• Journal of Chest Surgery
• /
• v.36 no.12
• /
• pp.911-920
• /
• 2003

In this study, we analyzed the long-term surgical outcome of partial atrioventricular septal defects during the past 17 years at Seoul National University Hospital. Material and Method: A retrospective analysis on mortality, survival, and reoperation and their risk factors was done in 93 patients who underwent surgical correction of partial atrioventricular septal defects between April 1986 and December 2002. 32 patients were male and 61 were female with a median age of 68 months (3∼818 months) and a mean follow-up period of 108 months (1∼200 months). Result: There were 4 operative deaths (4.3%) and one mortality during the follow-up period. 3, 5, 10, and 15 year actuarial survival rates were 95.7%, 94.3%, 94,3%, and 94.3%, respectively. After the surgical correction, left atrioventricular valve Incompetence was improved in 61patients (67.7%), remained same as the preoperative status in 14 patients (15.1%), and was aggravated in 12 patients (12.9%). Reoperation was performed in 8 patients (9.0%) after a mean interval of 38.6 months (3∼136 months). Freedom from reoperation rates at 3, 5, 10, and 15 years after surgical correction were 94.0%, 91.4%, 91.4%, and 88,2%, respectively Reasons for reoperation were 7 left atrioventricular valve incompetence, 2 left ventricular outflow tract obstruction, a residual atrial septal defect, a left atrioventricular valve stenosis, and a right ventricular failure. Left ventricular outflow tract obstruction was the only statistically significant factor. In ten patients, significant arrhythmia was developed and three of them were supraventricular arrhythmia. Complete atrioventricular block occurred in 7 patients and permanent pacemakers were implanted in six of them. Conclusion: Surgical corrections of partial atrioventricular septal defects were performed with low operative mortality. Since left atrioventricular valve incompetence was the most common cause of reoperation and left ventricular outflow tract obstruction was the only risk factor for reoperation, a precise estimation of the left atrioventricular valve morphology and the structure of left ventricular outflow tract are needed. Although left ventricular outflow tract obstruction rarely developed, reoperation was frequently required and resection of subaortic tissue could be peformed but the possibility of recurrence was high, so modified Konno operation could be performed with satisfactory results. Complete atrioventricular block developed frequently in early periods, but was overcome with a precise anatomical understanding of conduction system and experience.

• Journal of Chest Surgery
• /
• v.30 no.9
• /
• pp.869-875
• /
• 1997

Perimembranous ventri ular septal defects(PMVSDS) are the most common type of ventricular septal defects(VSDs) and consist morphologically of deficiency of the membranous septum and variable portions of the adjacent muscular septum. Repair of VSD has begun via a right ventriculotomy. Even with this exposure, however, it mght lead to ventricular dysfunction. Transatrial exposure of VSDs is luiown to a versatile approach to PMVSDS and even malaligunent defects can be repaired by this method. Although transatrial exposure can be improved by taking down'the atrioventricular valve at the annulus, surgeons have been hesitant to do so because of concern for valvular competence. Therefore, this study was undertaken to clarity the effects of transamlular approach of tricuspid valve (TATV) at operation of PMVSD. During last 5 years, twenty eight cases from 96 patients of PMVSD were closed by TATV and follow up study was done from 3 months to 33 months and results were obtained as follows. 1. Age at operation was fr m 4 months to 38 years and most patients(17, 62%) were above 5 years. 2. Preoperative pulmonary-systemic flow ratio(QPIQS) was ranged from 1 to 2.8 and 22 patients(79%) were less than 2. 3. Peak systolic pulmonary artery pressure was below 30mmHg in 8, 30-50mmHg in 17, above 50mmHg in 3 patients and 25 patients(89%) were less than 50mmHg. 4. Preoperative tricuspid regurgitation(TR) is none in 12, trivial in 6, mild in 3, moderate in 5, severe in 2 patients but postoperative TR was none in 18, trivial in 6, mild in 4 patients, so TR in most patients had decreased or not. 5. Indications for operation were based on the presence of a significant shunt. However, in patients with small shunts, indications for operation were included additional factors, tricuspid valve pouch, RVOT obstruction(right ventricular outflow tract obstruction), subacute bacterial endocarditis and associated anomalies. 6. There were no hospital deaths and residual shunts in postoperative echocardiography. Therefore TATV is especially a good method in PMVSn where patients have trcuspid valve pouch. And it is a safe and effective technique that improves exposure for PMVSD repair and does not adversely affect tricuspid valvular competence.

