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Surgical Treatment of Left Main Coronary Artery Diseases (좌주관동맥협착의 외과적 치료)

  • 안병희;장원채
    • Journal of Chest Surgery
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    • v.29 no.12
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    • pp.1323-1328
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    • 1996
  • The obstructive diseases involving the left main coronary artery(LMCA) are serious. Surgical treatment is generally regarded as much more effective than medical therapy in terms of long-term survival and relief of symptoms. This study represents an attempt to present an analysis of early surgical results in 21 cases conducted at Chonnam University Hospital between October 1992 And August 1995. The subject. 12 males and 9 female, ranged in age from 25 to 67 years with a mean age of 49.3${\pm}$12.5 years. As for indications for operation, unstable angina was reported on 66.7% of the subjects, while stable angina and acute myocardial infarction in 4 and 3 cases, respectively. There were also 2 cases of Takayasu's aortitis and 1 case of failed percutaneous translumlnal coronary angioplasty(PTCA). Eleven subjects had isolated LMCA diseases compared to 10 subjects with associated LMCA diseases. Of the patients with ass;3ciated LMCA diseases, 4 subjects had single coronary artery disease, 3 had double coronary artery disease, remaining 3 suffered from triple coronary artery disease. As for the group with isolated LMCA disease, ostidl angioplasty llsing autopericardium was conducted with 5 subjects. The remaining subjects with the isolated diseases and all of the patients with associated LMCA disease underwent aortocoronary bypass grafts. The left internal mammary artery was used in all patients and the average number of anastomoses was 3.13 ${\pm}$0.93. One subject died of low cardiac output syndrome at the second postoperative day. There were 5 instances of postoperative complication including reoperation for bleeding in two patients, wound infection in two, and arrhythmia in one. Follow-up coronary angiogram were conducted with eights patients, including five patients who underwent ostial angioplasty. In these cases, the patients showed surf. ficient enlargement of the left coronary ostium and the grafted vessels kept their patency. In our experience, surgical treatment of the LMCA diseases has not shown a higher rAte of operative mortAlity or morbidity than other obstructive coronary artery diseases. To patients with ostial stenosis, which is frequently observed among young female, angioplasly utilizing autopericardium seems to be a desirable choice considering the cosmetic effect, chances of reoperation and hemodynamic characteristics.

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Clinical Analysis of Children with Transitory Minimal Change Nephrotic Syndrome (MCNS) to Focal Segmental Glomerulosclerosis (FSCS) (미세변화형 신증후군(MCNS)으로부터 국소성 분절성 사구체 경화증(FSGS)으로 이행된 환아의 임상양상)

