• Journal of Chest Surgery
• /
• v.43 no.3
• /
• pp.246-253
• /
• 2010

Background: Our objective was to review the long-term prognosis of patients with preoperative mild to moderate ischemic mitral regurgitation who underwent off-pump coronary artery bypass grafting. Material and Method: We prospectively followed 1,000 consecutive and systematic off-pump coronary artery bypass grafting patients who were operated on between September 1996 and March 2004; follow-up was achieved for 97%. Sixty-seven patients (6.7%) had mild to moderate ischemic mitral regurgitation at the time of surgery. Operative mortality, actuarial survival and major adverse cardiac event free survival were compared to assess the effect of ischemic mitral regurgitation. Result: Average follow-up was $66{\pm}22$ months. Patients with ischemic mitral regurgitation were older (p<0.001), had lower ejection fractions (p<0.001) and more comorbidities. Significantly more female patients presented with ischemic mitral regurgitation (p=0.002). There was no significant difference in operative mortality and perioperative myocardial infarction in ischemic mitral regurgitation patients (p=0.25). Eight-year survival was decreased in ischemic mitral regurgitation patients ($39.6{\pm}11.8%$ vs $76.7{\pm}2.2$, p<0.001). However, after correcting for risk factors, mild to moderate ischemic mitral regurgitation was not found to be a significant independent risk factor for long-term mortality (p=0.42). Major adverse cardiac event free survival at 8 years was significantly lower in ischemic mitral regurgitation patients ($53.12{\pm}12%$ vs $77{\pm}2%$, p<0.001). After correction for risk factors, ischemic mitral regurgitation remained a significant independent cause of major adverse cardiac events (HR: 2.31), especially congestive heart failure and recurrent myocardial infarction. Conclusion: In our series, patients with preoperative mild to moderate ischemic mitral regurgitation had a higher prevalence of preoperative risk factors than patients without ischemic mitral regurgitation. They had comparable perioperative mortality and morbidity, but, in the long term, were found to be at elevated risk for recurrent cardiac events.

• Tuberculosis and Respiratory Diseases
• /
• v.56 no.2
• /
• pp.151-158
• /
• 2004

Background : When a non small cell lung caner patient at the $_cT_{1-2}N_0M_0$ stage is diagnosed with intrapulmonary nodule(s), the treatment plan and prognosis of the patient largely depend on whether the nodule is benign or malignant. In most cases, however, it is hard to conduct a biopsy on such a nodule, due to its small size. Furthermore, the predictive factors that may imply benignancy or malignancy of the nodules remain unknown. As such, the purpose of our study was to validate the incidence of malignant nodules in such cases, and find if there are any predictive factors. Methods : Chest computed tomography(CT) scans and the medical records of 444 patients, who had undergone non small cell lung cancer surgery, between July, 2001 and September, 2003, at Seoul National University Hospital, were retrospectively reviewed. Among $_cT_{1-2}N_0M_0$ non small cell lung cancer patients, with intrapulmonary nodule(s), only those cases where a CT scan or a biopsy of the nodules had been conducted, and had been followed up at intervals of more than 6 months were included. However, patients who had received chemotherapy or radiation therapy, pre- or post-operatively, or with calcified nodules, were excluded. Results : Our study group consisted of 39 patients, divided into two groups. The first group, 33 patients, had benign nodules, and the second group, 6 patients, had malignant nodules. The two groups were compared with regard to gender, age, cell type, pathologic stage, shape, size, location and number of nodules and presence of calcification around the nodules. There was no statistically significant difference between the two groups. Conclusion : The intrapulmonary nodules in non small cell lung cancer patients at the $_cT_{1-2}N_0M_0$ stage were mostly benign. Therefore, surgical treatment for such patients can be considered. Moreover, without predictive factors, pathological confirmation of the diagnosed nodules should be sought in all patients.

