• 한국간호교육학회지
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• 제20권2호
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• pp.321-331
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• 2014

Purpose: The purpose of this study was to investigate the effects of case management service for hypertensive elderly patients through the customized visiting home health care program. Method: Non-equivalent control group pretest-posttest design was employed. Data were collected from April 2007 to January 2009. Among a total of fifty subjects, 25 subjects were belonged to the case management group and the others were belonged to the general management group. Results: 1) In experimental group, significant increasing rate of number of people within normal blood pressure by time, but no significant increasing rate of number of people within normal blood neutral fat, total cholesterol, HDL, & LDL. 2) In experimental group, the score of knowledge about disease and healthy life practice were increased on 8 week period but decreased on follow up period. Number of people within normal blood HDL and mean score of healthy life practice were significantly higher than control group on follow up period. Conclusion: Case management service was effective on controlling blood pressure but partly effective on blood lipid, knowledge about disease, and healthy life practice in hypertensive patients. Further study is needed to conduct a periodic re-evaluation of the effect of case management and to verify an optimal interval to provide the case management service.

• Journal of Chest Surgery
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• 제11권3호
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• pp.303-315
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• 1978

During the full 10-year period from June 1968 through June 1978, 112 consecutive patients underwent isolated or double valve replacement. A total of 130 valves were used in aortic, mitral or tricuspid positions: 63 prosthetic valves in 56 and 67 glutaraldehyde-preserved porcine aortic valves in 56 patients. There were 31 early and 9 late deaths with a cumulative mortality rate of 35.7 percent. Eighty-five patients survived longer than 10 days postoperatively were studied for the occurrence of thromboembolism and complications related to anticoagulant therapy. At the end of follow-up period, 68 patients were on Coumadin; 74 were on Persantin with or without Coumadin; 11 were off any antithrombotic drugs with 6 of them being off electively after 6 months of tissue valve replacement. Thromboembolism occurred in 7 [8.2%] of 85 patients or 10.9%/patient-year. Embolic rates were as follows: one of 18 patients anticoagulated [5.6%] or 6.1%/patient-year and 4 of 16 patients not anticoagulated [25.0%] or 17.8%/patient-year for the prosthetic valve replacement; and one of 40 patients anticoagulated [2.5%] or 7.9%/patient-year and one of 11 patients not anticoagulated [9.1%] or 7.9%/patient-year for tissue valve replacement. Three complications of major bleeding were experienced by 3 patients during the follow-up period, being related to Coumadin therapy. The importance of proper anticoagulation were stressed for the successful management of patients after cardiac valve replacement, both prosthetic and tissue valves.

• 대한족부족관절학회지
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• 제9권1호
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• pp.131-134
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• 2005

Purpose: The purpose of this study was to investigate the clinical results of conservative treatment for Morton's neuroma and to analyze the factors which influenced on the results. Materials and Methods: In this retrospective study, 101 cases of 83 patients with interdigital neuroma were conservatively treated with follow-up period of at least 6 months. There was no significant difference in results among different age groups, sxes, and lesion sites. However, the results were significantly better if the treatment was started within 6 months after onset. Results: We had 28 excellent results (28%), and 13 good results (13%). Patients were grouped by sex, age, duration of symptom before treatment, affected location. The result of treatment was evaluated by comparing the subject pain and discomfort score of the first vist and last follow-up. Conclusion: There are excellent results over 41% by conservative treatment. The results of conservative treatment were not related to age, sex, and lesion site, but were related to pre-treatment period. The shorter the pretreatment period was, the better the results.

