Journal of Yeungnam Medical Science

Original articles

Incidence and risk factors of deep vein thrombosis and pulmonary thromboembolism after spinal cord disease at a rehabilitation unit: a retrospective study: Yoonhee Kim, Minjae Jeong, Myung Woo Park, Hyun Iee Shin, Byung Chan Lee, Du Hwan Kim; J Yeungnam Med Sci. 2023;40(Suppl):S56-S64. Published online September 20, 2023; DOI: https://doi.org/10.12701/jyms.2023.00689

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Background
Deep vein thrombosis (DVT) and pulmonary thromboembolism (PTE) are major complications of spinal cord disease. However, studies of their incidence in Korean patients are limited. Thus, this study investigated the incidence and risk factors of DVT and PTE in Korean patients with spinal cord disease.
Methods
We retrospectively analyzed the medical records of 271 patients with spinal cord disease who were admitted to a rehabilitation unit within 3 months of disease onset at a tertiary hospital. The presence of DVT and PTE was mainly determined using Doppler ultrasonography and chest embolism computed tomography. Risk factor analysis included variables such as sex, age, obesity, completeness of motor paralysis, neurological level of injury, cause of injury, lower extremity fracture, active cancer, and functional ambulation category (FAC) score.
Results
The incidences of DVT and PTE in the patients with spinal cord disease were both 6.3%. Risk factor analysis revealed that age of ≥65 years (p=0.031) and FAC score of ≤1 (p=0.023) were significantly associated with DVT development. Traumatic cause of injury (p=0.028) and DVT (p<0.001) were significant risk factors of PTE.
Conclusion
Patients with spinal cord disease developed DVT and PTE within 3 months of disease onset with incidence rates of 6.3% and 6.3%, respectively. Age of ≥65 years and an FAC of score ≤1 were risk factors for DVT. Traumatic cause of injury and DVT were risk factors for PTE. However, given the inconsistent results of previous studies, the risk factors for DVT and PTE remain inconclusive. Therefore, early screening for DVT and PTE should be performed in patients with acute-to-subacute spinal cord disease regardless of the presence or absence of these risk factors.

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Coagulation parameters correlate to venous thromboembolism occurrence during the perioperative period in patients with spinal fractures
Yong Jiao, Xiaohong Mu
Journal of Orthopaedic Surgery and Research.2023;[Epub] CrossRef

Risk factors for prostate-specific antigen persistence in pT3aN0 prostate cancer after robot-assisted laparoscopic radical prostatectomy: a retrospective study: Jun Seop Kim, Jae Hoon Chung, Wan Song, Minyong Kang, Hyun Hwan Sung, Hwang Gyun Jeon, Byong Change Jeong, Seong Il Seo, Hyun Moo Lee, Seong Soo Jeon; J Yeungnam Med Sci. 2023;40(4):412-418. Published online June 28, 2023; DOI: https://doi.org/10.12701/jyms.2023.00234

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Abstract PDF: Background
The aim of this study was to evaluate the risk factors for prostate-specific antigen (PSA) persistence in pathological stage T3aN0 prostate cancer (PCa) after robot-assisted laparoscopic radical prostatectomy (RALP).
Methods
A retrospective study was performed on 326 patients with pT3aN0 PCa who underwent RALP between March 2020 and February 2022. PSA persistence was defined as nadir PSA of >0.1 ng/mL after RALP, and the risk factors for PSA persistence were evaluated using logistic regression analysis.
Results
Among 326 patients, 61 (18.71%) had PSA persistence and 265 (81.29%) had PSA of <0.1 ng/mL after RALP (successful radical prostatectomy [RP] group). In the PSA persistence group, 51 patients (83.61%) received adjuvant treatment. Biochemical recurrence occurred in 27 patients (10.19%) in the successful RP group during the mean follow-up period of 15.22 months. Multivariate analysis showed that the risk factors for PSA persistence were large prostate volume (hazard ratio [HR], 1.017; 95% confidence interval [CI], 1.002–1.036; p=0.046), lymphovascular invasion (LVI) (HR, 2.605; 95% CI, 1.022–6.643; p=0.045), and surgical margin involvement (HR, 2.220; 95% CI, 1.110–4.438; p=0.024).
Conclusion
Adjuvant treatment may be needed for improved prognosis in patients with pT3aN0 PCa after RALP with a large prostate size, LVI, or surgical margin involvement.