• Tuberculosis and Respiratory Diseases
• /
• v.66 no.2
• /
• pp.116-121
• /
• 2009

Background: Tsutsugamushi, leptospirosis and hemorrhagic fever with renal syndrome (HFRS) are the prevalent diseases among the acute febrile illnesses in Korea. Pulmonary involvement in the patients with these diseases remains poorly recognized in endemic regions, and this is despite reports of recent outbreaks and epidemic episodes. Pulmonary involvement and a higher CRP level as clinical manifestations show a more severe form of infection. The aim of this study is to analyze the correlation of pulmonary involvement and the CRP level in patients with acute febrile illnesses. Methods: We retrospectively reviewed the clinical records of 105 patients who were diagnosed with tsutsugamushi, HFRS and leptospirosis from January 2002 to May 2008 in Chuncheon Sacred Heart Hospital. The radiographic images were retrospectively analyzed by two radiologists. We analyzed the pulmonary complications of the patients with these febrile diseases and we checked the CRP level at admission. Results: The study included 105 patients who were diagnosed with febrile diseases. Of these patients, 32 patients had hantaan, 10 patients had leptospirosis and 63 patients had tsutsugamushi disease. 42 (40%) patients had pulmonary complications, 20 patients had pulmonary edema, 20 patients had pleural effusion and 2 patients had interstitial pneumonitis. The patients with pulmonary involvement showed a more severe form of infection and a higher CRP level than that of those patients without pulmonary involvement (p=0.0073). Conclusion: Pulmonary involvement in patients with acute febrile diseases might be correlated with a higher CRP level. Identification of this factor on admission might provide useful selection criteria for the patients who need early intensive care.

• The Korean Journal of Emergency Medical Services
• /
• v.9 no.2
• /
• pp.111-128
• /
• 2005

Background: Cardiac arrest is one of the most critical diseases which can likely lead to severe cerebral disability or brain death when the cases can not recover their circulation within 10 minutes. Saving out-of-hospital cardiac arrest cases is a recent concern in Korea. Resuscitation has become an important multidisciplinary branch of medicine, demanding a spectrum of skills and attracting a plethora of specialities and organizations. The best survival can be achieved if all the following links have been optimized : rapid access, and early CPR, defibrillation and ACLS, Since the "Utstein Style" was advocated in 1991, many reports about out-of-hospital cardiac arrest have been published based on this guideline. These differences prevent valid inter-hospital and international comparisons. However, it is not known how effective resuscitation has become to the patients. In other words, there are no guidelines for reviewing, reporting, and conducting research on resuscitation in Korea. This dissertation aims to provide the basic data for a unified reporting guideline of resuscitation in Korea and evaluating the out-of-hospital factors associated with survival discharge of out-of-hospital cardiac arrest. Methods: As for this study, uses the collected data about Out-of-hospital cardiac arrests at 4 area, from January, 2005 to April. 2005. With a retrospective study, 174 cases were analyzed. The data was recorded based on the Out-of-Hospital Utstein Style. Results: Resuscitation was performed on 174 out-of-hospital cardiac arrest cases at the 4 area 14 patients(8.1%) recovered their spontaneous circulation. Overall, the ROSC of the out-of-hospital cardiac arrest patients was 8.1%, which was poorer than that of western countries. Gender distribution was 50 females(28.7%) and 124 males(71.3%), approximately twice as many males as females. ROSC of witnessed arrests was found out to be 97.7%. The ratio of the witnessed arrest groups showed higher results than that of unwitnessed arrest groups in the above-examined cases. Cardiac etiology consisted of cardiac(33.5%), non-cardiac(45.7%), trauma(20.1%), and unknown(6.0%). Cardiac was the best performance. Initial rhythm showed Ventricular Tachycardia/pulseless Ventricular Fibrillation in 8 patients(6.0%), asystole in 100(75.2%) and unknown in 25(18.8%). The results of the Ventricular Tachycardia/pulseless Ventricular Fibrillation showed higher results than the others cases, The proportion of the cardiogenic cause was 33.5%, which was only half of western countries. Ventricular Tachycardia/pulseless Ventricular Fibrillation is relatively rare. These differences were due to the prevalent pattern of Out-of-hospital cardiac arrest as well as prematurity of the EMSS. Bystander CPR was practiced on 13 patients(7.52%). ROSC was shown in 46.2% cases. CPR by EMT was carried out on 167 cases(96.5%). ACLS by EMf was rare. From collapse, 4 cases(2.6%) arrived to ED within 6 minutes. 13 (8.6%) within 10 minutes, and 49(32.5%) over 31 minutes. The sooner the patients arrived, the greater the ratio of ROSC and discharged alive became, and the same with collapse time to ROSC. As the results of the logistic regression analysis, ROSC was found out to be highly influenced by the time of ED arrival from collapse and Ventricular Tachycardia/pulseless Ventricular Fibrillation. Therefore, the ratio of ROSC depends on not any single factor but various intervention factors. Conclusion: This dissertation presents the following suggestions and directions of the study hereafter. First, the first step for a chain of survival should be taken to activate EMSS early with a phone as soon as cardiac arrests are witnessed. Second, it is keenly needed that emergency medical technicians should be increased through emergency education for living. Third, it is necessary to establish the emergency transportation system. Fourth, most of the Koreans have little understanding of EMT and the present operation systems have many problems, which should be fundamentally changed. Fifth, it is required to have an active medical control over Out-of-hospital CPR, And proper psychological supports should be given not only to patients themselves and their family but also individuals who are engaged in emergency situation. Finally, through studies hereafter on nationwide, comprehensive, and standard forms, it is needed to examine into the biological figures of human body, causes and trends of cardiac arrests, and then, to enhance the survival rate of Out-of-hospital cardiac arrests. Korean guidelines for Cardiopulmonary resuscitation need to be made.

