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Coronary Fistulas -20 years experience - (관상동맥루)

  • Lee Jeong Ryul;Jung Yo Chun;Choi Chang Hyu;Kim Woong Han;Kim Yong Jin;Bae Eun Jung;Noh Chung Il
    • Journal of Chest Surgery
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    • v.38 no.9 s.254
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    • pp.609-615
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    • 2005
  • Background: Some controversy still exists concerning the operative indications of coronary fistulas. Nevertheless, a short-term and long-term outcomes are excellent with surgical interventions. In this study, we assessed our surgical results on this disease entity during the last 20 years. Anatomic diversity was described as well. Material and Method: From April 1986 to March 2005, 20 patients with coronary fistulas underwent surgical correction in Seoul National University Children's Hospital. Their medical records were reviewed retrospectively. Result: Twelve patients ($60\%$) were asymptomatic prior to surgery. All had electrocardiogram and echocardiogram and all but 3 had coro-nary angiogram preoperatively. Anatomically, none of them had two or more coronary fistulas. The sites of origin were left coronary system in 11 patients and right in 9. The draining sites were right ventricle in 11, right atrium in 3, left ventricle in 3, main pulmonary artery in 2, and superior vena cavae in 1. All of the involved, the coro-nary arteries were dilated or aneurismal. In 1 case, there was atherosclerotic change but no ischemic evidence in preoperative electrocardiogram. Operative techniques included external obliteration (13), internal obliteration (5), and both (2). External obliteration was done by ligation of the fistulous tract only in T patients, by fstula ligation plus plication in 3 and by plication or patch closure via fistulotomy in 3. There was no operative mortality. All of postoperative morbidities including transient sinus arrhythmia (2), complete atrioventricular block (1), decreased left ventricular function (2), ventricular tachycardia (1), pericarditis (1), and seizure (1) improved on discharge. The mean follow-up was 55.1$\pm$50.2 months (4.0 months${\~}$18.0 years) and there were no recurrences of fistula. There was 1 second operation for aortic root aneurysm, which developed after external patch closure of right coronary fistula. Conclusion: We demonstrated here that coronary fistulas can be cured with excellent clinical outcome and low operative risk under precise diagnosis. Understanding the anatomic diversity will help to construct surgical plans.

Levels of Barriers to Pain Management of Cancer Patients and their Nurses (암 환자와 간호사의 통증관리 장애정도)

  • Yoo, Yang-Sook;Lee, Won-Hee;Cho, Ok-Hee;Lee, So-Woo
    • Journal of Hospice and Palliative Care
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    • v.8 no.2
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    • pp.224-233
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    • 2005
  • Purpose: This study was conducted to provide basic data for developing an effective strategy for cancer pain management by comparing the levels of barriers to pain management of metastatic or advanced cancer patient and their nurses. Methods: The subject of this study were 155 patients who were treated for metastatic or advanced cancer at one of three hospitals in Seoul from January 2004 to January 2005, and 153 nurses who take care of those patients. The levels of barriers to pain management were measured using a tool developed by Gunnarsdottir et al. (2002), 27 questions on a six point scale. The levels of stresses were measured using a tool modified from a stress response measurement reported by Goh Gyung-bong et al. (2000), 27 questions on a five point scale. The levels of barriers in cancer patients were analyzed using t-test and ANOVA, while the data obtained from patients and nurses were compared by t-test. Results: Higher levels of barriers to pain management were found in three groups: 'less than middle school,' 'not treated with anti-cancer chemotherapy,' and 'ECOG of 2.' The level (2.55) of barriers to pain management in the patient group was higher than that (1.76) of the nurse group. Both of the two groups had high levels of barriers in two variables: 'There is a danger of becoming addicted to pain medicine.' and 'Using pain medicine blocks your ability to know if you have any new pain.' There was not a significant difference in the levels of stresses between the two groups. Conclusion: It was found that, for effective cancer pain management practices, it would be necessary to provide cancer patients and their nurses with education and training about pain management and related barriers.

