• Title/Summary/Keyword: Significant Events

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Mid-Term Outcomes and Angiographic Patency of Redo Coronary Artery Bypass Grafting: A Comparison between OffPump and On-Pump Surgery

  • Sohn, Suk Ho;Kim, Seung Hyun;Hwang, Ho Young;Kim, Ki-Bong
    • Journal of Chest Surgery
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    • v.54 no.2
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    • pp.106-116
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    • 2021
  • Background: We evaluated the mid-term outcomes and angiographic patency of redo coronary artery bypass grafting (CABG). Methods: Of 2,851 patients who underwent isolated CABG at Seoul National University Hospital from 2000 to 2017, 88 underwent redo CABG. Patients' mean age at redo CABG was 66.0±8.0 years. The mean interval between the first-time and redo CABG was 113.0±62.4 months. The mean follow-up duration was 86 months. Early and mid-term clinical outcomes were evaluated. Angiographic patency rates were evaluated early (1-2 days), 1 year, and 5 years after surgery. Comparative analyses between on-pump and off-pump CABG were also performed. Results: The culprits for reoperation were previous grafts (65.6%), native coronary vessels (17.8%), and both (16.7%). Off-pump CABG was performed in 75 cases (85.2%), and the mean number of distal anastomoses was 1.8±0.8. The saphenous vein (39.7%) was used most frequently, followed by the right internal thoracic artery (28.4%), right gastroepiploic artery (21.3%), left internal thoracic artery (7.8%), and radial artery (2.8%). Operative mortality was 1.1%. The overall survival, cumulative incidence of cardiac death, and cumulative incidence of major adverse cardiac events were 71.3%,12.0%, and 23.3% at 5 years after surgery, respectively. The overall angiographic patency rates were 95.7%, 90.1%, and 92.2% on early, 1-year, and 5-year angiograms, respectively. The angiographic patency rates of saphenous vein grafts were 93.1%, 85.6%, and 91.3% on early, 1-year, and 5-year angiograms, respectively. No significant differences in clinical outcomes or angiographic patency rates were observed between the on-pump (n=13) versus off-pump (n=75) groups. Multivariable analysis revealed that age (hazard ratio [HR], 1.07; p=0.005) and chronic kidney disease (HR, 3.85; p=0.001) were risk factors for all-cause mortality. Conclusion: Redo CABG could mostly be performed using the off-pump technique and did not show increased operative mortality and morbidities.

Introduction plan of future integrated water circulation management system using LID facility model verification (LID시설 모델검증을 활용한 미래형 통합 물순환관리시스템 도입방안)

  • Lee, Jiwon;Gil, Kyungik
    • Journal of Wetlands Research
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    • v.23 no.1
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    • pp.67-73
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    • 2021
  • As the impermeable area increases due to urbanization and industrialization, the influence of non-point pollutants caused by rainfall runoff on the water system is increasing. In the past, the best management practices(BMP) were used a lot to manage non-point pollutants, but recently, technology that naturally treats them through LID (Low Impact Development) technology is widely used. In this study, various rainfall events were simulated through the SWMM model based on the data of rainfall monitoring in bioretention among natural facilities. The characteristic of LID modeling research is that it is difficult to build accurate modeling data with short-term data because real data is the result obtained through natural facilities, and it is difficult to implement an accurate model. In this study, the data monitored for 3 years It is significant in that it has built a precise model. The actual data monitored a total of 18 times was simulated, and the inflow and outflow and the removal efficiency of five pollutants were simulated. As a result of performing the performance evaluation, most of the 7 items showed excellent indicators, and the TN and TP showed relatively low simulation performance. In the future, it is expected that Korea will introduce an integrated water management system in which the water supply system and the sewage system are substantially integrated and operated. Therefore, the results of this study are considered to play an important role in the initial stage of rainfall management in the future integrated water management system, and the extent of rainfall runoff reduction and pollutant reduction in the expected installation area can be predicted in advance. This is expected to prevent overdesign of bioretention.

