• Title/Summary/Keyword: Risk factors analysis

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Understanding the Mismatch between ERP and Organizational Information Needs and Its Responses: A Study based on Organizational Memory Theory (조직의 정보 니즈와 ERP 기능과의 불일치 및 그 대응책에 대한 이해: 조직 메모리 이론을 바탕으로)

  • Jeong, Seung-Ryul;Bae, Uk-Ho
    • Asia pacific journal of information systems
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    • v.22 no.2
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    • pp.21-38
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    • 2012
  • Until recently, successful implementation of ERP systems has been a popular topic among ERP researchers, who have attempted to identify its various contributing factors. None of these efforts, however, explicitly recognize the need to identify disparities that can exist between organizational information requirements and ERP systems. Since ERP systems are in fact "packages" -that is, software programs developed by independent software vendors for sale to organizations that use them-they are designed to meet the general needs of numerous organizations, rather than the unique needs of a particular organization, as is the case with custom-developed software. By adopting standard packages, organizations can substantially reduce many of the potential implementation risks commonly associated with custom-developed software. However, it is also true that the nature of the package itself could be a risk factor as the features and functions of the ERP systems may not completely comply with a particular organization's informational requirements. In this study, based on the organizational memory mismatch perspective that was derived from organizational memory theory and cognitive dissonance theory, we define the nature of disparities, which we call "mismatches," and propose that the mismatch between organizational information requirements and ERP systems is one of the primary determinants in the successful implementation of ERP systems. Furthermore, we suggest that customization efforts as a coping strategy for mismatches can play a significant role in increasing the possibilities of success. In order to examine the contention we propose in this study, we employed a survey-based field study of ERP project team members, resulting in a total of 77 responses. The results of this study show that, as anticipated from the organizational memory mismatch perspective, the mismatch between organizational information requirements and ERP systems makes a significantly negative impact on the implementation success of ERP systems. This finding confirms our hypothesis that the more mismatch there is, the more difficult successful ERP implementation is, and thus requires more attention to be drawn to mismatch as a major failure source in ERP implementation. This study also found that as a coping strategy on mismatch, the effects of customization are significant. In other words, utilizing the appropriate customization method could lead to the implementation success of ERP systems. This is somewhat interesting because it runs counter to the argument of some literature and ERP vendors that minimized customization (or even the lack thereof) is required for successful ERP implementation. In many ERP projects, there is a tendency among ERP developers to adopt default ERP functions without any customization, adhering to the slogan of "the introduction of best practices." However, this study asserts that we cannot expect successful implementation if we don't attempt to customize ERP systems when mismatches exist. For a more detailed analysis, we identified three types of mismatches-Non-ERP, Non-Procedure, and Hybrid. Among these, only Non-ERP mismatches (a situation in which ERP systems cannot support the existing information needs that are currently fulfilled) were found to have a direct influence on the implementation of ERP systems. Neither Non-Procedure nor Hybrid mismatches were found to have significant impact in the ERP context. These findings provide meaningful insights since they could serve as the basis for discussing how the ERP implementation process should be defined and what activities should be included in the implementation process. They show that ERP developers may not want to include organizational (or business processes) changes in the implementation process, suggesting that doing so could lead to failed implementation. And in fact, this suggestion eventually turned out to be true when we found that the application of process customization led to higher possibilities of failure. From these discussions, we are convinced that Non-ERP is the only type of mismatch we need to focus on during the implementation process, implying that organizational changes must be made before, rather than during, the implementation process. Finally, this study found that among the various customization approaches, bolt-on development methods in particular seemed to have significantly positive effects. Interestingly again, this finding is not in the same line of thought as that of the vendors in the ERP industry. The vendors' recommendations are to apply as many best practices as possible, thereby resulting in the minimization of customization and utilization of bolt-on development methods. They particularly advise against changing the source code and rather recommend employing, when necessary, the method of programming additional software code using the computer language of the vendor. As previously stated, however, our study found active customization, especially bolt-on development methods, to have positive effects on ERP, and found source code changes in particular to have the most significant effects. Moreover, our study found programming additional software to be ineffective, suggesting there is much difference between ERP developers and vendors in viewpoints and strategies toward ERP customization. In summary, mismatches are inherent in the ERP implementation context and play an important role in determining its success. Considering the significance of mismatches, this study proposes a new model for successful ERP implementation, developed from the organizational memory mismatch perspective, and provides many insights by empirically confirming the model's usefulness.

