• Title/Summary/Keyword: medical usage

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Toothbrushing Behavior and Oral Health State of Immigrant Workers (외국인 이주노동자의 칫솔질행태와 구강건강상태)

  • Nam, In-Suk;Yoon, Sung-Uk;Kim, Jung Sook
    • Journal of dental hygiene science
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    • v.15 no.1
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    • pp.1-11
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    • 2015
  • This study analyzed the tooth brushing behavior and oral health status of foreigner immigrant workers and obtained the following results. Statistical significance based on different general characteristics. Gender, educational background, period of stay, health insurance, medical expense coverage, and whether or not one has friends or regular gatherings were significant traits for frequency, while age, marital status, income, and health insurance were traits for part (p<0.05). Statistical significance (p<0.05) was found in marital status and health insurance for time used to brush teeth, period of stay and whether or not one attends a regular gathering for tooth brushing training, and gender, educational background, period of stay, roommate status, medical expense coverage, and whether or not one attends a regular gathering for supplemental oral product usage. The averages of decayed, missing, and filled teeth (DMFT) index and community periodontal index of treatment needs (CPITN) for general characteristics were 6.98 and 3.03 respectively, and gender, roommate status, income, health insurance for DMFT index, and gender, age, marital status, educational background, roommate status, income, health insurance for CPITN were statistically significant (p<0.05). Tooth brushing frequency and part showed statistical significance (p<0.05) for DMFT index based on tooth brushing behavior, while tooth brushing part and time used to brush teeth were significant for CPITN. DMFT index was high at 8.34 for '3 times or more' in tooth brushing frequency, while DMFT index was high at 7.91 and CPITN was low at 2.94 for tooth brushing part. '3 minutes or longer' in time used to brush teeth was the lowest in CPITN at 2.88. As a result of analyzing the correlation between tooth brushing behavior and DMFT index, CPITN, tooth brushing frequency and part in DMFT index, and tooth brushing part and time used to brush teeth in CPITN showed significance (p<0.05). Based on the above results, we must promote the significance of brushing teeth and implement continuous training for correct tooth brushing management to enhance the oral health of foreign immigrant workers.

Analyzing Contextual Polarity of Unstructured Data for Measuring Subjective Well-Being (주관적 웰빙 상태 측정을 위한 비정형 데이터의 상황기반 긍부정성 분석 방법)

  • Choi, Sukjae;Song, Yeongeun;Kwon, Ohbyung
    • Journal of Intelligence and Information Systems
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    • v.22 no.1
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    • pp.83-105
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    • 2016
  • Measuring an individual's subjective wellbeing in an accurate, unobtrusive, and cost-effective manner is a core success factor of the wellbeing support system, which is a type of medical IT service. However, measurements with a self-report questionnaire and wearable sensors are cost-intensive and obtrusive when the wellbeing support system should be running in real-time, despite being very accurate. Recently, reasoning the state of subjective wellbeing with conventional sentiment analysis and unstructured data has been proposed as an alternative to resolve the drawbacks of the self-report questionnaire and wearable sensors. However, this approach does not consider contextual polarity, which results in lower measurement accuracy. Moreover, there is no sentimental word net or ontology for the subjective wellbeing area. Hence, this paper proposes a method to extract keywords and their contextual polarity representing the subjective wellbeing state from the unstructured text in online websites in order to improve the reasoning accuracy of the sentiment analysis. The proposed method is as follows. First, a set of general sentimental words is proposed. SentiWordNet was adopted; this is the most widely used dictionary and contains about 100,000 words such as nouns, verbs, adjectives, and adverbs with polarities from -1.0 (extremely negative) to 1.0 (extremely positive). Second, corpora on subjective wellbeing (SWB corpora) were obtained by crawling online text. A survey was conducted to prepare a learning dataset that includes an individual's opinion and the level of self-report wellness, such as stress and depression. The participants were asked to respond with their feelings about online news on two topics. Next, three data sources were extracted from the SWB corpora: demographic information, psychographic information, and the structural characteristics of the text (e.g., the number of words used in the text, simple statistics on the special characters used). These were considered to adjust the level of a specific SWB. Finally, a set of reasoning rules was generated for each wellbeing factor to estimate the SWB of an individual based on the text written by the individual. The experimental results suggested that using contextual polarity for each SWB factor (e.g., stress, depression) significantly improved the estimation accuracy compared to conventional sentiment analysis methods incorporating SentiWordNet. Even though literature is available on Korean sentiment analysis, such studies only used only a limited set of sentimental words. Due to the small number of words, many sentences are overlooked and ignored when estimating the level of sentiment. However, the proposed method can identify multiple sentiment-neutral words as sentiment words in the context of a specific SWB factor. The results also suggest that a specific type of senti-word dictionary containing contextual polarity needs to be constructed along with a dictionary based on common sense such as SenticNet. These efforts will enrich and enlarge the application area of sentic computing. The study is helpful to practitioners and managers of wellness services in that a couple of characteristics of unstructured text have been identified for improving SWB. Consistent with the literature, the results showed that the gender and age affect the SWB state when the individual is exposed to an identical queue from the online text. In addition, the length of the textual response and usage pattern of special characters were found to indicate the individual's SWB. These imply that better SWB measurement should involve collecting the textual structure and the individual's demographic conditions. In the future, the proposed method should be improved by automated identification of the contextual polarity in order to enlarge the vocabulary in a cost-effective manner.

