• Title/Summary/Keyword: The Secondary Poor

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Long-term Clinical Outcomes and Prognostic Factors After Endovascular Treatment in Patients With Chronic Limb Threatening Ischemia

  • Jung-Joon Cha;Jong-Youn Kim;Hyoeun Kim;Young-Guk Ko;Donghoon Choi;Jae-Hwan Lee;Chang-Hwan Yoon;In-Ho Chae;Cheol Woong Yu;Seung Whan Lee;Sang-Rok Lee;Seung Hyuk Choi;Yoon Seok Koh;Pil-Ki Min;K-VIS (Korean Vascular Intervention Society) investigators
    • Korean Circulation Journal
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    • v.52 no.6
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    • pp.429-440
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    • 2022
  • Background and Objectives: Endovascular therapy (EVT) first strategy has been widely adopted for the treatment of chronic limb threatening ischemia (CLTI) patients in real-world practice. This study aimed to investigate long-term outcomes of CLTI patients who underwent EVT and identify prognostic factors. Methods: From the retrospective cohorts of a Korean multicenter endovascular therapy registry, 1,036 patients with CLTI (792 men, 68.8 ± 9.5 years) were included. The primary endpoint was amputation-free survival (AFS) defined as the absence of major amputation or death. Secondary endpoints were major adverse limb events (MALE; a composite of major amputation, minor amputation, and reintervention). Results: Five-year AFS and freedom from MALE were 69.8% and 61%, respectively. After multivariate analysis, age (hazard ratio [HR], 1.476; p<0.001), end-stage renal disease (ESRD; HR, 2.340; p<0.001), Rutherford category (RC) 6 (HR, 1.456; p=0.036), and suboptimal EVT (HR, 1.798; p=0.005) were identified as predictors of major amputation or death, whereas smoking (HR, 0.594; p=0.007) was protective. Low body mass index (HR, 1.505; p=0.046), ESRD (HR, 1.648; p=0.001), femoropopliteal lesion (HR, 1.877; p=0.004), RC-6 (HR, 1.471; p=0.008), and suboptimal EVT (HR, 1.847; p=0.001) were predictors of MALE. The highest hazard rates were observed during the first 6 months for both major amputation or death and MALE. After that, the hazard rate decreased and rose again after 3-4 years. Conclusions: In CLTI patients, long-term outcomes of EVT were acceptable. ESRD, RC-6, and suboptimal EVT were common predictors for poor clinical outcomes.

Use of Space-time Autocorrelation Information in Time-series Temperature Mapping (시계열 기온 분포도 작성을 위한 시공간 자기상관성 정보의 결합)

  • Park, No-Wook;Jang, Dong-Ho
    • Journal of the Korean association of regional geographers
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    • v.17 no.4
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    • pp.432-442
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    • 2011
  • Climatic variables such as temperature and precipitation tend to vary both in space and in time simultaneously. Thus, it is necessary to include space-time autocorrelation into conventional spatial interpolation methods for reliable time-series mapping. This paper introduces and applies space-time variogram modeling and space-time kriging to generate time-series temperature maps using hourly Automatic Weather System(AWS) temperature observation data for a one-month period. First, temperature observation data are decomposed into deterministic trend and stochastic residual components. For trend component modeling, elevation data which have reasonable correlation with temperature are used as secondary information to generate trend component with topographic effects. Then, space-time variograms of residual components are estimated and modelled by using a product-sum space-time variogram model to account for not only autocorrelation both in space and in time, but also their interactions. From a case study, space-time kriging outperforms both conventional space only ordinary kriging and regression-kriging, which indicates the importance of using space-time autocorrelation information as well as elevation data. It is expected that space-time kriging would be a useful tool when a space-poor but time-rich dataset is analyzed.

