• Title/Summary/Keyword: 장기생존을

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Long-term Survival after Coronary Artery bypass Surgery (관상동맥 우회술의 장기 생존율)

  • Lee Mi Kyung;Jeong Eun Taik;Choi Jong Bum
    • Journal of Chest Surgery
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    • v.38 no.2 s.247
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    • pp.139-145
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    • 2005
  • Background: There were very few reports on long-term survival after coronary artery bypass graft (CABG) in this country. The aim of this study is to investigate the long-term result in patients undergoing CABG in the early period in this hospital. Material and Method: One-hundred and fourteen patients (male/female, 79/35) who had undergone CABG from December 1990 to December 1995 were identified. Most of the patients had undergone CABG using left internal thoracic artery and vein grafts under cardiopulmonary bypass and cardiopulmonary arrest, and the proximal and distal anastomoses of the grafts were performed during the single aortic cross clamping period. Result: During the mean follow-up period of $135.5\pm17.9$ months, 37 patients $(32.5\%)$ were dead and only 10 patients $(27\%)$ of them died of cardiac cause. Risk-unadjusted survival after CABG was $95.6\%,\;85.1\%,\;71.8\%,$ and $57.9\%$ at 1, 5, 10, and 13 years, respectively, and cardiac death-free survival was $97.4\%,\;94.5\%,\;92.1\%$, and $81.3\%$ at 1, 5, 10, and 13 years, respectively. Predictable factors of long-term survival were sex and age. Predictable factors of postoperative coronary angiography and intervention were hypertension, diabetes, and dyslipidemia. Conclusion: Long-term survival after CABG in the early operative period was comparable to the previous outcomes, and females showed the better long-term survival. Postoperative coronary intervention was more common in patients with preoperative dyslipidemia.

Prognostic Factors for Survival in Patients with Stage IV non-small Cell Lung Cancer (제 IV병기 비소세포폐암의 예후인자)

  • Kim, Myung-Hoon;Park, Hee-Sun;Kang, Hyun-Mo;Jang, Pil-Soon;Lee, Yun-Sun;An, Jin-Yong;Kwon, Sun-Jung;Jung, Sung-Soo;Kim, Ju-Ock;Kim, Sun-Young
    • Tuberculosis and Respiratory Diseases
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    • v.53 no.4
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    • pp.379-388
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    • 2002
  • Background : Although patients with stage IV non-small cell lung cancer are known to have a poor prognosis, the prognostic factors for survival have not been well evaluated. Such factors may be different from those for overall survival. This study was performed to analyze the prognostic factors for survuval and the variation of survival according to metastatic organ, in patients with stage IV non-small cell lung cancer. Materials and Methods : From January 1997 to December 2000, 151 patients with confirmed stage IV non-small cell lung cancer were enrolled into this study retrospectively. The clinical and laboratory data were analyzed using univareate Kaplan-Meied and Multivariate Cox regression models. Results : On univariate analysis, age, performance status, serum albumin level, weight loss, forced expiratory volume in one second (FEV1), systemic chemotherapy, the number of metastatic organs and serum lactate dehydrogenase (LDH) level were significant factors (p<0.05). In multivariate analysis, important factors for survival were ECOG performance (relative risk of death [RR]: 2.709), systemic chemotherapy (RR: 1.944), serum LDH level (RR: 1.819) and FEV1 (RR: 1.774) (p<0.05), Metastasis to the brain and liver was also a significant factor on univariate analysis). The presence of single lung metastasis was associated with better survival than that of other metastatic organs (p=0.000). Conclusion : We confirmed that performance status and systemic chemotherapy were independent prognostic factors, as has been recognized. The survival of stage IV non-small cell lung cancer patients was different according to the metastatic organs. Among the metastatic sites, only patients with metastasis to the lung showed bettrer survival than that of other sites, while metastasis of the brain or liver was associated with worse survival than that of other sites.

