• Title/Summary/Keyword: 위험성분석

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Post-Infarction Ventricular Septal Rupture : 10 Years of Experience (급성 심근경색증 후 심실중격 결손: 10년 경험)

  • Jung, Yo-Chun;Cho, Kwang-Ree;Kim, Ki-Bong
    • Journal of Chest Surgery
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    • v.40 no.5 s.274
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    • pp.351-355
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    • 2007
  • Background: Postinfarction ventricular septal rupture is associated with mortality as high as $85\sim90%$, if it is treated medically. This report documents our experience with postinfarction ventricular septal rupture that was treated surgically, Material and Method: We retrospectively reviewed the medical records of 11 patients who were operated on due to postinfarction ventricular septal rupture between August 1996 and August 2006. There were 4 men and 7 women, with a mean age of $70{\pm}11$ years (age range: $50\sim84$ years). The location of the rupture was anterior in 7 cases and posterior in 4 cases. The interval between the onset of acute myocardial infarction and the occurrence of the ventricular septal rupture was $2.0{\pm}1.3$ days (range: $1\sim5$ days). Operation was performed at an average of $2.4{\pm}2.7$ days (range: $0\sim8$ days) after the diagnosis of septal rupture. Preoperative intraaortic balloon pump therapy was performed in 10 patients. Result: The infarct exclusion technique was used in all cases. Coronary artery bypass grafting was done in 8 cases, with the mean number of distal anastomosis being $1.0{\pm}0.8$. There was one operative death. In 2 patients, reoperation was performed due to a residual septal defect. The postoperative morbidities were transient atrial fibrillation (n=7), paroxysmal supraventricular tachycardia (n=1), low cardiac output syndrome (n=3), bleeding reoperation (n=2), delayed sternal closure (n=2), acute renal failure (n=2), pneumonia (n=1), intraaortic balloon pump-related thromboembolism (n=1), and transient delirium (n=2). Nine patients have been followed up for a mean of $38{\pm}40$ months except for one follow-up loss. There have been 3 late deaths. At the latest follow-up, all 6 survivors were in a good functional class. Conclusion: We demonstrated satisfactory operative and midterm results with our strategy of preoperative intraaortic balloon pump therapy, early repair of septal rupture by infarct exclusion and combined coronary revascularization.

The comparison of inflammatory mediator expression in gingival tissues from human chronic periodontitis patients with and without type 2 diabetes mellitus (단순 만성 치주염 환자 및 2형 당뇨병환자의 만성 치주염 치은조직에서 염증성 매개인자의 발현 양상 비교)

  • Joo, Sang-Don;Lee, Jae-Mok
    • Journal of Periodontal and Implant Science
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    • v.37 no.sup2
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    • pp.353-369
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    • 2007
  • Gingival tissue samples were obtained during periodontal surgery or tooth extraction. According to the patient's systemic condition & clinical criteria of gingiva, each gingival sample was divided into three groups. Group 1 (n=8) is clinically healthy gingiva without bleeding and no evidence of bone resorption or periodontal pockets, obtained from systemically healthy 8 patients. Group 2 (n=8) is inflamed gingiva from patients with chronic periodontitis. Group 3 (n=8) is inflamed gingiva from patients with chronic periodontitis associated with type 2 diabetes. Tissue samples were prepared and analyzed by Western blotting. The quantification of $IL-1{\beta}$, MMP-13 and TIMP-1 were performed using a densitometer and statistically analyzed by one-way ANOVA followed by Tukey test. 1. The expressions of MMP-13 and TIMP-1 showed increasing tendency in group 2 & 3 compared to group 1. 2. The expressions of $IL-1{\beta}$ & MMP-13 were showed increasing tendency in group 3 compared to group 2. 3. As $IL-1{\beta}$ levels were increasing, MMP-13 showed increasing tendency in group 3, and although $IL-1{\beta}$ , MMP-13 levels were increasing, TIMP-1 levels were similar expressed comparing to group 2. In conclusion, this study demonstrated that the expression levels of MMP-13 and TIMP-1 had increasing tendency in inflamed tissue. It can be assumed that $IL-1{\beta}$ and MMP-13 may be partly involved in the progression of periodontal inflammation associated to type 2 DM.

