• Title/Summary/Keyword: 90세 이상

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Immediate Reoperation for Failed Mitral Valve Repair (승모판막성형술 실패 직후에 시행한 재수술)

  • Baek, Man-Jong;Na, Chan-Young;Oh, Sam-Se;Kim, Woong-Han;Whang, Sung-Wook;Lee, Cheol;Chang, Yun-Hee;Jo, Won-Min;Kim, Jae-Hyun;Seo, Hong-Ju;Kim, Wook-Sung;Lee, Young-Tak;Park, Young-Kwan;Kim, Chong-Whan
    • Journal of Chest Surgery
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    • v.36 no.12
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    • pp.929-936
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    • 2003
  • We analysed the surgical outcomes of immediate reoperations after mitral valve repair. Material and Method: Eighteen patients who underwent immediate reoperation for failed mitral valve repair from April 1995 through July 2001 were reviewed retrospectively. There were 13 female patients. The mitral valve disease was regurgitation (MR) in 12 patients, stenosis (MS) in 3, and mixed lesion in 3. The etiologies of the valve disease were rheumatic in 9 patients, degenerative in 8, and endocarditis in 1. The causes of reoperation was residual MR in 13 patients, residual MS in 4, and rupture of left ventricle in 1. Fourteen patients had rerepair for residual mitral lesions (77.8%) and four underwent replacement. Result: There was no early death. After mean follow-vp of 33 months, there was one late death. Echocardiography revealed no or grade 1 of MR (64.3%) in 9 patients and no or mild MS in 11 patients (78,6%). Reoperation was done in one patient. The cumulative survival and freedom from valve-related reoperation at 6 years were 94% and 90%, respectively. The cumulative freedom from recurrent MR and MS at 4 years were 56% and 44%, respectively. Conclusion: This study suggests that immediate reoperation for failed mitral valve repair offers good early and intermediate survival, and mitral valve rerepair can be successfully performed in most of patients. However, because mitral rerepair have high failure rate, especially in rheumatic valve disease, adequate selections of valvuloplasty technique and indication are important to reduce the failure rate of mitral rerepair.

Early Clinical Experience in Aortic Valve Replacement Using On-X$^{circledR}$Prosthetic Heart Valve (On-X$^{circledR}$ 기계판막을 이용한 대동맥판 치환술의 조기 임상 경험)

  • 안병희;전준경;류상완;최용선;김병표;홍성범;박종춘;김상형
    • Journal of Chest Surgery
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    • v.36 no.9
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    • pp.651-658
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    • 2003
  • Since the first implanted in September 1997, the use of On-X prosthetic heart valve has been increasing around in the world. This study was designed to assess the feasibility, safety, and the postoperative hemodynamics with this new valve in clinical setting. Material and Method: The current study was carried out on 52 patients undergoing aortic valve replacement with this prosthesis between April 1999 to August 2002 at Chonnam National University Hospital to evaluate the surgical results. 52% of the patients were male and the average age at implant was 50$\pm$13 years. The study followed the guidelines of the AATS/STS. Preoperatively, 32(61.5%) patients were in NYHA functional class III or IV and 2 patients had previous aortic valve surgery. Concomitant cardiac surgery was performed in 71.1%. The implanted valve sizes were 19 mm in 13 patients, 21 mm in 26, 23 mm in 10 and 25 mm in 3, respectively. Mean follow-up was 16.6$\pm$10.5 months (1∼39 months). Echocardiographic assessment was performed pre- and immediate postoperatively, as well as 3, 6, 12 months after surgery, evaluating pressure loss and regression of left ventricular hypertrophy. Result: Mean cardiopulmonary bypass time was 191$\pm$94.7 minutes with an aortic cross-clamp time of 142$\pm$51.7 minutes. There was no early and late mortality, Freedom from adverse events at 1 year in the study were as follows: thromboembolism, 95.6$\pm$6%; bleeding events, 90.2$\pm$4%; paravalvular leakage 92.3$\pm$4%; and overall valve-related morbidity at 1 year was 76.6$\pm$3%. There were no cases of valve thrombosis, prosthetic valve endocarditis and structural or non-structural failure. Left ventricular function at 12 months after surgery (EF=62.7$\pm$9.8%) revealed a statistically significant improvement compared to preoperative investigation (EF=55.8$\pm$15.9%, p=0.006). Left ventricular mass index was 247.3$\pm$122.3 g/$m^2$ on preoperative echocardiographic study, but regressed to 155.5$\pm$58.2 g/$m^2$ at postoperative 1 year (p=0.002). Over the follow-up period a further decrease of peak transvalvular gradients was observed in all patients: 62.5$\pm$38.0 mmHg on preoperative assessment, 18.2$\pm$6.8 mmHg at immediate postoperative period (p < 0.0001), 7.6$\pm$5.09 mmHg (p<0.0001) at 6 month, 18.0$\pm$10.8 mmHg (p<0.0001) at 1 year. Conclusion: The On-X prosthetic heart valve performs satisfactorily in the first 1 year period. Clinical outcome by examining NYHA functional classification revealed especially good results. Effective regression of left ventricular hypertrophy and statistically significant decrease of transvalvular gradient were observed over the first year, but longer-term follow-up of this patient group is needed to establish the expected rates for late valve-related events as well as the long-term clinical efficacy of this valve.

