1.Rethinking the time-to-laparotomy indicator of regional trauma center quality metrics in South Korea:a multicenter retrospective study with propensity score matching
Youngmin KIM ; Junsik KWON ; Hang Joo CHO ; Gil Jae LEE
Annals of Surgical Treatment and Research 2026;110(6):382-390
Purpose:
Timely surgical intervention is crucial in trauma care, particularly in patients with hypotensive abdominal injuries.In South Korea, the regional trauma center system has adopted a quality metric mandating initiation of emergency surgery within 1 hour of emergency department (ED) arrival for such patients. We evaluated the impact of ED-to-surgery time on clinical outcomes in hypotensive abdominal trauma and assessed the appropriateness of the 1-hour threshold.
Methods:
This multicenter retrospective study included 425 trauma patients who underwent emergency abdominal surgery at 2 regional trauma centers between 2019 and 2022. Patients with an initial or lowest recorded systolic blood pressure (SBP) <90 mmHg were included. The primary outcome was in-hospital mortality; secondary outcomes included complications, intensive care unit stay, and total hospital stay. Patients were categorized into early (≤1 hour) and delayed (>1 hour) surgery groups. Statistical analyses included logistic regression, propensity score matching (PSM), receiver operating characteristic curve, and complication analysis by 30-minute intervals.
Results:
We found that 243 patients (57.2%) underwent surgery within 1 hour. In-hospital mortality did not differ significantly between early and delayed groups. Age, Glasgow Coma Scale, lowest SBP, 4-hour RBC transfusion volume, and abdominal Abbreviated Injury Scale were independent mortality predictors. PSM confirmed no mortality difference by surgical timing. However, complication rates increased with surgical delays.
Conclusion
While surgical delay was not associated with mortality, it was linked to increased complications. Future trauma quality metrics should incorporate refined patient stratification and evaluate the entire process aimed at restoring physiological instability, rather than relying on a strict 1-hour threshold.
2.Clinical Characteristics of Apnea in Full-Term Infants: Compared to Late Preterm Infants
Youngmin YOUN ; Joo Yun YANG ; Jung In KANG ; Yejin HAN ; Dokyung LEE ; So-Yeon SHIM
Perinatology 2025;36(1):26-31
Objective:
Apnea in newborns is defined as a respiratory pause of 20 seconds or longer, or apnea accompanied by bradycardia or cyanosis. To date, research on neonatal apnea has focused on premature infants born within 34 weeks of gestation. The aim of this study is to present clinical significance of apnea in full-term infants compared with late premature infants born over 34 weeks of gestation.
Methods:
In a retrospective study, we reviewed medical records of neonates born over 34 weeks of gestation hospitalized for apnea and their mothers from November 2020 to May 2024. A total of 124 neonates were collected and divided into full-term infants (n=54) and late preterm infants (n=70) groups.
Results:
The mean gestational age of full-term and late preterm infants was 38 +5 weeks and 35 +2weeks, and the mean birth weight was 3.16 kg and 2.14 kg. Apnea was associated with diseases in 44.4% of full-term infants and 38.6% of late preterm infants. The rates of multiple births, small for gestational age, and cesarean section deliveries were significantly higher in late preterm infants.Apnea occurred significantly earlier and recovered faster in full-term infants. Neurologic disease was significantly more occurred in full-term infants (P=0.021). Especially, cerebral infarction and seizure were diagnosed only in full-term infants.
Conclusion
Apnea occurred earlier in full-term infants and severe neurologic diseases were significantly more found in full-term infants compared with late preterm infants. A close examination is needed in full-term infants with apnea.
3.Clinical Characteristics of Apnea in Full-Term Infants: Compared to Late Preterm Infants
Youngmin YOUN ; Joo Yun YANG ; Jung In KANG ; Yejin HAN ; Dokyung LEE ; So-Yeon SHIM
Perinatology 2025;36(1):26-31
Objective:
Apnea in newborns is defined as a respiratory pause of 20 seconds or longer, or apnea accompanied by bradycardia or cyanosis. To date, research on neonatal apnea has focused on premature infants born within 34 weeks of gestation. The aim of this study is to present clinical significance of apnea in full-term infants compared with late premature infants born over 34 weeks of gestation.
