• Title/Summary/Keyword: 한-일 대학

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Health Improvement; Health Education, Health Promotion and the Settings Approach (건강 향상: 건강 교육, 건강 증진 및 배경적 접근)

  • Green, Jackie
    • Proceedings of The Korean Society of Health Promotion Conference
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    • 2004.10a
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    • pp.111-129
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    • 2004
  • This paper develops the argument that the 'Healthy Cities Approach' extends beyond the boundaries of officially designated Healthy Cities and suggests that signs of it are evident much more widely in efforts to promote health in the United Kingdom and in national policy. It draws on examples from Leeds, a major city in the north of England. In particular, it suggests that efforts to improve population health need to focus on the wider determinants and that this requires a collaborative response involving a range of different sectors and the participation of the community. Inequality is recognised as a major issue and the need to identify areas of deprivation and direct resources towards these is emphasised. Childhood poverty is referred to and the importance of breaking cycles of deprivation. The role of the school is seen as important in contributing to health generally and the compatibility between Healthy Cities and Health Promoting Schools is noted. Not only can Health Promoting Schools improve the health of young people themselves they can also develop the skills, awareness and motivation to improve the health of the community. Using child pedestrian injury as an example, the paper argues that problems and their cause should not be conceived narrowly. The Healthy Cities movement has taught us that the response, if it is to be effective, should focus on the wider determinants and be adapted to local circumstances. Instead of simply attempting to change behaviour through traditional health education we need to ensure that the environment is healthy in itself and supports healthy behaviour. To achieve this we need to develop awareness, skills and motivation among policy makers, professionals and the community. The 'New Health' education is proposed as a term to distinguish the type of health education which addresses these issues from more traditional forms.

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A Study on the Sanctuary of the Residence in East China Sea Skirts Area (동중국해권 민가의 성역(聖域)에 관한 연구)

  • Youn, Lily;Onomichi, Kenji
    • Korean Journal of Heritage: History & Science
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    • v.43 no.2
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    • pp.60-81
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    • 2010
  • Jeju Island, in Korea, shows many characteristics that are differentiated from the rest of Korea. Its culture is rooted in mythology which advocates a egalitarian, rather than hierarchical, social structure, the place of women in the home is relatively high, and the formation of buildings, the separation of cooking and heating facilities, and the living format of residential homes is dissimilar. These disparities in culture indicate that Jeju Island's heritage was not formed only from influences from the North, but also from other places as well. To fill in the blanks, residential homes in Jeju Island were compared with those scattered throughout the East China Sea, which connect the southern coastline of the Korean peninsula and Jeju Island. The regions encompassed by the East China Sea, sharing the Kuroshio current and a seasonal wind, can be considered as one cultural region integrating cultural aspects from the continental North and the oceanbound South. The unique characteristics of southern culture as seen in southern residences was examined through an investigation of the sacred places in which gods were considered to dwell. First, the myths of these areas usually concerned with the ocean, and a sterile environment made sustenance impossible without a dual livelihood, usually taking on the forms of half-farming and half-fishing, or half-farming, half-gardening. Although family compositions were strongly matricentric or collateral thanks to southern influence, a patriarchical system like those found in the North were present in the upper classes and in the cities. Therefore, residential spaces were not divided based on age or gender, as in hierarchical societies, but according to family and function. Second, these areas had local belief systems based on animism and ancestor worship, and household deities were closely related to women, agriculture and fire. The deities of the kitchen, the granary and the toilet were mostly female, and the role of priest was often filled by a woman. After Buddhism and Confucianism were introduced from mainland Korea, China and Japan, the sacred areas of the household took on a dual form, integrating the female-focused local rites with male-centered Buddhist and Confucian rites. Third, in accordance with worship of a kitchen deity, a granary deity, and a toilet deity led to these areas of the home being separated into disparate buildings. Eventually, these areas became absorbed into the home as architectural technology was further developed and lifestyles were changed. There was also integration of northern and southern cultures, with rites concerning granary and toilet deities coming from China, and the personality of the kitchen deity being related to the southern sea. In addition, the use of stone in separate kitchens, granaries, and toilets is a distinguishing characteristic of the East China Sea. This research is a part of the results gained from a project funded by the Korea Research Foundation in 2006.

