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        Total Knee Arthroplasty: Is It Safe? A Single-Center Study of 4,124 Patients in South Korea

        Kyunga Ko,Kee Hyun Kim,Sunho Ko,Changwung Jo,Hyuk-Soo Han,Myung Chul Lee,Du Hyun Ro 대한정형외과학회 2023 Clinics in Orthopedic Surgery Vol.15 No.6

        Background: Although total knee arthroplasty (TKA) is considered an effective treatment for knee osteoarthritis, it carries risks of complications. With a growing number of TKAs performed on older patients, understanding the cause of mortality is crucial to enhance the safety of TKA. This study aimed to identify the major causes of short- and long-term mortality after TKA and report mortality trends for major causes of death. Methods: A total of 4,124 patients who underwent TKA were analyzed. The average age at surgery was 70.7 years. The average follow-up time was 73.5 months. The causes of death were retrospectively collected through Korean Statistical Information Service and classified into 13 subgroups based on the International Classification of Diseases-10 code. The short- and long-term causes of death were identified within the time-to-death intervals of 30, 60, 90, 180, 180 days, and > 180 days. Standard mortality ratios (SMRs) and cumulative incidence of deaths were computed to examine mortality trends after TKA. Results: The short-term mortality rate was 0.07% for 30 days, 0.1% for 60 days, 0.2% for 90 days, and 0.2% for 180 days. Malignant neoplasm and cardiovascular disease were the main short-term causes of death. The long-term (> 180 days) mortality rate was 6.2%. Malignant neoplasm (35%), others (11.7%), and respiratory disease (10.1%) were the major long-term causes of death. Men had a higher cumulative risk of death for respiratory, metabolic, and cardiovascular diseases. Age-adjusted mortality was significantly higher in TKA patients aged 70 years (SMR, 4.3; 95% confidence interval [CI], 3.3–5.4) and between 70 and 79 years (SMR 2.9; 95% CI, 2.5–3.5) than that in the general population. Conclusions: The short-term mortality rate after TKA was low, and most of the causes were unrelated to TKA. The major causes of long-term death were consistent with previous findings. Our findings can be used as counseling data to understand the survival and mortality of TKA patients.

      • SCOPUSKCI등재
      • KCI등재

        Bacillus cereus에 의한 대규모 집단식중독 원인 분석

        이현아,고영은,이다연,윤경아,김현정,김옥,박준혁,Hyunah Lee,Youngeun Ko,Dayeon Lee,KyungA Yun,Hyeonjeung Kim,Ok Kim,Junhyuk Park 한국식품위생안전성학회 2024 한국식품위생안전성학회지 Vol.39 No.2

        본 연구는 2020년 10월 중 충청남도내 단체 급식소에서 발생한 대규모 집단 식중독 원인에 대하여 분석하였다. 전체 급식원 135명 중 21명(15.6%)에서 음식을 섭취한 후 1시간 이내에 주로 매스꺼움과 구토 증상을 보였다. 유증상자 21명 중 11명과, 조리종사자 1명, 조리기구 2건과 보존식 8건에서 B. cereus가 검출됨에 따라 B. cereus에 의한 집단 식중독으로 판단하였다. 분리된 21개의 균주를 PFGE 분석한 결과, 19개의 균주가 동일한 것으로 판단되었고, 이들 균주가 가지고 있는 독소 유전자는 CER, nheA, entFM이었다. 실험결과, CER을 포함하고, 증상 발현 시간이 1시간 이내로 매우 짧아 B. cereus의 구토형 식중독으로 판단하였다. 집단식중독 원인으로 안전하지 않은 급식환경과 제대로 관리되지 않은 음식에 의한 것이라 조사되었다. 이러한 결과는 단체급식에서의 급식환경과 제공되는 음식이 철저하게 관리되어야 한다는 것을 보여준다. 이와 더불어 보존식에서 원인 병원체를 찾아내는 것은 식중독의 원인을 추정하는데 매우 중요하므로, 집단급식소에서 규정에 맞는 보존식 용기를 이용하여 이를 적정온도에 잘 보관해야한다. 또한 정밀한 식중독 역학조사를 기반으로 사례를 분석하고 결과를 전파함으로써 유사한 식중독이 재발하지 않도록 해야 한다. This study was performed to establish the epidemiological features of a food poisoning outbreak that occurred in the cafeteria of a company in Chungcheongnam-do Province, Korea, in October 2020, and to recommend measures to prevent similar outbreaks. Twenty-one patients with acute gastroenteritis, three food handlers, seven cooking utensils, and 12 preserved food samples were subjected to viral and bacterial analyses based on procedures described in the "Manual for Detection of Foodborne Pathogens at Outbreaks". Among 135 individuals who had been served the meals, 21 (15.6%) showed symptoms of nausea and vomiting within an hour of consuming the food. Bacillus cereus were isolated from 11 (52.4%) of the 21 patients, one food service employee, one item of cooking ware, and 12 preserved food samples. In addition, we confirmed the toxin genes CER, nheA, and entFM from the isolated B. cereus strains. Pulsed-field gel electrophoresis results indicated that all of the isolated B. cereus strains were closely related, with the exception of strains obtained from one patient and one sample of preserved food. These findings provide evidence to indicate that the isolated B. cereus originated from preserved foods and an unhygienic eating environment. This outbreak highlights that the provision of food in non-commercial food systems must be thoroughly managed. In addition, it emphasizes the necessity for the correct and timely identification of causal pathogens for tracing the cause of food poisoning outbreaks, and the need to preserve food under appropriate conditions. To prevent similar cases of food poisoning, it is necessary to investigate cases based on an epidemiological approach and share the findings.

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