• Title/Summary/Keyword: Obstructive Factors

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Analysis of Pretreatment Prognostic Factors in Locally Advanced Carcinoma of the Uterine Cervix (국소진행된 자궁경부암에 있어서의 예후인자 분석)

  • Oh, Do-Hoon;Ha, Sung-Whan;Lee, Moo-Song
    • Radiation Oncology Journal
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    • v.10 no.1
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    • pp.69-76
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    • 1992
  • To identify pretreatment prognostic factors in locally advanced carcinoma of the uterine cervix, retrospective analysis was undertaken of 154 patients treated with curative radiation therapy at Seoul National University Hospital, from March 1979 through December 1986. According to FIGO classification, eight patients were stage IIIA, 134 were stage IIIB, and 12 were stage IVA. Five year locoregional control rate was $58\%$, $51\%$, and $27\%$ in stage IIIA, IIIB, and IVA, respectively. Five year disease free survival was $57\%$, $40\%$, and $25\%$ for each stage respectively. Five year overall survival was $67\%$, $51\%$, and $33\%$ in stage IIIA, IIIB, and IVA, respectively. In univariate analysis, fewer than or equal to four of pregnancies, initial hemoglobin of lower than $10\;g\%$, and pelvic sidewall invasion on CT were associated with poor locoregional control. Number of pregnancies, initial hemoglobin level, obstructive uropathy on intavenous pyelography (IVP), pelvic lymph node (LN) status on CT, and pelvic sidewall invasion on CT were significant factors in disease free survival. In terms of overall survival, pelvic sidewall invasion on CT and bladder invasion on CT were prognostically significant. In multivariate analysis, no factor was found to affect locoregional control and pelvic LN status was a sole significant factor affecting disease free survival. in terms of overall survival, the size.

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Needs for Development of IT-based Nutritional Management Program for Women with Gestational Diabetes Mellitus (IT-기반의 임신성 당뇨병 영양관리 프로그램 개발을 위한 요구도 조사)

  • Han, Chan-Jung;Lim, Sun-Young;Oh, Eunsuk;Choi, Yoon-Hee;Yoon, Kun-Ho;Lee, Jin-Hee
    • Korean Journal of Community Nutrition
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    • v.22 no.3
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    • pp.207-217
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    • 2017
  • Objectives: The aim of this study was to examine self-management status, nutritional knowledge, barrier factors in dietary management and needs of nutritional management program for women with Gestational Diabetes Mellitus (GDM). Methods: A total of 100 women with GDM were recruited from secondary and tertiary hospitals in Seoul. The questionnaire composed of general characteristics, status of self-management, dietary habits, nutrition knowledge, barrier factors in dietary management, needs for nutrition information contents and nutritional management programs. Data were collected by a self-administered questionnaire. All data were statistically analyzed using student's t-test and chi-square test using SAS 9.3. Results: About 35% of the subjects reported that they practiced medical nutrition and exercise therapy for GDM control. The main sources of nutrition information were 'internet (50.0%)' and 'expert advice (45.0%)'. More than 70% of the subjects experienced nutrition education. The mean score of nutrition knowledge was 7.5 point out of 10, and only about half of the subjects were reported to be correctly aware of some questions such as 'the cause of ketosis', 'the goal of nutrition management for GDM', 'the importance of sugar restriction on breakfast'. The major obstructive factors in dietary management were 'eating more than planned when dining out', 'finding the appropriate menu when dining out'. The preferred nutrition information contents in developing management program were 'nutritional information of food', 'recommended food by major nutrients', 'the relationship between blood glucose and food', 'tips on menu selection at eating out'. The subjects reported that they need management program such as 'example of menu by calorie prescription', 'recommended weight gain guide', 'meal recording and dietary assessment', 'expert recommendation', 'sharing know-how'. Conclusions: Based on the results of this study, it is necessary to develop a program that provide personalized information by identifying the individual characteristics of the subjects and expert feedback function through various information and nutrition information contents that can be used in real life.

