As the epidemic of morbid obesity has been rising globally over the decade, bariatric surgery has also been grown to manage obesity and its comorbidities. Besides of its safety, laparoscopic adjustable gastric banding (LAGB) has been known to be more effective in handling obesity with regard to weight loss and its long-term sustainability, compared to medical treatments. Failure of LAGB, defined as either the unsatisfactory weight loss or the development of major long-term complications, results in revision or removal of gastric band. After explantation of gastric band, rebanding or conversion into other bariatric surgeries such as Roux-en-Y gastric bypass or sleeve gastrectomy is required in terms of maintaining weight loss. Major cause of band removal alone is psychogenic factors like patients' anxiety or feeing discomfort without anatomic problems. In Korea there has been grown of patients' vague demand to remove their gastric band regarding the death of a celebrity. Considering such trend, in order to prevent indiscriminate finish of the treatment, suggestion of appropriate time for gastric band removal on the basis of analyzing the course of weight loss and the occurrence of complications is essential.
Anxiety ; Bariatric Surgery ; Comorbidity ; Fees and Charges ; Gastrectomy ; Gastric Bypass ; Korea ; Obesity ; Obesity, Morbid ; Weight Loss

High blood pressure is a serious health problem and a primary risk factor for both stroke and heart disease. Many studies have strongly assessed short-term effects as well as long-term effects of bariatric surgery on type2 diabetes mellitus, whereas little attention has been paid to the effect on hypertension. This review study was designed to evaluate the impact of Bariatric Surgery and weight loss on obese patients with hypertension, and whether the hypertension improved or resolved post-surgery. Relevant papers were searched using MEDLINE, Science Citation Index, Pub Med, and Clinical Evidence, by using the searched terms (Hypertension, Bariatric, Obesity, and Surgery). The association between weight reduction and Hypertension control is hard to analyze. And well-organized studies with a long term follow up are required to determine the effect of Bariatric Surgery and Hypertension control.
Bariatric Surgery* ; Diabetes Mellitus ; Follow-Up Studies ; Heart Diseases ; Humans ; Hypertension* ; Obesity ; Risk Factors ; Stroke ; Weight Loss

Since patients with morbid obesity undergoing bariatric surgery are vulnerable to micronutrient deficiencies, close monitoring and supplementation are necessary. The importance of screening prior to surgery has increased in recent studies; preoperative screening is recommended for thiamine, vitamin B12, vitamin D and calcium, vitamin A, E, K, folic acid, and iron. Though preoperative weight loss (PWL) of more than 10% excess body weight may be beneficial for postoperative weight loss and shorter operative time, insurance-mandated PWL before bariatric surgery is not evidence-based, unsafe, and therefore strongly discouraged. Very-low-calorie diet (VLCD) in liquid form is recommended as a safe and effective way to lose weight preoperatively. Also, screening and correction of eating disorder and psychiatric problems prior to surgery contribute to better outcome.
Bariatric Surgery ; Body Weight ; Calcium ; Caloric Restriction ; Diet ; Eating ; Folic Acid ; Humans ; Iron ; Malnutrition ; Mass Screening ; Micronutrients ; Obesity, Morbid* ; Operative Time ; Preoperative Care ; Thiamine ; Vitamin A ; Vitamin B 12 ; Vitamin D ; Weight Loss

OBJECTIVES: To evaluate the clinical significance of vertebral bone bruise (VBB) in terms of subsequent collapse after osteoporotic thoracolumbar vertebral fractures. METHODS: We reviewed 41 consecutive patients with 46 osteoporotic thoracolumbar vertebral fractures treated nonoperatively from March 2007 to February 2010. Anterior wedge angle (AWA) was measured on plain radiographs and the change of AWA between the initial and last measurement was used to represent the subsequent vertebral collapse. The size of VBB was measured and VBB ratio was calculated on T1-weighted sagittal MR image. RESULTS: The average VBB ratio was 49.1% and the average change of AWA was 7.1degrees. Only VBB ratio significantly correlated with the change of AWA (P<0.001, cc=0.660). The other factors such as age, initial AWA, and endplate status showed no significant correlation with the change of AWA (P=0.629, P=0.724, P=0.690, respectively). In DEXA group, no correlation was found between T-score and the change of AWA as well as between T-score and VBB ratio (P=0.548, P=0.370, respectively). Five fractures were diagnosed as delayed post-traumatic vertebral collapse. Their average VBB ratio was 71.2% which was significantly higher than that of the other subjects (P=0.015). The fractures with VBB ratio more than 60% was likely to progress to delayed post-traumatic vertebral collapse. CONCLUSIONS: VBB after osteoporotic thoracolumbar vertebral fracture was significantly correlated with subsequent vertebral collapse (cc=0.660). We recommend the patients with a large vertebral bone bruise, especially more than 60%, should be followed up meticulously for the early detection of delayed post-traumatic vertebral collapse.
Contusions ; Humans

