1.Mortality-Related Risk Factors in Total Hip Arthroplasty for Femoral Neck Fractures in Elderly Patients
Jae Sung SUH ; Hyung Gon RYU ; Young Ju ROH ; Dae Won SHIN
Journal of the Korean Fracture Society 2022;35(2):51-56
Purpose:
Total hip arthroplasty (THA) using dual mobility components (DMC) is a reasonable surgical option for displaced femoral neck fractures in elderly patients, resulting in lower dislocation rates and improved stability. The purpose of this study was to investigate the clinical outcomes and risk factors responsible for mortality in elderly patients who were diagnosed with a displaced femoral neck fracture and had undergone DMC-THA.
Materials and Methods:
Out of 147 cases of THA from December 2018 to June 2020, a total of 79 cases were enrolled in this study, with the following characteristics: (1) Garden stage III or IV, (2) over 75 years of age, and (3) over 1 year of follow-up. All the patients received DMC-THA surgery using the anterolateral approach.
Results:
The mean follow-up period was 15.0±8.43 months and a total of one dislocation case was observed. The mortality rate was 17.7% (14/79), and it was especially higher in patients with a past medical history of malignancy (odds ratio [OR]=7.18, p=0.03) or a cognitive disorder such as dementia (OR=5.48, p=0.03). Preoperative low initial hemoglobin levels (OR=0.65, p=0.04) and low UCLA (Uni-versity of California at Los Angeles) score (OR=0.47, p=0.02) were also associated with mortality.
Conclusion
When considering THA as a treatment approach in elderly patients with a displaced femoral neck fracture, a high mortality rate is expected in patients with low preoperative hemoglobin levels or a history of malignancy or cognitive disorders. Hence, thorough monitoring and management should be undertaken before and after surgery.
2.Comparison of the U-Blade Gamma3 Nail and the Zimmer Natural Nail for the Treatment of Intertrochanteric Fracture
Jae Sung SUH ; Hyung-Gon RYU ; Young Ju ROH ; Dae Won SHIN ; Sang-Min KIM
Journal of the Korean Fracture Society 2021;34(2):57-63
Purpose:
This study was performed to compare the clinical results and radiological follow-up differences between intertrochanteric fractures treated with the U-blade Gamma3 nail or the Zimmer natural nail (ZNN).
Materials and Methods:
The medical records of 129 cases diagnosed with an intertrochanteric frac-ture (90 cases of U-blade Gamma3 nail, 39 cases of ZNN) from July 2015 to December 2018 were reviewed. Patients were assigned to a U-blade Gamma3 nail (n=39) or a ZNN (n=39) group. To reduce selective bias, groups were subjected to Propensity score matching by age, body mass index, bone mineral density, and fracture type. Patients that met the following criteria were excluded; age <65 years, non-ambulatory, high energy or pathologic fracture, and a follow-up of <6 months. Operation times, estimated blood losses, preoperative and postoperative Koval grades, Harris hip score and radiological lag screw positions in the femoral head, reduction quality, cut-out, tip-apex distance (TAD), lag screw sliding distances, and times to union were compared.
Results:
Clinical results were similar in the two groups, but lag screw TAD was significantly greater in Ublade Gamma3 nail group (23.4 mm vs. 21.0 mm) (p=0.042). One case of cut-out occurred in the Ublade Gamma3 nail group, but no other nail-related postoperative complication was noted.
Conclusion
No significant difference was observed between the outcomes of U-blade Gamma3 nail or ZNN treatments of intertrochanteric fractures. We conclude that the U-blade confers no specific advan-tage.
3.Comparison of the U-Blade Gamma3 Nail and the Zimmer Natural Nail for the Treatment of Intertrochanteric Fracture
Jae Sung SUH ; Hyung-Gon RYU ; Young Ju ROH ; Dae Won SHIN ; Sang-Min KIM
Journal of the Korean Fracture Society 2021;34(2):57-63
Purpose:
This study was performed to compare the clinical results and radiological follow-up differences between intertrochanteric fractures treated with the U-blade Gamma3 nail or the Zimmer natural nail (ZNN).
Materials and Methods:
The medical records of 129 cases diagnosed with an intertrochanteric frac-ture (90 cases of U-blade Gamma3 nail, 39 cases of ZNN) from July 2015 to December 2018 were reviewed. Patients were assigned to a U-blade Gamma3 nail (n=39) or a ZNN (n=39) group. To reduce selective bias, groups were subjected to Propensity score matching by age, body mass index, bone mineral density, and fracture type. Patients that met the following criteria were excluded; age <65 years, non-ambulatory, high energy or pathologic fracture, and a follow-up of <6 months. Operation times, estimated blood losses, preoperative and postoperative Koval grades, Harris hip score and radiological lag screw positions in the femoral head, reduction quality, cut-out, tip-apex distance (TAD), lag screw sliding distances, and times to union were compared.
