• Title/Summary/Keyword: Aged Replacement

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Midterm results of aortic root enlargement with AVR in patients with narrow aortic root and AS (협소 대동맥 판륜을 가진 환자에서의 대동맥치환술시 판륜 확장술의 중기 성적)

  • 박광훈;김하늘루;최강주;이양행;황윤호;조광현
    • Journal of Chest Surgery
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    • v.33 no.4
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    • pp.285-289
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    • 2000
  • Background: For AVR using conventional prosthetic valves in adult patients with a narrow aortic root, aortic root enlargement is necessary to reduce postoperative pressure gradient across the aortic valve (ΔP). An evaluation of early and mid-term results of aortic root enlargement with AVR and echocardiographic follow up of ΔP and left ventricular function was performed. Method: From Aug. 1991 to Feb. 1998, eighteen patients aged 17 to 59 years(mean, 38$\pm$12 years) underwent Manouguian procedure with AVR. Aortic annular circumstance was enlarged 10.0mm to 18.0mm(mean, 12.6$\pm$6.3mm). Eight patients(44.0%) had NYHA class III status before operation, and seven cases of them underwent concomitant MVR. Valve pathology was ASr in 6 cases, AS in 4 cases, nd ASr+MSr in 8 cases. Replaced valve size was 21mm in 8 cases and 23 mm in 10 cases, and St. Jude Medical mechanical valve was used in 10 cases and Carbomedics in 8 cases. Result: Follow-up duration was 6 to 57 months (mean, 26$\pm$18 months), and total follow-up was 287 patient-year. There were one hospital death and one late death, therefore, actuarial survival rate was 85.7% at 56 months. Peak ΔP wad decreased significantly at postoperative mid-term period as 13$\pm$5mmHg, compared with thepreoperative one (42$\pm$8mmHg) (p<0.01). LVM(gm/$m^2$) was also diminished as 35.8%(115$\pm$36gm/$m^2$)at postoperative mid-term period, compared with preoperative one (179$\pm$56gm/$m^2$)(p<0.05). Conclusion: There were no specific complications related to the procedure. And we could have adequate enlargement of aortic annulus to suitable prosthetic valve that have no effect of patient-prosthese mismatch.

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Outcomes of Venovenous Extracorporeal Membrane Oxygenation Support for Acute Respiratory Distress Syndrome in Adults

  • Ma, Dae-Sung;Kim, Joon-Bum;Jung, Sung-Ho;Choo, Suk-Jung;Chung, Cheol-Hyun;Lee, Jae-Won
    • Journal of Chest Surgery
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    • v.45 no.2
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    • pp.91-94
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    • 2012
  • Background: Despite improved managements for acute respiratory distress syndrome (ARDS), its mortality remains high. Extracorporeal membrane oxygenation (ECMO) has emerged as the final option for the treatment of ARDS unresponsive to conventional measures. This study describes our experiences of venovenous ECMO support for the treatment of ARDS. Materials and Methods: Between 2007 and 2010, 56 patients (aged $56.6{\pm}13.4$ years, 43 males) received venovenous ECMO for the treatment of ARDS. The detailed clinical records were retrospectively reviewed. Results: Before the institution of ECMO support, 35 patients (55.4%) required nitric oxide inhalation, 35 patients (55.4%) received continuous renal replacement therapy, and 20 patients (35.7%) were in shock status. The median duration of ECMO support was 164 hours (range, 5 to 1,413 hours). 27 (48%) patients could be successfully weaned from ECMO. Of them, 7 (13%) survived to discharge. On logistic regression analysis, a requirement for higher inspiratory pressure before ECMO support was the only significant factor that could predict ECMO weaning failure. Conclusion: The outcome of venovenous ECMO support for the treatment of ARDS was suboptimal. Further improvements in outcomes should be made through the accumulation of experience and establishment of a standardized protocol for the management of ECMO.