Long-term Survival after CABG in Patients with Abnormal LV Wall Motion after MI (심근경색으로 좌심실 벽 운동장애를 가진 환자들에서 관상동맥 우회술 후 장기생존율)

  • Lee, Mi-Kyung;Choi, Soon-Ho;Choi, Jong-Bum
    • Journal of Chest Surgery
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    • v.38 no.10 s.255
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    • pp.685-692
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    • 2005
  • Background: Wall motion abnormalities may be a significant predictor for long-term survival after coronary bypass surgery (CABG). The aim of this study is to see whether post-infarction wall motion abnormality of left ventricle affect on the long-term survival after CABG. Material and Method: One-hundred and thirty-three patients (male/female, 92/41) undergoing CABG more than 9 years ago were included in this study. Fifty-six patients (M/F, 42/14; mean age, $59.2\pm9.2$ years) with LV wall motion abnormalities were compared to 77 patients (M/F, 50/27; mean age, $58.0\pm7.6$ years) without the wall motion abnormalities. Most patients (112/133, $84.2\%$) had undergone on-pump CABG with the in-situ left internal thoracic artery and free grafts of saphenous vein, in which the proximal and distal anastomoses were done for the single aortic cross-clamping period. Result: Ejection fraction of left ventricle was lower in the group with LV wall motion abnormalities (mean ejection fraction, $48.7\pm13.2\%$) compared to the group without wall motion abnormalities (mean ejection fraction, $57.1\pm10.1\%$)(p=0.0001). Risk­unadjusted survivals after CABG in the group without wall motion abnormalities were $85.7\pm4.0\%,\;76.2\pm4.9\%,\;and\;57.2\pm10.3\%$ at 5, 10, and 13 years, respectively, and in the group with wall motion abnormalities were $80.4\pm5.3\%,\;58.7\pm7.3\%,\;and\;51.9\pm7.9\%$ at 5, 10, and 13 years, respectively (p=0.1). In univariate analysis, predictable factors of long-term survival in the patients with LV wall motion abnormalities were LV ejection fraction and post operative outpatient treatment. In multivariate analysis, predictable factor of long-term survival in the patients with the wall motion abnormalities was postoperative outpatient treatment, and that in those without the wall motion abnormalities was female. Conclusion: Although there was no significant survival difference after CABG between the group with LV wall motion abnormalities and that without wall motion abnormalities, the survival in the group with wall motion abnormalities seems to be more decreased. For the patients with LV wall motion abnormalities after myocardial infarction, the post-CABG outpatient treatment is suggested to be an important factor for the long-term survival.

신경망 기반 응용최적통계 기법을 이용한 전략 계획에 따른 단기 계획 조정 방법에 관한 연구

  • 김우주;최대우;김정수
    • Proceedings of the Korea Association of Information Systems Conference
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    • 1997.10a
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    • pp.53-73
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    • 1997
  • 대부분의 조직들은 그 조직의 생존과 발전을 위해 장기 전략 계획과 동시에 운영 을 위한 구체적 단기 계획(예 : 생산 계획)을 항상 수립 또는 조정하고 있다. 특히 장기적인 관점에서의 이익 극대화와 생존을 위해 수립되거나 조정된 장기 전략 계획을 효과적으로 달 성하기 위해서는 실제 그 전략을 수행하기 위한 단기 계획에 대한 전략 계획 결과의 일관되 고 지속적인 반영이 필수적이다. 그러나 단기 계획 수립 시점에서 전략 목표나 전략 계획의 내용을 단기적으로 실현 가능한 이익 관점에서 양적으로 구체화하여 평가하기 어려운 현실 적 이유로 인해 대부분의 경우 객관적으로 측정 가능한 단기 이익을 극대화하는 방향으로 단기 계획을 수립하는 것이 보통이다. 따라서 이러한 단기 계획의 수립은 장기 전략 계획과 의 불일치를 가져오게 되며 궁극적으로 기업의 장기적 이익 극대화와 생존에 불리한 결과를 초래할 수도 있다. 이에 따라 본 연구에서는 장기전략 계획이 구체적인 단기 계획에 있어 어떤 구체적이고 명시적인 의미나 결과를 가지게 되는지를 파악할 수 있는 체계를 모형화 하고, 이를 바탕으로 장기 전략 계획을 달성하기 위해 혹은 장기 전략 계획의 변화가 발생 했을 경우 이에 따른 단기 계획에의 일관된 조정을 수행할 수 있는 방법론을 개발 제시하고 자 한다. 본 연구에서는 이를 위해 장기 전략 계획으로는 포트폴리오(Portfolio) 계획 모형을 가정하고 있으며, 단기 계획 수립은 최적화 모형(예 : 선형계획법)을 사용하는 것을 전제로 하여 신경망 기반 응용최적통제(Adaptive Optimal Control)기법을 통해 포트폴리오 모형을 전략 목표를 위한 최적화 모형의 통제 및 조정을 수행함으로써 전략 계획에 의한 단기 계획 조정을 달성하고자 한다. 본 연구에서 제시한 방법론은 장기 전략 목포를 달성하기 위한 일 관적인 기군에 따른 적절한 단기 계획의 통제가 가능하다는 것을 보여주었으며 나아가서 장 기 전략 목표와 단기 이익간의 체계적인 상호 교환적 절충의 가능성 역시 경험적으로 증명 하고 있다. 이는 대부분의 기업 환경에 적용되어 현대의 빠른 기업 환경 변화에 대응하기 위한 전략 계획의 변화를 신속하고 효과적으로 단기 계획에 반영할 수 잇는 방법을 제시함 으로써 기업의 전략 목표 달성에 중요한 역할을 담당할 수 있을 것으로 기대한다.

