• Title/Summary/Keyword: 학제적(學際的) 연구

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Coronary Artery Bypass Graft Surgery in the Elderly (고령환자의 관상동맥 우회로 조성술)

  • 김학제;황재준;김현구;신재승;손영상;최영호
    • Journal of Chest Surgery
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    • v.32 no.8
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    • pp.715-721
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    • 1999
  • Background:The number of old patients receiving coronary artery bypass grafting(CABG) is increasing. With the more recent advances in operative techniques, the age at which CABG is indicated has also increased. This study evaluated the risk factors associated with the hospital mortality and the morbidity following CABG in elderly patients. Material and Method: Between March 1991 and June 1998, we retrospectively reviewed 45 consecutive patients aged 65 years or older who underwent CABG. We compared the data with the results of 179 patients under the age 65 years operated during the same period. Result: Mean age was 68${\pm}$1.41 years(range 65 to 74 years). Emergency surgery was required in 4, and elective surgery in 41 patients. The mean number of distal anastomosis per patient was 3.62 ${\pm}$0.81 and mean aortic cross-cramp time was 69.84${\pm}$18.5 minutes. Thirty patients had Canadian class III or IV preoperatively, but 43 patients had class I or II postoperatively. The left ventricular ejection fraction increased significantly from 54.23${\pm}$10.62% preoperatively to 58.14${\pm}$9.88% postoperatively(p<0.05). Postoperative complication was pneumonia in 2 patients, acute renal failure in 2 patients, sternal wound infection in 1 patient, and postoperative myocardial infarction in 1 patient. There were two postoperative deaths. The causes of deaths were low output syndrome in one patient, and sepsis due to pneumonia in the other patient. The hospital mortality was higher in the elderly group(4.4 versus 2.86%) but was not statistically significant(p>0.05). Incremental risk factors for hospital deaths in the elderly were emergent operation, preoperative PTCA, postoperative use of IABP and postoperative ARF(p<0.05). The duration of hospital stay after operation was significantly longer for the elderly group than the younger group(19.27${\pm}$12.51 vs 15.55${\pm}$6.99 days; p< 0.05). Follow-up was complete for 34 of the hospital survivors and ranged from 1 to 73 months(mean: 23.58${\pm}$19.56 months). There was no late mortality of cardiac origin. Conclusion: Age is an important factor in selecting optimal management for elderly patients with coronary compromise, but age alone should not dictate the choice of therapy. Coronary artery bypass surgery in the elderly is associated with acceptable early mortality and excellent long-term results.

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Sinus Node Function after Extended Transseptal Approach for Mitral Valve Surgery: 164 Clinical Cases (경중격 절개방식을 좌심방 상부까지 연장시킨 방법을 통한 승모판막 수술 후 동방 결절 기능부전에 대한 164예 임상분석)

  • Ryu Se Min;Kim Hyun Koo;Cho Yang Hyun;Sim Jae Hoon;Sohn Young-sang;Choi Young Ho;Kim Hark Jei
    • Journal of Chest Surgery
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    • v.38 no.3 s.248
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    • pp.214-220
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    • 2005
  • Extended transseptal approach can provide an excellent view of the mitral valve but the safety of this approach is controversial because this incision requires transaction of the sinus node artery, which in most cases and can result postoperative arrhythmia. The purpose of this study was to evaluate perioperative and longterm conduction disturbances and the cardiac rhythms of patients who underwent an extended transseptal approach for mitral valve surgery. Material and Method: Postoperative cardiac rhythms were analyzed in the 164 consecutive patients who received mitral valve replacements with a extended transseptal approach between March 1992 and July 2003. Result: Of the 84 patients in normal sinus rhythm, 34 ($39\%$) had developed transient junctional rhythm and atrial fibrillation after operation, lasting less than 72 hours in most of cases. No intractable arrhythmias occurred. Most of these arrhythmia were not detected at the time of discharge and only 8 patients ($9\%$) had atrial fibrillation at discharge. Postoperative PR intervals increased for 1 week, then decreased within 2 weeks postoperatively, and returned to normal range by 6 months postoperatively. During the postoperative period, 4 of the 78 patients with preoperative atrial fibrillation developed normal sinus thythm. Conclusion: The post-operative arrhythmias were temporary and showed no significant complications after extended transseptal approach for the mitral valve surgery.