A study on the gratification of the patient in the Dental Hospital (치과병원 내원환자의 만족도 조사분석)

  • Kim, Min-Young;Lee, Keun-Woo;Moon, Hong-Suk;Chung, Moon-Kyu
    • The Journal of Korean Academy of Prosthodontics
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    • v.46 no.1
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    • pp.65-82
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    • 2008
  • Statement of problem : Today's market economy has been changed more and more to consumer concerned. It is owing to not only consumers ' rising standard of living and education, but also purchasers' easy accessibilities to products through various mass media. The consumer centered market system, where customer can choose items with diverse alternatives to satisfy their self esteem, is also applied to the field of medical business, and accelerated by an increasing income level of shoppers and introducing the whole nations' medical insurance system. Today, the medical industry has become competitive due to increasing number of medical institutions and medical personnel, and this offers wide choices to consumers in the medical market place. At this point of time, it is essential to survey on the primary factor of gratification for the patient in the Dental clinic, as well as on the problems and suggestions in medical service. Purpose : The analysis in this study shows essential factors and expected influential elements in satisfaction of the patient in the Dental Hopsital, and strategic suggestions for the provider of dental service, which can be of benefit to the prospective customer as well as can make improvement in the quality of dental treatment service. Material and method : This study had been researched by collecting and analyzing the organized questionnaires, which were filled in directly from 784 patients, who visit Dental Hospital, Yonsei University in Seoul, from January 23rd to April 15th. Result : It can be summarized like the followings. 1. The social and demographical peculiarities of respondents are as follows. Samples of gender and marital status are adequately extracted, but data on occupation and treatment are are under a bias toward students, undergraduates and graduate students, and orthodontics. 2. 74% of patients who answer the questionnaire were highly satisfied with the service of dental clinic in the section of overall satisfaction. 3. The survey result about specific service of dental treatment, within sections of independent variables, is like the followings; Patients are highly gratified with service system, kindness, explanation, explanation on expected waiting hours, reservation system, emergency measures, expert treatment, existence of knowledge of dentistry, size of hospital, disinfection, equipment and parking, but lowly satisfied with expense of treatment, preparatory hours for treatment, waiting hours, treatment hours and the period of subscription. 4. The correlation analysis showed that there is no significant linear relationship between the independent variables. 5. The probit regression analysis showed that 8 out of 34 independent variables explained the dependent variables at the level of 0.01. 6. It shows that 8 independent variables, which can affect customers 'satisfaction, are clearing up of inconvenience, service system, kindness, explanation, treatment hours per attendance, reservation system, existence of knowledge of dentistry, and contentment of equipment in the hospital. Conclusion : The consumer's satisfaction totally relies on subjective evaluations of customers. Providing appropriate service, which can meet the criteria for the customer who demands various wares, pursues luxury goods, and expects high quality of medical service, is essential to fulfill patients' satisfaction. Many medical institutions do their best to satisfy their customer, touch their consumer, and offer patience centered services, and it is also applied to the field of dentistry. Establishing brand new strategic managements and elevating the quality of dental service based on this survey are required to improve the satisfaction of patience in the Dental Hospital.

Consideration on National Rituals and Folk Beliefs Found in 『Hajaeilgi』 (『하재일기』에 나타난 국가의례와 민간신앙 일고찰)

