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A study on the factors to affect the career success among workers with disabilities (지체장애근로자의 직업성공 요인에 관한 연구)

  • Lee, Dal-Yob
    • 한국사회복지학회:학술대회논문집
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    • 2003.10a
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    • pp.185-216
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    • 2003
  • This study was aimed at investigating important factors influencing career success among regular workers. The current researcher scrutinized the degree to which variables and factors affect the career success and occupational turnover rates of the research participants. At the same tune, two hypothetical path models established by the researcher were examined using linear multiple regression methods and the LISREL. After examining the differences among the factors of career success, a comparison was made between the disabled worker group and the non-disabled worker group. A questionnaire using the 5-point Likert scale was distributed to a group of 374 workers with disabilities and 463 workers without disabilities. For the data analysis purpose, the structural equation model, factor analysis, correlation analysis, and multiple regression analysis were carried out. The results of this study ran be summarized as follows. First, the results of factor analysis showed important categories of conceptual themes of career success. The initial conceptual factor model did not accord with the empirical one. A three-factorial model revealed categories of personal, family, and organizational factor respectively. The personal factor was composed of the self-esteem and self-efficiency. The family factor was consisted of the multi-roles stress and the number of children. Finally, the organizational factor was composed of the capacity for utilizing resources, networking, and the frequency of mentoring. In addition, the total 10 sub areas of career success were divided by two important aspects; the subjective career success and the objective career success. Second, both research participant groups seemed to be influenced by their occupational types. However, all predictive variables excluding the wage rate and the average length of work years had significant impact on job success for the disabled work group, while all the variables excluding the frequency of advice and length of working years had significant impact on job success for the non-disabled worker group. Third, the turnover rate was significantly influenced by the age and the experience of turnover of the research participants. However, the number of co-workers was the strongest predictive variable for the worker group with disabilities, but the occupation choice variable for the worker group without disabilities. For the disabled worker group, the turnover rate was differently influenced by the type of occupation, the length of working years, while multi-role stress and the average working years at the time of turnover for the worker group without disabilities. Fifth, as a result of verifying the hypothetical path model, it showed that the first model was somewhat proper and could predict the career success on both research participant groups. In the second model, the Chi-square, the degree of freedom (($x^2=64.950$, df=61, P=0.341), and the adjusted Goodness of Fit Index (AGFI) were .964, and the Comparative Fit Index (CFI) were .997, and the Root Mean Squared Residual (RMR) was respectively. .038. The model was best fitted and could predict the career success more highly because the goodness of fit index in the whole models was within the allowed range. In conclusion, the following research implications can be suggested. First, the occupational type of research participants was one of the most important variables to predict the career success for both research participant groups. It means that people with disabilities require human development services including education. They need to improve themselves in this knowledge-based society. Furthermore, for maintaining the career success, people with disabilities should be approached by considering the subjective career success aspects including wages and the promotion opportunities than the objective career success aspects.

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Determination of Minimal Pressure Support Level During Weaning from Pressure Support Ventilation (압력보조 환기법으로 기계호흡 이탈시 최소압력보조(Minimal Pressure Support) 수준의 결정)