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Nutritional Risks Analysis Based on the Food Intake Frequency and Health-related Behaviors of the Older Residents (50 Years and Over) in Andong Area (1) (안동주변 농촌지역 50세 이상 주민의 식품섭취빈도 및 건강행위에 따른 영양위험 분석 (1))

  • Lee, Hye-Sang;Kwun, In-Sook;Kwon, Chong-Suk
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.37 no.8
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    • pp.998-1008
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    • 2008
  • This study aimed to assess the nutritional status and the nutritional risks based on the food intake frequency and health-related behaviors of middle-aged and elderly people living in Andong area. Interviews were conducted with 1,384 subjects (532 males, 852 females) aged 50 years and over. Nutrient intakes, food intake frequency, and health-related behaviors including smoking, drinking, and exercise were investigated. The average energy intakes were 1410.5 kcal for males and 1279.2 kcal for females, and the percentages of the subjects consuming below the estimated energy requirement (EER) were 92.5% and 88.4%, respectively. The least consumed nutrients compared to the estimated average requirement (EAR) were riboflavin (92.5% for males, 89.6% for females), folic acid (89.7%, 88.5%), and calcium (78.9%, 85.8%), in order. According to the food intake frequency survey, the intakes of meat, fish and vegetable (except kimchi) were very poor, and this low intakes of meat and fish showed as poor status of protein, niacin, vitamin $B_6$, and zinc intakes. Health-related behaviors data showed that the ratio of cigarette smokers, especially male, was higher, while the ratio of the person exercising regularly was lower than that of the nationwide statistics, respectively. Cigarette smoking and drinking were not significantly related to the poor nutrition intake, while regular exercise positively influenced nutrient intakes in female subjects. These results showed that the nutritional status of the subjects was likely to be severely deficient and the low intakes of meat and fish to be highly related to the increase of nutritional risk. Therefore, in order to prevent the occurrence of the secondary disease related to the food intake and health-related behaviors of the subjects, the proper educational program on balanced dietary intake and the correction of health-related behaviors should be developed and applied to this area.

Clinical Features and Management of Multidrug-Resistant Tuberculosis (다제 내성 폐결핵 환자의 임상상 및 치료에 대한 고찰)

  • Lee, Jae-Cheol;Lee, Seung-Jun;Kim, Gye-Soo;Yoo, Chul-Gyu;Cheong, Hee-Soon;Kim, Young-Whan;Han, Sung-Koo;Shim, Young-Soo
    • Tuberculosis and Respiratory Diseases
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    • v.43 no.1
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    • pp.14-21
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    • 1996
  • Objectives: Although outbreak of MDR Tb has been a recent problem in western countries, it has been a longstanding problem in Korea. The poor outcome of MDR Tb is mainly due to poor compliance, high rate of side reaction of secondary drugs, and limitation in number of available drugs. Thus, to improve the outcome of MDR Tb, it is crucial to make individualized adequate prescription based on the knowledge of the patterns of resistance to each drugs in the community as well as the natural history. The purpose of present study is to evaluate the clinical features of Korean MDR Tb patients including patterns of drug resistance and success rate of treatment which was prescribed according to the sensitivity tests. Methods: Retroscpective analysis of 71 Korean patients with MDR Tb was made. All strains isolated from patients showed resistence to at least two first line drugs. Patients profile, previous treatment history, patterns of drug resistance, outcome of treatment was analysed. Initial treatment regimen was selected according to the previous treatment history and was modified according to the sensitivity reports. The regimen was composed to include at least 4 sensitive drugs when possible. Results: The patients showed resistance to 4.1 drugs on average. 90% of them were resistant to INH and RFP. Among 71 patients, 35 patients(49%) had cavitary lesions in CXR. Treatment outcome was analysed in 55 patients. 35 patients(67%) were improved after treatment and 18 patients(33%) showed treatment failure. 5 patients showed primary resistance. Treatment outcome could be evaluated in 4 of them and all showed improvement after treatment. 14 patients(20%) had to change their regimens due to drug side effects. The most frequent side effect was elevation of liver enzymes(6 patients). Others included dizziness, hyperuricemia, tinnitus, skin rash, GI troubles. More than 50% of side effects developed within 3 months. In repeated drug sensitivity test, the concordance rate of resistance to INH was 100% and RFP 98%. EMB, PZA showed 80% concordance rate. But in the other drugs, the concordances were less than 50%. Operation was done in 5 patient - 1 patients as a adjunctive means of chemotherapy -. In that case, negative conversion of sputum AFB was done. Conclusion: 2/3 patients of multidrug-resistant tuberculosis were improved by appropriate prescription and regular medication suggesting that more aggressive management and monitoring is indicated in multidrug-resistant tuberculosis.