  • Song, Jae Yong
    • (The)Study of the Eastern Classic
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    • no.69
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    • pp.349-371
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    • 2017
  • "Hajaeilgi(荷齋日記)" was written by Ji Gyu-sik, a gongin of Saongwon(司饔院)'s branch, almost everyday for 20 years and 7 months from January 1st, 1891 until the leap month of June 29th, 1911. It deals with many different areas including domestic and foreign circumstances, custom, rituals, all the affairs related to the branch, and also everyday life events he did see or hear about. Particularly, Ji Gyu-sik did not belong to the yangban class, and we can hardly find diaries written by such class' people. Here, what this author pays attention to among the things written in "Hajaeilgi" is the contents about folklore. Ji Gyu-sik wrote in his "Hajaeilgi" about things related to folklore, for example, seasonal customs, folk plays, rituals, or folk beliefs that were actually practiced then as a person not belonging to the yangban class. Such diaries are rare, and its value is highly appreciated as a material, and it is meaningful in the aspects of folklore as well. Therefore, as part of the work to look into folklore found in "Hajaeilgi", this author focuses on national rituals and folk beliefs in it. The things that have been discussed earlier can be summed up as follows: About national rituals, it is sorry that it only deals with the emperor's enthronement and emperor and crown prince's birthday in garye(嘉禮); however, it is meaningful to know that the people faithfully carried out national ceremonies and celebrations then. Particularly, it is noteworthy that during the national ceremonies or celebrations, students were asked to sing the national anthem. About hyungrye(凶禮), only it deals with the court funeral rite. Aside from Minbi's funeral rite, the court funeral rite was performed properly at the right time according to the procedure like before, and also, it seems that the people fulfilled it faithfully by order of the government. Also, it can be learned from it that Japanese killed Minbi, burned the body with oil, and left the ashes behind. About folk beliefs, the branch held a memorial service at the shrine of the town regularly. The town, too, performed Gocheongsinsa each year. The money needed for the memorial service was collected from the town people differently according to their financial situations, and they prepared for jesu for the ancestral rite altogether. The memorial service was carried out in Sansindang or Bugeundang, too, and it was common that they summoned a shaman to perform a gut. The diary is valuable as material. After being a Christian, Ji Gyu-sik once tried to abolish sinsa jesa held in hoesa and get rid of saesin(賽神), that is, a gut or pudakgeori, but he had no choice but to follow the precedent. Meanwhile, it is also noteworthy that when the town suffered from floor and infectious disease, Ji Gyu-sik installed an altar in front of his house for the town's wellbeing and health, prepared for jesu including offerings and drinks, and held a memorial service to Hwangcheonhuto(皇天后土; the gods of heaven and earth) accompanied with the town people. Also, when he had any hardships in his family, Ji Gyu-sik summoned a shaman for a gut or offered a devout prayer to the mountainous god. Such shamanism or the things like worshiping Gwanseongjegun(關聖帝君) mostly in the beginning of January and telling fortunes about the year were all folk beliefs. This was very popular among the people, and it seems that it was deeply rooted in his life as well. Also, Ji Gyu-sik supported Fengshui beliefs, and it seems that it is not different from the people's general tendencies, either. As described above, "Hajaeilgi" dealing with national rituals and folk beliefs in it is valuable as material and is meaningful for research on forklore, and moreover, it is also significant in the aspects of forklore as well.

A Study on the Forest Yield Regulation by Systems Analysis (시스템분석(分析)에 의(依)한 삼림수확조절(森林收穫調節)에 관(關)한 연구(硏究))

