Kim, Won-Gon;Oh, Sam-Sae;Kim, Ki-Bong;Ahn, Hyuk;Kim, Chong-Whan
Journal of Chest Surgery
/
v.31
no.9
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pp.877-883
/
1998
Background: Cardiopulmonary bypass(CPB), a standard adjunct for open heart surgery, can also play an important role in treating patients with noncardiac diseases. Material and Method: We report a collective analysis of noncardiac applications of cardiopulmonary bypass experienced at Seoul National University Hospital from 1969 to 1996. Out of a total of 20 patients, 8 were treated for membranous obstruction of inferior vena cava(MOVC), 5 for malignant melanoma, 3 for pulmonary embolism, 1 for double lung transplantation, 1 for intracranial giant aneurysm(GA), 1 for renal cell carcinoma(RC), and 1 for liposarcoma. CPB was used to induce profound hypothermia with circulatory arrest in 6 patients(MOVC 4, GA 1, RC 1). Result: CPB time was 113 mins on average for MOVC, 161 mins for GA, and 156 mins for RC, while the lowest rectal temperature was 26$^{\circ}C$ on average in MOVC, and 19$^{\circ}C$ in GA and RC. Postoperative recovery was good in all MOVC patients. The patient with GA, who underwent reoperation for the removal of hematoma, died 14 days postoperatively. The patient with RC recovered from the operation in a good condition but died from metastatic spread 6 months later. CPB was instituted for pulmonary embolectomy in 3 patients, in whom postoperative courses were uneventful, except in 1 patient who showed transient neurologic symptoms. CPB was used in a patient with double-lung transplantation for hemodynamic and ventilatory support. The patient was weaned successfully from CPB but died from low output and septicemia 19 days postoperatively. CPB without circulatory arrest was used to treat in 4 patients with MOVC. These patients showed good postoperative courses. CPB was used to administer high concentrations of chemotherapeutic agents to the extremities in 6 patients(malignant melanoma 5, recurrent liposarcoma 1). CPB time was 153 mins on average. No complications such as edema and neurologic disability were found. Conclusion: Although CPB has a limited indication in noncardiac diseases, if properly applied, it can be a very useful adjunct in a variety of surgical cases.
Korea has been entering the ageing society as the population of age over 65 shared over 7% since the year 2000. The ageing society needs to have transportation facility considering elderly people's travel behavior. This study aims to understand the elderly people's travel behavior using recent data in Korea. The activity schedule approach begins with travel outcomes are part of an activitv scheduling decision. For tho?e approach. used discrete choice models (especially. Nested Logit Model) to address the basic modeling problem capturing decision interaction among the many choice dimensions of the immense activity schedule choice set The day activity schedule is viewed as a sot of tours and at-home activity episodes tied togather with overarching day activity pattern using the Seoul Metropolitan Area Transportation Survey data, which was conducted in June, 2002. Decisions about a specific tour in the schedule are conditioned by the choice of day activity pattern. The day activity scheduling model estimated in this study consists of tours interrelated in a day activity pattern. The day activity pattern model represents the basic decision of activity participation and priorities and places each activity in a configuration of tours and at-home episodes. Each pattern alternative is defined by the primary activity of the day, whether the primary activity occurs at home or away, and the type of tour for the primary activity. In travel mode choice of the elderly and non-workers, especially, travel cost was found to be important in understanding interpersonal variations in mode choice behavior though, travel time was found to be less important factor in choosing travel mode. In addition, although, generally, the elderly was likely to choose transit mode, private mode was preferred for the elderly over 75 years old owing to weakened physical health for such things as going up and down of stairs. Therefore. as entering the ageing society, transit mode should be invested heavily in transportation facility Planning tor improving elderly transportation service. Although the model has not yet been validated in before-and-after prediction studies. this study gives strong evidence of its behavioral soundness, current practicality. and potential for improving reliability of transportation Projects superior to those of the best existing systems in Korea.
