Kim S.-J.,Yonsei University |
Lee S.-K.,Gwangmyung Sungae Hospital |
Choi C.H.,Yonsei University |
Kim S.-H.,Yonsei University |
And 2 more authors.
American Journal of Sports Medicine | Year: 2014
Background: There has been no previous study regarding graft selection in anterior cruciate ligament (ACL) reconstruction for smoking patients. Purpose: To compare the clinical outcomes of ACL reconstruction between smokers and nonsmokers and to find an optimal graft in ACL reconstruction with regard to clinical outcomes for smoking patients. Study Design: Cohort study; Level of evidence, 2. Methods: A total of 487 patients who underwent unilateral ACL reconstruction were retrospectively reviewed. Included patients were divided into 2 groups according to their history of smoking. Group 1 was composed of patients who had never smoked (n = 322), and group 2 consisted of patients who had reported smoking before ACL reconstruction and during rehabilitation (n = 165). Additionally, each group was divided into 4 subgroups according to the selected graft type (bone-patellar tendon-bone autograft, hamstring [semitendinosus-gracilis] tendon autograft, quadriceps tendon-bone autograft, or Achilles tendon-bone allograft). Patients were assessed for knee instability with the Lachman and pivot-shift tests as well as anterior translation measured by the KT-2000 arthrometer. Functional outcomes were evaluated with the Lysholm knee score, International Knee Documentation Committee (IKDC) subjective score, and IKDC objective grade. Results: The minimum follow-up period was 24 months. At the final follow-up evaluation, there were significant mean betweengroup differences regarding the side-to-side difference in anterior translation (group 1, 2.15±1.11 mm; group 2, 2.88±1.38 mm; P<.001), Lysholm knee score (group 1, 90.25±6.18; group 2, 84.79±6.67; P<.001), IKDC subjective score (group 1, 89.16±5.01; group 2, 83.60±7.48; P<.001), and IKDC objective grade (group 1, grade A = 151, B = 130, C = 36, D = 5 patients; group 2, grade A = 48, B = 71, C = 37, D = 9 patients; P<.001). With regard to differences in outcomes between the selected grafts within each group, the Achilles tendon-bone allograft showed the worst outcomes, with statistically significant mean differences for smoking patients in the side-to-side difference in anterior translation (3.59±1.26 mm), Lysholm knee score (81.05±2.82), and IKDC subjective score (79.73±4.29). Conclusion: Unsatisfactory outcomes with regard to stability and functional scores were shown in the smoking group compared with the nonsmoking group. In smokers, the patients receiving an Achilles tendon-bone allograft had poorer outcomes than those with autografts. The bone-patellar tendon-bone autograft is recommendable for ACL reconstruction in a smoking patient. © 2013 The Author(s).
Park S.,Yonsei University |
Yoon S.-J.,National Health Insurance Corporation |
Tae H.-J.,U.S. National Institute on Aging |
Shim C.Y.,Yonsei University
Frontiers in Bioscience | Year: 2011
RAGE is pattern recognizing receptors for diverse endogenous ligands. RAGE activation by RAGE ligands is known to be associated with reactive oxygen species generation, activation of NF kappa B, as well as recruitment of proinflammatory cells. Activated endothelial cells, vascular smooth muscle cells in atherosclerotic plaques and activated inflammatory cells all have increased expression of RAGE, which with its interaction with RAGE ligands increases the secretion of proinflammatory cytokines and cell adhesion molecules. Furthermore, RAGE may have a significant role in leukocyte recruitment into the intima of the atherosclerosis. Initial insults resulting in endothelial dysfunction will result in leukocyte infiltration, oxidative stress and vascular inflammation that is amplified by RAGE activation. RAGE and its interaction with RAGE ligands may be important for initializing and maintaining the pathological processes that result in various entities of cardiovascular disease. Soluble RAGE competitively inhibits the binding of RAGE ligands to RAGE and attenuates the development of atherosclerosis in vivo. Thus RAGE may be a promising target for treatment of cardiovascular disease in the future.
