• Title/Summary/Keyword: long term complications

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Long-term effects of gonadotropin-releasing hormone analogs in girls with central precocious puberty

  • Kim, Eun Young
    • Clinical and Experimental Pediatrics
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    • v.58 no.1
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    • pp.1-7
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    • 2015
  • Gonadotropin-releasing hormone analogs (GnRHa) are widely used to treat central precocious puberty (CPP). The efficacy and safety of GnRHa treatment are known, but concerns regarding long-term complications are increasing. Follow-up observation results after GnRHa treatment cessation in female CPP patients up to adulthood showed that treatment (especially <6 years) was beneficial for final adult height relative to that of pretreated or untreated patients. Puberty was recovered within 1 year after GnRHa treatment discontinuation, and there were no abnormalities in reproductive function. CPP patients had a relatively high body mass index (BMI) at the time of CPP diagnosis, but BMI standard deviation score maintenance during GnRHa treatment seemed to prevent the aggravation of obesity in many cases. Bone mineral density decreases during GnRHa treatment but recovers to normal afterwards, and peak bone mass formation through bone mineral accretion during puberty is not affected. Recent studies reported a high prevalence of polycystic ovarian syndrome in CPP patients after GnRHa treatment, but it remains unclear whether the cause is the reproductive mechanism of CPP or GnRHa treatment itself. Studies of the psychosocial effects on CPP patients after GnRHa treatment are very limited. Some studies have reported decreases in psychosocial problems after GnRHa treatment. Overall, GnRHa seems effective and safe for CPP patients, based on long-term follow-up studies. There have been only a few long-term studies on GnRHa treatment in CPP patients in Korea; therefore, additional long-term follow-up investigations are needed to establish the efficacy and safety of GnRHa in the Korean population.

Long-term Outcome of Laparoscopic Hernia Sac Transection and Intracorporeal Ligation in Children: A Single Center Cohort Study (복강 내 탈장낭 절개 및 봉합법을 이용한 소아 복강경 서혜부 탈장 수술의 장기 추적관찰 결과: 단일기관 코호트 연구)

  • Lee, Chang Hun;Boo, Yoon Jung;Lee, Eun Hee
    • Advances in pediatric surgery
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    • v.20 no.2
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    • pp.23-27
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    • 2014
  • Purpose: Laparoscopic hernia repair in children is still controversial. The aim of this study was to report our long-term results of the laparoscopic hernia technique, which is based on the same surgical principles as conventional open herniotomy. Methods: Five hundred fourteen pediatric patients with inguinal hernia were included in this study under informed consent. All patients underwent a laparoscopic technique of sac transection and intracorporeal ligation. The asymptomatic contralateral inguinal ring was routinely explored and repaired if a patient had patent processus vaginalis on the contralateral side. Patients were prospectively followed for 5 years. Those who were lost to follow-up were excluded from the study. Perioperative complications and recurrences were evaluated. Results: The mean follow-up period was 29 months. Mean operation time was 27.5 minutes. Forty one percent of the patients had contralateral patent processus vaginalis. Only one hernia recurred (0.19%). We had one case of contralateral metachronous hernia (0.21%) during follow-up period. Conclusion: The long-term follow-up results of our study revealed that laparoscopic hernia sac transection and ligation can be a safe and effective alternative for conventional herniorraphy.

Post-Coronavirus Disease 2019 Pulmonary Fibrosis: Wait or Needs Intervention

  • Yoon, Hee-Young;Uh, Soo-Taek
    • Tuberculosis and Respiratory Diseases
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    • v.85 no.4
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    • pp.320-331
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    • 2022
  • Coronavirus disease 2019 (COVID-19) has become a major health burden worldwide, with over 450 million confirmed cases and 6 million deaths. Although the acute phase of COVID-19 management has been established, there is still a long way to go to evaluate the long-term clinical course or manage complications due to the relatively short outbreak of the virus. Pulmonary fibrosis is one of the most common respiratory complications associated with COVID-19. Scarring throughout the lungs after viral or bacterial pulmonary infection have been commonly observed, but the prevalence of post-COVID-19 pulmonary fibrosis is rapidly increasing. However, there is limited information available about post-COVID-19 pulmonary fibrosis, and there is also a lack of consensus on what condition should be defined as post-COVID-19 pulmonary fibrosis. During a relatively short follow-up period of approximately 1 year, lesions considered related to pulmonary fibrosis often showed gradual improvement; therefore, it is questionable at what time point fibrosis should be evaluated. In this review, we investigated the epidemiology, risk factors, pathogenesis, and management of post-COVID-19 pulmonary fibrosis.

