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The In-hospital Analysis of Outcome of Off-pump CABG and On-pump CABG (비체외순환 및 체외순환하에서의 관상동맥우회로술의 임상 고찰)

  • 안재범;김인섭;정성철;배윤숙;유환국;김병열;김우식
    • Journal of Chest Surgery
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    • v.37 no.9
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    • pp.762-767
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    • 2004
  • With the developement of non-invasive surgical techeniques, coronary artery bypass graft without cardiopulmonary bypass has become popular. We compared the preoperative risk factors and in-hospital outcomes of patients having off-pump CABG with these having on-pump CABG. Material and Method: From January 2001 to June 2003, 87 patients underwent CABG. Thirty-sin patients underwent on-pump CABG, fifty-one patients under-went off-pump CABG. Preoperative risk factors, extent of coronary disease, operative time, postoperative endotracheal intubation time, duration of ICU stay & hospital stay, the amount of bleeding and postoperative levels of cardiac enzymes were compared in both groups, Result: The were no differences in their sex ratios, ages, preoperative risk factors, preoperative Ml, Canadian classes, extent of coronary artery diseases and, echocardio-graphic ejection fraction between Off-pump CABG and On-pump CABG groups. Off-pump CABG group had significantly lower mean operative time (270$\pm$79.3 min vs 372$\pm$142.2 min, p<0.001), mean ventilation time (17.1$\pm$13.4 hr vs 24.3$\pm$17.8 hr) and CK-MB level (8,9$\pm$18.7 IU/L vs 25.7$\pm$8.4 IU/L) than on-pump CABG groups, On-pump CABG group had more distal grafts (2.2$\pm$0.5 vs 1.7$\pm$0.71 than Off-pump CABG groups did. There were no differences in their postoperative complications and outcomes including amount of postoperative bleeding for 24 hrs, reoperation for bleeding control, mean in-hospital days, postoperative infection, renal failure and neurologic complications between Off-pump CABG and On-pump CABG groups. Conclusion: This study showed that patients who underwent Off-pump CABG had less operation time & intubation time and lower CK-MB level; however, they also have less distal graft. Even though CABG without CPB provided satisfactory results, more clinical experience & longer follow-up is required.

Analysis of health habit and hair mineral nutrition status of media addicted adolescent (미디어중독 청소년의 스마트폰 사용의존도에 따른 건강습관 및 모발 무기질 영양상태 분석)

  • Lim, Hee-Sook;Kim, Soon-Kyung
    • Journal of Nutrition and Health
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    • v.51 no.4
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    • pp.295-306
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    • 2018
  • Purpose: Koreans' internet and smartphone usage hours are steadily increasing and the dependence of young people on smartphones is causing social problems. Therefore, this study was conducted to examine health and dietary habits, as well as hair mineral contents according to the level of dependence of smartphone use among adolescents to clarify the interrelation of smartphone dependence, lifestyle, dietary behavior, and mineral nutrition status. Methods: A total of 80 smartphone-addicted adolescents participated in this study and were divided into three groups (general, potential and danger group) according to smartphone dependence. The subjects' lifestyles and dietary behaviors were then surveyed, and hair mineral contents were analyzed. Results: Higher smartphone dependence was associated with lower average weekly sleeping time and later first smoking age. In the danger group, the rate of eating fast and the rate of snacking twice a day was also relatively high. Parents (45.0%) and mobile (30.0%) were the factors having the greatest influence on an individual's dietary behavior. In the hair mineral analysis, all subjects had lower selenium concentrations and higher lead concentrations than normal. In addition, the levels of aluminum in the danger group were higher than in the normal range and the highest among the three groups. Conclusions: It is necessary to guide adolescents to use smartphones correctly and manage dietary habits. In addition, careful attention is needed the mineral nutritional status of smartphone-addicted adolescents.

