors affecting the severity of stroke patients. This study was performed by interviewing a total of 477 hospitalized and ambulatory patient of CVA in Seoul, Taejon, and Taegu and Pusan areas from April 1, 1998 through June 30, 1998. The results are as follows; 1. Two hundred and sixty seven $(56\%)$ at Four hundred and seventy seven subjects were manes, md two hundred and ten $(44\%)$ were females. $28.3\%$ of the subjects' ages were 50's and $27.3\%$ were 60's and $18.5\%$ were 70's. $22.6\%$ of the subjects' occupations were home makers, $17.8\%$ were farming. $66.4\%$ of the subjects spent their childhood in urban areas and $33.1\%$in rural areas. $41.7\%$ of the subjects became violin of CVA in Spring, $35.0\%$ in Winter. 2. On physical and mental conditions of the subjects at the occurrence of CVA, $28.7\%$ of the subjects were engaged in physical activities. $22.6\%$ were in a rest stale $19.5\%$ were in sleeping and $18.9\%$ were mentally shocked. $79.4\%$ of the male subjects and $14.8\%$ of female subjects smoked cigarettes. $82\%$ of male subjects drank coffee. $81.1\%$ of the subjects did not exercise regularly. $45.9\%$ of the subjects had the systolic blood pressures in the range of 160 to 199 mmHg and $5.6\%$ of the subjects had hypertension before the occurrence of stroke and $11.7\%$ had diabetes. 3. Of the types of strokes, cerebral hemorrhage was the highest $(49.1\%)$. cerebral infarction was the second $(41.1\%)$. Severe strokes were found in cerebral hemorrhage cases $(52.0\%)$ and cerebral infarction cases $(40.1\%).\;50.9\%$. of the male subjects were moderate cases, $50.9\%$ were severe cases. In females, moderate cases were $72.4\%$, severe cases $15.2\%$. $37.5\%$ of the subjects who had preceding diseases were severe cases, and $15.6\%$ of the subjects without preceding diseases were severe cases. $50.7\%$ of the subjects whose family members had strokes had severe strokes. $34\%$ of the subjects sleeping less than 6 hours a day, $42.4\%$ of the subjects with irregular eating habits, $33.3\%$ of the subjects who liked meat, and $42.3\%$ of the subjects who liked salty foods had severe strokes. $35.9\%$ of the subjects with hot temper, $27.6\%$ of the subjects with moderate temper and $14.5\%$ of subjects with mild temper were severe cases. 4. The correlation coefficient between obesity and blood pressure was 0.094.

• Asian Pacific Journal of Cancer Prevention
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• 제15권18호
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• pp.7897-7907
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• 2014

Background: There is paucity of studies defining the prevalence of non-communicable disease (NCD) risk factors in Saudi Arabia despite the surging epidemic of obesity, change in dietary habits and sedentary lifestyle. Objectives: This cross-sectional study aimed to assess the prevalence of NCDs risk factors among employees at King Faisal University in Al Hassa, Saudi Arabia and to determine the possible correlates for clustering of NCDs risk factors among them. Materials and Methods: All employees were invited to participate; the World Health Organization STEPwise approach was used for data collection which consisted of a personal interview to collect socio-demographic characteristics, NCD history, tobacco use, vegetables and fruit consumption, and physical activity (PA), followed by anthropometric measurements namely weight, height and waist circumference and blood pressure measurements, subjects were finally subjected to biochemical tests with determination of fasting plasma glucose, serum triglycerides, cholesterol and high density lipoproteins. Results: Of the surveyed employees (n=691), daily current smokers accounted for 22.7%. 94.9%, 95.1% and 86% consumed < 5 servings per day of vegetables, fruits and both fruits and vegetables respectively, 73% were physically inactive, 64% were overweight or obese, 22.1% had hypertension, and 21.5% were diabetics. Elevated cholesterol levels were found in 36.6%, low high density lipoproteins in 36.8%, and elevated triglycerides in 36.1%. Only 3% had no NCD risk factors, and 57.6% had ${\geq}3$ factors. Multivariate logistic regression showed that gender (being male, adjusted odds ratio 'aOR'=1.51), aged ${\geq}50$ years (aOR=3.06), < college education (aOR=1.75), current smokers (aOR=2.37), being obese (aOR=6.96) and having a low PA level (aOR=4.59) were the significant positive predictors for clustering of NCD risk factors. Conclusions: Over fifty percent of the studied university's employees had multiple (${\geq}3$) NCD risk factors. Screening and health promotion initiatives should be launched at least targeting the modifiable factors to avert the excessive risk for cardiovascular disease, diabetes mellitus and several types of cancers.