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Synthesis and Electrochemical Properties of Porous Li4Ti5O12 Anode Materials (기공구조로 제조된 Li4Ti5O12 음극활물질의 전기화학적 특성)

  • Seo, Jin-Seong;Na, Byung-Ki
    • Korean Chemical Engineering Research
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    • v.57 no.6
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    • pp.861-867
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    • 2019
  • $Li_4Ti_5O_{12}$ is a promising next-generation anode material for lithium-ion batteries due to excellent cycle life, low irreversible capacity, and little volume expansion during charge-discharge process. However, it has poor charge capacity at high current density due to its low electrical conductivity. To improve this weakness, porous $Li_4Ti_5O_{12}$ was synthesized by sol-gel method with P123 as chelating agent. The physical characteristics of as-prepared sample was investigated by XRD, SEM, and BET analysis, and electrochemical properties were characterized by cycle performance test, cyclic voltammetry (CV), electrochemical impedance spectroscopy (EIS). $Li_4Ti_5O_{12}$ synthesized by 0.01mol ratio of P123/Ti showed most unified particle size, high specific surface area, and relatively high porosity. EIS analysis showed that depressed semicircle size was remarkably reduced, which suggested resistance value in electrode was decreased. Capacity in rate performance showed 178 mAh/g at 0.2C, 170 mAh/g at 0.5C, 110 mA/h at 5C, and 90 mAh/g at 10C. Capacity retention also showed 99% after rate performance.

Clinical Characteristics of the Intracordal Cysts (성대낭종의 임상적 특성)

  • 홍기환;이상헌;최승철;임현실;김연우;전희석;양윤수
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.13 no.2
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    • pp.173-179
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    • 2002
  • Background and Objectives : Intracordal cysts may occur secondary to voice abuse and overuse or may be secondary to a remnant of epithelium trapped within the lamina propria. They nay occur spontaneously or may be associated with poor vocal hygiene. As the cyst enlarges it can start to significantly affect the vibratory region of the vocal fold. Recently, with the advancement of the microsurgical technique and the laryngeal stroboscopy, correct diagnosis of intracordal cyst have been increased. The aims of this study is to review the important clinical characteristics of the intracordal cyst. Materials and Method : In the present study, 121 cases of the intracordal cyst were treated by the microsurgical technique. These lesions were diagnosed before the operation with indirect laryngoscopy, laryngeal endoscopy, laryngeal stroboscopy and confirmed with the findings observed during operations and the results of the biopsies. Results : The intracordal cysts were 121 cases in the 2595 patients who underwent laryngeal micorosurgery(4.7%). Ductal cyst were 88 cases and epidermoid cyst were 33 cases. The lesions are more frequent in women and anterior third of true vocal cord is more frequently involved site. With the indirect laryngoscopic examination, the ductal cysts are more frequently misdiagnosed as other diseases of the vocal cord such as vocal polyps or nodules. The degree of postoperative voice satisfaction is similar to that of vocal polyps. Conclusion : Intracordal cysts are very similar to the other mucosal disorders of the vocal cord and it may be misdiagnosed as vocal polyps or nodules, frequently. Therefore careful preoperative examinations for the vocal cord lesions with stroboscopy and other endoscopic instruments are important part of the correct diagnosis. An ideal treatment is enucleation of the cysts without upture of the cystic wall or injury of the lamina propria.

