• Title/Summary/Keyword: Various age group

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Research on the Food Habits of Housewives of Korean Students Residing in a Southern Region of Texas, U.S.A. (미국 Texas 일부 지역에 거주하는 한국 유학생 부인들의 식생활습관에 관한 연구)

  • 김은실;송청락;정복미;심영자
    • Culinary science and hospitality research
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    • v.9 no.2
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    • pp.11-21
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    • 2003
  • The purpose of this study was to research on the preparing fermented foods and food habits of Korean women in Texas U. S. A. The preparing method of fermented foods and food habits of Korean housewives whose husbands are studying at the various universities in Houston, Texas are surveyed. The analysed results indicated were as follows ; 1. 64.4% of women were in the thirties at their age, those in twenties 29.7%. 75.2% of subject graduated college. Period of residence in America were 52.5% under 3yr, 25.7% over 5yr. The respondents were aged twenties(29.7%) to thirties(64.4%) who have graduated from college(75.2%) or graduate school(24.8%) and have had the residence period of less than three-(52.5%) to more than five years(25.7%). 2. The kind of cuisine chosen for dinner were Korean style food. The most considerable person when preparing menu were husband. 48.51% of those in age were 3∼39yr(p < 0.1). 60.40% of the response graduated college(p < 0.1). The Korean-style foods overwhelmed over western ones in their frequency for dinner(82.2% vs. 17.8%). The person most considered for choosing menu was their husbands as responded by the majority groups of aged thirties(48.5%), college graduates(60.4%) and residence period of less than three years(42.6%). They satisfied comparatively when they prepared the meal (p < 0.1). 55.4% of the response learned cooking method from neighbor, 39.6% of remainder studied from cuisine book, newspaper, magazine, TV. They satisfied comparatively for the preparation of the meal(56.4%) and have learned the new methods of cooking from neighborhoods(55.4%) or cuisine book, newspaper, magazine and TV(39.6%). 3. The frequency of eating-out mostly had once a month. 30.69% of response were 30∼39yr(p < 0.1). 33.66% of subjects lived under 3yr in America. The frequency of eating-out mostly had once a month. 30.69% of response were 30-39yr(p < 0.1). 33.66% of subjects lived under 3yr in America. Eating-out once a month occupied 30.7, 33.7, and 20.7% of the selected group of aged thirties, college graduates, and residence periods of less than three years, each respectively. The type of food selecting eating-out were western style. 38.31% of them were 30∼39yr(p < 0.1). 39.60% of them graduated college(p < 0.1). 29.70% of them lived under 3yr in America. For eating-out menu, the western-style foods were most favored by the groups of aged thirties(38.3%), college graduates(39.6%), and residence periods of less than three years(29.7%). 4. 50.5% of subject had beef once three days, 23.8% of the response had pork once two weeks, 27.7% of subject ate chicken once two weeks, 34.7% of the response enjoyed fish once a week. Eating animal foods once three days for beef(50.5%), once two weeks for pork(23.8%) and chicken(27.7%), and once a week for fish(34.7%) were most frequent. 5. Korean traditional fermented food were mostly enjoyed in order of kanjang(91.1 %), kochujang(87.2%), fermented fish(85.1%), deonjang(81.2%), jang-a-chi(76.2%). 81.2% of subject used prepared-food by themselves. 56.4% of response made kimch at home. Among Korean traditional fermented foods, kimchi(56.4%) and prepared side dishes(81.2%) were provided at home while kanjang(91.1%), kochujang(87.2%), fermented fish(85.1%), deonjang(81.2%), and jang-a-chi(76.2%) were mostly purchased from stores.

