• Journal of Chest Surgery
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• 제26권8호
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• pp.595-603
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• 1993

We analysed 60 consecutive patients who got Senning operation for transposition of the great arteries [TGA] with or without ventricular septal defects [VSD]. There were 41 simple TGA [group I] and 19 TGA with VSD [Group II], the operative mortality was 20 % [in group I 4.9 %, group II 52.6 %]. Among the survivors [n=48], the mean follow-up period was 7 years [range, 1 year to 13.5 years] and the actuarial survival rate at 13 years were 95 % in group I and 42 % in group II. Preoperative high left ventricular pressure and high pulmonary arterial pressure affected the surviving [p<0.01]. There occurred various type of arrhythmia like junctional rhythm, first degree atrioventricular [AV] block, sick sinus syndrome and complete AV block, and we inserted 2 permanent pacemakers for these patients. The incidence of arrhythmia were 28.2 % [11/39] in group I and 55.6 % [5/9] in group II, and the actuarial freedom from arrhythmia at 13 years after operation was 66 % [71 % in group I, 44 % in group II]. Increased aortic cross clamping time had affected the development of arrhythmia [p<0.05] which meant the complexity of the operation. The total incidence of left ventricular outflow tract obstruction [LVOTO] was 31.3 % [15/48], but only 3 patients [6.25 %] showed the significant gradient requiring reoperation. The pulmonary venous pathway obstruction [PVO] were found in 3 patients, all in group I, and among them only one required the reoperation. The estimated freedom from PVO was 89 % at 13 years [87 % in group I, 100 % in group II], but we couldn`t find any significant systemic venous obstruction in our series. There occurred 27.1 % [13/48] mild degree tricuspid valve regurgitation without necessary surgical correction. We experienced 14.6 % [7/48] reoperation rate: 3 residual VSD, 3 LVOTO, 1 PVO, 3 atrial baffle leakage. For this high incidence of complication rate after Senning operation and high mortality in TGA with VSD, We do not use this kind of surgical modality any more and do the Jatene operation for all the TGA patients since several years ago.

• 대한족부족관절학회지
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• 제16권4호
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• pp.223-228
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• 2012

Purpose: To treat hallux valgus in old age patients with chevron metatarsal osteotomy and to see the subsequent clinical and radiological outcomes. Materials and Methods: 23 cases of 18 hallux valgus patients of age 60 years or older who received proximal or distal corrective osteotomy from April 2007 to August 2009 and were followed up for at least 1 year were included in the study. The mean age at operation was 65 years (range, 60~81 years), and the mean follow-up period was 2 years and 6 months (range, 1 year~3 years 6 months). Clinical outcome was assessed with the American Orthopaedic Foot and Ankle Society (AOFAS) score, complications, satisfaction rate, as well as measurements and comparison of pre- and postoperative hallux valgus angles, the 1st~2nd intermetatarsal angle, and the position of hallucal medial sesamoid bone. Results: The AOFAS score was improved from preoperative average of 35.1 (range, 13-47) to average 85.1 at last follow-up (range, 75-100). Patients were satisfied about the operation in 21 cases (91.3%). Preoperative hallux valgus angle was $31.7^{\circ}$ on average (range, $19.1^{\circ}-48.9^{\circ}$), and $4.9^{\circ}$ on average at last follow-up (range, $0.3^{\circ}-21.2^{\circ}$). The 1st~2nd intermetatarsal angle was $14.4^{\circ}$on average (range, $8.7^{\circ}-25.7^{\circ}$) and $3.1^{\circ}$ on average at last follow-up (range, $0.6^{\circ}-7.5^{\circ}$). The hallucal medial sesamoid bone position was improved from preoperative average 3.5 (range, 3-4) to postoperative average 1.0 (range, 0-2). Conclusion: Proximal and distal metatarsal osteotomy treatment yielded good clinical and radiological outcomes in old age hallux valgus patients.