• Journal of Korean Home Economics Education Association
• /
• v.24 no.3
• /
• pp.143-173
• /
• 2012

We investigated environmental problems related to clothing, and attempted their practical solutions using Future Problem Solving Program in order to cultivate the creative character in teenagers. We applied "teaching and learning plans" to seventy-seven the first graders of high school students in 2 classes in Gyeonggi-do, one hour per day for 3 weeks, from August 23 to September 8 2011. Statistical analyses were performed using the SPSS for Windows software(version 17.0). Mean differences in results between pretest and posttest were evaluated using Student's t-test. We selected 'production of fabrics, production of clothing, disposal and recycling of clothing and washing of clothing' as the learning theme in educational content factors of 'clothing culture in consideration of environment'. And we developed thirteenth teaching and learning plans and educational materials including 4 problems, 2 worksheets, 10 team worksheets, 7 video materials and 7 Power Point materials using Future Problem Solving Program(FPSP). The measurements of fluency, flexibility, originality and problem-solving ability are significantly improved. The level of creativity in the items of fluency, flexibility and originality, in particular, exhibited marked improvement, 'below-average' to 'above-average', regardless of academic records and gender. Problem-solving ability in female students was more effective than that of male, but it showed no significant correlation with academic records. The analysis of character-change showed the highest improvement in the awareness on the protection of environment, the character factor in the educational contents. Personalities, confidence, consideration and cooperation in learning method of FPSP also exhibited a significant improvement. But character-change did not correlate with academic records or gender. In the present study, we found that home economics has a positive effect on cultivating creative character. When we selectively and properly apply a course of creative problem-solving of FPSP and a course of creative output to students, we can increase their ability to solve problems, cultivate their creative character and further enhance their interest on home economics.

