BACKGROUND: As South Korea is becoming an aged society very rapidly, the increase in osteoarthritis prevalence raises various public health issues in this country. This study aimed to explore the socio-demographic factors associated with osteoarthritis in the current Korean elderlies. METHODS: Using the National Survey of Korean Elderly data (2014, 2017), we analyzed 20,326 elderlies (males, 8,248; females, 12,078) and conducted multivariate logistic regression analyses by sex. The dependent variable is whether a participant was diagnosed with osteoarthritis or not. Independent variables of interest is socio-demographic factors such as age, marital status, household type, residential area, household income, religion, the longest job, the number of close relatives, the number of close friends, and survey year. Control variables are various health behavioral factors and disease-related factors. RESULTS: Prevalence of osteoarthritis was 19.2% in male elderlies and 47.0% in female elderlies. According to the results of the multivariate logistic regression adjusted for all studied control variables, the odds ratio (OR) for having osteoarthritis of under-elementary school graduates (their counterpart was college graduate group) was 1.81 (95% confidence interval [CI], 1.29–2.52) in males and 1.67 (95% CI, 1.12–2.47) in females. The OR of those having a job in agriculture & forestry fishery as their longest job (their counterpart was those who had never participated in labor force during their lifetime) was 5.07 (95% CI, 1.46–17.58) in males and 1.49 (95% CI, 1.27–1.74) in females. In males, the second-low quartile group in household yearly income (their counterpart was the highest quartile group) had the OR of 1.22 (95% CI, 0.98–1.53). In females, the OR of those having a religion of Buddhism (their counterpart was those having no religion) was 1.20 (95% CI, 1.07–1.35) and the OR of those who had no relatives (their counterpart was those having more than 3 close relatives) was 1.31 (95% CI, 1.10–1.56). CONCLUSION This study found that in Korean elderlies, education, the longest job, household income, religion, and the number of close relatives are associated with their suffering from osteoarthritis. Further study and designing appropriate interventions are needed to alleviate current and future individual and socioeconomic burdens of osteoarthritis in an aged society like South Korea.

No abstract available.
Colonoscopy*

Although the nasogastric tube (NGT) is widely used in critically ill patients, most intensivists do not give much thought to it or its possible complications. NGT syndrome is a rare but fatal complication characterized by throat pain and vocal cord paralysis in the presence of NGT. Recently, we experienced a case of NGT syndrome developed in an 86-year-old female twelve days after NGT insertion. We immediately removed the NGT and secured the airway by tracheostomy. She was treated successfully with an intravenous antibiotic, steroid and proton pump inhibitor and the syndrome did not recur after reinsertion of the NGT.
Aged, 80 and over ; Critical Illness ; Female ; Humans ; Intensive Care Units* ; Critical Care* ; Pharynx ; Proton Pumps ; Tracheostomy ; Vocal Cord Paralysis

Background: It is getting important to improve the oral health status of the elderly because oral health status may affect their health status of the whole body. In this respect, we aimed to explore the association of oral health status and behavior factors with self-rated health status by sex. Methods: Using the data from the 7th Korea National Health and Nutrition Examination Survey for health surveys and oral examinations (2016–2018), we analyzed a total of 3,070 people aged 65 or older (men: 1,329; women: 1,741). Our dependent variable, self-rated health status, was divided into two groups: not good (bad and very bad) and good (very good, good, and fair), whereas our independent variables of interest were oral health status and behavior factors. In addition to descriptive analysis and the Rao-Scott chi-square test, reflecting survey characteristics, we conducted hierarchical multivariable logistic regression analyses adjusted for socio-demographics and health status and behavior factors. All analyses were stratified by sex. Results: The proportion of people having ‘not good’ self-rated health was 36.5% in women but 24.5% in men. In a model adjusted for all covariates, the self-rated health status showed significant association with the self-rated oral health status. For example, in men, the risk of having ‘not good’ self-rated health was high in people having ‘poor’ (odds ratio [OR], 5.31; 95% confidence interval [CI], 2.34–12.03) self-rated oral health status and in those having ‘fair’ (OR, 4.03; 95% CI, 1.68–9.70) in comparison with those having ‘good’ self-rated oral health status. Dental status regarding speaking difficulty seemed to be very important in influencing self-rated health status. For instance, in women, compared to people having ‘no discomfort’ speaking difficulty, the risk of having ‘not good’ self-rated health was high in people having ‘not bad’ (OR, 1.60; 95% CI, 1.14–2.24) and ‘discomfort’ (OR, 1.79; 95% CI, 1.30–2.47) speaking difficulty. The covariates significantly associated with the risk of having ‘not good’ self-rated health were: physical activity, chronic disease, stress, and body mass index in both sexes; health insurance type and drinking only in men; and economic activity only in women. Conclusion Oral health status and behavioral factors were associated with self-rated health status among the elderly, differently by sex. This suggests that public health policies toward better health in the elderly should take their oral health status and oral health behaviors into account in a sex-specific way