Chung Eun Ji;Shin Hyun Soo;Lee Hyung Sik;Kim Gwi Eon;Loh John Juhn-Kyu;Suh Chang Ok
Radiation Oncology Journal
/
v.9
no.2
/
pp.277-284
/
1991
Survival data, prognostic factors, and patterns of failure were retrospectively analyzed for a total of 76 patients with adenocarcinoma of the uterine cervix treated between January 1981 and December 1987, which represents $4.1\%$ of all primary cervical carcinomas treated, at Department of Radiation Oncology, Yensei Cancer Center, Yonsei University College of Medicine. The mean age of the patients was 49 years (range, $27\~79$ years) and the peak incidence was in the group 50 to 59 years of age. More half of the patients were postmenopausal (46/76= $60.5\%$). Most patients ($76\%$) had abnormal vaginal bleeding either alone or in combination with other symptoms. The proportion of stage IIb was $43.4\%$. There were 4 major histologic subtypes: pure adenocarcinoma (48/76=$63.2\%$), adenosquamous carcinoma (20/76=$26.3\%$), papillary (5/76=$6.6\%$) and clear cell carcinoma (3/76=$3.9\%$). Of the many clinicopathologic variables evaluated for prognosis, the most significant prognostic factors were stage of disease and the size of tumor. The overall 5-year survival rate was $68\%$, and the 5-year survival rates for stage Ib, II and III were $90\%,\;66\%\;and\;54\%$, respectively. Control of pelvic tumors was achieved in $93.8\%,\;90.2\%\;and\;50.0\%$ of cases of stage Ib, II and III disease, respectively. In present study, treatment modalities (radiation therapy alone/combined operative and radiation therapy) did not affect the local control of tumor and the survival.
Purpose : The aim of this study is to analyze the treatment failure patterns and the risk factors for locoregional or distant failure of uterine cervical carcinoma treated with radiation therapy. Materials and methods . A retrospective analysis was undertaken of 154 patients treated with curative radiation therapy in Gyeongsang National University Hospital from April 1989 through December 1997. According to FIGO classification, 12 patients were stage IB, 24 were IIA, 98 were IIB, 1 were IIIA, 17 were IIIB, 2 were IVA. Results : Overall treatment failure rate was $42.1\%$ (65/154), and that of complete responder was $31.5\%$ (41/130). Among 65 failures, 25 failed locoregionally, another 25 failed distantly, and 15 failed locoregionally and distantly. Multivariate analysis confirmed tumor size (>4 cm) as risk factor for locoregional failure, and tumor size (>4 cm), pelvic lymph node involvement as risk factors for distant failure. Conclusion : On the basis of results of our study and recent published data of prospective randomized study for locally advanced uterine cervical carcinoma, we concluded that uterine cervical carcinoma with size more than 4 cm or pelvic lymph node involvement should be treated with concurrent chemoradiation.
Kang Ki Mun;Choi Byung Ock;Jang Hong Seok;Kang Young Nam;Chai Gyu Young;Choi Ihl Bohng
Radiation Oncology Journal
/
v.20
no.3
/
pp.215-220
/
2002
Purpose : Preoperative radiotherapy has been used to induce tumor regression and allow complete resection of rectal cancer with a sphincter preservation surgery. This study was performed to determine the effectiveness of preoperative radiotherapy for $T_2,\;T_3$ distal rectal carcinoma. Materials and Methods : From November 1995 to June 1997, fifteen patients with invasive distal rectal cancer were treated with preoperative radiotherapy followed by sphincter preservation surgery. Classification by preoperative T stage consisted of 7 $T_2$ and 8 $T_3$ tumors. Radiation therapy was delivered with 6 MV and 15 MV linear accelerator, at 1.8 Gy fractions for 5 days per week. Total radiation doses were 45 Gy to 50.4 Gy (median : 50.4 Gy). Sphincter preservation surgery was peformed $4\~6$ weeks after the completion of radiotherapy. Median follow-up was 22 months (range : $16\~37\;months$). Results : One patient $(6.7\%)$ had a complete pathologic response. Comparing the stage at the diagnostic workup with the pathologic stage, tumor downstaging of T stages occurred in 11 of 15 patients $(73.3\%)$ and $N_1$ stages occurred in 2 of 5 patients $(40\%)$. No patient developed progressive disease undergoing treatment. Two patients suffered local recurrence at 7 and 20 months, and one a distant metastasis at 30 months. No grade 3 or 4 toxicity was observed. Conclusion : Our experience suggests that preoperative radiotherapy followed by sphincter preservation surgery is well tolerated, and can significantly reduce the tumor burden for $T_2\;T_3$ distal rectal cancer.
