• Gut and Liver
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• 제12권6호
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• pp.674-681
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• 2018

Background/Aims: The cumulative surgery rate and postoperative relapse of intestinal Behçet's disease (BD) have been reported to be high. This study aimed to establish a scoring system based on follow-up endoscopic findings that can predict intestinal BD recurrence after surgery. Methods: Fifty-four patients with intestinal BD who underwent surgery due to bowel complications and underwent follow-up colonoscopy were retrospectively investigated. Their clinical data, including colonoscopic findings, were retrieved. Classification and regression tree analysis was used to develop an appropriate endoscopic classification model that can explain the postsurgical recurrence of intestinal BD most accurately based on the following classification: e0, no lesions; e1, solitary ulcer <20 mm in size; e2, solitary ulcer ${\geq}20mm$ in size; and e3, multiple ulcers regardless of size. Results: Clinical relapse occurred in 37 patients (68.5%). Among 38 patients with colonoscopic recurrence, only 29 patients had clinically relapsed. Multivariate analysis identified higher disease activity index for intestinal BD at colonoscopy (hazard ratio [HR], 1.013; 95% confidence interval [CI], 1.005 to 1.021; p=0.002) and colonoscopic recurrence (HR, 2.829; 95% CI, 1.223 to 6.545; p=0.015) as independent risk factors for clinical relapse of intestinal BD. Endoscopic findings were classified into four groups, and multivariate analysis showed that the endoscopic score was an independent risk factor of clinical relapse (p=0.012). The risk of clinical relapse was higher in the e3 group compared to the e0 group (HR, 6.284; 95% CI, 2.036 to 19.391; p=0.001). Conclusions: This new endoscopic scoring system could predict clinical relapse in patients after surgical resection of intestinal BD.

• Journal of Periodontal and Implant Science
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• 제49권5호
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• pp.287-298
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• 2019

Purpose: The aim of this retrospective study was to determine the prevalence of early implant failure using a single implant system and to identify the factors contributing to early implant failure. Methods: Patients who received implant treatment with a single implant system ($Luna^{(R)}$, Shinhung, Seoul, Korea) at Dankook University Dental Hospital from 2015 to 2017 were enrolled. The following data were collected for analysis: sex and age of the patient, seniority of the surgeon, diameter and length of the implant, position in the dental arch, access approach for sinus-floor elevation, and type of guided bone regeneration (GBR) procedure. The effect of each predictor was evaluated using the crude hazard ratio and the adjusted hazard ratio (aHR) in univariate and multivariate Cox regression analyses, respectively. Results: This study analyzed 1,031 implants in 409 patients, who comprised 169 females and 240 males with a median age of 54 years (interquartile range [IQR], 47-61 years) and were followed up for a median of 7.2 months (IQR, 5.6-9.9 months) after implant placement. Thirty-five implants were removed prior to final prosthesis delivery, and the cumulative survival rate in the early phase at the implant level was 95.6%. Multivariate regression analysis revealed that seniority of the surgeon (residents: aHR=2.86; 95% confidence interval [CI], 1.37-5.94) and the jaw in which the implant was placed (mandible: aHR=2.31; 95% CI, 1.12-4.76) exerted statistically significant effects on early implant failure after adjusting for sex, age, dimensions of the implant, and type of GBR procedure (preoperative and/or simultaneous) (P<0.05). Conclusions: Prospective studies are warranted to further elucidate the factors contributing to early implant failure. In the meantime, surgeons should receive appropriate training and carefully select the bone bed in order to minimize the risk of early implant failure.