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A Study on Health Status of the 1,559 Korean Applicants Applying for the Coal Miners in West Germany during the Year of 1972 and 1973 (우리나라 독일광부(獨逸鑛夫) 지원자(志願者)에 대(對)한 건강상태(健康狀態)에 관(關)한 조사연구(調査硏究))

  • Jun, Hyun-Sook;Choi, Sam-Sup
    • Journal of Preventive Medicine and Public Health
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    • v.7 no.2
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    • pp.383-393
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    • 1974
  • The importance of the health care for the miners not only concerns the productivity of the enterprises but also as a fundamental human right, it has to be secured and protected by the society and the government. The Korean coal miners began to find their works at overseas since 1963 when the Korean government selected and dispatched its miners to West Germany. As years go by, the demand and the supply of the coal miners, the program of the coal miners health care became the important tasks to be solved and the further studies and research were necessary to support these tasks achievement. The writers made a statistical analysis on health status of the 1,559 Korean applicants applying for the coal miners in West Germany during the year of 1972 and 1973 by the using of the data of physical examination which were directed by the Korea Overseas Development Cooperation. The standard of physical examination which was applied for coal miners applying the jobs in West Germany was authorized by the Government Office of Labor in 1967. The results are as following; 1. The applicants were from the various provinces throughout Korea; Gang Weon 50.2%, Jeon-Nam 16.8%, Chung-Nam 13.7%, Gyeong-Nam 10.5%, City of Seoul 5.4%, and others 3.7%. 2. The ages of the applicants were from 20 to 44. The age group of 25-29(36.3%) and of 30-34(55.2%) together occupied the 91.5 per cent of the total applicants. 3. Among the 1,559 applicants 52.1 per cent passed the physical examinations. The tendency were shown that as the age increased, the passing rate decreased, and the married applicnts had lower passing rates compared to the unmarried applicants. 4. The height of the applicants averaged $168.4{\pm}4.74(cm)$ and the weight averaged $61.3{\pm}5.65(kg)$. 5. The average vision of the left eye of the applicants was $0.92{\pm}0.23$ and the right eye was $0.91{\pm}0.30$. 6. The mean value of the systolic blood pressure of the applicants was $145{\pm}13(mmHg)$ and the diastolic blood pressure was $85{\pm}8(mmHg)$. 7. Fifteen hundred and fifty-nine applicants were taken chest X-ray and 17.2 per cent were found abonrmal. For each 1,000 applicants, 46 Pulmonary calcification and fibrosis, 45 chronic bronchitis, 27 pleural thickening and adhesion, 20 pulmonary tuburculosis, 11 anomalies of the rib, 10 pulmonary infiltration and 21 others diseases were found. 8. Lumber X-ray examination showed that 23.9 per cent (372 applicants) were found abnormal. For each 1,000 applicants, 77 osteoarthritis, 56 lumbarization, 15 fracture of vertebrae, 15 spondyloarthritis, 14 deformity of vertebrae, 13 spina bifida, 12 sacralization, 12 spondylolysis, and 5 others diseases were found. 9. In total, 47.9 per cent of 1,559 applicants failed the physical examinations, and the main causes for the failure were shown to be 7.1% of anomalies of spine, 6.3% of osteoarthritis, 4.7% of pulmonary calcification and fibrosis, 4.6% of chronic brochitis, 3.6% of hypertension (only), 3.4% of fracture of vertebrae. 3.1% of underweight(under 57.0kg), 2.0% of spondyloarthritis, 2.0% oe pulmonary tuberculosis, 1.7% of pleurisy, 1.0% of spina bifida, 1.5% of syphilis, 1.5% of color blindess, and 1.0% of underheight(under 160.0cm).

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Comparative Study on Acoustic Characteristics of Vocal Fold Paralysis and Benign Mucosal Disorders of Vocal Fold (성대마비와 양성 성대점막질환의 음향학적 특성비교)