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Relationship between Early Postoperative Renal Scintigraphy and Long-term Transplant Survival (신 이식 직후 신장 스캔 소견과 이식신 장기 생존의 관계)

  • So, Young;Lee, Kang-Wook;Shin, Young-Tai;Ahn, Moon-Sang;Bae, Jin-Sun;Sul, Chong-Koo;Jung, In-Mok
    • The Korean Journal of Nuclear Medicine
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    • v.35 no.4
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    • pp.251-257
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    • 2001
  • Purpose: We investigated the possibility of early postoperative Tc-99m DTPA scintigraphy in predicting long-term renal transplant survival. Materials and Methods: 64 living donor (LD) grafts were divided into two groups according to the graft function on early post-operative renal scintigraphy. Survival analysis was performed using Kaplan-Meier method and Cox proportional hazard model. Chi-square test was performed to evaluate the difference in the frequency of acute rejection. Results: Cumulative renal transplant survival was decreased in 11 patients with abnormal renal scintigraphy, but it was not statistically significant. Decreased graft function on early post-operative renal scintigraphy was not a predictor of long-term graft survival. The frequency of acute rejection was higher in abnormal scintigraphy group, and the difference was statistically significant. Conclusion: Decreased graft function on early post-operative renal scintigraphy has no direct effect on long-term renal transplant survival in LD transplantation. But it may have an indirect elect through increasing the frequency of acute rejection.

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Long-Term Result of Surgical Treatment for Esophageal Cancer -500 cases- (식도암에서 외과적 요법의 장기성적에 대한 임상적 고찰 -500예 보고-)

  • 임수빈;박종호;백희종;심영목;조재일
    • Journal of Chest Surgery
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    • v.34 no.2
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    • pp.148-155
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    • 2001
  • 배경: 본 연구는 1987년부터 1997년까지 원자력병원에서 수술을 시행한 500명의 식도암환자를 대상으로 하여 휴향적 방법을 통해 조기 및 장기성적, 재발양상, 예후인자 등을 보고하고자 한다. 대상 및 방법: 대상환자 중에서 발병암이 있는 경우, 인두식도 경계부위나 위식도 경계부위 암, 고식적 우회술 또는 인공식도 삽입예 그리고 시험적 개흉술이나 개복술 만을 시행한 경우는 제외 시켰다. 식도 절제는 대부분 우측 개흉술을 이용한 Ivor Lewis 술식을 사용하였고 대부분의 문합은 stapler를 사용하였다. Extended lymph node dissection은 1994년 8월부터 시행하였고 그 이전에는 standard lymph node dissection을 하였다. 96.8%에서 위를 식도 대체장기로 사용하였고 경부에서 절제 및 재건술을 시행한 경우를 제외한 모든 식도재건은 후종격동을 통해 시행하였다. 결과: 474예(94.8%)가 편평상피 세포암이었고 대부분(58.2%)은 중부식도에 위치하였다. 술후병기는 47.4%가 stage III이었고 25%가 stage IIA이었다. 392예에서 근치적 절제가 가능하였고 74예는 고식적 절제를 시행하였으며, 식도열공을 통한 식도절제술과 경부에서의 유리공장 이식술을 시행한 34예는 위분류에서 제외하였다. 술후 유병율은 38.4%이었고 수술 사망률은 5.8%로 호흡기 감염, 문합부 유출이 주요 원인이었다. 대상환자의 99.8%에서 추적은 가능하였고 수술사망 예를 포함한 전체환자의 1, 2, 5년 생존율은 각각 63.5%, 38.9%, 19.4% 이었다. Standard lymph node dissection 그룹에서의 1, 2, 5년 생존율이 60.7%, 35.9%, 16.9%이었으나 extended lymph node dissection그룹에서는 1, 2, 4년 생존율이 70.2%, 46.5%, 30.9%이었다. 근치적 절제의 경우는 1, 2, 5년 생존률이 69.4%, 43.9%, 21.9%이었고, 고식적 절제의 경우는 37.8%, 17.6%, 7.3%이었다. 수술사망을 제외한 근치적 절제술과 extended lymph node dissection을 함께 시행한 경우의 4년 생존율은 35.6%이었다. 수술후 재발은 226예에서 발견되었고 주로 국소임파절(69%; 경부, 종격동, 복부)이었으며, 전신재발은 간, 폐, 뼈, 뇌 등의 순이었다. 결론: 저자들은 적절한 술후 환자관리가 선행되어야 하지만 근치적 절제와 광범위한 임파절 절제가 장기성적의 향상에 필수적 요소이고, 진행된 식도암에 있어서는 보다 효과적인 보강적 복합치료가 연구되어야 할 것으로 생각된다.

