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1.
Child Health Nursing Research ; : 137-148, 2023.
Article in English | WPRIM | ID: wpr-999836

ABSTRACT

Purpose@#We developed a virtual reality (VR) program for use in pediatric nursing practicums to help nursing students learn to measure vital signs in children. @*Methods@#The analysis, design, development, implementation, and evaluation model was employed between July 2021 and December 2021 at a university in South Korea. In the analysis phase, in-depth interviews were conducted with four nursing students, two nursing school graduates, and four experts. The topic and contents of the VR program were settled in the design phase. The VR program was developed and subsequently used and evaluated by 20 nursing students and four experts. @*Results@#The contents of the VR program for pediatric nursing practicums included the measurement of vital signs in a newborn baby and a young child, as well as an evaluation system. The mean score for the nursing students' satisfaction with practice was 4.02 out of 5 points. The mean scores for overall satisfaction with the VR program were 4.15 and 4.79 out of 5 points for nursing students and experts, respectively. @*Conclusion@#The VR program developed in this study allows nursing students to practice measuring vital signs in children, thus improving the students' clinical performance in pediatric nursing.

2.
Biomolecules & Therapeutics ; : 682-691, 2023.
Article in English | WPRIM | ID: wpr-999683

ABSTRACT

Cell transformation induced by epidermal growth factor (EGF) and 12-O-tetradecanoylphorbol-13-acetate (TPA) is a critical event in cancer initiation and progression, and understanding the underlying mechanisms is essential for the development of new therapeutic strategies. Licorice extract contains various bioactive compounds, which have been reported to have anticancer and anti-inflammatory effects. This study investigated the cancer preventive efficacy of licochalcone D (LicoD), a chalcone derivative in licorice extract, in EGF and TPA-induced transformed skin keratinocyte cells. LicoD effectively suppressed EGF-induced cell proliferation and anchorage-independent colony growth. EGF and TPA promoted the S phase of cell cycle, while LicoD treatment caused G1 phase arrest and down-regulated cyclin D1 and up-regulated p21 expression associated with the G1 phase. LicoD also induced apoptosis and increased apoptosis-related proteins such as cleaved-caspase-3, cleaved-caspase-7, and Bax (Bcl-2-associated X protein). We further investigated the effect of LicoD on the AKT signaling pathway involved in various cellular processes and found decreased p-AKT, p-GSK3β, and p-NFκB expression. Treatment with MK-2206, an AKT pharmacological inhibitor, suppressed EGF-induced cell proliferation and transformed colony growth. In conclusion, this study demonstrated the potential of LicoD as a preventive agent for skin carcinogenesis.

3.
Biomolecules & Therapeutics ; : 312-318, 2023.
Article in English | WPRIM | ID: wpr-999671

ABSTRACT

The natural flavonoid macakurzin C (1) exhibited adiponectin biosynthesis-inducing activity during adipogenesis in human bone marrow mesenchymal stem cells and its molecular mechanism was directly associated with a pan-peroxisome proliferator-activated receptor (PPAR) modulator affecting all three PPAR subtypes α, γ, and δ. In this study, increases in adiponectin biosynthesisinducing activity by macakurzin C derivatives (2–7) were studied. The most potent adiponectin biosynthesis-inducing compound 6, macakurzin C 3,5-dimethylether, was elucidated as a dual PPARα/γ modulator. Compound 6 may exhibit the most potent activity because of the antagonistic relationship between PPARδ and PPARγ. Docking studies revealed that the O-methylation of macakurzin C to generate compound 6 significantly disrupted PPARδ binding. Compound 6 has therapeutic potential in hypoadiponectinemia-related metabolic diseases.

4.
Korean Journal of Anesthesiology ; : 67-71, 2023.
Article in English | WPRIM | ID: wpr-967990

ABSTRACT

Background@#The tracheal bronchus in Kartagener syndrome is a rare case that may cause difficulty in one-lung ventilation (OLV). Here we reported a case of successful OLV using bronchial blocker in a patient with tracheal bronchus and Kartagener syndrome (KS).Case: A 66-year-old female patient with Kartagener syndrome was admitted for left-side diaphragmatic plication. The patient’s preoperative computed tomography image showed a tracheal bronchus of the apical segment in the right upper lobe. The patient received epidural analgesia and general anesthesia through total intravenous anesthesia. An EZ-Blocker® (Teleflex Life Sciences Ltd., Ireland) was used to perform OLV. @*Conclusions@#OLV through an EZ-Blocker® can be successfully performed in tracheal bronchus patients with Kartagener syndrome without side effects.

