1.Laparoscopic Cholecystectomy for Polypoid Lesions of the Gallbladder.
Jae Seol LEE ; In Seok CHOI ; Byung Kook YEA ; Mun Sup SIM
Korean Journal of Hepato-Biliary-Pancreatic Surgery 2002;6(1):53-58
BACKGROUND/AIMS: The size and number of gallbladder polyps are used to differentiate between benign and malignant lesions before surgery. The objective of this study was to determine which polyps of the gallbladder should be operated upon and whether laparoscopic cholecystectomy is a safe and feasible method for gallbladder polypoid lesions of the gallbladder. METHODS: Data from 68 patients with polypoid lesions of the gallbladder treated by laparoscopic cholecystectomy at the Department of surgery, Pusan National University Hospital were reviewed retrospectively. the gallbladders were classified into four histologic groups. Clinical features, maximal diameter, and the number of lesions were compared among the groups. RESULTS: The mean maximal diameter of neoplasms was significantly larger than that of lesions in the nonneoplasm group. All four malignant lesions that were detected measured at least 1.5 cm. Univariate analysis showed that polypoid lesions of the gallbladder with neoplastic lesion correlated significantly with age, sex, and number of the lesions. Univariate analysis also showed that malignancy in polypoid lesions of the gallbladder correlated significantly with age, size, and number of the lesions. Multivariate logistic regression analysis showed that the age of the patient and the size of the lesion (> or =1.0 cm) are two independent factors in predicting neoplastic lesions in polypoid lesions of the gallbladder. The size of the lesion (> or =1.5 cm) is the only independent factor in predicting malignancy in the polypoid lesions of the gallbladder as shown by multivariate logistic regression analysis. CONCLUSION: Laparoscopic cholecystectomy is a safe and feasible method for gallbladder polypoid lesions. Neoplastic change in polypoid lesions of the gallbladder should be considered when a patient older than 50 years of age has a polypoid lesion larger than 1.0 cm. Cancer should be suspected when a polypoid lesion of the gallbladder is larger than 1.5 cm.
Busan
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Cholecystectomy, Laparoscopic*
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Gallbladder*
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Humans
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Logistic Models
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Polyps
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Retrospective Studies
2.Predictors of Continuous Positive Airway Pressure Adherence and Comparison of Clinical Factors and Polysomnography Findings Between Compliant and Non-Compliant Korean Adults With Obstructive Sleep Apnea
Seo-Eun CHO ; Joo Hyun JUNG ; Jae Myeong KANG ; Min Young CHO ; Yea Seol LEE ; Seung-Gul KANG ; Seon Tae KIM
Psychiatry Investigation 2024;21(2):200-207
Objective:
Continuous positive airway pressure (CPAP) is the preferred treatment for obstructive sleep apnea (OSA). However, compliance with CPAP therapy varies among studies, and studies on its predictors are insufficient in Korea. This study aimed to identify factors that predict compliance with CPAP therapy in patients with OSA.
Methods:
We retrospectively reviewed medical records, polysomnography (PSG) records, and self-report questionnaires of patients w ith OSA. Criteria for compliance was the use of CPAP devices for ≥4 h per night for ≥70% of the consecutive 30 nights (i.e., 21 days) during the first 3 months of treatment initiation. The patients were classified into two groups: compliant and non-compliant. Logistic regression analyses were performed to identify the clinical factors and PSG parameters associated with CPAP compliance.
Results:
Of the 188 participants, 80 were classified into the compliant group and 108 into the non-compliant group. The ratios of stage N1 (p=0.011) and health insurance coverage (p=0.007) were significantly associated with compliance with CPAP, with an explanatory power of 18.6% (R2=0.186, p<0.001).
Conclusion
Stage N1 ratio and health insurance coverage were significant predictors of CPAP compliance. It is necessary to confirm whether the relationship between a high stage N1 ratio and compliance can be reproduced in a larger sample and in individuals from other countries.