• Journal of Chest Surgery
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• 제16권4호
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• pp.602-614
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• 1983

Six hundred fourteen consecutive cases of bioprosthetic cardiac valve replacement performed during the period from March 1976 through December 1982 were reviewed. A total of 748 tissue valves [534 Ionescu-Shiley valves, 144 Hancock valves, 46 Angell-Shiley, and 24 Carpentier-Edwards] were implanted in 610 patients. Of these, 477 had single valve replacements [403 mitral, 60 aortic, and 14 tricuspid] including three REDO MVR and one REDO AVR. The remaining 129 had double valve replacements [95 AVR and MVR and 34 MVR and TVR] and 8 had triple valve replacement.592 cases were evaluated. Overall early mortality rate [within 30 days of operation] was 7.1% [6.2% in single valve replacement, 10.2% in double valve replacement, and 16.7% in triple valve replacement]. Leading causes of mortality were low cardiac output or myocardial failure and ventricular arrhythmias. The follow-up period was from one month to 7 years with a cumulative follow-up of 906.6 patient-years [mean 1.53 years]. The late mortality was 1.6%, 3.9%, 0%, 2.6%, 6.6% and 2.0% per patient-year for MVR, AVR, TVR or triple valve replacement, AVR+MVR, MVR+TVR and total, respectively. Actuarial analysis of late results including early mortalities indicates an expected survival rate of 87.6+1.8% at 3 years and 85.92.4% at 7 years for all cases. We also analyzed actuarial survival rate between groups of each valve replacement [AVR, TVR, Double valve, and Triple valve] and the tissue valve groups in MVR. We experienced 7 cases [0.77% per patient-year] of confirmed endocarditis, two of which were fatal. Valve failure-free rates calculated according to the confirmed cases were 97.5% at 4 years, 87.5% at 7 years, and 88.3% at 6 years for Ionescu-Shiley, Hancock and Angell-Shiley valves, respectively. The occurrence rate of thromboembolism was 2.0% per patient-year in total cases, although almost all the patients were given anticoagulant therapy for one year. The occurring rate in MVR was 1.5% and 2.7% per patient-year for Ionescu-Shiley and Hancock valve groups, respectively. The difference in actuarial rate free from thromboemboli between Ionescu-Shiley and Hancock groups was statistically significant [P value less than 0.001]. Thromboembolic events beyond the period of anticoagulation therapy mainly occurred in patients with atrial fibrillation. The actuarial thromboemboli free survival was 95.71.4% at 3 years and 80.17.3% at 7 years. The incidence of hemorrhagic complications was 1.2% per patient-year [fatality 0.55% per patient-year] for anticoagulated patients. Although our clinical data favorably compares with results from other reports, our results suggest that anticoagulant therapy be given on a short-term basis or not at all to hemodynamically stable patients. Long-term therapy with antiplatelet drugs is probably inevitable with patients who have thromboembolic risk factors [such as atrial fibrillation].

• Journal of Chest Surgery
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• 제25권12호
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• pp.1563-1569
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• 1992

From Jan. 1981 to Dec. 1991, we had treated 25 patients with congenital coronary art-eriovenous fistulas [CAVF] in Seoul National University Hospital. A retrospective review was made to delineate the course and the management of CAVF and to clarify the role of surgical treatment. Fifteen patients were male and 10 were female with The mean age of 17.4 years[from 3 months to 58 years]. The most frequent symptom was dyspnea on exertion[56%]. Other symptoms were angina and palpitation. Sixty-eight percent of the patients were symptomatic. Fifty-three percent of patients less than 20 years old were symptomatic and 100% of patients over 20 years old were symptomatic. Three patients had multiple CAVFs. The fistula drained into the right ventricle in 13, pulmonary artery in 9, left ventricle in 4, right atrium in 2, and left atrium in 1. Thirteen patients had other associated cardiac lesions. The mean pulmonary-to-systemic blood flow[Qp /Qs] in the isolate CAVF group was 2.19. All patients were operated on to correct the fistulas and other associated cardiac lesions. All patients were followed from 1 month to 11 years without late death. Postoperative complication rate was 24% -significant arrhythmia [3], recurred CAVF[1], psychosis[1], pneumonia [1]. Symptomatic improvement was evident postoperatively. Below 20 years old, 94% of patients were asymptomatic, but above 20 years old, symptoms persisted in 25%. In summary, early elective repair of CAVF is indicated in all patients because of higher complication rate and frequent persistent symptoms in older patients.