Background: It is getting important to improve the oral health status of the elderly because oral health status may affect their health status of the whole body. In this respect, we aimed to explore the association of oral health status and behavior factors with self-rated health status by sex. Methods: Using the data from the 7th Korea National Health and Nutrition Examination Survey for health surveys and oral examinations (2016–2018), we analyzed a total of 3,070 people aged 65 or older (men: 1,329; women: 1,741). Our dependent variable, self-rated health status, was divided into two groups: not good (bad and very bad) and good (very good, good, and fair), whereas our independent variables of interest were oral health status and behavior factors. In addition to descriptive analysis and the Rao-Scott chi-square test, reflecting survey characteristics, we conducted hierarchical multivariable logistic regression analyses adjusted for socio-demographics and health status and behavior factors. All analyses were stratified by sex. Results: The proportion of people having ‘not good’ self-rated health was 36.5% in women but 24.5% in men. In a model adjusted for all covariates, the self-rated health status showed significant association with the self-rated oral health status. For example, in men, the risk of having ‘not good’ self-rated health was high in people having ‘poor’ (odds ratio [OR], 5.31; 95% confidence interval [CI], 2.34–12.03) self-rated oral health status and in those having ‘fair’ (OR, 4.03; 95% CI, 1.68–9.70) in comparison with those having ‘good’ self-rated oral health status. Dental status regarding speaking difficulty seemed to be very important in influencing self-rated health status. For instance, in women, compared to people having ‘no discomfort’ speaking difficulty, the risk of having ‘not good’ self-rated health was high in people having ‘not bad’ (OR, 1.60; 95% CI, 1.14–2.24) and ‘discomfort’ (OR, 1.79; 95% CI, 1.30–2.47) speaking difficulty. The covariates significantly associated with the risk of having ‘not good’ self-rated health were: physical activity, chronic disease, stress, and body mass index in both sexes; health insurance type and drinking only in men; and economic activity only in women. Conclusion Oral health status and behavioral factors were associated with self-rated health status among the elderly, differently by sex. This suggests that public health policies toward better health in the elderly should take their oral health status and oral health behaviors into account in a sex-specific way

OBJECTIVE: This study is a retrospective cost-benefit analysis of cervical anterior interbody fusion and cervical artificial disc replacement, which are the main surgical methods to treat degenerative cervical disc disease.METHODS: We analyzed 156 patients who underwent anterior cervical disc fusion and cervical artificial disc replacement from January 1, 2008 to December 31, 2009, diagnosed with degenerative cervical disc disorder. In this study, the costs and benefits were analyzed by using quality adjusted life year (QALY) as the outcome index for patients undergoing surgery, and a Markov model was used for the analysis. Only direct medical costs were included in the analysis; indirect medical costs were excluded. Data were analyzed with TreeAge Pro 2015™ (TreeAge Software, Inc, Williamstown, MA, USA).RESULTS: Patients who underwent cervical anterior fusion had a total cost of KRW 2501807/USD 2357 over 5 years and obtained a utility of 3.72 QALY. Patients who underwent cervical artificial disc replacement received 4.18 QALY for a total of KRW 3685949/USD 3473 over 5 years. The cumulative cost-effectiveness ratio of cervical spine replacement surgery was KRW 2549511/QALY (USD 2402/QALY), which was lower than the general Korean payment standard.CONCLUSION: Both cervical anterior fusion and cervical artificial disc replacement are cost-effective treatments for patients with degenerative cervical disc disease. Cervical artificial disc replacement may be an effective alternative to obtain more benefits.
Cervical Vertebrae ; Cost-Benefit Analysis ; Female ; Humans ; Quality-Adjusted Life Years ; Retrospective Studies ; Spinal Fusion ; Spine ; Total Disc Replacement

Background: Metabolic syndrome has been known as a risk of cardiovascular disease. Meanwhile, high sensitivity C-reactive protein (hs-CRP) is used as a predictor of cardiovascular disease. In this paper, we aimed to investigate the association between hs-CRP and metabolic syndrome.Method: A total of 7,633 were chosen as the study population from the 7th Korea National Health and Nutrition Examination Survey dataset (2016–2017). Our dependent variable was whether an individual had metabolic syndrome or not, and the independent variable of interest was hs-CRP which was categorized into three groups. The chi-square tests and hierarchical logistic regression analyses reflecting survey characteristics were conducted. All analyses were stratified by gender. Results: According to the adjusted model with all covariates, compared to individuals having the low risk of hs-CRP, those having its average risk were more likely to have metabolic syndrome in men (odds ratio [OR], 1.41; 95% confidence interval [CI], 1.12–1.76) and women (OR, 1.69; 95% CI, 1.33–2.16). Individuals having the high risk was not significantly different in men; however, they were more likely to have metabolic syndrome in women (OR, 2.03; 95% CI, 1.28–3.23). Conclusion In an upcoming aging society, it is important to reduce the risk of metabolic syndrome to improve population health. This study suggests that hs-CRP may be used as a marker of the risk of metabolic syndrome in a gender-specific way, thereby contributing to enhancing awareness of the risk of metabolic syndrome among the general public.

