Kim, Young Woong;Jung, Sung-Ho;Choo, Suk Jung;Chung, Cheol Hyun;Lee, Jae Won;Kim, Joon Bum
Journal of Chest Surgery
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제51권1호
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pp.15-21
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2018
Background: Prosthetic valve endocarditis (PVE) is a serious complication of cardiac valve replacement, and many patients with PVE require reoperation. The aim of this study was to review our institutional 20-year experience of surgical reoperative valve replacement in patients with PVE. Methods: A retrospective study was performed on 84 patients (mean age, $54.8{\pm}12.7years$; 51 males) who were diagnosed with PVE and underwent reoperative valve replacement from January 1995 to December 2016. Results: PVE was found in 1 valve in 61 cases (72.6%), and in 2 or more valves in 23 cases (27.4%). The median follow-up duration was 47.3 months (range, 0 to 250 months). Postoperative complications occurred in 39 patients (46.4%). Reinfection occurred in 6 cases, all within 1 year. The freedom from reinfection rate at 5 years was $91.0%{\pm}3.5%$. The overall survival rates at 5 and 10 years were $64.4%{\pm}5.8%$ and $54.3%{\pm}7.3%$, respectively. In stepwise multivariable Cox proportional hazard models, older age (hazard ratio [HR], 1.48; 95% confidence interval [CI], 1.05 to 2.10; p=0.027) and cardiopulmonary bypass (CPB) time (HR, 1.03; 95% CI, 1.00 to 1.01; p=0.033) emerged as independent risk factors for death. Conclusion: Older age and a longer CPB time were associated with an increased risk of overall mortality in PVE patients.
Purpose: Transcatheter device closure of patent ductus arteriosus (PDA) is challenging in early infancy. We evaluated PDA closure in infants less than 6 months old. Methods: We performed a retrospective review of infants less than 6 months of age who underwent attempted transcatheter device closure in our institution since 2004. To compare clinical outcomes between age groups, infants aged 6-12 months in the same study period were reviewed. Results: A total of 22 patients underwent transcatheter PDA closure during the study period. Patient mean age was $3.3{\pm}1.5months$, and weight was $5.7{\pm}1.3kg$. The duct diameter at the narrowest point was $3.0{\pm}0.8mm$ as measured by angiography. The most common duct type was C in the Krichenko classification. Procedural success was achieved in 19 patients (86.3%). Major complications occurred in 5 patients (22.7%), including device embolization (n=1), acquired aortic coarctation (n=2), access-related vascular injury requiring surgery (n=1), and acute deterioration requiring intubation during the procedure (n=1). Two patients had minor complications (9.1%). Twenty-four infants aged 6-12 months received transcatheter device closure. The procedural success rate was 100%, and there were no major complications. The major complication rate was significantly higher in the group less than 6 months of age (P=0.045). There was a trend toward increased major complication and procedural failure rates in the younger age group (P<0.01). Conclusion: A relatively higher incidence of major complications was observed in infants less than 6 months of age. The decision regarding treatment modality should be individualized.
Neuroblastoma treatment remains challenging, but treatment has become more effective due to the establishment of clinical and biological variables that determine prognostic risks. Initially, stage and age were the prime determinants of survival used in clinical practice. Risk-based therapy currently is the hallmark of neuroblastoma treatment. This study reviews one center's experience with the management of neuroblastoma. Sixty-three patients with neuroblastoma were treated from 1989 to 2003. All patients were graded according to the International Neuroblastoma Staging System (INSS) at diagnosis. There were 37 boys and 26 girls. The median age was 2.14 years (range, 33 days-10.2years). The primary site was the adrenal gland in 47, dumbbell shape extending into spinal canal in 6, retroperitoneum in 5, mediastinum in 3, and other sites in 2. The probability of 5-year overall survival (OS) and event free survival (EFS) were 46.7 % and 44.2 % by Kaplan-Meier method. According to INSS, there were stage 1 in 2 cases, stage 2 in 5, stage 3 in 12, stage 4 in 42, and stage 4s in 2. There were statistically significant differences in the survival rates between patients with stage1, 2 and stage 3, 4(P<0.05). For the stage 3 and 4, the extents of surgical resection, determined from the operative records and pathologies, were complete resection in 17 cases, minimal residual in 15, and partial resection 11, and the 5-year OS rate was 57.8, 51.4, and 13.6 %, respectively. There is a trend toward higher OS with more complete resection (P<0.05). We conclude that age and stage at diagnosis are prognostic factors, and complete excision of the primary tumor can provide better prognosis for patients with stage 3 and 4 neuroblastoma.
