• Journal of Chest Surgery
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• v.31 no.11
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• pp.1049-1055
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• 1998

Background: Coronary artery bypass surgery is an important treatment for ischemic heart disease. Recently operative mortality and morbidity has decreased, however further improvement is necessary. Materials and methods: This study was designed to evaluate the risk of operative mortality and morbidity by retrospective method. From 1992 to 1997, eighty six patients underwent coronary artery bypass surgery. There were 61 males and 25 females aged 36~74 years(mean, 58.6). Fourteen patients(16%) had previous PTCA or stent insertion, 41 patients(48%) had unstable angina, and 45 patients(52%) had three vessel disease. Patients with low LV ejection fraction(<35%) were 7 cases and urgent or emergent operation were 10 cases. There were 6 cases of combined surgery which were mitral valve replacement(2 cases), aortic valve replacement(2 cases), ASD repair(1 case), and VSD repair(1 case). Average number of distal anastomosis was 3.5 per patient and average aortic cross clamp time was 115±38.3min. Preoperative risk factors were defined as follows: female, old age(>70 years), low body surface area(<1.5M2), PTCA or stent insertion history, hypercholesterolemia, smoking, hypertension, DM, COPD, urgent or emergent operation, left main disease, low LV ejection fraction(<35%), and combined surgery. Results: Operative mortality was 7cases(8%). As a postoperative morbidity, perioperative myocardial infarction was 6 cases, cerebrovascular accident 6 cases, reoperation for bleeding 5 cases, acute renal failure 4 cases, gastrointestinal complication 3 cases, and mediastinitis 3 cases. In the evaluation of operative risk factors, low body surface area, DM and low LV ejection fraction were found to be predictive risk factors of postoperative morbidity(p<0.05), and low ejection fraction was especially a risk factor of hospital mortality(p<0.05). Conclusions: In this study, low body surface area, DM and low LV ejection fraction were risk factors of postoperative morbidity and low ejection fraction was a risk factor of hospital mortality.

• The Journal of the Korea Contents Association
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• v.14 no.5
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• pp.251-261
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• 2014

Primary percutaneous coronary intervention (PCI) has been found to be superior, in terms of hospital mortality and long-term outcome, compared with thrombolytic therapy in patients with acute myocardial infarction (AMI). However, the clinical benefits of primary PCI have not been precisely evaluated in elderly patients.1,974 patients (Group I: n=1,018, $age{\geq}65years$, $73.8{\pm}5.99years$; Group II: n=956, age<65years, $52.8{\pm}7.96years$) who underwent primary PCI for AMI at Chonnam National University Hospital between 2006 and 2010 were analyzed according to their clinical, angiographic characteristics for hospital and one-year survival. Group I had a higher percentage of women, diabetes mellitus, hypertension, multi-vessel disease and lower prevalence of current smoking, hyperlipidemia, familial history than Group II. Culprit lesions were at the left anterior descending artery, left circumflex artery, right coronary artery and left main artery in 42.8% vs. 45.0%, 34.1% vs. 29.6%, 14.6% vs 14.6, 2.7% vs. 1.6%, respectively (p=0.007). Stent diameter was smaller in group I ($3.17{\pm}0.39$ vs. $3.29{\pm}0.42mm$, p=0.001). In-hospital mortality was higher in group I (8.4 vs. 1.9%, p<0.001). There were significant differences in the rates of major adverse cardiac events between the two groups during one-year clinical follow-up (20.1 vs.14.0%, p<0.001). On multiple logistic regression analysis, systolic blood pressure<100mmHg, serum $creatinine{\geq}1.3mg/dL$, Killip class> I, multivessel disease, left ventricular ejection fraction <40% and cerebro vascular disease were independent predictors of one-year motality in patients over 65 years after PCI.

