• Title/Summary/Keyword: 요인들

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Study on the utilization of the industrial waste materials and the briquette ash as mixing materials for the concrete Products (콘크리트 製品製造에 産業廢棄物과 연탄재의 利用에 關한 硏究)

  • Kim, Seong-Wan
    • Magazine of the Korean Society of Agricultural Engineers
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    • v.21 no.4
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    • pp.99-107
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    • 1979
  • In order to investigate the utilization of industrial waste and briquette ash for concrete production, briquette ash was used as fine aggregate for mortar production and three different kinds mortars were produced by mixing carbide and bottom aches with cement. These products were compared with mortar, produced by standard sand, in the respects of compressive, tensil and bending strengths. Further study on the economic aspect of utilization of briquette ash is needed but the results obtained from our preliminary study are summarized as follows : 1. The compressive strengths at the age of seven days of mortars, made of one to two ratios of cement to briquette ash, (cement+carbide ash) to briquette ash and(cement+bottom ash) to briquette ash were 70%, 61% and 58%, respectively, of the mortar made of standard sand. The compressive strengths of those mortars at the age of 28 days were 56%, 49% and 48% of the mortar made standard sand. 2. The compressive strengths at the age of seven days of the mortar made of one to two ratios of cement to briquette ash, (cement+carbide ash) to briquette ash and (cement+bottom ash) to briquette ash were 84%, 73%, and 70% of the mortar which was produced according to Korean Standard Value. The compressive strengths of those mortars at the age of 28 days were 85%, 73% and 73% of the mortar of the Korean Standard value. 3. The tensil strengths at the age of seven days of the mortars made of one to two ratios of cement to briquette ash, (cement+carbide ash) to briquette ash, and (cement+bottom ash) to briquette ash were 64%, 36%, and 36%, respectively, of the mortar of standard sand. The tensil strengths of those mortars at the age of 28 days were 70%, 47%, and 39%, respectively, of the standard mortar. The mortars made of one to two ratios of cement to briquette ash at the age of seven and 28 days were higher than the mortars of Korean Standard. The other mortars were 61 to 62% at the age of seven days and 75 to 90% at the age of 28 days of the Korean Standard mortar, respectively. 4. The bending strengths at the age of seven days of mortar made of one to two ratios of cement to briquette ash, (cement+carbide ash) to briquette ash, and (cement+bottom ash) to briquette ash were 46%, 53% and 50% of the mortar of standard sand. The bending strengths of those mortars at the age of 28 days were 90%, 77% and 69%, respectively of the mortar of standard sand. 5. The mortar of briquette ash which was lower in strengths compared with the mortar of cement have shown possibility of its secondary products of cement and concrete. The uses of briquette ash and industrial waste as construction materials would contribute toward solving various pollution problems caused by industrial wastes and saving labor costs needed to cleaning up. Furthermore, the effective use of briquette ash would greatly save the aggregate resources.

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Health Assessment of the Nakdong River Basin Aquatic Ecosystems Utilizing GIS and Spatial Statistics (GIS 및 공간통계를 활용한 낙동강 유역 수생태계의 건강성 평가)