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The Effect of Arthroscopic Medial Meniscectomy in Degenerative Arthritis of the Knee (슬관절 퇴행성 관절염에서 관절경적 내측 반월상 연골 절제술의 효과)

  • Kim, Do-Yeon;Choi, Yun-Jin;Lee, Seung-Joo;Ko, Min-Seok;Choi, Chong-Hyuk
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.9 no.2
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    • pp.79-84
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    • 2010
  • Purpose: In patients with meniscal tear with degenerative arthritis, controversy remains as to whether arthroscopic menisectomy is worthwhile or not. The purpose of this study was to evaluate the effect of arthroscopic medial meniscectomy in degenerative arthritis of the knee with meniscal tear. We also intended to identify pertinent indications and risk factors. Materials and Methods: 287 patients underwent arthroscopic medial meniscectomy from 2006 to 2008; 103 patients who had Kellgren-Lawrence grade II, III arthritis of the knee, were over 50 years old, and had minimum 1 year follow-up, were analyzed in this study. Clinical assessment was performed retrospectively using the arthroscopic surgery database, medical records, questionnires and interviews. Assessment included visual analogue scale (VAS) scores and Lysholm scores. Results: The mean Lysholm score increased from 69 to 85 after surgery. The mean VAS score improved from 7 to 3.1 after surgery. Kellgren-Lawrence grade II group and group with trauma history showed significant improvement of pain and function compared with grade III and group without trauma history. Outerbridge grade I showed significantly more improvement of pain than grade III and IV. Multiple regression analysis showed that trauma history and Outerbridge grade affect the improvement of Lysholm score. Conclusion: In one year follow-up, arthroscopic medial menisectomy can improve pain and function of patients in Kellgren-Lawrence grade II, III degenerative arthritis of the knee. We could expect good results especially in group with low Kellgren-Lawrence grade, trauma history, and mild articular cartilage lesion.

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Long-term Results after 1,144 CarboMedics Mechanical Valve Implantation (CarboMedics 기계판막을 이용한 1,144예 판막치환술의 장기 성적)

  • Kang, Chang-Hyun;Kim, Kyung-Hwan;Kim, Ki-Boong;Ahn, Hyuk
    • Journal of Chest Surgery
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    • v.37 no.7
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    • pp.559-569
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    • 2004
  • The CarboMedics mechanical valve has been reported to show acceptable valve-related complication rates. The aim of this study is to evaluate our clinical experience with the CarboMedics valve. Material and Method: Between August 1988 and September 1999, we implanted 1,144 CarboMedics valves in 850 patients (aortic 179; mitral 385; double-valve 234; tricuspid 52). The mean age was 44.5 $\pm$ 12.5 years. Follow-up was completed in 95.2% and median follow-up period was 7.9 years (6753 patient-years). Result: The overall hospital mortality rate was 3.4% and the mortality rate for each group was 1.7% for aortic group, 2.6% for mitral group, 4.7% for double-valve group, and 9.6% for tricuspid group, Tricuspid group showed significantly higher mortality rate than aortic and mitral group (p〈0.05). The actuarial survival at 10 years was 87.1 $\pm$ 2.6%, 88.9 $\pm$ 1.7%, 82.4 $\pm$ 2.9%, and 77.5 $\pm$ 7.0% for aortic, mitral, double, and tricuspid valve group, respectively. Age and tricuspid valve replacement were significant risk factors for long-term survival in multivariate analysis (p 〈 0.05). Freedom from valve thrombosis at 10 years was 99.4 $\pm$ 0.6%, 98.2 $\pm$ 0.8%, 99.2 $\pm$ 0.8%, and 87.6 $\pm$ 0.5% for aortic, mitral, double and tricuspid valve group. Tricuspid valve group showed significantly higher rate of valve thrombosis (p 〈 0.05). Conclusion: Long-term results of our experience demonstrated that CarboMedics valve showed acceptable incidence of valve-related complications. However, tricuspid valve replacement showed higher rate of early mortality and valve thrombosis than other valve replacement groups.