5.
Journal of Korean Medical Science ; : e333-2023.
Article in English | WPRIM | ID: wpr-1001203

ABSTRACT

Background@#Many studies have evaluated the prevalence of different reasons for retraction in samples of retraction notices. We aimed to perform a systematic review of such empirical studies of retraction causes. @*Methods@#The PubMed/MEDLINE database and the Embase database were searched in June 2023. Eligible studies were those containing sufficient data on the reasons for retraction across samples of examined retracted notices. @*Results@#A 11,181 potentially eligible items were identified, and 43 studies of retractions were included in this systematic review. Studies limited to retraction notices of a specific subspecialty or country, journal/publication type are emerging since 2015. We noticed that the reasons for retraction are becoming more specific and more diverse. In a meta-analysis of 17 studies focused on different subspecialties, misconduct was responsible for 60% (95% confidence interval [CI], 53–67%) of all retractions while error and publication issues contributed to 17% (95% CI, 12–22%) and 9% (95% CI, 6–13%), respectively. The end year of the retraction period in all included studies and the proportion of misconduct presented a weak positive association (coefficient = 1.3% per year, P = 0.002). @*Conclusion@#Misconduct seems to be the most frequently recorded reason for retraction across empirical analyses of retraction notices, but other reasons are not negligible. Greater specificity of causes and standardization is needed in retraction notices.

6.
Investigative Magnetic Resonance Imaging ; : 10-20, 2023.
Article in English | WPRIM | ID: wpr-1000622

ABSTRACT

Purpose@#To propose a novel standard magnetic resonance imaging (MRI) phantom, hereafter called the Korea Magnetic Resonance Phantom-4th edition (KMRP-4). Its related quality control (QC) assessment protocols and its comparison with the American College of Radiology (ACR) phantom and its QC assessment protocols. @*Materials and Methods@#Internally, the KMRP-4 phantom is composed of cubic and triangular vessels, brain tissue structures, and a uniform region designed to facilitate a variety of QC protocols. Using magnetic resonance (MR) images of these structures, we quantitatively evaluated a total of 10 parameters, seven from those of existing ACR protocols (i.e., geometric accuracy, high-contrast spatial resolution, slice thickness accuracy, slice position accuracy, image intensity uniformity, percent signal ghosting, and low-contrast object detectability) and three additional parameters for evaluating vessel conspicuity, brain tissue contrast, and signal-to-noise ratio (SNR) introduced in the KMRP-4 protocols. Twentytwo MRI systems of 0.32–3.0 T static magnetic field strength were tested using both ACR and KMRP-4 phantoms. Mann–Whitney U-tests were performed on the seven evaluation items of the ACR method to compare KMRP-4 and ACR methods. @*Results@#The results of Mann–Whitney U-test demonstrated that p-values were more than 0.05 for all seven items that could be assessed with both ACR and KMRP-4, indicating similar results between the two methods. Additionally, assessments of vessel conspicuity, brain tissue contrast, and SNR using the KMRP-4 method demonstrated utility of the KMRP-4 phantom. @*Conclusion@#A novel standard phantom and related QC methods were developed to perform objective, observer-independent, and semi-automatic QC tests. Quantitative comparisons of MR images with KMPR-4 and ACR phantoms were performed. Results demonstrated the utility of the newly proposed KMRP-4 phantom and its related QC methods.