Establishment of Overseas Expansion Support Policy for Green/Climate Technology SMEs: Integrated Viewpoints of Policy Makers and Beneficiaries (녹색/기후기술 중소기업의 해외진출 지원정책 수립 : 정책수혜자와 정책수립자 통합관점)

  • Kim, Sun-Hye;Oh, Myeong-Ji;Lee, Su-Yeong;Yoon, Byung-Un
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.21 no.7
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    • pp.201-211
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    • 2020
  • Green/climate technology has been emphasized as a growth engine that can boost the global economy via environmentally friendly products. Recently, SMEs in Korea have been recognized as a critical actor in the globalization of green/climate technologies. However, there has been no survey and few studies on the satisfaction level of the support for the overseas expansion of SMEs in the green/climate technology field. Therefore, this study aims to support a policy for the establishment of SMEs' green/climate technology by investigating and analyzing expert opinions on SMEs. Through a literature survey, support policies were classified into four types, and then according to the types, satisfaction factors and obstacle factors for overseas expansion were derived and analyzed. In the results, the SMEs overall showed low levels of awareness and satisfaction and were found to be struggling due to all obstructive factors. In addition, the most important success factor for overseas expansion was found to be the policy related to funding support. Thus, it is necessary to improve the accessibility, advertisement, and support strategies of support policies, and in particular, appropriate budget allocation should be made available by considering the characteristics of companies.

Factors Related to Exertional Oxygen Desaturation in Patients with COPD (만성 폐쇄성 폐질환(COPD) 환자에서 운동 시 발생하는 산소 불포화 반응과 관련된 인자)

  • Shim, Sang-Woo;Jo, Jun-Yeon;Kwon, Yong-Sik;Chae, Jin-Nyeong;Park, Jie-Hae;Lee, Mi-Young;Rho, Byung-Hak;Choi, Won-Il
    • Tuberculosis and Respiratory Diseases
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    • v.70 no.6
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    • pp.498-503
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    • 2011
  • Background: The causes of exertional desaturation in patients with COPD can be multifactorial. We aimed to investigate factors predict exertional desaturation in patients with moderate to severe COPD. Methods: We tested 51 consecutive patients with stable COPD (FEV1/FVC, $40{\pm}13%$ predicted). Patients performed a six minute walk test (6MWT). Pulse oxymetric saturation (SpO2) and pulse rate were recorded. Results: Oxygen desaturation was found in 15 subjects after 6MWT, while 36 subjects were not desaturated. Lung diffusing capacity was significantly lower in desaturation (DS) group ($62{\pm}18%$ predicted) compared with not desaturated (ND) group ($84{\pm}20$, p<0.01). However there was no statistical difference of FEV1/FVC ratio or residual volume between two groups. The pulse rate change was significantly higher in the desaturated compared with the not desaturated group. Six minute walking distance, subjective dyspnea scale, airflow obstruction, and residual volume did not predict exertional oxygen desaturation. Independent factors assessed by multiple logistic regression revealed that a pulse rate increment (odd ratio [OR], 1.19; 95% confidence interval [CI], 1.01~1.40; p=0.02), a decrease in baseline PaO2 (OR, 1.105; 95% CI, 1.003~1.218; p=0.04) and a decrease in lung diffusing capacity (OR, 1.10; 95% CI, 1.01~1.19; p=0.01) were significantly associated with oxygen desaturation. Receiver operator characteristic (ROC) analysis showed that an absolute increment in pulse rate of 16/min gave optimal discrimination between desaturated and not desaturated patients after 6MWT. Conclusion: Pulse rate increment and diffusion capacity can predict exertional oxygen desaturation in stable COPD patients with moderate to severe airflow obstruction.

Pulmonary Infarction Associated with Fracture of Right Clavicle and Multiple Ribs (우측 쇄골 및 늑골골절과 동반된 폐경식 1례)

  • 김수성;이종임
    • Journal of Chest Surgery
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    • v.30 no.9
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    • pp.941-944
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    • 1997
  • Pulmonary infarction is rarely diagnosed with certainty except at postmortem examination. Part of this uncertainty is because of the inability to distinguish between hemorrhage, congestive a electasis, and necrosis clinically and radiographically. The pathogenesis of pulmonary infarction is poorly understood. It is dif%cult to induce pulmonary infarction in animals by ligation of the arterial supply to the lung. Many factors seem to be important in its pathogenesis, in addition to congestive heart failure, malignant tumor, thrombophlebitis, chronic obstructive lung disease, nephrotic syndrome, and postopeiative state. However, pulmonary infarction have not been reported in association with chest trauma. We report a case of pulmonary infarction associated with fractures of right clavicle and multiple ribs. A 45-year-old male had admitted due to right chest pain and dyspnea, which developed after right chest trauma occurred at about 3 weeks ago. He was treated at local clinics under the diagnosis of fractures of right clavicle and ribs until the admission. Chest CT disclosed a huge mass with central low density in right upper lobe, and small masses were also seen on both l ng fields. Open lung biopsy resulted in negativity for the malignancy. Clinical symptoms and radiological findings were not improved by conservative treatment. Right upper lobectomy was done eventually. The final diagnosis was pulmonary infarction. And, the patient has been well after operation.