• Journal of Preventive Medicine and Public Health
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• v.29 no.3 s.54
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• pp.693-700
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• 1996

The purpose of this study was to determine whether workers at a factory next to a lead recycling factory in Pusan, were affected by lead contamination. The mean air lead concentration of lead recycling factory was $0.21mg/m^3(TWA=0.05mg/m^3)$. Thirty-nine male workers of Factory A, Cr. plating factory next to the lead recycling factory were exposed group and a comparison group, 62 male workers of Factory B were selected from another Cr. plating factory about 8.5km away from lead recycling factory. Air lead concentration of each workplace was checked for 4 times from August f to August 20 in 1995 by low volume air sampler. Each subject was interviewed about age, life-style, smoking, work history, and residence etc, and venous blood was drawn for lead measurement by graphite furnace atomic absorption spectrometry. We have observed that air lead concentration and blood lead concentration of Factory A was higher than Factory $B(2.6{\pm}1.6\;Vs.\;1.2{\pm}0.2{\mu}g/m^3,\;14.9{\pm}1.6\;Vs.\;12.2{\pm}1.6{\mu}g/dl)$. We believe that other environmental lead sources such as transportation and residence did not affect air lead and blood lead concentration differences of both factory. We concluded that high air lead and blood lead concentration of Factory A were caused by lead contamination generated by the neighboring lead recycling factory.

• Journal of Preventive Medicine and Public Health
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• v.28 no.2 s.50
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• pp.462-472
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• 1995

This study examined the relation between anger-coping types and hypertension in employed men aged $40\sim60$ who consented to participate during the biannual physical checkup in the department of health management in 1988. The subjects analyzed were five hundred thirteen excluding those having hypertension history and/or current antihypertensive medications. Anger-coping types were constructed from the Harburg's model with two hypothetical anger-provoking situations involving wife and boss. Hypertensives were defined more than 140mmHg systolic blood pressure and/or 90mmHg diastolic blood pressure. Hypertensives were one hundred fifty two(29.6%) and those who suppressed their anger were 61.6% and 62.8% in wife and boss situations respectively. Items of anger, guilt, protest, and suppressed anger in wife situation showed odds ratios of 0.78-0.94 without statistical significance. But four items in boss situation showed odds ratios more than 1, especially anger-in types of anger item had 1.58 times the prevalence of hypertension of anger-out types(95% confidence intervals(CI) $1.06\sim2.35$) and subjects who indicated that suppressed their anger had 1.55 times the prevalence of hypertension of those who expressed their anger(95% CI $1.03\sim2.32$). For anger suppressed vs. expressed types of total suppressed anger index, prevalence of hypertension was 1.31 (95% CI $0.83\sim2.08$). After adjusting for age, body mass index, smoking and drinking, the odds ratios were slightly increased in both situations except guilt items compared with univariate analysis. These results suggest that the relation between Harburg's anger-coping model and hypertension is replicated partially in this subjects.

• Journal of Chest Surgery
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• v.30 no.3
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• pp.308-314
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• 1997

A retrospective review of the histopathology and clinical information of primary lung cancer was performed to investigate the trends in the histologic type related to sex, age, and smoking history. During January 1988 and July 1995, 541 pateints were diagnosed as primary lung cancer at the Korea Univeristy Anam Hospital. Male (423) to female(118) ratio was 3. 6:1. The most frequent histologic type of lung cancer in male patients was squamous cell carcinoma (223 patients, 52.7%) followed by adenocarcinoma (86, 20.3%) and small cell carcinoma (85, 20.1 %). In female patients, adenocarcinoma (64, 54.2%) wa most common, which was followed by squamous cell carcinoma (22, 18.6%) and small cell carcinoma (22, 18. 6%). The incidence of adenocarnimoma had an increased tendency recently (14.3% in 1988, 33.3% in 1995)(P=0.019). The predominant type in smokers was squamous cell carcinoma; whereas adenocarcinoma was the most frequent type in non-smokers. The proportion of patients aged less than 40 years (younger group) was 4. 0% (n=22). Of them, adenocarcinoma (7) and small cell carcinoma (7) were most common. In patients older than 40 years (older group, n=519), 243 (46.8%) patients had squamous cell carcinoma, and 143 (27.6%) adenocarcinoma. As age increased, the prevalence of squamous cell carcinoma was increased (P=0.0005), adenocarcinoma decreased (P=NS), and small cell carcinoma remained unchanged. We suggest above data as a clinical guidance for management of primary lung cancer.