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Recognition and Attitude to Implement at ion of Service Area Assigned System of Public Health Programs among the Health Officer (공공보건사업의 지역담당제 실시에 관한 보건기관 근무 공무원의 인식과 태도)

  • Kim, Mi-Soon;Lee, Moo-Sik;Kim, Nam-Song
    • Journal of agricultural medicine and community health
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    • v.26 no.2
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    • pp.15-41
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    • 2001
  • Since medical clients and the community they live in are expected to be center of future public health and medical care system, new service programs must be developed with patients focused on in line with widening public access of information and social participation. Patients- focused service shall mean the area- oriented provision of public health service. In this study, health officers working at public health centers, public health sub- centers and medical offices in Jeonbuk- do area were taken for population in order to investigate their attitudes toward and knowledge about the service area assigning system under the public health programs. Findings from the survey to 260 health officers, divided by general category, are as follows : Government officers at public health organizations appeared to have high grade of understanding to the service area assigning system and also great appreciation for the necessity of it. Regarding the timing for the system to be introduced, they support the gradual implementation and, as for the type of service to be provided, they preferred home nursing and treatment of chronic diseases. Highly positive responses were centered on the health classes under the health promotion projects, and as far as health projects for the old are concerned, services for home nursing, for the disabled and for home- alone people are favored most. On the other hand, budgeting, manpower and reorganization are rated as prerequisite to establishment of the service area assigning system. From the viewpoint of system side, the improvement of working conditions is rendered as most urgent, while the information system for establishing the service area assigning system is conceived far from satisfactory. Proper assignment of specialists was noted as mostly important to establish the delivery system for medical service through the service area assigning system by team. As merits of the service area assigning system, it is pointed out that, through the system, health clients can better be managed and the nursing quality will be improved thank to the enhanced specialization. It is also perceived that the district health service is not well prepared to respond to the increased and diversified needs of community people and, furthermore, service programs of health centers have not been fully developed. The most serious problem standing in the way to expansion of health projects is, it is noted, uniformity (formality) of the project. Based on the results of the survey which suggest time has ripen to introduce the service area assigning system, following strategies are proposed to anchor down the system as soon as possible: First, we should introduce the system gradually, starting from the area selected, and in consideration of area specialities, refraining from the hitherto stereotyped way of providing health service. Second, we should seek to properly assign the specialists and improve the working conditions of the assigned officers by securing sufficient budget, since it is a most urgent step to lay foundation for the service area assigning system. Third, best service program should be developed to meet the satisfaction of community people by responding to their needs and solidifying the management of medical clients. Fourth, wide scope of study should further be conducted in order to help this system take roots in the central living of community residents since pilot project on the experimental base attended by specialists only can not win popularity among the masses.

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Development of a Real-Time Mobile GIS using the HBR-Tree (HBR-Tree를 이용한 실시간 모바일 GIS의 개발)

  • Lee, Ki-Yamg;Yun, Jae-Kwan;Han, Ki-Joon
    • Journal of Korea Spatial Information System Society
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    • v.6 no.1 s.11
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    • pp.73-85
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    • 2004
  • Recently, as the growth of the wireless Internet, PDA and HPC, the focus of research and development related with GIS(Geographic Information System) has been changed to the Real-Time Mobile GIS to service LBS. To offer LBS efficiently, there must be the Real-Time GIS platform that can deal with dynamic status of moving objects and a location index which can deal with the characteristics of location data. Location data can use the same data type(e.g., point) of GIS, but the management of location data is very different. Therefore, in this paper, we studied the Real-Time Mobile GIS using the HBR-tree to manage mass of location data efficiently. The Real-Time Mobile GIS which is developed in this paper consists of the HBR-tree and the Real-Time GIS Platform HBR-tree. we proposed in this paper, is a combined index type of the R-tree and the spatial hash Although location data are updated frequently, update operations are done within the same hash table in the HBR-tree, so it costs less than other tree-based indexes Since the HBR-tree uses the same search mechanism of the R-tree, it is possible to search location data quickly. The Real-Time GIS platform consists of a Real-Time GIS engine that is extended from a main memory database system. a middleware which can transfer spatial, aspatial data to clients and receive location data from clients, and a mobile client which operates on the mobile devices. Especially, this paper described the performance evaluation conducted with practical tests if the HBR-tree and the Real-Time GIS engine respectively.