7.
Korean Journal of Radiology ; : 159-171, 2022.
Article in English | WPRIM | ID: wpr-918218

ABSTRACT

Objective@#This study aimed to investigate the impact of baseline values and temporal changes in body composition parameters, including skeletal muscle index (SMI) and visceral adipose tissue area (VAT), measured using serial computed tomography (CT) imaging on the prognosis of operable breast cancers in Asian patients. @*Materials and Methods@#This study retrospectively included 627 Asian female (mean age ± standard deviation [SD], 53.6 ± 8.3 years) who underwent surgery for stage I–III breast cancer between January 2011 and September 2012. Body composition parameters, including SMI and VAT, were semi-automatically calculated on baseline abdominal CT at the time of diagnosis and follow-up CT for post-treatment surveillance. Serial changes in SMI and VAT were calculated as the delta values. Multivariable Cox regression analysis was used to evaluate the association of baseline and delta SMI and VAT values with disease-free survival. @*Results@#Among 627 patients, 56 patients (9.2%) had breast cancer recurrence after a median of 40.5 months. The mean value ± SD of the baseline SMI and baseline VAT were 43.7 ± 5.8 cm2 /m2 and 72.0 ± 46.0 cm2 , respectively. The mean value of the delta SMI was -0.9 cm2 /m2 and the delta VAT was 0.5 cm2 . The baseline SMI and VAT were not significantly associated with disease-free survival (adjusted hazard ratio [HR], 0.983; 95% confidence interval [CI], 0.937–1.031; p = 0.475 and adjusted HR, 1.001; 95% CI, 0.995–1.006; p = 0.751, respectively). The delta SMI and VAT were also not significantly associated with disease-free survival (adjusted HR, 0.894; 95% CI, 0.766–1.043; p = 0.155 and adjusted HR, 1.001; 95% CI, 0.989–1.014; p = 0.848, respectively). @*Conclusion@#Our study revealed that baseline and early temporal changes in SMI and VAT were not independent prognostic factors regarding disease-free survival in Asian patients undergoing surgery for breast cancer.

8.
Journal of the Korean Radiological Society ; : 230-238, 2022.
Article in English | WPRIM | ID: wpr-916900

ABSTRACT

Polyacrylamide gel (PAAG) has been used for augmentation mammoplasty in certain countries, such as China or Eastern European countries. However, owing to various complications, its use is currently banned in most countries. Nevertheless, because of the migratory stream of female from these countries, we also encounter patients with PAAG mammoplasty in Korea. Owing to the various imaging features of PAAG mammoplasty, it may interfere with the identification of malignancy or other pathologic conditions. Therefore, it is important to identify the imaging findings related to PAAG mammoplasty. However, there is limited literature on the radiologic findings of complications related to PAAG mammoplasty in Korea. Herein we report four cases of PAAG mammoplasty, the complications faced, and depict various radiologic features through multimodality imaging.

9.
Clinical Endoscopy ; : 77-85, 2022.
Article in English | WPRIM | ID: wpr-914028

ABSTRACT

Background/Aims@#Endoscopic submucosal dissection (ESD) of gastric tumors in the mid-to-upper stomach is a technically challenging procedure. This study compared the therapeutic outcomes and adverse events of ESD of tumors in the mid-to-upper stomach performed under general anesthesia (GA) or monitored anesthesia care (MAC). @*Methods@#Between 2012 and 2018, 674 patients underwent ESD for gastric tumors in the midbody, high body, fundus, or cardia (100 patients received GA; 574 received MAC). The outcomes of the propensity score (PS)-matched (1:1) patients receiving either GA or MAC were analyzed. @*Results@#The PS matching identified 94 patients who received GA and 94 patients who received MAC. Both groups showed high rates of en bloc resection (GA, 95.7%; MAC, 97.9%; p=0.68) and complete resection (GA, 81.9%; MAC, 84.0%; p=0.14). There were no significant differences between the rates of adverse events (GA, 16.0%; MAC, 8.5%; p=0.18) in the anesthetic groups. Logistic regression analysis indicated that the method of anesthesia did not affect the rates of complete resection or adverse events. @*Conclusions@#ESD of tumors in the mid-to-upper stomach at our high-volume center had good outcomes, regardless of the method of anesthesia. Our results demonstrate no differences between the efficacies and safety of ESD performed under MAC and GA.