An Empirical Study on Korean Stock Market using Firm Characteristic Model (한국주식시장에서 기업특성모형 적용에 관한 실증연구)

  • Kim, Soo-Kyung;Park, Jong-Hae;Byun, Young-Tae;Kim, Tae-Hyuk
    • Management & Information Systems Review
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    • v.29 no.2
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    • pp.1-25
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    • 2010
  • This study attempted to empirically test the determinants of stock returns in Korean stock market applying multi-factor model proposed by Haugen and Baker(1996). Regression models were developed using 16 variables related to liquidity, risk, historical price, price level, and profitability as independent variables and 690 stock monthly returns as dependent variable. For the statistical analysis, the data were collected from the Kis Value database and the tests of forecasting power in this study minimized various possible bias discussed in the literature as possible. The statistical results indicated that: 1) Liquidity, one-month excess return, three-month excess return, PER, ROE, and volatility of total return affect stock returns simultaneously. 2) Liquidity, one-month excess return, three-month excess return, six-month excess return, PSR, PBR, ROE, and EPS have an antecedent influence on stock returns. Meanwhile, realized returns of decile portfolios increase in proportion to predicted returns. This results supported previous study by Haugen and Baker(1996) and indicated that firm-characteristic model can better predict stock returns than CAPM. 3) The firm-characteristic model has better predictive power than Fama-French three-factor model, which indicates that a portfolio constructed based on this model can achieve excess return. This study found that expected return factor models are accurate, which is consistent with other countries' results. There exists a surprising degree of commonality in the factors that are most important in determining the expected returns among different stocks.

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The Current Status of Multidrug-Resistant Tuberculosis in One Tertiary Hospital in Busan, 2005~2009 (일개 부산지역 3차 병원에서 관찰한 다제내성 결핵의 실태, 2005~2009)

  • Yoon, Neul-Bom;Lee, Sung-Woo;Park, Su-Min;Jeong, Il-Hwan;Park, So-Young;Han, Song-Yee;Lee, Yu-Rim;Jung, Jin-Kyu;Kim, Joon-Mo;Kim, Su-Young;Um, Soo-Jung;Lee, Soo-Keol;Son, Choon-Hee;Hong, Young-Hee;Lee, Ki-Nam;Roh, Mee-Sook;Kim, Kyeong-Hee
    • Tuberculosis and Respiratory Diseases
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    • v.71 no.2
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    • pp.120-125
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    • 2011
  • Background: Although the prevalence of pulmonary tuberculosis has progressively decreased all over the world, drug-resistant tuberculosis is major obstacle in treating tuberculosis. This study was performed to examine the current prevalence and risk factors of drug resistant tuberculosis in a single tertiary hospital in Busan, Korea. Methods: We enrolled 367 patients with active pulmonary tuberculosis on a retrospective basis who had undergone mycobacterium culture and drug sensitivity tests between January 2005 and December 2009. We analyzed all clinical and radiographic parameters to find predictors related to drug resistant tuberculosis. Results: At least one incident of drug resistance was found in 75 (20.4%) patients. Isoniazid (18.8%) was the most frequent resistant drug, followed by rifampin (10.9%), ethambutol (7.1%), streptomycin (4.9%), and fluoroquinolone (2.7%). Resistance to second-line drugs was found in 37 (10.1%) patients. Multidrug resistance and extensively drug resistance was evident in 39 (10.6%) and 4 (1.1%) patients, respectively. Using multiple logistic regression analysis, history of previous treatment including relapse (odd ratio [OR], 11.3; 95% confidence interval [CI], 4.92~26.08; p<0.01), treatment failure (OR, 24.1; 95% CI, 5.65~102.79; p<0.01) and an age of below 46 years-old (OR, 3.8; 95% CI, 1.62~8.65; p<0.01) were found to be independent predictors of multidrug resistant tuberculosis. Conclusion: We found that the prevalence of drug resistant tuberculosis was considerably high. A careful consideration for possible drug resistant tuberculosis is warranted in patients with a history of previous treatment or for younger patients.

