• Title/Summary/Keyword: 은인

Search Result 38,565, Processing Time 0.072 seconds

A Survey on the Oral Health Conditions according to Dental Health Behaviors of Elderly People in Community (일부 지역사회 노인들의 구강보건행동에 따른 구강건강상태)

  • Kang, Hyeong-Ku;Yoon, Hyun-Suk;Cho, Young-Chae
    • Journal of agricultural medicine and community health
    • /
    • v.30 no.3
    • /
    • pp.263-277
    • /
    • 2005
  • Objectives: This study aimed to reveal the oral health conditions based on the dental health behaviors of a community-dwelling elderly. Methods: The subjects included 206 rural dwellers(100 men & 106 women) aged over 65 years old, who received dental health check-ups in the local public health center and its branches attached to 6 respective Myons of Chunchongnamdo Province, during the 2-month period from Jan. 1st to Feb. 28th, 2005. They were examined by dentists and given self-administered questionnaires asking about their dental heaith behaviors and subjective symptoms of gingival bleeding. Results: The oral health conditions based on dental health behavior showed that those who have not taken dental health service a year were found to have significantly greater number of missing teeth(p=0.002), DMFT(p=0.002) and CPITN(p=0.018), and those who have not observed intra-oral conditions a week to have significantly less number of filled teeth(p=0.002) and significantly greater number of missing teeth(p=0.000) and CPITN (p=0.000) than their respective counterparts. In terms of brushing, those who brushed their teeth below "3 times/day" were found to have significantly greater number of decayed teeth(p=0.000), missing teeth(p=0.000), DMFT(p=0.000) and CPITN(p=0.000) than their counterparts. In terms of time spent in brushing, those who spends "below 3 minutes" had significantly greater number of missing teeth(p=0.002) and DMFT(p=0.041), and significantly less number of filled teeth(p=0.036). According to the use of aid tools for cleaning teeth, the group who don't use them had significantly greater number of DMFT(p=0.041) and CPITN(p=0.018) than its counterpart. Classified by smoking habits, smoking groups had significantly greater number of decayed teeth(p=0.035) and CPITN(p=0.001) than non-smoking groups. Multiple regression analysis of the study data revealed that the significant factors influencing number of decayed teeth were number of brushing, sex and intra-oral observation (explanatory power of 14.2%). The significant factors for number of filled teeth were sex, intra-oral observation, use of aid tools, frequency of brushing, subjective health conditions and drinking of sweet beverages(explanatory power of 18.2%), those for number of missing teeth, number of brushing and age(explanatory power of 13.9%) those for DMFT, number of brushing, sex, use of dental service, age(explanatory power: 13.5%), and those for CPITN included smoking habits, use of dental service, use of aid tools (explanatory power: 10.8%). Conclusions: The study results revealed that the dental health behavior of the elderly population is in poor conditions and their consequent intra-oral health conditions are not good. To improve their oral conditions, public campaign and education will be needed to modify unhealthy dental health behaviors.

  • PDF

Health Status and Use of Health Care Services of the Elderly Utilizing Senior citizen Centers (경로당 노인의 건강상태와 건강관리서비스 이용 관련요인 분석)

  • Shin, Sun-Hye;Kim, Jin-Soon
    • Journal of agricultural medicine and community health
    • /
    • v.27 no.1
    • /
    • pp.99-113
    • /
    • 2002
  • For this study a sample of 205 people, 66 males and 139 females, over 65 years of age, residing in C-gu of S-si and utilizing senior centers, were selected, The objective of the study was to provide basic data for health promotion program development provided by health centers. A questionnaire was used to collect date on general characteristics, health status, social health status and utilization rate for health services. The instruments used in this study were the Lawton scale, to measure daily routine function, the MMSE-K developed by Folstein and modified to fit the Korea situation, for mental health status, and the CES-Dtool developed by Radloff, for emotional health status. the SPSS Window program was used to calculate percentages. Tests of significance were done using t-test and ANOVA. Multiple regression analysis was used to identify variables influencing the use of health services. The results are as follows : Of those utilizing senior citizen centers, 40.9% of males and 17.3% of the female thought they were healthy. The average score for IADL was 7.4. The daily routine of female respondents consisted of buying household articles and drugs, and other IADLs such as riding the bus or subway alone. These resulted in a higher score compared to males. For emotional health, 7.6% of the males reported depression compared to 21.6% of the females. For mental health, 48.5% of the males and 28.8% of the females were found to be in the group suspicious for dementia. On social health, 57.6% of the males and 62.6% of the females reported no intimate human relations. Of those older people who had close human relations, 52.5% of the males indicated a friend as the closest person and 53.8% of the females, their children. On use of health services, there was a significantly higher need for mobile medical care services treatment for those with lower education levels and status of window/widower. There was a significantly higher need for health exmination services for those with lower levels of exercise, greater satisfaction with sleep, higher levels of oral health care, and higher social contacts. In conclusion, there is a need to provide varied programs for the promotion of health, along with parallel resolution of social, psychological and economic issues. It is recommended that health services for elderly people provided by the health centers be implemented with full recognition of these characteristics and differences.