Risk Factors for Nosocomial Pneumonia in Patients at NS ICU (신경외과 중환자실의 병원성 폐렴 발생 위험요인)

  • Kim Nam Cho;Kim So Yeon
    • Journal of Korean Public Health Nursing
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    • v.15 no.2
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    • pp.239-248
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    • 2001
  • The purpose of this study was to analyze risk factors for nosocomial pneumonia in patients admitted to NS ICU, and to provide a basic data to decrease respiratory nosocomial infection rate engendered from medical environments in NS ICU. The study site was the NS ICU at a university hospital located in Seoul, Korea. The subjects were 31 patients diagnosed with nosocomial pneumonia, who were selected from the initial list of 300 potential subjects who had been a) admitted between September 1999 and January 2000, and September 2000 and January 2001, b) resided at the NS ICU over 72 hours. The diagnostic standard of nosocomial pneumonia was based on the nosocomial infection guides of C university hospital. The data were analyzed using frequencies and logistic regression analysis. The sputums obtained from the subjects were cultivated and causal viruses were separated. The results were as follows: 1. The nosocomial pneumonia rate was $10.3\%$. There were 7 types of causal viruses separated from the sputum. and the most prevalent type of virus was MRSA as $62.2\%$. 2. The factors significantly influencing the incidence of nosocomial pneumonia included age, the residential duration at the NS ICU, GCS scores, diabetes mellitus, insertion of tracheal tube and its duration, tracheostomy and its length of insertion, the use of artificial ventilator and the length of its use, and the insertion of naso-gastic tube. The most significant risk factor among these was the insertion of tracheal tube (odds ratio=18.684. $95\%$ CI=6.849-50.974), followed by the use of tracheostomy (odds ratio=15.419, $95\%$ CI=6.615-35.942), the insertion of naso-gastric tube (odds ratio=14.875, $95\%$ CI=6.396-34.595), and the use of artificial ventilator (odds ratio=13.000. $95\%$ CI=5.633­30.001). 3. Regarding the use of the mechanical aids, the insertion of tracheal tube resulted in 12.968 times increase of the nosocomial pneumonia rate, and the use of artificial ventilator lead 6.714 times increase of the nosocomial pneumonia rate. One point increase of the GCS score resulted in the 1.210 times increase of the nosocomial pneumonia rate. For patients who had tracheal tube, tracheostomy, and artificial ventilator, one day increase of their residential duration at NS ICU lead 1.073 times increase of the nosocomial pneumonia rate. 4. In terms of duration of the mechanical aid usage, one day increase in the use of artificial ventilator engendered 1.080 times increase in the nosocomial pneumonia rate. One day increase of the residential duration at the NS ICU lead 1.604 times increase in the nosocomial pneumonia rate. As one point of the GCS score increased, 0.876 times decrease of the nosocomial pneumonia rate was reported. These study findings show that the risk factors significantly influencing the incidence of nosocomial pneumonia include the use of tracheal tube, tracheostomy, naso-gastic tube, and artificial ventilator. It is recommended that nurses working at NS ICU should pay more attention to the patients with these factors as the risky group for the nosocomial pneumonia, and thus make more active efforts to provide nosocomial pneumonia prevention strategies for them. In further studies patients admitted to the different types of ICUs such as internal medicine or surgery unit ICU will be also included, and more wide investigation of nosocomial pneumonia risk factors will be conducted through one-year longitudinal follow up.