Analysis of the risk factors of acute kidney injury after total hip or knee replacement surgery: Yoo Jin Lee, Bong Soo Park, Sihyung Park, Jin Han Park, Il Hwan Kim, Junghae Ko, Yang Wook Kim; Yeungnam Univ J Med. 2021;38(2):136-141. Published online October 27, 2020; DOI: https://doi.org/10.12701/yujm.2020.00542

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Abstract PDF

Background
Postoperative acute kidney injury (AKI), which increases the risk of postoperative morbidity and mortality, poses a major concern to surgeons. We conducted this study to analyze the risk factors associated with the occurrence of AKI after orthopedic surgery.
Methods
This was a retrospective study that included 351 patients who underwent total hip or knee replacement surgery at Inje University Haeundae Paik Hospital between January 2012 and December 2016.
Results
AKI occurred in 13 (3.7%) of the 351 patients. The patients’ preoperative estimated glomerular filtration rate (eGFR) was 66.66±34.02 mL/min/1.73 m2 in the AKI group and 78.07±21.23 mL/min/1.73 m2 in the non-AKI group. The hemoglobin levels were 11.21±1.65 g/dL in the AKI group and 12.39±1.52 g/dL in the non-AKI group. Hemoglobin level was related to increased risk of AKI (odds ratio [OR], 0.13; 95% confidence interval [CI], 0.02–0.68; p=0.016). Administration of crystalloid or colloid fluid alone and the perioperative amount of fluid did not show any significant relationship with AKI. Further analysis of the changes in eGFR was performed using a cutoff value of 7.54. The changes in eGFR were significantly related to decreased risk of AKI (OR, 0.74; 95% CI, 0.61–0.89; p=0.002).
Conclusion
Renal function should be monitored closely after orthopedic surgery if patients have chronic kidney disease and low hemoglobin level. Predicting the likelihood of AKI occurrence, early treatment of high-risk patients, and monitoring perioperative laboratory test results, including eGFR, will help improve patient prognosis.

Citations

Citations to this article as recorded by

Supplemental oxygen is associated with increased complications and readmission following total shoulder arthroplasty
Nikhil Vallabhaneni, Alexander S. Guareschi, Josef K. Eichinger, Richard J. Friedman
Seminars in Arthroplasty: JSES.2023; 33(3): 512. CrossRef
Acute kidney injury after primary total hip replacement
M. L. Lebed, M. G. Kirpichenko, E. V. Novikova, T. G. Lebed, A. V. Mankov
Acta Biomedica Scientifica.2023; 8(5): 125. CrossRef

Risk factors affecting amputation in diabetic foot: Jun Ho Lee, Ji Sung Yoon, Hyoung Woo Lee, Kyu Chang Won, Jun Sung Moon, Seung Min Chung, Yin Young Lee; Yeungnam Univ J Med. 2020;37(4):314-320. Published online May 6, 2020; DOI: https://doi.org/10.12701/yujm.2020.00129

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Abstract PDF

Background
A diabetic foot is the most common cause of non-traumatic lower extremity amputations (LEA). The study seeks to assess the risk factors of amputation in patients with diabetic foot ulcers (DFU).
Methods
The study was conducted on 351 patients with DFUs from January 2010 to December 2018. Their demographic characteristics, disease history, laboratory data, ankle-brachial index, Wagner classification, osteomyelitis, sarcopenia index, and ulcer sizes were considered as variables to predict outcome. A chi-square test and multivariate logistic regression analysis were performed to test the relationship of the data gathered. Additionally, the subjects were divided into two groups based on their amputation surgery.
Results
Out of the 351 subjects, 170 required LEA. The mean age of the subjects was 61 years and the mean duration of diabetes was 15 years; there was no significant difference between the two groups in terms of these averages. Osteomyelitis (hazard ratio [HR], 6.164; 95% confidence interval [CI], 3.561−10.671), lesion on percutaneous transluminal angioplasty (HR, 2.494; 95% CI, 1.087−5.721), estimated glomerular filtration rate (eGFR; HR, 0.99; 95% CI, 0.981−0.999), ulcer size (HR, 1.247; 95% CI, 1.107−1.405), and forefoot ulcer location (HR, 2.475; 95% CI, 0.224−0.73) were associated with risk of amputation.
Conclusion
Osteomyelitis, peripheral artery disease, chronic kidney disease, ulcer size, and forefoot ulcer location were risk factors for amputation in diabetic foot patients. Further investigation would contribute to the establishment of a diabetic foot risk stratification system for Koreans, allowing for optimal individualized treatment.

