From August 1986 until June 1995, single aortic valve replacement was performed in 65 patients at the Chonnam National University Hospital. worthy-eight were male and 17 were female patients, ranging from 19 to 68 years of age(median : 43 years). The causes of the valve lesions were rheumatic in 29 patients (44.6%), bicuspid aortic valve in 6 patients (6.2%), endocarditis in 6 patients(6.2%), unknown in others. Concomitant surgical procedures were performed in 10 patients : repair of congenital defect in 5, pericardiectomy in 1, coronary artery bypass grafting in 1, noncoronary sinus plication in 1, Valsalva sinus aneurysmectomy in 1, subaortic membrane resection in 1 Used valves were 51. Jude-Medical valve in 42, Duromedics valve in 22, Bjork-Shiley valve in 2, Carpentier-Edward valve in 1. There were 3 hospital deaths (4.6%), and 2 late deaths (3.2%). Follow-up was 95.2% complete. The 10-year acturlal survival rate was 85.3%. Postoperative complications were low cardiac utput in 8, arrythmia in 5, valve related hemolysis in 1, cerebral infarction in 1, and gastrointestinal bleeding in 2. Reoperation was performed in 4 for surgical bleeding, in 3 for paravalvular leak. The mean improvement in New York Heart Association functional class is from 2.79 $\pm$ 0.66 preoperatively to 1.25 $\pm$ 0.49 postoperatively(p < 0.001) The change of cardiothoracic ratio from preoperative to postoperative is 0.57 $\pm$ 0.06 to 0.54 $\pm$ 0.05 (p < 0.05). The left ventricular ejection fraction change is not significant perioperatively. There are no mechanical failures. This early and intermediate-term follow-up suggests that in adults in whom valve repair is not possible, the mechanical valve is a reliable and durable prosthesis with good hemodynamic function and a low rate of thromboembolic event.
Journal of the Korea Academia-Industrial cooperation Society
/
v.17
no.3
/
pp.599-610
/
2016
This paper reports the results of a systematic review (SR) and meta-analysis research to compare the effect of Kangaroo care, targeting mothers and premature infants. A randomized clinical trial study was performed until February 2015. The domestic literature contained the non-randomized clinical trial research without restriction according to the level of the study design. A search of the Ovid-Medline, CINAHL, PubMed and KoreaMed, the National Library of KOREA, the National Assembly Library, NDSL, KISS and RISS. Through the KMbase we searched and combined the main term ((kangaroo OR KC OR skin-to-skin) AND (care OR contact)) AND (infant OR preterm OR Low Birth Weight OR LBW), ((kangaroo OR kangaroo OR kangaroo) AND (care OR nursing care OR management OR skin contact)) was made; these were all combined with a keywords search through the selection process. They were excluded in the final 25 studies (n=3051). A methodology checklist for randomized controlled trials (RCTs) designed by SIGN (Scottish Intercollegiate Guidelines Network) was utilized to assess the risk of bias. The overall risk of bias was regarded as low. In 16 studies that were evaluated as a grade of "++", 9 studies were evaluated as a grade of "+". As a result of meta-analysis, kangaroo care regarding the effects of premature mortality, severe infection/sepsis had an insignificant effect. Hyperthermia incidence, growth and development (height and weight), mother-infant attachment, hypothermia incidence, length of hospital days, breast feeding rate, sleeping, anxiety, confidence, and gratification of mothering role were considered significant. In satisfaction of the role performance, depression and stress presented contradictory research results for individual studies showing overall significant difference. This study has some limitations due to the few RCTs comparing kangaroo care in the country. Therefore, further RCTs comparing kangaroo care should be conducted.