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The In-hospital Clinical Outcomes of Extracorporeal Life Support after Adult Cardiovascular Surgery (성인 심혈관 수술 후 시행한 체외순환보조의 조기 임상결과)

  • Yie, Kil-Soo;Na, Chan-Young;Oh, Sam-Sae;Kim, Jae-Hyun;Ryu, Se-Min;Park, Sung-Min;Cho, Seong-Joon
    • Journal of Chest Surgery
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    • v.42 no.4
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    • pp.464-472
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    • 2009
  • Background: We analyzed the clinical results and the factors for survival of patients who underwent extracorporeal life support system after adult cardiovascular surgery. Material and Method: We retrospectively reviewed the medical record of 44 patients (1.6% of the total adult cardiovascular surgical cases) who underwent the use of a ventricular assisted device or extracorporeal membrane oxygenation from January 2002 to August 2008. There were 32 (72.7%) males and their mean age was 61.7$\pm$14.9(range: 20$\sim$73) years old. The mean duration of extracorporeal life support system was 5.3$\pm$3.0 (range: 1$\sim$12) days. Result: Of these 44 patients, 24 (54.5%) patients were successfully weaned from the extracorporeal device. Eighteen (40.9%) survivors were able to be discharged from the hospital. Complications were noted in 38 patients (86.4%). An emergency operation, no usage of a concomitant intraaortic balloon pump and major complications during use of the extra corporeal life support system such as bleeding, flow instability and renal failure were identified as significant risk factors for poor survival on univariated analysis. Owing to educational support and a continuous renal replacement therapy system, the clinical outcomes of these patients have improved since 2006. On multivariated analysis, renal failure and bleeding during extracorporeal life support were significant risk factors for poor survival. Conclusion: Although using. extracorporeal life support systems after adult cardiovascular surgery revealed acceptable clinical results, determining the optimal treatment strategy and further well designed larger studies are needed to improve the survival rate of patients who undergo extracorporeal life support after adult cardiovascular surgery.

A Comparative Study on Injury Severity, Self esteem, Health Locus of control and Health Promotion Lifestyles between Helmeted and Nonhelmeted Motorcycle Accident Victims (오토바이 사고환자의 안전모 착용여부에 따른 뇌 손상비교와 자아존중감, 건강통제위 성격, 건강증진행위의 비교연구)

