Nutrition and Exercise Treatment of Sarcopenia in Hip Fracture Patients: Systematic Review

유준일,Yong-Chan Ha,차용한 대한골대사학회 2022 대한골대사학회지 Vol.29 No.2

Background: This study aimed to investigate nutritional or rehabilitation intervention protocols for hip fracture patients with sarcopenia and to analyze the effect of these protocols through a systematic review of studies that reported clinical results. Methods: Studies were selected based on the following criteria: (1) study design: randomized controlled trials or non-randomized comparative studies; (2) study population: patients with hip fracture; (3) intervention: nutritional or rehabilitation; and (4) reporting the clinical outcomes and definition of sarcopenia. Results: Of the 247 references initially identified from the selected databases, 5 randomized controlled studies and 2 comparative studies were selected for further investigation. The total number of patients was 497. We found 2 specific rehabilitation interventions, one medication intervention using erythropoietin, and 4 nutritional interventions using amino-acid or protein. Among the studies included in this systematic review, 2 studies did not find a clear statistical difference in assessment tools compared to controls after intervention. On the other hand, the rest of the studies positively interpreted the results for intervention. The most frequently used assessment tool for intervention was handgrip strength. Conclusions: Although mainstream methods of intervention for sarcopenia include nutritional, exercise, and drug interventions, the validity of these interventions in elderly hip fractures has not been clearly proven. In addition, as most studies only reported short-term results, there is no consensus on the optimal long-term treatment.

감염병 확산에 따른 레스토랑 선택속성 변화 분석:텍스트마이닝 기법 적용

유준일,이은지,구철모 한국경영정보학회 2023 Information systems review Vol.25 No.4

In March 2020, as it was declared a COVID-19 pandemic, various quarantine measures were taken. Accordingly, many changes have occurred in the tourism and hospitality industries. In particular, quarantine guidelines, such as the introduction of non-face-to-face services and social distancing, were implemented in the restaurant industry. For decades, research on restaurant attributes has emphasized the importance of three attributes: atmosphere, service quality, and food quality. Nevertheless, to the best of our knowledge, research on restaurant attributes considering the COVID-19 situation is insufficient. To respond to this call, this study attempted an exploratory approach to classify new restaurant attributes based on understanding environmental changes. This study considered 31,115 online reviews registered in Naverplace as an analysis unit, with 475 general restaurants located in Euljiro, Seoul. Further, we attempted to classify restaurant attributes by clustering words within online reviews through TF-IDF and LDA topic modeling techniques. As a result of the analysis, the factors of “prevention of infectious diseases” were derived as new attributes of restaurants in the context of COVID-19 situations, along with the atmosphere, service quality, and food quality. This study is of academic significance by expanding the literature of existing restaurant attributes in that it categorized the three attributes presented by existing restaurant attributes and further presented new attributes. Moreover, the analysis results have led to the formulation of practical recommendations, considering both the operational aspects of restaurants and policy implications.

Factors Associated with the Risk of Articular Surface Perforation during Anchor Placement for Arthroscopic Acetabular Labral Repair

유준일,하용찬,황선철,오진영,장의찬,이영균,구경회 대한정형외과학회 2017 Clinics in Orthopedic Surgery Vol.9 No.4

Background: The purpose of this study was to evaluate factors associated with the risk of articular surface perforation during anchor placement for arthroscopic acetabular labral repair using follow-up computed tomographic arthrography (CTA). Methods: Forty-six patients (29 males and 17 females) underwent arthroscopic labral repair using 142 suture anchors (55 large anchors and 87 small anchors). The patients were followed with CTA 1 year postoperatively. Anchor position was assessed by the insertion angle and the distance of the suture anchor tip from the articular cartilage. The incidence of malposition of suture anchors was assessed in follow-up CTA. The location and incidence of malposition were compared between two groups divided according to the diameter of suture anchor. Results: The mean insertion angle and distance were significantly different between the groups. Of the 142 anchors, 15 (11%) were placed in the cartilage-bone transitional zone. Articular involvement was most common at the 3 o’clock position of the suture anchor (six out of 33 anchors, 18.2%). Both the insertion angle and distance showed small values in the articular involvement group. Conclusions: The radiographic analysis of the placement of suture anchors after arthroscopic labral refixation based on follow-up CTA demonstrates that articular involvement of anchors is related to the location on the acetabular rim (clock position) and anchor diameter.

