Park Jong Un;Shin Yoon Cheol;Kim Eung-Jung;Chee Hyun Keun
Journal of Chest Surgery
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v.39
no.2
s.259
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pp.91-98
/
2006
Background: There are many different opinions regarding the proximal anastomotic sites of radial artery in coronary artery bypass surgery. Therefore, we compared the clinical and angiographic findings according to anastomosis of radial artery to develop a guideline. Material and Method: From January 2003 to December 2004, 48 patients who underwent coronary artery bypass surgery using radial artery in Kangdong Sacred Heart Hospital were studied for clinical and coronary angiographic findings and were divided into group I for radial artery that anastomsed to aorta independently and group II that anastomosed to left internal mammary artery. Result: Patients in group I were 33 (men 26, women 7; mean age 61.93$\pm$6.56) and group II were 15 (men 13, women 2; mean age 59.53$\pm$6.02) and there was no difference in preoperative characteristics. Patients in group I had longer cardiopulmonary bypass time (169.36$\pm$40.28 versus 139.40$\pm$20.45, p=0.026) and patients in group II had more sequential grafts with RA per patients (5/33 versus 11/15, p < 0.05). Patients in group I used more vein graft for distal anatstomosis (47/117 ($40\%$) versus 9/48 ($18\%$), p=0.011) and there was no difference in perioperative outcome and overall survival. Mean follow-up time was 15.87$\pm$7.33 (1 to 28) months in patients of the group I and 21.40$\pm$2.85 (17 to 25) months in group II. Postoperative coronary angiography was performed 17/33 ($51.5\%$) in group I and 14/15 ($93.3\%$) in group II. Early perfect patency rate was not statistically different in left anterior descending artery (15/17 ($88.2\%$) versus 2/14 ($85.7\%$), p=1.00) and radial artery (17/20 ($85\%$) versus 30/30 ($100\%$), p=0.058). Late mortality was 1/33 ($3.0\%$) in group I and 1/15 ($6.7\%$) in group II. Conclusion: There was no difference in terms of clinical and postoperative angiographic findings except in cardiopulmonary bypass time, the number of sequential grafts with the RA per patients and the number of the used vein graft.
Kim, Woo-Jeong;Kim, Min-Young;Chang, Weon-Young;Choi, Jae-Hyuck
Journal of Hospice and Palliative Care
/
v.13
no.3
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pp.153-160
/
2010
Purpose: The purpose of the present study was to investigate needs and satisfaction on the medical services of cancer patients in Jeju Special Self-Governing Province. Methods: Total 174 cancer patients, who visited at the clinic of Jeju National University Hospital, submitted informed consent and participated in this study from July 13 to July 30, 2009. Self questionnaire was used and data were analyzed with Kolmogorov-Smirnov test, Mann-Whitney U test, ANOVA, and Kruskal-Wallis test. Results: Participants expressed the needs of most economical support (3.38 out of 4), followed by counseling of treatment plan (3.22), information of disease (3.07), and disease management except cancer (2.97). Participants were satisfied most with religious counseling (3.41), followed by nursing service support (3.39), employment counseling (3.26), and counseling for family or interpersonal relationships (3.26). The satisfaction of economical support was the lowest (1.98). Satisfaction of men was higher than women, and needs in patients who were living with children was the highest. Patients who were living alone or with children showed the lowest satisfaction about the medical services. There were no significant differences in the general characteristics, however, participants who were older than 60 years of age or had higher income showed lower needs and higher satisfaction. There were no significant differences in the medical characteristics, however, thyroid cancer patients and patients who were treated with radiation therapy or transarterial embolization showed low satisfaction. Conclusion: Cancer patients seemed to need more economical support, information of treatment or disease, and symptom management. Furthermore, there were various needs about the services, depending on family formation or economical support of patients. Therefore, it is certain that patients who were suffering from other cancers, except the 5 major cancers, needed more services. In conclusion, continuous and systemic policy to consider patient's characteristics and needs are needed in community as well as health care system.
This study aimed to examine earnings quality of firms selected as Global Champs project which has been promoted by the government since 2013 to support small and medium sized enterprises, for the screening year(t-1) and selected year(t). Earing quality is measured as the value of discretionary accruals estimated by Dechow et al.(1995) adjusted Jones model and Kothari et al.(2005) model, respectively. I analyze the differences of earning quality between the Global Champ firms and the paired firms selected through criteria of the similar total assets and the same industry in the screening year and the selected year. This study is motivated by the needs of measurement of the performance of the Project from the accounting transparent point of view. As the results of this study, major findings are summarized as follows. Firstly the earnings quality of the selected firms was lower than that of the paired firms. This can be explained as a result of motivation of earnings management by companies eager to meet the requirements to be selected for the Project. Secondly, in the selected year, the earnings quality was proved to improve, comparing to the screening year. This can be explained by the efforts of companies to reinforce management innovation and transparent management, which in turn led to positive effects on the earnings quality. These findings were found to be consistent in the additional analyses, where the earning quality of the reconstructed sample with only selected companies was compared for the screening year and the selected year, based on the year before the screening year(t-2).
