• Title/Summary/Keyword: risk function

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Comparison of the Neurologic Outcome according to the Method of Proximal Graft Anastomosis at the Aortic Side during Off-pump Coronary Artery Bypass Grafting: The Heartstring Sealing System versus Conventional Manual Anastomosis (무심폐기 관상동맥 우회술에 있어서 이식편의 대동맥부 근위부 문합 방법에 따른 수술 후 신경학적 합병증 발생의 비교: 하트스트링을 이용한 방법 대 고식적인 수기 문합술)

  • Cho, Won-Chul;Kim, Joon-Bum;Kim, Hee-Jung;Kim, Hwan-Wook;Kim, Yun-Seok;Jung, Jae-Seung;Choo, Suk-Jung
    • Journal of Chest Surgery
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    • v.42 no.4
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    • pp.441-446
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    • 2009
  • Background: Side clamping of ascending aorta during proximal graft anastomosis in coronary bypassing surgery in-creases the risk of direct aortic injury as well as embolization of intimal atheroma. Heartstring proximal sealing system (Guidant Corporation, Santa Clara, Calif), developed to avoid aortic side clamping, may minimize risks of such complications. The aim of the current study is to compare the surgical outcomes of the two proximal anastomosis techniquesi.e., Heartstring system versus aortic side clamping in off pump coronary bypassing' surgery (OPCAB). Material and Method: From January 2003 to August 2008, 499 patients underwent OPCAB. Of them, proximal graft anastomosis was performed using Heartstring system in 182 patients (Group I) and conventional manual anastomosis in 317 patients (Group II). The two groups were compared for postoperative major complications and mortality. Result: Two groups showed similar characteristics in terms of preoperative demographic data, left ventricular ejection fraction, renal function and history of diabetes, hypertension and smoking. Although there was no inter-group difference in the history of cerebral ischemia (p=0.48), preoperative brain magnetic resonance angiography revealed greater incidence of severe carotid artery stenosis (>75% of lumen) in the Group I than in the. Group II (44.5% in the Group I and 30.0% in the Group II, p=0.003). There were no inter-group differences in postoperative mortality (p=0.40) and complications (p=0.47) including neurologic events (3 in the Group land 2 in the Group II, p=0.258). Whereas neurologic events all comprised transient ischemic attacks in the Group I, they comprised multiple embolic strokes in the Group II. One patient in the Group II experienced aortic dissection during proximal anastomosis which resulted in ascending aortic replacement. Conclusion: Although proximal anastomosis using Heartstring system did not show statistically significant benefit over aortic side clamping, the. absence of embolic stroke maybe a definite benefit which may be better defined through further studies over a larger cohort.

The Differences of the Smoking Habit Between Emphysema and Chronic Bronchitis (폐기종과 만성기관지염의 흡연습관 차이)

  • Mun, Yeung-Chul;Yu, Sung-Keun;Park, Hye-Jung;Shin, Kyeong-Cheol;Chung, Jin-Hong;Lee, Kwan-Ho;Lee, Jung-Cheol
    • Tuberculosis and Respiratory Diseases
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    • v.50 no.6
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    • pp.693-703
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    • 2001
  • Background : Smoking is the most important and consistent determinant of the development and progression of COPD(Ed Note : Define COPD). The fact that cigarette smokers develop a different type of COPD, chronic bronchitis and emphysema, with different clinical and pathological aspects, suggests that the development of COPD has a relationship with other smoking-associated factors beyond just a simple smoking history. The aim of this was to analyze the smoking habits and history of patients with COPD and to evaluate the development of different types of COPD according to patient's smoking habits. Method : To evaluate the differences in the smoking patterns of patients with chronic bronchitis and emphysema, a pulmonary function test was conducted, and the smoking history and patterns was obtained through a smoking history questionnaire by a direct personal interview from 333 male cigarette smokers diagnosed with COPD, in the Yeungnam university medical center(190 patients diagnosed with chronic bronchitis, 143 patients diagnosed with emphysema). Result : The patients with emphysema smoked earlier and had a higher smoking history(ie, more packyears, more total amounts of smoked cigarette, and more deep inhalation and longer duration of plain cigarette exposure) than those with chronic bronchitis. The depth of inhalation was also significantly higher in the emphysema patients after taking into account age, cumulative cigarette consumption and the type of cigarette smoked. Conclusion : Emphysema was more associated with the increasing degree of inhalation as assessed by the depth of inhalation. A high alveolar smoke exposure may be a significant risk factor for the development of emphysema.