Purpose : The purpose of this study was to identify useful predictors for diagnosing bacterial meningitis and performing CSF studies in febrile infants three months or younger. Methods : Six hundred and fifty two febrile infants with a rectal temperature ${\geq}38.0^{\circ}C$ presented from January 2003 to April 2008 and were retrospectively studied. The total white blood cell count (WBC), band count, absolute neutrophil count (ANC), quantitative C-reactive protein (CRP) and blood cultures were performed on admission. The clinical variables associated with bacterial meningitis were analyzed. Results : In patients with bacterial meningitis, the clinical variables including CRP (P=0.036), band count (P=0.037), ANC (P=0.036) and age (P=0.001) were significantly different. The area under the receiver-operating characteristic curve was 0.969 for CRP, 0.946 for the band count, 0.765 for the ANC and 0.235 for age. A CRP cutoff point of 8 mg/dL was determined to maximize both the sensitivity and specificity (sensitivity 83%, specificity 95%, likelihood ratio 16.6). A CRP concentration of <7 mg/dL "ruled-out" bacterial meningitis, with a likelihood ratio of 0.17, a posttest probability of <0.1% and negative predictive value 91%. A CRP concentration greater than 9 mg/dL had a much higher likelihood ratio (20.1) than the band count (16.6) and ANC (2.2). Conclusion : The CRP concentration was a useful laboratory test for the differential diagnosis of bacterial meningitis among febrile infants three months of age or younger. A CRP concentration of <7 mg/dL effectively ruled out bacterial meningitis; a value ${\geq}9mg/dL$ increased the clinical suspicion of bacterial meningitis and the need for CSF evaluation.
This experiment was carried out to study the effect of sprinkler and fan cooling system on the physiological parameter, milk production and milk composition for Holstein cows in hot, humid climates. Thirty cows were assigned to one of two sections of open-sided loose barn. Water nozzles of sprinkler system were spaced in line at 1.2m intervals. Forced air was provided by 85cm diameter fans at rate of 3.4㎥/sec. The results obtained from these experiments are as follows: 1. There was no significant difference in meteorological data between control and fan + sprinkler cooling system(treatment group). 2. Skin temperature and rectal temperature of the treatment group were significantly lower than those of the control group (32.96 : 39.53$^{\circ}C$ vs 34.02 : 41.21$^{\circ}C$ respectively) (P<0.05). 3. Serum cortisol concentration of the treatment group(0.90$\mu\textrm{g}$/dL) was lower than that of control group(1.44$\mu\textrm{g}$/dL)(P<0.05). 4. Milk production of cows cooled with a sprinkler and fan cooling system was significantly higher than that of no cooling system (P<0.0l). 5. Lactose, protein and solid-not-fat content of milk were not changed by the treatments. Milk fat content of the control(3.23%) was low compared with the treatment group(3.38%). Somatic cell count was reduced by 26.63% in the treatment. The results indicate that a sprinkler and fan cooling systems can provide an effective means to relieve heat stress and enhance productivity of lactating Holstein cows during hot and humid summer season.
In accordance with the rapidly growing number of street food service without a registration, a study was undertaken to determine the present state of food service by the covered wagon bar, through an investigation in Jamwondong, around the south gate market and Kangnam subway station, in Seoul, between July 25th and August 25th of 1987. The survey was comprised of three parts: 1) foodservice operation in covered wagon, 2) personal and food handling hygiene, 3) food behaviors of customers. A total of 54 covered wagon bars, consisting of 51.8% mobile bars and 48.2% non-mobile bars, operating in the above three locations, were investigated. Survey results show non-mobile covered wagon bars to be more popular among persons in their thrities and fourties than among teens or the elderly; also among males than females; among company employees and college students than others. Seventy five percent of the mobile covered wagon bars served snack type foods and others served wine and foods for wine, in contrast to hundred percent of the non-mobile covered wagon bars served wine and foods for wine. The survey found many problems of hygiene, in method of food purchasing, menu planning, food preparation, dish washing treatment of leftovers and water supply, as well as personal hygiene. However, customers prefer the casual and popular atmosphere at the counter of the covered wagon bar. Finally, the study emphasizes a need for better operation of covered wagon bar, improvement of food stuff handling and the way of food services and personal hygiene. A change of the registration system from the illegal operation are urgently needed for better quality food services of covered wagon bars.