A Study on Satisfaction with Online Classes of Radiology Students due to COVID-19 (코로나-19로 인한 방사선(학)과 재학생들의 온라인 수업에 대한 만족도 연구)

  • Kang, Yeon-Hee;Park, Cheol-Woo
    • Journal of the Korean Society of Radiology
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    • v.16 no.1
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    • pp.35-43
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    • 2022
  • In this study, a survey was conducted and analyzed to find out the satisfaction of online classes among students enrolled in the radiology department of a university located in Busan city. As a result, in terms of satisfaction with online classes, male scores were higher, but there was no statistically significant difference. In the interdisciplinary system, the satisfaction score of the students enrolled in Bachelor's degree was high, and there was a statistically significant difference except for the satisfaction of learning participation (p<0.001, p<0.05). For class satisfaction by grade level, Senior had higher scores, and there were statistically significant differences except for learning participation satisfaction (p<0.001, p<0.01, p<0.05). In the satisfaction survey according to the number of lectures, the scores of the students who took 4-7 lectures were found to be high except for the satisfaction of learning participation, and there was a statistically significant difference (p<0.01, p<0.05). In the method of communication with the instructor, students who used e-mail showed high scores, and there was a statistically significant difference in lecture satisfaction (p<0.05). In the correlation analysis between sub-variables for online classes, statistically significant correlations were established in all areas. Most of the students preferred class methods such as recorded classes and classes using external content such as YouTube, and when asked about the merits of online classes, many students answered that the advantages of online classes were repetitive classes and no restrictions on time and place. When asked about the shortcomings of online classes, many students answered that it was a lack of concentration and lack of communication with the instructor. This study was conducted to provide basic data to improve the satisfaction of online classes that will increase in the future. Therefore, based on the results of this study, it is expected that more quality online classes will be produced so that students' satisfaction with online classes can be improved.

Development of Calcification-resistant Bovine Pericardium with PEO-$SO_3(II)$ -An implantation study of bovine pericardium at artery and peritoneum- (PEO-$SO_3$를 이용한 항석회화 조직첨포의 개발(II) -동맥과 복막 이식 실험연구-)

  • 김형묵;백만종;김광택;이인성;김학제;이원규;박기동
    • Journal of Chest Surgery
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    • v.31 no.11
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    • pp.1023-1030
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    • 1998
  • Background: Calcific degeneration limits durabilities of the bioprosthetic tissues implanted in the human body. The direct coupling sulphonated polyethyleneoxide(PEO-SO3) to the bioprosthetic tissues after glutaraldehyde(GA) fixation and the removal of residual aldehyde groups from the tissues can augment the effect of calcification-resistance. Materials and methods: To study the anti-calcification effect by PEO-SO3 modification and the removal of the residual aldehyde groups of tissues, surface modified bovine pericardia(BP-PEO-SO3) were preserved in aseptic saline to wash out GA(saline group) and 0.65% GA solution(GA group). And then above two groups and PERIGUARD (Bio-vascular. Co.) (product group) were evaluated with respects to calcium contents and microscopic findings using in vivo implantation models at carotid and femoral artery and peritoneum of 8 adult dogs. Results: In the tissues retrieved from carotid artery, calcium content was significantly decreased in saline group than in other two groups(saline; 2.89±0.31 vs. GA; 6.14±1.08 vs. product; 22.82±5.00 mg/g of dried tissue; p<0.05). In the tissues retrieved from femoral artery and peritoneum, calcium amount was also decreased in saline group than in other two groups, but not reached the significant difference between groups. On the other hand, the pathologic findings of pericardial tissues showed marked destructuction in GA group compared to the other two groups. Conclusions: In this study, covalently PEO-SO3 bound to bovine pericardium decreased calcifications and the anti-calcification effect of BP-PEO-SO3 could be augmented by the washing out the residual aldehyde groups using saline after GA fixation. Conclusively, the PEO-SO3 modified bovine pericardium is highly resistant to calcification and can be useful for the development of calcification-resistant cardiovascular patches and valves.

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A Study on the Students' Characteristics of Ophthalmic Optics under Bachelor's Degree Course in Academic Credit Bank System - Focus on the Educational Institutions in Gyeonggi Region - (학점은행제 학사학위과정 안경광학전공 학습자의 특성에 관한 연구 - 경기지역 교육기관을 중심으로 -)

  • Jung, Se-Hoon;Park, Hee-Kyoung;Lee, Ok-Jin
    • Journal of Korean Ophthalmic Optics Society
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    • v.19 no.4
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    • pp.445-455
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    • 2014
  • Purpose: By investigating the characteristics of the students ophthalmic optics under bachelor's degree course in academic credit bank system, this study aimed to utilize this survey as a basic material for the operation and the improvement of academic credit bank system as the continued education for opticians. Methods: A questionnaire survey for the characteristics of the students was conducted on 98 bachelors who registered in the academic credit bank system and an analysis was made out of the result. Results: As the purpose of selecting the academic credit bank system, acquisition of bachelor's degree took the major portion (51.0%); for information route, school or superior at work took the major portion (33.7%); and for educational institution, alma mater took the major portion (31.6%). Family cooperation (72.4%) to the students in the academic credit bank system was higher than workplace cooperation (46.9%) or social cooperation (39.8%). For the time required for the bachelor's degree course in the academic credit bank system, 2 semesters (55.6%) took the major portion, and 38.9% for entering graduate school and 5.6% for university transfer. The result showed a significant difference in the information route for the academic credit bank system (p<.05), selection criteria for educational institution (p<.05) and workplace cooperation (p<.01) depending on the age. It showed a significant difference in the selection purpose for the academic credit bank system (p<.01), average attendance day (p<.05), workplace cooperation (p<.01) and difficulties (p<.01) depending on working place. It showed a significant difference in the selection criteria for educational institution (p<.01) and family cooperation (p<.05) depending on the academic system of their alma mater. It showed a significant difference in the information route (p<.05), the selection criteria for educational institution (p<.01) and workplace cooperation (p<.05). Conclusions: It is necessary for optometrists to study and pay more attention to continuing education, and the operation and support for the academic credit bank system should be made in consideration of the characteristics of students.