Purpose: This study was conducted to identify the disease adaptation and related factors for the pediatric patients with diabetes mellitus. Methods: Participants in this study were 75 diabetic children or adolescent whose age were 10 to 18 years old visited the out-patient clinic in one general hospital located in Seoul. Data were collected using self-report questionnaires. Research tools measuring resilience, family support, psychological adaptation, Hemoglobin A1c (HbA1c) protein were used. Results: Resilience showed significant differences according to the age, gender, academic achievement, and hospitalization experience of the children. Family support was significantly different according to the age, religion, academic achievement, fathers' education level, and hospitalization experience of the children. Psychological adaptation to diabetes showed significant differences according to academic achievement. HbA1c was shown to be significant difference according to fathers' education level and hospitalization experience of the children. Positive correlations were identified among resilience, family support, and psychosocial adaptation, while negative correlations were found between HbA1c and all others including resilience, family support, and psychosocial adaptation. Conclusion: This study suggests that the educational programs as nursing intervention needs to be developed to enhance the resilience and family support for the pediatric diabetic patients.
. Tobacco Use and Mortality: - If things do not change, deaths due to tobacco use in the world will increase from 4 million in 1998 to 10 million in 2030 - Developed regions will experience 50% increase, while Asia will experience fourfold increase - globally, tobacco will be responsible for one in eight deaths by late 2020s. - Globally, at least one in three teen-age smokers will die prematurely as a result of smoking(omitted)
Seo, Seung Hyeon;Lee, Yeoun Joo;Mun, Sang Wook;Park, Jae Hong
고신대학교 의과대학 학술지
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제33권2호
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pp.150-158
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2018
Objectives: Although Campylobacter is the main cause for bacterial acute gastroenteritis (AGE), there has been no notable clinical research into it, especially for Korean children. In this study, we share our experience of clinical, laboratory and image findings with Campylobacter AGE. Methods: Between May 2013 and June 2016, children diagnosed as having Campylobacter AGE were retrospectively enrolled in our study. Campylobacter AGE was considered diagnosed when a patient had symptoms of bacterial AGE and a positive Campylobacter result in stool using multiplex PCR. Results: Among 539 patients with suspected bacterial AGE, 31 (5.8%) patients had a positive result for Campylobacter. The average age of the 31 patients was $10.2{\pm}5.0$ years with a range between 1.1 and 16.9 years. Eighteen (58%) of the total patients were hospitalized between June and August. Diarrhea (93.5%), abdominal pain (83%) and fever (83%) were common symptoms. For 20 patients (65%), diarrhea lasted for less than three days, and fever lasted for 2.1 days on average. Among the 20 patients subjected to imaging studies, 12 patients (60%) showed bowel wall thickening on the right side of colon. In blood tests of 30 patients, 22 (73%) and 29 (97%) patients exhibited leukocytosis and elevated C-reactive protein, respectively. During treatment for Campylobacter AGE, prediagnostic empirical antibiotics were used for 6 (19%) patients. All patients recovered without complications. Conclusions: Among the children with suspected bacterial AGE, 5.8% had a positive result on Campylobacter in stool using multiplex PCR. Therefore, we observe that Campylobacter AGE should be considered in school-age children who have diarrhea, fever, and abdominal pain.
