Impact of obesity on double-lumen endobronchial tube displacement after lateral decubitus positioning / 대한마취과학회지

Background@#Double-lumen endobronchial tube (DLT) displacement, defined as migration of the DLT > 15 mm from optimal position, may threaten patient safety. Lateral decubitus positioning (LDP) of the patient can induce DLT displacement; however, little is known regarding the predictors for DLT displacement after this maneuver. Obesity may further aggravate DLT displacement by distorting mediastinal anatomy, but no comprehensive data exist concerning the impact of obesity on DLT displacement after LDP. Therefore, we evaluated the predictive value of preoperative risk factors, including obesity, for DLT displacement after LDP in patients who underwent pulmonary resection. @*Methods@#Data of patients who underwent pulmonary resection between July 2020 and July 2021 were retrospectively reviewed. Age, sex, height, weight, body mass index, left main bronchus diameter, DLT size, lateral decubitus direction, DLT depth, patient height divided by the DLT depths in supine and lateral decubitus positions (H/Dsupine and H/Dlateral, respectively), and extent of DLT dislocation were assessed. Logistic regression analysis identified risk factors, and the optimal cutoff values for continuous variables were determined using receiver operating characteristic curve analysis. @*Results@#Data from 428 patients were analyzed. DLT displacement was observed in 52 patients (12.1%). Obesity and H/Dsupine were independent predictors for DLT displacement after LDP (odds ratio [OR]: 5.69, 95% CI [2.89, 11.23], P < 0.001 and OR: 8.28, 95% CI [2.92, 23.48], P < 0.001, respectively). @*Conclusions@#Obesity was significantly associated with DLT displacement after LDP. Pre-emptively advancing the DLT from its optimal position before LDP may be advantageous in patients with obesity.

Effect of Early Stabilization Exercise Focused on the Scapulothoracic Joint on the Recovery of Surgical Patients Due to Rotator Cuff Tear

Purpose@#This study examined the effects of early stabilization exercise focused on the scapulothoracic joint on the recovery of surgical patients due to rotator cuff tear. @*Methods@#The subjects were 30 patients divided randomly into two groups. Group I consisted of 15 patients who practiced shoulder joint stabilization exercises, including glenohumeral joint movement. Group II consisted of 15 patients who practiced scapulothoracic joint stabilization exercises, excluding glenohumeral joint movement. The duration of stabilization exercise was 30 minutes for one day, five days a week, and five weeks. To measure the dependent variables, the Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire, range of motion (ROM), dynamometer of measured grip were used. @*Results@#The DASH, ROM, and grip power were compared. A significant difference was observed before the intervention in each group (p.05). @*Conclusion@#Both shoulder joint and scapulothoracic joint stabilization exercises were effective after the intervention compared to pre-intervention, but there was no difference between the two groups. Unlike many recent studies on the initiation of stabilization exercises, this study allays the concerns between the advantages of ‘early exercise’ and oppositions of previous studies about ‘early exercise’. Nevertheless, further research regarding these subjects is needed.

Effect of Early Stabilization Exercise Focused on the Scapulothoracic Joint on the Recovery of Surgical Patients Due to Rotator Cuff Tear

Purpose@#This study examined the effects of early stabilization exercise focused on the scapulothoracic joint on the recovery of surgical patients due to rotator cuff tear. @*Methods@#The subjects were 30 patients divided randomly into two groups. Group I consisted of 15 patients who practiced shoulder joint stabilization exercises, including glenohumeral joint movement. Group II consisted of 15 patients who practiced scapulothoracic joint stabilization exercises, excluding glenohumeral joint movement. The duration of stabilization exercise was 30 minutes for one day, five days a week, and five weeks. To measure the dependent variables, the Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire, range of motion (ROM), dynamometer of measured grip were used. @*Results@#The DASH, ROM, and grip power were compared. A significant difference was observed before the intervention in each group (p.05). @*Conclusion@#Both shoulder joint and scapulothoracic joint stabilization exercises were effective after the intervention compared to pre-intervention, but there was no difference between the two groups. Unlike many recent studies on the initiation of stabilization exercises, this study allays the concerns between the advantages of ‘early exercise’ and oppositions of previous studies about ‘early exercise’. Nevertheless, further research regarding these subjects is needed.

