No abstract available.
Sertoli-Leydig Cell Tumor*

No abstract available.
Drug Therapy* ; Pregnancy*

BACKGROUND: Over the past decade, considerable evidence has been accumulated showing that social networks influence health. However few valid and reliable instruments exist for assessing social networks among elderly population. Therefore, we translated the Lubben social network scales (LSNS) and tested the validity and reliability of Korean version. METHODS: Ten items, self-administered questionnaires were translated by multidisciplinary committee members. Also they were reverse translated by bilingual and modified from pretest procedure. Reliability was tested by 4 weeks testretest reliability and internal consistency (Cronbach's alpha). Validity was tested by factor analysis and construct validity comparison with the Korean version of Duke-UNC and Korean Health Related Quality of Life Scale (KQOLS) were tested for validity testing. RESULTS: Cronbach's alpha was 0.75. Four weeks test-retest Pearson coefficient was 0.78 (P < 0.0001). Correlation coefficient with the Korean version of Duke-UNC was 0.58 (P < 0.0001). Correlation coefficient with social function domain of KQOLS was 0.40 (P < 0.0001). Principal components analysis identified 3 factors. Three contents areas are family and friends networks, interdependent social support and living arrangements. CONCLUSION: Korean version of LSNS is both valid and reliable instrument, but fine refinements will be needed to adapt for use in practical settings.
Aged ; Committee Membership ; Friends ; Humans ; Quality of Life ; Reproducibility of Results ; Residence Characteristics ; Weights and Measures ; Surveys and Questionnaires

Percutaneous vertebroplasty (PVP) is a minimally invasive surgical treatment for patients with osteoporotic vertebral compression fracture (OVCF) and can rapidly alleviate pain, improve mobility, and stabilize the vertebrae. However, it has the potential to cause complications such as cement embolism. A 55-year-old female presented with pain in the lumbar region as a chief complaint. PVP was performed after diagnosis of acute OVCFs at L4 and L5. No abnormal symptoms were reported after surgery, but a large cement embolism was observed in her right atrium and ventricle. After discussion in a multi-disciplinary team, the large cement embolism was successfully removed by a combination of endovascular procedure and an inferior vena cava exploration. Surgeons must consider the possibility of intra-cardiac cement embolism after PVP. A hybrid approach of an endovascular procedure and a vascular surgery may be a reasonable treatment option to minimize the surgical procedure in cases of a large intra-cardiac cement embolism.
Diagnosis ; Embolism* ; Endovascular Procedures* ; Female ; Fractures, Compression ; Heart Atria ; Humans ; Lumbosacral Region ; Middle Aged ; Spine ; Surgeons ; Vena Cava, Inferior* ; Vertebroplasty*

Purpose: Although endovascular aneurysm repair (EVAR) has been shown to be superior to open surgical repair (OSR) for abdominal aortic aneurysm (AAA) treatment, no large-scale studies in the Korean population have compared outcomes and costs. Methods: The National Health Insurance Service database in Korea was screened to identify AAA patients treated with EVAR or OSR from 2008 to 2019. Perioperative, early postoperative, and long-term survival were compared, as were reinterventions and complications. Patients were followed-up through 2020. Results: Of the 13,631 patients identified, 2,935 underwent OSR and 10,696 underwent EVAR. Perioperative mortality rate was lower in the EVAR group (4.2% vs. 8.0%, P < 0.001) even after excluding patients with ruptured AAA (2.7% vs.3.3%, P = 0.003). However, long-term mortality rate per 100 person-years was significantly higher in the EVAR than in the OSR group (9.0 vs. 6.4, P < 0.001), and all-cause mortality was lower in the OSR group (hazard ratio, 0.9; 95% confidence interval, 0.87–0.97, P = 0.008). EVAR had a higher AAA-related reintervention rate per 100 person-years (1.75 vs. 0.52), and AAA-related reintervention costs were almost 10-fold higher with EVAR (US dollar [USD] 6,153,463) than with OSR (USD 624,216). Conclusion While EVAR may have short-term advantages, OSR may provide better long-term outcomes and costeffectiveness for AAA treatment in the Korean population, under the medical expense system in Korea.

Background: Ruptured abdominal aortic aneurysm (rAAA) is a serious complication of abdominal aortic aneurysm associated with high operative mortality and morbidity rates. The present study evaluated the perioperative and long-term outcomes of Korean patients with rAAA based on national health insurance claims data. Methods: The National Health Insurance Service (NHIS) database was searched retrospectively to identify patients with rAAA who underwent endovascular aneurysm repair (EVAR) and open surgical repair (OSR) from 2009 to 2018. Perioperative (≤ 30 days), early postoperative (≤ 3 month), and long-term (> 3 month) survival, reinterventions, and complications were assessed. Results: The search identified 1,034 patients with rAAA, including 594 who underwent EVAR and 440 who underwent OSR. When the study period was divided into two, the total numbers of patients with rAAA, patients who underwent EVAR, and octogenarians were higher during the second half. The perioperative mortality rate was 29.8% in the EVAR and 35.0% in the OSR group (P = 0.028). Hartmann’s procedure for bowel infarction was performed more frequently in the OSR than in the EVAR group (adjusted odds ratio, 6.28; 95% confidence interval [CI], 2.33–21.84; P = 0.001), but other complication rates did not differ significantly. All-cause mortality during the entire observation period did not differ significantly in the EVAR and OSR groups (adjusted hazard ratio, 1.17; 95% CI, 0.98–1.41; P = 0.087). Abdominal aortic aneurysm-related reintervention rate was significantly lower in the OSR group (adjusted hazard ratio, 0.31; 95% CI, 0.14–0.70; P = 0.005). Conclusion Although EVAR showed somewhat superior perioperative outcomes for rAAA, the long-term outcomes of EVAR after excluding initial 3 months were significantly worse than OSR. When anatomically feasible for both treatments, the perioperative mortality risk and reasonable prospects of long-term survival should be considered in rAAA.