Kang J.I.,Yonsei University |
Sung N.Y.,Yonsei University |
Park S.J.,National Health Insurance Corporation |
Lee C.G.,National Health Insurance Corporation |
Lee B.O.,National Health Insurance Corporation
Psycho-Oncology | Year: 2014
Objective Population-based data on the epidemiology of psychiatric disorders in patients with breast cancer are lacking. Because the National Health Insurance (NHI) Program in South Korea is a compulsory social insurance system covering the entire Korean population, the NHI is a good source of information for epidemiological studies. In the present study, we examined the incidence of psychiatric disorders among Korean women newly diagnosed with breast cancer using the NHI Corporation (NHIC) database. Methods Data were collected for adult women newly diagnosed with breast cancer using the claim database and cancer registration files of the NHIC from 2005 to 2008. We analysed data for women diagnosed with psychiatric disorders over a 5-year period, from 2004 (at least 1 year before the cancer registration date) to 2009 (at least 1 year after the cancer registration date). Results We identified 6536 patients with psychiatric disorders among 42 190 women with breast cancer. The most prevalent psychiatric disorder was anxiety disorder (N = 2518). The incidence rates of anxiety disorders, depressive disorders, sleep disorders and adjustment disorders were 27.08, 22.41, 10.57 and 4.35 cases per 1000 person-year, respectively. Conclusion The incidence rates of psychiatric disorders in Korean women with breast cancer from the nationwide database were much lower than found by previous reports using screening tools. The finding implicates that psychiatric disorders among breast cancer patients tend to be underdiagnosed and undertreated in actual clinical practice. Our epidemiological findings provide important information for establishing a national strategy of cancer care to detect and manage psychiatric problems. Copyright © 2013 John Wiley & Sons, Ltd.
Kim K.H.,National Health Insurance Corporation |
Kim Y.S.,National Health Insurance Corporation
Korean Journal of Urology | Year: 2010
Purpose: Male overactive bladder (OAB) may be caused by prostatic pathologies such as bladder outlet obstruction (BOO). Intravesical prostatic protrusion (IPP) has been found to correlate with BOO and acute urinary retention. We investigated the interrelation between male OAB symptoms and IPP for estimating anatomical changes to the prostate. Materials and Methods: We assessed 179 consecutive men aged >40 years who presented with lower urinary tract symptoms. The initial evaluation included International Prostate Symptom Score (IPSS) and quality of life assessments, transrectal ultrasonography (TRUS), uroflowmetry, and postvoid residual urine volume. The degree of IPP was determined by the distance from the tip of the protrusion to the circumference of the bladder at the base of the prostate gland. Patients with IPP <0.5 cm were defined as group A (n=114), and patients having 0.5 cm≤IPP<1 cm were defined as group B (n=38). The others were defined as group C (n=27). Results: A total of 51 patients complained of urgency in group A, 38 patients in group B, and 27 patients in group C. Likewise, 14 patients had a history of acute urinary retention in group A, 8 patients in group B, and 16 patients in group C. IPP grade had a statistically significant relation with both OAB and a history of acute urinary retention. Conclusions: The results of our study have shown that male OAB is correlated with IPP. However, larger scale studies are needed to confirm these results. © The Korean Urological Association, 2010.
Kim M.,Yonsei University |
Paik J.K.,Yonsei University |
Kang R.,Yonsei University |
Kim S.Y.,Yonsei University |
And 2 more authors.
Metabolism: Clinical and Experimental | Year: 2013
Objective: The purpose of this study was to assess whether the metabolically healthy overweight/obese phenotype is associated with decreased oxidative stress compared with normal-weight individuals with metabolic syndrome (MetS). Materials/Methods: Plasma oxidized LDL (ox-LDL) and urinary 8-epi-prostaglandin F2α (8-epi-PGF2α) were analyzed in a cross-sectional study of 1846 healthy postmenopausal women. Participants were classified by presence (n = 569) or absence (n = 1277) of MetS and by BMI (18.5-24.9 kg/m2 = normal weight, n = 1254; ≥ 25 kg/m2 = overweight/obese, n = 592). MetS was diagnosed with the modified National Cholesterol Education Program Adult Treatment Panel III criteria. Results: Compared to normal weight women with MetS (n = 296), metabolically healthy overweight/obese women (n = 319) showed lower blood pressure, triglyceride, and glucose and higher HDL cholesterol, adiponectin, and LDL particle size. Ox-LDL was higher in overweight/obese women without MetS than in normal weight women without MetS (n = 958) but was lower than in women with MetS. Urinary 8-epi-PGF2α level was about 11% lower in women without MetS than in women with MetS. Normal weight women with MetS had greater odds of having ox-LDL (multivariate odds ratio [OR] 2.42, 95% CI: 1.65-3.55) and 8-epi-PGF2α (OR 1.49; CI: 1.03-2.14) levels in the top quartile compared to normal weight women without MetS after adjusting for age, drinking, smoking, total- and LDL-cholesterol, and high sensitivity C-reactive protein. Additionally, there was no significant correlation between ox-LDL and 8-epi-PGF2α. Conclusions: The metabolically healthy overweight/obese phenotype was associated with a better overall metabolic profile and less oxidative stress than that observed in normal weight individuals with MetS. Furthermore, there was a lack of association between ox-LDL and 8-epi-PGF2α. © 2013 Elsevier Inc.