• Women's Health Nursing
• /
• v.8 no.2
• /
• pp.232-243
• /
• 2002

The purpose of this study was to examine factors influencing the meaning of life for middle-aged women. The subjects for the study were 190 middle-aged women who live in Busan. Data were collected from May 25 to June 20, 1999. The instruments for this study were as follows : the meaning of life scale developed by Jung D. R(1978) ; the self-esteem scale developed by Ro, E. Y, Kwon, J. H.(1997) ; the volunteer activity scale developed by Park G. J.(1999), the marital satisfaction scale developed by Choi G. Y.(1999) ; and the health status scale developed by Kim S. Y. (1991). SPSS PC+ was utilized for data analysis. Data were analysed according to frequency and percentage, mean and standard deviation, t-test, ANOVA, Sheffe' s test and Pearson' s correlation coefficients and stepwise multiple regression. The reliability of the tools was tested by Cronbach's $\alpha$ : and it showed reliability scores of 0.88(for the meaning of life tool), 0.81(for the self-esteem tool), 0.94(for the marital satisfaction tool) and 0.78(for the health status tool). The results were as follows: 1) The scores showed that middle-aged women had a moderate level of meaning of life, with a mean of 30.31 and standard deviation of 6.24 (with values ranging from 12.00 to 48.00). The scores showed that middle-aged women had a moderate levels of self-esteem, with a mean of 28.92 and standard deviation of 4.67 (with values ranging from 10.00 to 40.00). The scores showed that middle-aged women had a very low level of volunteer activity, with a mean of 0.87 and standard deviation of 0.93(with values ranging from 0.00 to 1.00). The scores showed that middle-aged women had a moderate level of satisfaction in their marriages, with a mean of 31.99 and standard deviation of 7.84(with values ranging from 12.00 to 48.00). The scores showed that middle-aged women had a moderate level of health status, with a mean of 6.63 and standard deviation of 1.57(with values ranging from 3.00 to 9.00). 2) There was a statistically significant difference of the meaning of life of middle-aged women according to their religion(F=8.930, p=.000), christian ($31.94{\pm}5.96$) had more meaning th life than buddhists ($28.40{\pm}6.23$). 3) There was a statistically significant correlations between the subject' s self-esteem and the her meaning of life(r=0.477, p=0.000), the subject' s level of volunteer activity and meaning of life(r=.428, p=.000), her level of marital satisfaction and meaning of life(r=.417, p=.000), and her level of health status and meaning of life(r=.261, p=.000) among these middle-aged women. 4) Self- esteem was the highest factor influencing the level of meaning of life in middle-aged women. 40.0% of the total variance of levels of meaning of life by was dependent on self-esteem, volunteer activity, marital satisfaction and health status. In conclusion, the higher the self-esteem and levels of volunteer activity, marital satisfaction, and health status of middle-aged women, the higher the meaning of life for them. Therefore, it is necessary to elevate levels of the self-esteem and volunteer activity, marital satisfaction and health status in order to help middle-aged women have more meaning of life.

• Asia pacific journal of information systems
• /
• v.21 no.1
• /
• pp.1-27
• /
• 2011

In an attempt to cope with widespread, dynamic, and accelerating changes in both internal and external business environments, companies often utilize information technologies such as SCM(Supply Chain Management). To date, SCM research has mainly focused on the effects of dynamic factors on SCM success and emphasized adoption strategies and critical success factors. Consequently, the effects of more static factors such as interdependency between SCM partners have been largely ignored. The purpose of this study, therefore, is to examine the effects of both dynamic and static factors on SCM performance by controlling for information quality and partnership quality. The five factors examined in this study include innovative ness, mutual dependency, quality of information, partnership quality, and SCM performance. All factors were examined from the perspective of part suppliers, except the mutual dependency which was examined from two aspects: supplier's dependency on customer and customer's dependency on supplier. Data was collected through five hundred survey questionnaires distributed to the part supplier companies that have implemented SCM systems for at least one year. As a result, a total of 170 valid responses were obtained. A structural equation research model was fitted using SAS 9.1.3 and SMART-PLS 2.0. The results of this study can be summarized as follows. First, innovativeness positively affected SCM information quality. SCM partnership quality, and ultimately SCM performance. The path coefficient between innovativeness and information quality was 0.387, with a t-value of 3.528. Innovativeness also had a positively direct effect on partnership quality. The path coefficient was 0.351 with a t-value of 3.366. The total effect of innovativeness on partnership quality was significant, although its indirect effect on partnership quality by altering information quality was negligible. The total indirect effect of innovativeness on SCM performance by affecting information quality and partnership quality was significant with a p-value of 0.014. Innovativeness played an important role in determining SCM performance. Second, mutual dependency showed no significant effect on SCM information quality. This result contradicts the earlier assertion that the more dependent two companies are, the more accurate and timely the information they exchange ought to be. This study showed that this may not be the case; a partner may provide information of poor quality even when it is strongly dependent on the other. Mutual dependency showed significant effect on partnership quality. However, when the mutual dependency perceived by suppliers was divided into two parts, one being a supplier's dependency on its customer company and the other being a customer's dependency on the supplier, the latter showed a significant impact on the perceived SCM partnership quality. This result indicates that a customer company can hardly improve the partnership quality perceived by suppliers by making them more dependent. It improves only when the suppliers perceive that their partners, typically having more bargaining power, are more dependent on them. The overall effect of mutual dependency of any kind on SCM performance, however, was not significant. Although mutual dependency has been mentioned as an important static factor influencing almost every aspect of cooperation on a supply chain, its influences may not be as significant as it was initially perceived to be. Third, the correlation between information quality and partnership quality was 0.448 with a p-value of less than 0.001. Information quality had a path coefficient of 0.256 to partnership quality with a t-value of 2.940. The quality of information exchanged between partners may have an impact on their partnership quality. Fourth, information quality also had a significant impact on SCM performance with a path coefficient of 0.325 with a t-value of 3.611. In this study, SCM performance was divided into four categories: product quality, cost saving, service quality, and order fulfillment. Information quality has Significant impacts on product quality, cost saving and service quality, but not on order fulfillment. Fifth, partnership quality, as expected, had a significant impact on SCM performance. The path coefficient was 0.403 with a t-value of 3.539. Partnership quality, like information quality, had positive impacts on product quality, cost saving and service quality, but showed no impact on order fulfillment. It seemed that order fulfillment is the hardest category of performance that SCM can satisfy. One major limitation of this study is that it surveyed only the suppliers. To better understand the dual aspects of SCM, it is important to survey both suppliers and the assemblers, especially in pairs. This research, to our best knowledge, was the first attempt to study the level of dependency between the two groups by measuring the dual aspects of SCM and studying mutual dependency from the categories of suppliers and assemblers each.. In the future, a more comprehensive and precise measurement of SCM characteristics needs to be achieved by examining from both the supplier's and assembler's perspectives.