Citations

Citations to this article as recorded by

Efficacy of Chinese and Western Medical Techniques in Treating Diabetic Foot Ulcers With Necrotizing Fasciitis of the Lower Leg
Yongchong Chen, Yunzhu Wang, TaiAn Zhang, Chao Meng, Qing Li, Bohui Zhang, Kai Zhang, Chunfang Qin
The International Journal of Lower Extremity Wounds.2024; 23(1): 70. CrossRef
Classification of foot ulcers in people with diabetes: A systematic review
Matilde Monteiro‐Soares, Emma J. Hamilton, David A. Russell, Gulapar Srisawasdi, Edward J. Boyko, Joseph L. Mills, William Jeffcoate, Fran Game
Diabetes/Metabolism Research and Reviews.2024;[Epub] CrossRef
Renal function is highly associated with podiatric risk in diabetic patients
Jean-Baptiste Bonnet, Ilan Szwarc, Antoine Avignon, Sébastien Jugant, Ariane Sultan
Clinical Kidney Journal.2023; 16(11): 2156. CrossRef
Risk factor analysis for diabetic foot ulcer‐related amputation including Controlling Nutritional Status score and neutrophil‐to‐lymphocyte ratio
Yandan Zhu, Hongtao Xu, Yuzhen Wang, Xia Feng, Xinyu Liang, Liying Xu, Zhiqiang Liang, Zhongjia Xu, Yawen Li, Yi Le, Manchen Zhao, Jianfei Yang, Ji Li, Yemin Cao
International Wound Journal.2023; 20(10): 4050. CrossRef
The association between estimated glomerular filtration rate and prognosis in patients with diabetic foot osteomyelitis
Jinghang Zhang, Dong Chen, Xuemei Li, Min Ding, Jun Xu, Meijun Wang, Bai Chang
International Wound Journal.2022; 19(7): 1650. CrossRef
Renal Function Status in Patients with Diabetes Mellitus Having Diabetic Foot Infection and Role of Antibiotics
Shabab Hussain, . Arrham, Syeda Javeriya Saeed, Ahmad Murtaza Anwar, Asif Khan, Saifullah Brohi
Pakistan Journal of Health Sciences.2022; : 189. CrossRef
Re-understanding and focusing on normoalbuminuric diabetic kidney disease
Na An, Bi-tao Wu, Yu-wei Yang, Zheng-hong Huang, Jia-fu Feng
Frontiers in Endocrinology.2022;[Epub] CrossRef
The effects of curcumin intake on wound healing and metabolic status in patients with diabetic foot ulcer: A randomized, double‐blind, placebo‐controlled trial
Mehrdad Mokhtari, Reza Razzaghi, Mansooreh Momen‐Heravi
Phytotherapy Research.2021; 35(4): 2099. CrossRef
Prevalence of Sarcopenia and Its Association With Diabetes: A Meta-Analysis of Community-Dwelling Asian Population
Seung Min Chung, Jun Sung Moon, Min Cheol Chang
Frontiers in Medicine.2021;[Epub] CrossRef
Clinical outcomes among patients with chronic kidney disease hospitalized with diabetic foot disorders: A nationwide retrospective study
Michael Salim
Endocrinology, Diabetes & Metabolism.2021;[Epub] CrossRef

Original Articles

Risk factors for persistent otitis media with effusion in children: a case-control study: Ju Yeon Lee, Se-Hyung Kim, Chan Il Song, Young Ree Kim, Yoon-Joo Kim, Jae Hong Choi; Yeungnam Univ J Med. 2018;35(1):70-75. Published online June 30, 2018; DOI: https://doi.org/10.12701/yujm.2018.35.1.70

