OBJECTIVE: To investigate trends of the research designs and statistical methods in the Annals of Rehabilitation Medicine (ARM) published from 2005 to 2015 through a comparison of articles with the Archives of Physical Medicine and Rehabilitation (APMR). METHODS: The authors reviewed all articles published in ARM and APMR for the years 2005 and 2015 in order to determine their research designs as well as their statistical methods used in each article. RESULTS: In ARM, randomized controlled trials increased from 4.5% in 2005 to 6.5% in 2015. In APMR, randomized controlled trials increased from 8.1% in 2005 to 14.0% in 2015, meta-analyses increased to 5.3%, and systematic reviews increased to 6%. The number of studies using statistical methods increased in ARM from 1.9 to 2.6 per article and in APMR, from 2.7 to 3.1. Use of advanced methods in ARM also showed an increase from 2005 to 2015. CONCLUSION: This study concludes that there is a trend of increased awareness and attempts to use varied research approaches in ARM articles. There should also be more in-depth discussions and opportunities for researchers to share their experiences regarding statistical methods in the clinical field.
Arm ; Evidence-Based Medicine ; Methods* ; Physical and Rehabilitation Medicine ; Rehabilitation* ; Research Design*

PURPOSE: One of the major drawbacks of peritoneal dialysis (PD) is catheter migration and dysfunction. Preventing catheter migration is one of the main concerns. We compared laparoscopic internal fixation method with open surgical method for catheter migration rates. METHODS: From January 2008 to August 2009, PD catheters were inserted by laparoscopic fixation (LF) method in 22 patients and by open surgery (OS) in 32 patients. Clinical data were reviewed retrospectively. The frequency of migration, peritonitis, and other complications were compared. Catheter and patient survival rates were also compared. RESULTS: The mean age and sex ratio were not different between groups. Mean follow-up duration was 29.1 months in LF group and 26.1 months in OS group. More patients in LF group (27.3%) had history of laparotomy than in OS group (3.1%) (P = 0.01). The mean operation time was significantly longer in LF group (101.6 +/- 30.4 minutes) than in OS group (72.4 +/- 26.03 minutes) (P = 0.00). The cumulative incidence of catheter migration was 65.6% in OS group and 13.6% in LF group (P = 0.00). Migration-free catheter survival was higher in LF group (P = 0.001). There were no differences in complication rates between groups. Overall catheter survival was similar (P = 0.93). Patient survival rate at 2 years was not different (P = 0.13). CONCLUSION: Laparoscopic internal fixation of continuous ambulatory peritoneal dialysis catheter significantly reduces migration rates without any addition of complications. Also, laparoscopic technique did not incur patient morbidity or mortality despite the requirement for general endotracheal anesthesia and longer operation time. Therefore, internal fixation can be afforded safely in patients with previous abdominal surgery as either a salvage or preventive measure in patients with repeated catheter migration.
Anesthesia ; Catheters ; Follow-Up Studies ; Humans ; Incidence ; Laparoscopy ; Laparotomy ; Peritoneal Dialysis ; Peritoneal Dialysis, Continuous Ambulatory ; Peritonitis ; Retrospective Studies ; Sex Ratio ; Survival Rate

Renal artery aneurysm (RAA) is a rare disease, and the precise incidence has not been very well known. It appears that with the increasing use of diagnostic ultrasound, computed tomography and arteriography, RAA are being identified more frequently than in the past. Rupture of RAA is associated with 10% mortality and the chance of nephrectomy is very high. Although, most of renal artery aneurysms are treated by endovascular technique, surgery is often necessary for aneurysms associated with bifurcation area or large braches. Here, we report a case of saccular renal artery aneurysm which was managed by open surgery.
Aneurysm ; Angiography ; Endovascular Procedures ; Incidence ; Nephrectomy ; Rare Diseases ; Renal Artery ; Rupture