The Influence of Musical Activities on Social and Emotional Behavior of Infants (음악활동이 영아의 사회·정서적 행동에 미치는 영향 - 만 2세(25-36개월) 영아를 중심으로)

  • Nam, Ok Seon
    • Journal of Music and Human Behavior
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    • v.4 no.2
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    • pp.18-40
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    • 2007
  • The purpose of this study was to verify the influence of musical activities on social and emotional behavior of infants, through providing musical activities to the infants who were cared in a nursery and observing the interactions between peer group, or a therapist and an infant derived during them. The subject is 24 infants who are under 2 years of age(25~36months) at two nurseries located in Bundang area, and 13 infants among them are randomly assigned as study group and 11 infants as control group. Pretest and posttest about social and emotional behavior are performed, and ITSEA developed by Brggs-Gowan and Carter(2001) and amended by Shin Ji Yeon(2004) was used as an evaluation tool. Infants' changes of interaction behaviors during musical play were also analyzed quantitatively and qualitatively, and for the analysis, infant's social play behavior examination tool developed by Holloway and Reichhart-Erickson(1988) was adopted. Based on time sampling method, each item of this tool was evaluated. Each session was performed for 15 minutes, and 60 times of analysis about interactions per session was conducted at every 15 seconds. The analysis result was showed with a table and a graph, and described qualitatively about behavior changes. When compared social and emotional positive behavior average figures and negative behavior average figures between study group and control group, this study showed that the positive behavior figure of study group was increased and the negative behavior figure was decreased. While concentration and empathy among positive behaviors increased meaningfully, aggression, defiance, separation anxiety and rejection to new things among negative activities also decreased meaningfully. The conclusion of this study is as follows. First, interactions with peers or a therapist based on music and musical experience make an effect on strengthening positive behavior among social and emotional behavior and decreasing negative behavior. Second, music has influence on negative behaviors more than positive behaviors of an infant, and produces a good effect on sub behaviors of negative behaviors specially.

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Infliximab: The Benefit for Refractory Crohn Disease and Top-down Induction Therapy in Severe Crohn Disease (Infliximab: 불응성 크론병 치료법으로서의 유용성과 Top-down 관해 유도 요법으로서의 가능성)

  • Lee, Jee-Hyun;Lee, Hae-Jeong;Park, Sung-Eun;Choe, Yon-Ho
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.11 no.1
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    • pp.28-35
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    • 2008
  • Purpose: The aim of this study is to report the efficacy of infliximab, a monoclonal antibody directed against tumor necrosis factor alpha which is used for both treatment of refractory pediatric Crohn disease (CD) and induction of remission. Methods: Among pediatric patients who were diagnosed with CD at Samsung Medical Center between March 2001 and August 2007, a total of 16 patients were given infliximab to treat conventional therapyresistant refractory CD and severe active CD for induction of remission. Patients needing maintenance therapy were treated with an infliximab infusion every 8 weeks, and fistulizing CD patients occasionally received the infusion upon the condition that a fistula developed. The efficacy of treatment was assessed by comparing the Pediatric Crohn Disease Activity Index (PCDAI), Hct, ESR, CRP, and serum albumin levels using paired t-test. Results: The male/female ratio was 13:3, and the median age was 13 years (range, 21 months~15 years). The patients included 7 cases of therapy-resistant refractory CD, 7 cases of severe active CD, and 2 cases of fistulizing CD. Mean PCDAI before infliximab therapy was 34.19${\pm}$14.96, and mean follow-up PCDAI within 2 to 4 weeks after the last infusion was significantly lower, at 6.88${\pm}$10.31 (p=0.000). Hematological markers such as ESR (p=0.000), serum albumin (p=0.016), and CRP (p=0.009) also improved significantly after infusion. Remission was achieved in 2 of 4 patients refractory to conventional therapy. Among 3 steroid-dependent patients, 2 were able to discontinue steroid therapy, and dose reduction was possible in 1 patient. Remission after top-down therapy without prior use of other immunomodulators was achieved in 6 weeks in all 7 of the patients who had severe CD. Nine of ten refractory fistulizing CD patients also showed improvement after infliximab therapy. Conclusion: Infliximab was effective in pediatric refractory CD for induction of remission and maintenance therapy, as well as in severe CD for top-down induction therapy. Furthermore, infliximab has contributed to steroid cessation and dose reduction. Long-term follow-up evaluation is needed to determine safety and efficacy of infliximab in the future.