  • Kong, Il-Seung;Cho, Young-Ju;Lee, Myung-Hee;Kim, Jong-Seung;Yang, Yun-Su;Hong, Ki-Hwan
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.18 no.2
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    • pp.122-128
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    • 2007
  • This study aims to analyze the voices of the patients with voice disorders including vocal fold paralysis, vocal fold cyst and vocal nodule/polyp in the aspect of acoustic phonetics. This study intends to collect subsidiary acoustic data in order to make a speech treatment and an standardization of vocal disorders. Subjects and Methods: The subjects of this study were 64 adult patients who underwent indirect laryngoscopy and laryngostroboscopy, and were diagnosed as vocal fold paralysis, vocal fold cyst or vocal nodule/polyp. Experimental group consisted of 20 patients who were diagnosed as vocal fold paralysis, 21 patients who were diagnosed as vocal fold cyst and had the average age of 42.0 $({\pm}10.03)$ ; and 23 patients who were diagnosed as vocal nodule/polyp and had the average age of 40.9 $({\pm}13.75)$. For the methodology of this study, the patients listed above were asked to sit in a comfortable position at intervals of 10cm apart from the patient's mouth and a microphone, and subsequently to phonate a vowel sound /e/ for the maximum phonation time with natural tone and vocal volume then the sound was directly inputted on a computer. During recording, sampling rate was set to 44,100Hz and the 1-second area corresponding to stable zone except the first and the last stage of waveform of the vowel sound /e/ vocalized by the individual patients was analyzed. Results: First, there was no statistically significant difference in jitter and shimmer between vocal fold paralysis and vocal fold cyst, while there was highly statistically significant difference in them between vocal fold paralysis and vocal nodule/polyp. Second, looking into the mean values obtained from NNE, HNR and SNR results associated with noise ratio, the disease showing the most abnormal characteristics was vocal fold paralysis, followed by cyst and nodule/polyp in order. For NNE, there was statistically significant difference between vocal nodule/polyp, and cyst or paralysis. In other words, it was found that the NNE of vocal nodule/polyp was weaker than that of cyst or paralysis. Similarly, HNR and SNR also showed the same characteristics; there was statistically significant difference between vocal fold paralysis and vocal fold cyst or nodule/polyp, and HNR and SNR values of vocal fold paralysis were lower than those of vocal fold cyst or nodule/polyp. Conclusion: For vocal fold paralysis, the abnormal values of acoustic parameters associated with frequency, amplitude and noise ratio were statistically significantly higher than those of vocal fold cyst and nodule/polyp. This finding suggests that the voices of the patients with vocal fold paralysis are the most severely injured due to less stability of vocal fold movement, asymmetry and incomplete glottic closure. In addition, there was no statistically significant difference in the acoustic parameters of tremor among vocal fold paralysis, vocal fold cyst and vocal nodule/polyp. Further studies need to ascertain reasonable acoustic parameters with various vocal disorders as well as to clarify the correlation between acoustics-based objective tools and subjective evaluations.

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Epidemiological Studies on Giardia Infection Associated with environmental Pollution (Giardia에 의한 환경오염(環境汚染)과 감염(感染)에 관한 역학적(疫學的) 연구(硏究))

  • Lee, Keun-Tae;Kim, Seok-Chan;Song, Jong-Sool;Chung, Pyung-Rim
    • Journal of agricultural medicine and community health
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    • v.9 no.1
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    • pp.56-66
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    • 1984
  • Giardia lamblia is a pathogenic flagellate causing intestinal disorders such as diarrhea, abdominal pain and malabsorption of nutrients. Giardia is mainly infected by the ingestion of contaminated foods per os. Craun (1979) has recently reported that mass infection of this flagellate through the contaminated water supply systems is one of public health hazards. Also, so-called traveller's diarrhea is sometimes caused by Giardia infection (CDC, U.S.A., 1971). However, a few epidemiological studies figuring out the mode of infection or control measures of Giardia infection has been done so far in Korea. The present study was aimed to know the prevalence of Giardia infection in several Korean populations, detectability of this flagellate in water systems and the viability of the cysts against sewages and disinfectants applying to drinking water. In the present study, 388 stool specimens from orphanage children in Chun-joo, Chung-joo, On-yang and Chun-an areas and 538 stool specimens from inhabitants in Woo-do, In-chon, and Chun-joo were examined by formalin-ether concentration technique to detect out Giardia cysts. On the other hand, water samples from 14 sites of Han River and its tributaries were collected in May through July, 1984. Fifty liter of water sample in each sampling site was then filtered through water filtering system deviced by U.S. Environmental Proutection Agency and the sediments rinsed out from the thread rolls, a part of water filtering system, were examined to detect out the Giardia cysts. In order to observe the viability of Giardia cysts in the sewage samples, the cysts were treated in it at $4^{\circ}C$ or $25^{\circ}C$ for 7 through 28 days. For this purpose, the cysts were also exposed to various concentrations of disinfectants such as chlorine, iodine and ozone gas for proper time intervals. After treatment, the viability test of the Giardia cysts were carried out by method of Rice and Schaefer (1981) with minor modification. The results obtained in this study were as follows : 1) The detection rates of G lamblia cysts in the stool specimens were 18.3% in orphans and 4.3% in general examinees. 2) The prevalences of Giardia Infection were higher in the young age groups than in-adults. The highest positive rate was 18.4% in the age group less than 10. 3) Of 14 water specimens sampled from Han River system and its tributaries around the Seoul area, the Giardia cysts were detected from 4 samples, and no cyst was found in the water supply systems. 4) The cysts treated in the sewage survived for 28 days at $4^{\circ}C$ and for 13 days at $25^{\circ}C$. 5) The cysts were completely destroyed within 60 minutes by exposure to 8 mg/l of residual chlorine at 4g and within 30 minutes by exposure to the same concentration of chlorine at $25^{\circ}C$. 6) The cysts were all dead when exposed to 1 mg/1 of iodine for 60 minutes at $4^{\circ}C$ or $25^{\circ}C$. 7) The cysts were destroyed after 10 minute exposure in 0.15 mg to 0.25mg of residual ozone gas per liter. Summarizing the above results, it is considered that Giardia infection is regarded as water-borne disease and the cysts are able to be controlled by the application with the disinfectants in the water supply systems.