  • Cho, Eung-hyouk
    • Korean Journal of Agricultural Science
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    • v.4 no.2
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    • pp.344-390
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    • 1977
  • The purpose of this paper was to schedule optimum cutting strategy which could maximize the total yield under certain restrictions on periodic timber removals and harvest areas from an industrial forest, based on a linear programming technique. Sensitivity of the regulation model to variations in restrictions has also been analyzed to get information on the changes of total yield in the planning period. The regulation procedure has been made on the experimental forest of the Agricultural College of Seoul National University. The forest is composed of 219 cutting units, and characterized by younger age group which is very common in Korea. The planning period is devided into 10 cutting periods of five years each, and cutting is permissible only on the stands of age groups 5-9. It is also assumed in the study that the subsequent forests are established immediately after cutting existing forests, non-stocked forest lands are planted in first cutting period, and established forests are fully stocked until next harvest. All feasible cutting regimes have been defined to each unit depending on their age groups. Total yield (Vi, k) of each regime expected in the planning period has been projected using stand yield tables and forest inventory data, and the regime which gives highest Vi, k has been selected as a optimum cutting regime. After calculating periodic yields and cutting areas, and total yield from the optimum regimes selected without any restrictions, the upper and lower limits of periodic yields(Vj-max, Vj-min) and those of periodic cutting areas (Aj-max, Aj-min) have been decided. The optimum regimes under such restrictions have been selected by linear programming. The results of the study may be summarized as follows:- 1. The fluctuations of periodic harvest yields and areas under cutting regimes selected without restrictions were very great, because of irregular composition of age classes and growing stocks of existing stands. About 68.8 percent of total yield is expected in period 10, while none of yield in periods 6 and 7. 2. After inspection of the above solution, restricted optimum cutting regimes were obtained under the restrictions of Amin=150 ha, Amax=400ha, $Vmin=5,000m^3$ and $Vmax=50,000m^3$, using LP regulation model. As a result, about $50,000m^3$ of stable harvest yield per period and a relatively balanced age group distribution is expected from period 5. In this case, the loss in total yield was about 29 percent of that of unrestricted regimes. 3. Thinning schedule could be easily treated by the model presented in the study, and the thinnings made it possible to select optimum regimes which might be effective for smoothing the wood flows, not to speak of increasing total yield in the planning period. 4. It was known that the stronger the restrictions becomes in the optimum solution the earlier the period comes in which balanced harvest yields and age group distribution can be formed. There was also a tendency in this particular case that the periodic yields were strongly affected by constraints, and the fluctuations of harvest areas depended upon the amount of periodic yields. 5. Because the total yield was decreased at the increasing rate with imposing stronger restrictions, the Joss would be very great where strict sustained yield and normal age group distribution are required in the earlier periods. 6. Total yield under the same restrictions in a period was increased by lowering the felling age and extending the range of cutting age groups. Therefore, it seemed to be advantageous for producing maximum timber yield to adopt wider range of cutting age groups with the lower limit at which the smallest utilization size of timber could be produced. 7. The LP regulation model presented in the study seemed to be useful in the Korean situation from the following point of view: (1) The model can provide forest managers with the solution of where, when, and how much to cut in order to best fulfill the owners objective. (2) Planning is visualized as a continuous process where new strateges are automatically evolved as changes in the forest environment are recognized. (3) The cost (measured as decrease in total yield) of imposing restrictions can be easily evaluated. (4) Thinning schedule can be treated without difficulty. (5) The model can be applied to irregular forests. (6) Traditional regulation methods can be rainforced by the model.

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Studies on The Effects of Several Methods Irrigation Control Affecting The Growth and Yields of Rice Plants and Saving the Irrigation Water (관개조절의 몇가지 방식이 수함의 생육 및 수량과 관개수절약에 미치는 영향에 관한 연구)