Biomechanical Complications : Fracture and Screw loosening (Biomechanical Complications : 파절과 나사풀림)

  • Kim, Tae in
    • The Journal of the Korean dental association
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    • v.53 no.5
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    • pp.307-317
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    • 2015
  • Although the long-term success of osseointegrated endosseous implants for the support of fixed dental prostheses has been reported, the increasingly widespread use of implant-supported prostheses has led to problems associated with their structural integrity. The most common biomechanical complications observed in dental implant treatment are fracture and screw loosening. The nature of loosening or fracture of dental implant components is complex, since it involves fatigue, fitness, and varied chewing patterns and loads. To assess the service life of the components of the prosthetic system, a knowledge of the loads transmitted through the system is necessary. Design of the final restoration and occlusion in relation to the geometry of a prosthetic restoration has a great influence on the mechanical loading of the implant. It is proposed that control of force in oral cavity may play a larger role in failures than previously believed. Based on theoretic consideration and clinical experiences with dental implant, this article gives simple guidelines for controlling these loads.

Totally Implanted Port System for Terminal Cancer Pain; Problems and Complications (말기 암성통증을 위한 Totally Implanted Port System; 문제점과 합병증)

  • Hong, Kee-Hyek
    • The Korean Journal of Pain
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    • v.5 no.1
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    • pp.23-28
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    • 1992
  • The use of epidural narcotics to treat cancer pain was first described by Behar et al in 1979. More recently, a variety of implantable INDSs have been described for long-term intraspinal narcotic administration. Especially, among these systems INDS typeIII which is designed by Poletti et al is relatively low cost and less risk of infection, therefore this system has been widely accepted but the clinical experience is insufficient yet. 1, Problems, 1) thorough education of patients and care-givers about this system the method of drug delivery and the situations could be happen in using this system. 2) high cost of continuous drug delivery system 3) legal problems about morphine carry-out in the case of bolus infusion by syringe 1. Complications; 1) by morphine; Significant respiratory depression was not found in all 21cases. other morphine-related complications were occurred occasionally but improved within a few days by appropriate treatment. 2) by system, Blockage or leakage of catheter was occurred in 2cases and wound infection was occurred in 2cases and so reimplantation was done.

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Complications after craniofacial reconstruction with calcium phosphate cements: a case report and review of the literature

  • Pourdanesh, Fereydoun;Latifi, Noorahmad;Latifi, Fatemeh
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.44 no.5
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    • pp.207-211
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    • 2018
  • Among different graft materials for craniofacial reconstruction, calcium phosphate cements have the advantages of alloplastic grafts and wide use. The authors report a case of foreign body reaction following frontal reconstruction with JectOS (an injectable calcium orthophosphate cement; Kasios) and reviewed the literature on complications of this material after craniofacial reconstruction from 2002 to 2017. Complications were categorized into two groups: immunologic reactions (consisting of seroma collection, chronic sinus mucosa swelling, and foreign body reaction) and non-immune events (infection, fragmentation, and ejection). It is wise to use calcium phosphate-based material only in selected cases with small defects, and long-term follow-up is needed to observe their consequences.

Endoscopic Endonasal Approach for Suprasellar Lesions in Children : Complications and Prevention

  • Kim, Yong Hwy;Wang, Kyu-Chang;Phi, Ji Hoon;Kim, Seung-Ki
    • Journal of Korean Neurosurgical Society
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    • v.60 no.3
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    • pp.315-321
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    • 2017
  • The endoscopic endonasal approach (EEA) has been popularized in adults and has been applied to an expanding range of surgical modules and indications in this population. However, its clinical application in pediatric neurosurgery has been impeded by the differences in anatomical features and the relatively low incidence of diseases to which it is applicable. In this review article, we mainly discuss the surgical indications, feasibility, and complications of EEA for suprasellar lesions in children based on a review of the literature, focusing especially on the age-related anatomical features of the nasal cavity, various pathologic entities, and the impact of EEA on long-term craniofacial growth.