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Morphological Analysis of the Mental Foramen and Anterior Loop of the Mandibular Canal using Computed Tomography (전산화단층촬영 방사선영상을 이용한 이공과 하악관 전방고리의 형태학적 분석)

  • Kim, Yong-Gun
    • Journal of Dental Rehabilitation and Applied Science
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    • v.27 no.3
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    • pp.317-326
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    • 2011
  • The mental foramen and anterior loop of the mandibular canal are important landmarks for mandibular surgical procedures. The purpose of this study was to analyze the shape and position of the mental foramen and anterior loop of the mandibular canal on the computed tomography (CT) images, and apply the results clinically. CT images of 96 patients (33 male, 36 female, age range 17~43 years, mean $24.6{\pm}4.99$ years) were enrolled. The horizontal and vertical position of the mental foramen, as well as the distance from the root apices were measured. The distance of the anterior loop of the mandibular canal to the root apices, and the buccal angle were measured. The mental foramen was found mostly below the second premolar observed in 81 cases (46.0%), between the first and second premolars in 67 cases (38.0%), and between the second premolar and first molar in 19 cases (10.2%). The mean distance between the mental foramen and the lower border of the mandible was $12.20{\pm}1.77$ mm, the mean distance between the mental foramen and root apex was $5.16{\pm}0.98$ mm. The mean distance of the anterior loop of the mandibular canal was $5.80{\pm}2.00$ mm. The buccal angle measured at $47.7{\pm}9.07^{\circ}$. The distance between the root apex and mental foramen measured as $5.16{\pm}0.98$ mm on panoramic radiography, and $6.2{\pm}3.07$ mm on CT. The mean distance between the mental foramen and mandibular canal was $5.39{\pm}1.62$ mm. When performing surgical procedures such as installing dental implants, it is important to minimize surgical trauma, especially the risk of damage to the mental nerve. To optimize the surgical outcome, a careful assessment of the shape and position of the mental foramen and the anterior loop of the mandibular canal must be made. CT images are useful for finding such anatomic structures.

Full mouth Rehabilitation with Orthognathic Surgery in Facial Asymmetry Patient : Case Report (안면 비대칭환자의 악교정 수술을 동반한 완전구강회복)

  • Im, So-Min;Shin, Hyoung-Joo;Kim, Dae-Gon;Park, Chan-Jin;Cho, Lee-Ra
    • Journal of Dental Rehabilitation and Applied Science
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    • v.26 no.3
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    • pp.359-371
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    • 2010
  • Facial asymmetry has been found with a higher frequency (70~84%) in skeletal class III malocclusion patients. Anticipating the poor prognosis of prosthesis due to malocclusion, occlusal stability must be obtained by orthodontic treatment. Moreover, orthodontic surgery would be needed in some severe cases for better functional and esthetic results. The orthognathic surgery is performed on one jaw or two jaw depending on the results of facial diagnosis. Genioplasty may change the vertical, horizontal, sagittal position of chin by osteotomy or augmentation using implants, also. This case is about a 24 year-old male patient who visited our clinic to solve the facial asymmetry and mandibular prognathism. Skeletal class III malocclusion, maxillary canting and menton deviation to left by 13 mm were detected. Multiple ill-fitting prostheses, unesthetic maxillary anterior prostheses, and several dental caries were found. After pre-operative orthodontic treatment, Le-Fort I osteotomy, sagittal split ramus osteotomy, genioplasty, right mandibular angle augmentation were done for the correction of jaw relation and asymmetry. By diagnostic wax-up after post-operative orthodontic treatment, maxillary full mouth rehabilitation and mandibular posterior restorations were planned out. For better result, clinical crown lengthening procedure was done on #11, 12 and implant was placed on left mandibular first molar area. The patient was satisfied with the final prostheses. Because of his high caries risk, long-term prognosis will depend on the consistent maintenance of oral hygiene and periodic follow-up.

A Study on the Relationship Between Entrepreneur Characteristics and the Performance of Small Firms (창업자 특성과 소기업 사업성과 간 관계에 관한 연구)