The Classification System and Information Service for Establishing a National Collaborative R&D Strategy in Infectious Diseases: Focusing on the Classification Model for Overseas Coronavirus R&D Projects (국가 감염병 공동R&D전략 수립을 위한 분류체계 및 정보서비스에 대한 연구: 해외 코로나바이러스 R&D과제의 분류모델을 중심으로)

  • Lee, Doyeon;Lee, Jae-Seong;Jun, Seung-pyo;Kim, Keun-Hwan
    • Journal of Intelligence and Information Systems
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    • v.26 no.3
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    • pp.127-147
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    • 2020
  • The world is suffering from numerous human and economic losses due to the novel coronavirus infection (COVID-19). The Korean government established a strategy to overcome the national infectious disease crisis through research and development. It is difficult to find distinctive features and changes in a specific R&D field when using the existing technical classification or science and technology standard classification. Recently, a few studies have been conducted to establish a classification system to provide information about the investment research areas of infectious diseases in Korea through a comparative analysis of Korea government-funded research projects. However, these studies did not provide the necessary information for establishing cooperative research strategies among countries in the infectious diseases, which is required as an execution plan to achieve the goals of national health security and fostering new growth industries. Therefore, it is inevitable to study information services based on the classification system and classification model for establishing a national collaborative R&D strategy. Seven classification - Diagnosis_biomarker, Drug_discovery, Epidemiology, Evaluation_validation, Mechanism_signaling pathway, Prediction, and Vaccine_therapeutic antibody - systems were derived through reviewing infectious diseases-related national-funded research projects of South Korea. A classification system model was trained by combining Scopus data with a bidirectional RNN model. The classification performance of the final model secured robustness with an accuracy of over 90%. In order to conduct the empirical study, an infectious disease classification system was applied to the coronavirus-related research and development projects of major countries such as the STAR Metrics (National Institutes of Health) and NSF (National Science Foundation) of the United States(US), the CORDIS (Community Research & Development Information Service)of the European Union(EU), and the KAKEN (Database of Grants-in-Aid for Scientific Research) of Japan. It can be seen that the research and development trends of infectious diseases (coronavirus) in major countries are mostly concentrated in the prediction that deals with predicting success for clinical trials at the new drug development stage or predicting toxicity that causes side effects. The intriguing result is that for all of these nations, the portion of national investment in the vaccine_therapeutic antibody, which is recognized as an area of research and development aimed at the development of vaccines and treatments, was also very small (5.1%). It indirectly explained the reason of the poor development of vaccines and treatments. Based on the result of examining the investment status of coronavirus-related research projects through comparative analysis by country, it was found that the US and Japan are relatively evenly investing in all infectious diseases-related research areas, while Europe has relatively large investments in specific research areas such as diagnosis_biomarker. Moreover, the information on major coronavirus-related research organizations in major countries was provided by the classification system, thereby allowing establishing an international collaborative R&D projects.