  • JO, Myung-Hee;SIM, Jun-Seok;LEE, Jae-An;JANG, Sung-Hyun
    • Journal of the Korean Association of Geographic Information Studies
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    • v.18 no.2
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    • pp.174-189
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    • 2015
  • The objective of this study was to reconstruct spatial information using the results of the investigation and evaluation of the health of the living organisms, habitat, and water quality at the investigation points for the aquatic ecosystem health of the Nakdong River basin, to support the rational decision making of the aquatic ecosystem preservation and restoration policies of the Nakdong River basin using spatial analysis techniques, and to present efficient management methods. To analyze the aquatic ecosystem health of the Nakdong River basin, punctiform data were constructed based on the position information of each point with the aquatic ecosystem health investigation and evaluation results of 250 investigation sections. To apply the spatial analysis technique, the data need to be reconstructed into areal data. For this purpose, spatial influence and trends were analyzed using the Kriging interpolation(ArcGIS 10.1, Geostatistical Analysis), and were reconstructed into areal data. To analyze the spatial distribution characteristics of the Nakdong River basin health based on these analytical results, hotspot(Getis-Ord Gi, $G^*_i$), LISA(Local Indicator of Spatial Association), and standard deviational ellipse analyses were used. The hotspot analysis results showed that the hotspot basins of the biotic indices(TDI, BMI, FAI) were the Andong Dam upstream, Wangpicheon, and the Imha Dam basin, and that the health grades of their biotic indices were good. The coldspot basins were Nakdong River Namhae, the Nakdong River mouth, and the Suyeong River basin. The LISA analysis results showed that the exceptional areas were Gahwacheon, the Hapcheon Dam, and the Yeong River upstream basin. These areas had high bio-health indices, but their surrounding basins were low and required management for aquatic ecosystem health. The hotspot basins of the physicochemical factor(BOD) were the Nakdong River downstream basin, Suyeong River, Hoeya River, and the Nakdong River Namhae basin, whereas the coldspot basins were the upstream basins of the Nakdong River tributaries, including Andong Dam, Imha Dam, and Yeong River. The hotspots of the habitat and riverside environment factor(HRI) were different from the hotspots and coldspots of each factor in the LISA analysis results. In general, the habitat and riverside environment of the Nakdong River mainstream and tributaries, including the Nakdong river upstream, Andong Dam, Imha Dam, and the Hapcheon Dam basin, had good health. The coldspot basins of the habitat and riverside environment also showed low health indices of the biotic indices and physicochemical factors, thus requiring management of the habitat and riverside environment. As a result of the time-series analysis with a standard deviation ellipsoid, the areas with good aquatic ecosystem health of the organisms, habitat, and riverside environment showed a tendency to move northward, and the BOD results showed different directions and concentrations by the year of investigation. These aquatic ecosystem health analysis results can provide not only the health management information for each investigation spot but also information for managing the aquatic ecosystem in the catchment unit for the working research staff as well as for the water environment researchers in the future, based on spatial information.

An Exploratory Study on Channel Equity of Electronic Goods (가전제품 소비자의 Channel Equity에 관한 탐색적 연구)

  • Suh, Yong-Gu;Lee, Eun-Kyung
    • Journal of Global Scholars of Marketing Science
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    • v.18 no.3
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    • pp.1-25
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    • 2008
  • Ⅰ. Introduction Retailers in the 21st century are being told that future retailers are those who can execute seamless multi-channel access. The reason is that retailers should be where shoppers want them, when they want them anytime, anywhere and in multiple formats. Multi-channel access is considered one of the top 10 trends of all business in the next decade (Patricia T. Warrington, et al., 2007) And most firms use both direct and indirect channels in their markets. Given this trend, we need to evaluate a channel equity more systematically than before as this issue is expected to get more attention to consumers as well as to brand managers. Consumers are becoming very much confused concerning the choice of place where they shop for durable goods as there are at least 6-7 retail options. On the other hand, manufacturers have to deal with category killers, their dealers network, Internet shopping malls, and other avenue of distribution channels and they hope their retail channel behave like extensions of their own companies. They would like their products to be foremost in the retailer's mind-the first to be proposed and effectively communicated to potential customers. To enable this hope to come reality, they should know each channel's advantages and disadvantages from consumer perspectives. In addition, customer satisfaction is the key determinant of retail customer loyalty. However, there are only a few researches regarding the effects of shopping satisfaction and perceptions on consumers' channel choices and channels. The purpose of this study was to assess Korean consumers' channel choice and satisfaction towards channels they prefer to use in the case of electronic goods shopping. Korean electronic goods retail market is one of good example of multi-channel shopping environments. As the Korea retail market has been undergoing significant structural changes since it had opened to global retailers in 1996, new formats such as hypermarkets, Internet shopping malls and category killers have arrived for the last decade. Korean electronic goods shoppers have seven major channels : (1)category killers (2) hypermarket (3) manufacturer dealer shop (4) Internet shopping malls (5) department store (6) TV home-shopping (7) speciality shopping arcade. Korean retail sector has been modernized with amazing speed for the last decade. Overall summary of major retail channels is as follows: Hypermarket has been number 1 retailer type in sales volume from 2003 ; non-store retailing has been number 2 from 2007 ; department store is now number 3 ; small scale category killers are growing rapidly in the area of electronics and office products in particular. We try to evaluate each channel's equity using a consumer survey. The survey was done by telephone interview with 1000 housewife who lives nationwide. Sampling was done according to 2005 national census and average interview time was 10 to 15 minutes. Ⅱ. Research Summary We have found that seven major retail channels compete with each other within Korean consumers' minds in terms of price and service. Each channel seem to have its unique selling points. Department stores were perceived as the best electronic goods shopping destinations due to after service. Internet shopping malls were perceived as the convenient channel owing to price checking. Category killers and hypermarkets were more attractive in both price merits and location conveniences. On the other hand, manufacturers dealer networks were pulling customers mainly by location and after service. Category killers and hypermarkets were most beloved retail channel for Korean consumers. However category killers compete mainly with department stores and shopping arcades while hypermarkets tend to compete with Internet and TV home shopping channels. Regarding channel satisfaction, the top 3 channels were service-driven retailers: department stores (4.27); dealer shop (4.21); and Internet shopping malls (4.21). Speciality shopping arcade(3.98) were the least satisfied channels among Korean consumers. Ⅲ. Implications We try to identify the whole picture of multi-channel retail shopping environments and its implications in the context of Korean electronic goods. From manufacturers' perspectives, multi-channel may cause channel conflicts. Furthermore, inter-channel competition draws much more attention as hypermarkets and category killers have grown rapidly in recent years. At the same time, from consumers' perspectives, 'buy where' is becoming an important buying decision as it would decide the level of shopping satisfaction. We need to develop the concept of 'channel equity' to manage multi-channel distribution effectively. Firms should measure and monitor their prime channel equity in regular basis to maximize their channel potentials. Prototype channel equity positioning map has been developed as follows. We expect more studies to develop the concept of 'channel equity' in the future.