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The Incidence and Distribution of Viral Diseases in Barley Fields in Korea (국내 맥류재배지의 바이러스병 발생과 분포)

  • Park, Jong-Chul;Seo, Jae-Hwan;Choi, Min-Kyung;Lee, Kui-Jae;Kim, Hyung-Moo
    • Research in Plant Disease
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    • v.10 no.3
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    • pp.188-193
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    • 2004
  • The symptom expressions such as yellowish and mosaic spots in overwintering barley have been considered to be a damage by cold or water. However, it had revealed that the symptom expressions were caused by viruses throughout three year nationwide surveys. Barley yellow mosaic virus (BaYMV), Barley mild mosaic virus (BaMMV), and Soil-borne wheat mosaic virus (SBWMV) was detected in 2001-2003 and Barley yellow dwarf virus-MA V (BYDV -MA V) from field samples collected on March in 2003. The results of investigation showed that the incidence of BaYMV was more than 70% and that of BaMMV and SBWMV was 15.7-37.4% and 0.7-10.1 % in three year surveys, respectively. The incidence of BYDV-MAV was approximately 1 % in 2003 only. The distribution of BaYMV was relatively uniform throughout barley fields in Korea, but the incidence of the virus in Gyunggi Province was as low as 19% compared to 65-85% in the rest of regions. On the other hand, 70% of BaMMV was found to be in the west south regions of Korea, Jeonbuk and Jeonnam Provinces. Taken together, both BaYMV and BaMMV were thought to be dominant casual agents in overwintering barley by either single or mixed infections. Previous survey data for BaYMV from 1994 to 1996 indicated that the incidence of the virus was approximately 40% in Jeonbuk, Jeonnam, and Gyungnam Provinces. Thus, comparing with the results from the recent nationwide survey, the incidence of BaYMV had been rapidly increasing in overwintering barley fields in the southern part of Korea.

Experiences of the First 130 Patients in Gangnam Severance Hospital (강남세브란스병원 토모테라피를 이용한 치료환자의 130예 통계분석 및 경험)

  • Ha, Jin-Sook;Jeon, Mi-Jin;Kim, Sei-Joon;Kim, Jong-Dae;Shin, Dong-Bong
    • The Journal of Korean Society for Radiation Therapy
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    • v.20 no.1
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    • pp.45-53
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    • 2008
  • Purpose: We are trying to analyze 130 patients' conditions by using our Helical Tomotherapy, which was installed in our center in Oct. 2007. We will be statistically approach this examination and analyze so that we will be able to figure out adaptive plans according to the change in place of the tumor, GTV (gross tumor volume), total amount of time it took, vector (${\upsilon}=\surd$x2+y2+z2) and the change in size of the tumor. Materials and Methods: Objectives were the patients who were medicated with Tomotherapy in our medical center since Oct. 2007 August 2008. The Average age of the patients were 53 years old (Minimum 25 years old, Maximum 83 years old). The parts of the body we operated were could be categorized as Head&neck (n=22), Chest (n=47), Abdomen (n=25), Pelvis (n=11), Bone (n=25). MVCT had acted on 2702 times, and also had acted on our adaptive plan toward patients who showed big difference in the size of tumor. Also, after equalizing our gained MVCT and kv-CT we checked up on the range of possible mistake, using x, y, z, roll and vector. We've also investigated on Set-up, MVCT, average time of operation and target volume. Results: Mean time on table was 22.8 minutes. Mean treatment time was 13.26 minutes. Mean correction (mm) was X=-0.7, Y=-1.4, Z=5.77, roll=0.29, vector=8.66 Head&neck patients had 2.96 mm less vector value in movement than patients of Chest, Abdomen, Bone. In increasing order, Head&neck, Bone, Abdomen, Chest, Pelvis showed the vector value in movement. Also, there were 27 patients for adaptive plan, 39 patients, who had long or multiple tumor. We could know that When medical treatment is one cure plan, it takes 32 minutes, and when medical treatment is two cure plan, it takes 40 minutes that one medical treatment takes 21 minutes, and the other medical treatment takes 19 minutes. Conclusion:With our basic tools, we could bring more accurate IMRT with MVCT. Also, through our daily image, we checked up on the change in tumor so that adaptive plan could work. It was made it possible to take the cure of long or multiple tumor, the cure in a nearby OAR, and the complicated cure that should make changes of gradient dose distribution.