• Asia pacific journal of information systems
• /
• v.22 no.4
• /
• pp.7-29
• /
• 2012

Smartphone and its applications (i.e. apps) are increasingly penetrating consumer markets. According to a recent report from Korea Communications Commission, nearly 50% of mobile subscribers in South Korea are smartphone users that accounts for over 25 million people. In particular, the importance of smartphone has risen as a geospatially-aware device that provides various location-based services (LBS) equipped with GPS capability. The popular LBS include map and navigation, traffic and transportation updates, shopping and coupon services, and location-sensitive social network services. Overall, the emerging location-based smartphone apps (LBA) offer significant value by providing greater connectivity, personalization, and information and entertainment in a location-specific context. Conversely, the rapid growth of LBA and their benefits have been accompanied by concerns over the collection and dissemination of individual users' personal information through ongoing tracking of their location, identity, preferences, and social behaviors. The majority of LBA users tend to agree and consent to the LBA provider's terms and privacy policy on use of location data to get the immediate services. This tendency further increases the potential risks of unprotected exposure of personal information and serious invasion and breaches of individual privacy. To address the complex issues surrounding LBA particularly from the user's behavioral perspective, this study applied the privacy calculus model (PCM) to explore the factors that influence the adoption of LBA. According to PCM, consumers are engaged in a dynamic adjustment process in which privacy risks are weighted against benefits of information disclosure. Consistent with the principal notion of PCM, we investigated how individual users make a risk-benefit assessment under which personalized service and locatability act as benefit-side factors and information privacy risks act as a risk-side factor accompanying LBA adoption. In addition, we consider the moderating role of trust on the service providers in the prohibiting effects of privacy risks on user intention to adopt LBA. Further we include perceived ease of use and usefulness as additional constructs to examine whether the technology acceptance model (TAM) can be applied in the context of LBA adoption. The research model with ten (10) hypotheses was tested using data gathered from 98 respondents through a quasi-experimental survey method. During the survey, each participant was asked to navigate the website where the experimental simulation of a LBA allows the participant to purchase time-and-location sensitive discounted tickets for nearby stores. Structural equations modeling using partial least square validated the instrument and the proposed model. The results showed that six (6) out of ten (10) hypotheses were supported. On the subject of the core PCM, H2 (locatability ${\rightarrow}$ intention to use LBA) and H3 (privacy risks ${\rightarrow}$ intention to use LBA) were supported, while H1 (personalization ${\rightarrow}$ intention to use LBA) was not supported. Further, we could not any interaction effects (personalization X privacy risks, H4 & locatability X privacy risks, H5) on the intention to use LBA. In terms of privacy risks and trust, as mentioned above we found the significant negative influence from privacy risks on intention to use (H3), but positive influence from trust, which supported H6 (trust ${\rightarrow}$ intention to use LBA). The moderating effect of trust on the negative relationship between privacy risks and intention to use LBA was tested and confirmed by supporting H7 (privacy risks X trust ${\rightarrow}$ intention to use LBA). The two hypotheses regarding to the TAM, including H8 (perceived ease of use ${\rightarrow}$ perceived usefulness) and H9 (perceived ease of use ${\rightarrow}$ intention to use LBA) were supported; however, H10 (perceived effectiveness ${\rightarrow}$ intention to use LBA) was not supported. Results of this study offer the following key findings and implications. First the application of PCM was found to be a good analysis framework in the context of LBA adoption. Many of the hypotheses in the model were confirmed and the high value of $R^2$ (i.,e., 51%) indicated a good fit of the model. In particular, locatability and privacy risks are found to be the appropriate PCM-based antecedent variables. Second, the existence of moderating effect of trust on service provider suggests that the same marginal change in the level of privacy risks may differentially influence the intention to use LBA. That is, while the privacy risks increasingly become important social issues and will negatively influence the intention to use LBA, it is critical for LBA providers to build consumer trust and confidence to successfully mitigate this negative impact. Lastly, we could not find sufficient evidence that the intention to use LBA is influenced by perceived usefulness, which has been very well supported in most previous TAM research. This may suggest that more future research should examine the validity of applying TAM and further extend or modify it in the context of LBA or other similar smartphone apps.