Factors Associated with the Non-screening Status of Cervical Cancer Screening Test in Korean Adult Women: Korea National Health and Nutrition Examination Survey (2010-2012) (한국 성인여성의 자궁경부암 미수검 관련 요인분석: 국민건강영양조사(2010-2012년) 자료 이용)

  • Choi, Won-Mi;Han, Nam-Kyung;Chung, Woojin
    • Health Policy and Management
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    • v.29 no.4
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    • pp.399-411
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    • 2019
  • Background: This study aimed to explore the associations of social-demographic, health-behavioral, and woman-specific factors with the non-screening status of the cervical cancer screening test in Korean adult women. Methods: This study was a cross-sectional analysis of 9,698 Korean adult women aged 20 years or more who participated in the Korea National Health and Nutrition Examination Surveys V (2010-2012). Rao-Scott chi-square tests and survey logistic regression analyses were employed respectively to analyze the difference in the non-screening status of the cervical cancer screening test by each characteristic and to explore the factors related to the non-screening status. Results: The rate of the non-screening status of the cervical cancer screening test was 53.5% over the previous 2 years. In the survey logistics regression analysis, age, marital status, educational levels, income levels, residential area, occupation, private health insurance, smoking, alcohol, obesity, menstrual status, pregnancy experience, and hormone replacement therapy were significantly associated with the non-screening status of the cervical cancer screening test. Conclusion: On the basis of the results of this study, some social-demographic, health-behavioral, and woman-specific characteristics of Korean adult women seem to affect the non-screening status of the cervical cancer screening test. Therefore, appropriate health policies need to be designed, implemented, monitored, and evaluated to reduce the non-screening status of the cervical cancer screening test of them.

Bending Fatigue Life Assessment of Aged CWR using the Field Test (현장측정을 통한 노후레일의 휨 피로수명 평가)

  • Park, Yong-Gul;Sung, Deok-Yong;Park, Hong-Kee;Kong, Sun-Yong
    • Journal of the Korean Society for Railway
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    • v.11 no.3
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    • pp.317-325
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    • 2008
  • As a result of recent research, it is reported that the periodic replacements criterion of rails is able to extend as grinding rail surface and using the continuous welded rail (CWR). This study evaluated correlation between conditions of track and load capacity of rail by analysing the dynamic response of track while the metro train is running. Also, it was converted the measured stress waveform into stress frequency histogram by the rain-flow counting methods, and then accumulated fatigue damage ratio and remaining service life of laid rail were calculated so as the apply the equivalence of stress to S-N curve of a new welded rail. Finally, this study suggests a revision of the periodic replacements criterion of CWR, which was based on accumulated passing tonnage, classified by the types and conditions of track system.

A Clinical Survey of 9 dogs with Naturally Occurring Hypoadrenocorticism (자연발생 부신겉질저하증에 걸린 9마리 개에 대한 고찰)

  • Ko Young-hwan;Bae Bo-kyoung;Bhang Dong-ha;Choi Ul-soo;Youn Hwa-young;Hwang Cheol-yong;Choi Min-cheol;Yoon Jung-hee;Lee Chang-woo
    • Journal of Veterinary Clinics
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    • v.22 no.2
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    • pp.130-135
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    • 2005
  • A retrospective study was performed with 9 cases of spontaneous canine hypoadrenocorticism presented to the Veterinary Medical Teaching Hospital of Seoul National University. The disease occurred mostly in young to middle­aged dogs. Most dogs had chronic nonspecific signs such as episodic anorexia, lethargy and vomiting, but 3 dogs were brought to the hospital with an acute adrenal crisis. Serum biochemical analysis revealed azotemia, abnormal concentration of sodium, potassium, and chloride in almost all the patients. Diagnoses were made based on lack of adrenocortical response to exogenous adrenocorticotropic hormone(ACTH). Most dogs have been responded well with mineralocorticoid and glucocorticoid replacement except for a dog which died during treatment for adrenal crisis. Three dogs treated with fludrocortisone acetate(final median dosage, $31.0{\mu}g/kg/day$) for mineralocorticoid supplementation showed some adverse effects, such as excessive appetite and polyuria/polydipsia. In this study, it was suggested that clinicians should also consider hypoadrenocorticism when they diagnose a patient showing nonspecific gastrointestinal signs with unknown cause or laboratory findings which mimic primary renal diseases.