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6th Industry Management Body Develop Managerial and Technical Level Metrics - by Applying AHP Analysis - (6차산업화 경영체 경영.기술수준 평가지표 개발 -AHP 분석을 적용하여-)

  • Seo, Yoon Jeong;Park, Jeong Woon;Han, Sang Yeon;Hwang, Dae Yong;Yang, Jung Hyun
    • Asia-Pacific Journal of Business Venturing and Entrepreneurship
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    • v.8 no.4
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    • pp.177-191
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    • 2013
  • 6th Industry reduced agricultural income and rural areas, the economic downturn is going to be activated is attracting attention as an alternative. 6th industry means that the integrated or linked, the manufacture and processing of secondary industry based on primary industry, the distribution and service of tertiary industry. Park Geun-hye government to realize the creative economy in agriculture as an alternative to specifically evaluate the 6th industries and suggests various policy alternatives. In addition, to support the development of models and analysis of best practices, including sleep studies are in progress. However, the 6th Industry management body for performing management level, technical level, the leader in comprehensive evaluation of competencies and indicators on the development of an evaluation study is insufficient. In this regard, the present study performed 6th industry management body for the management level, technical level, the leader competency evaluation indicators to develop a comprehensive evaluation by utilizing AHP method was developed indicators. The results achieved in Korea As different countries and the FTA as cheap agricultural imports increased 6th industry revenues associated with the management body is very likely to be worse. The endless competition to survive in the most important of the strategy for each individual project management body to operate on their own, rather than to strengthen internal capacity by strengthening linkages with other industries, products, and services that promote the sale will be. This also is that you need to improve revenue management body. Thus, all 6th industry management body at the location of their efforts to gain the trust of consumers will require, moreover, for each management body to build cooperation between the various measures will be sought. In addition to the smart era rapidly changing needs of customers, depending on the life cycle of products and services are getting faster and the new consumer is getting more and more tend to find new products. Thus, customers and management body 6th industry changes quickly and accurately predict market trends, and also to market new products and services that further efforts would be needed.

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Characteristics of Premenstrual Changes in Patients with Affective Disorder (정서장애 환자의 월경전기변화 특성)

  • Ko, Young-Hoon;Joe, Sook-Haeng;Suh, Kwang-Yun
    • Korean Journal of Psychosomatic Medicine
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    • v.7 no.1
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    • pp.103-115
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    • 1999
  • Objectives : A large of studies have found an association between premenstrual syndrome and affective disorder, in particular, depression. Some studies have reported that women with depressive disorders may experience menstrual cycle-associated changes in the severity of their symptoms. This study was designed to compare the characteristics of premenstrual changes between control group and affective patient group, and to assess possible risk factors for premenstrual changes in patients. Methods : Eighty normal controls and eighty outpatients given maintenance therapy with fixed dose for at least more than four weeks were asked to complete questionnaires on menstrual history, obstetric-gynecological history, and functional impairment. In addition, to compare the characteristics of premenstrual changes, 16 items based on DSM-IV criteria A for premenstrual dysphoric disorder were rated on the following scale : 0(no change), 1(mild), 2(moderate), 3(severe). Moderate or severe change in each item was considered as premenstrual change and the subjects who reported more than one premenstrual change were defined as premenstrual change group. Results : The results were as follows : 1) The percentage of premenstrual change group was 32.6% in patient group and 50% in control group. 2) Frequently reported premenstrual changes were as follows in control group : breast tenderness; anger ; affective liability ; lethargy, easy fatigability, or marked lack of energy ; abdominal pain or discomfort. In patients, the mood or behavioral changes were frequently reported. The changes were as follows : lethargy, easy fatigability, or marked lack of energy ; change in appetite; affective liability ; sense of difficulty in concentrating : hypersomnia or insomnia. 3) In the premenstrual change group, the patients with only mood or behavioral changes were significantly more than those with only physical changes or both changes. 4) The severity of functional impairment was significantly correlated with the frequency of mood or behavioral changes in patients. 5) There were no significant differences in menstrual characteristics between patients with premenstrual changes and patients without them except the severity of dysmenorrhea. And the severity of dysmenorrhea was correlated with the frequency of premenstrual change. Conclusion : The proportion of patients with affective disorder, who reported moderate-to-severe premenstrual changes, experiencing mood or behavioral changes larger than those experiencing physical changes during premenstrual period. It is possible that some patients with affective disorder, who reported premenstrual mood or behavioral changes, suffer from coexisting premenstrual syndrome with affective disorder or premenstrual exacerbation of affective disorder. Since the more premenstrual changes, the severer functional impairment, the patients reporting mood or behavioral disturbance in premenstrual period should be carefully evaluated, and appropriate therapeutic stategies might be considered.