• Journal of the Korea Academia-Industrial cooperation Society
• /
• v.18 no.10
• /
• pp.505-512
• /
• 2017

The purpose of this study was to determine the quality of life according to the level of subjective perception as well as to analyze the influencing factors and improve the subjective perception to improve the quality of life. The results of the survey for adult patients in hospitals and neighborhood clinics in the region of Busan for nine months from December 2015 were as follows. Regarding the total symptoms, the women had a score of 1.41, and the younger respondents felt they suffered from no symptoms. An analysis of the quality of life by the general characteristics showed that the respondents who were better educated and had no systemic diseases had a higher score of 54.71 on the OHIP-14. The respondents who were better educated and had no systemic diseases had a higher score of 6.48 when a single item was used to determine their happiness index, and the respondents who were better educated and had no systemic diseases had a higher score of 3.82 when five items were used to rate their happiness index. The factor with the greatest influence on their scores on the OHIP-14 was the total symptoms, followed in order by the happiness index and self-rated oral health status. The variable that exerted the largest influence on the happiness index was the OHIP-14, followed by the self-rated health status, high-school or lower education, and the presence or absence of one or more chronic disease. Therefore, an improvement in the subjective awareness level is required to boost the quality of life, and a variety of health education programs should be prepared to raise the awareness level. In addition, there should be a chance to convey accurate information.

• Journal of the Korean Society of Food Science and Nutrition
• /
• v.45 no.8
• /
• pp.1177-1191
• /
• 2016

Estimation of food consumption details, such as portion size and frequency of consumption, is needed for exposure assessment step in microbiological risk assessment. This study investigated the amounts and frequencies of 50 kinds of consumed livestock products. A quantitative survey was performed by trained interviewers in face-to-face interviews with 1,500 adults aged over 19, who were randomly selected from seven major provinces in Korea. Respondents received a picture of one serving size for each of the 50 livestock products, including meats, processed meat products, milk and dairy products, and eggs and processed egg products. A t-test and general linear model were carried out using SPSS statistics. The most important factor affecting consumption of livestock products was residence area. The most frequently consumed food was milk (2.6 times/week), followed by pork (1.4 times/week), liquid yogurt (1.3 times/week), rolled omelet (1.2 times/week), semisolid yogurt (1.0 times/week), steamed egg (1.0 times/week), ice cream (0.9 times/week), chicken (0.8 times/week), low fat milk (0.7 times/week), and beef (0.6 times/week). In the case of consumption amount, people living in a city consumed meat (beef, pork, chicken, and duck) 1.5 times more than those living in a village, whereas milk and dairy products and eggs and processed egg products were consumed more frequently by people living in a town. When people eat meat, they consume twice the amount of one serving size. Students consumed livestock and processed livestock products more frequently with greater portions all at once. People living in Seoul, Incheon/Gyeonggi, and Busan/Ulsan/Gyeongnam consumed livestock products more frequently in large amounts. Data from this study can be used for risk assessment of livestock and processed livestock products as well as education for safe consumption of livestock products.