• Journal of Dental Anesthesia and Pain Medicine
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• v.16 no.4
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• pp.273-281
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• 2016

Background: Postoperative nausea and vomiting (PONV) is one of the most common postoperative complications. Despite this, few papers have reported the incidence and independent risk factors associated with PONV in the context of oral and maxillofacial surgery (OMFS). Therefore, we sought to determine the incidence of PONV, as well as to identify risk factors for the condition in patients who had undergone OMFS under general anesthesia. Methods: A total of 372 patients' charts were reviewed, and the following potential risk factors for PONV were analyzed: age, sex, body mass index, smoking status, history of PONV and/or motion sickness, duration of anesthesia, amount of blood loss, nasogastric tube insertion and retention and postoperative opioid used. Univariate analysis was performed, and variables with a P-value less than 0.1 were entered into a multiple logistic regression analysis, wherein P-values < 0.05 were considered significant. Results: The overall incidence of PONV was 25.26%. In the multiple logistic regression analysis, the following variables were independent predictors of PONV: age < 30 years, history of PONV and/or motion sickness, and anesthesia duration > 4 h. Furthermore, the number of risk factors was proportional to the incidence of PONV. Conclusions: The incidence of PONV in patients who have undergone OMFS varies from center to center depending on patient characteristics, as well as on anesthetic and surgical practice. Identifying the independent risk factors for PONV will allow physicians to optimize prophylactic, antiemetic regimens.

• Journal of Gastric Cancer
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• v.14 no.3
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• pp.187-195
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• 2014

Purpose: Laparoscopic gastrectomy in obese patients has been investigated in several studies, but its feasibility has rarely been examined in morbidly obese patients, such as in those with a body mass index (BMI) of ${\geq}30kg/m^2$. The present study aimed to evaluate the technical feasibility and safety of laparoscopic gastrectomy in morbidly obese patients with gastric cancer. Materials and Methods: A total of 1,512 gastric cancer patients who underwent laparoscopic distal gastrectomy (LDG) were divided into three groups: normal (BMI< $25kg/m^2$, n=996), obese (BMI $25{\sim}30kg/m^2$, n=471), and morbidly obese ($BMI{\geq}30kg/m^2$, n=45). Short-term surgical outcomes, including the course of hospitalization and postoperative complications, were compared between the three groups. Results: The morbidly obese group had a significantly longer operating time (240 minutes vs. 204 minutes, P=0.010) than the normal group, but no significant differences were found between the groups with respect to intraoperative blood loss or other complications. In the morbidly obese group, the postoperative morbidity and mortality rates were 13.3% and 0%, respectively, and the mean length of hospital stay was 8.2 days, which were not significantly different from those in the normal group. Subgroup analysis showed that postoperative complication rates were not high in morbidly obese patients, independent of the type of anastomosis technique used and level of lymph node dissection. Conclusions: LDG is technically feasible and safe in morbidly obese patients with a BMI of ${\geq}30kg/m^2$ and early gastric carcinoma. Except for a longer operating time, LDG might represent a reasonable treatment option in these patients.

• Journal of Gastric Cancer
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• v.18 no.2
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• pp.182-188
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• 2018