DGA Gases related to the Aging of Power Transformers for Asset Management

  • Kweon, Dongjin;Kim, Yonghyun;Park, Taesik;Kwak, Nohong;Hur, Yongho
    • Journal of Electrical Engineering and Technology
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    • v.13 no.1
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    • pp.372-378
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    • 2018
  • Life management technology is required as the failure risk of aged power transformers increases. Asset management technology is developed to evaluate the remaining life, establish the replacement strategies, and decide the optimal investment based on the reliability and economy of power transformers. The remaining life assessment uses data such as installation, operation, maintenance, refurbishment, and failure of power transformers. The optimal investment also uses data such as maintenance, outage, and social costs. To develop the asset management system for power transformers, determining the degradation parameters related to the aging of power transformers and evaluating the condition of power transformers using these parameters are important. In this study, since 1983, 110,000 Dissolved Gas Analysis (DGA) data have been analyzed to determine the degradation parameters related to the aging of power transformers. The alarm rates of combustible gases ($H_2$, $C_2H_2$, $C_2H_4$, $CH_4$, and $C_2H_6$), TCG, CO, and $CO_2$ were analyzed. The end of life and failure rate (bathtub curve) of power transformers were also calculated based on the failure data from 1981 to 2014. The DGA gases related to discharge, overheating, and insulation degradation were determined based on alarm and failure rates. $C_2H_2$, $C_2H_6$, and $CO_2$ were discharge, oxidation, and insulation degradation parameters related to the aging of power transformers.

The Development of Phlebitis in Relation to 18 Gauge Peripheral Intravenous Catheter Dwell Time among Surgical Patients (수술환자 18 Gauze 말초 정맥관 유지시간과 정맥염 발생률)

  • Choi, Jung Hee;Kang, Min Ja;Park, Youn Hee;Hong, Bo Ra;Lee, Dong Sook
    • Journal of Korean Clinical Nursing Research
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    • v.21 no.2
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    • pp.188-195
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    • 2015
  • Purpose: The purpose of this study was to evaluate the appropriateness of the replacement time intervals of 18 gauge peripheral intravenous catheters (PICs) by investigating the development of phlebitis. Methods: The subjects were 200 hospitalized patients over 18 yrs old aged who have 18 gauge PICs placed for surgery. After the insertion of PICs, the researcher monitored the insertion site daily for 96 hours for any signs of phlebitis. Results: Phlebitis developed in 25.7% of patients. Patients who developed phlebitis were significantly older and were receiving fluids with faster infusion rate. However, patients with and without phlebitis were not different by gender, insertion site, fluid osmolality, or pH of drugs administered. The incidence rate of phlebitis was higher than 10%(12.9%) starting 24~48 hours after the insertion of 18 gauge PICs. Conclusion: It is recommended to replace 18 gauge PICs within 24~48 hours after insertion. Close monitoring of the PICs insertion site for the signs of phlebitis is recommended.

Analysis of the Current State of Home Health Nursing for Elderly Patients in Advanced General Hospital (일 상급종합병원 노인 환자의 가정간호 서비스 이용 현황 분석)