10.
Ultrasonography ; : 718-727, 2022.
Article in English | WPRIM | ID: wpr-969214

ABSTRACT

Purpose@#This study evaluated how artificial intelligence-based computer-assisted diagnosis (AICAD) for breast ultrasonography (US) influences diagnostic performance and agreement between radiologists with varying experience levels in different workflows. @*Methods@#Images of 492 breast lesions (200 malignant and 292 benign masses) in 472 women taken from April 2017 to June 2018 were included. Six radiologists (three inexperienced [<1 year of experience] and three experienced [10-15 years of experience]) individually reviewed US images with and without the aid of AI-CAD, first sequentially and then simultaneously. Diagnostic performance and interobserver agreement were calculated and compared between radiologists and AI-CAD. @*Results@#After implementing AI-CAD, the specificity, positive predictive value (PPV), and accuracy significantly improved, regardless of experience and workflow (all P<0.001, respectively). The overall area under the receiver operating characteristic curve significantly increased in simultaneous reading, but only for inexperienced radiologists. The agreement for Breast Imaging Reporting and Database System (BI-RADS) descriptors generally increased when AI-CAD was used (κ=0.29-0.63 to 0.35-0.73). Inexperienced radiologists tended to concede to AI-CAD results more easily than experienced radiologists, especially in simultaneous reading (P<0.001). The conversion rates for final assessment changes from BI-RADS 2 or 3 to BI-RADS higher than 4a or vice versa were also significantly higher in simultaneous reading than sequential reading (overall, 15.8% and 6.2%, respectively; P<0.001) for both inexperienced and experienced radiologists. @*Conclusion@#Using AI-CAD to interpret breast US improved the specificity, PPV, and accuracy of radiologists regardless of experience level. AI-CAD may work better in simultaneous reading to improve diagnostic performance and agreement between radiologists, especially for inexperienced radiologists.

11.
Osong Public Health and Research Perspectives ; (6): 314-323, 2021.
Article in English | WPRIM | ID: wpr-918643

ABSTRACT

Objectives@#This study analyzed risk factors for suicidal ideation in South Koreans from a life cycle perspective. @*Methods@#A secondary analysis was conducted of data collected in 2015 as part of the 6th Korea National Health and Nutrition Examination Survey (KNHANES). The participants comprised 5,935 individuals aged 12 years or older. The statistical analysis reflected the complex sampling design of the KNHANES, and the Rao-Scott chi-square test and multiple logistic regression analysis were performed. @*Results@#The prevalence of suicidal ideation was 5.7% in adolescents, 3.7% in young adults, 5.4% in middle-aged adults, and 7.0% in older adults. Depression and stress were risk factors in every stage of the life cycle. In those aged 12 to 19 years, activity restrictions were significantly associated with suicidal ideation. Education and subjective health status were risk factors in adults aged 20 to 39 years, and education, activity restrictions, and quality of life were the major risk factors in those aged 40 to 64 years. For adults 65 years of age or older, the risk of suicidal ideation was higher among those with inappropriate sleep time. @*Conclusion@#The risk factors for suicidal ideation were found to be different across stages of the life cycle. This suggests a need for individualized suicide prevention plans and specific government policies that reflect the characteristics of each life cycle stage.

12.
Endocrinology and Metabolism ; : 1277-1286, 2021.
Article in English | WPRIM | ID: wpr-914237

ABSTRACT

Background@#The detrimental effects of excessive thyroid hormone on glucose metabolism have been widely investigated. However, the risk of diabetes in patients with long-standing hyperthyroidism, especially according to treatment modality, remains uncertain, with few longitudinal studies. @*Methods@#The risk of diabetes in patients with Graves’ disease treated with antithyroid drugs (ATDs) for longer than the conventional duration (≥2 years) was compared with that in age-and sex-matched controls. The risk was further compared according to subsequent treatment modalities after a 24-month course of ATD: continuation of ATD (ATD group) vs. radioactive iodine ablation (RIA) group. @*Results@#A total of 4,593 patients were included. Diabetes was diagnosed in 751 (16.3%) patients over a follow-up of 7.3 years. The hazard ratio (HR) for diabetes, after adjusting for various known risk factors, was 1.18 (95% confidence interval [CI], 1.10 to 1.28) in patients with hyperthyroidism. Among the treatment modality groups, the RIA group (n=102) had a higher risk of diabetes than the ATD group (n=4,491) with HR of 1.56 (95% CI, 1.01 to 2.42). Further, the risk of diabetes increased with an increase in the ATD treatment duration (P for trend=0.019). @*Conclusion@#The risk of diabetes was significantly higher in patients with long-standing Graves’ disease than in the general population, especially in patients who underwent RIA and prolonged ATD treatment. Special attention to hyperglycemia during follow-up along with effective control of hyperthyroidism may be necessary to reduce the risk of diabetes in these patients.