PURPOSE: Despite advances in the techniques and development of new devices, endovascular (EV) procedures are not the panacea for peripheral vascular diseases. This is partly because substantial cases are too complicated to manage with only EV procedures and partly because of the relatively large size of devices. We reviewed our experience of hybrid vascular procedures and report here on their outcomes. METHODS: Between August 2008 and March 2010, thirteen cases of hybrid vascular operation were performed. A retrospective review of electronic medical records was performed. The primary outcome measures were technical outcomes and patency rates. RESULTS: The mean follow-up duration was 17.7 months. Treatment indications were as follows: critical ischemia (n=6), claudication (n=3), abdominal aortic aneurysm with leg ischemia (n=3), and unstable aortic atheroma with recurrent embolism (n=1). All operations were performed under local anesthesia in an angiography suite. A single surgeon and a single interventional radiologist performed all the major procedures together. Technical and clinical success rates were 92.3%. All limbs were salvaged in patients with critical ischemia. The primary patency rate of the 13 cases was 83.3% at 1 year. There was no in-hospital mortality. CONCLUSION: hybrid vascular operation is useful for patients with a complex vascular condition. The role of hybrid vascular operation should be established with regards to not only the cost benefit but also the long-term outcomes.
Anesthesia, Local ; Angiography ; Aortic Aneurysm, Abdominal ; Chimera ; Cost-Benefit Analysis ; Electronic Health Records ; Embolism ; Extremities ; Follow-Up Studies ; Humans ; Ischemia ; Leg ; Outcome Assessment (Health Care) ; Peripheral Vascular Diseases ; Plaque, Atherosclerotic ; Retrospective Studies

PURPOSE: A classic approach to abdominal stab wounds has been a routine laparotomy for the purpose of diagnosis or treatment. However, management protocols for abdominal stab wounds are still contentious in most trauma centers. We examined the relationship between the character of the stab wound and the injured intraabdominal organs by retrospectively analyzing the medical records of patients with abdominal stab wounds admitted to Gil hospital, and the findings for our patients are then confronted with a review of the literature. We aimed to propose proper management protocols to approach abdominal stab wounds. METHODS: The medical records of all 80 patients sustaining abdominal stab wounds, admitted at the Department of Surgery, Gil Hospital, Gachon Medical School, from January 2004 to December 2008 were retrospectively reviewed. All the abdominal stab wounds were collated based on the site and the character of the injury, investigations performed on admission, results of investigations, operations performed and findings at the time of the operation. RESULTS: The most prevalent age group was patients in their forties and the average age of the patients was 41 years for both genders. The stab wounds were most commonly located at the periumbilical area (16.9%), followed by the epigastric area (15.6%), and 18.2% of the patients had multiple wounds. The most commonly eviscerated organ was the omentum (9 out of 16 cases); 61.7% of non-eviscerated patients underwent a therapeutic laparotomy while 81.3% of eviscerated patients underwent a therapeutic laparotomy. The small bowel was the most commonly injured organ (22.7%, 17 out of 75 injuries). The review revealed a relatively common diaphragmatic injury in abdominal stab wound patients (8 cases, 10.5%). The average hospital stay was 11 days. CONCLUSION: This review revealed commonly eviscerated and injured intraabdominal organs in abdominal stab wound patients and their relationship with a therapeutic laparotomy. Although the management is still controversial, the authors suggest indications for an immediate laparotomy and a protocol for managing abdominal stab wounds. Hemodynamic instability and peritoneal irritation signs are definite indicators for an immediate laparotomy, but the review revealed intraabdominal organ evisceration alone not to be a statistically significant factor. In addition, the authors suggest that abnormal CT findings can be valuable for making a decision on management of hemodynamically stable stab wound patients. Further study may clarify a role for a more selective approach to operative intervention and for a more extensive use of selective observation.
Hemodynamics ; Humans ; Laparotomy ; Length of Stay ; Medical Records ; Multiple Trauma ; Omentum ; Retrospective Studies ; Schools, Medical ; Trauma Centers ; Wounds, Stab

Fasciotomy wounds are a major contributor to prolonged hospital stay and can lead to amputation. Although it is generally recommended to close the fasciotomy wound as early as possible, it is usually challenging. Primary closure is more favorable because it commences more functional and esthetic results with less morbidity. But primary closure is difficult to achieve due to skin edema, retraction and necrosis. Topical negative pressure care (TNP) has been used in other areas of wound care, such as mediastinitis and burn wounds. TNP has recently gained popularity and has shown promising outcomes. Topical negative pressure systems are commercially available but very expensive. We designed a modified negative pressure system with wall-suction and applied it to a complicated fasciotomy wound. We herein report our experience with a review of related literatures.
Amputation ; Burns ; Edema ; Length of Stay ; Mediastinitis ; Necrosis ; Skin ; Vacuum