Background: Patient perception is a key element in improving compliance with medications for osteoporosis. This study evaluated the awareness, perception, sources of information, and knowledge of osteoporosis among Korean women with osteoporosis. Methods: A questionnaire survey was conducted from July 22, 2021 to 13 August 2021. Patients who were followed up in endocrinology (Endo), orthopedic surgery (OS), and gynecology (GY) were recruited (N=40, 40, and 20 in each group). Patients were allocated according to their age, as follows: 15, 15, and 10 patients in their 60s, 70s, and 80s for Endo and OS, and 10 and 10 patients in their 60s and 70s for GY. The questionnaire was composed of the following topics: patient journey to the hospital, drug-related issues, communication with medical doctors, patient knowledge, and sources of information about osteoporosis. Results: The results of medical check-ups were the most common reason for patient visits to the hospital for an initial diagnosis of osteoporosis (61%). A knowledge gap regarding mortality, refracture, and drug-induced osteoporosis was observed. Doctors were the most preferred and trustful source of information, while health-related TV shows were the second most common source of information. Patients with OS reported lower perceived severity and higher drug discontinuation, along with a higher proportion of fractures, as the initial reasons for hospital visits for osteoporosis. Conclusions Variations in perceptions according to the issue and group were identified. These should be considered during patient consultations to improve compliance with osteoporosis treatment.

PURPOSE: Partial necrosis of skin flaps remains a substantial problem in reconstructive surgery. We investigated the potential use of an adenovirus vector encoding the VEGF, COMP-angiopoietin-1 gene in an attempt to promote the viability of the inferior epigastric artery flap in a rat model. METHODS: Three by six cm lower abdominal transverse skin flaps, supplied only by the left inferior epigastric artery, were designed. After skin flap elevation, the adenovirus VEGF and adenovirus COMP-angiopoietin-1 were injected into the distal portion of the flap, which has a high tendency of developing flap ischemia. Control animals were injected with the same volume of normal saline. On 3, 7 and 14 days after the flap elevation, the flap survival and vascularization were assessed using Visitrak digital(R), CD31 immunohistochemistry in addition to evaluating the general histological characteristics. RESULTS: There was a significant increase in the mean percentage of flap viability by 89.8%, 91.1% and 94.8% in flaps transfected with adenovirus VEGF, COMP- angiopoietin-1, coadministraion of VEGF and COMP- angiopoietin-1 at seven days, and by 95.6%, 94.8% and 96.3% at 14 days. Histological assessment revealed that there were more blood vessels formed after adenovirus with VEGF, COMP-angiopoietin-1 or VEGF plus COMP- angiopoietin-1 than with adenovirus Lac Z. CONCLUSION: The results of this study suggest that adenovirus-mediated VEGF, COMP-angiopoietin-1 gene therapy, promote therapeutic angiogenesis in patients that undergo reconstructive procedures. Key Words:
Adenoviridae ; Angiopoietin-1 ; Animals ; Blood Vessels ; Epigastric Arteries ; Genetic Therapy ; Humans ; Immunohistochemistry ; Ischemia ; Necrosis ; Rats ; Skin ; Vascular Endothelial Growth Factor A

BACKGROUND: Liver transplantation (orthotopic) is considered as an important therapy for the end stage liver diseases, but because of the coagulopathies of these patients, the massive bleeding during the operation has been a disturbing problem. So, the role of blood bank has increasingly been important for the appropriate blood products supply for the operation. METHODS: The authors reviewed retrospectively the hospital records of 9 patients who had taken orthotopic liver transplantations (OLT) at the Seoul Paik Hospital from March, 1992 to November, 1994. RESULTS AND CONCLUSION: The mean operation time and hospitalization duration was 14.1 hours and 35.3 days, respectively. Intraoperatively, the operations required a mean of 2.4 units of whole blood (WB), 29.4 of red cells (RBCs), 32.0 of fresh frozen plasma (FFP), 17.5 of platelet concentrates (PLTs), and 4.1 of cryoprecipitates (CRYOs). During the entire hospital stay, a mean of 9.3 units of WB, 56.1 of RBCs, 108.3 of FFP, 210.8 of PLTs, and 5.6 of CRYOs were transfused.
Blood Banks ; Blood Platelets ; Hemorrhage ; Hospital Records ; Hospitalization ; Humans ; Length of Stay ; Liver Diseases ; Liver Transplantation* ; Liver* ; Plasma ; Retrospective Studies ; Seoul