  • PDF

Comparison of Dietary Patterns, Health, and Blood Parameters of Elderly Women and College Women in the Seoul Area (노화 과정에 따른 노인과 여대생의 식생활, 건강 상태 및 혈액 성상 비교 연구)

  • Shin, Kyung-Ok;Chung, Keun-Hee;Choi, Kyung-Soon
    • Journal of the East Asian Society of Dietary Life
    • /
    • v.19 no.5
    • /
    • pp.703-712
    • /
    • 2009
  • The principal objective of this study was to supply basic material determine basic information regarding effective health promotion regimens for elderly women via a comparative survey of health status by aging age between elderly women (=70 y) and college women. The subject groups of elderly women (=70 y) and college women were selected and surveyed from March to October, 2008, in the Seoul area. The average age of the elderly women assessed in this study was $78.64{\pm}7.30$, the average height was $147.07{\pm}5.72$ cm, and the average weight was $50.47{\pm}7.44$ kg. As compared with college women, a higher percentage of elderly women ate breakfast regularly, but the elderly women also experienced difficulties in chewing due to dentures, and therefore ate their meals with large quantities of liquids, and usually ate their meals within 10 minutes. The majority of elderly women suffered from at least one disease, and the most common symptom reported was hypertension (25%). 52.2% of elderly women and 47.8% of college women reported that they exercised 1~2 times per week. They reported that their favorite exercise was light exercise, such as jogging and athletics (73.1%). As compared with college women, the smoking rate was lower among elderly women, but some of the elderly women were long-time smokers or alcoholics. The differences in red blood cells counts, Hb, hematocrit, and MCV of the between elderly women and college women were significant. In addition, but the MCH and MCHC were higher in elderly women compared with college women and the total cholesterol of elderly woman ($175.62{\pm}38.89$ mg/dL) was significantly lower compared with college woman ($186.13{\pm}28.19$ mg/dL). TG ($127.89{\pm}51.25$ mg/dL) and LDL-cholesterol ($120.51{\pm}32.88$ mg/dL) of elderly woman were significantly higher than TG ($79.71{\pm}40.9$ 6mg/dL) and LDL-cholesterol($103.78{\pm}22.94$ mg/dL) of college woman (p<0.05). The levels of HDL-cholesterol ($58.78{\pm}12.90$ mg/dL) in the college women was significantly higher than the HDLcholesterol levels ($48.17{\pm}13.79$ mg/dL) of the elderly women (p<0.05). Serum vitamin C levels in elderly women were significantly higher than those of college women (p<0.05), whereas no significant difference was detected between the two groups. Consequently, it can be concluded that the appropriate education programs for dietary habits and health promotion are necessary for a healthier life. Additionally, it is necessary for individuals to precisely determine precisely their own health status, and develop appropriate dietary programs for themselves.

  • PDF

The Geochemistry of Yuksipryeong Two-Mica Leucogranite, Yeongnam Massif, Korea (영남육괴내 육십령 복운모화강암에 대한 지화학적 연구)