  • Kim, Wan-Jae;Chung, Hwa-Young
    • Asia-Pacific Journal of Business Venturing and Entrepreneurship
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    • v.2 no.3
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    • pp.33-60
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    • 2007
  • This study alms to analyze the entrepreneur characteristics of founder on enterprise performance from the strategic viewpoint as well as features of founder of small firms such as background feature of founder, psychological features and management skill. As considered by Background features of founder include educational background of founder, his experience in business creation, consultation or course related to business creation. This study verified the effects of factor which business performance (financial, non financial) on small firms. Also, this study considered psychological features of founder include achievement desire, risk-free propensity, level of patience on vagueness and control position. And it analyzed that between such factors and performance of small firms were examined in related. In the mean time, management ability of founder, entrepreneur ability, technical and function ability were considered for management skill of founder and alalyzed effect of the factors on performance of small firm were examined. Effects of strategic intention of founder of small firm were analyzed by the strategic viewpoint. At this time, strategy of small firm was divided into product-service reform differentiation strategy, marketing differentiation strategy and cost leadership strategy. This study distributed questionnaire on CEO of small firms in Daejeon and Chungnam area for accomplish the study objective and it collected a total of 145 copies of questionnaires. As a result of analyzing collected questionnaire, this study deduced the following study results and suggestions. First, results different from those of existing studies were found Since sales, net income and profit rate of small firm were not high cause economic depression on the whole. Second, entrepreneur ability was found to be required for success of business creation. Entrepreneur ability of founder was the factor that affects both financial and non - financial performance of small firm. As such, entrepreneur ability can be regarded as the most important factor for success in business creation of small firm. Accordingly, entrepreneur ability is the most important source for success in business creation of small firm. Third, strategy of small firm was found to be the important factor that affects the non-financial performance even if it could not give significant effects on financial performance. Thus, product service reform differentiation strategy, marketing differentiation strategy and cost leadership strategy have significant effects on non - financial performance of small firm. Accordingly, it is required to operate small firm with strategic mind - set for small firm to achieve success. This study analyzed the effects of feature of founder and strategy of small firm on business performance of small firm through practical analysis on small firms in Daejeon and Chungnam area, and deduced meaningful results. However, Since this study collected data on small firms in Daejeon and Chungnam only, there is a limit in generalizing the results of this study to all small firms in Korea. Companies answering to this questionnaire process were mainly wholesale and retail service companies. In addition, there is a limit in that it failed to analyze feature of representative type of industry due to limit in number of sample, it is required to divide representative type of industry and to compare and analyze types of industry in future studies.

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Arthroscopic Decompression of Spinoglenoid Ganglion Cyst (견갑골 극관절와 결절종의 관절경하 감압술)

  • Hwang, Tae Hyok;Wang, Tae Hyun;Cho, Hyung Lae;Kim, Keun Young
    • Journal of the Korean Arthroscopy Society
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    • v.15 no.2
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    • pp.92-98
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    • 2011
  • Purpose: We describe a all-arthroscopic technique for decompression of spinoglenoid ganglion cyst and present our clinical results for this procedure. Materials and Methods: From March 2006 to June 2009, eight patients (7 males, 1 female; mean age 40.6 years; range: 21~61) were included who underwent arthroscopic decompression of spinoglenoid ganglion cyst. The most common symptoms were vague shoulder pain and external rotation weakness, which lasted 6.4 months (range: 3~8) on average. Five of eight patients were noted abnormalities on electromyographic (EMG) examination to have suprascapular nerve neuropathy and magnetic resonance imaging (MRI) showed spinoglenoid ganglion cysts in all eight patients and the cyst size was 2.6 cm (range: 1.8~3.6). Labral pathology was identified intraoperatively in all patients and the cysts were decompressed by the posterosuperior capsulotomy under arthroscopic control and labral repair with suture anchors was performed in six patients. Results: The average clinical outcome scores including Constant and Murley, Simple shoulder test (SST) all improved significantly at the time of the final follow-up and there were no complications resulting from the procedures. All patients including the patients with abnormal EMG study recovered strength on isokinetic strength testing. Follow-up MRI scans were performed on all patients at a mean of 5.2 months postoperatively (range: 3~12) revealed complete resolution of the cysts and no evidence of recurrences were seen at an average of 18 months (range: 12~26) of follow-up. Conclusion: Arthroscopic decompression of spinoglenoid ganglion cyst effectively restores patient function and all patients in this study showed improvement in their postoperative MRI findings. Arthroscopic decompression is also useful in the appropriate treatment for labral pathology and may contribute to decreased risk of cyst recurrence.