  • Jung, Bock-Hyun;Koh, Youn-Suck;Lim, Chae-Man;Lee, Sang-Do;Kim, Woo-Sung;Kim, Dong-Soon;Kim, Won-Dong
    • Tuberculosis and Respiratory Diseases
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    • v.45 no.2
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    • pp.380-387
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    • 1998
  • Background: Minimal pressure support(PSmin) is a level of pressure support which offset the imposed work of breathing(WOBimp) developed by endotracheal tube and ventilator circuits in pressure support ventilation While the lower applied level of pressure support compared to PSmin could induce respiratory muscle fatigue, the higher level than PSmin could keep respiratory muscle rest resulting in prolongation of weaning period during weaning from mechanical ventilation PSmin has been usually applied in the level of 5~10 cm$H_2O$, but the accurate level of PSmin is difficult to be determinated in individual cases. PSmin is known to be calculated by using the equation of "PSmin = peak inspiratory flow rate during spontaneus ventilation$\times$total ventilatory system resistance", but correlation of calculated PSmin and measured PSmin has not been known. The objects of this study were firstly to assess whether customarily applied pressure support level of 5~10 cm$H_2O$ would be appropriate to offset the imposed work of breathing among the patients under weaning process, and secondly to estimate the correlation between the measured PSmin and calculated PSmin. Method : 1) Measurement of PSmin : Intratracheal pressure changes were measured through Hi-Lo jet tracheal tube (8mm in diameter, Mallinckroft, USA) by using pulmonary monitor(CP-100 pulmonary monitor, Bicore, USA), and then pressure support level of mechanical ventilator were increased until WOBimp was reached to 0.01 J/L or less. Measured PSmin was defined as the lowest pressure to make WOBimp 0.01 J/L or less. 2) Calculation of PSmin : Peak airway pressure(Ppeak), plateau airway pressure(Pplat) and mean inspiratory flow rate of the subjects were measured on volume control mode of mechanical ventilation after sedation. Spontaneous peak inspiratory flow rates were measured on CPAP mode(O cm$H_2O$). Thereafter PSmin was calculated by using the equation "PSmin = peak inspiratory flow rate$\times$R, R = (Ppeak-Pplat)/mean inspiratory flow rate during volume control mode on mechanical ventilation". Results: Sixteen patients who were considered as the candidate for weaning from mechanical ventilation were included in the study. Mean age was 64(${\pm}14$) years, and the mean of total ventilation times was 9(${\pm}4$) days. All patients except one were males. The measured PSmin of the subjects ranged 4.0~12.5cm$H_2O$ in 14 patients. The mean level of PSmin was 7.6(${\pm}2.5\;cmH_2O$) in measured PSmin, 8.6 (${\pm}3.25\;cmH_2O$) in calculated PSmin Correlation between the measured PSmin and the calculated PSmin is significantly high(n=9, r=0.88, p=0.002). The calculated PSmin show a tendancy to be higher than the corresponding measured PSmin in 8 out of 9 subjects(p=0.09). The ratio of measured PSmin/calculated PSmin was 0.81(${\pm}0.05$). Conclusion: Minimal pressure support levels were different in individual cases in the range from 4 to 12.5 cm$H_2O$. Because the equation-driven calculated PSmin showed a good correlation with measured PSmin, the application of equation-driven PSmin would be then appropriate compared with conventional application of 5~10 cm$H_2O$ in patients under difficult weaning process with pressure support ventilation.

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Prognostic Value of TNM Staging in Small Cell Lung Cancer (소세포폐암의 TNM 병기에 따른 예후)

  • Park, Jae-Yong;Kim, Kwan-Young;Chae, Sang-Cheol;Kim, Jeong-Seok;Kim, Kwon-Yeop;Park, Ki-Su;Cha, Seung-Ik;Kim, Chang-Ho;Kam, Sin;Jung, Tae-Hoon
    • Tuberculosis and Respiratory Diseases
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    • v.45 no.2
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    • pp.322-332
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    • 1998
  • Background: Accurate staging is important to determine treatment modalities and to predict prognosis for the patients with lung cancer. The simple two-stage system of the Veteran's Administration Lung Cancer study Group has been used for staging of small cell lung cancer(SCLC) because treatment usually consists of chemotherapy with or without radiotherapy. However, this system does not accurately reflect segregation of patients into homogenous prognostic groups. Therefore, a variety of new staging system have been proposed as more intensive treatments including either intensive radiotherapy or surgery enter clinical trials. We evaluate the prognostic importance of TNM staging, which has the advantage of providing a uniform detailed classification of tumor spread, in patients with SCLC. Methods: The medical records of 166 patients diagnosed with SCLC between January 1989 and December 1996 were reviewed retrospectively. The influence of TNM stage on survival was analyzed in 147 patients, among 166 patients, who had complete TNM staging data. Results: Three patients were classified in stage I / II, 15 in stage III a, 78 in stage IIIb and 48 in stage IV. Survival rate at 1 and 2 years for these patients were as follows: stage I / II, 75% and 37.5% ; stage IIIa, 46.7% and 25.0% ; stage III b, 34.3% and 11.3% ; and stage IV, 2.6% and 0%. The 2-year survival rates for 84 patients who received chemotherapy(more than 2 cycles) with or without radiotherapy were as follows: stage I / II, 37.5% ; stage rna, 31.3% ; stage IIIb 13.5% ; and stage IV 0%. Overall outcome according to TNM staging was significantly different whether or not received treatment. However, there was no significant difference between stage IIIa and stage IIIb though median survival and 2-year survival rate were higher in stage IIIa than stage IIIb. Conclusion: These results suggest that the TNM staging system may be helpful for predicting the prognosis of patients with SCLC.