코로나19 상황에서 텍스트마이닝 기법을 통한 레스토랑 선택 속성 분석: 을지로 지역을 중심으로

유준일,이은지,구철모 한국경영정보학회 2022 한국경영정보학회 학술대회논문집 Vol.2022 No.11

2020년 3월, 코로나바이러스 팬데믹으로 선포되면서, 다양한 방역 조치가 취해져 왔다. 이에 따라, 관광 및 환대 산업 내의 많은 변화들이 야기되었다. 특히, 레스토랑 산업은 코로나19의 정책적 지침에 따라, 운영적 측면에서 많은 변화가 나타났다. 레스토랑 선택 속성과 관련 기존 선행 연구는 기존 분위기, 서비스, 음식 품질과 같은 요소들을 주로 다뤄왔으나, 코로나19 이후 연구에서 발견된 위생(hygiene), 청결(cleanliness) 요인의 중요성을 강조한 연구는 미비하다. 이에 따라, 본 연구에서는 코로나19 이후 연구에서 발견된 위생, 청결 요인이 국내 온라인 리뷰 상에서 해당 요인이 선택 속성으로 발견되는지 탐색적인 접근을 시도하고자 하였다. 본 연구의 대상은 서울 을지로 지역 내 406개의 레스토랑을 대상으로 수집한 31,115개의 온라인 리뷰이며, 텍스트마이닝 기법을 통해 분석을 시도하였다. 분석 결과, 코로나19 이후 레스토랑의 새로운 선택 속성으로 코로나19와 관련된 토픽을 새롭게 발견하였다. 연구 결과에 기반하여, 레스토랑 운영 방안에 대한 실무적 제언을 시도하였다.

Mean Hand Grip Strength and Cut-off Value for Sarcopenia in Korean Adults Using KNHANES VI

유준일,최하나,하용찬 대한의학회 2017 Journal of Korean medical science Vol.32 No.5

The purpose of this study was to report age- and gender-specific distribution of the hand grip strength (HGS) using data from the Korea National Health and Nutrition Examination Survey (KNHANES) VI-3 (2015) survey and determine cut-off values for low muscle strength of HGS of Koreans. Of a total of 7,380 participants, 4,553 were subjected to measurements of HGS, including 1,997 men and 2,556 women with a mean age of 49.3 years (range, 19–80 years). The mean ages of men and women were 49.0 and 49.5 years, respectively. HGS was measured using a digital hand dynamometer. It was defined as maximal measured grip strength of the dominant hand. The cut-off value for low muscle strength was defined as the lower 20th percentile of HGS of the study population. Maximum grip strength of men was significantly higher than that of women (40.2 kg in men vs. 24.2 kg in women, P < 0.001). The mean HGS was increased from the age of 19 to 39 years. It was peaked in the age of 35 to 39 years range for both men and women. It was then decreased after 39 years. The cut-off values of HGS in male and female elderly healthy populations were 28.6 and 16.4 kg, respectively. These data might be used as reference values when evaluating sarcopenia and assessing hand injuries.

Early Rehabilitation in Elderly after Arthroplasty versus Internal Fixation for Unstable Intertrochanteric Fractures of Femur: Systematic Review and Meta-Analysis

유준일,하용찬,임재영,강현,윤병호,김현호 대한의학회 2017 Journal of Korean medical science Vol.32 No.5

The purpose of this study was to compare the outcomes focusing on the functional outcome and clinical results of replacement arthroplasty (AP) vs. internal fixation (IF) for the treatment of unstable intertrochanteric femoral fracture in elderly. Systematic review and meta-analysis were performed on 10 available clinical studies (2 randomized controlled trials and 8 comparative studies). Subgroup analysis was performed by type of methodological quality. Partial weight bearing time in AP group was earlier than that in IF group (SMD = −0.86; 95% CI = −0.42, 1.29; P = 0.050). The overall outcomes such as mortality, reoperation rate, and complication showed no significant diffrence between the 2 groups (AP vs. IF). Therefore, this systematic review demonstrates that AP provides superior functional outcomes especially earlier mobilization, as compared to IF in elderly patients with an unstable intertrochanteric femoral fracture.

Concerns for Older Adult Patients with Acute Hip Fracture

유준일,이영균,구경회,박영진,하용찬 연세대학교의과대학 2018 Yonsei medical journal Vol.59 No.10

Purpose: The purpose of this study was to identify concerns among older adult patients with acute hip fracture. Materials and Methods: This study was performed with 152 consecutive patients with hip fracture. Details were obtained onperioperative concerns about hip fracture using a questionnaire that was specifically designed for this study and was administeredface to face upon admission. The study inclusion criteria were age older than 65 years and having experienced femur neck,intertrochanteric, or subtrochanteric fracture. The exclusion criteria were not understanding the study purpose, having difficultycommunicating, or refusing to participate. Results: Older adult patients with acute hip fracture expressed concerns regarding excessive pain, medical staff, postoperative recovery,rehabilitation, and hospital expenses. In addition, fear of falling from the bed and anxiety regarding re-fracture were thepatients’ most significant concerns. Conclusion: Older adult patients reported fear of falling from bed and re-fracture as primary concerns. To overcome these concerns,fracture liaison services to prevent re-fracture should be introduced and enforced.