The Effect of Meteorological Factors on PM10 Depletion in the Atmosphere and Evaluation of Rainwater Quality (기상인자에 따른 대기 중 미세먼지 감소 및 빗물 특성 연구)

  • Park, Hyemin;Kim, Taeyong;Yang, Minjune
    • Korean Journal of Remote Sensing
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    • v.36 no.6_3
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    • pp.1733-1741
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    • 2020
  • This study analyzed the effect of meteorological factors on the concentration of PM10 (particulate matter 10) in the atmosphere and the variation of rainwater quality using multivariate statistical analysis. The concentration of PM10 in the atmosphere was continuously measured during eleven precipitation events with a custom-built PM sensor node. A total of 183 rainwater samples were analyzed for pH, EC (electrical conductivity), and water-soluble cations (Na+, Mg2+, K+, Ca2+, NH4+) and anions (Cl-, NO3-, SO42-). The data has been analyzed using two multivariate statistical techniques (principal component analysis, PCA, and Pearson correlation analysis) to identify relationships among PM10 concentrations in the atmosphere, meteorological factors, and rainwater quality factors. When the rainfall intensity was relatively strong (> 5 mm/h, rainfall type 1), the PM10 concentration in the atmosphere showed a negative correlation (r = -0.55, p < 0.05) with cumulative rainfall. The PM10 concentration increased the concentration of water-soluble ions (r = 0.25) and EC (r = 0.4), and decreased the pH (r = -0.7) of rainwater samples. However, for rainfall type 2 (< 5 mm/h), there was no negative correlation between the PM10 concentration in the atmosphere and cumulative rainfall and no statistically significant correlation between the PM10 concentration in the atmosphere and rainwater quality.

Comparison of Long-Term Angiographic Results of Wide-Necked Intracranial Aneurysms : Endovascular Treatment with Single-Microcatheter Coiling, Double-Microcatheter Coiling, and Stent-Assisted Coiling

  • Kim, Hyun Sik;Cho, Byung Moon;Yoo, Chan Jong;Choi, Dae Han;Hyun, Dong Keun;Shim, Yu Shik;Song, Joon Ho;Oh, Jae Keun;Ahn, Jun Hyong;Kim, Ji Hee;Chang, In Bok
    • Journal of Korean Neurosurgical Society
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    • v.64 no.5
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    • pp.751-762
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    • 2021
  • Objective : Endovascular treatment of intracranial aneurysms is challenging in case of wide-necked aneurysms because coils are prone to herniate into the parent artery, causing thromboembolic events or vessel occlusion. This study aims to compare long-term angiographic results of wide-necked aneurysms treated by stent-assisted, double-microcatheter, or single-microcatheter groups. Methods : Between January 2003 and October 2016, 108 aneurysms that were treated with endovascular coil embolization with a neck size wider than 4 mm and a follow-up period of more than 3 years were selected. We performed coil embolization with single-microcatheter, double-microcatheter, and stent-assisted techniques. Angiographic results were evaluated using the Raymond-Roy occlusion classification (RROC). All medical and angiographic records were reviewed retrospectively. Results : Clinical and angiographic analyses were conducted in 108 wide-necked aneurysms. The immediate post-procedural results revealed RROC class I (complete occlusion) in 66 cases (61.1%), class II (residual neck) in 36 cases (33.3%), and class III (residual sac) in six cases (5.6%). The final follow-up results revealed class I in 48 cases (44.4%), class II in 49 cases (45.4%), and class III in 11 cases (10.2%). Of a total of 45 (41.6%) radiologic recurrences, there were 21 cases (19.4%) of major recurrence that required additional treatment, and 24 cases (22.2%) of minor recurrence. The final follow-up angiographic results showed statistically significant differences between the stent-assisted group and the others (p<0.01). Conclusion : Long-term follow-up angiography demonstrated that the stent-assisted technique had a better complete occlusion rate than the other two techniques.