Methods:
In a retrospective study, we reviewed medical records of neonates born over 34 weeks of gestation hospitalized for apnea and their mothers from November 2020 to May 2024. A total of 124 neonates were collected and divided into full-term infants (n=54) and late preterm infants (n=70) groups.
Results:
The mean gestational age of full-term and late preterm infants was 38 +5 weeks and 35 +2weeks, and the mean birth weight was 3.16 kg and 2.14 kg. Apnea was associated with diseases in 44.4% of full-term infants and 38.6% of late preterm infants. The rates of multiple births, small for gestational age, and cesarean section deliveries were significantly higher in late preterm infants.Apnea occurred significantly earlier and recovered faster in full-term infants. Neurologic disease was significantly more occurred in full-term infants (P=0.021). Especially, cerebral infarction and seizure were diagnosed only in full-term infants.
Conclusion
Apnea occurred earlier in full-term infants and severe neurologic diseases were significantly more found in full-term infants compared with late preterm infants. A close examination is needed in full-term infants with apnea.
4.Clinical Characteristics of Apnea in Full-Term Infants: Compared to Late Preterm Infants
Youngmin YOUN ; Joo Yun YANG ; Jung In KANG ; Yejin HAN ; Dokyung LEE ; So-Yeon SHIM
Perinatology 2025;36(1):26-31
Objective:
Apnea in newborns is defined as a respiratory pause of 20 seconds or longer, or apnea accompanied by bradycardia or cyanosis. To date, research on neonatal apnea has focused on premature infants born within 34 weeks of gestation. The aim of this study is to present clinical significance of apnea in full-term infants compared with late premature infants born over 34 weeks of gestation.
Methods:
In a retrospective study, we reviewed medical records of neonates born over 34 weeks of gestation hospitalized for apnea and their mothers from November 2020 to May 2024. A total of 124 neonates were collected and divided into full-term infants (n=54) and late preterm infants (n=70) groups.
Results:
The mean gestational age of full-term and late preterm infants was 38 +5 weeks and 35 +2weeks, and the mean birth weight was 3.16 kg and 2.14 kg. Apnea was associated with diseases in 44.4% of full-term infants and 38.6% of late preterm infants. The rates of multiple births, small for gestational age, and cesarean section deliveries were significantly higher in late preterm infants.Apnea occurred significantly earlier and recovered faster in full-term infants. Neurologic disease was significantly more occurred in full-term infants (P=0.021). Especially, cerebral infarction and seizure were diagnosed only in full-term infants.
Conclusion
Apnea occurred earlier in full-term infants and severe neurologic diseases were significantly more found in full-term infants compared with late preterm infants. A close examination is needed in full-term infants with apnea.
5.Clinical Characteristics of Apnea in Full-Term Infants: Compared to Late Preterm Infants
Youngmin YOUN ; Joo Yun YANG ; Jung In KANG ; Yejin HAN ; Dokyung LEE ; So-Yeon SHIM
Perinatology 2025;36(1):26-31
Objective:
Apnea in newborns is defined as a respiratory pause of 20 seconds or longer, or apnea accompanied by bradycardia or cyanosis. To date, research on neonatal apnea has focused on premature infants born within 34 weeks of gestation. The aim of this study is to present clinical significance of apnea in full-term infants compared with late premature infants born over 34 weeks of gestation.
Methods:
In a retrospective study, we reviewed medical records of neonates born over 34 weeks of gestation hospitalized for apnea and their mothers from November 2020 to May 2024. A total of 124 neonates were collected and divided into full-term infants (n=54) and late preterm infants (n=70) groups.