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Abstract PDF

Background
Otitis media with effusion (OME) is defined as middle ear effusion without acute signs of infection. OME usually resolves spontaneously; however, persistent OME may require the insertion of a ventilation tube. This study investigated risk factors for persistent OME in children who undergo ventilation tube insertion.
Methods
Children who were admitted to undergo ventilation tube insertion at Jeju National University Hospital between August 2015 and July 2016 were enrolled as the case group. Healthy children without persistent OME from August 2016 to July 2017 were enrolled as the control group. Baseline characteristics and predisposing factor data were collected using an interview questionnaire. Middle ear fluids were collected from the case group.
Results
A total of 31 patients underwent ventilation tube insertion. The mean age of the case group was 4.53 years, with a male-to-female ratio of 21:10. Twenty-nine (93.5%) children attended a daycare center, and 21 (67.7%) had experience with bottle feeding. Fifteen (48.4%) children in the case group and 3 (9.7%) in the control group first attended a daycare center at <1 year of age (odds ratio=9.96; 95% confidence interval=2.44-39.70; p=0.001). No bacteria were found in middle ear fluid collected from the 31 operated children. Nasopharyngeal bacterial colonization was found in 13 (41.9%) and 17 (54.8%) children in the case and control groups, respectively.
Conclusion
Earlier attendance at a daycare center was the only predisposing factor for ventilation tube insertion in our study. The aseptic nature of middle ear fluids found in children with OME highlights the efficacy of antimicrobial use.

Citations

Citations to this article as recorded by

Impact of COVID-19 on nationwide pediatric otolaryngology: Otitis media and myringotomy tube trends
David Z. Allen, Sai Challapalli, Sean McKee, Kyung Hyun Lee, Cynthia S. Bell, Soham Roy, Sarah Bowe, Karthik Balakrishnan, C.W. David Chang, Zhen Huang
American Journal of Otolaryngology.2022; 43(2): 103369. CrossRef
Special Considerations for Tympanoplasty Type I in the Oncological Pediatric Population: A Case-Control Study
Celine Richard, Emily Baker, Joshua Wood
Frontiers in Surgery.2022;[Epub] CrossRef

High levels of carcinoembryonic antigen and smoking might be markers of colorectal adenoma in Korean males aged 40-49 years.: In Cheol Yoon, Jeong Hyeon Cho, Heejin Choi, Young Hoon Choi, Kyu Min Lim, Sung Hwa Choi, Jae Ho Han, Hyeon Ju Jeong, Hong Sub Lee; Yeungnam Univ J Med. 2016;33(1):13-20. Published online June 30, 2016; DOI: https://doi.org/10.12701/yujm.2016.33.1.13

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Abstract PDF: BACKGROUND
Prevalence of adenoma in males aged 40-49 years in Korea was higher than expected. The aim of this study was to investigate the prevalence and risk factors of colorectal adenoma in males aged 40-49 years. METHODS: Total 1,902 asymptomatic subjects with a mean age of 47.9±6.7 years, who underwent a screening colonoscopy in a health promotion center of Myongji Hospital from 2010 to 2013 were enrolled in this study. We conducted a case-control study to determine the risk factors for adenoma. The subjects were classified into two groups (adenoma vs. controls). To validate the diagnostic value of carcinoembryonic antigen (CEA) for adenoma, area under the receiver operating characteristic curve (AUROC) was calculated. RESULTS: At least one colorectal adenoma was identified in 385 subjects (20.2%). Among these 385 subjects, 372 subjects were found to have a non-advanced adenoma, 13 subjects had an invasive adenoma. One subject had cancer. Male sex, age, smoking, metabolic syndrome, and elevated CEA level were significantly associated with a colorectal adenoma in univariate analysis. However, metabolic syndrome was not significant in multivariate analysis. In the male group, the AUROC of CEA for colorectal adenoma was 0.600 (0.543 to 0.656) in non-smokers under 50 years of age, and 0.615 (0.540 to 0.690) in smokers under 50 years of age. CONCLUSION: Male sex, smoking, and high levels of CEA seem to be associated with colorectal adenoma. High levels of CEA and smoking may be diagnostic markers for any colorectal adenoma in Korean males aged 40-49 years.