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Clinical Characteristics of the Intracordal Cysts (성대낭종의 임상적 특성)

  • Cho, Young-Ju;Yang, Yoon-Su;Yoon, Yong-Joo;Kwon, Sam-Hyun;Hong, Ki-Hwan
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.20 no.1
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    • pp.47-51
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    • 2009
  • Background and Objectives: Intracordal cysts may occur secondary to voice abuse and overuse or may be secondary to a remnant of epithelium trapped within the lamina propria. They may occur spontaneously or may be associated with poor vocal hygiene. As the cyst enlarges it can start to significantly affect the vibratory region of the vocal fold. With the advancement of the microsurgical technique and the laryngeal stroboscopy, correct diagnosis of intracordal cyst have been increased. The aims of this study is to review the important clinical characteristics of the intracordal cyst. Materials and Methods: In the present study, 212 cases of the intracordal cysts were treated by the microsurgical technique. These lesions were diagnosed before the operation with indirect laryngoscopy, laryngeal endoscopy, laryngeal stroboscopy and confirmed with the findings observed during operations and the results of the biopsies. Results : The intracordal cysts were 212 cases in the 4,20 I patients who underwent laryngeal microsurgery (5.04%). Ductal cysts were 156 cases and epidermoid cysts were 56 cases. The lesions are more frequent in women and anterior third of true vocal cord is more frequently involved site. With the preoperative laryngoscopic examination, the intracordal cysts were mostly misdiagnosed as other disease of the vocal cord such as vocal polyps or nodules. And main cause of intracordal cysts was thought of vocal abuse. From view of the surgical approach, Ductal cysts was difficult to remove completely than epidermoid cyst without cystic wall rupture. Conclusion : Intracordal cysts are very similar to the other mucosal disorders of the vocal cord and it may be misdiagnosed as vocal polyps or nodules, frequently. Therefore careful preoperative examinations for the vocal cord lesions with stroboscopy and other endoscopic instruments are important part of the correct diagnosis. An ideal treatment is enucleation of the cysts without rupture of the cystic wall or injury of the lamina propria. And marsupialization is meaningful to ductal cyst that cannot be enucleated completely.

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Evaluation of TQM(Total Quality Management) of Home Economics Education Department in the University by Students (가정교육과 교사교육의 TQM(Total Quality Management: 총체적 질 관리) 구성요소에 대한 재학생들의 평가)

  • Kim, Sung-Gyo;Chae, Jung-Hyun
    • Journal of Korean Home Economics Education Association
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    • v.20 no.3
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    • pp.179-200
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    • 2008
  • This study is aimed at contributing to the future development of Home Economics Education Department by suggesting basic data of TQM(Total Qualify Management) for evaluating TQM of Home Economics Education Departmeut in education colleges. A survey was conducted involving all junior(3rd year) students of Home Economics Education Department in education colleges either by making a visit to 3 different schools or by sending it in the mail to 10 different schools. Responding answer-sheets, 302 copies(88.3%) out of 342 copies in total were returned. Finally, we used 285 copies(83.3%) as data for analysis. The results of this study are as follows: In terms of Professional Qualification of Home Economics Teachers, the students had passion for their Home Economics Education and also had a great pride and mission to be future Home Economics teachers. However, their ability proved to be poor and low in presenting a vision for Home Economics, in conducting extra-curricular activities, and the computer skills. In the case of college students, their satisfaction showed an average point 3.15 on a scale of 5. Those students who entered school voluntarily or those who hoped for re-entrance showed more satisfaction than those who entered school with good academic records or those who do not hope for re-entrance into school. In terms of professors' leadership, Students are perceived to choose 'Transactional Leadership' instead of 'Transformational Leadership'. Students', who have higher satisfaction and hopes for re-entrance, perception level about their professors' leadership style showed higher satisfaction than average. The students empowerment level showed average point 3.52, which is considered relatively high. Students at the college where professors majored in Home Economics Education are employed showed higher empowerment level than students at the college with professors who did not major in Home Economics Education. The result of evaluating general demand for renovating of Home Economics Education Dept. showed that: they perceived the "Teacher Education Course" of Home Economics Education Dept. as in need of cultivating practical skills in secondary school. They also said, "Teaching Method" is in great need of renovation. In the case of teaching method, they preferred laboratory work, and practical training. In earning credits, they emphasized the importance of faithfully completing the "Study of Content". For the Subject Matter Education, they required a training course to be set up in the secondary school. Finally they claimed that the teachers and students need to take the initiative in developing a Curriculum of Home Economics Education Dept. Based on the findings mentioned above, I would like to suggest further research on how to adopt and evaluate TQM in Home Economics Education, and faculty-centered evaluation methods. I also would like to suggest to vitalize quality research through the form of narrative research.