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A Survey on Child Battering among Elementary School Children and Related Factors in Urban and Rural Areas (도시 및 농어촌 아동의 가정내 구타발생률 및 관련요인 조사)

  • Jeon, Kae-Soon;Park, Jung-Han
    • Journal of Preventive Medicine and Public Health
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    • v.24 no.2 s.34
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    • pp.232-242
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    • 1991
  • To determine the incidence rate of child battering and related factors, a questionnaire survey was Conducted on 1,255 children in 4th and 5th grades of two elementary schools (one in the upper economic class area with 519 students and the other in the lower economic class area with 504 students) in Taegu and two schools in rural areas of Kyungpook province (120 and 112 students, respectively) from 1st May to 10th May 1990. Total number of children who were battered during one-month period (1-30 April 1990) prior to the survey was 918 (73.1%). Among the battered children 87 (6.9%) were severely battered (twice or more in a month by kicking or more severe method) and 831 children (66.2%) were moderately battered (all other battering than severe battering). The percentage of battered children and degree of battering were not significantly different between two schools in Taegu and between urban and rural areas. Common reasons for battering were disobediance (61.9%), making troubles (34.9%), and poor school performance (33.3%). However, 16.1% of severely battered children responded that the perpetrators battered them to wreak their anger and 5.7% of them did not know the reason why they were battered. A majority of the battered children (65%) regretted their fault after being battered but 20.7% of the severely battered children wanted to run away and 9.2% of them had an urge to commit suicide. While most of the physical injuries due to battering were minor as bruise (52.7%) but some of them were severe, e.g., bone fracture (2.5%), skin laceration (1.5%), and loss of consciousness. (0.2%). The common psycho-behavioral complaints of the severely battered children were unwillingness to study (31%), unwillingness to live (17.2%), and reluctance to go home (13.8%). The incidence rate of severe battering was significantly higher (p=0.018) among the children living in a quarter attached to a store (14.0%) than the children living in an apartment (6.6%) and individual house (6.2%). The incidence rate of severe battering was higher among children living in a rental house (8.4%) than children living in their own house 6.3%) (p=0.005). The children of father only working (5.1%) and mother only working (4.5%) had a lower incidence rate of severe battering than the children of both parents working (9.1%) and both parents unemployed (20.7%) (p=0.006). More children were battered when there was a sick family member (80.8%) compared with the children without a sick family member (71.4%) (p=0.001). The incidence rates of severe and moderate battering increased as the frequency of quarreling between mother and father increased (P=0.000). The percentage of unbattered children was higher among children whose father's occupation was professional (39.4%) than that of the total study subjects (26.9%) (p<0.001).

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Construction of Consumer Confidence index based on Sentiment analysis using News articles (뉴스기사를 이용한 소비자의 경기심리지수 생성)