• 보건교육건강증진학회지
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• 제6권1호
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• pp.48-59
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• 1989

The study was designed. to analyse the factors effecting to smoking and drinking of community people in rural area. The study has been surveyed through interviews by trained college students for 1,846 residents who live in rural area(Eup or Myun office is located)for 20days(from 3rd. to 22M. in August, 1988) The summary and conclusions are as follows. 1. The number of answers on the questionaires was 1846. And the percent of man was 55.7 %(woman 44.3 %). Among age group 20-29 years group with 30.4 % was larger than any other group. Anaverage age of answers was 38.6 years. 2.In the period of residence, 21.5 % of the residents lived within 5 years(This group was larger than any other group). In occupations, workers in agriculture and fishing was more than other job occupants. In education, the percent of high school graduates was 44.0 %(higher than any other group) 3.The smoking rate of rural residents was 41.8 %and man's smoking rate was 76.0 % (woman's smoking rate was 7.6 %). These rates were higher than the rates in 1985 (The smoking rate of nation was 32.0 %). First of all, woman's smoking rate increased rapidly 4.As for smoking amount, in male 52.8% of smokers smoked a cigarette case (20 cigarettes) in a day, and 16.9 % of smokers smoked more than one cigarette case. In female 42.5 % of woman smokers smoked a half case in a day and the rate of non-smokers diminished to 77.8 % 5.The rate of non-smokers in 21-29 years group was higher than any other group and a smoking rate increased as an age increased. However, a smoking amount decreased as an age increased. This suggests that people are more concerning about their health as their ages increase.. 6.The smoking rate of college graduates was 58.8 %(higher than any other group) and in a smoking amount 36.4 % of college graduates, 29.8 % of high school graduates smoked more than a cigarette case in a day. This shows that people in a higher education group smoke more than those in other groups. 7.As for non-smoking rate, students, service job workers, company employees, and teachers was 54.1%, 43.4%. 40.1% and 39.5%. respectively. As for smoking rate, workers in agriculture and fishing was the highest level of all job employees. Public officers smoked less than the workers in agriculture and the smoking rate of teachers was less than that of public officers. with regard to smoking amount. above one cigarette case in a day was 39.9 % in public officers, 39.2 % workers in agriculture and fishing, 37.9 % in businessmen, 34.2 % in teachers, 31.9 % in service job employees and 31.6 % in a company employees. 8.The variables which had an effect on smoking were sex (B=.1701), job(B=.1688), education(B=.1671), age(B=.1125). These variables were significant in P＜0.05 statistically. Explanatory variance level was 19% 9.The drinking rate of community residents was 61.8% and man's drinking rate was 81.7%(woman's drinking rate was 38.9%). As drinking rate 18.0%(the highest rate) of man drinkers drank 3 bottles of beer in a general drinking and 12.1% of them drank more than 10 bottles. 12.1% (the highest rate)of woman drinkers drank 2 cups of beer. The rising rate of woman's drinking of alcohol was remarkable. 10.Each non-drinking rate of age groups was 27.6% (in 20-30 years group), 28.0% (in 30-39 years group), 28.9%(in 40-49 years group) and 32,6%(in 50-59 years group), 10,7%(the highest rate) of 20-29 and 30-39 years groups drank above 3 bottles. 7.5% of 20-29 years group and 7.7% of 30-39 years group drank above 10 bottles. In 40-49 years group, 14.4 % of them drank a bottle and 8.1% of them drank above 10 bottles. In 50-59years group, 14,2% of them drank 2 bottles and 5.3 % of them drank above 10 bottles. This shows that a drinking rate decresed as an age increased. 11.Non-drinking rate was higher as an education level was lower. Each non-drinking rate of non-educated group, elementary school group, middle school group and high school group was 41.0 % of high school graduates and 14.5 % of college graduates drank 3 bottles of beer. 9.7 %(the highest rate) of college graduates drank above 10 bottles, in general drinking. 12.Each non-drinking rate of businessmen, farmers, service job workers, and students was 31.3%, 28.2%, 26.8% and 25.9%. However, Each drinking rate of public officers, company employees and teachers was 73.3 %, 72.2 % and 68.4 %. This tells us that the drinking rate of mental workers is higher than that of physical workers. 14.9 % of farmers and 14.4 % of public officers drank 3 bottles at a time. 10.5 % of teachers and 9.9 % of public officers drank above 10 bottles. 13.The variables which affect on drinking were sex(B=.1545), education(B=.1476), job(B=.1064), and age(B=.1052). These variables were significant in the level of 0.05 % and explanatory variance level was 18 %. 14.Government have to educate people and demonstrate the health hazards caused by smoking and over-drinking. Especially, No-smoking campaign for woman and education not to over drink for professional job workers are necessary.