  • 최스미
    • Journal of Korean Academy of Nursing
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    • v.23 no.4
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    • pp.585-601
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    • 1993
  • Data on 63 patients who had had motorcycle accidents and who were admitted to four general hospitals in the Chung Chung Nam Do area from July / 1993 to August 1993 were analyzed. The tool used for this study was a structured questionnaire which consisted of ten items on self- esteem, 18 items on health locus of control and 37 items profiling health prometion lifestyle. Injury severity scores were calculated bated based on data from the patients’ medical records. The collected data were analyzed using the SPSS, yielding descriptive statistics, t-test, ANOVA, Pearson’s Product Moment Correlation. The findings of this study are as follows. 1) Of the 63 injured motorcyclists, 35(55.6%) were helmeted and 28(44.4%) were nonhelmeted, and the nonhelmeted motorcyclists were predominantly young and male. The demographic variables for the helmeted and nonhelmeted groups were heterogeneous for age and occupation. 2) The results of the comparison between the two groups showed a statistically significant difference in the injury severity score(t=-4.70, p=0.000). The helmeted group had lower scores on injury severity score (9.00±3.93) than the nonhelmeted group(14.32土5.05). More than 60% of the nonhelmeted motorcyclists had brain injuries compared to only a third of the helmeted cyclists. 3) There .was a statistically significant difference between the two groups on self esteem(t=4.5, 000). The helmeted group had a higher mean score (31.27±2.72) than the nonhelmeted group(27.46±3.80). 4) The means for Internal health locus of control (IHLC), Powerful others health locus of control (PHLC), and Chance health locus of control (CHLC) in the two groups were similar to instrument norms reported in other literature. The mean scores on the IHLC in the two groups were higher than scores on the PHLC or the CHLC. However, there was a significant difference between the mean scores for the two groups on the PHLC (t=2.85, P=0.006). 5) The mean score for the helmeted group on the health promotion lifestyle profile was higher than the mean score for the nonhelmeted group(107.30±11.10, 96.57土 15.54 respectively), and there was a significant difference between the mean scores (t=3.64, p=0.001) . The highest score for helmeted group on the health promotion lifestyle profile was in the health care domain. However, for the nonhelmeted group the highest score was in the exercise domain and the lowest score was in the health care domain. 6) With regard to the relationship between health promotion lifestyle, health locus of control and self esteem in the two groups, the correlation coefficient between health promotion lifestyle and internal health locus of control for the helmeted group was 50(p〈0.01). For the nonhelmeted group, there was no correlation between health promotion lifestyle and internal health locus of control. However, there were significant correlation between health pro-motion lifestyle and external locus of control(r=0. 46, p〈0.01), and self esteem(r=0.495, p〈0.01). 7) Among the demographic variables, age and education had an impact on individual’s self-esteem The modifying factors of age made a contribution to explaining health - promoting lifestyle. In the present study, more than 40% rf the motorcyclists were riding without a helmet. The incidence of brain injury for patients riding without a helmet was nearly twice as high in the nonhelmeted rider as compared to the helmeted rider. The nonhelmeted motorcyclists in this study had lower self-esteem, obtained a higher score on the IHLC, and were not strongly engaged in performing health promotion activities as compared to the helmeted riders. However, some of the nonhelmeted riders who had a strong belief in PHLC were positively associated with engaging in health promotion activities. Based on the results obtained from this study, strategies to promote helmet usage for motorcyclists have to be developed.

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A Comparative Case Study on the Adaptation Process of Advanced Information Technology: A Grounded Theory Approach for the Appropriation Process (신기술 사용 과정에 관한 비교 사례 연구: 기술 전유 과정의 근거이론적 접근)