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Effects of Freeze-Dried Garlic Powder on Lipid Improvement in Rats Fed a High Fat-Cholesterol Diet (고지방-콜레스테롤 식이 급이 흰쥐에 대한 동결건조 마늘분말의 지질개선 효과)

  • Kang, Jae-Ran;Kang, Min-Jung;Byun, Hee-Wook;Shin, Jung-Hye
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.46 no.9
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    • pp.1035-1044
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    • 2017
  • This study was carried out to investigate the effects of freeze-dried garlic powder (FDGP) on the lipid metabolism in rats fed a high fat-cholesterol (HFC) diet for 4 weeks to induce hyperlipidemia. The rats were divided into the following four experimental groups: normal diet group (NC), HFC diet group (HFC), HFC+FDGP 5 mg/100 g body weight (BW) group (FGT-1), and HFC+FDGP 15 mg/100 g BW group (FGT-2). Body weight gains and food efficiency ratios were significantly lower in the FGT groups compared to the HFC group, and the food intake was not significantly different in all experimental groups. Serum total lipid, triglyceride, and total cholesterol levels were significantly lower in the FGT groups compared to the HFC group. Total lipid content of the FGT-2 group was reduced by about 9% and 12% compared to the FGT-1 group and HFC group, respectively. The FGT groups also showed about 10% reductions low density lipoprotein (LDL)-cholesterol, atherogenic index (AI), and cardiac risk factor (CRF) compared to the HFC group. Liver function index (alkaline phosphatase, aspartate aminotransferase, and alanine aminotransferase) and lipid components were significantly lower in the FGT groups compared to the HFC group. Thiobarbituric acid reactive substances content of serum and liver tissue was reduced in the FGT groups compared to the HFC group, and was lower in the FGT-2 group compared to the FGT-1 group in serum. Antioxidant activities in serum and liver tissue were in the order of FGT-2> FGT-1> HFC group, significantly. In conclusion, FDGP effectively reduced the lipid components of serum and liver tissue. Feeding FDGP did not increase high density lipoprotein-cholesterol, but reduced LDL-cholesterol content, AI and CRF, especially. This shows that FDGP, will be effective in preventing and improving cardiovascular diseases such as arteriosclerosis and hyperlipidemia.

Characteristics of Percutaneous Absorption of Glycol ethers (Glycol ethers에 대한 피부 투과 특성)

  • Lee, Han-Seob;Choi, Sung-Boo;Kim, Nac-Joo;Keun, Jang-Hyoun;Hwang, Hyun-Suk;Baek, Jung-Hun;Choi, Jin-Ho;Lee, Ho-Joon
    • Journal of the Korean Applied Science and Technology
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    • v.30 no.1
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    • pp.116-126
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    • 2013
  • Glycol ethers are a group of solvents based on alkyl ethers of ethylene glycol commonly used in paints. These solvents typically have a higher boiling point, together with the favorable solvent properties of lower-molecular weight ethers and alcohols. The word "Glycol ethers" was registered as a United States trademark by Union Carbide Corp. Typically, glycol ethers are found in pharmaceuticals, sunscreens, cosmetics, inks, dyes and water based paints. On the other hand, glycol ethers are used in degreasers, cleaners, aerosol paints and adhesives. Most glycol ethers are relatively water soluble, biodegradable and only a few are considered toxic. Therefore, they are unlikely to pose an adverse risk to the environment. Recent study suggests that occupational exposure to glycol ethers is related to low motile sperm count in men, but the finding has been disputed by others. In this study, skin permeation of 3 types glycol ethers were studied in vitro using matrix such as solvent and detergent. The absorption of glycol ethers[methyl glycol ethers(MC), ethyl glycol ethers(EC) and butyl glycol ethers(BC)] has been measured in vitro through rat skin. Epidermal membranes were set up in Franz diffusion cells and their permeability to PBS measured to establish the integrity of the skin before the glycol ethers were applied to the epidermal surface. Absorption rates for each glycol ethers were determined and permeability assessment made to quantify any irreversible alterations in barrier function due to contact with the esters. Types of glycol ethers in vitro experimental results on MC> EC> BC quickly appeared in the following order: skin permeation was beneficial to the skin permeation small molecular weight, the difference in chemical structure, such as hydrophilic, because with the partition coefficient and solubility mechanisms and passive diffusion to increase the speed at which transmission is considered.

Effects of a Critical Pathway of Posterolateral Fusion in Patients with Lumbar Spinal Stenosis (측후방융합술을 시행한 요추관협착증 환자의 Critical Pathway 적용효과)