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Spatial problems of Korea -A delphi survey- (國土管理의 方向定立을 위한 國土診斷 -專門家 集團의 問題意識을 中心으로-)

  • Kim, Inn;Yu, Woo-Ik;Huh, Woo-Kung;Park, Young-Han;Park, Sam-Ock;Yu, Keun-bae;Choi, Byung-Seon
    • Journal of the Korean Geographical Society
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    • v.29 no.1
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    • pp.16-38
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    • 1994
  • The spatial structure of Korea has been changed drastically during the second half of this century. The events such as the Korean War and the resultant division of the Korean Peninsular into two Koreas, rapid industrialization and urbanization are the major causes among others for the spatial changes of the nation. The changes in turn have spawned a number of spatial problems. It is time, we argue, to diagnose how much the nation is now ill-structured, and to discuss of which directions the long-term spatial management be reoriented. A delphi survey was conducted during the early 1993 to fulfill such research needs. Questionnaires were distributed among geographers, planners, and high governmental officials throughout the nation. These 'experts of spatial problems' were requested to evaluate the past spatial policies and strategies, and to identify spatial and environmental problems at the national, regional and local levels. The survey included questions with regard to the spatial problems in North Korea too. A complementary literature survey in the fields of spatial sciences was accomplished as well in order to identify the major research interests and issues with regard to the nations's spatial structure. The delphi survey results indicatee that the present spatial structure: in relation to consumption, housing and economic activities is satisfactory in overall, while rather poor in terms of education, leisure and community activities. Most of the experts consider infrastructural improvements are urgent in the areas of roads, waste disposal facilitles, railroads, harbors, water supply and drainage systems. The over-concentration of economic, social and political function in the Seoul Metropolitan Region is perceived to be the most serious spatial problem in Korea. The long-term solutions suggested are strategies toward a more balanced regional development as well as toward a cleaner environment. The concensus among the experts for the short-term solution is the redistribution of population and industries from the Seoul Metropolitan Region to the intermediate and small cities. The land use policies and concurrent large-scale infrastructural projects are evaluated largely pertinent and desirable in general. It is, however, suggested that development projects be conducted in a more harmonious way with environment. The survey respondents suggest that the present environmental management policies should be reexamined critically. With regard to regional and local problems, transportation and pollutions are thought to be most serious in the Seoul Metropolitan Region, while employment opportunities, and information, education and health care services are most deprived in small cities and rural areas. The majority of the experts consider a city size of 250, 000-500, 000 population is desirable to live within. Respondents beileve that North Korea's physical environment is still not aggravated much whereas its infrastructural provisions are largely pool. The co-authors of this research figure a "environmentaly sound and spatially balanced Korean Penninsular" as the ideal type of spatial structure in Korea. The basic guidelines toward this ideal prototype are suggested: the recovery of spetial integrity, progressive restructuring of the nation, land uses geared to public welfare rather than private interests, and eco-humanistic approach in spatial policies.

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The Importance and Performance Analysis of Service Encounter Quality by Types of Restaurants (레스토랑 유형별 서비스 인카운터 품질의 중요도 및 수행도 분석)