Purpose: As the number of gastric cancer survivors is increasing and their quality of life after surgery is being emphasized, single-port surgery is emerging as an alternative to conventional gastrectomy. A novel multi-degree-of-freedom (DOF) articulating device, the ArtiSential ® device (LivsMed, Seongnam, Korea), was designed to allow more intuitive and meticulous control for surgeons facing ergonomic difficulties with conventional tools. In this study, we evaluated the feasibility of this new device during single-port laparoscopic distal gastrectomy (SP-LDG) for early gastric cancer (EGC) patients. Materials and Methods: Consecutive patients diagnosed with EGC who underwent SP-LDG with ArtiSential ® (LivsMed) graspers between April 2018 and August 2020 were enrolled in the study. The clinical outcomes were compared with those of a control group, in which prebent graspers (Olympus Medical Systems Corp) were used for the same procedures. Results: Seventeen patients were enrolled in the ArtiSential ® group. There was no significant difference in operative time (205.4±6.0 vs. 218.1±9.9 minutes, P= 0.270) or the quality of surgery, in terms of the number of retrieved lymph nodes (49.5±3.5 vs. 45.9±4.0, P=0.473), length of hospital stay (15.4±2.0 vs. 12.4±1.3 days, P=0.588), and postoperative complications (40.0% vs. 41.2%, P=0.595), between the ArtiSential ® group and the control group. Conclusions The new multi-DOF articulating grasper is feasible and can be used as an alternative for prebent graspers during SP-LDG.

Arthritis, Rheumatoid* ; Glucose-6-Phosphate Isomerase

PURPOSE: Laparoscopic total fundoplication is the standard surgery for gastroesophageal reflux disease. However, partial fundoplication may be a viable alternative. Here, we conducted a nationwide survey of partial fundoplication in Korea. METHODS: The Korean Anti-Reflux Surgery study group recorded 32 cases of partial fundoplication at eight hospitals between September 2009 and January 2016. The surgical outcomes and postoperative adverse symptoms in these cases were evaluated and compared with 86 cases of total fundoplication. RESULTS: Anterior partial fundoplication was performed in 20 cases (62.5%) and posterior in 12 (37.5%). In most cases, partial fundoplication was a secondary procedure after operations for other conditions. Half of patients who underwent partial fundoplication had typical symptoms at the time of initial diagnosis, and most of them showed excellent (68.8%), good (25.0%), or fair (6.3%) symptom resolution at discharge. Compared to total fundoplication, partial fundoplication showed no difference in the resolution rate of typical and atypical symptoms. However, adverse symptoms such as dysphagia, difficult belching, gas bloating and flatulence were less common after partial fundoplication. CONCLUSION: Although antireflux surgery is not popular in Korea and total fundoplication is the primary surgical choice for gastroesophageal reflux disease, partial fundoplication may be useful in certain conditions because it has less postoperative adverse symptoms but similar efficacy to total fundoplication.
Deglutition Disorders ; Diagnosis ; Eructation ; Flatulence ; Fundoplication* ; Gastroesophageal Reflux ; Humans ; Korea*

No abstract available.
Adenocarcinoma* ; Cervix Uteri* ; Female ; Humans

PURPOSE: Atypical femoral fractures (AFFs) occur in two distinct part, subtrochanter and diaphysis. The aim of this study was to investigate the relationship between the lateral femoral bowing angle and the location of AFF. MATERIALS AND METHODS: This study included a total of 56 cases in 45 patients who underwent surgical treatment between January 2010 and December 2015. For the diaphyseal and subtrochanteric AFFs, we evaluated the relationship between the anatomic location and lateral femoral bowing angle. Lateral femoral bowing angle was measured by two orthopaedic surgeons and average value of two calibrators was used in statistic analysis. Other variables like age, height, weight, body mass index and bone mineral density were also evaluated. We also calculated the cutoff value for the location of the fractures from the raw data. RESULTS: The average lateral femoral bowing angle was 10.10°±3.79° (3°-19°) in diaphyseal group and 3.33°±2.45° (1.5°-11°) in subtrochanter group. Lateral femoral bowing angle was statistically significant in logistic regression analysis. According to the receiver operating characteristic curve, cutoff value for the location of the fracture was 5.25°. In other words, the femoral diaphyseal fractures are more frequent if the lateral femoral bowing angle is greater than 5.25°. CONCLUSION: The lateral femoral bowing angle is associated with the location of the AFFs and the cutoff value of lateral femoral bowing angle was 5.25°.
Body Weight ; Bone Density ; Diaphyses ; Femoral Fractures* ; Femur ; Humans ; Logistic Models ; ROC Curve ; Surgeons

Objectives: Public healthcare data have become crucial to the advancement of medicine, and recent changes in legal structure on privacy protection have expanded access to these data with pseudonymization. Recent debates on public healthcare data use by private insurance companies have shown large discrepancies in perceptions among the general public, healthcare professionals, private companies, and lawmakers. This study examined public attitudes toward the secondary use of public data, focusing on differences between public and private entities. Methods: An online survey was conducted from January 11 to 24, 2022, involving a random sample of adults between 19 and 65 of age in 17 provinces, guided by the August 2021 census. Results: The final survey analysis included 1,370 participants. Most participants were aware of health data collection (72.5%) and recent changes in legal structures (61.4%) but were reluctant to share their pseudonymized raw data (51.8%). Overall, they were favorable toward data use by public agencies but disfavored use by private entities, notably marketing and private insurance companies. Concerns were frequently noted regarding commercial use of data and data breaches. Among the respondents, 50.9% were negative about the use of public healthcare data by private insurance companies, 22.9% favored this use, and 1.9% were “very positive.” Conclusions This survey revealed a low understanding among key stakeholders regarding digital health data use, which is hindering the realization of the full potential of public healthcare data. This survey provides a basis for future policy developments and advocacy for the secondary use of health data.