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A Study on Satisfaction and Evaluation of Students현 Spot-Practice in Department of Food and Nutrition (식품영양학과 학생들의 현장실습 만족도 및 평가도에 관한 연구)

  • 최미경;전예숙;홍원주;김순경;김동희;김애정;강명화;김미현
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.33 no.2
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    • pp.373-380
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    • 2004
  • The purpose of this study was to estimate satisfaction and evaluation degree of students' spot-practice in department of food and nutrition and to investigate relating factors to them for development of spot-practice Programme. The survey for analysis was conducted through the questionnaires to 229 students finished internship. Proportions of the students were 93.9% for senior, 93.9% for female. Proportions of spot-practice facilities were 38.9%, 46.7%, and 14.4% for school, business & industry, and hospital respectively. The major part of subjects (83.8%) took part in spot-practice during 2 weeks. The satisfaction scores to spot-practice were the lowest for pay, and the highest for a kind of spot-practice facilities. The evaluation scores were the lowest for 'I made a plan and prepared my work in advanced', and the highest for 'I did my best for doing my work'. The satisfaction score in hospital was significantly lower than those in school or business & industry. The satisfaction score in self-operated foodservice was significantly higher than that in contract managed one. However, there no significant differences in evaluation scores by foodsevice employment type. In the case of coincidence of area in spot-practice and residence, or facilities of spot-practice and job desired, the satisfaction and evaluation scores were significantly higher than those of others. The period of spot-practice was significantly positively correlated with satisfaction scores for atmosphere of spot-practice facilities, service and treatment for spot-practice student, while negatively correlated with evaluation score for 'I did my best for doing my work'. The spot-practice pay was significantly positively correlated with satisfaction and evaluation scores for various items. In conclusion, various factors are related to satisfaction and evaluation degree of spot-practice students, and consist concern and support from college St university, foodservice institution, and government for systematic spot-Practice are required.