Results:
The mean gestational age of full-term and late preterm infants was 38 +5 weeks and 35 +2weeks, and the mean birth weight was 3.16 kg and 2.14 kg. Apnea was associated with diseases in 44.4% of full-term infants and 38.6% of late preterm infants. The rates of multiple births, small for gestational age, and cesarean section deliveries were significantly higher in late preterm infants.Apnea occurred significantly earlier and recovered faster in full-term infants. Neurologic disease was significantly more occurred in full-term infants (P=0.021). Especially, cerebral infarction and seizure were diagnosed only in full-term infants.
Conclusion
Apnea occurred earlier in full-term infants and severe neurologic diseases were significantly more found in full-term infants compared with late preterm infants. A close examination is needed in full-term infants with apnea.
6.Clinical Characteristics of Apnea in Full-Term Infants: Compared to Late Preterm Infants
Youngmin YOUN ; Joo Yun YANG ; Jung In KANG ; Yejin HAN ; Dokyung LEE ; So-Yeon SHIM
Perinatology 2025;36(1):26-31
Objective:
Apnea in newborns is defined as a respiratory pause of 20 seconds or longer, or apnea accompanied by bradycardia or cyanosis. To date, research on neonatal apnea has focused on premature infants born within 34 weeks of gestation. The aim of this study is to present clinical significance of apnea in full-term infants compared with late premature infants born over 34 weeks of gestation.
Methods:
In a retrospective study, we reviewed medical records of neonates born over 34 weeks of gestation hospitalized for apnea and their mothers from November 2020 to May 2024. A total of 124 neonates were collected and divided into full-term infants (n=54) and late preterm infants (n=70) groups.
Results:
The mean gestational age of full-term and late preterm infants was 38 +5 weeks and 35 +2weeks, and the mean birth weight was 3.16 kg and 2.14 kg. Apnea was associated with diseases in 44.4% of full-term infants and 38.6% of late preterm infants. The rates of multiple births, small for gestational age, and cesarean section deliveries were significantly higher in late preterm infants.Apnea occurred significantly earlier and recovered faster in full-term infants. Neurologic disease was significantly more occurred in full-term infants (P=0.021). Especially, cerebral infarction and seizure were diagnosed only in full-term infants.
Conclusion
Apnea occurred earlier in full-term infants and severe neurologic diseases were significantly more found in full-term infants compared with late preterm infants. A close examination is needed in full-term infants with apnea.
7.Bowel complications requiring surgical intervention in kidney transplant recipients:a retrospective study of clinical characteristics and risk factors
Jin-Myung KIM ; Tuan Thanh NGUYEN ; Hye Eun KWON ; Youngmin KO ; Joo Hee JUNG ; Hyunwook KWON ; Young Hoon KIM ; Sung SHIN
Clinical Transplantation and Research 2025;39(4):317-325
Background:
Bowel complications following kidney transplantation (KT) are rare but life-threatening, often necessitating bowel resection. These complications are associated with immunosuppressive therapy, comorbidities, and viral infections. This study aimed to analyze the characteristics and risk factors of patients who underwent bowel resection after KT.
Methods:
A retrospective review was conducted of 31 KT recipients who underwent bowel resection between 1990 and 2020 at a single center. Patient data, including demographics, comorbidities, transplant-related factors, cytomegalovirus (CMV)/Epstein-Barr virus (EBV) infections, and surgical outcomes, were analyzed.
Results:
Bowel resection was necessary in under 0.5% of KT recipients, primarily for perforation (48.4%), ischemia, posttransplant lymphoproliferative disorder, and obstruction. Bowel inflammation was the most common cause of perforation, followed by fungal infection (e.g., aspergillosis, mucormycosis) and Kayexalate ileitis. The mean patient age was 53.6±14.2 years, and 54.8% were male. Notable characteristics of those undergoing bowel resection included ABO incompatibility (25.8%), cardiac comorbidities (29.0%), diabetes mellitus (41.9%), and history of retransplantation (19.4%). Bowel resection was performed at an average of 54.3 months post-KT (standard deviation, 77.2 months). All patients were CMV immunoglobulin G (IgG) positive and 91.3% were EBV IgG positive, indicating prior viral infections.