  • Song, Minchae;Shin, Kyung-shik
    • Journal of Intelligence and Information Systems
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    • v.23 no.3
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    • pp.1-27
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    • 2017
  • It is known that the economic sentiment index and macroeconomic indicators are closely related because economic agent's judgment and forecast of the business conditions affect economic fluctuations. For this reason, consumer sentiment or confidence provides steady fodder for business and is treated as an important piece of economic information. In Korea, private consumption accounts and consumer sentiment index highly relevant for both, which is a very important economic indicator for evaluating and forecasting the domestic economic situation. However, despite offering relevant insights into private consumption and GDP, the traditional approach to measuring the consumer confidence based on the survey has several limits. One possible weakness is that it takes considerable time to research, collect, and aggregate the data. If certain urgent issues arise, timely information will not be announced until the end of each month. In addition, the survey only contains information derived from questionnaire items, which means it can be difficult to catch up to the direct effects of newly arising issues. The survey also faces potential declines in response rates and erroneous responses. Therefore, it is necessary to find a way to complement it. For this purpose, we construct and assess an index designed to measure consumer economic sentiment index using sentiment analysis. Unlike the survey-based measures, our index relies on textual analysis to extract sentiment from economic and financial news articles. In particular, text data such as news articles and SNS are timely and cover a wide range of issues; because such sources can quickly capture the economic impact of specific economic issues, they have great potential as economic indicators. There exist two main approaches to the automatic extraction of sentiment from a text, we apply the lexicon-based approach, using sentiment lexicon dictionaries of words annotated with the semantic orientations. In creating the sentiment lexicon dictionaries, we enter the semantic orientation of individual words manually, though we do not attempt a full linguistic analysis (one that involves analysis of word senses or argument structure); this is the limitation of our research and further work in that direction remains possible. In this study, we generate a time series index of economic sentiment in the news. The construction of the index consists of three broad steps: (1) Collecting a large corpus of economic news articles on the web, (2) Applying lexicon-based methods for sentiment analysis of each article to score the article in terms of sentiment orientation (positive, negative and neutral), and (3) Constructing an economic sentiment index of consumers by aggregating monthly time series for each sentiment word. In line with existing scholarly assessments of the relationship between the consumer confidence index and macroeconomic indicators, any new index should be assessed for its usefulness. We examine the new index's usefulness by comparing other economic indicators to the CSI. To check the usefulness of the newly index based on sentiment analysis, trend and cross - correlation analysis are carried out to analyze the relations and lagged structure. Finally, we analyze the forecasting power using the one step ahead of out of sample prediction. As a result, the news sentiment index correlates strongly with related contemporaneous key indicators in almost all experiments. We also find that news sentiment shocks predict future economic activity in most cases. In almost all experiments, the news sentiment index strongly correlates with related contemporaneous key indicators. Furthermore, in most cases, news sentiment shocks predict future economic activity; in head-to-head comparisons, the news sentiment measures outperform survey-based sentiment index as CSI. Policy makers want to understand consumer or public opinions about existing or proposed policies. Such opinions enable relevant government decision-makers to respond quickly to monitor various web media, SNS, or news articles. Textual data, such as news articles and social networks (Twitter, Facebook and blogs) are generated at high-speeds and cover a wide range of issues; because such sources can quickly capture the economic impact of specific economic issues, they have great potential as economic indicators. Although research using unstructured data in economic analysis is in its early stages, but the utilization of data is expected to greatly increase once its usefulness is confirmed.

Study on Environmental Hazards of Alternatives for PFOS (PFOS 대체물질의 환경유해성에 관한 연구)

  • Choi, Bong-In;Chung, Seon-Yong;Na, Suk-Hyun;Shin, Dong-Soo;Ryu, Byung-Taek
    • Journal of Korean Society of Environmental Engineers
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    • v.38 no.6
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    • pp.317-322
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    • 2016
  • While PFOS sodium salt ($C_8F_{17}SO_3Na$) was not degraded by microorganisms for 28 days, the 4 alternatives were biodegraded at the rates of 21.6% for $C_{25}F_{17}H_{32}S_3O_{13}Na_3$, 20.5% for $C_{15}F_9H_{21}S_2O_8Na_2$, 15.8% for $C_{23}F_{18}H_{28}S_2O_8Na_2$ and 6.4% for $C_{17}F_9H_{25}S_2O_8Na_2$, respectively. The acute toxicity test using Daphnia magna was conducted for 48 hours, the half effective concentration ($EC_{50}$) of PFOS sodium salt ($C_8F_{17}SO_3Na$) was evaluated in 54.5 mg/L. While the 4 alternatives did not show any effect at 500.0 mg/L. The surface tension of the PFOS salt ($C_8F_{17}SO_3Na$) is 46.2 mN/m at a concentration of 500.0 mg/L. While the surface tension of the 4 alternatives was found to be superior to PFOS sodium salt ($C_8F_{17}SO_3Na$). The surface tension of $C_{23}F_{18}H_{28}S_2O_8Na_2$ (20.9 mN/m) has the lowest, followed by $C_{15}F_9H_{21}S_2O_8Na_2$ (23.4 mN/m), $C_{17}F_9H_{25}S_2O_8Na_2$ (27.3 mN/m), $C_{25}F_{17}H_{32}S_3O_{13}Na_3$ (28.2 mN/m). The four kinds of alternatives ($C_{15}F_9H_{21}S_2O_8Na_2$, $C_{17}F_9H_{25}S_2O_8Na_2$, $C_{23}F_{18}H_{28}S_2O_8Na_2$, $C_{25}F_{17}H_{32}S_3O_{13}Na_3$) were found to be superior to PFOS sodium salt ($C_8F_{17}SO_3Na$) in terms of biodegradation, Daphnia sp. acute toxicity and surface tension, and thus they were considered applicable as PFOS alternatives. Especially biodegradation rate of $C_{15}F_9H_{21}S_2O_8Na_2$, $C_{23}F_{18}H_{28}S_2O_8Na_2$ and $C_{25}F_{17}H_{32}S_3O_{13}Na_3$ was relatively high as 15.8~21.6%, and Daphnia sp. acute toxicity and surface tension were considerably superior (surface tension 39~55%) to PFOS sodium salt. Therefore, these alternatives are considered to be available as an alternative of PFOS.