13.
Cancer Research and Treatment ; : 1134-1147, 2021.
Article in English | WPRIM | ID: wpr-913794

ABSTRACT

Purpose@#Chemotherapy-related cognitive impairment (CRCI) is a controversial concept not much explored on colorectal cancer patients. @*Materials and Methods@#We identified 11 prospective studies: eight studies on 696 colorectal cancer patients who received chemotherapy and three studies on 346 rectal cancer patients who received neoadjuvant chemoradiotherapy. Standardized mean differences (SMDs) of neuropsychological test results and the cognitive quality-of-life scale were calculated using random effect models. A meta-regression was conducted to investigate the association between mean study population age and effect sizes. @*Results@#The association between chemotherapy and cognitive impairment was not clear in colorectal cancer patients (SMD, 0.003; 95% confidence interval, ‒0.080 to 0.086). However, a meta-regression showed that older patients are more vulnerable to CRCI than younger patients (β=‒0.016, p < 0.001). @*Conclusion@#Chemotherapy has an overall positive negligible effect size on the cognitive function of colorectal patients. Age is a significant moderator of CRCI.

14.
Journal of the Korean Radiological Society ; : 173-181, 2021.
Article in English | WPRIM | ID: wpr-875128

ABSTRACT

Purpose@#To evaluate the ability of the Hounsfield unit (HU) measurement of the femoral neck during multidetector computed tomography (MDCT) for assessing osteoporosis compared with dual-energy X-ray absorptiometry (DXA). @*Materials and Methods@#Forty-two patients with femoral neck fractures who underwent MDCT and DXA from July to December 2016 were included in this study. HU measurements were made of the cancellous portions of the normal contralateral femoral neck on MDCT. Bone mineral density (BMD) and T-scores were obtained at the femur DXA. Correlations of HU values with BMD and T-scores were analyzed using Spearman’s correlation test. @*Results@#The mean BMD and T-score of the femoral neck were 0.650 g/cm2 and -2.4, respectively. The mean HU values for the normal, osteopenia, and osteoporosis groups were 131.9, 98.9, and 41.3, respectively. HU values at the femoral neck were positively correlated with BMD (r2 = 0.670; p < 0.001) and T-scores (r 2 = 0.676; p < 0.001). @*Conclusion@#The HU values of the femoral neck on MDCT are significantly correlated with BMD and T-scores of femur DXA. The HU values may serve as a diagnostic tool for the screening of regional bone quality when MDCT is performed for other reasons.

15.
Journal of the Korean Ophthalmological Society ; : 29-35, 2021.
Article in Korean | WPRIM | ID: wpr-875080

ABSTRACT

Purpose@#To compare eyelid heating efficacy according to the type and the method of use of eyelid warm compress products commercially available in South Korea. @*Methods@#For six healthy adults, three types of eyelid warm compresses were worn for 10 minutes and the temperature of the product surface, external upper lid, external lower lid, and internal lower lid were measured every 2 minutes. The average of the measured values was divided into four groups according to the type of product (Moist Heat Eye Compress®, Megrythm Steam Eye Mask®, Nurieye-5900®-High Temperature Mode [H], Nurieye-5900®-Low Temperature Mode [L]) and were compared. @*Results@#Eyelid temperature showed a significant difference between each group after the first 2 minutes of treatment (p < 0.000). In the Moist Heat Eye Compress® group, the temperature of the external upper lid was maintained above 38°C until 6 minutes and the remaining groups did not exceed 38°C. The temperature of the inner lower lid was maintained at 37°C or higher for 10 minutes in the Moist Heat Eye Compress® use group and exceeded 37°C at 6 minutes in the Megrythm Steam Eye Mask® use group. The remaining groups did not exceed 37°C. @*Conclusions@#For the external eyelid, only the Moist Heat Eye Compress® group were heated above 38°C. For the inner lower lid, Moist Heat Eye Compress® and Megrythm Steam Eye Mask® groups were heated above 37°C, showing a higher heating effect. Further studies are required on the effects of the three warm compress products in patients with Meibomian gland dysfunction.