Results:
Clinical results were similar in the two groups, but lag screw TAD was significantly greater in Ublade Gamma3 nail group (23.4 mm vs. 21.0 mm) (p=0.042). One case of cut-out occurred in the Ublade Gamma3 nail group, but no other nail-related postoperative complication was noted.
Conclusion
No significant difference was observed between the outcomes of U-blade Gamma3 nail or ZNN treatments of intertrochanteric fractures. We conclude that the U-blade confers no specific advan-tage.
4.Effect of Korean High School Students' Mental Health on Academic Achievement and School Dropout Rate.
Eun Ju BANG ; Du Hyung KIM ; Beop Rae ROH ; Hye Seung YOO ; Ji Hyeon JANG ; Kyung Hee HA ; Eun Jin PARK ; Hyun Ju HONG
Journal of the Korean Academy of Child and Adolescent Psychiatry 2016;27(3):173-180
OBJECTIVES: The purpose of this study was to explore the influence of high school students' mental health on their academic achievement and school dropout rate by using longitudinal data. METHODS: For this study, 153 high schools were randomly sampled on a nationwide scale. The descriptive data was collected from a school information internet site which is organized by the Korean Ministry of Education. We used the schools' mean scores on the Adolescent Mental Health Problem-Behavior Questionnaire-II (AMPQ-II) scale which was used for estimating students' mental health in the 2013 school-based mental health screening test. The data analysis was conducted by using hierarchical regression analysis. RESULTS: The results of this study showed that the AMPQ-II scale's mean scores have significant effects on the following year's academic achievement and annual dropout rates. Especially, the AMPQ-II scale's mean scores tend to increase the school dropout rate in vocational schools. CONCLUSION: The finding of this study is that Korean high school students' mental health states significantly influence their academic achievement and school dropout rate.
Adolescent
;
Education
;
Humans
;
Internet
;
Mass Screening
;
Mental Health*
;
Statistics as Topic
;
Student Dropouts*
5.A Case of Pelvic Arteriovenous Malformation.
Ju Won ROH ; Noh Hyun PARK ; Yong Sang SONG ; Soon Beom KANG ; Jae Hyung PARK ; Sang Joon KIM ; Hyo Pyo LEE
Korean Journal of Obstetrics and Gynecology 1997;40(3):639-644
Arteriovenous malformation of the female pelvis is a rare condition, and its diagnosis, classification, and treatment are still sources of considerable confusion. Now, multidisciplinary and individualized approaches with the use of modern interventional radiologic technology are stressed and play an important role in the management of female pelvic arteriovenous malformation. We experienced a patient, 28-year0old woman with a uterine arteriovenous malformation presenting with irregular vaginal bleeding. At physical examination the slightly enlarged uterus was found, but no other abdominal or cardiopulmonary abnormalities were found. Diagnosis was established by angiography and contrast-enhanced CT/MRI scan. The patient underwent preoperative intra-arterial embolization to decrease operative morbidity and facilitate complete removal. Hysterectomy and resection of surrounding tissue was done successfully. Pathologic examination showed that the uterine myometrium was involved by the arteriovenous malformation and it was composed of fat and fibrous tissues with shick-walled and dilated blood vessels of various diameter. Now we report a case of arteriovenous malformation with a brief review.
Angiography
;
Animals
;
Arteriovenous Malformations*
;
Blood Vessels
;
Classification
;
Diagnosis
;
Female
;
Humans
;
Hysterectomy
;
Mice
;
Myometrium
;
Pelvis
;
Physical Examination
;
Technology, Radiologic
;
Uterine Hemorrhage
;
Uterus
6.An Analysis of Cost-Effective Screening Interval for HCC in Korean Hepatitis B Virus Carriers.