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Development and Characterization of Rice Lines with Clustered Spikelets and Dense Panicles (군집소수를 가진 고착립밀도 이삭형 벼 개발 및 특성 분석)

  • Park, Hyun-Su;Baek, Man-Kee;Kim, Choon-Song;Lee, Gun-Mi;Park, Seul-Gi;Lee, Chang-Min;Suh, Jung-Pil;Cho, Young-Chan
    • Korean Journal of Breeding Science
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    • v.50 no.4
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    • pp.415-423
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    • 2018
  • Rice panicle architecture is an important factor affecting yield potential. Korean rice cultivars have a narrow genetic background for panicle architecture. To enhance the yield potential of Korean rice cultivars, we developed and characterized rice lines with new panicle architecture. Rice with improved panicle architecture has clustered spikelets and dense panicles (CD type). CD rice was derived from a cross between "Binhae Col.#1" carrying dense panicles, and "ARC10319" that has the clustered spikelets gene (Cl). CD rice lines had short and semi-erect panicles with two to five high density spikelets clustered at the tips of primary and secondary rachis branches. CD rice lines had dramatically increased numbers of spikelets; almost twice as many as those of Korean rice cultivars. The increase in spikelet number was mainly caused by the increased spikelets and branches on secondary rachises compared to those on primary rachises. The increase in spikelet number was expected to enhance the yield of CD rice by expanding sink capacity. However, the yield of selected lines; CD9, CD27, CD34, and CD39, did not reach the level of the Korean high-yielding cultivars "Boramchan" and "Hanareum2," due to the reduction in panicle number and grain weight, and poor ripening. Although no substantial yield increase was observed in CD rice, the panicle architecture of CD rice, clustered spikelets, and dense panicles could be new genetic resources as breeding material for diversifying panicle architecture and enhancing yield potential.

A Case of Cushing's Syndrome Associated with Ectopic Corticotropin Production in Patient with Small-Cell Lung Cancer (이소성 ACTH 생산에 의해 야기된 Cushing 증후군이 동반된 소세포 폐암 1예)

  • Kwak, Young-Im;Im, Young-Hyuck;Cheon, Young-Kug;Yi, Ka-Hee;Nam, Hyeon-Seok;Lee, Choon-Taek;Kang, Yoon-Koo;Lee, Jhin-Oh;Kang, Tae-Woong
    • Tuberculosis and Respiratory Diseases
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    • v.42 no.6
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    • pp.934-940
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    • 1995
  • Small cell lung cancer(SCLC) is frequently associated with paraneoplastic syndromes, which occur in approximately 20% of patients at presentation. Clinical Cushing's syndrome secondary to ectopic ACTH production is uncommon, occurring in approximately 5% of all SCLC patients. However, biochemical evidence of hypercortisolism can be detected in up to 50% of patients. Patients with Cushing's syndrome from ectopic ACTH production show hypertension, weakness, hyperglycemia, and hypokalemic metabolic alkalosis, but differ from patients with classic Cushing's disease in that symptoms develop more rapidly. Ectopic ACTH production is associated with a poor response to chemotherapy, short survival, and a high risk of treatment-related complications. We report a case of Cushing's syndrome associated with ectopic corticotropin production in 59-year-old male patient with extensive stage of SCLC.

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