  • Koh, Jeong-Seon;Yun, Sung-Hyo
    • The Journal of the Petrological Society of Korea
    • /
    • v.12 no.3
    • /
    • pp.119-134
    • /
    • 2003
  • Yuksipryeong two-mica granite presents strongly peraluminous characteristics in both mineralogy and geochemistry. It has high aluminum saturation index with 1.15∼l.20 and high corundum with 2.20∼2.98 wt% CIPW norm. As the color index is <16% and FeO$\^$T/+ MgO + TiO$_2$is average 1.9 wt%, it corresponds to leucogranite. Yuksipryeong two-mica leucogranite shows negative linear trend for TiO$_2$, Al$_2$O$_3$, FeO, Fe$_2$O$_3$, MgO, CaO, K$_2$O, P$_2$O$\_$5/, Rb, Ba, and Sr as SiO$_2$increases, and the positive relation of Zr and Th, which result from feldspar, biotite, apatite and zircon fractionation. Pegmatitic dike has higher SiO$_2$and P$_2$O$\_$5/, but lower another major elements. Yuksipryeong two-mica leucogranite has lower Rb, but higher Ba and Sr than Manaslu, Hercynian two-mica leucogranites, and S-type granites in Lachlan Fold Belt. Pegmatitic dike has higher Rb and Nb but lower Ba, Sr, Zr, Th, and Pb contents than Yuksipryeong two-mica leucogranite, resulting in removing or mobilizing for some trace elements from the granitic melt. Yuksipryeong two-mica leucogranite has total REEs with 95.7∼l23.3 ppm, and chondrite-normalized REE pattern is very steep ((La/Yb)$\_$N/ = 6.9∼24.8), light REEs (LREEs)-enriched End heavy REEs (HREEs)- depleted pattern with low to moderate Eu anomalies (Eu/Eu*= 0.7∼0.9). While pegmatitic dike has low total REEs with 7.0 ppm, and chondrite-normalized REE pattern is flat-pattern ((La/Yb)$\_$N/ = 2.1) with strong negative Eu anomalies (Eu/Eu*= 0.2). The melt compositions having formed two-mica leucogranites depend on not only the source rock but also the amounts of the residual remaining after melting of source rocks. The CaO/Na$_2$O and Rb/Sr-Rb/Ba ratios depend mainly on the composition of source rocks in the strongly peraluminous granite, that is, plagioclase/clay ratio of the source rocks. Yuksipryeong two-mica leucogranite has higher CaO/Na$_2$O and lower Rb/Sr-Rb/Ba ratios than Manaslu and Hercynian two-mica leucogranites (Millevaches and Gueret) derived from clay-rich, plagioclase-poor (polite), which suggest that the probable source rocks for Yuksipryeong two-mica leucogranite is clay-poor, plagioclase-rich quartzofeldspathic rocks. As the concentrations of Al$_2$O$_3$remain nearly constant but those of TiO$_2$increases as increasing temperature in the strong peraluminous melt, the Al$_2$O$_3$/TiO$_2$ratio may reflect relative temperature at which the melts have formed. Comparing the polite-derived Manaslu and Hercynian two- mica leucogranites, Manaslu two-mica leucogranite has higher Al$_2$O$_3$/TiO$_2$ratio than latter, and its melt have formed at relatively lower temperature ($\leq$ 875$^{\circ}C$) than Hercynian two-mica leucogranites. Likewise, comparing the quartzofeldspathic rock-derived granites, Yuksipryeong two-mica granite has higher Al$_2$O$_3$/TiO$_2$, ratio than S-type granites in Lachlan Fold Belt (>875$^{\circ}C$). The melt formed Yuksipryeong two-mica leucogranite are considered to have been formed at temperature at below the maximum 875$^{\circ}C$C$.

Magnetic Characterization of the Cretaceous Rocks from the Buyeo and Hampyeong Basins (부여분지와 함평분지에 분포하는 백악기 암석에 대한 자기특성 연구)