Evaluation of Stent Apposition in the LVIS Blue Stent-Assisted Coiling of Distal Internal Carotid Artery Aneurysms : Correlation with Clinical and Angiographic Outcomes

  • Kwon, Min-Yong;Ko, Young San;Kwon, Sae Min;Kim, Chang-Hyun;Lee, Chang-Young
    • Journal of Korean Neurosurgical Society
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    • v.65 no.6
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    • pp.801-815
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    • 2022
  • Objective : To evaluate the stent apposition of a low-profile visualized intraluminal support (LVIS) device in distal internal carotid artery (ICA) aneurysms, examine its correlation with clinical and angiographic outcomes, and determine the predictive factors of ischemic adverse events (IAEs) related to stent-assisted coiling. Methods : We retrospectively analyzed a prospectively maintained database of 183 patients between January 2017 and February 2020. The carotid siphon from the cavernous ICA to the ICA terminus was divided into posterior, anterior, and superior bends. The anterior bends were categorized into angled (V) and non-angled (C, U, and S) types depending on the morphology and measured angles. Complete stent apposition (CSA) and incomplete stent apposition (ISA) were evaluated using unsubtracted angiography and flat-panel detector computed tomography. Dual antiplatelet therapy with aspirin 200 mg and clopidogrel 75 mg was administered. Clopidogrel resistance was defined as fewer responders (≥10%, <40%) and non-responders (<10%) based on the percent inhibition (%INH) of the VerifyNow system. These were counteracted by a dose escalation to 150 mg for fewer responders or substitution with cilostazol 200 mg for non-responders. IAEs included intraoperative in-stent thrombosis, transient ischemic attack, cerebral infarction, and delayed in-stent stenosis. A multivariate logistic regression analysis was used to determine the predictive factors for ISA and IAEs. Results : There were 33 ISAs (18.0%) and 27 IAEs (14.8%). The anterior bend angle was narrower in ISA (-4.16°±25.18°) than in CSA (23.52°±23.13°) (p<0.001). The V- and S-types were independently correlated with the ISA (p<0.001). However, treatment outcomes, including IAEs (15.3% vs. 12.1%), aneurysmal complete occlusion (91.3% vs. 88.6%), and recanalization (none of them), did not differ between CSA and ISA (p>0.05). The %INH of 27 IAEs (13.78%±14.78%) was significantly lower than that of 156 non-IAEs (26.82%±20.23%) (p<0.001). Non-responders to clopidogrel were the only significant predictive factor for IAEs (p=0.001). Conclusion : The angled and tortuous anatomical peculiarity of the carotid siphon caused ISA of the LVIS device; however, it did not affect clinical and angiographic outcomes, while the non-responders to clopidogrel affected the IAEs related to stent-assisted coiling.

The Effectiveness of Traditional Korean Medicine for Treating Postoperative Ileus in Gastric Cancer Patients: A Systematic Review and Meta-Analysis (위암 수술 후 장마비에 대한 한의학적 치료의 효과 : 체계적 문헌 고찰 및 메타분석)

  • Bae, Hye-ri;Kim, Eun-ji;Seo, Hyun-sik;Lee, Nam-hun
    • The Journal of Internal Korean Medicine
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    • v.43 no.4
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    • pp.625-642
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    • 2022
  • Objectives: Postoperative ileus (POI) is a common impairment of gastrointestinal motility and causes a delay in postoperative recovery, as well as an increased length of hospital stay, but no single strategy has a significant recuperative effect on POI. Studies of traditional Korean medicine (TKM) have reported improvements in bowel function after surgery. The aim of this systematic review was to assess the effectiveness of TKM on postoperative ileus in gastric cancer patients. Methods: We used six databases to search for studies published from January 1, 2007, until May 11, 2022. The included studies were those reporting gastric cancer patients who received TKM treatment after gastrectomy through indicators related to POI. Results: The search identified 27 RCTs that used herbal medicine (Daegeonjung-tang and Gami-leejoongtang), herbal medicine combined with acupuncture (Sama-tang, Gumiseunggi-tang, Daeseunggi-tang, and Insam-tang), acupuncture, acupuncture and moxibustion, electroacupuncture, warm needling, transcutaneous electroacupuncture (TEA), low-frequency electrical acupoint stimulation (LEAS), moxibustion, auricular acupressure, and ST-36 acupoint injection with neostigmine as treatments for POI. The time to first flatus was shortened by herbal medicine combined with warm needling (Sama-tang, Gumiseunggi-tang, Daeseunggi-tang, and Insam-tang), acupuncture, electroacupuncture, warm needling, TEA, moxibustion, auricular acupressure, and ST-36 acupoint injection with neostigmine (p<0.00001). The time to the first defecation decreased significantly in response to the herbal medicine combined with warm needling (Sama-tang, Gumiseunggi-tang, Daeseunggi-tang, and Insam-tang), acupuncture, electroacupuncture, warm needling, TEA, moxibustion, auricular acupressure, and ST-36 acupoint injection with neostigmine (p<0.00001). No serious adverse events occurred. Conclusions: TKM could be a promising option for preventing and resolving POI in gastric cancer patients after gastrectomy.