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최적의 입지유형에 위치한 점포의 5년 이상 생존에 미치는 영향 -편의점 사례 중심-

  • Gwon, Yong-Seok;Gwon, Myeong-Jung
    • 한국벤처창업학회:학술대회논문집
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    • 2017.04a
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    • pp.26-26
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    • 2017
  • 이 연구의 목적은 실제 창업하여 5년 이상 생존한 편의점이 최적의 입지유형에 위치한 것이 크다는 영향을 증명하는데 있다. 이 목적을 달성하기 위하여 서울 주요 지역의 5년 이상 생존 점포 사례를 본인과 지인의 사례 점포, A 메이저 프랜차이즈 편의점 직원이 제공한 자료를 토대로 연구 결과를 분석하고 실제 창업 생존률을 높이는데 도움을 주고자 한다. 실증분석결과, 첫째로 입지요인은 편의점 성과에 영향을 미치는 것으로 나타났다. 둘째, 최적의 입지유형에 위치한 점포는 5년 이상 생존하는데 영향을 주는 것으로 나타났다. 최적의 입지유형에 위치한 편의점 창업은 5년 이상 생존하는데 상당한 영향을 미치므로 입지유형에 대한 인식과 실전 적용은 필요한 것으로 나타났다. 전체 창업시장으로 보면 편의점과 같이 상품의 동질성이 높은 업종이나 위치에 중점을 둔 창업인 경우 까지 확대하여 창업가의 실패를 줄이고 장기적 생존률을 높일 수 있는 연구가 확대 되어야 할 것이다.

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Long-Term Survival Analysis of Unicompartmental Knee Arthroplasty (슬관절 부분 치환술의 장기 생존 분석)