A Study on the Expressed Desire at Discharge of Patients to Use Home Nursing and Affecting Factors of the Desire (퇴원환자의 가정간호 이용의사와 관련 요인)

  • Lee, Ji-Hyun;Lee, Young-Eun;Lee, Myung-Hwa;Sohn, Sue-Kyung
    • The Korean Journal of Rehabilitation Nursing
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    • v.2 no.2
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    • pp.257-270
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    • 1999
  • The purpose of this study is to investigate factors related to the intent of using home nursing of chronic disease patients who got out of a university hospital. For the purpose, the study selected 153 patients who were hospitalized and left K university hospital with diagnoses of cancer, hypertension, diabetes and cerebral vascular accident and ordered to be discharged and performed interviews with them and surveys on their medical records to obtain the following results. For this study a direct-interview survey and medical record review was conducted from June 28 to Aug. 30, 1998. The frequency and mean values were computed to find the characteristics of the study subjects, and $X^2$-test, t-test, factor analysis and multiple logistic regession analysis were applied for the analysis of the data. The following results were obtained. 1) When characteristics of the subjects were examined, men and women occupied for 58.8% and 41.2%, respectively. The subjects were 41.3 years old in aver age and had the monthly aver age earning of 0.99 million won or below, which was the most out of the total subjects at 34.6%. Among the total, 87.6% resided in cities and 12.4 in counties. The most left the hospital with diagnosis of cancer at 51.6%, followed by hyper tension at 24.2%, diabetes at 13.7% and cerebral vascular accident at 7.2%. 2) 93.5% of the selected patients had the intent of using home nursing and 6.5%, didn't. Among those patients having the intent, 85.6% had the intent of paying for home nursing and 14.4%, didn't. The subjects expected that the nursing would be paid 9,143 won in aver age and 47.7% of them preferred national authorities as the main servers. 86.3% of the subjects thought that home nursing business had the main advantage of making it possible to learn nursing methods at home and thereby contributing to improving the ability of patients and their facilities to solve health problems. 3) Relations between the intent of use and characteristics of the subjects such as demography-related social, home environment, disease and physical function characteristics did not show statistically significant differences among one another. Compared to those who had no intent of using home nursing, the group having the intent had more cases of male patients, the age of 39 or below, residence in cities, 5 family member s or more, no existence of home nursing servers, leaving the hospital from a non-hospitalized building, disease development for five months or below, hospitalization for ten days or more, non-hospitalization with in the recent one month, two times or over of hospitalization, leaving the hospital with no demand of special treatment, operation underwent, poor results of treatment, leaving the hospital with demand of rehabilitation services, physical disablement and high evaluation point of daily life. 4) Among those patients having the intent of using home nursing, 47.6% demanded technical nursing and 55.9%, supportive nursing. As technical nursing,' inject into a blood vessel ' and 'treat pustule and teach basic prevention methods occupied for 57.4%, respectively, topping the list. Among demands of supportive nursing, 'observe patients 'status and refer them to hospitals or community resources as available, if necessary' was the most with percent age point of 59.5. Regarding the intent of paying for home nursing, 39.2% of those patients wishing to use the nursing responded paying for technical services and 20.2, supportive services. In detail, 70.0% wanted to pay for a service stated as 'inject into a blood vessel', highest among the former services and 30.7%, a service referred to as 'teaching exercises needed to make the body of patients move', highest among the latter. When this was analyzed in terms of a relation between the need(the need for home nursing) and the demand(the intent of paying for home nursing), The rate of the need to the demand was found two or three times higher in technical nursing(0.82) than in supportive nursing(0.35). In aspects of tech ical nursing, muscle injection(1.26, the 1st rank) was highest in the rate while among aspects of supportive nursing, a service referred to as 'teach exercises needed for making patients move their bodies normally'(0.58, the 1st rank). 5) factors I(satisfaction with hospital services), II(recognition of disease state), III(economy) and IV(period of disease) occupied for 34.4, 13.8, 11.9 and 9.2 percents, respectively among factors related to the intent by the subjects of using home nursing, totaled 59.3%. In conclusion, most of chronic disease patients have the intent of using hospital-based home nursing and satisfaction with hospital services is a factor affecting the intent most. Thus a post-management system is needed to continue providing health management to those patients after they leave the hospital. Further, supportive services should be provided in order that those who are satisfied with hospital services return to their community and live their in dependent lives. Based on these results, the researcher would make the following recommendation. 1) Because home nursing becomes more and more needed due to a sharp increase in chronic disease patients and elderly people, related rules and regulations should be made and implemented. 2) Hospital nurses specializing in home nursing should be cultivated.