• Annals of Geriatric Medicine and Research
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• 제22권4호
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• pp.184-188
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• 2018

Background: The risk factors of nocturia in older adults remain unclear. We aimed to investigate factors associated with nocturia using the National Health and Nutrition Examination Survey (NHANES) data. Methods: Among 40,790 participants, 4,698 participants aged ${\geq}65$ years were included from the NHANES dataset between 2005 and 2012. A multivariate logistic regression analysis was performed to determine the odds ratio (OR) for nocturia. A subgroup analysis was conducted based on sex and underlying diseases. Results: In the multivariate logistic regression model, obesity (OR, 1.46; 95% confidence interval [CI], 1.28-1.68), hypertension (OR, 1.28; 95% CI, 1.07-1.52), and diabetes mellitus (DM) (OR, 1.27; 95% CI, 1.11-1.45) were significantly associated with nocturia. These factors were associated with nocturia regardless of sex. In a subgroup of participants with hypertension, obesity (OR, 1.44; 95% CI, 1.25-1.67) and DM (OR, 1.26; 95% CI, 1.09-1.45) were associated with nocturia. In the additional analysis on patients with DM, nocturia was associated with obesity (OR, 1.33; 95% CI, 1.06-1.67) and duration of DM (OR, 1.02; 95% CI, 1.01-1.03). Conclusion: This study demonstrated that hypertension, DM, and obesity were significantly associated with the prevalence of nocturia in older adult patients regardless of sex. In particular, obesity was associated with nocturia in every subgroup analysis.

• Journal of Periodontal and Implant Science
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• 제49권3호
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• pp.158-170
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• 2019

Purpose: This study investigated the association between health status and tooth loss based on data from the National Health Insurance Service-Health Examinee Cohort in 2002-2015. Methods: Multivariate Cox proportional hazards regression analyses were applied to a longitudinal retrospective database, which was updated and newly released in 2018, to assess the association between health status and tooth loss while adjusting for potential confounders among sociodemographic and economic factors (sex, age, household income, insurance, and presence of disability), general and oral health status (body mass index [BMI], smoking and drinking status, periodic dental visits and scaling, and brushing before sleep), and comorbid disease (hypertension, diabetes mellitus [DM], and Charlson comorbidity index [CCI]). Results: Among 514,866 participants from a South Korean population, 234,247 (45.5%) participants satisfying the inclusion criteria were analyzed. In the adjusted multivariate analysis, sex, age, household income, insurance, presence of disability, BMI, smoking and drinking status, periodic scaling, tooth brushing before sleep, DM, and CCI showed statistically significant associations with the loss of at least 1 tooth. The risk of experiencing a loss of ${\geq}4$ teeth was associated with an increase in age (in those 50-59 years of age: hazard ratio [HR], 1.98; 95% confidence interval [CI], 1.93-2.03; in those 60-69 years of age: HR, 2.93; 95% CI, 2.85-3.02; and in those 70-79 years of age: HR, 2.93; 95%, CI 2.81-3.05), smoking (HR, 1.69; 95% CI, 1.65-1.73), and DM (HR, 1.43; 95% CI, 1.38-1.48). Conclusions: The results of this study showed that the risk of experiencing tooth loss was related to multiple determinants. DM and smoking were especially significantly associated with tooth loss.

• Journal of Gastric Cancer
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• 제21권2호
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• pp.122-131
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• 2021

Purpose: To date, there are no promising treatments for gastric carcinoma with peritoneal metastasis. Some researchers have suggested a survival benefit of gastrectomy in select patients. This study investigated the survival of gastric carcinoma patients with stand-alone peritoneal metastasis according to the type of treatment modality. Materials and Methods: We reviewed the data of 132 patients with gastric carcinoma and stand-alone peritoneal metastasis. We performed gastrectomy when the primary tumor was deemed resectable and systemic chemotherapy was administered. We analyzed patient survival according to the type of treatment, and the prognostic value of gastrectomy was evaluated in univariate and multivariate models. Results: Among all patients, 70 underwent gastrectomy plus chemotherapy, 20 underwent gastrectomy alone, 36 underwent chemotherapy alone, and 6 received supportive care. The median patient survival was 13 months. Patients who underwent gastrectomy had significantly longer survival than those who did not undergo gastrectomy (14 vs. 8 months, P<0.001). Patients who received chemotherapy showed significantly longer survival than those who did not (13 vs. 7 months, P=0.032). Patients who underwent gastrectomy plus chemotherapy showed better survival than those who underwent other treatments. In multivariate analysis, gastrectomy was found to be an independent prognostic factor (hazard ratio, 0.52; 95% confidence interval, 0.33-0.82) in addition to chemotherapy. Conclusions: Our study showed that patients who underwent gastrectomy plus chemotherapy had the best survival. Although the survival benefit of gastrectomy remains uncertain, it is a favorable prognostic indicator in patients with stand-alone peritoneal metastasis.