The Phenomenological Study on Self-actualization of Middle-aged Single Mothers - Application of Guided Imagery and Music (GIM) - (한 부모 중년 여성가장의 자기실현과정에 관한 현상학적 연구 -심상유도 음악치료(GIM) 적용-)

  • Lim, Jae-Young;Shin, Dong-yeol;Lee, Ju-Young
    • Industry Promotion Research
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    • v.6 no.2
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    • pp.55-62
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    • 2021
  • The number of single-parent families in South Korea increased since 2000, related to a sharp rise in the divorce rate of 50s and an increase in male mortality rates among those aged 40s-50s. Middle-aged single mothers experience a critical period realizing self-actualization needs, while being in the middle adulthood from the lifespan developmental perspective. In this respect, it is significant to study self-actualization of middle-aged single mothers through guided imagery and music (GIM) in order to provide them with psychological support. This study was conducted from September 2018 to June 2020, and the GIM sessions were conducted at least 10 times. Four participants were selected among the middle-aged single mothers. The imagery experiences of participants in the GIM sessions were classified into four sub-elements: physicalness, emotion, memory, and sense. Within those sub-elements, eight semantic units were categorized into 46 elements. Finally, 152 semantic units were derived. Moreover, the self-actualization which participants experienced through GIM presented three archetypal images: shadow, persona, and the self. In the GIM sessions, experiences of putting their negative emotions associated with family into words and changing passive self-imagery into active one enabled participants to bring the shadow into their consciousness, there by recognizing their positive and bright internal self. Furthermore, participants could map that their current status as people marginalized by siblings and parents, enraged and holding double standards for others, was suppressed by their 'good daughter' and 'religious' personas. This realization lead them to realize and restore their persona. The use of GIM in the study allowed participants to elicit re-experiences of the negative events, while experiencing various imagery and music. This process helped participants achieve self-actualization.

The Effect of Job Insecurity and Entrepreneurship on the Entrepreneurial Intention: Focusing on Shapero's Entrepreneurial Event Model (직장인의 직무불안정성과 기업가정신이 창업의도에 미치는 영향: Shapero의 창업이벤트모델을 중심으로)

  • Ahn, Eun-Ju;Yang, Dong-Woo
    • Korean small business review
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    • v.42 no.3
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    • pp.275-304
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    • 2020
  • The purpose of this study is to present implications for revitalizing start-ups and contribute to enhancing the success rate of start-ups by clarifying factors and processes for converting workers with knowledge, experience and networks in related fields into entrepreneur. Based on the Shapero's Entrepreneurial Event Model, this study demonstrated whether the job insecurity and entrepreneurship of the workers were precipitating events of the entrepreneurial intention and whether the perceived desirability and feasibility of the entrepreneurial behaviour mediated between them. According to the results of the study, first, it was confirmed that job insecurity, innovativeness, and risk-taking of workers are factors that increase the entrepreneurial intention. Second, the indirect effect of perceived desirability between all components of job insecurity and entrepreneurial intentions was not significant, but all components of entrepreneurship appeared to improve entrepreneurial intention through perceived desirability. Third, it has been confirmed that job insecurity, innovativeness, and risk-taking strengthen the entrepreneurial intention through the perception of feasibility for entrepreneurial behavior. Through this study, it is confirmed that in order to convert workers into entrepreneur, it is necessary to strengthen entrepreneurship education and support for internal ventures for workers to increase their positive attitude and confidence in implementation. Therefore, it is expected to help solve job problems and revive the sluggish economy by contributing to boosting start-ups.