  • Park, Sung Hye;Jang, Yeon Soo;Kim, Su Jin
    • Journal of Korean Clinical Nursing Research
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    • v.25 no.3
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    • pp.275-284
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    • 2019
  • Purpose: The purpose of this study was to analyze the current state of home health nursing (HHN) for elders and to provide basic data on policy alternatives for establishing home medical care in the advanced general hospital. Methods: This study was conducted as a secondary data analysis, using electronic medical record (EMR) data of older patients who received HHN more than once from the S advanced general hospital between January 2016 and December 2018. Results: A total of 1,790 patients received HHN visits, with 22,477 visits being made. The mean age was 76.8±7.3 years old, 96.0% of elders had health insurance and 24.6% had orthopedics problems. Of the 1,168 people who visited emergency rooms, the most frequent symptom was pain (23.4%) and all patients visited the hospital at least once and at most 163 times outpatient care during HHN. Causative diseases were degenerative knee joint osteoarthritis (0.6%), surgery for right knee replacement (4.0%), and for dressings (9.7%) in the HHN service content analysis. Conclusion: The progress towards an aging society and the introduction of community care are expected to further enhance the need for HHN which should be able to provide comprehensive and continuous visiting health care services to the older patients. The results of this study are expected to help doctors solve problems not solved by HHN, reduce unnecessary emergency room or outpatient visits, and readmission, while at the same time contributing to the improvement of patient quality of life through efficient patient health care.

COVID-19 and changes in Korean consumers' dietary attitudes and behaviors

  • Rha, Jong-Youn;Lee, Bohan;Nam, Youngwon;Yoon, Jihyun
    • Nutrition Research and Practice
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    • v.15 no.sup1
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    • pp.94-109
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    • 2021
  • BACKGROUND/OBJECTIVES: The coronavirus disease 2019 (COVID-19) outbreak has dramatically changed nearly every aspect of our lives. Although Dietary lifestyle includes attitudes and behaviors to meet their most basic needs, but few studies have examined the pattern of changes in dietary lifestyle driven by COVID-19. This study explores changes in dietary attitudes and behaviors among Korean consumers after COVID-19. SUBJECTS/METHODS: An online survey was conducted with 549 Korean adults aged 20 and older to identify general demographics and changes in dietary attitudes and behaviors. Data were collected from Oct 12 to Oct 18, 2020. Frequency, percentage, and mean values were calculated and a K-means cluster analysis was performed to categorize consumers based on the 5S of dietary attitudes (i.e., savor-oriented, safety-oriented, sustainability-oriented, saving-oriented, and socializing-oriented). RESULTS: Findings indicate consumers considered safety, health, and freshness to be most important when choosing groceries and prepared meal such as home meal replacement and delivery food. Among the types of services, a large proportion of consumers increased their delivery and take-out services. Regarding retail channels, the increase in the use of online retailers was remarkable compared to offline retailers. Finally, consumers were classified into four segments based on changes in dietary attitudes: "most influenced," "seeking safety and sustainability," "abstaining from savor and socializing," and "least influenced." Each type of consumer exhibited statistically significant differences by sex, age, household composition, presence of disease, and perceived risk of COVID-19. CONCLUSIONS: This exploratory study provides initial insights for future research by identifying various aspects of dietary attitudes and behaviors among Korean consumers after COVID-19.

Factors affecting the Length of Stay in Patients with Total Knee Arthroplasty (슬관절 전치환술 환자의 재원일수에 영향을 주는 요인)

  • Lee, Hye-Seung;Kim, Hwan-Hui
    • Journal of Korea Entertainment Industry Association
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    • v.14 no.6
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    • pp.201-208
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    • 2020
  • The purpose of this study was to analyze the claim data of Health Insurance Review & Assessment Service to determine what factors affected the length of stay in patients aged 65 and older and undergoing total knee arthroplasty due to the principal diagnosis of gonarthrosis by the type of medical institutions. As a result of making an analysis, gender, age, medical security type, severity, residential area and the number of sickbeds were identified as the factors that influenced the length of stay in each type of medical institutions. At this point in time when an increase in the elderly population triggered by population aging and another subsequent increase in medical expenses put a heavy strain on household and national economy, it's necessary to consider how to shorten the length of stay and how to ensure the efficient management of sickbeds based on the findings of this study. In addition, this study is of significance in that it could be used as basic data on quality life-care for elderly patients by the introduction of a systematic management system geared toward lessening patient burden for medical expenses.