Study for Reliability of Interpretation of the Three Phase Bone Scintigraphy in Patients with Post-traumatic Complex Regional Pain Syndrome (외상 후 복합부위통증증후군 환자에서 시행한 삼상 뼈 스캔의 판독 신뢰도에 관한 연구)

  • Park, Jung-Mi;Kim, Seon-Jung;Chung, Seung-Hyun;Lee, Yong-Taek
    • Nuclear Medicine and Molecular Imaging
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    • v.42 no.1
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    • pp.44-51
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    • 2008
  • Purpose: We performed this study to evaluate reliability on interpretation of three phase bone scintigraphy (TPBS) in patients with post-traumatic complex regional pain syndrome (PT-CRPS). Methods: Based on International Association for the Study of Pain guideline in 1994, 34 patients with PT-CRPS were selected for this study. Two nuclear medicine physicians evaluated identical TPBS according to the uptake pattern, extent and intensity of the lesion, and their agreements (kappa values) were analysed. The final diagnosis based on arbitrary criteria of each physician were compared with those obtained by the criteria for PT-CRPS established in this study, which are hyperactivity on all phases (criteria 1), hyperactivity of whole joints on delayed phase (criteria 2), and hyperactivity of either whole or FDGal joints on delayed phase (criteria 3). Results: Intra-observer agreements were good for uptake pattern, intensity, and extent on TPBS. Inter-observer agreements were also good, except extent on blood pool phase (0.55). The inter-observer agreements on final diagnosis improved when criteria 1-3 were applied (0.77-0.88), compared to when physician's own criteria were used (0.63). Those also improved from 0.29 to 0.47-0.82 for acute stage, and from 0.37 to 1.0 for chronic stage. The sensitivities of chronic stage were relatively lower to those of acute stage. Conclusions: Inter-observer's variations in diagnosis of the patients with PT-CRPS using TPBS were observed. These results were attributed to different criteria set by observers. In order to improve agreement on interpretation of TPBS, common positive criteria should be established, especially considering uptake pattern and clinical stages.

Effect of orthodontic force on the amount of tooth movement and root resolution in rat (교정력이 흰쥐의 치아이동량과 치근흡수에 미치는 영향)

  • Kim, Il-Gon;Kim, Kwang-Won;Yoon, Young-Jooh
    • The korean journal of orthodontics
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    • v.29 no.5 s.76
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    • pp.551-562
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    • 1999
  • This study was undertaken to investigate the relation between orthodontic force magnitude and the amount of tooth movement. And more light force application for reducing root resorption Twenty-four rats were divided into three experimental groups(A, B, C) based on force magnitude and application method. Springs of 50g force were applied to A group, springs of 100g force were applied to B group and springs of 25g force were applied to C group initially, and after 4 days springs of C group were changed to springs of 50g force. Two kinds of $sentally^{(R)}$(GAC U.S.A.) closed coil spring, 50g and 100g, were used. And we made 25g springs by heat treatment process of 50g springs. Each spring was inserted between the maxillary central incisor and the maxillary left first molar. Amounts of tooth movement were measured everyday by digital caliper($Digimatic^{(R)}$, Mitutoyo, Japan) under inhalation anesthesia for 15 days. After 15 days, all rats were sacrificed and histological samples were obtained with Hematoxyline-Eosin stain and Masson's trichrome stain. Following conclusion were made; 1. Group B showed the mean cumulative tooth movement of $2.19{\pm}0.41mm$ at 15th day, which was greatest among three groups, followed by group C($2.06{\pm}0.10mm$), group A($1.90{\pm}0.49mm$) respectively. however, there was no statistically difference among three groups. 2. All groups showed general tooth movement pattern and A, B, C group finished lag phase at 9th, 8th, 7th day, but there was no statistical significance. 3. Group A,B,C showed root resorption and especially group B showed the most severe root resorption and group C showed milder root resorption than other groups. According to the above results, large initial force with the development of a flirty widespread hyalinized zone may cause severe root resorption, so initial force should be applied lightly to reduce hyalinized area and eventually root resorption and then increased force will induce efficient tooth movement.