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A Survey on the Dietary Behavior of High School Students -About Regularity of Meal and Number of Meal Per Day- (남녀 고등학생의 식생활태도에 관한 조사 -식사의 규칙성과 1일 식사횟수에 대하여-)

  • Kim, Geum-Ran;Kim, Mi-Jung
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.40 no.2
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    • pp.183-195
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    • 2011
  • This study was conducted to investigate dietary behavior patterns of high school students. As for regularity of meal, female students were significantly more regular than those of the male students in a day. They answered 'between 4th and 6th grades in elementary school' as 'the time for formation about number of meal intake'. As for a highly influential meal, males were higher answered 'lunch (41.0%)' while females were higher answered 'breakfast (39.8%)'. About 'number of meals per day by the grade', they ate 3 times per day mostly. As for the time for formation about number of meal intake: 'before 4th to 6th in elementary school'> 'before elementary school'. In the result of regularity of meal and general characteristics, a family of 5 was higher in regularity and those with pocket money showed lower regularity in meal. As for the person who prepares a meal, mothers prepared meals regularly. Also, higher parents age and education level resulted in more regularity in meals. In number of meals per day and general characteristics, they were eating 3 times; moreover, this trend was evident as parents' age and education level and the household income was higher. Students answered generally regularity in meal in family where parents' jobs were administrative assistant (father job (56.9%)) and housewife (mother (56.9%). In the formation time of meal intake number and general characteristics, they answered order 'middle school'> 'before elementary school'. A highly influential meal, they answered as the highest 'lunch' (37.6%). This study may provide information on dietary behavior of high school students, suggesting that nutrition education or counseling can improve food habits and develop positive behavior.

Relationship between Broca Index of Late School-Aged Children and Their Mothers' Eating, Cooking, and Exercise Habit (어머니의 식습관, 요리습관 및 운동습관과 학령기 후기 아동의 Broca 체질량지수와의 상관관계 연구)

  • Lee, Hyerim;Lee, Kyoung-Eun;Ko, Kwang Suk;Hong, Eunah
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.45 no.10
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    • pp.1488-1496
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    • 2016
  • The purposes of this study were to analyze mothers' eating, cooking, and exercise habits based on their demographic characteristics and to examine the relationship between those habits and their late school-aged children's Broca index. A total of 393 questionnaires were mailed to the mothers of late school-aged children who registered at four elementary schools in the Seoul area, of which 159 participants (40.0%) completed questionnaires. Statistical data analyses were performed using SPSS/Win 21.0 for descriptive statistics, t-test ANOVA, and Pearson's regression coefficient. There was a statistically significant difference in mothers' cooking habit (F=3.920, P=0.022) and exercise habit (F=3.211, P=0.043) according to their educational level. Interestingly, 82.4% of mothers had a Broca index of less than 90% of normal body mass level. A significant positive correlation of Broca index between mothers and their late school-aged children (r=0.345, P<0.001) indicated that children whose mothers had a low body mass level also tended to have a low body mass level. In this study, late school-aged children's Broca index was not significantly related with mother's eating (r=-0.072, P=0.367) or exercise habits (r=-0.010, P=0.897) but was significantly related with their mother's cooking habits (r=-0.157, P=0.048). Considering there are few studies examining the impacts of mother's cooking habits on their children's appropriate body mass, the results suggest that developing an effective educational program to cultivate mothers' healthy cooking habits to improve school-aged children's health status is very important. The findings of this study provide important data that could be used when developing health education programs tailored to the multi-dimensional impacts of mothers' life habits on their last school-aged children's developmental health status.