Kim, Doo-Sup;Yoon, Yeu-Seung;Yi, Chang-Ho;Woo, Ju-Hyung;Rah, Jung-Ho
Clinics in Shoulder and Elbow
/
v.15
no.2
/
pp.130-137
/
2012
Purpose: To evaluate and report the clinical outcome after surgical treatment of intra-articular comminuted fracture of distal humerus in the elderly with osteoporosis. Materials and Methods: From January 2007 to October 2009, 24 patients aged older than 65 years with intra-articular comminuted fracture of distal humerus underwent surgical treatment. 18 patients (Group I) were managed using primary open reduction and internal fixation (OR IF) through the modified posterior approach and 6 patients (Group II) were taken primary total elbow arthroplasty. The average follow up period was 17.2 months. According to the AO classification, there were 8 C2, 16 C3 type fractures. All enrolled patients were evaluated radiographically and clinically. Clinical outcomes were assessed with the Mayo Elbow Performance, Disabilities of Arm and Shoulder and Hand, and Musculoskeletal Functional Assessment functional questionnaires. Results: The bony union was observed in 18 patients in group I at average 14 weeks. There were 2 patients with neurapraxia of whom the ulnar nerve symptom did not improve despite of anterior transposition. And non-union at osteotomy sites was seen in 2 patients. The mean Mayo Elbow Performance score was 87.0. The mean DASH score was 32.4. The average arc of elbow flexion was $121.0^{\circ}$ (range, $95{\sim}145^{\circ}$) with mean flexion-contracture of $12.0^{\circ}$ (range, 0 to 35). 6 patients in Group II showed no complication during follow up periods. The mean Mayo Elbow Performance score was 89.1. The mean DASH score was 44.3. The average arc of elbow flexion was $125.1^{\circ}$ (range, $100{\sim}145^{\circ}$) with mean flexion-contracture of $12.6^{\circ}$ (range, 0 to 30). Conclusions: With careful patient selection, Total elbow arthroplasty as well as OR IF could achieve good outcomes in elderly of comminuted intra-articular distal humerus fracture with osteoporosis.
Purpose: A dedifferentiated chondrosarcoma is a rare lethal tumor characterized by a low grade chondrosarcoma juxtaposed with a high grade dedifferentiated sarcoma, such as osteosarcoma, fibrosarcoma. The aim of our study was to document the clinical manifestation and oncologic outcomes of a dedifferentiated chondrosarcoma. Materials and Methods: This study identified 11 patients who were diagnosed and treated for dedifferentiated chondrosarcoma between January 2007 and December 2016. The identified cohort was then reviewed regarding age, sex, symptom onset, tumor location, magnetic resonance imagings (MRIs), surgical margin, and pathologic diagnosis. The time to local recurrence and/or metastasis, follow-up duration, and the patients' final status were analyzed. Results: The patients were comprised of 7 males and 4 females with a mean age of 54 years (range, 33-80 years). The location of the tumor was in the femur in 6 cases, pelvis in 4 cases, and metatarsal in 1 case. The average tumor diameter was 12.7 cm (range, 6.0-26.1 cm). At the time of diagnosis, 2 patients showed pathologic fracture; 1 patient was Enecking stage IIA, 9 patients were stage IIB, and 1 patient was stage III. Eight patients were classified as a primary dedifferentiated chondrosarcoma and 3 patients were secondary. One of the primary lesions was misinterpreted initially as a low grade chondroid lesion by MRI and underwent curettage. Local recurrence occurred in 8 cases and distant metastasis occurred in 10 cases with a mean duration of 8 months (range, 2-23 months) and 7 months (range, 1-32 months), respectively. The three-year overall survival of patients with dedifferentiated chondrosarcoma was 18%, and 10 patients died due to disease progression. Conclusion: Dedifferentiated chondrosarcoma developed lung metastases in the early period of the clinical courses and the prognosis was dismal.