• Journal of Korean Public Health Nursing
• /
• v.10 no.2
• /
• pp.103-118
• /
• 1996

It is to be growing up the interest of community health affairs through visiting nursing care. The health medical treatment of Korea has been changed largely on the period. The juvenile population has decreased. This means that is has took the population consensus of advanced national organization to be increased by the old age. The transition of disease has changed from the contagious disease importance to the chronicity disease omportance because the domestic district population has experienced the sudden urbanization circumstance district population has experienced the sudden urbanization circumstance to be growing up $70\%$ of the whole population. When the nursing service has common function to be delivering from all direction to home, this study is getting the great important phase velocity in order to manage the kernel questional adult chronicity disease of health medical institution at the present age. (1) community over system or with people particularity (2) the first of third step medical treatments. The variety of medical treatments organization has quantity of the delivery manpower and specially between consumers and rdlated person. A qualitative difference is showed at the purpose to be seizing. That research related person is use at district health center in Seoul, by foundation on nurse registration book of H collage hospital and public health registration book. According the chronicity disease. age. and sex. nature agree-able standard 54 people took the content analysis on nurse registration book of total 108 people. The results of the study were as follows: 1. General background factors are houses or kind of medical facilities and number of patients in family. The first medical treatment is more patients than third medical treatment organization. The first medical treatment of economic environment os appering to be worse. 2. The chronicity disease frequency have been different speciality according to medical treatment organization. On case of the first medical treatment. Diabetes and High Blood Pressure were good but Cerebrum Vascular Accident(CVA) showed many for bed case. In addition. the number of family is comparative large exception of CVA on according for moving condition and health more than the first medical treatment. However. family condition. whole family percentage is decreasing preferably through the potential resource is increasing by the number of and the construction of family. The ability of real resource is considered to be low. 3. The average percentage of nurse service has appered to be differed two groups by the first step medical treatment(33.72 times) and third step medical treatment(45.70 times). However, the difference (the first step medical treatment and third step medical treatment) is to be limited to issue the medicine at the service. The condition of nurse care was the indirect nursing care. Supportiong area was to be related to volunteer service and administration support. 4. The various nursing care average percentage of the chronicity disease was increased by orders of Diabetes. High Blood Pressure. and CVA in examination result and the medical treatment. The indirect nursing care was also same. At third step medical treatment, orders of chronicity disease were same. The case of other area on service conditions were increased by order of Diabetes. High Blood Pressure, and CVA. However. it is never appearing the difference at bottleneck affairs nursing care. 5. When the visiting nursing care demand particularly. the average percentage of nursing care from the first step medical treatment that the time under a person is many more than the time over two people. However, there was no difference in statistic. Third step medical treatment is $49.81\%$ at the time under a person. The average nursing care service is appeared by more many when the visiting nursing care demand is a few by 12.83 at the time over two people. 6. By visiting nursing care percentage to be frequency that nursing care averaghe percentage and inter-relation are large. The related factor of the first medical treatment is 0.96. However, the related factor of third medical treatment has shown the decreased 0.49 for the condition of relation more than that. Therefore. the nursing care average percentage is related to the visiting times of a nurse. This result is be showing the obvious fact that the first step medical treatment is few more than third step medical treatment.

• Journal of Korean Ophthalmic Optics Society
• /
• v.12 no.3
• /
• pp.39-48
• /
• 2007