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The Case Study on the Niche Experimentation in Offshore Wind Renewable Energy Transition (해상풍력 기술의 사회-기술시스템 전환과정에 관한 탐색적 사례연구)

  • Kim, Bonggyun;Kim, Dukyoung;Kim, Kyungnam;Kim, Donghwan
    • Journal of Korea Technology Innovation Society
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    • v.17 no.2
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    • pp.355-379
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    • 2014
  • For the transition to the low carbon society, it is inevitable but difficult journey that the new energy technology spread co-exists with formal social system. The objective of offshore wind power plant that has been implemented by the government is to connect large capacity new renewable energy to the central electric power system. Therefore, for the successful introduction of offshore wind power system, the transition of the formal social technology system should be companied. This study analysis the energy system transition about niche strategy adjustment using Multiple Level Perspectives & Strategic Niche Management. It also multi level analyzes and structuralizes the process that new technology, as a research result, evolves through connecting and communicating with formal regime and landscape. Also, adjusting Strategic Niche Management, it diagnoses the obstructive factors in the initial stage of niche experiment and found the major reasons why offshore wind power test plant had been delayed. Through this study, it reaches to the practical implication that offshore niche technology could grow stably in the energy system and various policies.

Long-term Results Following Surgical Repair of Total Anomalous Pulmonary Venous Return (총폐정맥 환류 이상증에 대한 술후 장기성적 검토)

  • 원태희
    • Journal of Chest Surgery
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    • v.28 no.6
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    • pp.565-570
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    • 1995
  • Seventy-three patients with isolated total anomalous pulmonary venous connection the patients associated with other major cardiac anomalies such as single ventricle, DORV[Double Outlet Right Ventricle and large VSD[Ventricular Septal Defect were excluded were underwent surgical repair from January 1980 through October 1993. There were 45 boys and 28 girls. The mean age at operation was 19.9 months[range 6 days to 24 years and mean body weight was 7.1kg[range 2.6kg to 45kg . The anomalous locations of connection were supracardiac in 38, cardiac in 21, infracardiac in 5, and mixed in 9. In 38 patients[52% , the venous drainage was obstructed. The obstruction ratios according to the connection type were as follows: 53%[28/38 in supracardiac, 52%[11/21 in cardiac, 100%[5/5 in infracardiac, 22%[2/9 in mixed type. The associated cardiac anomalies were persistent left SVC[2 , tricuspid valve regurgitation[3 , cor triatriatum[1 , and mitral cleft[1 . And associated noncardiac anomalies were imperforate anus[1 and Neil Weightman syndrome[1 . The operative mortality was 23%. The causes of death were pulmonary hypertensive crisis, perioperative myocardial failure, pneumonia with sepsis, arrhythmia and etc. The statistically significant factors in postoperative mortality were the pulmonary venous obstruction and age [p<0.01 . The operative mortality was high in groups of age under 1 month and pulmonary venous obstruction. The mean follow-up was 27.1 months. There were two late deaths. The first patient was three months old boy with supracardiac type and severe obstructive symptoms. The postoperative echocardiography was showed anastomotic stenosis and reoperations were performed twice but the patients expired due to pneumonia and sepsis. The second patient was three month old boy with supracardiac type and total correction was done and was doing well postoperatively. Eight years later, he expired suddenly due to arrhythmia. But all the other patients were in NYHA Fc I and received no medications. The 5-year survival rate excluding early expired patients is 97.1 $\pm$ 0.03 %. In conclusion, although the operative mortality of total anomalous pulmonary venous connection was relatively high compared to other major cardiac anomalies, we could expect excellent long-term results by early surgical correction.