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Congenital Anomaly of Urinary Tract in Children (소아 선천성 요로계 기형에 관한 고찰)

  • Shin Weon Hye;Ko Cheol Woo;Koo Ja Hoon;Chung Sung Kwang
    • Childhood Kidney Diseases
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    • v.3 no.1
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    • pp.88-94
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    • 1999
  • Purpose : Malformation of urinary tract is among the most common of all congenital anomalies and can progress to irreversible renal damage before diagnosis due to difficulty of early diagnosis. Present study was undertaken to determine the clinical characteristics of urinary tract anomaly and to find out the most appropriate diagnostic and therapeutic measures for children with these anomalies. Methods : During the past 10 years from 1987 to 1998, review of medical records revealed 65 children with congenital anomaly of urinary tract and the following results were obtained. Results : The most common anomalies were ureteropelvic junction obstruction occuring in 26 cases ($36\%$), followed by ureteral duplication in 11 cases, renal agenesis in 10 cases and ureterovesical function obstruction in 7 cases. Complex anomaly of urinary tract was found in 8 cases and anomaly of other systems such as congenital heart disease was detected in 11 cases. The most frequent age group at the time of diagnosis was below 1 year of age constituting 39 cases ($60\%$) and male preponderance was noted as male to female ratio being 2.25:1. Presenting symptoms were urinary tract infection in 25 cases, followed by hematuria, abdominal mass, abdominal pain and voiding difficulty, etc, and in 11 cases, the anomaly was picked up by routine prenatal ultrasonography. Azotemia was noted in 9 cases and the underlying anomaly was obstructive uropathy in 4 out of these 9 cases. Surgical correction was undertaken in 38 cases (most frequently in cases of obstructive uropathy) and in 2 out off cases with obstructive uropathy in whom surgical correction was done, azotemia disappeared during follow up period of 1-5years. No new cases of deteriorating renal function appeared during follow-up period. Conclusion : In spite of high incidence of congenital malformation of urinary tract, early diagnosis is still hampered by nonspecific symptoms and signs. Therefore, in patients with symptoms such as urinary tract infection, abdominal pain and voiding problems, etc, it Is advisable to take various diagnostic tests promptly to pick up any urinary tract anomaly and to apply proper therapy in order to avoid progression to irreversible renal damage. In this regard, prenatal ultrasonography should be utilized more widely as a routine procedure to detect any urinary tract anomalies before birth.