  • 이창구
    • Magazine of the Korean Society of Agricultural Engineers
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    • v.13 no.3
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    • pp.2322-2341
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    • 1971
  • The studies were conducted to determine the methods of irrigation control which is not only able to save the irrigation water as a adaptable measures for the insufficient irrigation water and the drought but also increase the yields of rice, in the paddy field which shows over percolating tendency through the couple years of 1968 and 1969 at Suwon. These experiments were carried with late maturing rice variety, Norim No. 6 and the major treatments in this experiments were filling the clay under surface soil, periodic irrigation and lining the Vinyl under the surface soil and three replicated completely randomized design was employed. Results obtained will be summarzed as follows. 1. Through the couple years, the plots tilled the clay under 15cm of the surface soil saved the irrigation water by 364% to 45% and 78% to 88% respectively. Particulary, the plot of filling the clay with 9cm thick under 15cm of the surface soil, saved the amount of irrigation water by 45% to 88% and also increased yields by 12% to 20% through the couple years. 2. The plots in which amount of 40mm of irrigation water is irrigated periodically from 5 to 8 days at the stages of tillering and ripening, saved theamount of irrigation water by 41% to 55% and also increased yields by 10% to 16% respectively through the couple years. 3. The plot lined the Vinyl under 15cm of the surface soil, saved the amount of irrigation water by 75% to 88% in accordance with the size of hole. The plot of lining the Vinyl with $3cm/m^2$ hole yielded almost same as the check plot, but in the case of lesser hole than above yielded less. 4. The plots inserted the Vinyl paper in 57cm depth and with 6cm height from the soil surface around the plot to prevent the ridge percolation reduced the amount of percolation by 25% to 33%. 5. The plot filled the wheat straw with 6cm thick under 15cm of the surface soil increased yields by 30% in former year but opposite results were gained in later year. 6. Generally, yields and yield components such as number of spikes of spikes per hill and number of grains per spike were decreased in 1969. These faots are considered to depend upon the rainy and cold weather in the stages of vigorous tillering and less sunshine in the stages of ripening. 7. The variation of characters among the plots will be summarized as follows. (1) Tallerplant height was found in the plots of clay filling and irrigation control. (2) longer culm length and higher yields were founds in the plots filled the clay with 9cm thick and controled the irrigation periodically froir 7 to 8 days. (3) Length of spike increased generally with yields but opposite tendency was found also. (4) Number of spikes per hill increased with yields in the plots of irrigation control. (5) Number of grains per spike increased with yields in the plots filled the clay with 9cm thick and controled irrigation periodically from 5 to 8 days. (6) Tendency of variation of 1000 grain weight is similar to Number of grains per spike. (7) Percentage of complete grains increased in the plot of clay filling and irrigation control.

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Quality of Life and Its Related Factors of Radiation Therapy Cancer Patients (방사선 치료를 받은 암환자의 삶의 질과 관련요인)

  • Shin, Ryung-Mi;Jung, Won-Seok;Oh, Byeong-Cheon;Jo, Jun-Young;Kim, Gi-Chul;Choi, Tae-Gyu;Lee, Sok-Goo
    • The Journal of Korean Society for Radiation Therapy
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    • v.23 no.1
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    • pp.21-29
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    • 2011
  • Purpose: The purpose of this master's thesis is to utilize basic data in order to improve the quality of life of cancer patients who received radiation therapy after analysing related factors that influence patient's quality of life and obtaining information about physical, mental problems of patients. Materials and Methods: By using a structured questionnaire about various characteristics and forms of support, I carried out a survey targeting 107 patients that experienced radiation therapy at a university hospital in the Daejeon metropolitan area from July 15 to August 15, 2010 and analysed the factors influencing quality of life. Results: In case of pain due to disease, 65.15 and painless 81.87 showed a high grade quality of life. As body weight decreases, the quality of life become lower. When the grade of quality of life according to economic characteristics was compared, all items except treatment period showed a difference (P=0.000). When the score of social support, family support, medical support and self-esteem was low, the mark of quality of life showed respectively 61.71, 68.77, 71.31, and 69.39 on the basis of 128 points. When the score of support form was high, the mark of quality of life showed 90.47, 83.29, 90.40, and 90.36 (P<0.05). When analyzing the correlation between social support, family support, medical support and self-esteem and the degree of quality of life, social support was 0.768, family support 0.596, medical support 0.434, self-esteem 0.516. They indicated the correlation of meaningful quantity statistically (P<0.01). The factors that improved the quality of life were married state, having a job and painless status. As monthly income increases, the quality of life was also much improved (P<0.05). Among the factors related to quality of life, social support and medical support and higher self-esteem scores of the quality of life score increased 0.979 point, 0.508 points and 1.667 point, respectively. Conclusion: In conclusion, the quality of life of cancer patients that received radiation treatment is related to social support, medical support and self esteem. Self-esteem is an important factor that influenced quality of life, so if government offers works that doesn't affect patient's health, they are a useful method that maximize self-esteem and lessen their financial burden at the same time. Along with these policies, the developments of the attention of medical and the program for cancer patient's family are needed for the purpose of improving quality of life of cancer patients. Lastly, medical team, patients and family have to cooperate in harmony to overcome difficulties of cancer patients.