  • Hong, Jun-Pyo;Suk, Dong-Woo;Doh, Seong-Jae
    • Economic and Environmental Geology
    • /
    • v.40 no.2 s.183
    • /
    • pp.191-207
    • /
    • 2007
  • A paleomagnetic investigation for the Cretaceous rocks in the Buyeo and Hampyeong Basins, located out of the Gyeongsang Basin, was carried out in order to elucidate the paleomagnetic directions in conjunction with the formation of the basins. Typical stepwise thermal demagnetization and measurement methods were used to determine the directions of characteristic remanent magnetizations (ChRMs). The mean direction of the sedimentary rocks from the Buyeo Basin after bedding correction $(D/I=356.5^{\circ}/61.5^{\circ},\;k=39.3\;\alpha_{95}=7.4^{\circ})$, is more dispersed than that before bedding correction $(D/I=356.5^{\circ}/61.5^{\circ},\;k=39.3\;\alpha_{95}=7.4^{\circ})$, which suggests that the rocks in the Buyeo Basin were remagnetized. However, the statistics and dispersion of the ChRM directions after bedding correction are still acceptable and the paleomagnetic pole position after tilt correction $(Lat./Long.=69.3^{\circ}N/186.7^{\circ}E,\;K=11.6\;A_{95}=14.0^{\circ})$ is closer to that of the Late Cretaceous pole of the Korean Peninsula. More detailed study is needed to confirm the nature of the remagnetization in the Buyeo Basin. On the other hand, the paleomagnetic pole before bedding correction $(Lat./Long.=81.6^{\circ}N/106.9^{\circ}E,\;K=25.1\;A_{95}=9.3^{\circ})$ is positioned near the paleogene pole of the Eurasian APWP. The mean ChRM direction of the sedimentary rocks from the Hampyeong Basin after bedding correction is $D/I=32.5^{\circ}/55.4^{\circ},\;(k=35.6,\;\alpha_{95}=8.7^{\circ})$. It is more clustered than that before bedding correction $D/I=18.3^{\circ}/62.5^{\circ},\;k=14.1,\;\alpha_{95}=14.2^{\circ})$, indicating that the ChRM was acquired before tilting of the strata. The paleomagnetic pole position of the Cretaceous sedimentary rocks in the Hampyeong Basin, averaged out of site pole positions calculated from the tilt-corrected ChRMs, is $Lat./Long.=63.9^{\circ}N/202.7^{\circ}E,\;(K=21.3,\;A_{95}=7.6^{\circ})$, similar to the Late Cretaceous paleomagnetic pole of the Korean Peninsula $(Lat./Long.=70.9^{\circ}N/215.4^{\circ}E,\;A_{95}=5.3^{\circ})$, suggesting that the Hampyeong Basin has been stable since the Late Cretaceous period. One normal and two reversed ChRM directions are revealed through the measurements of the volcanic rocks from the Hampyeong Basin. Although these normal and reversed directions are not exactly antipodal, it is interpreted that the normal direction is the representative primary direction of the volcanic rocks of the Hampyeong Basin and the mixed polarity is the records of geomagnetic field at the time of the formation of the volcanic rocks. Paleomagnetic poles are at $Lat./Long.=70.2^{\circ}N/199.5^{\circ}E,\;(K=18.1,\;A_{95}=9.6^{\circ})$ for the normal direction, and $Lat./Long.=65.5^{\circ}S/251.3^{\circ}E,\;(K=7.1,\;A_{95}=20.7^{\circ})$ for the reversed direction. Compared with the representative pole positions of the Cretaceous period of the Korean Peninsula, it is concluded that the age of the volcanic rocks in the Hampyeong Basin is of the Late Cretaceous.

Clinical Findings of Mycoplasma pneumoniae pneumonia under 3 Year-Old Children (3세 이하 Mycoplasma pneumoniae 폐렴환자의 임상적 고찰)