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A Study on the Fashion Information Activities of Clothing Manufactures (의류제조업체의 패션 정보활동에 관한 연구)

  • 송미령
    • Journal of the Korean Society of Costume
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    • v.22
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    • pp.135-158
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    • 1994
  • The fashion industry of today is closely re-lated with the information activity. This study investigates now they take advantage of the fashion information by analysing some related fields including fashion design. Furthormore this study identify the factor which makes the design activity distinctive and predict and fu-ture trend in design. The purposes of this study through analysis are : to help find the way to facilitate the fashion industry and to develop the fashion merchandising in order to activate the re-cession of manufacturers and to improve competitiveness in the world market and to contribute to the academic achievement in the study of fashion merchandising. In the experimental approach the tasks of research are as follows: Research 1: The application of fashion infor-mation is discussed in terms of process and level. Research 2: The differences of the fashion design activities are captured on the basis of the characteristics of manufactures and fashion specialists and fashion information ac-tivities. The factors are identified which pre-dict and discriminate the results of fashion de-sign activities. The questionaire and interview were conduc-ted among women's clothing manufactures in Seoul and their fashion specialists in charge of merchandise development. The methods of survey were designed on the basis of theories developed so far and on he advice from the social scientists and fashion specialists. the methods were corrected and complemented through the 1st and 2nd preliminary investigations before their application For data analysis cronbach's a coefficient fre-quency percentage average standard devi-ation pearson's correlation coefficient were calculated and t-test F-test(ANOVA) Duncan's multiple range test regression and Discriminant analysis were conducted. The results of analysis throughout the experimen-tal studies were as follows: 1. The analysis of fashion in formation (1) the present application of information a. The source of information : Both the foreign and the domestic information came mostly from fashion journals magazines newspapers and other periodicals, the main source of market information was collected from the survey of popular items in recent years the data about the life-style of customers and their tastes for wearing were widely used as the information about consumers. b. The applicaton of information : The most widely used information was about fabrics. The foreign information was prefered on the whole. The domestic problems pointed out in this investgation were that the domestic journals showed the lack of specialty and the special organizations for fashion informatino were in urgent need. (2) The research of fashion information a. The various processes and levels of in-formation activities: Among the process of collection analysis and distribution the collec-tion process showed a good acheivement whereas the distribution whereas the distribution didn't. In levels of the systematic activities the acceptance of support and the utility of supported instruments the first indicated a high degree whereas the second showed lowest. b. The correlationship among subvariables : There was a significant correlation between the collection and the analysis process. The systematic activities revealed close relation-ship with the analysis process and the accept-ance of support with the distribution process. The close correlation was found between the utility of supported instruments and the analy-sis process. 2. The analysis of the fashion design activities (1) No significant differences were found in the design activities when the characteristics of companies were compared only. (2) According to the characteristics of fashion specialists the one with age experi-ence and high income showed rather good achievement but no significant differences were captured among sex department in charge title academic background education in abroad and field experience (3) The fashion information activities were strongly correlated with the design achieve-ment : The analysis process and the system-atic activity level had a great influence on the design activities. (4) In order to examine which cha-racteristics in (1-3) made it possible to pre-dct and discriminate the achievement in de-sign activities the Discriminant analysis was carried out. The results were as follows: the fashion information activities showed the highest discriminant rate. Next came the in-come level experience and age in that order Those four variables discrimated 37 from 50 who showed great achievement in design area (74%) and 51 from 83 in low achievement group (81%) Thus the total discriminant rate was 77.5%.

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A Clinical Analysis of Pneumonia in Acute Drug Intoxication (급성 약물 중독환자에서 발생된 폐렴의 임상양상 및 위험인자에 대한 고찰)

  • Yoon, Hyun Ju;Son, Ji Woong;Choi, Eu Gene
    • Tuberculosis and Respiratory Diseases
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    • v.59 no.4
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    • pp.380-388
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    • 2005
  • Background : Acute drug intoxication has recently become an important issue in the social and clinical areas. There are various complications associated with acute drug intoxication such as pneumonia, but the process is was not fully understood. The aim of this study was to analyze our cases of pneumonia associated with acute drug intoxication and to determine the associated risk factors. Methods : Forty four cases out of 237 patients, who were acute drug intoxicated from May 2000 to Feb. 2005, were diagnosed with pneumonia at the Konyang University hospital. These cases were analyzed by a retrospective review of their medical records. Results : The incidence of pneumonia in acute drug intoxication was 18.6%. There was no gender difference in terms of the incidence, but the age group with the highest incidence was in the $5^{th}$ decade (22.5%) followed by the $7^{th}$ decade (17.9%). Most common drug of associated with pneumonia was organophosphate insecticides, and the others were herbicides. Suicidal attempts were the most common motive of intoxication. The incidence of pneumonia was increased in old age (${\beta}=0.128$, p<0.05). A drowsy or comatous mental status was an independent risk factors of pneumonia (${\beta}=-0.209$, p=0.006). A longer hospital duration was also a risk factor for pneumonia (${\beta}=0.361$, p<0.001). The intubated state, intensive care unit care and longer duration of admission correlated with the course of pneumonia in acute drug intoxicated patients (p<0.05). The culture study revealed MRSA to be most common pathogen. Conclusion : The incidence of pneumonia associated with acute drug intoxication was higher in the older aged patients, those with a decreased initial mental status and a longer hospital duration. The number of days in the intensive care unit and intubation were associated prognostic factors for pneumonia in acute drug intoxication patients.