  • Choi, Hee-Jae;Lee, Zoon-Ky
    • Asia pacific journal of information systems
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    • v.19 no.3
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    • pp.99-124
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    • 2009
  • Many firms in Korea have adopted and used advanced information technology in an effort to boost efficiency. The process of adapting to the new technology, at the same time, can vary from one firm to another. As such, this research focuses on several relevant factors, especially the roles of social interaction as a key variable that influences the technology adaptation process and the outcomes. Thus far, how a firm goes through the adaptation process to the new technology has not been yet fully explored. Previous studies on changes undergone by a firm or an organization due to information technology have been pursued from various theoretical points of views, evolved from technological and institutional views to an integrated social technology views. The technology adaptation process has been understood to be something that evolves over time and has been regarded as cycles between misalignments and alignments, gradually approaching the stable aligned state. The adaptation process of the new technology was defined as "appropriation" process according to Poole and DeSanctis (1994). They suggested that this process is not automatically determined by the technology design itself. Rather, people actively select how technology structures should be used; accordingly, adoption practices vary. But concepts of the appropriation process in these studies are not accurate while suggested propositions are not clear enough to apply in practice. Furthermore, these studies do not substantially suggest which factors are changed during the appropriation process and what should be done to bring about effective outcomes. Therefore, research objectives of this study lie in finding causes for the difference in ways in which advanced information technology has been used and adopted among organizations. The study also aims to explore how a firm's interaction with social as well as technological factors affects differently in resulting organizational changes. Detail objectives of this study are as follows. First, this paper primarily focuses on the appropriation process of advanced information technology in the long run, and we look into reasons for the diverse types of the usage. Second, this study is to categorize each phases in the appropriation process and make clear what changes occur and how they are evolved during each phase. Third, this study is to suggest the guidelines to determine which strategies are needed in an individual, group and organizational level. For this, a substantially grounded theory that can be applied to organizational practice has been developed from a longitudinal comparative case study. For these objectives, the technology appropriation process was explored based on Structuration Theory by Giddens (1984), Orlikoski and Robey (1991) and Adaptive Structuration Theory by Poole and DeSanctis (1994), which are examples of social technology views on organizational change by technology. Data have been obtained from interviews, observations of medical treatment task, and questionnaires administered to group members who use the technology. Data coding was executed in three steps following the grounded theory approach. First of all, concepts and categories were developed from interviews and observation data in open coding. Next, in axial coding, we related categories to subcategorize along the lines of their properties and dimensions through the paradigm model. Finally, the grounded theory about the appropriation process was developed through the conditional/consequential matrix in selective coding. In this study eight hypotheses about the adaptation process have been clearly articulated. Also, we found that the appropriation process involves through three phases, namely, "direct appropriation," "cooperate with related structures," and "interpret and make judgments." The higher phases of appropriation move, the more users represent various types of instrumental use and attitude. Moreover, the previous structures like "knowledge and experience," "belief that other members know and accept the use of technology," "horizontal communication," and "embodiment of opinion collection process" are evolved to higher degrees in their dimensions of property. Furthermore, users continuously create new spirits and structures, while removing some of the previous ones at the same time. Thus, from longitudinal view, faithful and unfaithful appropriation methods appear recursively, but gradually faithful appropriation takes over the other. In other words, the concept of spirits and structures has been changed in the adaptation process over time for the purpose of alignment between the task and other structures. These findings call for a revised or extended model of structural adaptation in IS (Information Systems) literature now that the vague adaptation process in previous studies has been clarified through the in-depth qualitative study, identifying each phrase with accuracy. In addition, based on these results some guidelines can be set up to help determine which strategies are needed in an individual, group, and organizational level for the purpose of effective technology appropriation. In practice, managers can focus on the changes of spirits and elevation of the structural dimension to achieve effective technology use.

Analysis of Prenatal and Postnatal Factors Associated with Complications and Prognosis in Premature Infants with Leukemoid Reaction (백혈병양반응을 보인 미숙아의 합병증과 예후에 관한 산전과 산후 인자에 대한 분석)

  • Kwon, Se-Ho;Lee, Byoung-Kook;Lee, Heun-Ji;Na, So-Young;Lee, Jung-Ha;Park, Su-Yeon;Kang, Eun-Kyeung;Kim, Do-Hyeon;Lee, Kwan;Kim, Hee-Sup
    • Neonatal Medicine
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    • v.15 no.2
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    • pp.151-159
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    • 2008
  • Purpose : This study determined the prenatal and postnatal factors associated with complications and prognosis in premature infants with leukemoid reaction. Methods : We retrospectively reviewed the medical records of premature infants with gestational ages <37 weeks and low birth weights (<2,500 g) who were admitted immediately after birth to the neonatal intensive care unit at the Dongguk University Ilsan Hospital between June 2005 and July 2006. A leukemoid reaction was defined as an absolute neutrophil count (ANC) >30,000/$mm^3$. The infants who had leukemoid reaction comprised the study group, while the remainder of infants made up the control group. The relationships between maternal and neonatal variables and ANC were studied. Results : Leukemoid reaction was detected in 3.1% of the study infants (8 of 252). Factors more frequently associated with infants with leukemoid reaction were as follows: maternal chorioamnionitis, high levels of maternal and infant C-reactive protein, gestational age <37 weeks, birth weight <2,500 g, low Apgar score, prolonged ventilator support, and a high incidence of bronchopulmonary dysplasia (BPD). However, there were no significant differences with respect to the antenatal usage of steroids, the incidences of patent ductus arteriosus, necrotizing enterocolitis, intraventricular hemorrhage, retinopathy of prematurity, and mortality between the two groups. Conclusion : Leukemoid reaction in premature infants was associated with chorioamnionitis and high levels of serum C-reactive protein in mothers and infants, and BPD in infants. These findings suggest that leukemoid reaction is secondary to inflammation caused by infection.