  • Park, Hae-Ok
    • Journal of Korean Academy of Nursing Administration
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    • v.7 no.2
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    • pp.265-284
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    • 2001
  • The case management has been applied to improve the quality of care and the cost-effectiveness in the most health care institutions. In a way of case management, the critical pathway(CP) has been executed in many acute care settings, focused on the diagnoses with high cost, high volume, and high risk. This study was conducted to develop a case management program using CP as an intervention of patients with lumbar spinal stenosis for the surgery of posterolateral fusion, and to find out the effects of the critical pathway on the quality of nursing care, patient satisfaction as an outcome of care, length of stay and medical charge, and nurses' job satisfaction. At the same time, patients' functional states were checked with the Oswestry Low Back Pain Index, to show that the CP would not decrease the patients' function compared to the control group. The subjects were 25 control patients with a usual operation of lumbar fusion and 25 experimental patients with CP. They were all female, aged $50s{\sim}70s$, admitted in the Orthopedic surgery ward of a university hospital. Also nurses on the floor using CP were asked to respond to measurement tool of job satisfaction before and after the application of CP, and compared with other nurses on the different wards. Data were analyzed with t-test for continuous variables and chi-square for non-parametric variables in addition to the reliability test of the measurement tools. The results of this study were as followings: 1. Patients' functional states The differences in Oswestry scores of the experimental and control groups assessed at preoperation and at discharge were not statistically significant. The change in scores of the experimental group measured at preoperation and at discharge was larger than that of the control group, however the difference was not statistically significant. The results indicate that the CP did not decrease the patients' functional status. 2. The quality of nursing care The total of quality of nursing care given to the experimental group was better than that of the control group(P=.000). In addition, the experimental group showed better scores of quality of every item of care than the control group(P=.000 -.004). 3. Patient satisfaction Patients of the experimental group were not more satisfied with general care than the control group. But they were more satisfied with discharge care of 'explanation about medication, body posture, and brace application' and 'explanation about the adjustment of daily living and exercise during recovery'(P= .047, P=.028). 4. Nurses' job satisfaction Nurses working with the CP showed more job satisfaction than before the CP introduction(P=.048). But the control group of nurses on a different floor showed no change in job satisfaction at the same period of time. 5. Length of stay and medical charge The mean length of stay of the experimental group was shorter than that of the control group without statistical significance. The charge of medication and treatment of the experimental group were smaller than that of the control group(P=.011, P=.000). The results of the study support that the case management using critical pathway enables to improve the quality of care and job satisfaction, to reduce the medical charge, and consequently to increase satisfaction with care. However, the case management should be instituted focusing on the quality improvement of nursing and the client satisfaction, not just for the purpose of cost-effectiveness of health care facilities.

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Study on the Fire Risk Prediction Assessment due to Deterioration contact of combustible cables in Underground Common Utility Tunnels (지하공동구내 가연성케이블의 열화접촉으로 인한 화재위험성 예측평가)

  • Ko, Jaesun
    • Journal of the Society of Disaster Information
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    • v.11 no.1
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    • pp.135-147
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    • 2015
  • Recent underground common utility tunnels are underground facilities for jointly accommodating more than 2 kinds of air-conditioning and heating facilities, vacuum dust collector, information processing cables as well as electricity, telecommunications, waterworks, city gas, sewerage system required when citizens live their daily lives and facilities responsible for the central function of the country but it is difficult to cope with fire accidents quickly and hard to enter into common utility tunnels to extinguish a fire due to toxic gases and smoke generated when various cables are burnt. Thus, in the event of a fire, not only the nerve center of the country is paralyzed such as significant property damage and loss of communication etc. but citizen inconveniences are caused. Therefore, noticing that most fires break out by a short circuit due to electrical works and degradation contact due to combustible cables as the main causes of fires in domestic and foreign common utility tunnels fire cases that have occurred so far, the purpose of this paper is to scientifically analyze the behavior of a fire by producing the model of actual common utility tunnels and reproducing the fire. A fire experiment was conducted in a state that line type fixed temperature detector, fire door, connection deluge set and ventilation equipment are installed in underground common utility tunnels and transmission power distribution cables are coated with fire proof paints in a certain section and heating pipes are fire proof covered. As a result, in the case of Type II, the maximum temperature was measured as $932^{\circ}C$ and line type fixed temperature detector displayed the fire location exactly in the receiver at a constant temperature. And transmission power distribution cables painted with fire proof paints in a certain section, the case of Type III, were found not to be fire resistant and fire proof covered heating pipes to be fire resistant for about 30 minutes. Also, fire simulation was carried out by entering fire load during a real fire test and as a result, the maximum temperature is $943^{\circ}C$, almost identical with $932^{\circ}C$ during a real fire test. Therefore, it is considered that fire behaviour can be predicted by conducting fire simulation only with common utility tunnels fire load and result values of heat release rate, height of the smoke layer, concentration of O2, CO, CO2 etc. obtained by simulation are determined to be applied as the values during a real fire experiment. In the future, it is expected that more reliable information on domestic underground common utility tunnels fire accidents can be provided and it will contribute to construction and maintenance repair effectively and systematically by analyzing and accumulating experimental data on domestic underground common utility tunnels fire accidents built in this study and fire cases continuously every year and complementing laws and regulations and administration manuals etc.