  • Park, Cheol Hee;Lee, Ho Jin;Son, Hyuck Sung;Bae, Dae Kyung;Song, Sang Jun
    • Journal of the Korean Orthopaedic Association
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    • v.54 no.5
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    • pp.427-434
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    • 2019
  • Purpose: This study evaluated the long term clinical and radiographic results and the survival rates of unicompartmental knee arthroplasty (UKA). In addition, the factors affecting the survival of the procedure were analyzed and the survival curve was compared according to the affecting factors. Materials and Methods: Ninety-nine cases of UKA performed between December 1982 and January 1996 were involved: 10 cases with Modular II, 44 cases with Microloc, and 45 cases with Allegretto prostheses. The mean follow-up period was 16.5 years. Clinically, the hospital for special surgery (HSS) scoring system and the range of motion (ROM) were evaluated. Radiographically, the femorotibial angle (FTA) was measured. The survival rate was analyzed using the Kaplan-Meier method. Cox regression analysis was used to identify the factors affecting the survival according to age, sex, body mass index, preoperative diagnosis, and type of implant. The Kaplan-Meier survival curves were compared according to the factors affecting the survival of UKA. Results: The overall average HSS score and ROM was 57.7 and 134.3° preoperatively, 92.7 and 138.4° at 1 year postoperatively, and 79.1 and 138.4° at the last follow-up (p<0.001, respectively). The overall average FTA was varus 0.8° preoperatively, valgus 4.1° at postoperative 2 weeks, and valgus 3.0° at the last follow-up. The overall 5-, 10-, 15- and 20-year survival rates were 91.8%, 82.9%, 71.0%, and 67.0%, respectively. The factors affecting the survival were the age and type of implant. The risk of the failure decreased with age (hazard ratio=0.933). The Microloc group was more hazardous than the other prostheses (hazard ratio=0.202, 0.430, respectively). The survival curve in the patients below 60 years of age was significantly lower than those of the patients over 60 years of age (p=0.003); the survival curve of the Microloc group was lower compared to the Modular II and Allegretto groups (p=0.025). Conclusion: The long-term clinical and radiographic results and survival of UKA using old fixed bearing prostheses were satisfactory. The selection of appropriate patient and prosthesis will be important for the long term survival of the UKA procedure.

The Influence of Gender on the Long-term Outcome of Coronary Artery Bypass Surgery (성별에 따른 관상동맥 우회술의 장기 결과)

  • Choi Jong-Bum;Lee Mi-Kyung;Cha Byoung-Ki;Lee Sam-Youn
    • Journal of Chest Surgery
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    • v.39 no.6 s.263
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    • pp.449-455
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    • 2006
  • Background: Female sex was known to be a risk factor for mortality after coronary bypass grafting (CABG), and women showed higher in-hospital mortality than men. Material and Method: Between 1992 and 1996, 147 consecutive patients (98 men and 49 women) undergoing CABG were included in the study. Most patients had undergone CABG with left internal thoracic artery and saphenous vein under cardiopulmonary bypass. We examined the influence of gender on survival after CABG and looked for risk factors for survival. Result: There was no in-hospital mortality in women, but 3 death (3.0%) in men. During the mean follow-up period of $138.5{\pm}23.0$ months, mortality was lower in women than in men (20.4% vs 44.9%, p=0.004), and the most common cause of death in women was chronic renal failure (40%). Survival in women at 1, 5, 10, and f4 years was 100%, $98.0{\pm}2.0%,\;81.2{\pm}5.6%,\;and\;78.4{\pm}6.1%$, respectively, which was better than in men (p=0.004). Although preoperative left ventricular ejection fraction was higher in women than in men, this did not affect early and long-term survival difference between two sexes (p=0.15). Risk factor for long-term survival in women was diabetes (p=0.033) and in men number of diseased coronary artery (p=0.006). Conclusion: Long-term survival after CABG was better in women than men. Risk factor for long-term survival in women was morbid disease rather than cardiac disease.

Mycelial viability and cultivation characteristics of Hypsizygus marmoreus after long-term storage in different conditions (장기 저장 후 느티만가닥버섯(Hypsizygus marmoreus) 균주의 균사 생존력과 재배 특성에 대한 연구)

  • Lee, Hyae-Jung;Ro, Hyeon-Su;Kim, Jong-Guk;Lee, Chang-Yun
    • Journal of Mushroom
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    • v.12 no.1
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    • pp.29-34
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    • 2014
  • Mycelial viability and cultivation characteristics of strains of Hypsizygus marmoreus after long-term storage were investigated. The experimental conditions were the storage at $4^{\circ}C$ using a slant culture technique with or without mineral oil, and in liquid nitrogen tank in the presence of 10% glycerol or 10% glycerol with 5% trehalose. The myceila of four strains of H. marmoreus were thawed at 9, 21, 33, and 45 months after beginning of the storage, and then the growth of the mycelia was measured on a PDA plate with serial transfers to new plate for the recovery. The mycelial growth data after 45 months showed that the mycelia were mostly viable but not fully active particularly when they were stored in liquid nitrogen with 10% glycerol. The growth activity could be fully recovered after second transfer to new PDA plate. Cultivation of mushroom fruiting body using the recovered mycelia also demonstrated that the storage methods employed in this work were applicable for the long-term storage of H. marmoreus.