  • Jo, Mi-Na
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.35 no.8
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    • pp.1076-1087
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    • 2006
  • The purpose of this study was to identify critical control points of service encounter by types of restaurants in order to manage moment of truth when customers encounter services. Questionnaires were collected from 812 customers (aged 15 years or older) who had used restaurants in Seoul, from October 24, 2005 to November 6, 2005. The main results of this study were as follows: Statistically significant differences were shown between importance and performance of interaction quality, physical environment quality and outcome quality. Significant differences were also shown in importance and performance of interaction and physical environment quality, and performance of outcome quality by restaurant types but no significant difference was indicated in importance of outcome quality by restaurant types. That is, the importance of outcome quality, which means the quality of food, was regarded as important by customers who use restaurants regardless of types of restaurants. The result of examining interaction quality showed that family restaurants managed waiting customers quite well and provided information on the Internet homepage. Performance of responding to customers with complaints was rated the highest in family restaurants. Regarding physical environment quality, importance and performance scores significantly differed by types of restaurants in order of fine-dining restaurants, family restaurants, and fast-food restaurants. In terms of service encounter quality, items whose importance scores were high but performance scores were low in importance-performance analysis matrix were 'quality of provided food is always uniform' and 'the space between other tables is enough' for fine-dining restaurants. In family restaurants, 'size of chairs or tables is enough', and 'the space between other tables is enough' were included in the items, while 'interior facilities are attractive', 'size of chairs and tables is enough', and 'the space between other tables is enough' were included in the items in case of fast-food restaurants. A difference was indicated depending on types of restaurants.

Crime Incident Prediction Model based on Bayesian Probability (베이지안 확률 기반 범죄위험지역 예측 모델 개발)

  • HEO, Sun-Young;KIM, Ju-Young;MOON, Tae-Heon
    • Journal of the Korean Association of Geographic Information Studies
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    • v.20 no.4
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    • pp.89-101
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    • 2017
  • Crime occurs differently based on not only place locations and building uses but also the characteristics of the people who use the place and the spatial structures of the buildings and locations. Therefore, if spatial big data, which contain spatial and regional properties, can be utilized, proper crime prevention measures can be enacted. Recently, with the advent of big data and the revolutionary intelligent information era, predictive policing has emerged as a new paradigm for police activities. Based on 7420 actual crime incidents occurring over three years in a typical provincial city, "J city," this study identified the areas in which crimes occurred and predicted risky areas. Spatial regression analysis was performed using spatial big data about only physical and environmental variables. Based on the results, using the street width, average number of building floors, building coverage ratio, the type of use of the first floor (Type II neighborhood living facility, commercial facility, pleasure use, or residential use), this study established a Crime Incident Prediction Model (CIPM) based on Bayesian probability theory. As a result, it was found that the model was suitable for crime prediction because the overlap analysis with the actual crime areas and the receiver operating characteristic curve (Roc curve), which evaluated the accuracy of the model, showed an area under the curve (AUC) value of 0.8. It was also found that a block where the commercial and entertainment facilities were concentrated, a block where the number of building floors is high, and a block where the commercial, entertainment, residential facilities are mixed are high-risk areas. This study provides a meaningful step forward to the development of a crime prediction model, unlike previous studies that explored the spatial distribution of crime and the factors influencing crime occurrence.

The Relation between Mother's LOHAS Propensity and Healthy Dietary Life Attitude perceived by Chinese University Students (대학생 자녀가 지각한 어머니의 로하스(LOHAS) 성향과 건강식생활 태도와의 관련성 연구 - 중국대학생을 중심으로 -)

  • Lee, Yeon-Jung;Ahn, Gee-Jung
    • Culinary science and hospitality research
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    • v.21 no.4
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    • pp.101-120
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    • 2015
  • This study was conducted to examine the relation between a mother's LOHAS lifestyle propensity, healthy dietary life, and nutrient intake perceived by Chinese university students. The subjects consisted of 376 Chinese university students. The research results are summarized below. The mother's LOHAS attitude index was 76.02 points out of a perfect score of 100 points. High LOHAS attitude factors of mothers were 'health', whereas 'social welfare' scored low. The highest LOHAS attitude items of mothers that Chinese university students perceived was 'My mother uses health food, organic food, clean food'(4.26 points). Males who lived on their own in a large city and have normal BMI ($18.5{\sim}22.9kg/m^2$) perceived a high mother's LOHAS score. The highest food habit variables are 'eating without spilling food' 'cleaning up after meals around' and 'washing my hands before meals'. The highest healthy dietary life item is 'I try to maintain a pleasant and enjoyable life'(3.83 points). The highest nutrient intake attitude score is 'I tend to eat yellowish-green vegetables every day.'(3.92 points). According to mother's LOHAS lifestyle score, it was verified that the higher mother's LOHAS lifestyle score, the higher children's food habit, healthy dietary life, and nutrient intake score are. Mother's environment-friendly LOHAS attitude index has a meaningful impact on the child's food habits, healthy dietary life, and nutrient intake.