• 대한기관식도과학회:학술대회논문집
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• 대한기관식도과학회 1981년도 제15차 학술대회연제순서 및 초록
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• pp.41.2-41
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• 1981

편도선 및 아데노이드 비대 제거술은 이비인후과 영역에서 매우 중요한 수술중의 하나이다. 최근 수술후 합병증이나 편도선및 아데노이드의 면역학적, 해부학적 기능에 대한 재고찰등으로 인해 세심한 수술 선택이 있음에도 불구하고 여전히 소아 수술중 가장 많은 부분을 차지 하고 있다. 특히 아데노이드 비대 제거술은 아데노이드 증식으로 인한 비인강 기도 폐색을 해소시키며 심부전 등의 합병증이나 아데노이드 비대와 동반 할 수 있는 재발성 혹은 만성 중이염을 예방할 수 있다. 저자들은 1979년 4월부터 1981년 2월까지 본원에서 T&A를 받은 환자 117례와 통례검사를 받은 환자 266례의 X-선 사진에서 아데노이드 비대의 지표가 되는 A/N ratio를 조사 비교하고 T&A를 받은 환자의 Impedance청력검사 및 X-선 사진을 분석하여 다음과 같은 결과를 얻었다. 1) 266례의 정상소아의 연령별 A/N ratio치는 0∼3세 : 0.508, 4∼6세 ; 0.533, 7∼9세 ; 0.524, 10∼12세 ; 0.519, 13∼15세 : 0.507, 15세 이상 ; 0.481을 보였는데 4∼6세의 소아에서 가장 높았고 남녀간 A/N ratio에는 큰 차이가 없었다. 2) T&A를 받은 117례의 연령별 A/N ratio치는 0∼3세 : 0.709, 4∼6세 ; 0.733, 7∼9세 ; 0.693, 10∼12세 ; 0.707, 13∼15세 ; 10.620, 15세 이상 ; 0.756을 보였다. 3) T&A를 받은 117례 중, 비정상적인 tympanogram을 보인 57례의 A/N ratio 평균치는 0.688을 보였고, 정상적인 tympanogram을 보인 60례의 A/N ratio 평균치는 0.705를 보였다. 4) 비정상적인 tympanogram을 보인 57례의 A/N ratio를 분석하면, 6례(10.5%)에서 0.40∼0.59, 44례(77.2%)에서 0.60∼0.79, 7례(12.3%)에서 0.8이상을 나타냈다. 5) T&A를 받은 117례 중, A/N ratio가 0.6미만인 경우 15례 중 3례 (20%)에서, T/N ratio가 0.6 이상인 경우 102례 중 67례 (66%)에서 Water's view상 부비동염을 보였다.

• 한국환경과학회지
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• 제25권8호
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• pp.1077-1085
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• 2016

The present study was investigated the effect of recycled coir organic substrates on the growth of different vegetable crops. The recycled coir had better physical and chemical properties than the new coir. The growth of tomato plant was better on the coir substrate that had been used for 2 years than that on the new coir substrate. The average number of tomato fruits was 108 on the new coir substrate, while it was 179 and 165 on the coir substrate used for 1 and 2 years, respectively. The growth of cherry tomato plant was also better on the coir substrate used for 2 years than that on the new coir substrate. The average number of cherry tomato fruits was 43 on the new coir substrate, while it was 206 and 164 on the coir substrate used for 1 and 2 years, respectively. The growth of brussel sprout was better on the coir substrate used for 3 years than that on the new coir substrate and the average number of brussel sprout leaves was 26.8 on the new coir substrate, while it was 34.3 on the coir substrate used for 3 years. The growth of Korean cabbage improved on the coir substrate used for 1 years compared to the new coir substrate and the number of leaves was 15.1 on the new coir substrate, while it was 24.3 on the coir substrate used for 1 year. Thus, used coir can be recycled to improve vegetable yields compared to using new coirs.

• Asian Pacific Journal of Cancer Prevention
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• 제16권7호
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• pp.2653-2657
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• 2015

Nasopharyngeal carcinoma (NPC) is the second most common neoplasm of head and neck in Tunisia. The distribution is bimodal with a first period occurrence between 15 and 20 years old and a second peak at around 50 years of age. Undifferentiated carcinoma of nasopharynx type III (UCNT) is the predominant histological type (93.4%). Data of cancer registry of North Tunisia confirmed that it is an intermediate risk area for NPC with overall ASRs of 3.6 and 1.6/100,000 respectively in males and females. This study aimed to present the evolution of incidence rate of nasopharyngeal carcinoma over a period of 12 years (1994-2006). Data of cancer registry of North Tunisia (NTCR), covering half of the Tunisian population, were used to determine evolution of NPC incidence, calculated by 5 year periods. The estimated annual percentage change (EAPC) was used as an estimate of the trend. To best summarize the behavior or the data trend across years, we used a join-point regression program. Between 1994 and 2006, we observed negative annual average change of standardized incidence in men and women (-3.3%and -2.7%) also for the standardized incidences which showed a rather important decline (26.4% in males and 22.3% in females). The truncated age standardized incidence rate of NPC in adults aged of 30 years old and more (N= 1209) decreased by -0.4% per year from 1994 to 2006 over time in north Tunisia dropping from 6.09 to 4.14 person-years. However, the rate was relatively stable during this period among youths aged 0-29 years (N= 233) in both sexes. NPC demonstrated a favorable evolution from 1994-2006 probably due to a improvement in socioeconomic conditions.