Purpose: Despite the fact that there are several reports of single-port laparoscopic distal gastrectomy (SPDG), no analysis of its learning curve has been described in the literature. The aim of this study was to investigate the favorable factors for SPDG and to analyze the learning curve of SPDG. Materials and Methods: A total of 125 cases of SPDG performed from November 2011 to December 2015 were enrolled. All operations were performed by 2 surgeons (surgeon A and surgeon B). The moving average method was used for defining the learning curve. All cases were divided into 10 cases in a sequence, and the mean operative time and estimated blood loss data were extracted from each group. Results: Surgeon A performed 68 cases (female-to-male sex ratio, 91.1%:8.82%), and surgeon B performed 57 cases (female-to-male sex ratio, 61.4%:38.5%). The operative time of surgeon B significantly decreased after 30 cases ($157.8{\pm}38.4$ minutes vs. $118.1{\pm}34.5$ minutes, P=0.003); that of surgeon A did not significantly decrease before and after around 30 cases ($160.8{\pm}51.6$ minutes vs. $173.3{\pm}35.2$ minutes, P=0.6). The subgroup analysis showed that the operative time significantly decreased in the patients with body mass index (BMI) of <$25kg/m^2$ (<$25kg/m^2$:${\geq}25kg/m^2$, $159.3{\pm}41.7$ minutes: $194.25{\pm}81.1$ minutes; P=0.001). Conclusions: Although there was no significant decrease in the operative time for surgeon A, surgeon B reached the learning curve upon conducting 30 cases of SPDG. BMI of <$25kg/m^2$ was found to be a favorable factor for SPDG.

• Journal of the Korean Society of Radiology
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• v.14 no.5
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• pp.705-713
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• 2020

Arteriosclerosis is a disease in which blood circulation is impaired due to loss of elasticity as blood vessels become narrower, and is a potential cause of recently increasing cardiovascular and cerebrovascular diseases. Carotid ultrasound is used as a predictor of cardiovascular and cerebrovascular diseases by evaluating the degree of atherosclerosis. Therefore, this paper attempted to investigate the correlation between the increase in the thickness of the inner media and various clinical variables in carotid ultrasound. Patients with carotid ultrasound findings were classified into three stages: mild intima thickening, sclerosis, and significant stenosis. CAVI (Carotid Ankle Vascular Index: vascular age) data measured in the degree and physical characteristics of the carotid artery(gender, age, body mass index, blood pressure), blood test(total cholesterol, triglycerides, high-density lipoprotein, low-density lipoprotein, creatine phosphokinase, fasting blood sugar), and arteriosclerosis test were collected. It was confirmed that the carotid intima thickness was correlated with variables such as hypertension, hyperlipidemia, and BMI, and also correlated with the risk factors of cardiovascular disease as CAVI increased.

• Archives of Plastic Surgery
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• v.42 no.3
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• pp.321-326
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• 2015

Background The acellular dermal matrix (ADM)-assisted breast reconstruction technique is widely known, but discouraging results due to early postoperative complications have been reported. As the literature identifies seroma as the most common issue after breast surgery without identifying its pathogenesis, we aimed to report the trend of postoperative daily serum collection after ADM-assisted breast reconstruction and compare it with data in the literature in order to discover more about this little-known topic. Methods A retrospective study on 28 consecutive patients who received ADM-assisted breast reconstruction between February 2013 and February 2014 was performed. In order to reduce the number of variables that could affect serum production, only one brand of ADM was used and all tissues were handled gently and precisely. The daily drainage volume was recorded per patient during the first four days of hospitalization. Likewise, postoperative complications were noted during routine follow-up. Results In total, five (17.9%) bilateral and 23 (82.1%) unilateral ADM-assisted breast reconstructions (33 implants) were performed. The mean age, body mass index, and length of hospital stay were 53.6 years, $21.3kg/m^2$, and 4.5 days, respectively. One major complication led to implant loss (3.0%), and nine minor complications were successfully treated with ambulatory surgery (27.3%). Serum collection linearly decreased after 24 hours postoperatively. Conclusions Daily drainage decreased following the theoretical decline of acute inflammation. In concordance with the literature, daily serum production may not be related to the use of ADM.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.16 no.3
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• pp.178-184
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• 2013