  • Lee Ji Eun;Yook Jinwon;Lee Eui Seong;Kim Ji Hong;Kim Pyung-Kil;Chung Hyun Joo
    • Childhood Kidney Diseases
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    • v.4 no.1
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    • pp.17-24
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    • 2000
  • Purpose: MCNS is found in approximately $85\%$ of the idiopathic nephrotic syndrome in children and shows good prognosis with initial steroid therapy. However in FSGS, there is poor prognosis with initial therapy and shows higher rate of progression to chronic renal failure and relapse after kindney transplantation. We have experienced 8 patients who were diagnosed as MCNS on initial renal biopsy and then progressed to FSGS on follow-up biopsy. So we have investigated their clinical course and risk factors for transition of MCNS to FSGS. Methods: We conducted a retrospective study with a review of histopathologic findings and clinical manifestations of 296 cases of MCNS and FSGS that were diagnosed from January 1988 to May 1999. We classified them into 3 groups according to the histopathologic finding; MCNS, FSGS, MCNS progressed to FSGS in follow-up biopsy. Results: The number of children was 296 cases comprising 241 cases($81.4\%$) showing MCNS, 8 cases($2.7\%$) transition group, 47 cases($15.9\%$) FSGS. The mean onset age was $6.0{\pm}2.6$years in MCNS, transition group $8.3{\pm}2.3$years, FSGS $7.2{\pm4.3$years, and the gender (M:F) ratio was 3.7:1 in MCNS, 3:1 in transition group, 1.8:1 in FSGS. Comparing the presence of initial hematuria, hypertension,24 hour urine protein, serum albumin, serum creatinine, there were significant difference between the transition group and the FSGS group in the following points; 24hour urine protein $684:342mg/m^2/hr$(P<0.05), serum albumin 1.92: 2.47g/dL(P<0.05), serum cholesterol 494:343mg/dL(P<0.05). Refractoriness to steroid therapy was 13.3$\%$ in MCNS. $12.5\%$ in transition group, $29.6\%$ in FSGS; significantly higher in FSGS(P<0.05). Immunosuppressant therapy was performed in $58.5\%$ of MCNS, $100\%$ in transition group, $80.8\%$ in FSGS; transition group showed significantly higher .ate(P<0.05) comparing with MCNS. Mean number of relapse and duration from onset to first relapse showed no significance difference between these groups. Conclusion: 249 patients with MCNS have been followed and $3.2\%$ (8 patients) of them has shown change in pathologic diagnosis from MCNS to FSCS. The risk factor for transition could not be found. Our results point to the need for a follow-up biopsy to certify the possibility of transition to FSCS in some MCNS cases with refractory cases to steroid therepy, frequent relapsing cases, or in case of no remission in spite of vigorous immunosuppressant therapy.

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Factors Related with the Compliance and Treatment in Patients with Pulmonary Tuberculosis in Urban and Suburb Area (도시와 농촌지역의 폐결핵 환자 순응도 및 치료에 관련된 요인)

  • Kim, Sang-Soon;Kim, Yoon-Ock
    • Research in Community and Public Health Nursing
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    • v.7 no.1
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    • pp.69-79
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    • 1996
  • To investigate the factors related with the compliance and the treatment of the patients with pulmonary tuberculosis in urban and suburb area, we followed up all the 755 registered patients(at urban Public Health Office 544, at suburb 210) as follow from January 1,1992 to December 31, 1993. We describe the general characteristics and the characteristics related with the disease of the patients according to the area as follow. 150 patients(27.5%) were at their age of 20 to 29 years in the urban area, whereas 45 patients (21.4%) were 60 to 69 years and another 45 patients(21.4%) were 70 to 79 years in the suburb area. According to the first chest X -ray examination, 54.5% of all cases were proved to be mild in the urban area. But in the suburb area, moderate cases (44.3%) were more than mild cases(p<0.01). Follow-up X-ray's were performed more properly(p<0.05) in the urban area(94.3%) than in the suburb area(90.0%). Most cases were found in the chest X -ray examination performed by Public Health Office (p<0.01) : payable chest X-ray in the urban area (56.7%) and free chest X-ray in the suburb area(35.2%). More patients were cured in the urban area(90.8%) than in the suburb area(87.1%). The presence of supporting family member were significantly higher(p<0.05) in the urban area(79.1%) than in the suburb area(88.1%). In the analysis of the treatment efficacy, more cure ate were found in the patients cytologically confirmed to be culture (+). In the urban area, 201 culture (+) patients (93.5%) 294 culture (-) patients (89.1%) were cured. In the suburb area, 99 culture (+) patients(91.7%) and 84 culture (-) patients(82.4%) were cured. Age, the presence of supporting family member, and the socioeconomic status of the patient had significant association with the prescription compliance related with the general characteristics of the patients. Whereas, X-ray finding and AFB culture finding were the significant factors associated with the prescription compliance related with pulmonary tuberculosis (p<0.05). The cumulative compliance in the survival analysis was 92.5% in the urban area and 88.1% in suburb area, at sixth month of follow-up. Failure rate for regular drug receipt was highest at second month in the urban area(3.75%) and at fourth month in the suburb area(4.15%). In logistic regression of the factors related with the tratment result, first X-ray examination and prescription compliance were significantly associated in the urban area(p<0.05). However, there is no factor significantly associated with the treatment result in the suburb area. It could be explained by too small size of the sample. In logistic regression of the factors related with the prescription compliance, first chest X-ray, sputum culture outcome and the presence of supporting family member were significant variables in the urban area(p<0.05). Most patients with family member were proved to be compliant with the prescription. This shows that it is important for the patients with long-lasting ilnesses to have supporting family member. Therefore, to improve prescription compliance we should strengthen the health education before the initiation of treatment and take special interest in the patients without supporting family member.