Awareness, Attitude and Impact of Perceived Depression in the Workplace in Korea / 신경정신의학

OBJECTIVES: Depression is a common disabling psychiatric illness in the workplace and is associated with high burden to both employer and employee. Little is known about the awareness, attitude, and impact of depression in the Korean workplace. This study investigates how workers perceive the symptomatology, disability, and management of depression. METHODS: This study is a cross-sectional web-based survey of 1000 workers recruited from online sites. Selected panel members were invited to participate in the survey through Ipsos MORI (www.ipsos-mori.com/) between 10th and 19th February 2014. The participants were Korean workers, aged 16-64, who are either currently working or had worked within the past year. Subjects were encouraged to respond to a 13-item questionnaire on the awareness, attitude, and impact of depression. RESULTS: According to the results, 7.4% of the subjects responded that they had ever been diagnosed as having depression from medical professionals. One third of workers with depression who had taken time off from work did not provide the actual reason to their employers, and the mean number of days off work was 9.8 days. The most common symptoms were depressed mood (76.7%), loss of interests (71.5%), sleep problem (69.8%), and cognitive dysfunction (47.0%). Cognitive symptoms (72.2%) were prominent among the workers who continued to work under the influence of depression. CONCLUSION: Korean workers reported a low rate of depression. Those who have been diagnosed with depression reported shorter number of days taken off from work compared to other countries. These results suggest that depression is poorly recognized and disclosed to employers in the Korean workplace. Presenteeism rather than absenteeism may be a major loss of productivity in Korea. An employee assistance program for depressed workers and new therapeutic strategies for treatment of cognitive symptoms of depression should be provided in Korea.

Relationship between Premorbid Personality and Behavioral and Psychological Symptoms in Dementia in Korean Patients with Alzheimer's Disease

OBJECTIVE: We performed a cross-sectional study to examine the relationship between premorbid personality and behavioral and psychological symptoms in dementia (BPSD) in Korean patients with Alzheimer's disease (AD). METHODS: We assessed 103 patients diagnosed with AD for the presence of BPSD over the disease course by using the caregiver-rated Korean version of the Neuropsychiatric Inventory (K-NPI) and for the premorbid personality by using a retrospective version of the NEO-Five Factor Inventory questionnaire completed by informants. RESULTS: Premorbid neuroticism was significantly correlated with delusion, agitation, anxiety, disinhibition, total K-NPI score (p<0.05), and sleep disturbances (p<0.01). Lower premorbid conscientiousness was significantly correlated with symptoms of hallucinations and sleep disturbances in AD patients (p<0.05). However, premorbid neuroticism and low premorbid conscientiousness did not act as independent predictors for "psychosis, hyperactivity," or "moods, apathy, frontal" factors of BPSD. CONCLUSION: Premorbid personality was associated with the K-NPI score, but was not observed to be potential predictors of BPSD.

Imaging of Distal Dural Ring Plane and Paraclinoid Internal Carotid Artery Aneurysms with 3D Rotational Angiography / 신경중재치료의학