Food Safety and Nutrition Education Program for Elderly and Assessment of Program Effectiveness Based on Health Belief Model (건강신념모델에 근거한 노인 대상 식품안전·영양교육 프로그램 효과 평가)

  • Choi, Jung-Hwa;Lee, Eun-Sil;Lee, Yoon-Jin;Lee, Hye-Sang;Chang, Hye-Ja;Lee, Kyung-Eun;Yi, Na-Young;Ahn, Yoon;Kwak, Tong-Kyung
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.45 no.9
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    • pp.1366-1374
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    • 2016
  • Most elderly have difficulties in managing food safety and nutrition by themselves. Various nutrition educations for the elderly have been developed, but food safety and nutrition education program and educational tools for the elderly are very limited. The aim of the study was to evaluate a food safety and nutrition education program based on the Health Belief Model (HBM) for the elderly. Education program was implemented for 220 seniors (137 educated group and 83 control group) aged over 65 years at senior welfare community centers. The intervention study was carried out on a weekly basis during each of 5 weeks, and each session lasted about 35 or 40 minutes. The effectiveness of the program was assessed with a questionnaire before and after education. Education program consisted of a 5 week program, and topics were 'Dietary changes for the elderly's healthy life', 'Prevention of food poisoning in everyday life', 'Safe food handling for my health', 'Healthy dietary life to prevent chronic disease', and 'Safety! nutrition! healthy dietary life'. Education program materials such as slides, handouts, videos, leaflet, and booklets were developed. As a result, there were score improvements in knowledge, dietary behaviors, and health belief after intervention in the intervention group, which were higher than those of the control group. In particular, there was a meaningful interrelation between dietary behavior and health belief (r=0.520, P<0.001). This finding suggests that changing beliefs is very important to make desirable dietary behavioral changes. For this reason, we can conclude HBM theory is an effective model to educate nutrition and food safety for the elderly. Furthermore, food safety and nutrition education programs are implemented and delivered continuously at various settings such as a health center or community welfare center, and those will contribute significantly to enhance perception and change their desirable dietary behaviors for the elderly.

Changes of Lipid and Lipoprotein Compositions in Kawasaki Disease and its Impact on Cardiac Complications (가와사끼병에서 혈중 지질과 지단백의 변화와 심장 합병증에 미치는 영향에 관한 연구)

  • Yun, Sin Weon;Lee, Ho Seok;Kim, Dong Woon;Rhee, Kang Won;Jung, Young Soo
    • Clinical and Experimental Pediatrics
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    • v.48 no.12
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    • pp.1370-1377
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    • 2005
  • Purpose : Delineation of serum lipid and lipoprotein values in children after Kawasaki disease(KD) is important because of the predilection of this disease for the coronary arteries. Methods : The KD group was composed of 51 patients who were hospitalized from Jan. 2002 to Dec. 2003. Control was 25 patients with non-KD febrile illness. The levels of total lipid, phospholipid, triglyceride, HDL-cholesterol(HDL-C), LDL-cholesterol, total cholesterol, apolipoprotein A1(apo A1), apolipoprotein B, and Lipoprotein(a) were measured and compared with Echocardiographic findings. Measurements were obtained in four time periods: acute febrile, subacute, convalescent phase and 1 year after KD. Results : HDL-C($33.64{\pm}7.49mg/dL$ vs $50.43{\pm}14.41mg/dL$, P<0.01) and apo A1($99.75{\pm}6.39mg/dL$ vs $113.34{\pm}11.35mg/dL$, P<0.05) were decreased more in the acute febrile period of KD than in the control, but these changes were not correlated with cardiac complications. All lipid profiles were markedly elevated in the subacute stage and normalized in the convalescent stage; there were no changes until 1-year follow up. There were no significant differences in the changes of lipid profiles, including Lp(a) and coronary dilatation, in any time periods. Conclusion : KD is associated with important abnormalities in lipid metabolism, but these changes were transient and appear to be due to the disease itself. These data lead us to infer that KD dose not cause such permanent changes in lipid abnormalities as to be considered a risk factor for atherosclerosis, beyond that caused by the disease itself.