Background. Limited ischemic tolerance of the lung has remained one of the factors that limits the expansion of pulmonary transplantation as a treatment for end-stage pulmonary disease. Numerous studies on safe long term preservation for lung transplantation has been performed for the purpose of developing ideal preservation solution with extracellular type or intracellular type solutions. In this. study, we examined the efficacy of L DG solution in lung preservation longer than 20 hours by comparison with modified Euro-Collins solution. Iwethods. Thirty-(our adult mongrel dogs were divided into two groups. Donor lungs were flushed with LPDG solution(n=9) or modified Euro-Collins(MEC) solution(n=8) and stored for 24 hours at 1$0^{\circ}C$. All donor lungs were perfused through the pulmonary arteries with solutions containing prostaglandin El and verapamil. Left canine lung allotransplantations wereperformed. Assessment(hemodynamic indices and arterial blood gas analysis) of left implanted lung was made by occluding the right pulmonary artery for ten minutes using pulmonary artery Cuff. Assessment was repeated at the interval of 30 minutes, one hour, and two hours later after reperfusion and then chest X-ray, computed tomogram and lung perfusion scan were obtained. In survival dogs follow-up studies were done with assessment with chest X-ray, computed tomogram of the chest and lung perfusion scan on 7th day postoperatively. After preservation above 20 hours, pathological examinations for ultrastructural findings on right lung were performed in each group. Results. With respect to arterial oxygen tension, LPDG group was superior to MEC but there was no statistical significance for 2 hours after reperfusion. Mean pulmonary artery pressure was less increased(p < 0.05) and cardiac output higher(p <0.05) than MEC group until 2 hours after reperfusion. After 2 hours of reperfusion, both groups showed transplanted lung function deteriorated gradually. Perfusion scan of the transplanted lung in LPDG group showed better perfusion rate in immediate post-reperfusion, 3 days and 7 days later respectively but there was no statistical significance and corelation with PaO2 and computed tomoRravhic views. In scanning electron microscopy of pulmonary artery after preservation, LPDG group relatively shows less irregular protrusion of the inner surface of endothelial cell of poulmonary artery than MEC group. Conclusions, e concluded that LPDG solution can offer safe lung preservation above 20 hours with adequate immunosuppressive therapy and prevention of the infection.
The advantages of mitral valve reconstruction have been well established and so mitral valve reconstruction is now considered as the procedure of choice to correct mitral valve disease. This is the report of intermediate-term results of 38 cases that performed mitral valve reconstruction for valve insufficiency(the total number of mitral valve reconstruction were 49 cases, but 11 cases that performed mitral valve replacement due to incomplete reconstruction were excluded). Material and Method : From March 1991 to March 2001, 38 patients underwent mitral valve repair due to mitral valve regurgitation with or without stenosis. Mean age was 47.6$\pm$14.7 years(range 15 to 70 years) : 11 were men and 27 were women. The causes of mitral valve regurgitation were degenerative in 14, rheumatic in 21, infective in 2 and the other was congenital. Result : According to the Carpentier's pathologic classification of mitral valve regurgitation, 3 were type 1 , 16 were type II and 19 were type III. Surgical procedures were annuloplasty 15, commissurotomy 19, leaflet resection and annular plication 9, chordae shortening 11, chordae transfer 5, new chordae formation 2, papillary muscle splitting 2 and vegetectomy 2. These procedures were combined in most patients. There were 2 early death and the causes of death were respiratory failure, renal failure and sepsis. There was no late death. Valve replacement was done in 6 patients after repair due to valve insufficiency or stenosis 3 weeks, 1, 3, 51, 69, 84months later respectively. These patients have been followed up from 1 to 116 months(mean 43.0 months). The mean functional class(NYHA) was 2.36 pre-operatively and improved to 1.70. Conclusion : In most cases of mitral valve regurgitation, mitral valve reconstruction when technically feasible is effective operation that can achieve stable functional results and low surgical and late mortality.
This study is to investigate consequent nutrient intake status, Influences of body mass index (BMI) and serum lipid composition, and fat distribution on the cocoon hydrolysate, green tea leaves and dietary fiber supplementation. During 2 months of this research (April to May, 2002), 47 women aged 20 yr-30 yr (average age 26.2 yr) were selected as subjects. Nutrient intake was investigated by questionnaire and 24-hr recall method. Antropometric assessments of the subjects were investigated by SBIA method (Segmental bioimpedance assay, Inbody 3.0). The results were as follows: mean body weight was 60.7 kg, mean body height 161.7 cm and mean BMI 23.4. Status of energy intakes significantly decreased (p<0.01) and dietary fiber intakes significantly increased (p<0.001) after supplementation. BMI and WHR (waist-hip ratio) significantly decreased (p<0.01) and body fat significantly decreased after supplementation (p<0.001). Total cholesterol and LDL-cholesterol significantly decreased after supplementation (p<0.05). HDL-cholesterol was negatively correlated with BMI and WHR (p<0.01). LDL/HDL ratio was positively correlated with BMI (p<0.01) and WHR (p<0.05). Above results of this study show that low-molecule peptide, green tea leaves and dietary fiber supplementation-added routine diet improves lessening body fat distribution, total cholesterol, LDL-cholesterol. Especially, decrease of abdominal fat and WHR were notable. That meant decrease of risk factors.