The purpose of this paper is to evaluate 1) blood lead levels of workers at auto repair shops as Biological Exposure Indices (BEI) of toxic substances such as lead and toluene that are produced during automotive painting process, 2) the differences depending on personal characteristics of workers who have been exposed to toluene by using urine hippuric acid concentration as a marker and 3) the correlation between the concentration of hazardous chemicals in each workplace and the BEL. All subjects were male with a mean age of 36.2 years. In terms of age, most were in the 30 to 40 age group (13 persons, 48.1%). In relation to the length of work experience, the highest proportion had experience of 10 years of less (18 persons, 66.7%). Twenty three workers were cigarette smokers (85.2%) while 4 (14.8%) were non-smokers. In addition, more than 80% of the workers drank alcohol. Dust concentration and toluene exposure during automotive painting showed no significant difference with age, length of work experience, smoking and drinking while a significant difference (p<0.05) has been detected between lead concentration and smoking. The geometric mean of dust concentration, lead concentration and toluene concentration were $0.38mg/m^3,\;0.0021mg/m^3$ and 1.08ppm respectively. In addition, the geometric mean of blood lead levels and urine hippuric acid concentration were $1.70{\mu}g/dl$ and 0.25g/g respectively, which were lower than the standard levels suggested by the Ministry of Labor. To determine the influential factors on blood lead and urine hippuric acid concentrations, a correlation analysis has been conducted with variables of air, lead and toluene concentrations, age, length of work experience and amount of cigarette smoking. According to the analysis, a relatively high correlation (p<0.01) has been observed between air lead concentration and biological sample concentration.
This study investigates the actual hospital-clothes consumption experience of consumers according to gender and age. An all age survey was conducted among male and female ex-patients in Korea nationally. From data collected during April and May 2009, a total of 513 responses were analyzed using descriptive statistics, chi-square analysis, two-way ANOVA, and MANOVA using SPSS 10.1.4. The results are as follows. The hospitalization ratio was higher in the male group than in the female group and increased with age. Many hospitalizations were taken to the department of orthopedics, internal treatment, obstetrics and gynecology, and surgery. The satisfaction with patient gowns was low regarding size, fabric touch, color and pattern, Psychological comfort, and holistic satisfaction, Specifically, the stiffness of the fabric, cheerless colors, and the limited number of sizes were the main complaints; size dissatisfaction was expressed strongly by females. About 35% of respondents showed a positive attitude to wear premium patient gowns. Various medical supplies were used and different items were utilized according to gender and age of patients. Uncomfortableness of medical supplies were highly related to laundry and fabric touch.
The purpose of this study is to investigate the effects of the exhibition displays and events of the Agro-healing Experience Hall in the Agricultural Technology Exhibition 2018 on satisfaction and revisit intention of visitors. A survey was conducted on visitors of the Agro-healing Experience Hall and the responses of 274 visitors excluding 26 cases with inappropriate responses were analyzed. For psychological measurement, the Perceived Restorativeness Scale (PRS), Profile of Mood States (POMS), level of plant gardening experience, satisfaction and loyalty were measured. There was a significant difference among age groups in all four factors of the PRS (repose, fascination, coherence, and legibility). In the case of education level, there was a significant difference in the three factors (repose, fascination, and legibility). In addition, average monthly income showed a significant difference among groups in the two factors (fascination and coherence). As a result of analyzing the mood states of visitors for the exhibition events of the Agro-healing Experience Hall, there was a significant difference among age groups only in the case of vigor (p < .05). As a result of analyzing the correlation between the level of plant gardening activities (3 factors) and PRS (4 factors) in the exhibition events of the Agro-healing Experience Hall, plant preference tendency and plant-related event showed a high positive correlation of 0.5 or more with repose of the PRS factors. A multiple regression analysis was conducted to investigate the effects of the level of plant gardening activities, PRS and POMS on the satisfaction and loyalty of visitors. As a result, it was found that in terms of relative explanatory power over independent variables affecting satisfaction and revisit intention, fascination had the greatest effect, followed by vigor, fatigue, and occupation (company employee). The results of this study suggest that exhibition events of the Agro-healing Experience Hall affect repose, fascination or vigor of visitors, and thus can be used positively to increase satisfaction and revisit intention of visitors.
Background: Rapid population aging in developed countries has resulted in the working-age population increasingly being tasked with the provision of informal care. Methods: An educational intervention was delivered to 21 carer-employees employed at a Canadian University. Work role function, job security, schedule control, work-family conflict, familywork conflict, and supervisor and coworker support were measured as part of an aggregated workplace experience score. This score was used to measure changes pre/post intervention and at a follow-up period approximately 12 months post intervention. Three random intercept models were created via linear mixed modeling to illustrate changes in participants' workplace experience across time. Results: All three models reported statistically significant random and fixed effects intercepts, with a positive coefficient of change. Conclusion: This suggests that the intervention demonstrated an improvement of the workplace experience score for participants over time, with the association particularly strong immediately after intervention.
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