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The Variation of Natural Population of Pinus densiflora S. et Z. in Korea (VI) - Genetic Variation of the Progency Originated from Myong-Ju, Ul-Jin and Suweon Populations - (소나무 천연집단(天然集團)의 변이(變異)에 관(關)한 연구(硏究)(VI) - 명주(溟洲), 울진(蔚珍), 수원(水原) 소나무 집단(集團)의 차대(次代)의 유전변이(遺傳變異) -)

  • Yim, Kyong Bin;Kwon, Ki Won;Lee, Kyong Jae
    • Journal of Korean Society of Forest Science
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    • v.38 no.1
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    • pp.33-45
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    • 1978
  • The purpose of present study is to analyze the genetic variation of natural stand of Pinus densiflora. In 1975 following after the selection of 1974, twenty trees from each of three natural populations of the species were selected and their open-pollinated seeds were collected, and the locations and conditions of the populations ate presented in table 1, 2 and figure 1. Some morphological traits of the populations were already detailed in our second report of this series, in which Myong-Ju and Ul-Jin populations were regarded to be superior phenotypically to suweon population. The morphological traits of cone, seed and seed-wing, and also the growth performances and needle characters of the seedling were observed in the present study according to the previous methods. The results obtained are summarized as follows; 1. The meteorological data obtained by averaging the records of 30 year period (1931~1960) measured from the nearest meteorological stations to each population are shown in fig.2, 3, 4. The distributional patterns of investigated climate factors are generally considered to be similar among the locations. However, the precipitation density during growing season and the air temperature during dormant season on Suweon area, population 6, were quite different from those of the other areas. 2. The measurements of fresh cone weight, length, diameter and cone index, i.e., length to diameter ratio are presented in table 7. As shown in table 7, all these traits except for cone diameter seem to be highly significant in population differences and family differences within population. 3. The morphological traits of seed and seed-wing are detailed in table 8, 9, and highly significant differences are recognized among the populations and the families within population in seed-wing length, seed-wing index, seed weight, seed-length and seed index but not among the populations in the other observed traits. The values of correlation coefficient between the characters of cone and seed are given in table 10 and the positive significant correlations can be observed in the most parts of the compared traits. 4. Significant statistical differences among populations and families within population are observed in the growth performances of 1-0 and 1-1 seedling height of these progenies. But the differences in root collar diameter are shown only among families within population. As shown in table 13, the most parts of correlations are not significant statistically between the growth performances of seedling and the seed characters. 5. The number of stomata row on both sides of needle and the serration density were measured in the seedlings from each of the families of the three populations. As shown in table 15, statistical differences are considered to be significant among the populations and among the families within population in serration density but not among the populations in stomata row on both sides of the needle. The results differ from those of the third report of this series. Even if one of the reason seems to be the diversity of selected populations, it could not be confirmed definitely. The correlations between progenies and parents are not generally observed in the investigated traits of needle as shown in table 16.