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The Effect of Deep Breathing Methods on Pulmonary Ventilatory Function of Patients Who experiened Upper-abdominal surgery (심호흡 방법에 따른 상복부 수술환자의 폐 환기능에 미치는 효과)

  • Hwang Jin-Hee;Park Hyung-Suk
    • Journal of Korean Academy of Fundamentals of Nursing
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    • v.1 no.2
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    • pp.129-147
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    • 1994
  • The purpose of this study was to examine the effect of deep breathing exercise with Incentive Spirometer on the pulmonary ventilatory function of postoperative patients. This experiment was operated by quasi-experimental design which was compared pre-experimental measures with post-experimental ones. The subject of this study was 46 inpatients who were scheduled for elective upper abdominal surgery under the general anesthesia in P National University Hospital in Pusan and classified into the experimental group(23 patients) and control group(23 patients) by using Incentive Spirometer or unusing one. The data were collected from November, 1, 1993, to December, 31, 1993. The effects of the deep breathing exercise on the pulmonary ventilatory function were compared between experimental group who were recieved deep breathing exercise with Incentive Spirometer and control group who were recieved same method without Incentive Spirometer. The Forced Vital Capacity (FVC) and the First Second Forced Expiratory Volume ($FEV_1$) were represented as index of the pulmonary ventilatory function and those were measured by Vitalograph Compact. The collected data were analysed by SPSS/PC+ (percentage, average, standard deviation, chi-square test, t-test, and ANOVA). The results were as follow : (1) The $FVC_s$ of the experimental group were significantly increased in course of time, 24, 48, 72 hours after surgery(F=3.530, P=0.035). (2) The $FVC_s$ and $FEV_{1S}$ of the control group were significantly increased in course of time, 24, 48, 72 hours after surgery ($FVC_s$ : F=3.480, P=0.037, $FEV_{1S}$ : F=6. 153, P=0.004). (3) The FVC which was measured at 72 hours after surgery was significantly higher in the experimental group than in the control group(t=2.620, P=0.013). (4) The $FEV_{1s}$ which were measured at 24 and 72 hours after surgery were significantly higher in the experimental group than in the control group(24hr. : t=2.530, P=0.017, 72hr. : t=2.540, P=0.016). (5) Among general characteristics, sex was significant variable which influenced to effect of pulmonary ventilatory function. In conclusion, this study showed that the deep breathing exercise with Incentive Spirometer was more effective to recover the pulmonary ventilatory function after surgery than the deep breathing exercise without Incentive Spirometer.

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Performance State and Improvement Countermeasure of Primary Health Care Posts (보건진료소(保健診療所)와 업무실태(業務實態)와 개선방안(改善方案))