Risk Factors of Acute Renal Failure after Colorectal Surgery.: Hae Mi Lee, Chang Jae Hwang, Jaehwang Kim, Heung Dae Kim, Dae Pal Park, Il Suk Seo, Sun Ok Song, Sae Yeon Kim, Deuk Hee Lee, Daelim Jee; Yeungnam Univ J Med. 2007;24(2):275-286. Published online December 31, 2007; DOI: https://doi.org/10.12701/yujm.2007.24.2.275

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Abstract PDF: BACKGROUND
Acute renal failure is one of the leading causes of postoperative morbidity and mortality. The purpose of this study was to determine the risk factors that are associated with acute renal failure after colorectal surgery. MATERIALS AND METHODS: Five hundred seventy patients who operated colorectal surgery at the Yeungnam University Medical Center over three years from 2004 to 2006 were enrolled in this study. The effects of gender, age, ASA classification, concomitant disease, surgery type and duration, reoperation, urogenital manipulation, medication, hypotension, hypovolemia, transfusion, and postoperative ventilatory care on the occurrence of acute renal failure after colorectal surgery were studied. RESULTS: The major risk factors of acute renal failure after colorectal surgery were age of patients (P=0.003), ASA classification (P<0.001), concomitant disease (P<0.001), duration of the time surgery (P=0.034), reoperation (P=0.001), use of intraoperative diuretics (P=0.005), use of postoperative diuretics (P<0.001), intraoperative hypotension (P=0.018), intraoperative transfusion (P<0.001), postoperative transfusion (P<0.001), and postoperative ventilatory care (P=0.001). CONCLUSION: Multiple factors cause synergistic effects on the development of acute renal failure after colorectal surgery. Therefore, efforts to reduce the risk factors associated with acute renal failure are needed. In addition, intensive postoperative care should be provided to all patients.

Review Article

Epidemiology, Risk Factors, and Pathophysiology of Osteoarthritis: Choong-ki Lee; Yeungnam Univ J Med. 2007;24(2 Suppl):S132-141. Published online December 31, 2007; DOI: https://doi.org/10.12701/yujm.2007.24.2S.S132

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Abstract PDF

Osteoarthritis (OA) is the most prevalent form of arthritis and a major cause of disability in people aged 65 and older. OA is not a single disease; rather, it is a group of overlapping yet distinct diseases with different etiologies but similar pathologic, morphologic, and clinical outcomes. OA occurs when the dynammic equilibrium between the breakdown and reapir of joint tissues is overwhelmed. Systemic and local biomechanical factors contribute to the development of the disease, with systemic factors also making the joint vulnerable and resulting in a greater impact of local joint factors. Systemic risk factors include ethnicity, gender, age, genetic factors, hormonal status, bone density, and nutritional factors. Local biomechanical factors include altered joint biomechanics, prior injuries, the effects of physical activities, sports participation, occupation, developmental abnormalities, and obesity. The normal joint is protected by biomechanical factors such as alignment and muscle strength, the lubrication provided by the synovial fluid, and the shock-absorbing function of bone and cartilage. When these functions are altered, changes occur at both the macroscopic and cellular levels, with derangements in any structure contributing to further joint destruction. 1) Further studies of both risk factor modification and cellular changes in OA will hopefully continue to enhance our understanding of this complex disease and lead to improved outcomes.

Citations

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Prevalence of Osteoarthritis and Its Affecting Factors among a Korean Population Aged 50 and Over
Hye-Ryoung Kim, Eun-Jung Kim
Journal of Korean Public Health Nursing.2013; 27(1): 27. CrossRef

Original Article

The Factors Related to Intractability in Patients with Partial Epilepsy.: Yeung Ki Lee, Yeing Ju Byun, Mee Yeong Park, Jung Sang Hah, Se Jin Lee; Yeungnam Univ J Med. 1995;12(2):306-318. Published online December 31, 1995; DOI: https://doi.org/10.12701/yujm.1995.12.2.306

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Abstract PDF: To evaluate the intractability of partial epileptic patients by variables, the author studied 113 patients (uncontrolled: 45, controlled: 68) who were admitted to the Department of Neurology, College of Medicine, Yeungnam University from January, 1991 to August, 1993. The results were as follows. The items related to complex partial seizures, multiple seizure types and a histories of status epilepticus or clusters of seizures were significantly associated with drug-refractoriness (p<0.01). A high frequency of seizures before evaluation was associated with a poor outcome(p<0.01). The presences of known etiology of seizures, neurologic abnormalities and psychiatric disturbance were associated with limited treatment responses(p<0.01, p<0.05, p<0.01). An abnormal EEG findings such as background slowing, focal slowing, epileptiform discharges or secondarily bilateral synchrony were statistically significant (p<0.01). Age at onset, sex, distribution of epileptic foci, duration of seizure before evaluation, family history and abnormal neuroradiologic findings were not statistically significant. By these results, it was suggested that having at least four factors of the above variables were associated with limited treatment response.

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