• Journal of Preventive Medicine and Public Health
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• 제27권2호
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• pp.175-185
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• 1994

In order to anticipate disease pattern and health problems of Koreans in the 1st part of 21st century (by the year 2020), transition of population characteristics, mortality and morbidity data during the last 30 years Koreans have experienced were reviewed. On the actual basis of epidemiologic transition process that has undergone during last 30 years since 1960 along with socioeconomic development and successful implementation of selective national health policies (family planning, medical insurance and etc.), following changes can be expected in the 21st century in Korea, under the assumption that the current rate of progress is maintained. The population of South Korea alone will be doubled the population of 1960 by the year 2013 : aged Population older than 65 years will be increased from 3.3% in 1960 to 11.4% in 2020 with increased average age of the population from 23.6 year in 1970 to 39.2 year in 2020; urban population from 28% in 1960 to 83% in 2005. GNP/capita has increased tremendously from U.S. $120 in 1970 to $6,749 in 1992, and the government estimated it would be 519,350 in 2010 and $29,460 in 2020. Growth and developmental indices of children, educational achievement and social status of women also showed a remarkable improvement and anticipated to make futher progress. Leading causes of mortality and morbidity have shown a striking change during the last 30 years, from infectious diseases to chronic degenerative diseases and man-made injuries. Occurrence of communicable diseases may become minimal although viral hepatitis, venereal diseases Including AIDS, and well adapted herpes virus infections will maintain their endemic level. Newly evolving infectious agents, however, should be carefully monitored because of rapidly changing environments and human behaviours. Tuberculosis may increase up to the epidemic level when AIDS prevails. Ischemic heart diseases may increase steadily with increasing occurrence of hypertension and diabetes mellitus whereas cerebrovascular diseases may be decreased slowly. Musculaskeletal diseases which contribute a lot to the disability of aged people may be a major health problems due to increased aged population. Mental diseases, particularly that caused by alcohol and drug abuse, and senile dementia may become a prominent health problem. On the other hand injuries caused by traffic and industrial accidents that have shown most striking increase till now may be decreased considerably by intensive intervention. The health policies in the 21st century will be oriented to the health promotion for good quality life rather than life-savings.

• Archives of Plastic Surgery
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• 제44권6호
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• pp.516-522
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• 2017

Background Implant-based breast reconstruction is being performed more frequently, and implants are associated with an increased risk of infection. We reviewed the clinical features of cases of implant infection and investigated the risk factors for breast device salvage failure. Methods We retrospectively analyzed 771 patients who underwent implant-based breast reconstruction between January 2010 and December 2016. Age, body mass index, chemotherapy history, radiation exposure, and smoking history were assessed as potential risk factors for postoperative infection. We also evaluated the presence and onset of infection symptoms, wound culture pathogens, and other complications, including seroma, hematoma, and mastectomy skin necrosis. Additionally, we examined the mastectomy type, the use of acellular dermal matrix, the presence of an underlying disease such as hypertension or diabetes, and axillary node dissection. Results The total infection rate was 4.99% (58 of 1,163 cases) and the total salvage rate was 58.6% (34 of 58). The postoperative duration to closed suction drain removal was significantly different between the cellulitis and implant removal groups. Staphylococcus aureus infection was most frequently found, with methicillin resistance in 37.5% of the cases of explantation. Explantation after infection was performed more often in patients who had undergone 2-stage expander/implant reconstruction than in those who had undergone direct-to-implant reconstruction. Conclusions Preventing infection is essential in implant-based breast reconstruction. The high salvage rate argues against early implant removal. However, when infection is due to methicillin-resistant S. aureus and the patient's clinical symptoms do not improve, surgeons should consider implant removal.

• 한국의료질향상학회지
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• 제9권2호
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• pp.210-228
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• 2002

Background: The purpose of this research was to examine the fall incidence rate and its related factors of fall in inpatients. Methods: The data were collected from the 138 fall incident reports in one tertiary hospital in Seoul from April 1st 1999 to September 30th 2001. The Fall Incident Report Form was originally developed based on that of Massachusetts General Hospital revised in 1995. And this was modified for this survey by the collaborating work of QI team including researcher and department of nursing service of this particular hospital. The contents of Fall Incident Form were general characteristics of patient. factors related to fall. types and places of fall. circumstances, nursing interventions. and outcome. Results: 1) The incidence rate of fall was 0.08% of total discharged patients and 0.081 per 1000 patient-day. This incidence rate is much lower than that of several hospitals in USA. This finding might result from the different incidence report system of each hospital. 2) The characteristics of fall-prone patient were found as follows. They were mostly over 60 years old, in alert mental status, ambulatory with some assistance, and dependent on ambulatory device. The types of diseases related high incidence rate were cerebrovascular disease(3.2), hypertension(1.6), cardiovascular disease(1.4), diabetes(1.3) and liver disease(0.6). 3) The majority of fall events usually occurred m bed. bedside(walking or standing) and bathroom in patient room. Usually they were up on their own when they fell. And there were more falls of elderly occurred during night time than day or evening. 4) 63.8% of fall events resulted in physical injuries such as fracture and usually the patients had diagnostic procedures and some treatment(ex. suture) which caused additional cost to the patients and their families. 5) The found risk factors of fall were drugs(antihypertensive drug, diuretics) and environmental factors like too high bed height, long distance of bedside table and lamp switch, and slippery tile of bathroom floor. Conclusion: Considering these results, every medical and nursing staff should be aware of the risk factors of patients in hospital, and should intervene more actively the preventive managements, specially for the elderly patients during night. Therefore, it is recommended that the development of Fall Prevention Programs based on these results.