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The effects of Lubric Learning Strategy Program, to solve problems of the Middle School Students' learning, on learning motivation, self-efficacy and self-regulation (루브릭 학습전략 프로그램이 중학생 학습문제 및 학습동기와 자기효능감, 자기조절력에 미치는 효과)

  • Jung, Jung-Soon;Byun, Sang-Hae
    • Asia-Pacific Journal of Business Venturing and Entrepreneurship
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    • v.7 no.1
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    • pp.27-33
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    • 2012
  • The purpose of this research is to investigate the effects of Lubric Learning Strategy Program, to solve problems of the Middle School Students' learning, on learning motivation, self-efficacy and self-regulation. The objects of this investigation was 60 students sampled from the first, second and third year students of Y Middle school in Seoul, which was divided equally -30 students each- into experimental group and control group. The progress covered 10 weeks period, a hour and half every week on Tuesdays and Thursdays. The conclusion derived from the results and discussion is as follows: First, the learning motivation of experimental group participated in the Lubric Learning Strategy Program to solve learning problems has changed quite meaningfully compared to the control group. It showed positive changes in all suborn ate variables such as class motivation, continuing motivation, intrinsic motivation, and extrinsic motivation. Second, the self-efficacy of experimental group participated in the Lubric Learning Strategy Program to solve learning problems has changed quite meaningfully compared to the control group. These results showed positive changes in subordinate variables such as preference level to subjects and self-control efficacy, though did not show notable changes in confidence area. However as confidence area doesn't really matter in total score, Lubric Learning Strategy Program is considered to have good influence in self-efficacy. Third, the self-regulation of experimental group participated in the Lubric Learning Strategy Program to solve learning problems has changed quite meaningfully compared to the control group. It showed positive changes in all subordinate variables such as self-control mode and inhibitory will mode. Fourth, the use on learning strategy of experimental group participated in the Lubric Learning Strategy Program to solve learning problems has changed quite meaningfully compared to the control group. These results showed positive changes in subordinate variables such as rehearsal, elaboration, organization and inspection, though did not show notable changes in schedule and control area. However, as the total score of use on learning strategy has changed prominently, Lubric Learning Strategy Program is considered to have good influence in use of learning strategy.

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Comparison of Life Style, School Achievement and Snaking Behaviors among Underweight and Overweight Adolescents (일부 저체중과 과체중 청소년의 생활습관, 학업성취도 및 간식섭취행동의 비교)

  • Kim, Hye-Kyung;Kim, Jin-Hee
    • Journal of Nutrition and Health
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    • v.44 no.2
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    • pp.131-139
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    • 2011
  • The purpose of this study was to obtain information related to life style characteristics, school achievement and snacking behaviors among underweight and overweight adolescents in Ulsan area. The survey was carried out by self-questionnaires with 464 adolescents (333 underweight and 131 overweight). The results were as follows: Average BMI of the subjects was $19.81{\pm}3.10\;kg/m^2$ which was normal range, but average BMI of underweight and overweight were $16.90{\pm}1.19\;kg/m^2$ and $25.38{\pm}2.16\;kg/m^2$ respectively. The 49.5% of underweight and 94.7% of overweight students have correct perception about their body image. In the sleeping time, 58.9% of underweight and 66.4% of overweight students go to bed after PM 12 o'clock. In the regularity of eating breakfast, 68.5% of underweight and 67.9% of overweight students skipping breakfast at least 5 times per week. 32.6% of the subjects had snack once or more a day. Underweight students had more frequently ate snack than overweight students. The criteria of choosing snack were taste (77.4%), nutrition (9.3%), and price (6.3%). Food as snack they frequently had fruits, milk & milk products, cookies in order. Underweight students had more dodkboki & sundae, candy & chocolate and cake & bread than overweight students, although overweight students had more milk & yogurt than underweight students. The group who had a higher school record, they significantly had more fruits, milk & milk products (p < 0.01) and had not less nutritious foods (p < 0.001). This study may provide basic information on weight status, sleeping and snacking behaviors of adolescents. Therefore they should have nutrition education program to improve their life style and snacking patterns for underweight and overweight adolescents toward healthy weight.