• Journal of Chest Surgery
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• 제26권11호
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• pp.827-832
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• 1993

From Jan 1982 through Dec.1991, thirty-three DeVega`s tricuspid annuloplasties were performed in association with mitral and combined mitral and aortic valve disease. Preoperatively,all of the patients were in NYHA functional class III or IV.There were one early death and 4 patients died during follow up period of 18 to 138 months [ mean follow up : 67.3 months ]. Nine patients required reoperation because of biological mitral valve failure at 4.7 to 11 years after tricuspid annuloplasty[TAP]. Among these patients,2 cases needed for reoperation of TAP due to loosening of suture material. Twenty four [86%] of the survivors were in NYHA functional class I or II after TAP.The actuarial survival rate for the TAP was 74% at 138 months. Rt atrial pressure of 9 reoperation cases were significantly decreased [P<0.05] compared with initial Rt.atrial pressure [ Mean period; 93.6 months].Doppler echocardiographic studies for tricuspid regurgitation were performed in 15 cases after TAP [Mean period: 42.3 months].These results showed significantly reduced [P<0.01] tricuspid annulus diameter and tricuspid regurgitation distance [ P<0.05 ].Our surgical experience that the DeVega`s TAP is a simple,safe,effective procedure and resulted in good hemodynamic improvement with moderate to severe functional tricuspid regurgitation.

• Journal of Chest Surgery
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• 제14권3호
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• pp.247-253
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• 1981

A total and consecutive 46 patients have undergone cardiac valvular surgery including 8 open mitral commissurotomy and 38 mitral, aortic, mitral-aortic, mitral-tricuspid, tricuspid valve replacements using 46 artificial valves in a period between September 1976 and July 1981. They were 19 males and 27 females with the age ranging from 16 to 50 (mean 32.6) years. Out of 46 valves replaced, 6 were prosthetic valves and 40 were tissue valves, and 33 were replaced in mitral, 9 in aortic and 3 In tricuspid position. Isolated replacements were 33 mitral valves, 6 aortic valves and 1 tricuspid valve; double valve replacements were 6 mitral-aortic valves and 2 mitral-tricuspid valves. . Early mortality within 30 days after operation was noted in 4 cases; 3 after MVR and 1 after open mitral commissurotomy. Causes of death were thrombus obstruction of Beall-Surgitool, Cerebral air embolism, acute renal shut down due to low output syndrome, and left upper pUlmonary vein rupture after open mitral commissurotomy (early mortality 8.7%). 3 late deaths were noted during the follow-up period from 2 to 59 months; 1 due to cerebral hemorrhage from warfarin overdose 3 months, 1 due to miliary tuberculosis 9 months, and another 1 due to cardiac failure after open mitral commissurotomy 42 months postoperatively. Total survival rate 59 months after valvular surgery was 84.8%; there were no early and late death in the group of AVR, TVR and double valve replacements. Preoperative NYHA Class III & IV were 35 cases (76%) out of total 46 cases, and 38 cases (94.8%) out of 39 survival cases were included In NYHA Class I & II during the follow-up period.

• 대한정형도수물리치료학회지
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• 제15권2호
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• pp.44-49
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• 2009

Purpose : The purpose of this study was to evaluate the incidence and mortality for hip fracture in the elderly in Jeju-do. Methods : We enrolled 254 cases among 318 patients older than 50 years of age with a hip fracture during two years period(2003-2004). We investigated the incidence and mortality during follow up 3~4 years period until December 31, 2007. Results : The crude incidences of hip fracture the age group ${\geq}50$ years were 141(11.2/10,000) in 2003, 177(13.6/10,000) in 2004, and 249(17.0/10,000), 69(6.3/10,000) for women and men, respectively. The mean age of them was 78.3 years, male was 69(21.7%), female was 249(78.3%) among 318 patients. Survivor was in the 146(57.5%), death was in the 108(42.5%) among 254 cases period for follow up. In the death group, activity was significantly lower at the time of post-fracture 3(p=0.013), 6(p=0.000), and 12 months(p=0.000). The mortality of hip fracture and crude death rate(CDR) were 108(42.5%, n=254), 11,884(1.7%, n=675,889) in 2003~2007 in Jeju. Conclusion : Developing and applying a variety of activity programs that increase activity in post-fracture may improve activities of daily living, reduce burden of family and society, be useful in improving the quality of life and ultimately lower the mortality.