Short-term Clinical Experience with CarboMedics Valve (CarboMedics 기계판막의 단기 임상 성적)

  • 우석정
    • Journal of Chest Surgery
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    • v.25 no.6
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    • pp.661-671
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    • 1992
  • From March 1988 to May 1991, 140 CarboMedics cardiac valve prostheses[75 mitral, 9 aortic and 28 double aortic-mitral] were implanted in 112 consecutive patients[mean age 36.7$\pm$11.6 years, male/female 48/76] by one surgical team operating on adult cardiac patients at Kyoungpook University Hospital Associated Surgical procedures were performed in 19 patients[16.9%]. Total follow up represented 2,345 patient-months[mean 22.4 months] and was 100% complete. Eighty-two patients[73%] were in NYHA functional class IIIor IV preoperatively and 102 patients [95%] were in class I or II postoperatively. Hospital[30 day] mortality was 4.4%, [3/75 mitral, 1/9 aortic, 1/28 double valve replacement] and late death was 1.7%. [1 /74 mitral, 1 /28 double valve replacement] The actuarial survival at 36 months was 94.0% after mitral, 80% after aortic, 92% after double valve replacement, and 93.2% for the total group. The linearized incidence of valve relater death, prosthetic valve thrombosis, anticoagulant related hemorrhage, and reoperation was 1.00%/pt-yr, 0.51%/pt/yr, 0.51%/pt-yr, and 0.51%/pt-yr respectively. The 36 month rates of freedom from valve replated death, thromboembolism, endocarditis, anti-coagulant related hemorrages, and reoperation were 98.75%, 99.08%, 100%, 99.04%, and 99.08% respectively. The 36 month rate of freedom from all valve related complications and deaths including hospital mortality was 90.2%. These fact suggest that the CarboMedics heart valve has excellent short-term result, low incidence of valve-related complications and valve dysfunction, and additional long term follow up study is necessary.

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What do we know about uncommon complications associated with third molar extractions? A scoping review of case reports and case series

  • Naichuan Su;Sana Harroui;Fred Rozema;Stefan Listl;Jan de Lange;Geert J.M.G. van der Heijden
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.49 no.1
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    • pp.2-12
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    • 2023
  • The current study aimed to explore the types and frequencies of uncommon complications associated with third molar extractions based on a scoping review of case reports and case series. The study used an electronic literature search based on PubMed and Embase up to March 31, 2020, with an update performed on October 22, 2021. Any case reports and case series that reported complications associated with third molar extractions were included. The types of complications were grouped and the main symptoms of each type of complication were summarized. A total of 51 types of uncommon complications were identified in 248 patients from 186 studies. Most types of complications were post-operative. In the craniofacial and cervical regions, the most frequent complications included iatrogenic displacement of the molars or root fragments in the craniofacial area, late mandibular fracture, and subcutaneous emphysema. In other regions, the most frequent complications include pneumomediastinum, pneumorrhachis, pneumothorax, and pneumopericardium. Of the patients, 37 patients had life-threatening uncommon complications and 20 patients had long-term/irreversible uncommon complications associated with third molar extractions. In conclusion, a variety of uncommon complications associated with third molar extractions were identified. Most complications occurred in the craniofacial and cervical regions and were mild and transient.

The Impact of Preoperative Low Body Mass Index on Postoperative Complications and Long-term Survival Outcomes in Gastric Cancer Patients

  • Kim, Chang Hyun;Park, Seung-Man;Kim, Jin-Jo
    • Journal of Gastric Cancer
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    • v.18 no.3
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    • pp.274-286
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    • 2018
  • Purpose: The aim of this study was to investigate the impact of preoperative low body mass index (BMI) on both the short- and long-term outcomes in patients with gastric cancer. Materials and Methods: A total of 510 patients with gastric cancer were divided into the following 3 groups: low BMI group (${\leq}18.5kg/m^2$, n=51), normal BMI group ($18.6-24.9kg/m^2$, n=308), and high BMI group (${\geq}25.0kg/m^2$, n=151). Results: There were significantly more stage III/IV patients in the low BMI group than in the other groups (P=0.001). Severe postoperative complications were more frequent (P=0.010) and the survival was worse (P<0.001) in the low BMI group. The subgroup analysis indicated that survival was worse in the low BMI group of the stage I/II subgroup (P=0.008). The severe postoperative complication rate was higher in the low BMI group of the stage III/IV subgroup (P=0.001), although the recurrence rate and survival did not differ in the stage III/IV subgroup among all the BMI groups. Low BMI was an independent poor prognostic factor in the stage I/II subgroup (disease-free survival: hazard ratio [HR], 13.521; 95% confidence interval [CI], 1.186-154.197; P=0.036 and overall survival: HR, 5.130; 95% CI, 1.644-16.010; P=0.005), whereas low BMI was an independent risk factor for severe postoperative complications in the stage III/IV subgroup (HR, 17.158; 95% CI, 1.383-212.940; P=0.027). Conclusions: Preoperative low BMI in patients with gastric cancer adversely affects survival among those with stage I/II disease and increases the severe postoperative complication rate among those with stage III/IV disease.