A Clinical and Pathological Analysis of Children with Membranoproliferative Glomerulonephritis According to the Clinical Manifestations at Presentation (발견 양상에 따른 소아 막증식성 사구체신염의 임상적 및 병리조직학적분석)

  • Jeon Chang-Ho;Kang Mi-Seon;Chung Woo-Yeong
    • Childhood Kidney Diseases
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    • v.8 no.2
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    • pp.186-194
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    • 2004
  • Purpose: Membranoproliferative glomeulonephritis(MPGN) has been diagnosed in an increasing number of asymptomatic cases. These cases have been detected by school urinary screening test even though the total cases of MPGN show a decreasing trend. We have analyzed the clinical and pathological characteristics of children with MPGN according to the clinical manifestations at the time of disease presentation. Methods: A total of 18 patients who had been diagnosed with idiopathic MPGN by percutaneous renal biopsy from January 1990 to February 2004 were involved in our study. The patients were divided into 2 groups as the school urinary screening(A) group and the symptomatic(S) group according to the clinical manifestations at the time of disease presentation. Results: Out of the total 18 patients, 8(44.4%) were in the S group and 10(55.6%) were in the A group. The mean serum total protein, albumin and $C_3$ levels in the S group were significantly lower than those levels of the A group, respectively($4.9{\pm}1.2\;g/dL,\;vs\;7.0{\pm}0.5\;g/dL\;P=0.002,\;2.8{\pm}0.9\;g/dL\;vs.\;4.1{\pm}0.3\;g/dL\;P=0.002,\;63.9{\pm}36.4\;mg/dL\;vs.\;100.8{\pm}39.5\;g/dL\;P=0.041$). The mean total protein amount of 24 hour collected urine in the S group were significantly higher than that of the A group($3684.0{\pm}2601.3\;mg/m^2\;vs.\;559.4{\pm}4.6.9\;mg/m^2$, respectively, P=0.001). Hypocomplementemia was observed in 11(61.1%) out of 18 patients at the time of disease onset, 7(87.5%) in the S group and 4(40%) in the A group. However the hypocomplementemia was decreased in 6(33.3%) out of 18 patients at the time of final follow-up, 3(37.5%) in the S group and 3(30%) in the A group. According to the pathologic type, hypocomplementemia was observed 8 patients(61.5%) with type I disease, 1 patients (100%) with type II disease, 2 patients(50%) in type III disease at the disease onset, but 4 patients(30.8%) in type I disease, 1 patient(100%) in type II disease, 1 patient(33.3%) with type III disease at the time of last follow-up. The incidence of cellular crescent formation and tubular atropy. as observed on light microscopy, were higher in the S group compared to the A group. Mean grade of capillary wall thickening and, mesangial proliferation were significantly higher in the S group. Conclusion: MPGN, as diagnosed in patients with only asymptomatic urinary abnormalities, has been increasing, it is more frequent in asymptomatic patients than in patients with presenting symptoms. Our result suggests that MPGN should be considered in the renal biopsy diagnosis regardless of serum $C_3$ level when urinary abnormalities are found by school urinary screening test.

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Community-based Helicobacter pylori Screening and its Effects on Eradication in Patients with Dyspepsia (지역사회에서 소화불량 환자의 Helicobacter pylori 감염에 대한 집단검진 및 치료효과)