Ju Hyung ROH ; Su Jong LEE ; Jun Yeong CHOI ; Sun Nyu LEE ; Yong Kyung SHIN
Journal of the Korean Academy of Family Medicine 2002;23(11):1340-1347
BACKGROUND: The purpose of this study was to evaluate the cost-effectiveness of screening tests (AFP and US) for early detection of primary hepatocellular carcinoma (HCC) and its optimal screening interval in Korean hepatitis B virus carriers. METHODS: Data relating to tumor incidence, efficacy of screening tests, tumour growth times and various cost for detecting HCC were obtained from reviews of Korean literature. Decision analysis technique was used to calculate the efficacy of these screening tests and screening interval. RESULTS: When the doubling time of HCC was 6 months, the most cost-effective screening interval of each AFP and US was 6 months, respectively. The optimal screening intervals of AFP and US were 3 and 5 months for each, respectively, and 7 months for both when a detection rate of 80% was expected. These results were significantly altered when the different tumour growth times reported in other literatures were applied. CONCLUSION: If the doubling time of HCC was 6 months, the optimal screening interval was 7 months on using both tests. Because the tumour doubling time alters the optimal screening interval, further evaluation on the doubling time of Korean hepatoma is needed.
Carcinoma, Hepatocellular
;
Decision Support Techniques
;
Hepatitis B virus*
;
Hepatitis B*
;
Hepatitis*
;
Incidence
;
Mass Screening*
7.A Case of Broncholithiasis caused by Aspergillus.
Mi Young KWON ; Yoon Ju OH ; Jeong Seon RYU ; Seung Min KWAK ; Hong Lyeol LEE ; Chul Ho CHO ; Hyung Keun ROH ; Joon Mee KIM
Tuberculosis and Respiratory Diseases 1999;46(1):136-141
Broncholith is a calcified lymph node which partially or completely erodes into the bronchial lumen and broncholithiasis is a relatively rare condition which related to late tissue response to healing granulomatous pulmonary infections, most commonly histoplasmosis or tuberculosis. The prominent symptoms of broncholithiasis are coughing followed by hemoptysis and symptoms related to bronchial obstruction. The complications include bronchoesophageal fistula and aortotracheal fistula. We report one case of broncholithiasis caused by Aspergillus. The case was a 53 year-old house wife whose chief complaints were recurrent fever, chill and malaise. The chest film revealed an ovoid hazziness on the right middle lobe and chest CT scan showed consolidation of lateral segment of right middle lobe with calcified small low attenuated lesion in right middle lobe bronchus. Aspergillosis confirmed by pathology after bronchoscopic removal of impacted Aspergillus containing muddy plug from lateral segmental branch of right middle lobe bronchus.
Aspergillosis
;
Aspergillus*
;
Bronchi
;
Cough
;
Cytochrome P-450 CYP1A1
;
Fever
;
Fistula
;
Hemoptysis
;
Histoplasmosis
;
Humans
;
Lymph Nodes
;
Middle Aged
;
Pathology
;
Spouses
;
Thorax
;
Tomography, X-Ray Computed
;
Tuberculosis
8.Comparison Between Beers Criteria and Screening Tool of Older Person's Prescriptions as a Screening Tool for the Detection of Potentially Inappropriate Medicines and Adverse Drug Events in the Elderly Patients.
Joo Hyung LEE ; Ju Hyun ROH ; Ye Won SUH ; Jung Hwa LEE ; Eun Sook LEE ; Byung Koo LEE ; Kwang Il KIM ; Cheol Ho KIM
Journal of the Korean Geriatrics Society 2013;17(1):28-36
BACKGROUND: Beers criteria are used to identify the potentially inappropriate medications (PIMs) in elderly patients. However, the criteria have limitations such as lacking consideration of drug-drug and duplicated prescriptions. The aim of this study is to compare the efficacy of newly developed screening tool of older person's prescriptions (STOPP) with Beers criteria in identifying PIMs and adverse drug events (ADEs) in elderly patients. METHODS: We included 115 elderly patients older than 65 years who visited the outpatients' clinic or have been hospitalized for medical illness. Comprehensive geriatric assessments including medication review by the pharmacists were performed by the multidisciplinary team. Beers criteria and STOPP were used to find out PIMs. The association between PIMs defined by both criteria with ADEs was also evaluated. RESULTS: A total of 59 patients (50.4%) by Beers criteria and 76 patients (65.0%) by STOPP had been prescribed with PIMs. Compared with Beers criteria, STOPP had advantage in identifying more PIMs. In addition, STOPP could identify more ADEs related medications than Beers criteria. STOPP was also useful to detect duplicate drug class prescription and nonsteroidal anti-inflammatory drugs for renal impaired patients. CONCLUSION: STOPP criteria PIMs can detect more duplicated prescription and are significantly associated with avoidable ADEs in older individuals compared with that of Beers criteria PIMs.