Evaluation of Air Quality in the Compost Pilot Plant with Livestock Manure by Operation Types (축분 퇴비화시스템 운용방식에 따른 실내 대기오염 평가)

  • Kim, K.Y.;Choi, H.L.;Ko, H.J.;Kim, C.N.
    • Journal of Animal Science and Technology
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    • v.46 no.2
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    • pp.283-294
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    • 2004
  • Air quality in the livestock waste compost pilot plant at the Colligate Livestock Station was assessed to quantity the emissions of aerial contaminants and evaluate the degree of correlation between them for different operation strategies; with the ventilation types and agitation of compost pile, in this study. The parameters analyzed to reflect the level of air quality in the livestock waste compost pilot plant were the gaseous contaminants; ammonia, hydrogen sulfide, and odor concentration, the particulate contaminants; inhalable dust and respirable dust, and the biological contaminants; total airborne bacteria and fungi. The mean concentrations of ammonia, hydrogen sulfide, and odor concentration in the compost pilot plant without agitation were 2.45ppm, 19.96ppb, and 15.8 when it was naturally ventilated, and 7.61ppm, 31.36ppb, and 30.2 when mechanically ventilated. Those with agitation were 5.50ppm, 14.69ppb, and 46.4 when naturally ventilated, and 30.12ppm, 39.91ppb, and 205.5 when mechanically ventilated. The mean concentrations of inhalable and respirable dust in the compost pilot plant without agitation were 368.6${\mu}g$/$m^3$ and 96.0${\mu}g$/$m^3$ with natural ventilation, and 283.9${\mu}g$/$m^3$ and 119.5${\mu}g$/$m^3$ with mechanical ventilation. They were also observed with agitation to 208.7${\mu}g$/$m^3$ and 139.8${\mu}g$/$m^3$ with natural ventilation, and 209.2${\mu}g$/$m^3$ and 131.7${\mu}g$/$m^3$ with mechanical ventilation. Averaged concentrations of total airborne bacteria and fungi in the compost pilot plant without agitation were observed to 28,673cfu/$m^3$ and 22,507cfu/$m^3$ with natural ventilation, and 7,462cfu/$m^3$ and 3,228cfu/$m^3$ with mechanical ventilation. They were also observed with agitation to 19,592cfu/$m^3$ and 26,376cfu/$m^3$ with the natural ventilation, and 18,645cfu/$m^3$ and 24,581cfu/$m^3$ with the mechanical ventilation. It showed that the emission rates of gaseous pollutants, such as ammonia, hydrogen sulfide, and odor concentration, in the compost pilot plant operated with the mechanical ventilation and with the agitation of compost pile were higher than those with the natural ventilation and without the agitation. While the concentrations of inhalable dust and total airborne bacteria in the compost pilot plant with the natural ventilation and with the agitation, the concentrations of respirable dust and total airborne fungi in the compost pilot plant with the mechanical ventilation and agitation were higher than those with the natural ventilation and without the agitation of compost pile. It was statistically proved that indoor temperature and relative humidity affected the release of particulates and biological pollutants, and ammonia and hydrogen sulfide were believed primary malodorous compounds emitted from the compost pilot plant.