PURPOSE: The distal dural ring (DDR) plane separates the intradural from extradural paraclinoid internal carotid artery (ICA) aneurysm. The purpose of this study was to evaluate the feasibility of the localization of the DDR plane drawn by the bony landmarks in patients with paraclinoid ICA aneurysms at 3D rotational angiography (3DRA). MATERIALS AND METHODS: 13 consecutive patients who underwent a 3DRA for the evaluation of 16 paraclinoid ICA aneurysms were reviewed retrospectively. On a dedicated workstation, multiplanar reconstruction (MPR) image along the virtual plane of DDR was reconstructed from the mask run image of 3DRA. Three bony landmarks were used to locate virtual plane of DDR: tuberculum sellae, inferior root of anterior clinoid process (ACP) and supero-medial aspect of optic strut. The MPR image was fused with 3D volume-rendered reconstruction image. Medial and posterior inclination angle of virtual plane of DDR was measured. The location of the paraclinoid ICA aneurysm was categorized into indradural, transdural, and extradural. RESULTS: In all cases, the DDR plane was identified and the relationship between the DDR plane and the paraclinoid ICA aneurysm was successfully determined on fusion image of 3DRA mask and contrast runs by dual volume visualization. The aneurysm locations determined with 3DRA were 8 intradural, 6 transdural and 2 extradural. The medial and posterior inclination angles of DDR plane ranged at 8 to 43degrees(mean 17.4degrees), and -2 to 20degrees(mean 6.4degrees), respectively. CONCLUSION: Localization of the paraclinoid ICA aneurysm in relation to the virtual plane of DDR is feasible with 3DRA and dual volume visualization.

Bullous reaction to topical methchlorethamine in mycosis fungoides.

We describe a patient with mycosis fungoides who developed a bulla shortly after the start of topical methchlorethamine. Dermal-epidermal separation has been reported to occur with topical methchlorethamine on histological examination. It is plausible that the compromised dermal-epidermal junction may manifest as a clinical bulla after a secondary insult. To our knowledge, clinical bulla formation due to topical methchlorethamine has not been reported.

Survey of Physically Disabled in Korea

The number of physically disabled in Korea and their biodemographic characteristics are estimated through a national sample survey of about 100,000 population or 22,134 households. The results showed that 7.98 persons per 1,000 population were found to be physically disabled including inconvenience to body or limb, as well as being mute, deaf or blind. Males had a higher prevalence ratio of disability compared to females, particularly in rural areas, among the less educated, divorced or widowed males.

AN Analysis of Cause of Death from the Reported Death Certification / 예방의학회지

Recent changes in the cause of death among the Korean population seem to be systematic and significant. Data on cause of death from the medically certified death certificates provide at least four types of evidence: a sudden increase in recent years in the numbers of death due to cerebrovascular disease or circulatory diseases including rheumatic fever and chronic heart disease and althersclerosis; increasing steadily in the numbers of death due to malignant neoplasm of various sites, and death due to accident; decreasing steadily in the numbers of death due to communicable diseases or parasite diseases; and a large number of deaths with unspecified symptoms and ill-defined conditions. The lack of complete registration of the occurred or the incomplete description on the cause of death reported suggests that statistical information of cause if death form the medically certified death records is meaning in interpreting changing patterns.

An Analysis of Inpatients' Morbidity Changes at Severance Hospital: Mar. 1970-Feb. 1978

Pattern of changes in hospital morbidity rates, calculated from medical records were presented for the inpatients population, who were admitted to Severance Hospital and were discharged from March 1, 1970 to February 28, 1978. Diseases were classified according to the International Classification of Diseases and Injuries of the World Health Organization. Infectious diseases, such as bacillary and amebic dysenteries, parasitic diseases and respiratory tuberculosis have decreased, and non-infectious diseases, such as malignant neoplasms, congenital anomalies, diabetes mellitus, and hypertensive heart diseases have increased.

Measurement of Cause-Specific Death Rate from Civil Registration in Korea: 1970-1974

No abstract available.