pT1N3 Gastric Cancer (pT1N3 위암)

  • Ahn, Dae-Ho;Kwon, Sung-Joon;Yun, Hyo-Yung;Song, Young-Jin;Mok, Young-Jae;Han, Sang-Uk;Kim, Wook
    • Journal of Gastric Cancer
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    • v.6 no.2
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    • pp.109-113
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    • 2006
  • Purpose: Various minimally invasive surgical techniques, such as an endoscopic mucosal resection and a laparoscopic gastrectomy, are becoming common practice for some cases of early gastric cancer (EGC) defined in terms of the depth of invasion being limited to the mucosa or submucosa. However, there are rare cases of early gastric cancer with massive lymph-node metastasis. Materials and Methods: From 6 university hospitals of Korea, 2,772 EGC cases were resected during the various period of analysis (1,432 cases of mucosal cancer and 1,340 of submucosal cancer). Results: As control data, we used the data from a single institute, CHA University Hospital. There were nine cases of early gastric cancer (9/2,772, 0.32%) with N3 lymph node metastasis defined by more than 15 lymph nodes being metastasized according to the UICC-TNM classification (pT1N3, stage IV). Two cases were mucosal cancer (2/1,432, 0.1 4%), and seven cases were submucosal cancer (7/1,340, 0.52%). Metastasized lymph nodes varied in number from 18 to 52. There were three male and six female patients with a mean age of 57. This is a totally reversed sex ratio compared to the usual gastric cancer or EGC. Among the total of 9 EGC patients, there were 5 who had superficial spreading carcinomas with surface areas larger than $25\;cm^2$. This is a significantly higher proportion compared to the general EGC population. When we compared the tumor size according to the LN status, the N3 group was definitely larger than the other groups. 78% of the pT1N3 cases showed lymphatic invasion, which is very high compared to the 4.7% in general EGC cases. Among the 9 cases, 6 patients had too short a follow-up period to evaluate the correct prognosis, but there was one patient with a non-curative resection and two patients with early recurrence. Although the sample size is small and the follow-up period is short, we can expect a very poor prognosis when we consider the common prognosis of EGC that is widely known and accepted. Conclusion: From these results, we can a conclude that the risk factors for pT1N3 gastric cancer are female patients, submucosal invasion, larger tumor size, and lymphatic invasion. However rare, the existence of pT1N3 gastric cancer needs to be taken into consideration, especially during the diagnosis. Furthermore, minimally invasive treatment for EGC needs to be chosen with great precaution. Since the prognosis of pT1N3 gastric cancer is expected to be poor, aggressive adjuvant chemotherapy may be necessary. (J Korean Gastric Cancer Assoc 2006;6:109-113)

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Relation between Helicobacter pylori Infection and Socioeconomic Status in Korean Adolescents (Helicobacter pylori 감염과 사회경제적 요인에 대한 연구)