16.
Journal of Korean Academic Society of Nursing Education ; : 29-38, 2021.
Article in Korean | WPRIM | ID: wpr-874705

ABSTRACT

Purpose@#The purpose of this study was to describe the meaning of incivility experienced by nursing students in relations with nurses during clinical practice. @*Methods@#This is a descriptive qualitative study that included thirty participants using convenience sampling in universities in S, J, Ch, and C provinces. Data saturation was achieved and methodological rigor was established. Qualitative content analysis was used to inductively determine categories. @*Results@#The four categories derived from analysis were ‘left alone at clinical field’, ‘treated as an assistant’, ‘not respected as a person’ and ‘ignored future dreams’. @*Conclusions@#Nursing students continue to carry out repetitive, low-risk tasks, for which they are not properly trained due to the lack of practical guidance in clinical practice. During clinical practice, they are not respected as persons by nurses and are negatively influenced by nurse professionals. A solution to this requires organic cooperation and policy preparation at universities and hospital sites to improve practical training of nursing students.

17.
Sleep Medicine and Psychophysiology ; : 34-42, 2021.
Article in English | WPRIM | ID: wpr-903401

ABSTRACT

Objectives@#This study investigated sleep quality in female full-time homemakers and evaluated the relationship of sleep disturbance with psychological and socio-environmental factors. @*Methods@#This cross-sectional study adopted a structured survey and sequential recruitment method for randomized participation of community-dwelling full-time female homemakers. Sleep quality and mental health were measured using the Korean version of the Pittsburgh Sleep Quality Index (K-PSQI), Korean version of the Beck Depression Inventory-II (K-BDI-II), Korean version of the Beck Anxiety Inventory (K-BAI), and Korean version of the Beck Hopelessness Scale (K-BHS). The willingness-to-pay (WTP) method was selected to measure the self-evaluated monetary value of household service work. The relationship among the main relevant factors was statistically analyzed through a mediation model. @*Results@#A total of 166 participants were analyzed and classified having poor versus good sleep quality (poor : 24.1%, n = 40 ; good : 75.9%, n = 126 ; cut-off point = 9 on the K-PSQI). Significant between-group differences were observed in mental health status (K-BDI-II, p < 0.001 ; K-BAI, p < 0.001 ; K-BHS, p = 0.003). The moderated mediation model was verified, indicating that depression may mediate the association between nurturing burden and sleep disturbance. The path from nurturing burden to depression may be moderated by average monthly household income. @*Conclusion@#A relatively high portion of full-time female homemakers may suffer from sleep disturbance and interactions between psychological and socio-environmental factors might determine sleep quality, suggesting the need for public health policies targeting improvement of sleep quality and mental health among full-time homemakers.

18.
Journal of the Korean Radiological Society ; : 889-902, 2021.
Article in English | WPRIM | ID: wpr-901315

ABSTRACT

Purpose@#To assess the diagnostic performance of contrast-enhanced ultrasound (CEUS) for additional MR-detected enhancing lesions and to determine whether or not kinetic pattern results comparable to dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) of the breast can be obtained using the quantitative analysis of CEUS. @*Materials and Methods@#In this single-center prospective study, a total of 71 additional MR-detected breast lesions were included. CEUS examination was performed, and lesions were categorized according to the Breast Imaging-Reporting and Data System (BI-RADS). The sensitivity,specificity, and diagnostic accuracy of CEUS were calculated by comparing the BI-RADS category to the final pathology results. The degree of agreement between CEUS and DCE-MRI kinetic patterns was evaluated using weighted kappa. @*Results@#On CEUS, 46 lesions were assigned as BI-RADS category 4B, 4C, or 5, while 25 lesions category 3 or 4A. The diagnostic performance of CEUS for enhancing lesions on DCE-MRI was excellent, with 84.9% sensitivity, 94.4% specificity, and 97.8% positive predictive value. A total of 57/71 (80%) lesions had correlating kinetic patterns and showed good agreement (weighted kappa = 0.66) between CEUS and DCE-MRI. Benign lesions showed excellent agreement (weighted kappa = 0.84), and invasive ductal carcinoma (IDC) showed good agreement (weighted kappa = 0.69). @*Conclusion@#The diagnostic performance of CEUS for additional MR-detected breast lesions was excellent. Accurate kinetic pattern assessment, fairly comparable to DCE-MRI, can be obtained for benign and IDC lesions using CEUS.