Estimation of Future Women of Childbearing Ages in Korea, 1970-1976

This study deals with the projection of Korean female population of childbearing ages from 1970 to 1976 Korea. The underlying consideration of this study is to provide information regarding the size of Korean female population and its growth by calendar year for the next few years. Procedures for estimating the future number of women of childbearing age are from the method of estimating survival ratios with the use of model life tables when mortality rates are steadly declining in the future. Computation of the women are grouped according to five year increments. Estimates resulted from estimating the current levels and future trends of survival ratios with the use of model life tables are 4,572,139 in 1970, 4,691,642 in 1971, 4,811,145 in 1972, 4,930,647 in 1973, 5,050,149 in 1974, 5,169,653 in 1975 and 5,344,853 in 1976 respectively.

An Analysis of Short-Stay Hospital Records and Measurement of the Probability Discharged as Cured from the Severance Hospital, l967~l969

This study presents some of the first statistical findings of the Severance Hospital discharge survey. The purpose of this study described in this report was twofold: 1) The underlying consideration was model building for the distribution of short-stay hospitalized patients; and 2) The immediate target was a better understanding of the impact of certain measurement probability discharged as cured present in the survey of medical records. In building up the duration-of-stay model, the conditional probabilities of discharge on a particular day were computed for the January-December, 1967 in order to obtain an appropriate theoretical distribution. The rise and fall of these conditional probabilities as duration of stay increased was characteristic of the log-normal distribution. Therefore, the log-normal distribution, ... was fitted to the available duratin-of-stay data. The parameters found for the distribution were estimated as mu=1.834 and delta=0.675 in 1967. As for measuring the probability of patient discharged as cured, life table model was adopted. Discharge as cured including improved patient and death including transferred to other hospital without improved are takan as the two attrition factors for decrement of a single population. The probabilities of being discharged as cured during the first week after hospitalization were found .as P0=0.41877 in 1967, P0=0.44113 in 1968 and P0=0.47387 in 1969. The average expectations of post discharge life were e0=2.048 weeks in 1967, e0=2.160 weeks in 1968 and e0=1.961 weeks in 1969. During the first fourteen days after hospitalization the probabilities as cured were 2P0=0.6814 in 1967, 2P0=0.7056 in 1968 and 2P0=0.7352 in 1969, which showed the rate has been steadly increased.

An Estimation of Level of Fertility in Korea from the Special Demographic Survey Data on Births and Children Ever Born

Brass' theoretical model of fertility was applied to the tabulated data of the specific demographic sampling survey (BOS, 1966) in order to assess and to estimate fertility rates in Korea. The estimated total fertility rate, age pattern of fertility rate and other related findings are summarized as follows: 1) In estimating fertility rates throughout the model, the ratios of estimated average parity (Bi) to cumulative current fertility (Fi) showed that the model is only applicable to the data from sub-sample 2 of the rural area. 2) The level of fertility in terms of the total fertility rate in the rural area was in the range of 6.49 to 6.62, remaining at this high level until 1966. 3) The corrected age (grouped in five years)specific birth rates in the rural area by the model were fl=0.015, f2=0.243, f3=0.427, f4=0.278, f5=0.232, f6=0.093 and f7=0.011. These rates followed the general shape of age specific fertility schedule but the level in each age group (except 15-19) was higher than that of such countries as rural Japan (Aoki, 1967), rural Taiwan (Lu, 1967) and Ryukyu (Gov. of Ryukyu, 1967) respectively. 4) In the urban area, every Bi/Fi ratio was above 1.000. This indicated that if "reference period" error was small the current fertility had been downward in recent years against the estimated average panty. 5) Errors due to either recall lapse or interviewer's bias in reporting birth events during the "reference period" was found for older women. However, the errors seemed to be small because recall period during which live births occurred was for the preceeding eighteen instead of twelve months. Out of these eighteen-month events only twelve month births were counted and tabulated. 6) Sub-sample 2 showed a less distorted degree of non-sampling error in comparison to sub-sample 1 in terms of Bi/Fi. 7) Both in the urban and rural areas fertility started relatively late (fl/f2=0.072, f2/f3=0.449 in the rural area; fl/f2=0.063, f2/f3=0.572 in the urban area).