Fracture Preventing Effects of Maxmarvil® Tablets (Alendronate 5 mg + Calcitriol 0.5 μg) in Patients with Osteoporosis

유준일,하용찬,원예연,양규현,김상범,유주형,김동수 대한골대사학회 2017 대한골대사학회지 Vol.24 No.2

Background: The purpose of this prospective, open-label, observational study was to assess the fracture preventing effect of Maxmarvil® tablets (alendronate 5 mg + calcitriol 0.5 μg) in patients with osteoporosis and to evaluate the change in bone mineral density (BMD) at the minimum 1-year follow-up. Methods: In this multicenter observational study, 691 patients with osteoporosis (aged 50 years or older) were treated with alendronate 5 mg + calcitriol 0.5 μg/day during their normal course of care. Patients were assessed at baseline and at 6 and 12 months. Baseline characteristics (including age, gender, concomitant disease, and baseline fractures) were evaluated. Results: From among the 848 participants, 149 individuals were lost to follow-up at the time of the study and 8 people had died. The 691 participants (54 men and 637 women) finished the follow-up study and completed the questionnaire. The mean age of the participants was 71.5 years (range, 50-92 years; mean age, 72.3 years for men and 71.4 years for women). Osteoporotic fracture occurred in 19 patients (2.7%). BMD of the lumbar spine and hip was improved by 5% and 1.5% at the latest follow-up. At the latest follow-up, 24 patients (3.5%) complained of drug-related complications such as dyspepsia, constipation, and nausea. Conclusions: This prospective observational study demonstrated that alendronate 5 mg + calcitriol 0.5 μg/day had a preventive effect on osteoporotic fracture and it increased the BMD of the lumbar spine by 5% at the latest follow-up.

Incidence and Mortality of Osteoporotic Refractures in Korea according to Nationwide Claims Data

유준일,하용찬,박기수,김록범,서성효,구경회 연세대학교의과대학 2019 Yonsei medical journal Vol.60 No.10

Purpose: Studies on the incidence and mortality of refractures after primary osteoporotic fracture are limited by the relatively rareincidence of such refractures and small sample sizes. The objectives of this research were: 1) to determine the incidence of osteoporoticrefractures and fracture locations and 2) to assess mortality rates associated with osteoporotic refracture over a medianfollow up of 3 years using nationwide claim database. Materials and Methods: Patients over 50 years of age who had an osteoporotic fracture that was confirmed operationally wereenrolled. Refracture was defined as that after 6 months of an untreated period. Mortality rate was calculated using the Charlsoncomorbidity index and was analyzed using Cox proportional hazards regression analysis. Results: A total of 18956 first-time instances of osteoporotic fracture were reported between 2007 and 2012 after a median followup of 3.1 years (range, 1 to 7 years). Among 18956 patients, 2941 (15.50%) experienced refracture. After follow up for 1 year, cumulativemortality rates for re-fracture and non-refracture groups were 9.1% and 7.2%, respectively. After adjusting for covriates,mortality rate was 1.2 times greater in patients with re-fracture than in patients without re-fracture over a median follow up of 3years (hazard ratio: 1.20, 95% confidence interval: 1.08–1.34, p<0.001). Conclusion: The incidence of osteoporotic re-fracture in this nationwide study was 15.5%, and the mortality rate of re-fracturepatients was 1.2 times higher than that of non-refracture patients over a median follow up of 3 years.

Age-related Reference Intervals for Total Collagen-I-N-terminal Propeptide in Healthy Korean Population

유준일,박애자,임용관,권오주,최재희,도재혁,김선주,김영기,하용찬 대한골대사학회 2018 대한골대사학회지 Vol.25 No.4

Background: Procollagen type I N-terminal propeptide (PINP) is one of the most clinically useful bone formation biomarkers. Therefore, the purpose of this study was to independently evaluate the performance of automated total PINP assay and established age- and gender- specific reference intervals for PINP in healthy Korean population. Methods: The imprecision, linearity, and detection capability of Elecsys total PINP assay was determined and reference interval was established using 599 serums from Korean population with normal bone mineral densities based on bone densitometry. Age groups were divided into 20s, 30s, 40s, 50s, 60s and over. Results: Elecsys total PINP had excellent performance in imprecision, linearity, and detection capability. When partitioning age groups in Korean male and female populations, there was significant difference in total PINP between different age groups. In male populations, PINP level was decreased with increasing age, then it remained steady after middle-age. In female populations, there was a decreasing tendency similar to that in the male population with a sharp increase in the 50 to 59 age group. Conclusions: Elecsys total PINP assay showed precise and reliable performance in our study. We established age-related PINP reference intervals for Korean male and female population with normal bone mineral densities.