In this study, microbial investigation is accomplished for 554 Jeot-kal samples(102 of Jeot-kal, 448 of Seasoned Jeot-kal and 4 of Sik-khe, respectively) that corresponds with Coliform-bacteria, Escherichia coli, Aerobic live bacteria as hygienic indicator microorganisms, and Staphylococcus aureus, Vibrio parahaemolyticus as Food-borne pathogenic microorganisms, Based on the methods in Korea Food Code, reliable data are obtained as follows; in 31.9% rate of the samples, Coliform bacteria are verified in the extent of $0{\sim}20,000$ CFU/g as 2.3 logCFU/g. Especially, Seasoned Jeot-kal(37.7%,2.3 logCFU/g) are detected to 6 and 2 folds higher than those of Jeot-kal, 5.9% and 1.4 logCFU/g. Likewise, Escherichia coli is detected from 9 samples only in Seasoned Jeot-kal, that includes seasoned squid, seasoned octopus, seasoned roe of pollack, seasoned large-eyed herring and seasoned hairtail. Aerobic live bacteria are also detected in the range of $0{\sim}8.9{\times}10^8CFU/g$. Against salinity, E. coli are detected in samples only less than 10% salinity. Concomitantly, aerobic live bacteria count is decreased to $5.5{\sim}3.6$ log CFU/g upon the salinity is increased up to 25%. However, S. aureus and V. parahaemolyticus are not detected in 554 samples, presumptively referring Jeot-kal products are somehow free from such food-borne pathogens. As the results above, we deliberately consider that the sanitary control in Jeot-kal, which be necessarily fermented- as well as non-microbially inactivated should be ensured in near future and also suggest an effectual microbial standard corresponding to the Negativity in E. coli for Jeot-kal products.
Chu, Mi Ae;Choi, Byung Ho;Choi, Hee Joung;Kim, Yeo Hyang;Kim, Gun Jik;Cho, Joon Yong;Hyeon, Myung Chul;Lee, Sang Bum
Clinical and Experimental Pediatrics
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v.52
no.2
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pp.194-198
/
2009
Purpose : Active perioperative intervention and improvement on surgical technique has decreased the mortality rate of total anomalous pulmonary venous connection (TAPVC); however, when complicated with pulmonary venous obstruction, operative mortality is still high. The purpose of this study was to investigate the clinical course of TAPVC. Methods : Twenty-seven patients who were diagnosed with TAPVC (without other complex heart anomalies) by echocardiogram at Kyungpook National University Hospital from January 1994 to February 2008 were included. Results : Mean age at diagnosis was $28.1{\pm}33.4$ days (1-126 days). Sites of drainage were supracardiac type (15), cardiac (6), infracardiac (5), and mixed (1). Seven patients had pulmonary venous obstruction: 5 with supracardiac type, 1 with cardiac, and 1 with infracardiac. Intraoperative trans-esophageal echocardiograms were performed in 14 patients (58.3%). The operative mortality was 16.7% (4 of 24) and overall hospital mortality (including deaths without operation) was 22.2% (6 of 27). There were 5 postoperative pulmonary venous obstructions. The sites of obstruction were anastomotic in 3 of 5 (60%) patients, and ostial pulmonary vein in the other 2 (40%) patients. Three patients who presented with anastomotic pulmonary venous obstruction underwent reoperation, but all the patients were found to have pulmonary venous anastomotic obstruction. The other 2 patients with ostial pulmonary vein obstruction who had no significant symptoms were diagnosed by routine echocardiographic examination during follow-up. Conclusion : In TAPVC patients, early diagnosis and aggressive surgical management will improve prognosis, and we must pay attention to early and late pulmonary vein restenosis through intraoperative trans-esophageal echocardiogram and peri- and post-operative echocardiographic follow-up examinations.