The stimulus of accommodation A, the stimulus of convergence C and the prism diopter ${\Delta}$ are reviewed and redefined more obviously. How the A and C are managed in the practice are reviewed and summarized. As a result, the common practical process of the binocular vision findings is most suitable in the case of the $l_c=26.67mm$, where the near distance is measured from the test lens to the near target and its value is 40 cm and the average of the P.D equal to 64 mm. The $l_c$ is the distance between the test lens and the center of rotation. Those values were used at calculating the various values in this paper. The error of the stimulus of accommodation values which are evaluated by the practically used formula (5) are calculated. Where the distance between lens and the principle point of eye is 15.07 mm ($=l_H$). The incremental stimulus of convergence values P' caused by the addition prism $P_m$ are evaluated by the recursion computation method. The P' are varied with the $P_m$, the distance $p_c$ between the prism and the center of rotation, the initial convergence value (or inverse target distance) $C_o$ and the refractive index n of the prism material. The recursion computation method and the other formulas are described in detail. In this paper n=1.7 is used. The two factors by which the P' is increased are exist. The one which is major is the property by which the values of convergence whose unit is ${\Delta}$ are not added in the generally way. The other is the that the actual power of the prism is varied with the angle of incidence light. And the P' is decreased remarkably by an increase in the $p_c$ and $C_o$. The $P^{\prime}/P_m$ are calculated and graphed which are varied with the $p_c$ and $C_o$, where the $P_m=20{\Delta}$, P.D=64 mm and n=1.7. The index n dependence of the $P^{\prime}/P_m$ is negligible (refer to fig. 6). The $p_c$ are evaluated at which the P' equal to the $P_m$ for various $P_m$ (refer to table 1). The actual values of the stimulus of convergence and accommodation which are manipulated simply in the practice are calculated. Two graphical forms are suggested. The one is like as the commonly used one. But the stimulus of convergence and of accommodation values in the practice are positioned at the exact positions when the graphic is made (refer to fig. 9). The other is the form that the incremental stimulus of convergence values caused by the addition prisms are represented at actual positions (refer to fig. 11).

• Clinical and Experimental Pediatrics
• /
• v.52 no.7
• /
• pp.785-790
• /
• 2009

Purpose : Febrile convulsions are a common pediatric neurological disease, and it is important to prevent such a disease by controlling the risk factors that may recur. A recent report states that influenza virus infections have a high probability of a relationship with febrile convulsions; therefore, it is necessary to identify the clinical properties of febrile convulsions in relation to domestic influenza virus infections. Methods : Between November 2005 and February 2008, children hospitalized because of febrile convulsions and subsequently confirmed to have influenza infections were enrolled as subjects (patient group, n=11). The control subjects were those admitted with influenza virus infections but no febrile convulsions (control group 1, n=46) and those who developed febrile convulsions without influenza virus infection (control group 2, n=53). Results : The patient group showed a higher maximum body temperature ($39.3{\pm}0.5^{\circ}C$), more histories of past febrile convulsions (72.7%), and a shorter total duration of fever ($2.9{\pm}1.2$ days) than control group 1. When multivariate analysis was performed, the probability of febrile convulsions was found to be as high as 225.9 times in patients who had influenza virus infections with a past history of febrile convulsions (OR=225.9, 95% CI: 1.7-4780.0, P<0.05). When patients with febrile convulsions were compared based on the symptoms of influenza virus infections, the patient group showed a shorter duration of fever ($0.9{\pm}0.7$ days) before convulsion than control group 2; these convulsions were mostly a recurrence of febrile convulsions. When multivariate analysis was performed, the cases with a past history of febrile convulsions showed 5.5 times (OR=5.5, 95% CI: 1.2-25.1, P=0.03) the probability of convulsions when infected with the influenza virus, and this probability decreased by 0.3 times over one-day increments of the febrile period until febrile convulsions (95% CI: 0.1-0.9, P=0.02). Maximum body temperature, total duration of fever, family history of febrile convulsions, and complex febrile convulsions did not show a statistical significance. Conclusion : In cases of pediatric influenza virus infection, the past history of febrile convulsions could be identified within the risk factor of recurrent febrile convulsions. Therefore, influenza vaccination of children having a past history of febrile convulsions will be helpful to avoid the recurrence of these convulsions.

• Clinical and Experimental Pediatrics
• /
• v.52 no.8
• /
• pp.875-880
• /
• 2009

Purpose : Iron-deficiency anemia remains the most common nutritional deficiency in young infants. This study aimed to survey the actual condition of feeding patterns and weaning diet and to study the association between these factors and the prevalence of anemia in infants aged over 9 months. Methods : We studied 171 infants aged 9-24 months who were hospitalized in the general ward with mild to moderate acute illnesses. The mothers answered a questionnaire about the feeding patterns and the status of the weaning diet of their infants. The infants were divided into three groups: infants who were exclusively breast-fed, those who had been given mixed feeding, and artificial milk feeders. Results : The incidence of anemia was significantly higher in exclusively breast-fed infants (23/68, 33.8%) than in the infants with mixed feeding (11/62, 17.7%) and artificial milk feeders (5/41, 12.1%). The mothers' awareness about the state of their infants󰡑 weaning diet was not related to the presence of anemia in the exclusively breast-fed infants. About 70% of the infants had started the weaning diet before age 6 months in all three groups, without any difference according to feeding patterns. Conclusion : The incidence of anemia was significantly higher in the breast-fed group than in the other infants. Many mothers of breast-fed infants with anemia also believed that their infants were taking sufficient weaning foods. Therefore, further education of the mothers about iron-rich weaning foods and the importance of iron intake during infancy is needed to prevent anemia, especially in breast-fed infants.