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A Study on the Development of Cookbooks for Children Based on the Dietary Behaviors of Elementary School Students - Focused on the 5th and 6th Grades of Elementary School - (초등학생들의 식행동 분석에 따른 어린이 요리책 개발에 관한 연구 - 일부 초등학교 5, 6학년을 중심으로 -)

  • Jung, Kyung-Ah
    • Culinary science and hospitality research
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    • v.16 no.2
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    • pp.351-366
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    • 2010
  • This study was conducted to develop a cookbook for children as a nutritional education material considering the dietary behaviors of elementary school students. Dietary behaviors were surveyed in 5th and 6th grade students(male 45, female 45) in Gangwon-do. 48.9% of the children ate breakfast every day, and 67.8% ate Korean food such as cooked rice, soup, and side dishes for breakfast. The reason for skipping the breakfast was 'have no time'. 42.2% of the children answered 'cook the foods that they want to eat' about the question how to eat when they are alone at home. 52.2% of the children ate snacks 1~2 times a day, and such snacks included fruits(46.6%), ice cream(22.2%), bread or cookies(21.1%), and instant foods(11.1%). Children preferred meats to vegetables and preferred Bokeum(27.8%), Twigim(25.6%), Guk Jjigae(21.1%) to other cooking methods. 96.7% of the children have cooked at least 1 time. 64.4% of the children have cooked because they 'just want to cook.' The kinds of the foods that they have cooked were Ramen(68.8%), fried eggs(53.3%), Bokeumbap(37.8%), and sandwiches(18.9%). Considering these results, cookbooks were categorized by 'cook by myself', 'cook snacks speedily', and 'show off my cooking skills' with 5~6 dishes in each. They have pictures of a cooking process about all dishes and provide information on the contents of protein, fat, calcium, sodium as well as energy, the method to plan balanced diet by using the food pyramid and the portion size for children. This cookbook gives basic knowledge about cooking such as measuring, sanitation, and the separation of food garbage. I expect that the cookbook can be used as a nutritional education material to improve the dietary behaviors of children.

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Effect of Academic Examination Stress on Taste Perception and Nutrient Intake in University Students (대학생의 시험 스트레스가 미각과 영양소 섭취에 미치는 영향)

  • 전예숙;최미경
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.33 no.2
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    • pp.349-355
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    • 2004
  • The purpose of this study was to estimate effect of academic examination stress on taste perception and nutrient intakes in university students. Physical status, blood pressure, stress score using stress test of 2 types, recognition threshold and preference for taste, nutrient intakes using diet record method were measured before and after examination in 20 subjects. Mean age, height, weight, and BMI of the subjects were 23.39$\pm$1.20 years, 164.56$\pm$7.99 cm, 60.66$\pm$13.23 kg, 22.28$\pm$4.56 kg/$m^2$, respectively. Stress scores before examination of the subjects were significantly higher than those after examination. There were no significant differences in blood pressure, pulse rate, recognition threshold and just right concentration for sweetness and saltness, and food and nutrient intakes between pre- and post-examination. There were significantly positive correlation between stress score and diastolic blood pressure. And threshold concentration for saltness was positively correlated with threshold concentration for sweetness and animal protein intake. These results show no effect of examination stress on taste perception and nutrient intakes in university students. This may be due to low level of stress. Therefore, it is needed to study about effect of more higher level of stress on taste perception and nutrient intakes.

Analysis of Consumer Consumption Status and Demand of Rice-wine (약주에 대한 소비자의 소비실태 및 요구도 분석)

  • Kim, Eun-Hae;Ahn, Byung-Hak;Lee, Min-A
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.42 no.3
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    • pp.478-486
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    • 2013
  • The purpose of this study was to analyze consumer consumption and product concept demands of Korean rice-wine. An online survey, conducted from April 28, 2010 to May 6 2010, targeted 200 consumers in Seoul and the Gyeonggi-do area. More than half of the respondents (51.3%) drank rice-wine because of the taste. The common reasons for dissatisfaction with rice-wine were hangovers (35.7%) and taste (16.9%). From analyzing rice-wine preferences, the most preferred ingredient was rice (57.8%), while the most preferred aroma and taste was derived from the fruit (48.7% and 58.4%, respectively). The most common methods consumers observed for promoting rice-wine consumption were the "development and management of rice-wine brands" (59.7%), and "continuous promotion" (44.8%). The most important attributes of a rice-wine product included its taste (4.60), followed by its quality (4.41) using 5-point Likert scale. An importance-performance analysis (IPA) was performed for the 17 attributes of rice-wine and identified targets for product management strategies, including the "usage of domestic ingredients", "ease of purchase", clarity of "product information", and "external image". Therefore, developing solid concepts in marketing strategy are required and may be achieved by understanding the consumer preferences and demands of rice-wine.