• Asian Pacific Journal of Cancer Prevention
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• 제17권7호
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• pp.3647-3650
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• 2016

Background: Colorectal cancer is one of the major health problems worldwide. However, limited studies have been reported from ASEAN countries. This study was conducted to evaluate clinical characteristics and survival of colorectal cancer cases aged <65 years and ${\geq}65$ years in the central region of Thailand. Materials and Methods: Clinical information, histological features, endoscopic findings and treatment outcome were collected and reviewed from Thammasat University Hospital, Pathumthani, Thailand between November 2011 and October 2015. Results: A total of 121 colorectal cancer patients, comprising 69 men and 52 women with a mean age of 65.8 years, were included. There were 57 aged <65 years and 64 aged ${\geq}65$ years. Common presenting symptoms were abdominal pain (37%), weight loss (34%) and anemia (32%). Mean duration of symptoms prior to diagnosis was 173 days. However, longer diagnosis time was demonstrated in patients aged <65 years than age more than ${\geq}65$ years (119.4 vs 58.4 days, P-value=0.30). Colonic fungating mass was the most common endoscopic finding (64.4%) and the location was significantly more commonly left than right side of the colon, both in younger and elderly groups (87.7% vs 12.3%, P=0.02 and 70.3% vs 29.7%, P=0.02, respectively). Adenocarcinoma with moderated differentiated was the most common histology (67.3%). More than half of the patients presented with advanced stage (28.9% with TNM stage 3 and 38.8% TNM stage 4, respectively). Overall 1-year and 5-year survival rates were 76.9% and 5%. Conclusions: Most colorectal cancer patients in Thailand have adenocarcinomas and present at advanced stage with poor prognosis. Screening of high risk patients and early detection might be essential factors to improve the treatment outcome and overall survival rate of colon cancer patients in Thailand and other ASEAN countries.

• Journal of Chest Surgery
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• 제22권2호
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• pp.246-255
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• 1989

A total and consecutive 291 patients of isolated single mitral valve replacement using the Ionescu-Shiley bovine pericardial xenograft valve operated on between October 1978 and June 1983 were retrospectively studied for the durability of the substitute valves based on the structural degeneration of primary tissue failure which had been proved on their re-replacement surgery. The mean age at the initial surgery was 32.4*12.5 years, and the operative mortality rate was 5.2 %. The early survivors of 276 patients were followed up for a total 1148.3 patient-years[mean\ulcornerD, 4.16*2.57 years]at the follow-up end of June 1988. They experienced 4 major late complications: 1.045 % thromboembolism/patient-year [pt-yr]; 0.871 % bleeding/pt-yr; 0.610% endocarditis/pt-yr; and 3.309% overall valve failure/pt-yr or 1.655% primary tissue failure/pt-yr. The actuarial survival rates were 89.4*2.2% and 87.7*2.5% at 5 and 10 years after initial surgery respectively. The probabilities of freedom from thromboembolism were 95.1*1.6% and 93.2*2.0% at 5 and 10 years after surgery. Nineteen patients underwent re-replacement of the Ionescu-Shiley valve because of primary tissue failure, and there was no operative mortality. The incidence of primary tissue failure was highest for the patients less than 15 years of age occurring in 9 out of 27 patients [33.3 %] or 8.68 %/pt-yr, while it was 4.0 % or 0.96 %/pt-yr for the rest of patients older than this age. The probabilities of freedom from primary tissue failure were 96.7*1.4 % and 84.2*3.8% at 5 and 9 years after surgery. The freedom from tissue failure increased as the age limits of cumulative younger patients were increased while it decreased as the age limits of cumulative older patients were decreased. Although it is clear that the Ionescu-Shiley valve would degenerate prematurely in young patients, the definite age limit could not be identified when the risk of early failure was significantly high.