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The Influence of Chronic Disease on the Stress Cognition, Depression Experience and Suicide Thoughts of the Elderly (만성질환이 노인들의 스트레스인지, 우울증상 경험 및 자살생각에 미치는 영향)

  • Choi, Ryoung;Moon, Hyun-Ju;Hwang, Byung-Deog
    • The Korean Journal of Health Service Management
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    • v.4 no.2
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    • pp.73-84
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    • 2010
  • This study conducted a secondary analysis by using original data of performed by Korea Institute for Health and Social Affairs to determine factors affecting doctor's diagnosed disease-related mental health for the elderly aged over 65 years living in Korea. The survey was conducted in 2007 and it evaluated finally 720 cases by excluding cases with no answer or a wrong answer. The results were as follows. The proportion of the elderly who stress cognition was influenced when subjects were female and older, lower subjective health condition and osteoporosis, showed statistically significant difference. The proportion of the elderly who experience depression was influenced when subjects were older, had not health insurance or medical care, and lower subjective health condition, showed statistically significant difference. The proportion of the elderly who have suicide thoughts was influenced when subjects were female and higher educational background, lower subjective health condition, COPD(Chronic obstructive pulmonary disease), and diabetes mellitus, showed statistically significant difference. We knew that the relationship between diseases and depression in the elderly influenced on the depression about most of the diseases. Particularly, Depression and suicide had a high correlation. The results suggest that it should be necessary to systematic management of diseases in the depression treatment of the Elderly in Korea.

An Analysis on the Internet Uses and Barriers of the Older Adults in Korea (고령층의 인터넷 활용 및 장애 요인 분석)

  • Kim, Heesop;Kim, Pansoo;Lee, Misook
    • Journal of the Korean Society for Library and Information Science
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    • v.48 no.1
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    • pp.257-276
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    • 2014
  • The purpose of this study is to investigate the patterns and barriers of the Internet for the elderly adults in Korea. Data was collected through the face to face interview using a questionnaire for the residence of Daegu and Kyungsang Buk-Do areas targeted over the 60-years-olds elder adults. A total of 119 valid response data were analyzed with the descriptive statistics and the group differences by age and gender using SPSS 18.00. It found that the most of the elder adults access the Internet to seek the entertainment contents, the knowledge-related contents, and the cultural and art contents. They spend most of the Internet online session to do searching information and enjoying movie and music. However, there were age differences and gender differences within the subjects. The complexity of computer and the Internet usage is one of the barriers for the Internet access, and they suggest that a customized education and training courses of computer literacy for the elderly adults would be the ways of resolve those obstructions.

Follow up study of pulmonary function after pneumonectomy (일측 폐절제술후 폐기능의 추적관)

  • Park, Jae-Gil;Kim, Se-Hwa;Lee, Hong-Gyun
    • Journal of Chest Surgery
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    • v.16 no.4
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    • pp.539-546
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    • 1983
  • Maximal expiratory flow-volume [MEFV] curves were studied in 22 patients who underwent pneumonectomy with various pulmonary lesions, such as lung cancer, bronchiectasis and tuberculosis etc, at the preoperative stage and 3 week, 4 month and 12 month after pneumonectomy for the analysis of the reduction and progressive improvement of postoperative ventilatory function. And the factors affecting them like as age difference and the site of pneumonectomy were also analyzed. From these curves peak flow rate [PF R], maximal expiratory flows at 25% and 50% of expired forced vital capacity [V25, V50] and forced vital capacity [FVC] were obtained. In addition, partial pressure of oxygen and carbon dioxide in arterial blood were measured. The results were as follows; 1. The mixed type, especially obstructive type of ventilatory impairment was observed at 3 week after operation. For 1 year of postpneumonectomy FVC was increased by 12.3% of predicted compared to 2.6% of predicted V50. 2. The improvement of FVC during 1 year of postpneumonectomy showed decreasing tendency with the increase of age but the changes of V25 and V50 were unremarkable. 3. The differences of immediate postoperative reduction and progressive improvement of ventilatory capacity after right and left pneumonectomy were analyzed. The reduction of V50, V25 and FVC at 3 week of postoperation were greater in patients with right pneumonectomy [20.9%, 18.2% and 26.2% of predicted] than in patients with left pneumonectomy 16.5%, 18.2% and 18.1%]. But there was no significant difference of these values at 12 month after pneumonectomy. 4. The partial pressure of oxygen in arterial blood [$PaO_2$] was decreased by 13.6 mmHg at 3 week after pneumonectomy compared to the preoperative stage but returned to the normal range within 4 month after pneumonectomy. However, TEX>$PaCO_2$ was within the normal range during 1 year of postoperation.

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