PURPOSE: Although cyclosporine (CsA) improves short-term renal graft outcomes, many paradigms reduce or withdraw this drug because of its nephrotoxicity. However, inadequate immunosuppression with azathioprine led to little success. We conducted a prospective study to define the prolonged effect of CsA reduction in stable renal transplant recipients with mycophenolate mofetil (MMF). METHODS: Thirty-nine primary renal transplant recipients were divided into two cohorts, the AZA (N=13) and the MMF cohort (N=26). Both cohorts were allowed to reduce the CsA dose up to 50% of baseline within 3 to 4 months of conversion to AZA or MMF. Graft function, clinical parameters, and adverse events were monitored for up to 3 years. RESULTS: Ccr gradually deteriorated in the AZA cohort, but was stable in the MMF cohort. There was no episode of acute rejection or graft loss observed in either cohort. CONCLUSION: The CsA dose can be reduced in combination with MMF treatment in stable renal transplant recipients after 2 years of transplantation, resulting in beneficial effects on Ccr, lipid profiles, and blood pressure.
Azathioprine ; Cohort Studies ; Cyclosporine ; Immunosuppression ; Kidney Transplantation ; Mycophenolic Acid ; Prospective Studies ; Rejection (Psychology) ; Transplants

PURPOSE: It has been known that the incidence of post-transplant diabetes mellitus (PTDM) is variable according to the immunosuppressant used. The goals of this study are to uncover the factors associated with the development of PTDM and to clarify the fate of PTDM. METHODS: The medical records of 267 patients who underwent renal transplant between 1996 and December 2002 at Seoul National University Hospital were retrospectively reviewed. Patients were divided into three groups: cyclosporine group (CsA, n=179), high tacrolimus group (HFK, mean trough level during post-transplant 2 week>15 ng/m, n=33) and low tacrolimus group (LFK, mean trough level during post- transplant 2 week< or =15 ng/mL, n=55). The incidence, risk factors of PTDM and clinical fate were analyzed. RESULTS: PTDM developed in 46 (17.2%) patients. PTDM incidence of HFK group (60.6%) was significantly higher than CsA group (10.1%) and LFK group (14.5%) (P=0.000). Tacrolimus use, age at the time of transplantation (>40year), family history of diabetes and obesity (BMI>25) were the risk factors for PTDM development. Incidences of associated clinical events, such as acute rejection, cerebrovascular accident, myocardial infarction, or infection were not different between PTDM and non-PTDM group. PTDM was resolved in 13 out of 46 patients (28.3%). Only 7 out of 33 patients (21.2%) in whom PTDM persisted lost their graft. CONCLUSION: PTDM incidence was higher in HFK group. So, LFK protocol is considered to be safe and beneficial, at least in terms of PTDM. Tacrolimus as immunosuppressant, recipient, family history of DM and obesity were the risk factors of PTDM development. PTDM was reversible in 28.3% of patients. PTDM had little impact on clinical outcomes during mid-term period.
Cyclosporine ; Diabetes Mellitus* ; Humans ; Immunosuppression ; Incidence ; Medical Records ; Myocardial Infarction ; Obesity ; Retrospective Studies ; Risk Factors ; Seoul ; Stroke ; Tacrolimus ; Transplants

A transomental hernia is a rare type of internal hernia. Only one case of this type of hernia has been reported in Korea whereas several cases have been described in other countries. This is the second case of a mechanical obstruction caused by a transomental internal hernia in Korea. We report this case with a brief review of the relevant literature.
Hernia* ; Intestinal Obstruction* ; Korea

Leiomyosarcoma of the inferior vena cava (IVC) is an uncommon tumor and usually shows poor prognosis. Complete surgical resection is the only proven therapy and the effect of adjuvant therapy on the patient's survival has still not been demonstrated. We recently, experienced a case of IVC leiomyosarcoma that had been surgically resected and the tumor was noted to have spread to the liver on follow up. Metastatic tumor was removed by hepatectomy without any further evidence of necurrence. We report here on this case of the IVC leiomyosarcoma along with conducting a review of the relevant literatures.
Follow-Up Studies ; Hepatectomy ; Leiomyosarcoma* ; Liver ; Prognosis ; Vena Cava, Inferior*