  • Park, Young-Hee;Kam, Sin;Han, Chang-Hyun;Cha, Byung-Jun;Kim, Tae-Woong;Gie, Jung-Aie;Kim, Byong-Guk
    • Journal of agricultural medicine and community health
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    • v.25 no.2
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    • pp.353-377
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    • 2000
  • This study was performed to investigate the performance state and improvement countermeasure of Primary Health care Posts(PHPs). The operation reports of PHPs(1996 330 PHPs, 1999 313 PHPs) located in Kyongsangbuk-Do and data collected by self-administered questionnaire survey of 280 community health practitioners(CHPs) were analyzed. The major results were as follows: Population per PHP in 1999 decreased in number compared with 1996. But population of the aged increased in number. The performance status of PHP in 1999 increased compared with 1996. A hundred forty one community health practitioners(50.4%) replied that the fiscal standing of PHP was good. Only 1.4% replied that the fiscal standing of PHP was difficult. For the degree of satisfaction in affairs, overall of community health practitioners felt proud. The degree of cooperation between PHP and public health institutions was high and the degree of cooperation of between PHP and private medical institutions was high. The degree of cooperation between PHP and Health Center was significantly different by age of CHP, the service period of CHP, and CHP's service period at present PHP. Over seventy percent of CHPs replied that they had cooperative relationship with operation council, village health workers, community organization. CHPs who drew up the paper on PHP's health activity plan were 96.4 % and only 11.4% of CHPs participated drawing up the report on the second community health plan. CHPs who grasped the blood pressure and smoking status of residents over 70% were 88.2%, 63.9% respectively and the grasp rate of blood pressure fur residents were significantly different according to age and educational level of CHP. CHPs received job education in addition continuous job education arid participated on research program in last 3 years were 27.5%, respectively. CHPs performed the return health program for residents in last 3years were 65.4%. Over 95% of CHPs replied that PHPs might be necessary and 53.9% of CHPs replied that the role of PHPs should be increased. CHPS indicated that major reasons of FHPs lockout were lack of understanding for PHP and administrative convenience, CHPs were officials in special government service governors intention of self-governing body. CHPs suggested number of population in health need such as the aged and patients with chronic disease, opinion of residents, population size, traffic situation and network in order as evaluation criteria for PHP and suggested results of health performance, degree of relationship with residents, results of medical examination anti treatment, ability for administration and affairs in order as evaluation criteria for CHP. CHPs replied that the important countermeasures for PHPs under standard were affairs improvement of PHPs and shifting of location to health weakness area in city. Over 50% of CHPs indicated that the most important thing for improvement of PHPs was affairs adjustment of CLIP. And CHPs suggested that health programs carried out in priority at PHP were management of diabetes mellitus and hypertention. home visiting health care, health care for the aged. The Affairs of BLIP should be adjusted to satisfy community health need and health programs such as management of diabetes mellitus and hypertention, home visiting health care, health care for the aged should be activated in order that PHPs become organization reflecting value system of primary health care.

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Analysis of Postpneumonectomy Complication without Balanced Chest Bottle (흉관 삽입술 없이 시행한 전폐절제술 후 발생한 합병증에 대한 분석)

  • Kim, Tae-Gyun;Chung, Won-Sang;Kang, Jung-Ho;Kim, Young-Hak;Kim, Hyuck;Jee, Heng-Ok;Lee, Chul-Bum;Ham, Shi-Young
    • Journal of Chest Surgery
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    • v.35 no.4
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    • pp.290-295
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    • 2002
  • Backgroud: Pneumonectomy carries the possibility of numerous dangerous complications as well as the vast effect the operation itself has on the cardiopulmonary function. Most of operations are done with the insertion of the chest tubes upon completion, but because of the high incidence of pyothorax as its complications, we have tried to analyze and compare the cases without inserting the chest tubes. Material and Method: During a 5 year period from January, 1996 to December 2000, 100 cases, which were operated at the Hanyang University Hospital, were selected using the patient's charts. The age, gender, indication of operation, associated diseases, and operation site(left or right) were classified accordingly and the postoperative complications and mortality were statistically analyzed using the $\chi$ 2-test. After resecting the lung, the intrathoracic pressure was set at -15 ~ -20cm $H_2O$ using the nelaton catheter, and the thoracotomy site was then closed. The gradual collection of the fluid and blood in the thorax of the operated side, as well as the mediastinum location, were observed carefully for 4~5 days postoperatively with the aid of the simple chest x-rays. Result: Of the 100 cases, 16 cases of pulmonary tuberculosis(16%), 81 cases of lung tumor(81%), 2 cases of bronchiectasis(2%), and 1 case of aspergilloma associated bronchiectasis were noted. There were 8 mortality cases(8%), and of the 34 cases(34%), 44 complications were noted. The age, sex, and operation site(left or right) were not statistically significant with the complications. 7 of the 16 cases of pulmonary tuberculosis(44%) and 27 of the 81 cases of lung tumor(33%) had complications, but they were found not to be statistically significant. The increase of the complication rate in the pulmonary tuberculosis patients was 3.86. The evidence of postoperative bleeding was observed in 6 cases with the 3 cases being the pulmonary tuberculosis patients and the 3 cases were others. This shows that the increase in postoperative bleeding in the pulmonary tuberculosis is statistically significant(p=0.019). Of the 100 cases, there were 8 mortality cases(8%), with 5 cases from the 81 cases of the lung tumor group(6.1%), 3 cases from the 16 cases of pulmonary tuberculoses group(18.7%).