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Structural analysis of the Social Support, Career Capability, Career Decision-making Self-Efficacy and Career Adaptability for the Reemployment Women (재취업여성이 지각한 사회적지지, 진로역량 진로결정자기효능감 및 진로적응성 간의 구조적 관계 분석)

  • Shin, Su-Jeong;Lee, In-Hee
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.19 no.8
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    • pp.422-432
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    • 2018
  • This study is designed to find out the causal relation between social support, career capability, career decision-making self-efficacy and career adaptability for the career interrupted women. For this purposes the scales of social support, career capability, career decision related self efficacy and career adaptability were used. For this study, the questionnaires were distributed from Mar. 2, 2018 to Apr. 6, 2018 to 960 to the career interrupted women who had the experience of getting training at the vocational school, beauty school and women's centers located in Seoul and Gyeonggi area (composed of married women in their 30s and 50s who were receiving the education of beauty care for more than 1-9 months). 920 questionnaires got responded from the women and they were used for the final analysis with Cronbach's ${\alpha}$, exploratory factor analysis, factor analysis, frequency analysis and correlation analysis performed with SPSS program and the structural equation performed with AMOS program. The findings from the analysis are as follows; First, it was found that the structural model between career capability, social support, career decision related self efficacy and career adaptability are proper. Second, the path coefficient of the structural model was found to be statistically significant with respect to all of career capability, social support, career decision related self efficacy and career adaptability. Third, it was found that in the relation between career capability, social support and career adaptability, the career decision related self efficacy has the mediating effect. These results show that if the level of career adaptability is to be enhanced for the caber interrupted women, the career decision related self efficacy can make the critical role in addition to the career capability and social support. So, this study tries to offer the basic data required for the preparation of career and the development of future career for the success of career interrupted women going back to the workplace.

Clinical Study of Acute Pyogenic Osteomyelitis in Children (소아 급성 화농성 골수염의 임상적 고찰)

  • Park, Ji Sook;Yeom, Jeong Suk;Hwang, Sun Chul;Park, Eun Sil;Seo, Ji Hyun;Lim, Jae Young;Park, Chan Hoo;Woo, Hyang Ok;Youn, Hee Shang
    • Clinical and Experimental Pediatrics
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    • v.48 no.7
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    • pp.731-736
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    • 2005
  • Purpose : Acute pyogenic osteomyelitis is uncommon in children. Delayed diagnosis and inappropriate treatment are leading to growth failure and deformation. We review the clinical manifestations and treatment of acute osteomyelitis in children according to age. Methods : A retrospective analysis was made of 32 patients who underwent antibiotic management or operation between Aug 1989 and Dec 2003 for acute pyogenic osteomyelitis in age from 0 to 15 years old. Results : The study group was composed of 21 boys and 11 girls. The subjects were divided into four groups according to age : 0-1 yr(n=6), 1-5 yr(n=11), 6-10 yr(n=8), and 11-15 yr(n=7). Nineteen cases were diagnosed in Winter. Femur was the most common infected site(37.5%). There were no predisposing factor in 17 patients, and 7 of 15 patients had trauma history. Sepsis was important predisposing factor in neonates. The chief complaints were pain, swelling and fever. S. aureus(61%) is the most common organism. Twenty-nine patients were treated with operation and concomitant antibiotics. Two cases had sequelae in follow-up period : One is avascular necrosis of femur and the other is discrepancy of leg length. Conclusion : In our review, because of poor prognosis in septic neonates, we recommend to treat actively neonatal sepsis and prevent or detect osteomyelitis early. Because most of patients were diagnosed and treated in orthopedic surgery, the rate of operation was too high. So, protocol for further evaluation and management of acute osteomyelitis in pediatric patients were needed.