Effect on Identification of Irradiated Wheat and Soybean by the Full-overlapped Gravitational Field Energy(FGFE) Treatment (중첩중력에너지가 방사선 조사된 밀과 대두의 판별특성에 미치는 영향)

  • Oh, Sang-Lyong;Ahn, Jae-Jun;Kwon, Joong-Ho;Kim, Hak-Je
    • Food Science and Preservation
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    • v.18 no.3
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    • pp.294-301
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    • 2011
  • The aim of this study was to investigate the changes in identification markers of irradiated foods after treatment of the full-overlapped gravitational field energy (FGFE). Wheat and soybean samples were irradiated at 0-5 kGy of Co-60 gamma energy, and analyzed for photostimulated and thermo luminescence characteristics (PSL and TL) and sprouting rate at 0 and 6th month after FGFE treatment. As a screening method for irradiated samples, PSL photon counts (PCs) for the non-irradiated samples appeared negative (<700 PCs), while irradiated samples gave positive (>5,000 PCs). But FGFE-treated irradiated samples appeared intermediate (700-5,000 PCs), showing decreased PCs during storage. The TL analysis on irradiated samples exhibited glow curve peaks in range of $150-200^{\circ}C$ and TL ratio ($TL_1/TL_2$) was also >0.1. Therefore, identification of irradiated samples was possible using thermoluminescence. But the glow curve range of FGFE-treated irradiated samples shifted from $150-200^{\circ}C$ to $180-230^{\circ}C$ and TL intensity was decreased 37-60% resulting from FGFE treatment. After 6 months of storage, all the samples showed a decrease in TL intensity, but identification was still possible. The sprouting rate of irradiated samples decreased by about 72%, whereas that of FGFE-treated irradiated samples showed by about 85%, as compared to non-irradiated samples. More detailed study is required to investigate sprouting phenomena for FGFE-treated samples.

Usefulness of LIFE in diagnosis of bronchogenic carcinoma (기관지 암의 진단에서 형광기관지 내시경검사의 유용성)

  • Lee, Sang Hwa;Shim, Jae Jeong;Lee, So Ra;Lee, Sang Youb;Suh, Jung Kyung;Cho, Jae Yun;Kim, Han Gyum;In, Kwang Ho;Choi, Young Ho;Kim, Hark Jei;Yoo, Se Hwa;Kang, Kyung Ho
    • Tuberculosis and Respiratory Diseases
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    • v.44 no.1
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    • pp.69-84
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    • 1997
  • Background : Although the overall prognosis of patients with lung cancer is poor, highly effective treatment exists for the small subset of patients with early lung cancer(carcinoma in situ/micro- invasive cancer). But very few patients have benefit from them because these lesions are difficult to detect and localize with conventional white-light bronchoscopy. To overcome this problem, a Lung Imaging Fluorescence Endoscopic device(LIFE) was developed to detect and clearly delineate the exact location and extent of premalignant and early lung cancer lesions using differences in tissue autofluorescence. Purpose : The purpose of this study was to determine the difference of sensitivity and specificity in detecting dysplasia and carcinoma between fluorescence imaging and conventional white light bronchoscopy. Material and Methods : 35 patients (16 with abnormal chest X-ray, 2 with positive sputum study, 2 with undiagnosed pleural effusion, 15 with respiratory symptom) have been examined by LIFE imaging system. After a white light bronchoscopy, the patients were submitted to fluorescence bronchoscopy and the findings of both examinations have been classified in 3 categories(class I, II, III). From of all class n and III sites, 79 biopsy specimens have been collected for histologic examination: a comparison between histologic results and white light or fluorescence bronchoscopy has been performed for assessing sensitivity and specificity of the two methods. Results : 1) Total 79 sires in 35 patients were examined. Histology demonstrated 8 normal mucosa, 21 hyperplasia, 23 dysplasia, and 27 microinvasive and invasive carcinoma. 2) The sensitivity of white light or fluorescence bronchoscopy in detecting dysplasia was 60.9% and 82.6%, respectively. 3) The results of this study showed 70.3 % sensitivity for microinvasive or invasive carcinoma with LIFE system, versus 100% sensitivity for white light in 27 cases of carcinoma. The false negative study of LIFE system was 8 cases(3 adenocarcinoma and 5 small cell carcinoma), which were infiltrated in submucosal area and had normal epithelium. Conclusion : To improve the ability 10 diagnose and stage more accurately, fluorescence imaging may become an important adjunct to conventional bronchoscopic examination because of its high detection rate of premalignant and malignant epithelial lesion. But. it has limitation to detect in submucosal infiltrating carcinoma.

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