Purpose: The clinical presentations of inflammatory bowel disease (IBD) prior to diagnosis are so diverse or vague that many of them waste time before final diagnosis. This study was undertaken to know the medical history of the pediatric patients until the final diagnosis could be reached. Methods: The medical records of all pediatric patients who were diagnosed with IBD (Crohn's disease [CD] in 14 children, ulcerative colitis [UC] in 17) during the last 13 years were reviewed. We investigated the length of the diagnostic time lag, chief clinical presentation, and any useful laboratory predictor among the routinely performed examinations. Indeterminate colitis was not included. Results: The mean ages of children at the final diagnosis was similar in both diseases. As for the pre-clinical past history of bowel symptoms in CD patients, 5 were previously healthy, 9 had had 1-3 gastrointestinal (GI) symptoms, weight loss, bloody stool, anemia and rectal prolapse. With UC, 9 were previously healthy, 8 had had 1-3 GI symptoms, bloody stool, anorexia. The average diagnostic time lag with CD was 3.36 months, and with UC 2.2 months. Body mass index (BMI) and the initial basic laboratory data (white blood cell, hemoglobin, mean corpuscular volume, serum albumin, and serum total protein) were lower in CD, statistically significant only in BMI. Conclusion: IBD shows diverse clinical symptoms before its classical features, making the patients waste time until diagnosis. It is important to concern possibility of IBD even in the mildly sick children who do not show the characteristic symptoms of IBD.

• Herbal Formula Science
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• v.24 no.3
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• pp.153-161
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• 2016

Chronic alcoholic myopathy is one of the most common skeletal muscle disorders. It is characterized by a reduction in the entire skeletal musculature, skeletal muscle weakness, and difficulties in gait. Patients with alcoholic hepatitis and cirrhosis have severe muscle loss that contributes to worsening outcome. Although the myopathy selectively affects Type II (fast twitch, glycolytic, anaerobic) skeletal muscle fibers, total skeletal musculature is reduced. The severity of the muscle atrophy is proportional to the duration and amount of alcohol consumed and leads to decreased muscle strength. The mechanisms for the myopathy are generally unknown but it is not due to overt nutritional deficiency, nor due to either neuropathy or severe liver disease. Skeletal muscle mass and protein content are maintained by a balance between protein synthesis and breakdown and in vivo animal models studies have shown that ethanol inhibits skeletal muscle protein synthesis. Daekumeumja is a traditional Korean medicine that is widely employed to treat various alcohol-induced diseases. Muscle diseases are often related to liver diseases and conditions. The main objective of this study was to assess that Daekumeumja extract could have protective effect against alcoholic myopathy in a Sprague-Dawley rat model. Rats were orally given 25% ethanol (5ml/kg, body weight) for 8 weeks. After 30 minutes, rats were administrated with Daekumeumja extract. Controls were similarly administrated with the vehicle alone. The weights of gastrocnemius, soleus and plantaris muscles were assessed and the morphologic changes of gastrocnemius and plantaris muscles were also assessed by hematoxylin and eosin staining. In results, The muscles from ethanol treated rats displayed a significant reduction in muscle weight and average cross section area compared to Normal group. Daekumeumja extract treated group showed increased muscle weight and muscle fiber compared to the ethanol treated group. It was concluded that Daekumeumja extract showed ameliorating effects on chronic alcohol myopathy in skeletal muscle.

• Journal of the Korean Dietetic Association
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• v.19 no.4
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• pp.400-415
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• 2013

The purpose of the study was to examine the current status of nutritional management at elderly nursing homes. A survey was performed of 83 nursing homes from January 5, 2011 to January 21, 2011 via mail. A total of 34 nursing homes responded to the survey and 149 elderly subjects were analyzed according to the presence of a dietitian. Among the 34 nursing homes, 70.6% had a dietitian on duty. All of the facilities with a dietitian had the dietitian making the meal plan, whereas 70% of the facilities without dietitian served meals planned by a non-professional person. Overall, however, a low proportion of nursing homes implemented dietetic treatments for residents with diseases. For the nutritional assessment of these residents, a mini nutritional assessment (MNA) was performed. MNA scores were significantly associated with body mass index (BMI), mid-arm circumference (MAC), calf circumference (CC), ingestion problems, and weight loss during the last 3 months (P<0.001). Among the elderly studied, 5.4% were malnourished, and 36.9% were at risk for malnutrition by MNA score. The results of this survey show that the current management of nutrition at nursing homes is insufficient because the elderly who needed dietetic treatment did not receive proper care. Dietetic management is the most important service in all nursing homes. Therefore, to improve the nutritional status of elderly residents in nursing homes, systematic nutrition management by nutrition experts should be implemented.