• 보건행정학회지
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• 제31권2호
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• pp.197-206
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• 2021

Background: The purpose of this study was to identify factors affecting unmet healthcare needs due to physical accessibility by residential area by utilizing the Korea Community Health Survey (KCHS). Methods: Andersen's medical service behavioral model was applied to analyze the enabling factors, predisposing factors, and needs factors of unmet healthcare needs focusing on residential areas. This study used data from the KCHS (2017-2019, n=440,792). We used multivariate survey logistic regression analysis in order to identify affecting factors. Sub-group analysis was conducted in order to evaluate the effects of residential areas. Results: Some participants (2,621, 0.59%) had experienced unmet healthcare needs due to physical accessibility and 2,047 subjects (78.1%) of them lived in rural areas. Multivariate survey logistic regressions revealed that experience of unmet healthcare needs due to physical accessibility increased when people lived in rural areas (odds ratio [OR], 3.95; 95% confidence interval, 3.46-4.51). Conclusion: This study showed that despite the development of transportation and efforts to alleviate medical inequality, residents in rural areas may still have higher experience of unmet healthcare needs due to physical accessibility compared to the metropolitan city regardless of any other sub-group differences (OR range, 1.90-6.31). This study suggested that government and policymakers should identify the causes of the experience of unmet healthcare needs due to physical accessibility and should develop policies to alleviate those healthcare disparities.

• Journal of Gastric Cancer
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• 제20권3호
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• pp.328-336
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• 2020

Purpose: The standard treatment for stage IB gastric cancer is curative surgery alone, but some patients show poor survival with disease recurrence after curative surgery. The aim of this study was to identify prognostic factors of recurrence and long-term survival in patients with stage IB gastric cancer after surgery. Materials and Methods: We retrospectively reviewed data from 253 patients with stage IB gastric cancer who underwent gastrectomy between 2011 and 2016 at Kyungpook National University Chilgok Hospital and analyzed the clinicopathological characteristics associated with recurrence and survival. Results: Fourteen patients experienced recurrence with a mean follow-up of 54.1 months. Two of these patients had locoregional recurrence and 12 patients had systemic recurrence. The median interval between the operation day and the day of recurrence was 11 months (range 4-56 months). Multivariate analysis revealed that lymphatic vessel invasion (LVI) (hazard ratio [HR], 3.851; 95% confidence interval [CI], 1.264-11.732) and the elderly (age≥65) (HR, 3.850; 95% CI, 1.157-12.809) were independent risk factors for recurrence after surgery. The LVI (HR, 3.630; 95% CI, 1.105-11.923) was the independent prognostic factors for disease-specific survival (DSS). The 5-year DSS rates were 96.8% in patients who did not have LVI, and 89.3% in patients who had LVI. Conclusions: This study shows that LVI was associated with recurrence and poor survival in patients with stage IB gastric cancer after curative gastrectomy. Patients diagnosed with LVI require careful attention for systemic recurrence during the follow-up period.