Aged
;
Beer
;
Drug Toxicity
;
Geriatric Assessment
;
Humans
;
Imidazoles
;
Mass Screening
;
Nitro Compounds
;
Pharmacists
;
Prescriptions
9.Assessment of flavin-containing monooxygenase (FMO) activity by determining urinary ratio of theobromine and caffeine in a Korean population after drinking a cup of coffee .
Woon Gye CHUNG ; Ju Hee KANG ; Hyung Keun ROH ; Kyung Hoon LEE ; Chang Shin PARK ; Young Nam CHA
The Korean Journal of Physiology and Pharmacology 1999;3(2):207-213
To examine individual variation in drug metabolism catalyzed by flavin-containing monooxygenase (FMO), 179 Korean volunteers' urinary molar concentration ratio of theobromine (TB) and caffeine (CA) was determined. Their urine was collected for 1 hr (between 4 and 5 hrs) after they drank a cup of coffee containing 115 mg CA and analyzed by an HPLC system. The lowest TB/CA ratio obtained was 0.40, the highest ratio was 15.17 (38-fold difference), and the median ratio for all subjects was 1.87. The mean was 2.66 with 2.36 S.D.. In 134 nonsmokers, the mean ratio was 2.35 +/- 1.93, that of 51 males was 2.30 +/- 2.26 and 83 females was 2.37 +/- 1.85, respectively. There was no significant gender difference in the obtained TB/CA ratio (Mann-Whitney test; p=0.518). There were no smokers among the 83 female volunteers. In the remaining 96 male subjects, the ratio obtained in 51 nonsmokers was 2.30 +/- 2.06 and that of 45 smokers was 3.62 +/- 3.19. This indicated that the TB/CA ratio was increased significantly in smokers (p=0.007). However, when the TB/CA ratios (FMO activity) obtained in all 179 Korean volunteers are compared with the urinary concentration ratios of paraxanthine (PX) plus 1,7-dimethylurate (17U) to CA (CYP1A2 activity), there was a weak but significant correlation (Pearson's correlation coefficient test; r2=0.28, p<0.0001). This indicates that, although the urinary TB/CA ratio mostly represents FMO activity, minor contribution by CYP1A2 activity cannot be ignored. In conclusion, the FMO activity measured by taking the urinary TB/CA ratio from normal healthy Korean volunteers shows marked individual variations without significant gender differences and the increased TB/CA ratio observed in cigarette smokers may have been caused by the increased CYP1A2 activity.
Caffeine*
;
Chromatography, High Pressure Liquid
;
Coffee*
;
Cytochrome P-450 CYP1A2
;
Drinking*
;
Ethanol
;
Female
;
Humans
;
Male
;
Metabolism
;
Molar
;
Theobromine*
;
Tobacco Products
;
Volunteers
10.Fabrication of 3D-Printed Implant for Two-Stage Ear Reconstruction Surgery and Its Clinical Application
Oh Young JOO ; Tae Ho KIM ; Young Seok KIM ; Tai Suk ROH ; Eun-Ju LEE ; Jin-Hyung SHIM ; Hyun Woo CHO ; In Sik YUN
Yonsei Medical Journal 2023;64(4):291-296
Purpose:
Ear reconstruction is one of the most difficult areas in the field of reconstructive surgery. Due to limitations of the current practice, a novel method of auricular reconstruction is needed. Major advancements in three-dimensional (3D) printing technique have rendered the process of ear reconstruction more favorable. Herein, we present our experience in designing and clinically using 3D implants in both 1st and 2nd stage ear reconstruction surgery.
Materials and Methods:
After obtaining 3D CT data from each patient, a 3D geometric ear model was created using mirroring and segmentation processes. The 3D-printed implant design resembles but does not exactly match the normal ear shape, and can be inserted in harmony with the currently used surgical technique. The 2nd stage implant was designed to minimize dead space and support the posterior ear helix. The 3D implants were finally fabricated with a 3D printing system and used in ear reconstruction surgery in our institute.
Results:
The 3D implants were manufactured for application to the currently used two-stage technique while maintaining the shape of the patient’s normal ear. The implants were successfully used for ear reconstruction surgery in microtia patients. A few months later, the 2nd stage implant was used in the 2nd stage operation.
Conclusion
The authors were able to design, fabricate, and apply patient-specific 3D-printed ear implants for 1st and 2nd stage ear reconstruction surgeries. This design, combined with 3D bioprinting technique, may be a future alternative for ear reconstruction.