Journal of the Korea Academia-Industrial cooperation Society
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v.18
no.1
/
pp.262-268
/
2017
The energy consumption of buildings is approximately 20.5% of the total energy consumption, and the interest in energy efficiency and low consumption of the building is increasing. Several studies have performed energy analysis and evaluation. Energy analysis and evaluation are effective when applied in the initial design phase. In the initial design phase, however, the energy performance is evaluated using general level information, such as glazing area and surface area. Therefore, the evaluation results of the detailed design stage, which is based on the drawings, including detailed information of the materials and facilities, will be different. Thus far, most studies have reported the analysis and evaluation at the detailed design stage, where detailed information about the materials installed in the building becomes clear. Therefore, it is possible to improve the accuracy of the energy environment analysis if the energy environment information generated during the life cycle of the building can be established and accurate information can be provided in the analysis at the initial design stage using a probability / statistical method. On the other hand, historical data on energy use has not been established in Korea. Therefore, this study performed energy environment analysis to construct the energy environment historical data. As a result of the research, information classification system, information model, and service model for acquiring and providing energy environment information that can be used for building lifecycle information of buildings are presented and used as the basic data. The results can be utilized in the historical data management system so that the reliability of analysis can be improved by supplementing the input information at the initial design stage. If the historical data is stacked, it can be used as learning data in methods, such as probability / statistics or artificial intelligence for energy environment analysis in the initial design stage.
Purpose: The purpose of the study was to identify teacher's knowledge about sodium, dietary behaviors related to sodium, attitudes towards a low-salt diet, and meal attitude guidance as well as examine the relationship between these variables. Methods: The participants were 351 teachers at an elementary school in the Jeonbuk area. The data were analyzed using ANOVA, Duncan test, and Pearson correlation coefficients with SPSS v. 20.0. Results: The score for teachers' knowledge about sodium was 12.92 points of a possible 16, the score for dietary behavior related to sodium was 46.85 points of a possible 70, and the score for attitude towards a low-salt diet was 33.63 points of a possible 50. Their score for meal attitude guidance was 59.95 points of a possible 80. The knowledge showed significant differences by hypertension drug (p < 0.05) and stress level (p < 0.05). The dietary behavior of sodium use showed significant differences by gender (p < 0.01), work experience (p < 0.05), BMI (p < 0.01), drinking (p < 0.05), concern about health (p < 0.05), and stress level (p < 0.05). The attitude towards a low-salt diet showed significant differences by gender (p < 0.05), marital status (p < 0.05), work experience (p < 0.05), drinking (p < 0.05), concern about health (p < 0.001), and stress level (p < 0.05). Meal attitude guidance showed a significant difference by marital status (p < 0.001), age (p < 0.001), work experience (p < 0.001), drinking (p < 0.01), regularity of health checkup (p < 0.001), concern about health (p < 0.001), and stress level (p < 0.05). There was a low positive correlation between knowledge about sodium and dietary behavior related to sodium as well as between dietary behavior related to sodium and attitudes towards a low-salt diet. Attitudes towards a low-salt diet showed a positive correlation with meal attitude guidance. Conclusion: Therefore, it is necessary to consider educational programs on increasing knowledge and attitudes towards a low-salt diet in teachers for improvement of meal attitude guidance activities for students.
This study is therefore aimed at measuring the surface dose rate and the spatial dose rate in and outside the radionuclide facility in order to ensure safety of the patients, radiation workers and family care-givers in their use of such equipment and to provide a basic framework for further research on radiation protection. The study was conducted at 4 restrooms in and outside the radionuclide facility of a general hospital in Incheon between May 1 and July 31, 2014. During the study period, the spatial contamination dose rate and the surface contamination dose rate before and after radiation use were measured at the 4 places-thyroid therapy room, PET center, gamma camera room, and outpatient department. According to the restroom use survey by hospitals, restrooms in the radionuclide facility were used not only by patients but also by family care-givers and some of radiation workers. The highest cumulative spatial radiation dose rate was 8.86 mSv/hr at camera room restroom, followed by 7.31 mSv/hr at radioactive iodine therapy room restroom, 2.29 mSv/hr at PET center restroom, and 0.26 mSv/hr at outpatient department restroom, respectively. The surface radiation dose rate measured before and after radiation use was the highest at toilets, which are in direct contact with patient's excretion, followed by the center and the entrance of restrooms. Unsealed radioactive sources used in nuclear medicine are relatively safe due to short half lives and low energy. A patient who received those radioactive sources, however, may become a mobile radioactive source and contaminate areas the patient contacts-camera room, sedation room, and restroom-through secretion and excretion. Therefore, patients administered radionuclides should be advised to drink sufficient amounts of water to efficiently minimize radiation exposure to others by reducing the biological half-life, and members of the public-family care-givers, pregnant women, and children-be as far away from the patients until the dose remains below the permitted dose limit.
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