Urinary Tract Infection Following Voiding Cystourethrography (배뇨 방광 요도 조영술 시행 후 발생하는 요로 감염에 대한 고찰)

  • Ryu, Jung-Min;Ahn, Yo-Han;Lee, So-Hee;Choi, Hyun-Jin;Lee, Beom-Hee;Kang, Hee-Gyung;Ha, Il-Soo;Cheong, Hae-Il;Choi, Yong
    • Childhood Kidney Diseases
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    • v.12 no.2
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    • pp.194-201
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    • 2008
  • Purpose : Voiding cystourethrography(VCUG) is required to detect vesicoureteral reflux(VUR), which may manifest as urinary tract infection(UTI) in children. It is well known that VCUG can cause UTI(post-VCUG UTI). In this study, risk factors for post-VCUG UTI and the preventive effect of antibiotics against this complication of VCUG were explored. Methods : Medical records of 284 patients who underwent VCUG at our hospital in 2007 were reviewed retrospectively. The incidence of post-VCUG UTI and risk factors for post-VCUG UTI, and the impact of antibiotic use on prevention of post-VCUG UTI were evaluated. According to antibiotics usage, we divided the enrolled patients into 4 groups of noantibiotics group, prophylactic antibiotics group(prophylactic antibiotics having been used before), antibiotics-for-VCUG group(antibiotics added for VCUG) and antibiotics-for-treatment group(treatment dose of antibiotics). Results : Seven of 284 children(2.5%) developed UTI after they underwent VCUG. Highgrade(grade$\geq$III) VUR was the only statistically significant risk factor(odds ratio[OR] 6.266, P=0.026) for post-VCUG UTI, while sex, age, and other anomalies of urinary system were not significant. Five post-VCUG UTI cases belonged to prophylactic antibiotics group. Antibiotics use (three groups using antibiotics vs. no-antibiotics group) or addition of antibiotics for VCUG (antibiotics-for-VCUG vs. other groups) did not have any effect on prevention of post-VCUG UTI. Conclusion : The risk factor for post-VCUG UTI was high-grade VUR. Antibiotics use did not prevent post-VCUG UTI in this study.

Drugs Most Frequently Used in OPD of Yeungnam University Hospital: March to August, 1985 (영남대학교 의과대학 부속병원 외래환자에 대한 약물처방 동향의 분석)

  • Lee, Kwang-Youn;Kim, Won-Joon;Kim, Sung-Hoon
    • Journal of Yeungnam Medical Science
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    • v.2 no.1
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    • pp.95-102
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    • 1985
  • This report offers descriptive data about the drugs utilized in out patient department (OPD) of Yeungnam University Hospital (YUH) in the period of march to august in 1985. The data in this report were produced by the computerized totalization of the number of mentions of individual drugs included in the prescriptions. The 100 drug entries that were most frequently recorded are listed in rank order. The listing is arbiturarily restricted to the drugs that were prescribed as single preparations, the drugs of basis of compound preparations and the drugs of adjuvent or corrective of compound preparations that have significant therapeutic effects either by generic names. And in addition, the listing also involves the compound preparations used in relatively large frequency, and the individual components of which have the unique pharmacological actions each other by proprietary names. And all routes of administrations were allowed. The 10 drugs most frequently named are diazepam, aluminum compounds, acetaminophen, isoniazid, metoclopramide, $polaramine^{(R)}$, carboxymethylcystem, ephedrine, codeine and caroverine in order. The 521,855 drug mentions listed as above are described by the chief therapeutic usage that each is intended to apply generally. The drugs which account the largest proportion of total mentions were those acting on the central nervous system (20.57%), including tranquilhzers and sedative hypnotics (11.71%), analgesic antipyretics (5.55%), antidepressants (2.15%) etc. Gastrointestinal drugs and smooth muscle preparations (18.64%) included antacids and anti-ulcer drugs (9.24%), antiemetics (3.57%), spasmolytics (3.14%) and others. Respiratory drugs (16.11%) included expectorants and cough preparations (10.99%) and bronchodilators (5.12%). Chemotherapeutic agents (15.12%) included the antiTbc drugs (7.09%) most frequently, and the penicillins (3.33%) accounted the largest proportion among the antibiotics. Cardiovascular drugs (5.64%) included cardiac drugs and coronary vasodilator (4.12%) and antihypertensives and vasodilators (1.06%). And anti-inflammatory drugs (4.33%), vitamins of single preparations (3.76%), hormones and their antagonists (3.29%), common cold preparations (3.12%), diuretics (2.81%), drugs supporting liver function (2.02%), drugs affecting autonomic nervous system(1.89%) including anti-glaucomas, atropine and cerebral vasodilators, antihistamine drugs (1.02%) and disinfectants (0.74%) were following in order. The data in this report were compared to those reported by H. Koch, et al. in United States (US), 1981 as "Drugs Most Frequently Used in Office Practice:National Ambulatory Medical Case Survey, 1981." Cardiovascular drugs prescribed in YUH were much less in proportion than in US (10.56%), but gastrointestinal drugs accounted the larger proportion than in US (3.72%). Expectorants and cough preparations in YUH also accounted the larger proportion than in US (2.74%). In conclusion, in the period of march to august, 1985, OPD of YUH prescribed the CNS drugs including diazepam most frequently, and gastrointestinal, repiratory and chemotherapeutic drugs in next orders. It is supposed that the eating habits of Koreans and a unique atmospheric condition in Taegu as a basin were some important factors that affected the proportions of drugs acting on gastrointestinal and respiratory tracts.