• Journal of Chest Surgery
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• 제27권8호
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• pp.669-676
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• 1994

Because the number of patients who require maintenance hemodialysis is increasing in number recently, angioaccess has become important to many vascular surgeons participating in the management of such patients.The authors created 269 arteriovenous fistulas[AVF] for angioaccess in 229 patients with chronic renal failure[CRF] at the Department of Thoracic and Cardiovascular Surgery in Chungnam National University Hospital during the period from August 1990 to March 1993. We analyzed the results of 260 operations for 220 patients except 9 patients who were lost during the follow up period. We performed snuffbox AVF in 171 cases, classic radiocephalic AVF in 46 cases, direct AVF at other site in 5 cases, forearm Gore-Tex AVF in 29 cases, and upper arm Gore-Tex AVF in 9 cases. We experienced 13 cases of operative failures, 11 cases of early complications, and 60 cases of late complications including obstructions during follow-up period. The 1 year, 2 year and 3 year patency rates of snuffbox AVF[Group 1], classic radiocephalic AVF[Group 2], and Gore-Tex AVF[Group 3] are like followings; 89, 84, 76% in group 1, 84, 75, 68% in group 2, and 79, 66, 55% in group 3. It showed a statistically significant difference between group 1, 2 and group 3.

• Journal of Korean Neurosurgical Society
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• 제39권4호
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• pp.265-270
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• 2006

Objective : Microvascular decompression[MVD] at root exit zone[REZ] of the facial nerve has been largely popularized and it has become the standard treatment for patients with hemifacial spasm[HFS]. This sturdy is performed to evaluate the efficacy of MVD over the course of time. Methods : From 1994 to 2003, 50 patients with HFS who underwent MVD were followed up for more than 6 months. We retrospectively analyzed results with medical records and telephone researches. Results : The mean age of patients at the time operation was 57.6 years and 84% of the patients were female. The mean duration of follow-up after operation was 3.4 years [range $0.5{\sim}7.8\;years$]. One day after MVD, 54% of patients had complete relief of spasm immediately. Continuous improvements of HFS were observed during the follow-up period and these improvements were statistically significant with time (P< 0.05). Until 6 months after operation, complete relief of spasm was observed in 84% of patients. The delayed relief of spasm was observed in 35.7% of our patients who experienced complete relief. Conclusion : The efficacy of MVD in HFS is improves with time. Continuous follow-up evaluations for the duration of more than at least 6 months after MVD are important for the decision of its clinical results because delayed relief of spasms occurs.

• 대한안전경영과학회지
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• 제3권4호
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• pp.65-76
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• 2001

Field data have been recorded as the time to failure or the number of failure of systems. We consider the time to failure and covariate variables in some pre-specified follow-up or warranty period. This paper aims to investigate study on the reliability estimation when some additional field data can be collected within-warranty period or after-warranty period. A various likelihood-based methods are outlined and examined for exponential or Weibull distribution.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제18권4호
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• pp.268-275
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• 2015

Purpose: Primary sclerosing cholangitis (PSC) is a rare condition that can be associated with inflammatory bowel disease (IBD). The aim of this study was to evaluate PSC and its association with IBD in children. Methods: We retrospectively enrolled 13 pediatric patients (<18 years) with PSC treated at Asan Medical Center between June 1989 and December 2013. Clinical findings and long-term outcomes were investigated. During the same period, the incidence of PSC among IBD patients was evaluated among 600 Crohn disease (CD) and 210 ulcerative colitis (UC) patients. Results: All 13 study patients diagnosed with PSC also presented with IBD. Eleven boys and two girls with a median age of 15.0 years old (9.0-17.8 years) were included. The cumulative incidence of PSC for UC was 5.7% (12 of 210) and 0.2% for CD (1 of 600), respectively. PSC occurred during follow-up for IBD for five patients (38.5%) whereas, IBD developed during follow-up for PSC for two patients (15.4%), and was diagnosed during the initial work-up for PSC for 6 patients (46.2%). For the 77.3 month median follow-up period, 9/13 patients (69.2%), neither the clinical symptoms nor blood test results worsened. Two cases (15.4%) developed liver cirrhosis and underwent liver transplantation. Among 13 PSC patients with IBD, two (15.4%) developed colorectal cancer, and no one developed cholangiocarcinoma. Conclusion: All patients with PSC in this study had associated IBD. The incidence of PSC was not rare compared to reports in adults. PSC should be considered during the management of IBD and vice versa in children.