• Journal of Mushroom
• /
• v.11 no.1
• /
• pp.36-40
• /
• 2013

Armillaria gallica was ecologically surveyed to investigate its relationship with Gastrodia elata in cultivation areas of Korea in 2012. In the observation made around October 17 in the area of Namyangju (Gyeonggi), Sangju (Gyeongbuk) and Gimcheon (Gyeongbuk) in Korea, the fruit bodies of A. gallica were consistently found near the cultivation areas of Gastrodia elata across these cultivation areas. Since the temperature and rainfall have been considered as important factors of fruiting of A. gallica, we checked the temperature and rainfall around two weeks ago of mushroom fruiting. The average temperature of all cultivation areas was $9.9{\sim}17.5^{\circ}C$ (the lowest temp.: $3{\sim}23^{\circ}C$, the highest temp.: $15{\sim}26^{\circ}C$) and the annual rainfall was 0.5~1.0mm on October 10 which can be compared to 2.5~4.5mm on October 17. Fruiting bodies were generally developed at weedy field in which G. elata were cultivated five years ago. The field was inclined 15 degrees, east-facing and consists of loam. The fruit bodies were formed on both sides of a small ditch between the Gastrodia elata cultivation fields and neighboring fields, and the areas were common weeds and moisture at all times. The fruiting bodies were growing above the soil rather than oak wood. Gregarious, but also occurs to 1-5 fruiting bodies occur sporadically. Results observed in detail the growing areas, some fruit bodies were developed along the black and thick rhizomorph formation.

• Journal of the Korean Society of School Health
• /
• v.1 no.2
• /
• pp.50-65
• /
• 1988

This study was conducted in order to grasp the condition of about the school nurse's service and to offer the basic materials of improving the school health service. The objects were comprised of 98 volunteered school nurses who take service in the elementary school. The material of this study was the questionaire suited to the purpose of this research which has been made through studying references and this questionaire has been corrected and revised three times. All the questionaire written by school-nurses. The results are as follows; 1. General features of the objects of study Average age was 35.9 and average career was 9.2 years. Except working as school-nurse, the past career was that average clinical-field was 3.4 years and health service was 4 months. Their educational level was as high as 72.4% of the objects were graduated from above 3 years college and 89.8% were married. 76.5% have religions and 94.8% were working at with national and public schools. 99.0% were doing only nursing service. 2. The conditions of the school health resources. The ratio of school-nurse to students was one to 2630. School-nurse to classes, one to 49.3, and school-nurse to teachers, one to 54. For total amount of a year budget of school health, from three hundred thousands to fifty nine hundred thousands won was most common. Expenses for purchasing medicine were used most. 58.2% of school-nurses hasn't known a year budget. There was an organization for school health in 74.2% of schools. 42.9% of nursing rooms were in the center of school and 88.8% were on first floor. Nursing room were used alone without being used by another purpose and the room size of 71.6% was below 10 pyong. 3. The conditions of school health service Average users of nursing room were 413 a month. The most of them had digestive trouble. Sending letters to home was 15.9 times a year. The most contents of letters was about health education. Object spent much time managing nursing room. 4. The degree of school health service When 2 points was given to "perform" and 1 point was to "not perform" the total average was 1.75, health education 1.89, environmental management 1.86, plan of project and evaluation 1.83, management of nursing room 1.82, health management 1.78, run of school health organization 1.32. 5. Correlation between the school health services and variables (1) The part of project plan and evaluation of school health service has relationship to existence or none-existence of school health organization (P<0.01), past health service career (P<0.05), number of classes (P<0.01), number of students (P<0.01), sending letters to home about health education (P<0.01) and number of users (P<0.05). (2) The part of nursing room management has relationship to ages (P<0.05) past clinical career (P<0.05), number of classes (P<0.05), number of students (P<0.05) and sending letters to home about health education (P<0.01). (3) The part of health education has relationship to existence or none-existence of school health organization (P<0.05), past clinical career (P<0.05), the ratio of health management to school nurse's all work (P<0.05) and the ratio of health education to school nurse's all work (P<0.01). (4) The part of environmental management to ages (P<0.01), career as a school-nurse (P<0.01), salary step(P<0.01), sending letters to home about health education (P<0.01), sending all letters to home (P<0.001), the ratio of health management to school nurse's all work (P<0.05), the ratio of health education to school nurse's all work (P<0.05) and area of school-nurse's room to be used. (5) The part of school health organization management to number of classes (P<0.05). (6) The part of health management to number of classes (P<0.05), sending letters to home about health education (P<0.001), sending all of letters to home (P<0.01) and the ratio of health management to school nurse's all work (P<0.05). (7) The part of school health service to ages (P<0.05), past clinical career (P<0.05), past health career (P<0.01), number of classes (P<0.05), number of student (P<0.05), sending letters to home about health education (P<0.05), sending all letters to home (P<0.05), the ratio of health management to school nurse's all work (P<0.05), the ratio of health education to school nurse's all work (P<0.01) and area of school - nurse's room to be used (P<0.05). ## Suggestion for further studies are as follows. 1. School-nurse should exert herself to advance a quality to take care of school population's health. 2. It is necessary that systematic support required to keep school population's health. 3. Home, school and community should make efforts cooperatively and the proper roles of students, teachers, health team members and parents must be achieved.

