http://chineseinput.net/에서 pinyin(병음)방식으로 중국어를 변환할 수 있습니다.
변환된 중국어를 복사하여 사용하시면 됩니다.
Woo Hyeonseong,Lee Sanghee,Lee Hyun Sung,Chae Hyun Jun,Jung Jongtak,Song Myung Jin,Lim Sung Yoon,Lee Yeon Joo,Cho Young-Jae,Kim Eu Suk,Kim Hong Bin,Lim Jae-Young,Song Kyoung-Ho,Beom Jaewon 대한의학회 2022 Journal of Korean medical science Vol.37 No.34
Background: This study aimed to investigate the effects of comprehensive rehabilitation management on functional recovery and examine the correlation between clinical parameters and improvements in functional outcomes in severe-to-critical inpatients with coronavirus disease 2019 (COVID-19) in a tertiary hospital. Methods: Post-acute COVID-19 patients who had a World Health Organization (WHO) ordinal scale of 5–7, underwent intensive care, and received comprehensive rehabilitation management, including exercise programs, nutritional support, dysphagia evaluation, and psychological care were included. The appendicular skeletal muscle mass index (SMI), Medical Research Council sum score, handgrip strength, number of repetitions in the 1-minute sit-to-stand test, gait speed, Berg Balance Scale (BBS), and Functional Ambulation Classification (FAC) were evaluated at hospital stay, discharge, and 1-month follow-up. The correlation between the rehabilitation dose and improvement in each outcome measure was analyzed. Results: Overall, 37 patients were enrolled, of whom 59.5% and 32.4% had a score of 6 and 7 on the WHO ordinal scale, respectively. Lengths of stay in the intensive care unit and hospital were 33.6 ± 23.9 and 63.8 ± 36.5 days. Outcome measures revealed significant improvements at discharge and 1-month follow-up. The SMI was significantly increased at the 1-month follow-up (6.13 [5.24–7.76]) compared with that during the hospital stay (5.80 [5.39–7.05]). We identified dose-response associations between the rehabilitation dose and FAC (ρ = 0.46) and BBS (ρ = 0.50) scores. Patients with older age, longer hospitalization, longer stay at the intensive care unit, longer duration of mechanical ventilation, tracheostomy, a more depressive mood, and poorer nutritional status revealed poorer improvement in gait speed at the 1-month follow-up. Conclusion: Comprehensive rehabilitation management effectively improved muscle mass, muscle strength, and physical performance in severe-to-critical COVID-19 patients. Dose-response relationship of rehabilitation and functional improvement emphasizes the importance of intensive post-acute inpatient rehabilitation in COVID-19 survivors.
Preoperative Evaluation of Living Donor Candidate for Liver Transplantation
( Sanghee Song ),( Ok Kyung Kim ),( Myung Eun Lee ),( Jin Yong Choi ),( Hyeyoung Kim ),( Sung-woo Ahn ),( Hyo-sin Kim ),( Kyung Chul Yoon ),( Suk Kyun Hong ),( Nam-joon Yi ),( Kwang-woong Lee ),( Kyun 대한간학회 2016 춘·추계 학술대회 (KASL) Vol.2016 No.1
The downside of living donor liver transplantation, of course, is the risk to the healthy donor. For the donor safety, preoperativeevaluation of donor is important and it should be included psychosocial and ethical issues as well as medical suitability. Here,we introduce a preoperative evaluation of living donor candidate for liver transplantation. Since 2011 our institution`s protocolwas introduced, this three-step evaluation protocol have been used in our center (Fig.1). At Step1, the medical examination ofcandidate for donor by interview includes the medical history, psychosocial circumstance and age; usually 16-60 years. The relationshipbetween the recipient and donor should be within the third degree of consanguinity or an intense emotional relationshipjudged by ethical board of local committee. At Step 2, potential donor undergoes tests two phase medical evaluation, ethicalevaluation and document process. First phase medical evaluation includes basic blood and urine profile, Liver CT scan forgraft/remnant volume of liver, ECG and chest X-ray. Second phase medical evaluation includes viral and neoplastic disease andimaging studies, especially primovist MRI and MRCP, for anatomy and quality of the liver include the degree of fatty change.If necessary, the invasive procedures including liver biopsy and additional consultations required to investigate the potential problemsdiscovered during phases 1 and 2 are done. At Step 3, the multidisciplinary team discuss about donor and decide thedonation. A preoperative liver biopsy was applied to the moderate steatosis from imaging studies. The presence of mild systemicdiseases (e.g., well-controlled hypertension or diabetes) cannot be a contraindication in our protocol. The donors are disciplinedto quit smoking and drinking. The remnant liver volume ≥ 30% of the whole liver is recommended. If macrovesicular steatosisis ≥ 10%, we do liver biopsy and recommend diet control. Donors with a GRWR > 0.8% were generally accepted. Usually minimalanantomical variation of the liver has been accepted. Only candidate who passed these all examination, can be a donor for livertransplantation. This detailed evaluation undoubtedly play a role in our successful living donor liver transplantation program,and there was no donor mortality and the overall donor morbidity was < 6.0%, including 0.9% of major complications (> gradeIII). In conclusion, meticulous donor evaluation is important for the successful LDLT.
Jun Woo Bong*,Sanghee Kang*,Pyoungjae Park 대한외과학회 2023 Annals of Surgical Treatment and Research(ASRT) Vol.105 No.5
Purpose: The role of paraaortic lymph node dissection (PALND) in colorectal cancer (CRC) has been less evaluated than surgical treatments for other distant metastases. We evaluated surgical outcomes after PALND and identified prognostic factors. Methods: The medical records of patients who underwent PALND for paraaortic lymph node metastasis (PALNM) were reviewed retrospectively. All patients were categorized into the M1a group (isolated PALNM, n = 27), and the M1bc group (distant metastases other than PALNM, n = 26). Three severity factors (PALNM-SF: number of harvested paraaortic lymph nodes [hLN], ≥14; number of metastatic paraaortic lymph nodes [mLN], ≥5; and lymph nodes ratio [mLN/hLN], ≥0.5) were defined to determine their effects on survival. Results: The 5-year overall survival (OS) of the M1a and M1bc groups were 61.1% and 6.4%, respectively (P = 0.0013). The 5-year disease-free survival (DFS) of the M1a group was 47.4%, and the 3-year DFS of the M1bc group was 9.1% (P < 0.001). Patients with 2 or more PALNM-SFs showed worse OS than those with 1 PALNM-SF (P = 0.017). In multivariate analysis, M1bc (non-isolated PALNM) was the only significant factor for survival. In the M1a group, patients with 2 or more PALNMSFs showed significantly worse survival than those with a single PALNM-SF. In multivariate analysis, 2 or more PALNM-SF was a significant factor for survival. Conclusion: PALND for CRC provided favorable outcomes in the survival of an isolated PALNM, although this was uncertain for non-isolated PALNMs. The PALNM-SFs helped assess the prognosis after PALND.