Health Behavior and Health Condition of the Rural Young-Old and the Rural Old-Old in an Agricultural District (농촌 전기노인과 후기노인의 건강행태와 건강상태)

  • Hwang, Seong-Ho;Lee, Myeong-Sook;Lee, Sung-Kook
    • Journal of agricultural medicine and community health
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    • v.36 no.4
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    • pp.207-217
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    • 2011
  • Objectives: The purpose of this study is to garner useful information through a comparative analysis of health behaviors and health states between the young-old and old-old elderly in a rural Korean area. Methods: We define the young-old elderly as those 65 to 74 years of age, and the old-old as those over 70. The survey was administered in October and November of 2009 at senior citizen centers in Sangju City, Kyongsangbuk-do, South Korea. The number of subjects surveyed approximated the demographics of the aged population of the administrative district of centers of 24 eup, myeon, and dong. Results: Compared with the young-old elderly, the old-old were vulnerable to population sociological characteristics. While there were many cases of contraction of diseases, only a small percentage of old-old elderly were engaged in regular exercise. In addition, the old-old elderly lagged behind the young-old in terms of physical activity, mental and oral health, hearing, and vision. Conclusions: The vulnerability of the old-old elderly in terms of physical and mental health needs to be acknowledged as various characteristics of the elderly that appears according an age group. A variety of disease prevention and health promotion programs that focus on the health behavior and status of the young-old and old-old elderly need to be developed and put into practice.

A Study on the Distribution of Startups and Influencing Factors by Generation in Seoul: Focusing on the Comparison of Young and Middle-aged (서울시 세대별 창업 분포와 영향 요인에 대한 연구: 청년층과 중년층의 비교를 중심으로)

  • Hong, Sungpyo;Lim, Hanryeo
    • Asia-Pacific Journal of Business Venturing and Entrepreneurship
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    • v.16 no.3
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    • pp.13-29
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    • 2021
  • The purpose of this study was to analyze the spatial distribution and location factors of startups by generation (young and middle-aged) in Seoul. To this end, a research model was established that included factors of industry, population, and startup institutions by generation in 424 administrative districts using the Seoul Business Enterprise Survey(2018), which includes data on the age group of entrepreneurs. As an analysis method, descriptive statistics were conducted to confirm the frequency, average and standard deviation of startups by generation and major variables in the administrative districts of Seoul, and spatial distribution and characteristics of startups by generation were analyzed through global and local spatial autocorrelation analysis. In particular, the spatial distribution of startups in Seoul was confirmed in-depth by categorizing and analyzing startups by major industries. Afterwards, an appropriate spatial regression analysis model was selected through the Lagrange test, and based on this, the location factors affecting startups by generation were analyzed. The main results derived from the research results are as follows. First, there was a significant difference in the spatial distribution of young and middle-aged startups. The young people started to startups in the belt-shaped area that connects Seocho·Gangnam-Yongsan-Mapo-Gangseo, while middle-aged people were relatively active in the southeastern region represented by Seocho, Gangnam, Songpa, and Gangdong. Second, startups by generation in Seoul showed various spatial distributions according to the type of business. In the knowledge high-tech industries(ICT, professional services) in common, Seocho, Gangnam, Mapo, Guro, and Geumcheon were the centers, and the manufacturing industry was focused on existing clusters. On the other hand, in the case of the life service industry, young people were active in startups near universities and cultural centers, while middle-aged people were concentrated on new towns. Third, there was a difference in factors that influenced the startup location of each generation in Seoul. For young people, high-tech industries, universities, cultural capital, and densely populated areas were significant factors for startup, and for middle-aged people, professional service areas, low average age, and the level of concentration of start-up support institutions had a significant influence on startup. Also, these location factors had different influences for each industry. The implications suggested through the study are as follows. First, it is necessary to support systematic startups considering the characteristics of each region, industry, and generation in Seoul. As there are significant differences in startup regions and industries by generation, it is necessary to strengthen a customized startup support system that takes into account these regional and industrial characteristics. Second, in terms of research methods, a follow-up study is needed that comprehensively considers culture and finance at the large districts(Gu) level through data accumulation.