19.
Journal of Korean Medical Science ; : e57-2021.
Article in English | WPRIM | ID: wpr-899988

ABSTRACT

Background@#We compared early and 2-year clinical outcomes of sutureless aortic valve replacement (SAVR) with conventional aortic valve replacement (CAVR) in a nationwide study based on claims data. @*Methods@#From December 2016 to November 2018, 3,173 patients underwent bioprosthetic aortic valve replacements. SAVR and CAVR were performed in 641 and 2,532 patients, respectively. Propensity score-matched analysis was performed in 640 patient pairs. @*Results@#Operative mortality rate was 2.8% without significant differences between the SAVR (3.4%) and CAVR (2.3%) groups (P = 0.324). There were no significant differences in postoperative morbidities between the groups except for permanent pacemaker (PPM) implantation. PPM implantation rate was significantly higher in the SAVR (3.8%) than in the CAVR group (0.9%) (P < 0.001). One- and two-year overall survival was 89.1% and 87.5%, respectively, without significant differences between the groups (SAVR group vs. CAVR group = 89.9% and 90.5% vs. 87.2% and 88.7%, respectively; P = 0.475). There were no significant differences in the cumulative incidence of cardiac death, stroke, aortic valve reoperation and infective endocarditis between the groups. Cumulative PPM implantation incidence at 6 months in the CAVR was 1.1%, and no patient required PPM implantation after 6 months. In the SAVR, the cumulative PPM implantation incidence at 0.5, one, and two years was 3.9%, 5.0% and 5.6%, respectively. The cumulative PPM implantation rate was higher in the SAVR group than in the CAVR group (P < 0.001). @*Conclusion@#Early and 2-year clinical outcomes between SAVR and CAVR were not different except for a high rate of permanent pacemaker implantation in the SAVR group.

20.
Journal of Korean Medical Science ; : e163-2021.
Article in English | WPRIM | ID: wpr-899932

ABSTRACT

Background@#This study aimed to evaluate the performance of the Society of Thoracic Surgeons (STS) risk model and European System for Cardiac Operative Risk Evaluation (EuroSCORE) II for patients undergoing anaortic off-pump coronary artery bypass grafting (OPCAB). @*Methods@#From January 2010 to June 2017, 1,048 patients (isolated anaortic OPCAB: 1,043, on-pump conversion:5) undergoing isolated anaortic OPCAB were enrolled. The STS risk score and EuroSCORE II were calculated with dedicated online software. Calibration of the models were performed by the risk-adjusted event ratio that was defined as observed events divided by expected events (O/E ratio) and Hosmer-Lemeshow test. The discrimination powers were evaluated by the area under the receiver operating characteristic curve (AUC). @*Results@#Operative mortality occurred in 10 patients (0.95%). The predicted mortality rates by the EuroSCORE II and STS risk model were 2.58 ± 4.15% and 1.72 ± 2.92%, respectively. The O/E ratio of the EuroSCORE II was 0.370 with significant overprediction of operative mortality (confidence interval [CI], 0.157–0.652; P = 0.003). The STS score also overpredicted the operative mortality (O/E ratio, 0.556) with marginal significance (CI, 0.266–1.023; P = 0.052). Permanent stroke occurred in 6 patients (0.53%). The predicted permanent stroke occurrence rate was 1.73 ± 1.48%. The O/E ratio was 0.332 with significant overprediction of permanent stroke (CI, 0.121–0.722; P = 0.011). Regarding discrimination power for the STS risk model, the operative mortality was excellent (AUC, 0.876) and permanent stroke was acceptable (AUC, 0.740). The EuroSCORE II showed good discrimination power (AUC, 0.784). There was a significant difference in discrimination power for mortality between STS and EuroSCORE II risk models (P = 0.007). @*Conclusion@#Preexisting risk predicting scoring systems, STS risk model and EuroSCORE II, overpredict the risk of mortality and stroke rate for anaortic OPCAB. These findings suggest the possibility that anaortic OPCAB can lower the operative mortality and occurrence of postoperative stroke than conventional coronary artery bypass grafting.

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