Kim J.H.,Yonsei University |
Kim Y.M.,Yonsei University |
Chung E.J.,National Health Insurance Corporation |
Lee S.Y.,National Medical Center |
Koh H.J.,Yonsei University
American Journal of Ophthalmology | Year: 2012
To evaluate the utility of preoperative optical coherence tomography (OCT) and multifocal electroretinography (mfERG) in prediction of visual outcomes after idiopathic epiretinal membrane (ERM) surgery. Retrospective, observational case series. One hundred eyes of 100 patients with idiopathic unilateral ERM who underwent vitrectomy for ERM removal were retrospectively reviewed. Correlations between preoperative data (OCT and mfERG) and final best-corrected visual acuity (BCVA) were investigated using Pearson correlation analysis. One-way analysis of variance (ANOVA) was used to determine whether final BCVA and mfERG values differed among subgroups varying in photoreceptor integrity status. Receiver operating characteristic (ROC) curve analysis was performed to obtain a cutoff value of the P1 implicit time predicting visual recovery (final BCVA <20/25). BCVA significantly improved, and 65 of 84 eyes (77%) achieved visual recovery of more than 2 Snellen lines after ERM surgery. Final BCVA was significantly correlated with preoperative photoreceptor integrity and P1 implicit time. The area under the ROC (AUROC) curve was statistically significant when P1 implicit time was examined, and the cutoff value for good visual prognosis was 40.81 msec (sensitivity: 72.7%; specificity: 81.3%). Photoreceptor disruption detected by OCT and P1 implicit time delay on mfERG were significant predictors of poor visual recovery after ERM surgery. © 2012 Elsevier Inc. All Right Reserved.
Park M.-J.,National Health Insurance Corporation |
Kim H.-S.,Catholic University of Korea
International Journal of Medical Informatics | Year: 2012
Purpose: The present study evaluated whether an intervention using a short message service (SMS) by personal cellular phone and Internet would reduce cardiovascular risk factors in post-menopausal women with abdominal obesity over 12 weeks. Methods: This is a quasi-experimental design with pre and post tests. Participants were recruited from the gynecology outpatient and family medicine departments of a tertiary care hospital located in an urban city of South Korea. Only 67 subjects completed the entire study, 34 in the intervention group and 33 controls. The goal of intervention was to reduce waist circumference (WC), body weight (BW) and blood pressure (BP) levels. Before the intervention, demographic variables, WC, BW, BP, fasting plasma glucose (FPG) and serum lipids were measured as pre-test data. The WC, BW, BP, FPG and serum lipids were measured again 12 weeks later. Patients in the intervention group were requested to record their WC, BW, BP, type and amount of diet and exercise in a weekly web-based diary through the Internet or by cellular phone. The researchers sent weekly recommendations on diet and exercise as an intervention to each patient, by both cellular phone and Internet. The intervention was applied for 12 weeks. Results: WC and BW significantly decreased by 3.0. cm and 2.0. kg, respectively, at 12 weeks compared with the baseline in the intervention group. However, the mean changes in the control group significantly increased by 0.9. cm and 0.7. kg. Systolic BP (SBP) and diastolic BP (DBP) significantly decreased by 6.5 and 4.6. mmHg in the intervention group, respectively. The mean changes in the control group were not significant in either SBP or DBP. A significant mean decrease in total cholesterol (TC) was observed for the intervention group by 12.9. mg/dl, while the control group showed a significant mean increase by 1.5. mg/dl. Low-density lipoprotein-cholesterol (LDL-C) for the intervention group showed a significant mean decrease 11.3. mg/dl. The mean change in the control group was, however, not significant. Conclusion: Web-based individual intervention using both SMS and Internet improved WC, BW, BP, TC, and LDL-C during 12 weeks in post-menopausal women with abdominal obesity. © 2012 Elsevier Ireland Ltd.