  • Jung, Min-Kyong;Kwon, Young-Se;Choe, Hyon;Choe, Yon-Ho;Hong, Yun-Chul
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.3 no.1
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    • pp.17-22
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    • 2000
  • Purpose: This study was conducted to evaluate the association between H. pylori infection and socioeconomic status and to determine the current prevalence of H. pylori infection in Korean adolescents. Methods: A structured questionnaire was sent to the children's parents to obtain demographic information on the parents and environmental information. Of the 532 questionnaires sent out, 375 (70.5%; 170 girls and 205 boys) were returned. Their ages ranged from 10 to 15 years (mean, 12.9 years). After collecting blood samples, we measured serum IgG antibody to H. pylori using ELISA method. The association of risk factors such as age, sex, socioeconomic class, type of house, and crowding index with H. pylori infection were analyzed by multiple regression analysis. Socioeconomic status was estimated from the parents' education and occupation using a modified Hollingshead index. Results: The prevalence rate of H. pylori infection was 16.8% (63/375). It increased with age (10.3% at 10~11 years, 15.9% at 12~13 years, and 20.7% at 14~15 years). The H. pylori infection was inversely related to the socioeconomic class (6.3% for the upper class, 16.0% for the middle class, and 20.0% for the lower calss). Crowding condition and type of house did not affect significantly on seroprevalence of H. pylori infection. After logistic regression, we found that the odds ratio for age was 2.2 (95% confidence interval 0.9~5.4), and for socioeconomic status, 3.6 (95% confidence interval 0.5~28.9). Conclusion: The prevalence of H. pylori infection in Korean adolescents was 16.8%. It related inversely to socioeconomic status but was not statistically significant. Socioeconomic status based on parents' education and occupation seemed to affect more on H. pylori seroprevalence than crowding or type of house did.

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Clinical Features of Cricopharyngeal Incoordination in Newborns and Infants (신생아 및 영아기 윤상인두 협조불능의 임상적 고찰)

  • Han, Young-Mi;Park, Jae-Hong
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.11 no.2
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    • pp.116-121
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    • 2008
  • Purpose: Cricopharyngeal incoordination is a rare cause of swallowing difficulties in newborns and infants; it is characterized by delayed pharyngeal contractions related to cricopharyngeal relaxation. Dysphagia and repeated aspiration are common findings despite normal sucking. We conducted this study to assess the clinical features of cricopharyngeal incoordination in newborns and infants. Methods: An analysis of the clinical data from 17 patients with cricopharyngeal incoordination who were admitted to the Department of Pediatrics, Pusan National University Hospital, between 2000 and 2006 was conducted retrospectively. The diagnosis of cricopharyngeal incoordination was established by the clinical characteristics and the videofluoroscopic swallowing studies. Results: The male to female ratio was 1:1.1 (males 8, females 9) the age range 1 to 60 days. The body weight of 11 patients (64.7%) was less than the $10^{th}$ percentile at diagnosis. Six patients (35.3%) were born prematurely. The associated anomalies or diseases were chromosomal anomaly (2 cases), congenital heart disease (3 cases), and laryngomalacia, hypoxic brain damage or neonatal seizures (1 case each). The chief complaints of patients were recurrent aspiration pneumonia (10 cases), feeding difficulty (9 cases), dyspnea (4 cases), and chocking (4 cases). The severity of aspiration on the videoesophagogram or esophagogram was mild in 12 cases. The correlation between the severity of aspiration and the duration of tube feeding after the diagnosis was significant (p<0.05). Conclusion: Cricopharyngeal incoordination should be considered in the differential diagnosis of newborns and infants, without known risk factors associated with swallowing dysfunction, when they present with unexplained respiratory problems. Although the prognosis of cricopharyngeal incoordination is good, early diagnosis and tube feeding are recommended to prevent the complications associated with this disorder.

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Significance of Serum Ferritin in Multiple Trauma Patients with Acute Respiratory Distress Syndrome (다발성 외상 환자에서 발생되는 급성 호흡 곤란 증후군의 예측 인자로서 혈청 페리틴의 의의)