Reliability of Non-invasive Sonic Tomography for the Detection of Internal Defects in Old, Large Trees of Pinus densiflora Siebold & Zucc. and Ginkgo biloba L. (노거수 내부결함 탐지를 위한 비파괴 음파단층촬영의 신뢰성 분석(소나무·은행나무를 중심으로))

  • Son, Ji-Won;Lee, Gwang-Gyu;An, Yoo-Jin;Shin, Jin-Ho
    • Korean Journal of Environment and Ecology
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    • v.36 no.5
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    • pp.535-549
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    • 2022
  • Damage to forests, such as broken or falling trees, has increased due to the increased intensity and frequency of abnormal climate events, such as strong winds and heavy rains. However, it is difficult to respond to them in advance based on prediction since structural defects such as cavities and bumps inside trees are difficult to identify with a visual inspection. Non-invasive sonic tomography (SoT) is a method of estimating internal defects while minimizing physical damage to trees. Although SoT is effective in diagnosing internal defects, its accuracy varies depending on the species. Therefore, it is necessary to analyze the reliability of its measurement results before applying it in the field. In this study, we measured internal defects in wood by cross-applying destructive resistance micro drilling on old Pinus densifloraSiebold & Zucc. and Ginkgo bilobaL., which are representative tree species in Korea, to verify the reliability of SoT and compared the evaluation results. The t-test for the mean values of the defect measurement between the two groups showed no statistically significant difference in pine trees and some difference in ginkgo trees. Linear regression analysis results showed a positive correlation with an increase in defects in SoT images when the defects in the drill resistance graph increased in both species.

The Effects of Ecklonia stolonifera Extracts on Improvement of Hepatic Function: a Double-Blind, Randomized, Placebo-Controlled Clinical Study (곰피추출물의 간기능 개선 효과 평가를 위한 12주, 무작위배정, 이중맹검, 위약-대조 인체적용시험)

  • Kim, Junghee;Kim, Eun Jin;Kang, Dahye;Kim, Hyung-Bin;Jang, Jae Young;Om, Ae-Son;Kim, Jongwook
    • Journal of Food Hygiene and Safety
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    • v.37 no.3
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    • pp.198-205
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    • 2022
  • Hepatic diseases are divided into two types: alcoholic and non-alcoholic. Non-alcoholic liver injury finally induces fatty liver and damages liver function. Many studies have demonstrated that Ecklonia stolonifera has antioxidative, anti-inflammatory, and hepatoprotective activities. We conducted a 12-week double-blind, placebo-controlled, randomized trial to examine the efficacy of E. stolonifera extracts (ESE) on biochemical markers of hepatic function. Sixty-five subjects with mild or moderate liver injuries were randomly allocated to receive either 420 mg/d of ESE or a placebo for 12 weeks. Fifty-five participants completed the trial. No significant adverse events were observed among the subjects during the study. The primary end points were changes in plasma levels of aspartate transaminase (AST), alanine transaminase (ALT), and γ-glutamyltransferase (γ-GT). The secondary end points were changes in lipid profile levels, including total cholesterol (TC), triglyceride (TG), high-density lipoprotein cholesterol (HDL), and low-density lipoprotein cholesterol (LDL). Compared with the baseline, AST and ALT levels decreased significantly in the ESE group compared to those in the placebo group (P<0.001). In addition, γ-GT levels in the ESE group were significantly lower than those in the placebo group (P=0.016). There were no differences in the TC, TG, HDL, and LDL levels between groups. In conclusion, ESE consumption for 12 weeks improved liver parameters in subjects with liver injury. Regular consumption of ESE could maintain liver health in individuals at risk of hepatic damage.