The characteristic laboratory findings of non-responsiveness to intravenous immunoglobulin in children with Kawasaki disease (가와사끼병 재 치료군의 특징적인 검사 지표)

  • Cho, Han Gil;Cho, Young Kuk;Ma, Jae Sook
    • Clinical and Experimental Pediatrics
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    • v.53 no.2
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    • pp.228-234
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    • 2010
  • Purpose : Although intravenous immunoglobulin (IVIG) treatment is an effective first-line treatment for Kawasaki disease, 10-20% of the patients develop persistent fever or coronary artery complications. Medical records of Kawasaki disease patients were reviewed to assess the characteristic laboratory findings of IVIG nonresponsiveness. Methods : We reviewed the clinical records of 118 children with Kawasaki disease who were treated at the Chonnam National University Hospital from March 2003 to February 2008. The laboratory findings of the IVIG-responder group (n=110) and the IVIG-nonresponder group (n=8) were compared at admission day and at 48 hours and 14 days after IVIG administration. Results : At admission, the level of creatine kinase (CK) was lower (P =0.03) and that of total protein was higher (P <0.01) in the nonresponders than in the responders. At 48 hours after IVIG administration, the white blood cell (WBC) count (P =0.04) and neutrophil% (P <0.01) was higher in the nonresponders than in the responders. The neutrophil% (P <0.01) and CK (P =0.01) level at admission was lower than that at 48 hours after IVIG administration in the responders; this decrease was not as apparent in the nonresponders. Conclusion : IVIG nonresponders have lower CK and higher total protein levels at admission and higher WBC count and neutrophil% at 48 hours after IVIG administration. The decrease in the neutrophil% and CK level between at admission and at 48 hours after IVIG administration is remarkably higher in responders than in nonresponders.

Strategy for Bio-Diversity and Genetic Conservation of Forest Resources in Korea (생물종(生物種) 다양성(多樣性) 및 삼림유전자원(森林遺傳資源) 보존(保存) 전략(戰略))

  • Park, Young Goo
    • Journal of Korean Society of Forest Science
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    • v.83 no.2
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    • pp.191-204
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    • 1994
  • Due to its topographic complexities and various climatical condition, Korea exhibits diverse forest types. Dominant tree species in this zone are Quercus spp., Betula spp., Zelkova spp., Fraxinus spp., Pinus densiflora, Pinus koraiensis, and Pinus thunbergii ete. Genetic conservation in forest species in Korea there are three ways ; one is in situ, other is ex situ and third is in-facility conservation. In situ conservation include that are the present status of conservation of rare and endangered flora and ecosystem, the reserved forest, the national and provincial park, and the gene pool of natural forests. Ex situ conservation means to be established the new forest from in situ forest stands, progeny and provenance test populations, seed orchard and clone banks, and gene conservation in-facility. As a tool for low temperature storage, several aspects on in vitro system were studied ; (1) establishment of in vitro cultures from juvenile and/or rejuvenated tissues, (2) induction of multiple shoots from the individual micropropagules, (3) elongation of the proliferated shoots. Studies on cold storage for short-and long-term maintenance of in vitro cultures under $4^{\circ}C$ in the refrigerator were conducted. For the cryopreservation at $-196^{\circ}C$, various factors affecting survivability of the plant materials are being examined. The necessity of gene conservation of forest trees is enlarged not only to increase the adaptability for various environments but also to gain the breeding materials in the future. For effective gene conservation of forest trees, I would like to suggest followings ; 1. Forest stands reserved for other than the gene conservation purposes such as national parks should be investigated by botanical and gene-ecological studies for selecting bio-diversity and gene conservation stands. 2. Reserved forest for gene pool should be extented both economically important tree spp. and non-economical species. 3. Reserved forest for progeny test and clone bank should be systematically investigated for the use of Ex situ forest gene conservation. 4. We have to find out a new methodology of genetic analysis determining the proper and effective size of subpopulation for in situ gene conservation. 5. We should develop a new tree breeding systems for successful gene conservation and utilization of the genetic resources. 6. New method of in-facility gene conservation using advanced genetic engineering should be developed to save time and economic resources. 7. For the conservation of species with short-life span of seed or shortage of knowledge of seed physiology, tissue culture techniques will be played a great role for gene conservation of those species. 8. It is are very useful conservation not only of genes but of genotypes which were selected already by breeding program. 9. Institutional and administrative arrangements including legistlation must be necessarily taken for gene conservation of forest trees. 10. It is national problems for conservation of forest resources which have been rapidly destroyed because of degenerating environmental condition and of inexperienced management system of bio-diversity and gene conservation. 11. In order to international cooperation for exchanging data of bio-diversity and gene conservation, we should connect to international net works as soon as possible.