In contrast to the increase in demand for high quality healthcare, there is limited medical human resources such as doctors and nurses so an excessive amount of workload is being forced to them. Therefore, a patient monitoring system using USN(Ubiquitous Sensor Network) is becoming a solution. This paper proposes a patient monitoring system applying USN in maternity hospital to reduce the workload of nurses. According to the efficiency evaluation test based on the model of two university hospitals(S, K University Hospital) and their doctor's diagnosis, the results showed that under the circumstances that one nurse is in charge of 12 patients(6 normal delivery patients and 6 cesarean delivery patients), a total of 1,260 minutes of workload was saved during hospitalization period(5 days). Also, we compared the workload of nurses with or without our proposed system, and the figures showed that in case of normal delivery patients, the workload of nurses decreased by 50 minutes per patient, whereas in case of cesarean delivery patients, the workload of nurses decreased by 130 minutes per patient.
Mandible defects could be caused by congenital malformations, trauma, osteomyelitis, tumor resection. If large areas are included for reconstruction, those are primarily due to tumor resection defects. The large jaw defect results in a problem about mastication, swallowing, occlusion and phonetics, and poor esthetics causes a lot of inconvenience in daily life. It is almost impossible to be a part underwent mandibular resection completely reproduced, should be rebuilt artificially. This case is of a patient who was diagnosed with squamous cell carcinoma pT1N0M0, stage I in February 2004 and received surgery (combined mandibulectomy and neck dissection operation (COMMANDO) in oromaxillofacial surgery) in March 2004, by implant assisted removable partial denture. We could obtain good retention and stability through sufficient coverage and implant holding. Follow up period was about four years. Mandibular left third molar regions have been observed to have resorption of surrounding bone, and periodic check-ups are necessary conditions.
Purpose : To evaluate the efficacy of radiotherapy for the low-grade astrocy-tomas and confirm the variables influencing treatment results. Materials and Methods : Forty-six patients with low-grade astrocytoma received radiotherapy after surgical removal (36 patients) or biopsy (10 patients) from 1979 to 1990. Twenty patients had grade I histology and 26 had grade II. External radiotherapy was done by conventional schedule with the total dose of 45 to 60 Gy (median: 54 Gy). The median follow-up period was 5 years. Results : The 2- and 5-year survival rates were $80\%$ and $72\%$, respectively and the 2- and 5-year progression-free survival was $75\%$ and $63\%$, respectively. The survival was influenced significantly by the histologic grade, the histologic type, and performance status. Major complication was not found. Conclusion: In spite of good survival, the local failure was still the major problem. Age and the extent of surgery as well as three favorable factors should be considered in the future treatments.
Transactions of the Korean Society of Mechanical Engineers B
/
v.36
no.11
/
pp.1081-1090
/
2012
This study aims to track the longitudinal alteration pattern on the trabecular bone microarchitecture at tibial epiphysis induced by T-OA over time using in vivo micro computed tomography (${\mu}CT$). Ten SD rats were divided into control (n = 5) and T-OA (n = 5) groups. Anterior cruciate ligament transaction was performed for the T-OA group. The results showed that the alteration pattern on the trabecular bone microarchitecture at tibial epiphysis in the T.OA group was definitely different compared with that in the CON group from 0 to 8 weeks (approximately 4-16%, P > 0.05). In particular, a difference was observed in the bone formation and density distributions over time (from 0 or 4 to 8 weeks; approximately 5.15%, P < 0.05). An improved understanding of the alteration pattern on the trabecular bone microarchitecture at tibial epiphysis may assist in developing more targeted treatment interventions for T-OA.
Ahn Sung Ja;Chung Woong Ki;Nam Taek Keun;Nah Byung Sik
Radiation Oncology Journal
/
v.10
no.2
/
pp.181-186
/
1992
A retrospective analysis was undertaken for 22 patients with early glottic cancer ($T_1N_0M_0$; 17, $T_2N_0M_0$; 5) who completed curative radiotherapy at the Department of Therapeutic Radiology, Chonnam University Hospital between November 1985 and December 1990. Median follow-up period was 39 months. The 3 year actuarial survival rate of T1, T2 was $81\%$ and $80\%$. respectively. Three patients ($13\%$) showed second malignant tumors and the site of the new primary was esophagus in two patients and lung in the other one. They were excluded from the local control analysis. The local control rate of T1. T2 group was $66\%$ and $50\%$. respectively. The surgical salvage rate and the ultimate local control rate of T1 group was $80\%$ (4/5) and $93\%$. and that of T2 group was $100\%\;(2/2)\;and\;75\%$. respectively. The local control rates of T1 stage were evaluated according to the various parameters. The local control rate of the superficial and exophytic lesion was better than that of the ulcerative and infiltrative one, and the involvement of anterior commissure was not seemed to be adverse prognostic factor. But the protracted treatment time showed the adverse effect on the local control of the disease. All of the eleven patients controlled by primary radiation therapy have maintained their voice well without any significant complication.
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