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Coronary Artery Bypass Graft in Patient with Advanced Left Ventricular Dysfunction (중등도 이상의 좌심실 기능 부전 환자에서의 관상동 우회술의 임상 분석)

  • 정종필;김승우;신제균
    • Journal of Chest Surgery
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    • v.34 no.12
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    • pp.901-908
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    • 2001
  • Background : Coronary artery bypass graft(CABG) in patients with advanced left ventricular dysfunction has often been regarded as having high mortality rate, despite the great improvement in operative result of CABG. With recent advances in surgical technique and myocardial protection, surgical revascularization improved the symptom and long-term survival of these high risk patients more than the medical conservative treatment. Material and Methold : Clinical data of 31(4.1%) patients with preoperative ejection fraction less than 30% among 864 CABGs performed between January 1995 and March 1999 were retrospectively analyzed and pre- and postoperative changes of the ejection fraction on echocardiography were analyzed. There were 26 men and 5 women. The mean age was 60.7 years(range 41 to 72 years). History of myocardial infarction(30 cases, 98%) was the most common preoperative risk factor. There were seven irreversible myocardial infarction on thallium scan. Most patients had triple vessel diseases(26 cases, 84%) and first degree of Rentrop classification(16 cases, 52%) on coronary angiography. The mean number of distal anastomosis during CABG was per patient was 4.9${\pm}$0.8 sites in each patient. In addition to long saphenous veins, the internal mammary artery was used in 20 patients. Total bypass time was 244.7${\pm}$3.7 minutes(range, 117 to 567 minutes), and mean aortic cross-clamp time was 77.9 ${\pm}$ 1.6 minutes(range, 30 to 178 minutes). There were five other reparative procedures such as two left ventricular aneurysrmectomy, two mitral repair, and one aortic valve replacement. There were twelve postoperative complications such as three cardiac arrhythmia, two bleeding(re-operation), one delayed sternal closure, eleven usage of intra-aortic balloon counterpulsation for low cardiac output. Two patients died, postoperative mortality was 6.5% . Twenty-nine patients were relieved of chest pain and left ventricular ejection fraction after operation was significantly higher(38.5${\pm}$11.6%, p 0.001) as compared with preoperative left ventricular ejection fraction(25.3${\pm}$2.3%). The follow up period of out patient was 25. 3 months. Conclusion: In patients with coronary artery disease and advanced left ventricular dysfunction, coronary artery bypass grafting can be performed relatively safely with improvement in left ventricular function, but it will be necessary to study long term results.

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