  • Lee, Sung-Soo;Youn, Kyung-Lim;Kang, Hyeon-Ho;Cho, Byoung-Soo;Cha, Sung-Ho
    • Pediatric Infection and Vaccine
    • /
    • v.6 no.1
    • /
    • pp.78-85
    • /
    • 1999
  • Purpose : Mycoplasma pneumoniae pneumonia has been to be developed frequently in school age children and adolescence and hard to see under 3 year-old children. But it seems to be increased in number of patients with Mycoplasma pneumoniae pneumonia under 3-year old in clinical practice in these days. We have aimed to examine the characteristics of clinical findings of Mycoplasma pneumonia under 3 year-old children. Methods : We had performed retrospective review of medical records of 30 patients with Mycoplasmal pneumonia under 3-year old children who admitted to Department of Pediatrics, Kyunghee University Hospital from Jan. 1994 to Dec. 1997. The diagnostic criteriae was Cold agglutinin titer>1:64 or Mycoplasma antibody titer>1:80. Results : Mycoplasmal pneumonia was 30 out of 235 cases(12.7%) of total pneumonia under 3 year old children. Male female ratio was 1.3 : 1 and age distributions were 0~1y : 0, 1~2y : 8, 2~3y : 22 cases. Clinical symptoms and signs were cough(100.0%), sputum(83.3%), fever(80.0%) rhinorrhea(33.3%), vomiting(33.3%), moist rale(86.7%), decreased breathing sound(26.7%), wheezing(20.0%), and pharyngeal injection(30.0%). Thirteen out of 30 cases(43.3%) had unilateral infiltration, 10 cases(33.4%) had bilateral infiltration, 1 case(3.3%) had pleural effusion, and 6 cases(20.0%) had negative findings on chest radiography and there was no cases of atelectasis. On laboratory findings, 6 out of 30 cases(20.0%) had leukocytosis, 1 case(3.3%) had neutrophilia, 10 cases(30.0%) had eosinophilia, 17 cases(56.7%) had increased ESR, and 18 cases(60.6%) had positive CRP. Positive cold agglutinin titers(>1 : 64) were 19 cases(63.3%), and positive mycoplasma antibody(M-ab) titers(>1 : 80) were 27 cases(93.3%). Mycoplasma antibody test was more valuable than cold agglutinin test for the diagnosis of Mycoplasmal pneumonia and there was no correlation between cold agglutinin titer and mycoplasma antibody titer. Mycoplasma-polymerase chain reaction(M-PCR) was done with 13 cases, 12 out of 13 cases(92.3%) were positive. M-PCR test was valuable to the diagnosis of Mycoplasmal pneumonia but it will be needed to further study for their clinical application. Among 30 cases, 5 cases(16.7%) had complications, 3 cases(10.0%) had skin rash, 1 case(3.3%) had pleural effusion, 1 case(3.3%) had arthralgia, but all complications were mild and recovered without residual sequelae. Conclusion : The occurrence of Mycoplasmal pneumonia under 3 year-old children was not rare from this study. Clinical characteristics of Mycoplasmal pneumonia under 3-year old were normal radiologic findings in many cases, low complication rate, mild clinical course, and tend to rapid recovery compared with general manifestations of Mycoplasmal infectionsin children and adolescence. There were likely to be missed patients with Mycoplasmal pneumonia which did not diagnose by conventional serologic tests that had low sensitivity and specificity. We have to pay attention to the Mycoplasmal infection of the young children with pneumonia during epidemic periods of Mycoplasmal infection.

  • PDF

Evaluation of the Parameters of Soil Potassium Supplying Power for Predicting Yield Response, K2O Uptake and Optiumum K2O Application Levels in Paddy Soils (수도(水稻)의 가리시비반응(加里施肥反応)과 시비량추정(施肥量推定)을 위한 가리공급력(加里供給力) 측정방법(測定方法) 평가(評価) -I. Q/I 관계(関係)에 의(依)한 가리(加里) 공급력측정(供給力測定)과 시비반응(施肥反応))

  • Park, Yang-Ho;An, Soo-Bong;Park, Chon-Suh
    • Korean Journal of Soil Science and Fertilizer
    • /
    • v.16 no.1
    • /
    • pp.42-49
    • /
    • 1983
  • In order to find out the possibility of predicting fertilizer K requirement from the K supplying capacity of soil, the relative K activity ratio, Kas/kai, the potential buffering capacity of $K^+$ ($PBC^k$ ; the liner regression coefficient) and its activity ratio ($AR^k_o$ ; $^{k+}$/${\sqrt{Ca^{+2}+Mg^{+2}}}$ in mol/l) at ${\delta}K$ = O, in the Q/I relationships of Beckett(1964), were determined for the soils before flooding and the samples taken at heading stage of transplanted rice in pot experiment. These parameters assumed as the K supplying capacity of soils were subjected for the investigation through correlation stady between themselves and other factors such as grain yield or the amounts of $K_2O$ uptake by rice plant at harvest. The results may be summarized as follows; 1. The potassium supplying power of the flooded soil was considered to be ruled by the amounts of exchangeable K before flooding, since there was little change in exchangeable K concentration from no-exchangeable K during the incubation periods of 67 days. 2. The $PBC^k$ values, in soils before flooding were 0.027, 0.014 and 0.009, where as the $AR^k_o{\times}10^{-3}$ values were 9.1, 7.6, and 15.4, respectively, in clay, loamy and sandy loam soils. 3. The $PBC^k$ values, determined in the soil samples taken at heading stage, varied little compared with the values of orignal soil, regardless of those different fertilizer treatments and textures, showing the possibility of using them as a factor for the improvement of soil to increase the efficiency of fertilizer K. 4. The significant yield responses to potassium fertilizer application were observed wherever the $AR^k_o$ values in soil at heading stage drop down to the original $AR^k_o$ values, regardless of any levels of fertilizer application. 5. The higher correlations between the gain yield or the amounts of $K_2O$ uptake and by the use of both soil factors of $PBC^k$ and $AR^k_o$ at heading stage were observed compared with the use of any single factor. 6. The Kas/Kai value in the soil, estimated prior to the experiment, had high possitive correlation with the $AR^k_o$ determined in the soil at heading stage and could be used as a soil factor for predicting potassium fertilizer requirement.