Investigation of Poultry Farm for Productivity and Health in Korea (한국에 있어서 양계장의 실태와 닭의 생산성에 관한 조사(위생과 질병중심으로))

  • 박근식;김순재;오세정
    • Korean Journal of Poultry Science
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    • v.7 no.2
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    • pp.54-76
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    • 1980
  • A survey was conducted to determine the status of health and productivity of poultry farms in Korea. Area included Was Kyunggido where exist nearly 50% of national poultry population. From this area, 41 layer and 34 broiler farms covering 21 Countries were selected randomly for the survey. When farms were divided in the operation size, 95.1% of layer and 82.3% of broiler farms were classified as business or industrial level while the rest were managed in a small scale as part time job. Generally layer farms had been established much earlier than broiler farms. Geographically 10.7% of layer farms were sited near the housing area such as field foreast and rice field. No farms were located near the seashore. The distance from one farm from the other was very close, being 80% of the farms within the distance of 1km and as many as 28% of the farms within loom. This concentrated poultry farming in a certain area created serious problems for the sanitation and preventive measures, especially in case of outbreak of infectious diseases. Average farm size was 5,016${\times}$3.3㎡ for layers and 1,037${\times}$3.3㎡ for broilers. 89.5% of layer ana 70.6% of broiler farms owned the land for farming while the rest were on lease. In 60% of layer farms welters were employed for farming while in the rest their own labour was used. Majority of farms were equipped poorly for taking necessary practice of hygiene and sanitation. The amount of disinfectant used by farms was considerably low. As many as 97.6% of lave. farms were practised with Newcastle(ND) and fowl pox(F$.$pox) vaccine, whereas only 43.6% and 5.1% of broiler farms were practised with ND and F$.$pox vaccine, respectively. In 17-32.7% of farms ND vaccine was used less than twice until 60 days of age and in only 14.6% of farms adult birds were vaccinated every 4months. Monthly expense for preventive measures was over 200,000W in 32% of farms. Only 4.9-2.7% of vaccine users were soaking advice from veterinarians before practising vaccination, 85% of the users trusted the efficacy of the vaccines. Selection of medicine was generally determined by the farm owner rather than by veterinarans on whom 33.3% of farms were dependant. When diseases outbroke, 49.3% of farms called for veterinary hospital and the rest were handled by their own veterinarians, salesmen or professionals. Approximately 70% of farms were satisfied with the diagnosis made by the veterinarians. Frequency of disease outbreaks varied according to the age and type of birds. The livabilities of layers during the period of brooding, rearing ana adultwere 90.5, 98.9 and 75.2%, respectively while the livalibility of broilers until marketing was 92.2%. In layers, average culling age, was 533.3 day and hen housed eggs were 232.7. Average feed conversion rates of layers and broilers were 3.30 and 2.48, respectively. Those figures were considerably higher than anticipated but still far lower than those in developed countries.

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Clinical Outcomes of Corrective Surgical Treatment for Esophageal Cancer (식도암의 외과적 근치 절제술에 대한 임상적 고찰)