• Asian Pacific Journal of Cancer Prevention
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• 제15권6호
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• pp.2797-2801
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• 2014

Background: Endometrial adenocarcinoma is the most common gynecological cancer in the Western world and its incidence appears to be rising. However, population-based studies on endometrial cancer providing survival estimates by age, histology, and stage in Asia have been sparse. The aim of this study was to evaluate the clinicopathological data and survival for patients with endometrial adenocarcinoma treated at three institutions in Yazd, Iran. Materials and Methods: Medical and anatomicopathological records at the Department of Pathology and Radiotherapy of the Shahid Sadoughi University of Medical Sciences and Madar private hospital, between 2005 and 2012 were reviewed. All cases of endometrial adenocarcinoma were included. The Kaplan-Maier method was used for survival analysis and Cox proportional hazards model for multiple regression analysis. Results: The study included 84 patients. Stages I, II, III, and IV were identified in 65.4%, 21.5%, 11.9% and 1.2%, respectively. Disease-free survival rate was $73.9{\pm}3.77$ months (95% confidence interval, 64.51-83.22 months) and relapse occurred in 12.3% of the patients. The overall survival rate was $78.2{\pm}3.65$ months (95% confidence interval, 71.0-85.3 months). A multivariate analysis revealed that stage and grade were associated with overall survival. Conclusions: In this survival analysis of patients with endometrial cancer, we found that the prognosis of endometrial cancer was fair but strongly varied by stage and grade, and moderately varied by histology and age.

• Journal of Korean Neurosurgical Society
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• 제61권5호
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• pp.582-591
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• 2018

Objective : To evaluate the magnetic resonance (MR) imaging features that have a statistically significant association with the need for a tracheostomy in patients with cervical spinal cord injury (SCI) during the acute stage of injury. Methods : This study retrospectively reviewed the clinical data of 130 patients with cervical SCI. We analyzed the factors believed to increase the risk of requiring a tracheostomy, including the severity of SCI, the level of injury as determined by radiological assessment, three quantitative MR imaging parameters, and eleven qualitative MR imaging parameters. Results : Significant differences between the non-tracheostomy and tracheostomy groups were determined by the following five factors on multivariate analysis : complete SCI (p=0.007), the radiological level of C5 and above (p=0.038), maximum canal compromise (MCC) (p=0.010), lesion length (p=0.022), and osteophyte formation (p=0.015). For the MCC, the cut-off value was 46%, and the risk of requiring a tracheostomy was three times higher at an interval between 50-60% and ten times higher between 60-70%. For lesion length, the cut-off value was 20 mm, and the risk of requiring a tracheostomy was two times higher at an interval between 20-30 mm and fourteen times higher between 40-50 mm. Conclusion : The American Spinal Injury Association grade A, a radiological injury level of C5 and above, an MCC ${\geq}50%$, a lesion length ${\geq}20mm$, and osteophyte formation at the level of injury were considered to be predictive values for requiring tracheostomy intervention in patients with cervical SCI.

• Journal of Korean Biological Nursing Science
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• 제18권4호
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• pp.193-202
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• 2016

Purpose: The study was to analyze clinical outcomes and risk factors of for complications associated with the hip fracture surgery in the elderly before and after interdisciplinary treatment. Methods: A retrospective method was used to investigate the general and therapeutic characteristics, frequency of complications and clinical outcomes. The subjects of the study were 553 patients who underwent hip fracture surgery from January, 2009 to December, 2014. Results: The interdisciplinary group was older and less likely to walk independently even before the fracture than a usual care group. The incidence of complications was higher in the interdisciplinary group than the usual care group. The prevalence of complications in both groups was 66.5%. Multivariate logistic regression analysis showsed that the risk factors for complications of hip fracture surgery were as follows: advanced age, stroke, Parkinson disease, time interval from emergency room to operation, pre & post ambulatory status, American Society of Anesthesiologists (ASA) classification quality of postop intensive care unit (ICU) care and foley indwelling. Conclusion: This study has implications in that it recognized the necessity for interdisciplinary treatment and provided the basic base data for nursing intervention of the elderly patients who underwent hip fracture surgery.