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Psychosocial Characteristics and Factors Associated with Referral to Psychiatric Care in the Suicide Attempters Visiting Emergency Center (응급실에 내원한 자살 시도자들의 정신사회학적 특성과 정신건강의학과 진료 의뢰 관련 요인)

  • Kwon, Jung-Woo;Ko, Young-Hoon;Han, Chang-Su;Lee, Moon-Soo;Yoon, Ho-Kyung;Lee, Hongjae
    • Korean Journal of Psychosomatic Medicine
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    • v.21 no.2
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    • pp.106-113
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    • 2013
  • Objectives: The purpose of this study was to examine the characteristics and the psychosocial factors associated to the referral to psychiatric care in the suicide attempters visiting emergency center. Methods: We conducted a systematic chart review of 377 suicidal attempters visiting emergency center of the Korea University Ansan Hospital between January 2008 and December 2011. We gathered a data contain 20 items including psychosocial characteristics and factors related to suicide and factors related to psychiatric treatment. Multivariate logistic regression models were fitted to data to estimate the unique effects of sex, drunken status, companion, suicidal methods, place of suicide and current use of psychiatric medication on the referral to psychiatric care. Results: The female gender(OR=1.63, 95% CI=0.99-2.69), suicidal attempts at home(OR=3.40, 95% I= 1.21-9.56) and drunken state at visit(OR=2.34, 95% CI=1.10-5.01) are the factors that predict the risk of the non-referral of the patients to psychiatric intervention. Place of suicidal attempt was the most important factor do play a role in determining whether referral to psychiatric care will take place or not. Current use of psychiatric medication showed a trend toward significance(p=0.08, OR=1.67, 95% CI=0.95-2.95). Conclusions: These results suggest that when deciding whether to adapt or to refuse the referral to psychiatric care, the factors such as suicidal intent, lethality of suicide methods, familiar factors and alcohol may contribute onto the referral to psychiatric care. Additional research is required to investigate an association of these factors with referral to psychiatric care.

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Estimated flavonoid intakes according to socioeconomic status of Korean adults based on the Korea National Health and Nutrition Examination Survey 2007~2012 (우리나라 성인의 사회경제적 수준에 따른 플라보노이드 섭취현황 : 2007~2012년 국민건강영양조사 자료를 이용하여)

  • Kim, Seong-Ah;Hei, Yang;Jun, Shinyoung;Wie, Gyung-Ah;Shin, Sangah;Hong, Eunju;Joung, Hyojee
    • Journal of Nutrition and Health
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    • v.50 no.4
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    • pp.391-401
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    • 2017
  • Purpose: The purpose of this study was to estimate the dietary flavonoid intakes of Korean adults according to socioeconomic status. Methods: Using data from the 2007~2012 Korea National Health and Nutrition Examination Survey, a total of 31,112 subjects aged over 19 years were included in this study. We estimated individuals' daily intakes of total flavonoids and seven flavonoid subclasses, including flavonols, flavones, flavanones, flavan-3-ols, anthocyanins, proanthocyanidin, and isoflavones,by linking food consumption data with the flavonoids database for commonly consumed Korean foods. We compared intakes of flavonoids according to the levels of household income and education. Results: Average dietary flavonoid intakes of the study subjects were 321.8 mg/d in men and 308.3 mg/d in women. Daily flavonoid intakes were positively associated with household income level (p < 0.0001) and education level (p < 0.0001). The subjects in the highest household income and highest education level group (OR 0.37, 95% CI 0.30~0.45, p < 0.0001 in men, OR 0.50, 95% CI 0.41~0.60, p < 0.0001 in women) had a lower likelihood of having low total flavonoid intake (less than 25 percentile) compared to the lowest household income and lowest education level group. The food group that contributed to total flavonoid intake with the biggest difference between the lowest and highest groups for both household income level and education level was beverages. Conclusion: This study shows that socioeconomic status was positively associated with flavonoid intake in a representative Korean population. Further research is needed to analyze the association of flavonoid intake with health outcomes according to socioeconomic status such as household income and education level.