Building up User-Oriented Road Planning and Design Schemes (국민참여형 도로계획의 수립방향)

  • Kim, Eung-Cheol;Kwon, Young-In;Yun, Seong-Soon;Kang, Jin-Goo
    • Journal of Korean Society of Transportation
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    • v.23 no.5 s.83
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    • pp.47-55
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    • 2005
  • Roads deeply affect the life of people and keep doing an important role to support economic growth of a country. According to the budget plan of the ministry of construction and transportation of Korea, 8.1 trillion won have been allotted for road investment in the year of 2002 which occupy 61% of the transportation infrastructure special account (13.3 trillion won) and 4.7% of the total national budget (1,740 trillion won). It is true that services generated from road investment such as mobility enhancement and increased accessibility have shown positive effects through shortened travel time and decreased vehicle operating cost. However, it is also notable that many negative effects are gradually being discussed and those are nowadays getting severer due to enhanced people interests about road construction, increased concerns on environment and active public involvement that were evoked by traffic accidents, air pollution & noise and destruction of environment. Road construction processes in Korea are normally governed by administrative sectors (suppliers) not by users. These processes ate very weak to accomodate user s needs and community concerns thus easy to fail finalizing a road project without hassles. A public hearing process is supposed to be held in the processes of detailed design step and the environmental impact analysis. However, it is not enough to grab user's needs and community concerns. Increased public involvement frequencies, optimized public involvement timing and enhanced depth of public involvement magnitude are suggested to improve the current poor public involvement schemes in road planning and design processes. The application of these recommended methods to the road planning and design processes may guarantee the change from the current supplier-oriented schemes to the new user-oriented one. Also, this study suggests to reset objectivity and clarity of road construction process, to make conciliation guidelines based on many practical cases that produced good results, to introduce public involvement techniques in a stepwise basis, and to foster the professionals via education and training programs.

A Demonstrative Study on the Intake Habits of Dairy Goats (Saanen) Fed with Roughages (유산양의 조사료 채식습성에 관한 실증적 연구)

  • Gang, Byung-Ho;Lee, In-Duk;Lee, Hyung-Suk
    • Journal of The Korean Society of Grassland and Forage Science
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    • v.29 no.1
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    • pp.63-72
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    • 2009
  • The experiment was conducted from 2007 to 2008. The experimental roughages include five sources and 25 species in all; grasses and legumes: 5 species (mixed grasses, orchardgrass, tall fescue, alfalfa, white clover), native grasses and weeds: 5 species (mixed native grasses, Miscanthus sinensis Anderss, Arundinella hirta (Thunb.) Tanaka, barnyard grass, short awn, forage crops and straw: 5 species (barley 4- hairy vetch, wheat 4- hairy vetch, rye silage, barley silage, baled rice straw), browse and fallen leaves: 5 species (mixed browse, oriental white oak browse, Quercus serrta Thunb., browse oriental cherry fallen leaves, Japanese chestnut fallen leaves), and imported hay and straw: 5 species (timothy hay, tail fescue straw, annual ryegrass straw, klinegrass hay, alfalfa hay). Ten dairy goats (Saanen) were selected which had nearly the same body weight (25kg). The experiment was carried out on the dairy goats farm at Geumsan-Cun in Chungnam province. The chemical composition and dry matter digestibility of each roughage source and species were significantly different at the sampling area, plant species, growth stages and cutting period. Among all the 25 species of roughages, the favorite intake species order by dairy goats was observed like this: mixed grasses, white clover, alfalfa and the lower intake species order was baled rice straw and rye silages. The dairy goats ate more roughages which had low fibrous contents, but high dry matter digestibility. On the other hand, compared to each roughage source, the goat's favorite roughage were grasses and legumes (34.6%) among the trial species. Based on the result, it is reconfirmed that the food habit of dairy goats seems to be closer to that of graters.