• Journal of Dental Rehabilitation and Applied Science
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• v.19 no.2
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• pp.57-67
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• 2003

Suppose that dental occlusion is related to body posture. We want to find out that improving occlusal balance may affect vibration and distribution of C.O.P. in which way, by measuring change of posture and center of gravity (center of pressure, C.O.P.) which plays important role in measuring balance sensation. Total 11 students at Kyung Hee dental college students, 4 females and 9 males (age: 23-30) participated in this test, who have normal occlusion (Angle's classification I), no TMJ problems. All of the participants have no tooth loss except 3rd molar, no prosthesis over single tooth restoration, no orthopedic problems which affect balance sensation, and no otorhinolaryngological problems. First, we registrated bite by centric relation, and then fabricated stabilization splint that is increased 3.5mm vertical dimension around premolar region. By F-scan (Tekscan Inc., Boston, Mass), we measured discrepancy of average contact pressure of left and right foot. And we also measured discrepancy of vibration of C.O.P(center of pressure). before setting stabilization splint and after wearing stabilization splint at intervals of 1 week, 2 weeks, 3 weeks after. In normal human beings, improved occlusal balance by stabilization splint leads to decrease of vibration of C.O.P. (P<0.05). One week after wearing stabilization splint, vibration of C.O.P. decreased reliably (P<0.05), two weeks after wearing stabilization splint, vibration of C.O.P. decreased similarly comparing to before wearing and one week after wearing. (P<0.05) After two weeks and three weeks, however, it was hard to find reliability. (P>0.05) Difference between average contact pressure of right and left foot also decreased. (P<0.05) We could find decrease after one week of wearing stabilization splint (P<0.05) and two weeks after, the decrease was more reliable than one week after. (P<0.05) After two weeks and three weeks, however, it was hard to find reliability. Improvement of occlusal balance leads to decrease of vibration of C.O.P. and decrease of difference between right and left average contact pressure.

• Journal of Gastric Cancer
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• v.7 no.4
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• pp.228-236
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• 2007

Purpose: We have evaluated changes of body composition for patients that underwent a radical gastrectomy for stomach cancer by the use of available bioelectrical impedance analysis during the first year following surgery. We plan to utilize these findings in nutritional and physiological studies. Materials and Methods: We evaluated clinical changes in body composition in patients using the bioelectrical impedance method (Inbody 4.0, Biospace, Korea), between November 2003 to November 2004. A total of 98 patients agreed to enroll in this study among all of the patients that underwent a radical gastrectomy. Results: The average weight decreased by 6.7%, and 9.4%, within the first and 6 months after surgery, respectively (P<0.01). The fat free mass (FFM) dropped by 4.9% within the first month and there were no more changes after this period (P<0.01). The fat mass (FM) and visceral fat area (VFA) decreased 24.3% and 14.1% within the first 6 months (P<0.01), respectively. The reduction effects for female patients were greater than for male patients for weight, FFM and VFA (P<0.05). The edema index was higher in patients with stage III-IV disease than in patients with stage I-II disease (P<0.05). There were significant differences for Billroth I and Billrothl II patients as compared to patients that underwent an esophagojejunostomy for a reduction of the FM, as measured in the in the 12th month after surgery (27.6%, 22.1%, and 41.2%, respectively; P<0.05). Conclusion: Since nutritional supplementation and an improvement in body weight loss after a radical gastrectomy is significantly related with quality of life, nutritional and physiological studies should be greatly considered. In this study, bioelectrical impedance analysis was very useful in analyzing the diminution of body composition and we hope this study on the nutritional and physiological aspects related to a radical gastrectomy will be useful for later studies.