Nuclear Terrorism and Global Initiative to Combat Nuclear Terrorism(GICNT): Threats, Responses and Implications for Korea (핵테러리즘과 세계핵테러방지구상(GICNT): 위협, 대응 및 한국에 대한 함의)

  • Yoon, Tae-Young
    • Korean Security Journal
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    • no.26
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    • pp.29-58
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    • 2011
  • Since 11 September 2001, warnings of risk in the nexus of terrorism and nuclear weapons and materials which poses one of the gravest threats to the international community have continued. The purpose of this study is to analyze the aim, principles, characteristics, activities, impediments to progress and developmental recommendation of the Global Initiative to Combat Nuclear Terrorism(GICNT). In addition, it suggests implications of the GICNT for the ROK policy. International community will need a comprehensive strategy with four key elements to accomplish the GICNT: (1) securing and reducing nuclear stockpiles around the world, (2) countering terrorist nuclear plots, (3) preventing and deterring state transfers of nuclear weapons or materials to terrorists, (4) interdicting nuclear smuggling. Moreover, other steps should be taken to build the needed sense of urgency, including: (1) analysis and assessment through joint threat briefing for real nuclear threat possibility, (2) nuclear terrorism exercises, (3) fast-paced nuclear security reviews, (4) realistic testing of nuclear security performance to defeat insider or outsider threats, (5) preparing shared database of threats and incidents. As for the ROK, main concerns are transfer of North Korea's nuclear weapons, materials and technology to international terror groups and attacks on nuclear facilities and uses of nuclear devices. As the 5th nuclear country, the ROK has strengthened systems of physical protection and nuclear counterterrorism based on the international conventions. In order to comprehensive and effective prevention of nuclear terrorism, the ROK has to strengthen nuclear detection instruments and mobile radiation monitoring system in airports, ports, road networks, and national critical infrastructures. Furthermore, it has to draw up effective crisis management manual and prepare nuclear counterterrorism exercises and operational postures. The fundamental key to the prevention, detection and response to nuclear terrorism which leads to catastrophic impacts is to establish not only domestic law, institution and systems, but also strengthen international cooperation.

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Ventilator-Associated Pneumonia in Neonatal Intensive Care Unit : Clinical Manifestations, Ddiagnostic Availability of Endotracheal Tip Culture (신생아 집중치료실에서 인공 환기요법 관련 폐렴의 임상양상과 기관내 삽관의 유용성에 관한 연구)

  • Kim, Nam Young;Sung, Tae Jung;Shin, Seon Hee;Kim, Sung Koo;Lee, Kon Hee;Yoon, Hae Sun
    • Pediatric Infection and Vaccine
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    • v.12 no.1
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    • pp.67-74
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    • 2005
  • Purpose : The incidence of mortality associated with respiratory difficulties is decreasing nowadays contributed to the development of neonatology. However, complications associated with mechanical ventilator are increasing. This study is to determine clinical manifestations, diagnositc availability of the endotracheal tip culture in patients with Ventilator-Associated Pneumonia(VAP) in neonatal intensive care unit(NICU). Methods : A retrospective analysis of 50 neonates who were admitted to the NICU of Kangnam Sacred Heart Hospital and had given mechanical ventilator from 1 January 2000 to 30 June 2003. VAP group defined as neonates who had pneumonia with mechanical ventilation longer than 48 hours. They were classified into VAP group(n=13) and control group (n=37) and the prevalence, microorganisms cultured from the endotracheal tube tip and risk factors were investigated. Results : The prevalence of VAP was 26.0%(n=13) and the most dominant microorganism cultured in our NICU was methicillin-resistant coagulase negative staphylococcus(MR-CNS) in 4 cases. Other microorganisms were Pseudomonas, Enterobacter, methicillin-resistant Staphylococcus aureus(MRSA) and Klebsiella. Gestational age, birth weight, Apgar score, respiratory distress syndrome, retinopathy of prematurity, bronchopulmonary dysplasia, sepsis, renal failure, pulmonary hemorrhage, pneumothorax were not different significantly between two groups except intraventricular hemorrhage(P<0.001) and patent ductus arteriosus(P<0.05). Duration of hospital stay and mortality rate were also not different significantly. Conclusion : VAP occurred at a significant rate among mechanically ventilated NICU patients. Despite of limitation of encotracheal tip culture, the most common microorganism was MR-CNS. We should be aware of occurrence of VAP in NICU neonate who were with mechanical ventilator and should treat with great care.

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