• Journal of Chest Surgery
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• 제38권2호
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• pp.139-145
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• 2005

배경: 관상동맥 우회술 후 장기 생존율에 대한 우리의 보고는 많지 않다. 이 연구는 관상동맥 우회술 시작 초기에 수술 받은 환자들의 장기 생존율을 알아보았다. 대상 뜻 방법: 1990년 12월부터 1995년 12월까지 관상동맥 우회술을 받은 114예(남 79예, 여 35예, 평균연령 58.4세)를 대상으로 하였다. 대부분의 환자가 체외순환 하에 좌측 속가슴동맥과 하지 복재정맥으로 우회로술을 받았고 대동맥 차단상태에서 근위부 및 원위부 문합을 시행하였다. 결과: 평균 $135.5{\pm}17.9$개월의 추적 기간 동안 모두 37예$(32.5\%)$가 사망하였으며, 사망자 중 심장사망은 10예$(27\%)$뿐이었다 수술 후 전체 사망에 대한 1년, 5년, 10년, 13년의 생존율은 각각 $95.6\%,\;85.1\%,\;71.8\%,\;57.9\%$였고, 심장사망에 대한 1년, 5년, 10년, 13년의 생존율은 각각 $97.4\%,\;94.5\%,\;92.1\%,\;81.3\%$였으며, 장기 생존율에 대한 예상인자로는 성별 및 연령이었다 수술 후 관상동맥 조영술 및 중재술의 예상인자는 수술 전의 고혈압, 당뇨병, 고지혈증 등이었다. 결론: 초기의 관상동맥 우회술 후 장기생존율은 다른 보고와 비슷하였으며, 여성에서 장기생존율이 우수하였고 수술 전 고지혈증을 가진 환자에서 수술 후 관상동맥 중재술이 더 많았다.

• IMMUNE NETWORK
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• 제1권2호
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• pp.104-108
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• 2001

Aging is a senescence and defined as a normal physiologic and structural alterations in almost all organ systems with age. As Leonard Hayflick, one of the first gerontologists to propose a theory of biologic aging, indicated that a theory of aging or longevity satisfies the changes of above conditions to be universal, progressive, intrinsic and deleterious. Although a number of theories have been proposed, it is now clear that cell aging (cell senescence) is multifactorial. No single mechanism can account for the many varied manifestations of biological aging. Many theories have been proposed in attempt to understand and explain the process of aging. Aging is effected in individual by genetic factors, diet, social conditions, and the occurrence of age-related diseases as diabetes, hypertension, and arthritis. It involves an endogenous molecular program of cellular senescence as well as continuous exposure throughout life to adverse exogenous influences, leading to progressive infringement on the cell's survivability so called wear and tear. So we could say the basic mechanism of aging depends on the irreversible and universal processes at cellular and molecular level. The immediate cause of these changes is probably an interference in the function of cell's macromolecules-DNA, RNA, and cell proteins-and in the flow of information between these macromolecules. The crucial questions, unanswered at present, concerns what causes these changes in truth. Common theories of aging are able to classify as followings for the easy comprehension. 1. Biological, 1) molecular theories - a. error theory, b. programmed aging theory, c. somatic mutation theory, d. transcription theory, e. run-out-of program theory, 2) cellular theories - a. wear and tear theory, b. cross-link theory, c. clinker theory, d. free radical theory, e. waste product theory, 3) system level theory-a. immunologic/autoimmune theory, 4) others - a. telomere theory, b. rate of living theory, c. stress theory, etc. Prevention of aging is theoretically depending on the cause or theory of aging. However no single theory is available and no definite method of delaying the aging process is possible by this moment. The most popular action is anti-oxidant therapy using vitamin E and C, melatonin and DHEA, etc. Another proposal for the reverse of life-span is TCP-17 and IL-16 administration from the mouse bone marrow B cell line study for the immunoglobulin VDJ rearrangement with RAG-1 and RAG-2. Recently conclusional suggestion for the extending of maximum life-span thought to be the calory restriction.