A Study on the Differences in the Dietary Habits, Nutrient Intake and Health Status of Vegetarian (Lacto-Ovo Vegetarian) and Non-Vegetarian Korean Elementary School Children (초등학생의 Vegetarian(lacto-ovo vegetarian)과 Non-Vegetarian의 식습관, 영양소 섭취 및 건강습관 차이에 관한 연구)

  • Choi, Kyung-Soon;Shin, Kyung-Ok;Jung, Tae-Hwan;Chung, Keun-Hee
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.40 no.3
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    • pp.416-425
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    • 2011
  • The objective of this study was to investigate the effects of vegetarian (lacto-ovo vegetarian) and non-vegetarian diets on dietary habits, nutrient intake, and health status. The vegan subjects were 22 children. Among them, 54.5% of the subjects had a specific religion, 36.4% had been vegetarian since weaning, and 9.1% had become vegetarian to prevent obesity or atopy. The percentages of excessive eating by the vegetarian children were lower compared to the non-vegetarian children. The rates of intake of vegetables (42.2%) and fruits and fruit juice (55.9%) by the vegetarian children were higher compared to non-vegetarian subjects. Non-vegetarian children consumed more milk, dairy products, as well as meat, fish, eggs, soybean, and tofu than the vegetarian subjects. Vegetarian children ate more bread, potato, and fruits as snacks than non-vegetarian children. Furthermore, non-vegetarian children consumed more carbonated beverages and ice cream than the vegetarian subjects (p<0.05). Generally, the subjects' energy intake was lower than standard values, and vegetarian children's calcium intake was deficient. Non-vegetarian children's fiber intake was deficient, and they consumed fat, vitamin $B_2$, calcium, and cholesterol excessively (p<0.05). Nutrition tablet intake was higher among non-vegetarian children; however, the rate of fatigue among subjects was higher among vegetarian subjects than non-vegetarian subjects. Among the vegetarian subjects, 19.6% reported that they had a cold. Consequently, for the purpose of attaining balanced physical development and growth among children, an education program that emphasizes complete diets should be prepared.

Phytophagous Insect Fauna of Dicotyledoneae(Tracheophyta : Angiospermae) Weeds (쌍자엽 식물아강(관속식물문 : 피자식물강)의 잡초가해 곤충상)

  • ;;Patrick J.Shea
    • Korean journal of applied entomology
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    • v.31 no.4
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    • pp.496-508
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    • 1992
  • Phytophagous insects associated with Dicotyledoneae weeds and host specificities in the field populations were investigated for the survey of biological control agents of weeds in Korea. Fifty four weed species in 39 genera were collected during the survey. The most insects were collected from Polygonales by 24 species in 22 genera and followed by Urticales and Centrospermales by 17 species of 17 genera. The insects collected in the other weed orders were ranged from 1 to 12 species. Out of 17 insect species collected in Urticales, Baris sp. damaged the leaves of Hamulus japonicus in Cannabinaceae as scattered holeshape and showed host specificity. In Polygonaceae, Rumex japonicus and R. crispus were severely damaged by Aphis rumicis and Gastrophysa atrocyanea. G. atrocyanea leaf beetle had host specificity on R. japonicus and ate all the leaves except veins. The leaf beetle, Lypesthes japonicus was a potential biological control agent by feeding leaves of Persicaria spp .. And Lixus spp. were also often collected from Persicaria spp .. Liothrips vaneeckei was first collected from weed, P. modosa. P. senticosa was damaged by unidentified geometrid moth larvae and P. perfoiliata by Miarus atricolor snout beetle. Cassida piperata damaged leaves of Chenopodium album of Centrospermales and showed host specificity. In a soybean field, C. album and Amaranthus mangostanus were severely damaged by Spodoptera litura larvae which were eating soybean leaves. This phenomenon indicates that the presence of weed in cultivated land influences the outbreak of insect pests. Altica oleracea leaf beetle was frequently collected from Oenothera spp. of Onagraceae in Myrtales. Aphis gossyphi was outbroken on Solanum nigrum and Phylliodes brettinghami leaf beetle was first recorded on the same plant. Leaf beetles, Longitarsus scutellais and Hemipyxis plagioderoides were first collected from Plantago asiatica of Plantaginaceae in Plantaginales. They showed host specificities in the fields. The hemipterans were collected from many weeds during the survey and their roles on weeds should be investigated. A tractomorpha bedeli was also collected from many kinds of weeds in forest areas.

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