This study on the some urban salaried workers' eating habits was performed according to age, sex, and occupation. The results were as follows: 1. The subjects of Pusan amount to 14.2%, Yosu 25.3%, Changwon 26.8%, Chinju 13%, and Inchon 20.7%. The proportion of women to men is 29.5% to 60.5%. The subjects in there twenties and thirties were 40.4%, those in there forties and fifties 26.9%. 2. 84.6% of the subjects had breakfast regularly(p<0.005). It turned out that males enjoyed breakfast more than females. The main reason for skipping breakfast was the shortage of appetite. 3. Over 80% of subjects enjoyed Korean food for breakfast. 4. Most subjects usually ate lunch at the cafeteria. They enjoyed stew and usually paid ₩3,500-4,000 for lunch(p<0.005). 5. 71.8% of subjects always had dinner(p<0.005). Younger people under 20 skipped dinner sometimes as a means of weight control. 6. 60% of subjects enjoyed eating out for dinner once or twice a week(p<0.005). Women ate out more than men, and the young ate out more than the old. People aged 30 to 40 ate out most frequently. 7. The subjects thought dinner was the most important dish, followed by lunch and then breakfast. 8. 66.6% of subjects had meat once or twice a week(p<0.01). 13.8% under 20 didn't eat meat at all as a means of weight control. Women enjoyed meat more than men. The reasons for not consuming meat were a dislike and insufficient financial resources. According to the survey, most urban salaried workers had breakfast and dinner regularly, preferred Korean food for breakfast, had lunch from mass food supplies, enjoyed eating out once or twice a week, and women ate out more frequently than men. This study includes that it helps to develop the right eating habits and provide a more balance and varied diet.
Journal of the Korea Academia-Industrial cooperation Society
/
v.17
no.10
/
pp.591-599
/
2016
Among the employer-supported subscribers to the National Health Insurance Service, 6,797 people with mild disabilities with western ages of 20 and up and who received health checkups were investigated. Of these 6,797 people, 3,186 and 3,611 received health checkups in 2009 and 2013, respectively. Those people who were diagnosed with physical handicaps, brain lesions, visual impairment, hearing impairment, intellectual disabilities, mental disorders, kidney disorders or other disorders according to the classification standard for people with disabilities were classified into disability groups of the 3rd through 6th degrees. The purpose of this study was to examine the dangerous influence of obesity of people with mild disabilities on their hyperglycemia, hypertension and high cholesterol. The items measured in this study were abdominal obesity, body mass index, fasting glucose, total cholesterol, systolic blood pressure and diastolic blood pressure. To look for connections between the obesity level and at-risk groups for each disease, cross tabulation and multinomial logistic regression analyses were utilized. Higher levels of abdominal obesity and BMI were found among those who were male, were younger and had higher incomes. The risks of abdominal obesity and BMI were higher in the abnormal groups for each disease. In 2009, the obesity group whose BMI was higher had a 1.51-fold higher risk of hypertension than the normal group. The abdominal obesity group had a 1.59-fold higher risk of high cholesterol, a 1.26-fold higher risk of hypertension and a 1.54-fold higher risk of hyperglycemia than the normal group. In 2013, the obesity group whose BMI was higher had a 1.72-fold higher risk of high cholesterol and a 1.43-fold higher risk of hypertension than the normal group. Those with abdominal obesity had a 1.59-fold higher risk of hyperglycemia than the normal subjects. As the risk of obesity was higher in those with disabilities than in those without disabilities, the former should be encouraged to undergo health checkups on a regular basis, and the coverage of the health checkups should be extended to keep track of their illness. In addition, appropriate education and concern are both required to prevent obesity.
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