  • PDF

Diagnosis of the Field-grown Rice Plant -II. Diagnosis by total plant analysis (포장재배(圃場栽培) 수도(水稻)의 영양진단(營養診斷) -II. 전분석(全分析)에 의(依)한 진단(診斷))

  • Park, Hoon;Park, Chon Suh
    • Korean Journal of Soil Science and Fertilizer
    • /
    • v.6 no.3
    • /
    • pp.165-172
    • /
    • 1973
  • The optimum time for nutritional diagnosis of the field-grown rice plant by total plant analysis, and the relationship between maximum or minimum nutrient content at various growth stages and corresponding yield and between maximum or minimum yield and corresponding nutrient content were as follows. 1. The percentage occurence of the minimum nutrient content in straw or grain of minus nutrient plot was in the order of 20 days after transplanting (20)>maximum tillering (MT)>harvested straw (HS)> earformation (EF)>straw at flowering (FS)>harvested grain (HG)>ear at flowering (FE) for nitrogen, MT>EF>HS>20=FS>FE>HG for phosphorus and MT>EF>20>FS>HG>FE for potassium. 2. The time when the occurece of minimum nutrient content in minus plot is highest was considered as the optimum time for nutritional diagnosis of root zone. It was 20 days after transplanting in N and maximum tillering stage in P and K. 3. The highest relative difference($100{\times}(L-H)/H$), between maximum (H)and minimum(L) nutrient content appeared in harvested straw for N and P while in harvested grain for K and Si, suggesting the close relation to their translocation from straw to grain. 4. The corresponding yield of maximum nutrient content was higher than that of minimum content at all growth stages in N, at all stages except MT and EF in P, at 20 days after trans planting and harvest in K, but it was always lower in Si, thus the contribution of nutrient content to yield will be in the order of N>P>K>Si. 5. The highest relative difference ($100{\times}(L-H)/H$, where H and L stand for yields) between yields corresponding to maximum and minimum nutrient content appeared at 20 days after transplanting for N. P. K, indicating the time of the closest relation between yield and nutrient content. 6. The highest difference (H-L, where H and L stand for nutrient content) between N. P. K contents corresponding to maximum or minimum yields came at 20 days after transplanting. The contents of N. P. K corresponding to the maximum total dry matter yield were lower than those corresponding the maximum grain yield at this stage. These facts support the closest relation between yield and nutrient content at this time. 7. The highest yield among yields corresponding to maximum nutrient contents occured at 20 days after transplanting in N. P. K but the lowest yield among yields corresponding to minimum nutrient contents appeared at the same stage only in nitrogen. 8. From the above facts the optimum time for diagnosis of nutrient around root zone seems different from that for diagnosis of nutritional status in relation to grain yield.

  • PDF

Off Pump Total Arterial Myocardial Revascularization (동맥 도관만을 이용하여 체외심폐순환 없이 시행한 관상동맥우회술)