Tetralogy of Fallot Associated with Pulmonary Atresia and Major Aortopulmonary Collateral Arteries -Comparison between the different surgical approaches- (폐동맥폐쇄와 주대동맥폐동맥혈관부행지를 동반한 활로씨사징증 -다양한 외과적 치료접근의 비교-)

  • 이정렬;양지혁;김용진;노준량
    • Journal of Chest Surgery
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    • v.32 no.5
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    • pp.471-479
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    • 1999
  • Background: Patients with tetralogy of Fallot(TOF), pulmonary atresia(PA) and major aortopulmonary collateral arteries(MAPCAs) have been managed by heterogenous surgical strategies. We have taken 5 different surgical approaches to this lesion. In this study, relative advantages and disadvantages of each strategy were discussed by analyzing our surgical results. Material and Method: Between January 1986 and June 1998, 50 patients aged 1 to 177(39${\pm}$31) months at a various morphologic spectrum of this lesion were treated at our institution. The groups, which were classified according to the initial approaches, consisted of one-stage unifocalization(A-1, n=9), staged unifocalization(A-2, n=11), right ventricle to pulmonary artery connection(RV-PA)(B-1, n=11), one-stage RV-PA plus unifocalization (B-2, n=11), and one-stage definitive repair(C, n=8). Morphologic charateristics, operative mortalities, and probabilities of definitive repair were compared between the groups and the causes of death, complications and the follow-up results were described. Result: Mean ages at the first operation were 57${\pm}$18(A-1), 42${\pm}$48(A-2), 18${\pm}$14(B-1), 52${\pm}$55(B-2), and 32${\pm}$34(C) months (p<0.05). Mean numbers of MAPCAs were least in group C (A-1=4.3${\pm}$1.0, A-2=4.5${\pm}$1.3, B-1=4.1${\pm}$1.9, B-2=4.1${\pm}$1.6, C=3.4${\pm}$1.8 : p<0.05). The ratios of the direct and the indirect MAPCAs in each group were not different between the grousps (A-1=91%/9%, A-2=78%/22%, B-1=80%/20%, B-2=80%/20%, C=81%/19% : p>0.05). Nineteen patients had more than 1 dependent MAPCAs. True pulmonary arteries were not present 13 patients and they were confluent in 29. A total of 101 operations were performed. Operative mortalities of initial procedures were 33%(3/9, A-1), 18%(2/11, A-2), 0%(0/11, B-1), 36%(5/11, B-2) and 13%(1/8, C) (p<0.05). Percentages of the definitive repair among the patients of each group were 22%(2/9, A-1), 18%(2/11, A-2). 45%(5/11, B-1), 27%(4/11, B-2), and 100%(8/8, C)(p<0.05). Hypoxic respiratory and cardiac failure(6), hypoxic encephalopathy(2) and sepsis(4) were the major causes of death. Phrenic nerve palsy occured in 5 patients. Thirty-one patients among the survivals have been followed up for a mean duration of 74${\pm}$42(3-145) months. One and five year actuarial survival rates were 73% and 73 %. Conclusion: In conclusion, Right ventricle to pulmonary artery connection used in patients with TOF/PA/MAPCA as an inital procedure appeared to be highly successful in enhancing the chance of satisfactory definitive repair without the significant surgical risks. One-stage total repair at an ealier age group could be performed safely with the resonable outcomes. Unifocalization approach, whether it was performed in a single stage or in the multiple stages, resulted in the high operative mortality and the lowest chance of definitive repair, however more tailored selection of the patients and the long follow-up is mandatory to prove the usefulness of this approach.

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