  • Ryu Se Min;Jo Won Min;Mok Young Jae;Kim Hyun Koo;Cho Yang Hyun;Sohn Young-sang;Kim Hark Jei;Choi Young Ho
    • Journal of Chest Surgery
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    • v.38 no.2 s.247
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    • pp.157-163
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    • 2005
  • Background: Clinical outcomes of esophageal cancer have not been satisfactory in spite of the development of surgical skills and protocols of adjuvant therapy. We analyzed the results of corrective surgical patients for esophageal cancer from January 1992 to July 2002. Material and Method: Among 129 patients with esophageal cancer, this study was performed in 68 patients who received corrective surgery. The ratio of sex was 59 : 9 (male : female) and mean age was $61.07\pm7.36$ years old. Chief complaints of this patients were dysphagia, epigastric pain and weight loss, etc. The locations of esophageal cancer were 4 in upper esophagus, 36 in middle, 20 in lower, 8 in esophagogastric junction. 60 patients had squamous cell cancer and 7 had adenocarcinoma, and 1 had malignant melanoma. Five patients had neoadjuvant chemotherapy. Result: The postoperative stage I, IIA, IIB, III, IV patients were 7, 25, 12, 17 and 7, respectively. The conduit for replacement of esophagus were stomach (62 patients) and colon (6 patients). The neck anastomosis was performed in 28 patients and intrathoracic anastomosis in 40 patients. The technique of anastomosis were hand sewing method (44 patients) and stapling method (24 patients). One of the early complications was anastomosis leakage (3 patients) which had only radiologic leakage that recovered spontaneously. The anastomosis technique had no correlation with postoperative leakage, which stapling method (2 patients) and hand sewing method (1 patient). There were 3 respiratory failures, 6 pneumonia, 1 fulminant hepatitis, 1 bleeding and 1 sepsis. The 2 early postoperative deaths were fulminant hepatitis and sepsis. Among 68 patients, 23 patients had postoperative adjuvant therapy and 55 paitents were followed up. The follow up period was $23.73\pm22.18$ months ($1\~76$ month). There were 5 patients in stage I, 21 in stage 2A, 9 in stage IIB, 15 in stage III and 5 in stage IV. The 1, 3, 5 year survival rates of the patients who could be followed up completely was $58.43\pm6.5\%,\;35.48\pm7.5\%\;and\;18.81\pm7.7\%$, respectively. Statistical analysis showed that long-term survival difference was associated with a stage, T stage, and N stage (p<0.05) but not associated with histology, sex, anastomosis location, tumor location, and pre and postoperative adjuvant therapy. Conclusion: The early diagnosis, aggressive operative resection, and adequate postoperative treatment may have contributed to the observed increase in survival for esophageal cancer patients.

The Comparison Study of Early and Midterm Clinical Outcome of Off-Pump versus On-Pump Coronary Artery Bypass Grafting in Patients with Severe Left Ventricular Dysfunction (LVEF${\le}35{\%}$) (심한 좌심실 부전을 갖는 환자에서 시행한 Off-Pump CABG와 On-Pump CABG의 중단기 성적비교)

  • Youn Young Nam;Lee Kyo Joon;Bae Mi Kyung;Shim Yeon Hee;Yoo Kyung-Jong
    • Journal of Chest Surgery
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    • v.39 no.3 s.260
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    • pp.184-193
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    • 2006
  • Background: Off-pump coronary artery bypass grafting (OPCAB) has been proven to result in less morbidity. The patients who have left ventricular dysfunction may have benefits by avoiding the adverse effects of the cardiopulmonary bypass. The present study compared early and midterm outcomes of off-pump versus on-pump coronary artery bypass grafting (On pump CABG) in patients with severe left ventricular dysfunction. Material and Method: Ninety hundred forth six patients underwent isolated coronary artery bypass grafting by one surgeon between January 2001 and Febrary 2005.. Data were collected in 100 patients who had left ventricular ejection fraction (L VEF) less than $35\%$ (68 OPCAB; 32 On pump CABG). Mean age of patients were 62.9$\pm$9.0 years in OPCAS group and 63.8$\pm$8.0 years in On pump CABG group. We compared the preoperative risk factors and evaluated early and midterm outcomes. Result: In OPCAB and On pump CABG group, mean number of used grafts per patient were 2.75$\pm$0.72, 2.78$\pm$0.55 and mean number of distal anastomoses were 3.00$\pm$0.79, 3.16$\pm$0.72 respectively. There was one perioperative death in OPCAB group ($1.5\%$). The operation time, ventilation time, ICU stay time, CK-MB on the first postoperative day, and occurrence rate of complications were significantly low in OPCAB group. Mean follow-up time was 26.6$\pm$12.8 months (4${\~}$54 months). Mean LVEF of OPCAB and On pump CABG group improved significantly from $27.1\pm4.5\%$ to $40.7\pm13.0\%$ and $26.9\pm5.4\%$ to $33.3\pm13.7\%$. The 4-year actuarial survival rate of OPCAB and On pump CABG group were $92.2\%,\;88.3\%$ and the 4-year freedom rates from cardiac death were $97.7\%,\;96.4\%$ respectively. There were no significant differences between two groups in 4 year freedom rate from cardiac event and angina. Conclusion: OPCAS improves myocardial function and favors early and mid-term outcomes in patients with severe left ventricular dysfunction compared to On pump CABG group. Therefore, OPCAB is a preferable operative strategy even in patients with severe left ventricular dysfunction.