Concurrent Chemoradiotherapy in Elderly Patients with Locally Advanced Esophageal Carcinoma (고령의 국소 진행된 식도암환자에서 동시 항암화학방사선치료)

  • Jung, Bae-Kwon;Kang, Ki-Mun;Lee, Gyeong-Won;Kang, Jung-Hoon;Kim, Hoon-Gu;Lee, Won-Seob;Chai, Gyu-Young
    • Radiation Oncology Journal
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    • v.27 no.2
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    • pp.84-90
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    • 2009
  • Purpose: The effect of concurrent chemoradiotherapy was analyzed in elderly patients when used in the treatment of locally advanced esophageal cancer. Materials and Methods: The retrospective analysis included 28 elderly patients aged 65 or older, with histopathologically confirmed squamous cell carcinoma of the esophagus, underwent concurrent chemoradiotherapy from January 2001 to July 2007. The squamous cell carcinoma disease stages included 8 patients (28.8%) in stage IIa, 10 patients (35.7%) in stage IIb, and 10 patients (35.7%) in stage III. Fractionated radiotherapy was performed with a 6 MV or 10 MV X-ray for 45~63 Gy (median: 59.4 Gy). Chemotherapy was applied concurrently with the initiation of radiotherapy. A 75 mg/$m^2$ dose of Cisplatin was intravenously administered on day 1. Further, 5-FU 1,000 mg/$m^2$ was continuously administered intravenously from days 1 to 4. This regimen was performed twice at 3-week intervals during radiotherapy. Two cycles of consolidation chemotherapy was performed after radiotherapy. Results: The follow-up period was 3~72 months (median: 19 months). The treatment responses after concurrent chemoradiotherapy included a complete response in 11 patients (39.3%), a partial response in 14 patients (50.0%), and no response in 3 patients (10.7%). The overall response rate was 89.3% (25 patients). The overall 1-, 2- and 3-year survival rates were 55.9%, 34.6% and 24.2%, respectively. The median survival time was 15 months. Two-year survival rates of patients with a complete response, partial response, and no response were 46.2%, 33.0%, and 0%, respectively. The stage and tumor response after concurrent chemoradiotherapy were statistically significant prognostic factors related with survival. No treatment-related deaths occurred in this study. Conclusion: Concurrent chemoradiotherapy is a relatively effective treatment without serious complications in elderly patients with locally-advanced esophageal cancer.

The Effect of Information Protection Control Activities on Organizational Effectiveness : Mediating Effects of Information Application (정보보호 통제활동이 조직유효성에 미치는 영향 : 정보활용의 조절효과를 중심으로)

  • Jeong, Gu-Heon;Jeong, Seung-Ryul
    • Journal of Intelligence and Information Systems
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    • v.17 no.1
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    • pp.71-90
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    • 2011
  • This study was designed to empirically analyze the effect of control activities(physical, managerial and technical securities) of information protection on organizational effectiveness and the mediating effects of information application. The result was summarized as follows. First, the effect of control activities(physical, technical and managerial securities) of information protection on organizational effectiveness showed that the physical, technical and managerial security factors have a significant positive effect on the organizational effectiveness(p < .01). Second, the effect of control activities(physical, technical and managerial securities) of information protection on information application showed that the technical and managerial security factors have a significant positive effect on the information application(p < .01). Third, the explanatory power of models, which additionally put the information protection control activities(physical, technical and managerial securities) and the interaction variables of information application to verify how the information protection control activities( physical, technical and managerial security controls) affecting the organizational effectiveness are mediated by the information application, was 50.6%~4.1% additional increase. And the interaction factor(${\beta}$ = .148, p < .01) of physical security and information application, and interaction factor(${\beta}$ = .196, p < .01) of physical security and information application among additionally-put interaction variables, were statistically significant(p < .01), indicating the information application has mediated the relationship between physical security and managerial security factors of control activities, and organizational effectiveness. As for results stated above, it was proven that physical, technical and managerial factors as internal control activities for information protection are main mechanisms affecting the organizational effectiveness very significantly by information application. In information protection control activities, the more all physical, technical and managerial security factors were efficiently well performed, the higher information application, and the more information application was efficiently controlled and mediated, which it was proven that all these three factors are variables for useful information application. It suggested that they have acted as promotion mechanisms showing a very significant result on the internal customer satisfaction of employees, the efficiency of information management and the reduction of risk in the organizational effectiveness for information protection by the mediating or difficulty of proved information application.