Conclusions
Although infrequent, bowel complications represent a serious concern for KT recipients. Identifying contributing factors—including viral infections, comorbidities, and immunosuppressive therapies—could aid in recognizing patients at high risk. Implementing preventive strategies and closely monitoring KT recipients may help reduce the incidence of these complications and improve posttransplant outcomes.
9.Knowledge on complementary foods of mothers with young children and their perception of convenience complementary foods
Yoojeong JOO ; Jihyun YOON ; Linxi HUANG ; Youngmin NAM
Korean Journal of Community Nutrition 2024;29(1):16-33
Objectives:
The purpose of this study was to examine mothers’ knowledge levels on complementary foods and their perception of convenience complementary foods.
Methods:
An online survey was conducted with mothers aged 20–49 years who had purchased convenience complementary foods and had a preschool child aged 4 months or older. The respondents were categorized into 3 groups based on their knowledge scores:low- (0–50 points), mid- (55–65 points), and high- (70–100 points) knowledge groups.
Results
The average score of mothers’ knowledge on complementary foods was 58.8 out of 100 points. Working mothers were found to have lower levels of knowledge compared to mothers who were housewives. Only 1/4 of responding mothers had educational experience on complementary foods. Mothers expressed a desire for information on the types of complementary foods (72.2%) and the intake amounts (60.3%) corresponding to each phase of their child’s development. Multivariate analysis of variance revealed significant differences in health (P = 0.002), variety (P = 0.039), and hygiene (P = 0.041) among the factors taken into consideration when purchasing convenience complementary foods according to the mothers’ knowledge levels. Mothers in the high-knowledge group placed a greater importance on ‘balanced nutrition’ (P = 0.022) and ‘hygienic cooking’ (P = 0.010) compared to mothers in the low-knowledge group. The results of the modified importance-performance analysis, which compared the importance and performance of the factors taken into consideration when purchasing convenience complementary foods, highlighted the need for efforts in ‘health,’‘hygiene,’ and ‘price,’ while also indicating an excessive effort in ‘convenience.’ Conclusions: This study suggests expanding relevant education programs to enhance mothers’ knowledge on complementary foods, especially for working mothers. In the industry, marketing strategies for complementary food products could be developed that align with the needs of mothers, focusing on health, hygiene, and price.
10.Hepatocellular carcinoma and cancer-related mortality after kidney transplantation with rituximab treatment
Hayoung LEE ; Young Hoon KIM ; Seong Jun LIM ; Youngmin KO ; Sung SHIN ; Joo Hee JUNG ; Chung BAEK ; Hyosang KIM ; Su-Kil PARK ; Hyunwook KWON
Annals of Surgical Treatment and Research 2022;102(1):55-63
Purpose:
There are increased therapeutic usages of rituximab in kidney transplantation (KT). However, few studies have evaluated the effect of rituximab on cancer development following KT. This study aimed to evaluate the effect of rituximab on the cancer occurrence and mortality rate according to each type of cancer.
Methods:
Five thousand consecutive recipients who underwent KT at our center were divided into era1 (1990–2007) and era2-rit– (2008–2018), and era2-rit+ (2008–2018) groups. The era2-rit+ group included patients who received single-dose rituximab (200–500 mg) as a desensitization treatment 1–2 weeks before KT.
Results:
The 5-year incidence rates of malignant tumors after KT were 3.1%, 4.3%, and 3.5% in the era1, era2-rit–, and era2-rit+ group, respectively. The overall incidence rate of cancer after transplantation among the 3 study groups showed no significant difference (P = 0.340). The overall cancer-related mortality rate was 17.1% (53 of 310). Hepatocellular carcinoma (HCC) had the highest mortality rate (61.5%) and relative risk of cancer-related death (hazard ratio, 8.29; 95% confidence interval, 2.40–28.69; P = 0.001). However, we found no significant association between rituximab and the incidence of any malignancy.
Conclusion
Our results suggest that single-dose rituximab for desensitization may not increase the risk of malignant disease or cancer-related mortality in KT recipients. HCC was associated with the highest risk of cancer-related mortality in an endemic area of HBV infection.

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