• Journal of Chest Surgery
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• v.42 no.1
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• pp.53-58
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• 2009

Background: The goal of this study was to compare the patency and complications of femoropopliteal bypass with superficial femoral artery stenting for patients with atherosclerotic superficial femoral artery occlusive disease. Material and Method: Between July 2005 and July 2008, we reviewed 29 femoropopliteal bypass procedures (24 patients) with prosthetic grafts (the bypass group) and 19 superficial femoral artery stentings (15 patients) with nitinol stent (the stent group). There were 35 male patients (89.7%) and the mean age of the patients was 69.2 years (range: 48~84). The number of patients who had DM, hypertension and a smoking history was 25 patients (64.1%), 17 patients (43.6%) and 30 patients (76.9%), respectively. 23 (59.0%) patients had skin ulceration or tissue gangrene at admission. Result: There were 27 cases (93.0%) of TASC C&D lesion in the bypass group and 16 cases (84.2%) of TASC A&B lesion in the stent group. There were significant differences for the indications for a procedure between the two groups (p<0.01). The primary patency rates at 6 months, 12 months and 24 months were 91.9%, 79.7% and 79.7% for the bypass group and 93.3%, 86.2% and 86.2% for the stent group, respectively. There were no statistical difference between the two groups (p=0.48). Conclusion: There were no significant differences in the outcome between two groups. TASC C&D lesion and failed intervention therapy should be treated with femoropopliteal bypass surgery, and TASC A&B lesion and the high-risk patients should be treated with femoral artery stent insertion.

• Journal of Chest Surgery
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• v.42 no.1
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• pp.34-40
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• 2009

Background: The principal surgical technique for treating an abdominal aortic aneurysm since the 1960s has been the transperitoneal approach, yet there have been some recent studies that have reported improved surgical results with using the retroperitoneal approach. However, there are only limited clinical Korean studies that have, compared between the transperitoneal and retroperitoneal approaches. Material and Method: This study included 36 patients who had been diagnosed as having an aneurysm of the abdominal aorta and they were surgically treated between January 2001 and July 2007. The patients were subdivided into the retroperitoneal approach group (n=17) and the transperitoneal approach group (n=19), and they were compared in terms of the preoperative risk factors, the postoperative complications and the operative mortality. The risk factors of operative mortality risk and long-term survival for the 36 patients were assessed by the Kaplan-Meier method. Result: There were no significant differences between the groups in terms of gender, age, the underlying disease, a history of smoking, rupture of aneurysm, the preoperative symptoms, the operation time and the incidence of postoperative complications. However, the duration of postoperative fasting, the number of days of having an indwelling nasogastric tube and the length of the stay in the intensive care unit were significantly short for the retroperitoneal approach group (p<0.05). There was a 16.7% rate of operative mortality (6/36) and five of the deaths were attributed to preoperative ruptured aneurysm. On univariate analysis, a higher preoperative serum creatinine level (SCr ${\geq}$1.8 mg/dL, p=0.016) and ruptured aneurysm (p<0.001) were the significant risk factors of operative mortality. As assessed by the Kaplan-Meier method, the long-term survival was comparable between the groups and the five-year survival rate of all the patients was 57.5%. Conclusion: In the present study, a retroperitoneal approach has several advantages such as a shorter intensive care unit stay, a shorter duration of postoperative fasting and a shorter duration of an indwelling nasogastric tube. Therefore, unless there is any contraindication for a retroperitoneal approach, it could be considered as a primary surgical access for repairing an abdominal aortic aneurysm.

• Journal of Sasang Constitutional Medicine
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• v.12 no.1
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• pp.120-135
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• 2000