  • Youn Young Nam;Lee Kyo Joon;Lee Gy Jong;Joo Hyun Chul;Lim Sang Hyun;Kim Seung Ho;Kwak Young Lan;Yoo Kyung Jong
    • Journal of Chest Surgery
    • /
    • v.38 no.5 s.250
    • /
    • pp.349-356
    • /
    • 2005
  • Background: Arterial conduits using in coronary artery bypass grafting (CABG) have been known a great long term patency rates, and improved short and long term clinical outcomes. It has been reported that Off pump CABG has better clinical results than CABG using cardiopulmonary bypass. To evaluate the advantage of arterial conduits over venous conduits and to avoid the adverse effects of cardiopulmonary bypass, we performed total arterial Off pump CABG. Material and Method: From January 2001 to October 2004, Off pump CABG using only arterial conduits was performed on 325 patients with a mean age of $59.3\pm11.9$ years ($36\~83$). Mean ejection fraction was $55.4\pm14.0\%\;(15\~86).$ Angiography showed left main disease or triple-vessel disease in $81.9\%$ of the patients. Indications of using arterial conduits was stenosis $\ge50\%$ of left anterior descending artery, stenosis $\ge80\%$ of branches of left circumflex artery, and stenosis $\ge90\%$ of right coronary artery and its branches. Multi-slice computed tomography was performed on 194 patients to evaluate the short term patency rates. Result: A total of 928 distal anastomoses were performed and the average anastomoses per a patient were $2.86\pm0.78$. There was 1 operative mortality. Postoperative complications were mediastinitis in 6 patients ($1.8\%$), renal failure in 4 patients ($1.2\%$), perioperative myocardial infarction in 3 patients ($0.9\%$), reoperation for bleeding in 3 patients ($0.9\%$). There was no postoperative stroke. Patency rate of arterial conduits was $99.3\%$ (581/585). There were 4 stenoses or competitive flows in 2 radial arteries and 2 right internal mammary arteries. Conclusion: Total arterial Off pump CABG appears to be safe, showing a low surgical mortality and morbidity and excellent short term patency rates of arterial conduits.

Clinical Results and Optimal Timing of OPCAB in Patients with Acute Myocardial Infarction (급성 심근경색증 환자에서 시행한 OPCAB의 수술시기와 검색의 정도에 따른 임상성적)

  • Youn Young-Nam;Yang Hong-Suk;Shim Yeon-Hee;Yoo Kyung-Jong
    • Journal of Chest Surgery
    • /
    • v.39 no.7 s.264
    • /
    • pp.534-543
    • /
    • 2006
  • Background: There are a lot of debates regarding the optimal timing of operation of acute myocardial infarction (AMI). Off pump coronary artery bypass grafting (OPCAB) has benefits by avoiding the adverse effects of the cardio-pulmonary bypass, but its efficacy in AMI has not been confirmed yet. The purpose of this study is to evaluate retrospectively early and mid-term results of OPCAB in patients with AMI according to transmurality and timing of operation. Material and Method: Data were collected in 126 AMI patients who underwent OPCAB between January 2002 and July 2005, Mean age of patients were 61.2 years. Male was 92 (73.0%) and female was 34 (27.2%). 106 patients (85.7%) had 3 vessel coronary artery disease or left main disease. Urgent or emergent operations were performed in 25 patients (19.8%). 72 patients (57.1%) had non-transmural myocardial infarction (group 1) and 52 patients (42.9%) had transmural myocardial infarction (group 2). The incidence of cardiogenic shock and insertion of intra-aortic balloon pump (IABP) was higher in group 2. The time between occurrence of AMI and operation was divided in 4 subgroups (<1 day, $1{\sim}3\;days,\;4{\sim}7\;days$, >8 days). OPCAB was performed a mean of $5.3{\pm}7.1$ days after AMI in total, which was $4.2{\pm}5.9$ days in group 1, and $6,6{\pm}8.3$ days in group 2. Result: Mean distal an-astomoses were 3.21 and postoperative IABP was inserted in 3 patients. There was 1 perioperative death in group 1 due to low cardiac output syndrome, but no perioperative new MI occurred in this study. There was no difference in postoperative major complication between two groups and according to the timing of operation. Mean follow-up time was 21.3 months ($4{\sim}42$ months). The 42 months actuarial survival rate was $94.9{\pm}2.4%$, which was $91.4{\pm}4.7%$ in group 1 and $98.0{\pm}2.0%$ in group 2 (p=0.26). The 42 months freedom rate from cardiac death was $97.6{\pm}1.4%$ which was $97.0{\pm}2.0%$ in group 1 and $98.0{\pm}2.0%$ in group 2 (p=0.74). The 42 months freedom rate from cardiac event was $95.4{\pm}2.0%$ which was $94.8{\pm}2.9%$ in group 1 and $95.9{\pm}2.9%$ in group 2 (p=0.89). Conclusion: OPCAB in AMI not only reduces morbidity but also favors hospital outcomes irrespective of timing of operation. The transmurality of myocardial infarction did not affect the surgical and midterm outcomes of OPCAB. Therefore, there may be no need to delay the surgical off-pump revascularization of the patients with AMI if surgical revascularization is indicated.