Clinical features and results of recent total anomalous pulmonary venous connection : Experience in a university hospital (Clinical study of total anomalous pulmonary venous connection) (최근 총폐정맥 환류이상의 임상 경과 및 수술 결과 : 단일 대학병원에서의 경험(총폐정맥 환류이상의 최근 결과))

  • Chu, Mi Ae;Choi, Byung Ho;Choi, Hee Joung;Kim, Yeo Hyang;Kim, Gun Jik;Cho, Joon Yong;Hyeon, Myung Chul;Lee, Sang Bum
    • Clinical and Experimental Pediatrics
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    • v.52 no.2
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    • pp.194-198
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    • 2009
  • Purpose : Active perioperative intervention and improvement on surgical technique has decreased the mortality rate of total anomalous pulmonary venous connection (TAPVC); however, when complicated with pulmonary venous obstruction, operative mortality is still high. The purpose of this study was to investigate the clinical course of TAPVC. Methods : Twenty-seven patients who were diagnosed with TAPVC (without other complex heart anomalies) by echocardiogram at Kyungpook National University Hospital from January 1994 to February 2008 were included. Results : Mean age at diagnosis was $28.1{\pm}33.4$ days (1-126 days). Sites of drainage were supracardiac type (15), cardiac (6), infracardiac (5), and mixed (1). Seven patients had pulmonary venous obstruction: 5 with supracardiac type, 1 with cardiac, and 1 with infracardiac. Intraoperative trans-esophageal echocardiograms were performed in 14 patients (58.3%). The operative mortality was 16.7% (4 of 24) and overall hospital mortality (including deaths without operation) was 22.2% (6 of 27). There were 5 postoperative pulmonary venous obstructions. The sites of obstruction were anastomotic in 3 of 5 (60%) patients, and ostial pulmonary vein in the other 2 (40%) patients. Three patients who presented with anastomotic pulmonary venous obstruction underwent reoperation, but all the patients were found to have pulmonary venous anastomotic obstruction. The other 2 patients with ostial pulmonary vein obstruction who had no significant symptoms were diagnosed by routine echocardiographic examination during follow-up. Conclusion : In TAPVC patients, early diagnosis and aggressive surgical management will improve prognosis, and we must pay attention to early and late pulmonary vein restenosis through intraoperative trans-esophageal echocardiogram and peri- and post-operative echocardiographic follow-up examinations.

Effect of joint mobilization on improvement of knee pain, isokinetic strength, muscle tone, muscle stiffness in an elite volleyball player with knee injury (무릎손상 엘리트 배구선수에 관절가동운동이 무릎통증, 등속성 근력, 근긴장도, 근경직 개선에 미치는 효과)

  • Wang, Joong-San;An, Ho-Jung;Kim, Yong-Youn
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.17 no.7
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    • pp.326-333
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    • 2016
  • This case study identified the effects of joint mobilization on knee pain, isokinetic strength, muscle tone, and muscle stiffness in an elite volleyball player with a knee injury. The subject had experienced cartilage defects of the left knee joint and underwent surgery to correct the condition. The patient complained of continuous pain in the left knee joint in daily life in addition to pain during exercise. The study was conducted from August 5 to 12, 2015 and joint mobilization was applied to the left knee joint for 15 minutes once a day for 8 days. Knee pain was measured using a visual analogue scale, and the concentric peak torque of the quadriceps and hamstring muscles was measured using an isokinetic muscular strength measurement device. The muscle tone and stiffness of the rectus femoris muscle, vastus medialis, and vastus lateralis on the injured side were measured using a myotonometer. All the measurements were conducted before and after the intervention. Joint mobilization was effective in reducing knee pain on the injured side, increasing the concentric peak torque of the quadriceps and hamstring muscles on both sides, and increasing the muscle stiffness of the quadriceps muscle on the injured side. Concentric peak torque of the quadriceps muscle on the injured side increased a great deal as the number of joint mobilizations was increased, largely diminishing the difference in concentric peak torque between the normal side and injured side. On the other hand, joint mobilization was ineffective in improving the hamstring to quadriceps strength ratio on the injured side. While this study suggests that joint mobilization can be an effective intervention to improve the knee pain, isokinetic strength, and muscle stiffness of elite volleyball players, it should be performed alongside training for an appropriate strength ratio.