• Radiation Oncology Journal
• /
• v.8 no.2
• /
• pp.219-223
• /
• 1990

This is a retrospective review of 33 patients with large cell lung carcinoma treated at Yonsei University Cancer Center between Jan.1985 and Dec.1989. Of the thirty-three patients, twenty eight were men and five women. Median age was 59 years. Large cell undifferentiated carcinoma was the most common pathologic type, $78.8\%$. Twenty one of thirty three patients had far advanced diseases, stage IIIB-IV at the time of initial diagnosis. Pleural effusion was initially presented in 12 patients, and SVC syndrome appeared in 5 patients. As to location of the primary tumor,19($57.6\%$) appeared in the right lung and 14 ($42.4\%$) in the left. Patients with a centrally located primary tumor mass were nearly the same as those peripherally located (17 vs.16). Fifteen of thirty three patients developed metastasis involving not only bone, brain, the opposite lung, adrenal gland but also soft tissue, skin, pancreas and appendix. Treatment was individualized with 19 treated radically and 14 palliatively. After treatment, only two patients showed a complete response. Long term survival was observed in 4 patients: 1 (24 mo.),2 (41 mo.) and 1 (54 mo.). The overall 2 year survival rate was $14.3\%$ while the median survival time was 6.0 months. Through the analysis of the various factors affecting survival, we observed that pleural effusion-absent group and complete response group had a statistical significant better survival rate (p<0.01).

• Journal of Chest Surgery
• /
• v.39 no.5 s.262
• /
• pp.347-353
• /
• 2006

Background: Despite recent advances in surgical technique and perioperative care of total anomalous pulmonary venous return (TAPVR), post-repair pulmonary vein stenosis (PVS) remains as a serious complication. We thought that the most important factors of TAPVR repair to prevent PVS were good exposure, proper alignment, and sufficient stoma size. We analyzed our experience retrospectively. Material and Method: Between Jan. 1995 and Feb. 2005, we studied 74 patients diagnosed with TAPVR suitable for biventricular repair. Supra-cardiac type (n=41, 55.4%) was the most common. Mean CPB time, ACC time, and TCA (40.5%, 30/74) time were $92.1{\pm}25.9\;min,\;39.1{\pm}10.6\;min$, and $30.2{\pm}10.7\;min$, respectively. Mean follow-up duration was $41.4{\pm}29.1$ months and follow-up was possible in all patients. Result: The median age and body weight at operation were 28.5 days ($0{\sim}478$ days) and 3.4 kg $(1.4{\sim}9\;kg)$. Early mortality was 4.1% (3/74). Causes of death were pulmonary hypertensive crisis, sepsis, and sudden death. There was PR-PVS in 2 patients (early: 1, late: 1). Both patients were cardiac type TAPVR drained to coronary sinus. Re-operations were done but only one patient survived. Cumulative survival rate in 5 year and percent freedom from PVS were $94.5{\pm}2.7%\;and\;97.2{\pm}2.0%$, respectively. Conclusion: There was no PVS in patients who underwent extra-cardiac anatomosis between LA and CPVC. Therefore it could be said that our principle might be effective in preventing PR-PVS in patients suitable two-ventricle.