Objective ; The purpose of this study is to find out the constitutional symptomatic pattern of Soyangin and Taeumin through investigation of difference between two groups in stroke. Method ; 70 inpatients(Soyangin 31, Taeumin 39) in stroke, admitted into Kyung-Hee Oriental Hospital from 1. July. 1999 to 20. Sept. 1999, were investigated through questionnare which consists of 16 parts 155 questions, and the problems which have significant difference between Soyangin and Taeumin group were analyzed statistically. Result 1. The analysis of general characteristic difference between Soyangin and Taeumin group (1) The number of Soyangin patients is 31, Taeumin 39 and the number of Male patients 43, Female 27. (2) The mean weight of Taeumin group is heavier than that of Soyangin group and the degree of obesity of Taeumin group higher. (3) The number of patients who have smoking history is more at Soyangin group. (4) In neurological problem, dizziness is more complained of in Soyangin group. 2. The analysis about the result of Questionnare (1) In problems related with 'Sleeping', the time of going to bed and getting up and the duration of sleeping are more irregular in Taeumin group. (2) In problems related with 'Defecation', the shape of stool is more variable in Taeumin group. (3) In problems related with 'Urination', Soyangin group have more complaint. (4) In problems related with 'The condition of digestion', Taeumin group have a good appetite and more compalint in lower abdominal region, but on the contrary Soyangin group lose appetite and have more complaint in upper abdominal region. (5) In problems related with 'Head and Face', Soyangin group have more complaint. (6) In problems related with 'Eye, Ear and Nose', Soyangin group have more complaint at eye and ear. (7) In promlems related with 'Chest region', Soyangin group easily feel choked up and Taeumin group heart throbs. (8) In problems related with 'Skin', Taeumin group easily feel change of color tone at skin and Soyangin group dry.

• Journal of agricultural medicine and community health
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• v.26 no.2
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• pp.147-159
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• 2001

A questionnaire survey of 568 women over the age of 30 in 11 dongs of Goryeong- gun was performed to identify the practice rate of breast self- examination and its related factors. It was found that the practice rate of breast self- examination was 28.2%, with 9.7% of those surveyed performing breast self- examinations more than once a month. The practice rate of breast self- examination showed significant differences according to factors, such as age, presence of spouse, educational level, occupation, economic status, smoking, regular exercise and chronic disease. According to age, the highest practice rate of breast self-examination was between the ages of 40-49 and the lowest over the age of 60. The practice rate increased with higher the educational level and presence of spouse. According to occupation, administrative and managerial occupations presented the highest practice rate of breast self- examination. Higher economic status, regular exercise and positive family history of breast cancer each presented high practice rates of breast self- examination. The practice rate revealed higher in those who did not smoke and who had no chronic diseases than others. The greatest reason for performing breast self- examination was decided by myself for health reasons, followed by effect of mass media and promotion by health center. The most common reasons for not performing breast self- examination were don't feel the need, followed by don't know how to perform the exam and don't know about the exam itself. Multiple logistic regression analysis showed that factors, such as over the age of 60, less education, and no experience with mammography all lowered the practice rate of self-breast examination. Inconclusion, the rates of breast self- examination and regular check-ups of people in rural areas, who are characteristically older and have low educational backgrounds, were 28.2% and 9.7%. These results show the immediate need for the education of the methods for breast self- examination to be carried out by health centers in these areas. Such efforts and programs could increase the practice rate of breast self- examination and thereby improve health and enhance the quality of life of women in rural areas.

• Tuberculosis and Respiratory Diseases
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• v.39 no.1
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• pp.15-23
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• 1992

Background: The prognosis of lung cancer remains poor and early detection and curative surgery is still the most effective treatment for many. In the early detection of lung cancer, sputum cytology and simple chest x-ray are used, but both of these tests are far from being perfect. So we studied the characteristics of patients diagnosed as lung cancer without demonstrable mass lesion on simple chest x-ray to help in the early diagnosis of lung cancer. Methods: We conducted a retrospective study on 11 subjects who were diagnosed as lung cancer at Seoul National University Hospital between August 1986 and June 1989 and had no demonstrable mass lesion on simple chest x-rays. Results: Ten of 11 patients were male, 8 had a history of smoking, most frequent symptoms were sputum, cough, and hemoptysis, and 3 patients either had wheezing or stridor. In 3 of the cases, although there were no mass lesion, there were ill-defined infiltration, major fissure thickening, and fibrostreaky density mimiking tuberculosis where the tumor was eventually found and in one patient tumor was masked by a rib shadow. Also in one case, lateral chest film demonstrated a retrocardiac mass. Both bronchoscopy and computed tomogram were useful in the localization of the tumor. Seven of 11 had relatively early disease (less than StageII). Four of 11 are still alive without any evidence of recurrence between 2 and a half and 4 years after the operation. Conclusion: We conclude that in patients with respiratory symtoms in whom cancer cannot be ruled out, sputum cytology and lateral chest x-rays should be taken and that if necessary further studies like computed tomogram and bronchoscopy should be done to aid in the early diagnosis of lung cancer.