Kim H.S.,National Health Insurance Corporation |
Joo S.H.,National Health Insurance Corporation |
Cho H.K.,National Health Insurance Corporation |
Kim Y.W.,Yonsei University
Archives of Physical Medicine and Rehabilitation | Year: 2013
Objectives: To provide a quantitative analysis of ultrasonographic measurements and possible pathophysiology of carpal tunnel syndrome by comparing cross-sectional areas of the median nerve, carpal tunnel, and nerve/tunnel index and the difference in ultrasonographic findings between affected and nonaffected hands and between sexes. Design: Blinded comparison study. Setting: Secondary referral and training hospital of institutional practice. Participants: Patients (N=51; 42 women, 9 men) with suspected carpal tunnel syndrome who underwent sonography within 1 week after the electrodiagnostic study. Interventions: Not applicable. Main Outcome Measures: Electrodiagnostic and ultrasonographic studies were conducted on both upper extremities. Cross-sectional areas of the median nerve and carpal tunnel were measured at 2 separate levels; proximal and distal cross-sectional areas of the carpal tunnel were each measured at the scaphoid-pisiform and trapezium-hamate levels, respectively. Results: Comparison between normative (n=24) and abnormal hands (n=78) revealed the following: the mean proximal cross-sectional areas of the median nerve, carpal tunnel, and nerve/tunnel index of electrodiagnostically normative hands were 10.941mm2, 192.43mm2, and 5.635%, respectively, whereas those of abnormal hands were 13.74mm2, 208.87mm2, and 6.693%, respectively, showing statistically significant differences for all (P<.05). Distal measurements of the cross-sectional area of the median nerve, carpal tunnel, and nerve/tunnel index were 10.088mm2, 150.4mm2, and 6.762%, respectively, in normative hands, and 11.178mm2, 149.6mm2, and 7.493%, respectively, in abnormal hands, showing no statistically significant differences (P>.05). In women, proximal cross-sectional areas of the median nerve and nerve/tunnel index of abnormal hands showed statistically significant differences, but no ultrasonographic measurement with a statistically significant difference was observed in men. Conclusions: Compared with nonaffected hands, the proximal cross-sectional areas of the median nerve and carpal tunnel were greater, but the distal ultrasonographic measurements were not in affected hands. Ultrasonographic findings of carpal tunnel syndrome were different according to sex. © 2013 by the American Congress of Rehabilitation Medicine.
Lee T.G.,Yonsei University |
Chung S.,National Health Insurance Corporation |
Chung Y.K.,Yonsei University
Archives of Plastic Surgery | Year: 2012
Background Even though the quality of medical and surgical care has improved remarkably over time, iatrogenic injuries that require surgical treatment including injuries caused by cast and elastic bandage pressure, extravasation, and dopamine-induced ischemia still frequently occur. The goal of this study was to estimate the incidence and analyze the distribution of iatrogenic injuries referred to our department. Methods A retrospective clinical review was performed from April 2006 to November 2010. In total, 196 patients (116 females and 80 males) were referred to the plastic surgery department for the treatment of iatrogenic injuries. We analyzed the types and anatomic locations of iatrogenic complications, along with therapeutic results. Results An extravasation injury (65 cases, 37.4%) was the most common iatrogenic complication in our study sample, followed by splint-induced skin ulceration, dopamineinduced necrosis, prefabricated pneumatic walking brace-related wounds and elastic bandage-induced wounds. Among these, prefabricated pneumatic walking brace-related complication incidence increased the most during the 5-year study period. Conclusions The awareness of the very common iatrogenic complications and its causes may allow physicians to reduce their occurrence and allow for earlier detection and referral to a plastic surgeon. We believe this is the first study to analyze iatrogenic complications referred to a plastic surgery department in a hospital unit. © 2012 The Korean Society of Plastic and Reconstructive Surgeons.
Ko M.J.,National Health Insurance Corporation |
Han J.T.,National Health Insurance Corporation
Cancer Causes and Control | Year: 2010
Background: The relationship between alcohol and cancer death has not been well established in Asian population, particularly among women. Method: We evaluated the association between alcohol consumption and all-cause and cancer mortality in a large-scale prospective study of 1,341,393 Korean men and women aged 40-69 years who participated in health examination in 2000. After 5 years follow-up for mortality (2001-2005), 19,375 deaths were identified, and Cox regression was used for longitudinal analyses. Results: The J-shaped relationship between alcohol consumption and all-cause and all-cancer mortality was found in men. However, heavy drinking was positively associated with the risk of all-cause and all-cancer mortality in men and women. Alcohol consumption was positively associated with the risk of cancer mortality such as cancers of liver, stomach, colorectal, prostate, esophageal, brain, and larynx and cancer of lips, oral cavity, pharynx in men and increased the risk of all-cancer and colorectal cancer mortality in women. Kidney cancer mortality was inversely associated with alcohol consumption in men. Conclusion: Heavy drinking showed an increased mortality risk of all-cause, all-cancer, and several cancers in men and women. There was no favorable effect of light drinking on all-cause and all-cancer mortality for women. © 2010 Springer Science+Business Media B.V.