  • Kim, Seong-Ho;Hong, Dae-Yong;Lee, Kyeong-Soo;Kim, Seok-Beom;Kim, Sang-Kyu;Suh, Jeong-Ill;Kim, Mee-Kyung;Kang, Pock-Soo
    • Journal of Preventive Medicine and Public Health
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    • v.33 no.3
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    • pp.285-298
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    • 2000
  • Objectives : To investigate the positive rate of Helicobacter pylori in patients with dyspepsia; medical compliance and related factors; the eradication rate a year after screening and related factors; the relationship between the eradication of Helicobacter pylori and the improvement of symptoms; and the estimated cost of three alternative approaches to treat Helicobacter pylori in the community. Methods : A total of 510 subjects with dyspeptic symptoms were selected and given the serological test in March 1998. The subjects were all adults over 30 years of age residing in Kyongju city. Results : Of the 510 selected subjects, 375 (73.5%) subjects proved positive for Helicobacter pylori on serological testing. Of these 304 (81.1%) who consented to an endoscopic examination, underwent a Campylobacter-like organism (CLO) test. Of these 304 subjects, 204 (67.1%), who had positive CLO test results, were given the triple therapy - tripotassium dicitrato bismuthate, amoxicillin, and metronidazole. To determine the eradication rate of Helicobacter pylori, 181 (88.1%) out of the 204 subjects who were given the triple therapy completed a follow-up urea breath test one year later. Of these, the Helicobacter pylori of 87(48.1%) subjects was eradicated. Among the 122 subjects who were medication compliant, the Helicobacter pylori eradication rate was 57.4% (70 subjects), while the eradication rates was only 28.8% (17subjects) in the non-compliant group. The Helicobacter pylori eradication was significantly related to compliance (p<0.01), but not to other characteristics and habits. The symptom improvement rate tended to be higher 62.1%), in the Helicobacter pylori eradicated group than in the non-eradicated group (59.6%). Conclusions : When the advantages and disadvantages of each alternative treatment were considered in the light of cost, antibiotic tolerance and the number of patients to be treated, alternative II was favorable in terms of cost. Alternative III was favorable in terms of the number of patients to be treated, antibiotic tolerance and early detection of gastric cancer. Further long-term research analyzing the cost-benefit and cost-effectiveness of each treatment will be needed as supporting material in creating new policies.

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Prognosis Factors of Tricuspid Regurgitation after the Operation for Left-sided Valvular Heart Disease (좌심실 판막질환 수술 후 동반된 삼첨판패쇄부전증의 경과에 영향을 미치는 요인)

  • Jin, Ung;Kim, Hwan-Wook;Lee, Jong-Ho;Kweon, Jong-Bum;Jo, Min-Seop;Yoon, Jeong-Seob;Moon, Seok-Whan;Sim, Sung-Bo;Park, Kuhn;Kim, Chi-Kyung;Cho, Keon-Hyun;Wang, Young-Pil;Lee, Sun-He;Kwack, Moon-Sub
    • Journal of Chest Surgery
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    • v.36 no.3
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    • pp.150-156
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    • 2003
  • Tricuspid regurgitation has been considered as a secondary lesion when it is combined with left valvular heart diseases. However, there have been some reports which show that tricuspid regurgitation keeps going and results in congestive heart failure even after a successful operation for left valvular heart disease. So far, there are no definite operation indications and predictive factors for the tricuspid re-gurgitation which is resulted from the left sided valvular heart disease. We designed this study to evaluate the effects of pulmonary artery pressure and left ventricular ejection fraction on the prognosis of tricuspid regurgitation, and to make an operation indication for the patients with secondary tricuspid regurgitation. Material and Method: We reviewed the medical records of patients who underwent surgery for the left sided valvular heart disease with tricuspid regurgitation and were followed for more than 1 year with echocardiograms. There was a total of 114 cases. We compared the grades of tricuspid regurgitations and pulmonary artery pressures and left ventricular ejection fractions on the basis of echocardiograms which were checked preoperatively and on the last follow up. Result: There were 43 cases of tricuspid an-nuloplasty. In these patients, the grades of tricuspid regurgitations were improved in 42 cases (97.7%). But in 71 cases without annuloplasty, 29 cases (41%) were improved, 32 cases (45%) had no change, and 29 cases (14%) were aggravated. This finding shows significant differences in the prognoses of tricuspid regur-gitations between the two groups (p<0.05). There was no difference in pulmonary artery pressures and ejection fractions between the patients who showed progression of tricuspid regurgitations and those who didn't (p > 0.05). The improvements of tricuspid regurgitations are not statistically related to the changes of pulmonary artery pressures or left ventricular ejection fractions. Conclusion: This study shows that it is impossible to predict the prognoses of tricuspid regurgitations with preoperative pulmonary artery pressures or left ventricular ejection fractions. Also, the excellent results of tricuspid annuloplasty is proven in controlling the secondary tricuspid regurgitations. Therefore, when tricuspid regurgitation is detected preoperatively, the procedures to correct the tricuspid regurgitation at the time of the operation for the left-sided valvular heart disease must be considered positively, regardless of the grades of tricuspid regurgitations, to prevent sig-nificant tricuspid regurgitation that may develop later.