  • Ji, Yae-Sub;Kim, Nak-Hee;Jung, Ho-Geun;Ha, Dong-Yeup;Jung, Ki-Hoon
    • Journal of Trauma and Injury
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    • v.20 no.2
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    • pp.57-64
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    • 2007
  • Purpose: Clinically, acute respiratory distress syndrome (ARDS) occurs within 72 hours after acute exposure of risk factors. Because of its high fatality rate once ARDS progresses, early detection and management are essential to reduce the mortality rate. Accordingly, studies on early changes of ARDS were started, and serum ferritin, as well the as injury severity score (ISS), which has been addressed in previous studies, thought to be an early predictive indicator for ARDSMethods: From March 2003 to March 2005, we investigated 50 trauma patients who were admitted to the intensive care unit in Dongguk University Medical Center, Gyeongju. The patients were characterized according to age, sex, ISS, onset of ARDS, time onset of ARDS, serum ferritin level (posttraumatic $1^{st}\;&\;2^{nd}$ day), amount of transfused blood, and death. Abdominal computed topography was performed as an early diagnostic tool to evaluate the onset of ARDS according to its diagnostic criteria. The serum ferritin was measured by using a $VIDAS^{(R)}$ Ferritin (bioMeriux, Marcy-1' Etoile, France) kit with an enzyme-linked fluorescent assay method. For statistical analysis, Windows SPSS 13.0 and MedCalc were used to confirm the probability of obtaining a predictive measure from the receiver operating characteristics (ROC) curve. Results: The ISS varied from 14 to 66 (mean: 33.8) whereas the onset of ARDS could be predicted with the score above 30 (sensitivity: 90.0%, specificity: 60.0%, p<0.05). On the posttraumatic $1^{st}$ day, the serum ferritin levels were measured to be from 31 mg/dL to 1,200 mg/dL (mean: 456 mg/dL), and the onset of ARDS could be predicted when the value was over 340 mg/dL (sensitivity: 80.0%, specificity: 65.0%, p<0.05). On the posttraumatic $2^{nd}$ day, the serum ferritin levels were measured to be from 73 mg/dL to 1,200 mg/dL (mean: 404 mg/dL), and the onset of ARDS could be predicted when the value was over 627 mg/dL (sensitivity: 60.0%, specificity: 92.5%, p<0.05). The serum ferritin levels and the ISS were significantly higher on the posttraumatic $1^{st}$ and $2^{nd}$ day in the ARDS group, suggesting that they are suitable indices predicting the onset of ARDS, however relationship between the serum ferritin levels and the ISS was not statistically significant. Conclusion: In this study, we discovered increasing serum ferritin levels in multiple- trauma patients on the posttraumatic $1^{st}$ & $2^{nd}$ day and concluded that both the serum ferritin level and the ISS were good predictors of ARDS. Although they do not show statistically significant relationship to each other, they can be used as independent predictive measures for ARDS. Since ARDS causes high mortality, further studies, including the types of surgery and the methods of anesthesia on a large number of patients are essential to predict the chance of ARDS earlier and to reduce the incidence of death.

The Clinical Effects of Surgical Treatment for Hemoptysis due to Inflammatory Lung Disease (염증성 폐질환에 의한 객혈에 대한 수술적 치료 효과)

  • Yun, Ju-Sik;Na, Kook-Joo;CheKar, Jay-Key;Jeong, In-Seok;Song, Sang-Yun;Oh, Sang-Gi
    • Journal of Chest Surgery
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    • v.43 no.2
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    • pp.144-149
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    • 2010
  • Background: Many studies have demonstrated the various therapeutic options for treating hemoptysis caused by inflammatory lung disease. However, there is debate over the surgical management of the ongoing hemoptysis. Therefore, we evaluated the clinical results of pulmonary resection that was done due to hemoptysis in patients with concomitant inflammatory lung disease. Material and Method: We performed a retrospective analysis of 75 patients who received pulmonary resection for hemoptysis and concomitant inflammatory lung disease between 2001 and 2007. The mean age was $52.1{\pm}12.5$ years old, and the male; female ratio was 52:23. Result: The underlying disease was aspergilloma in 30 patients (40%), pulmonary tuberculosis in 20 patients, bronchiectasis in 18 patients and other causes in 7 patients. The surgical treatment included lobectomy in 55 patients, bilobectony in 2 patients, pneumonectomy in 17 patients and wedge resection in 1 patient. There were 3 early deaths, and the causes of death were pneumonia in 1 patient and BPF in 2 patients. The early mortality was statistically higher for such risk factors as a preoperative Hgb level <10 g/dL, COPD and an emergency operation. Conclusion: In conclusion, pulmonary resection for treating hemoptysis showed the acceptable range of mortality and it was an effective method for the management of hemoptysis in patients with inflammatory lung disease. However, relatively high rates of mortality and morbidity were noted for an emergency operation, and so meticulous care is needed in this situation.