• Title/Summary/Keyword: Associated Factors

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Clinical Analysis of Mitral Valve Repair with Artificial Chordae (인공 건삭을 이용한 승모판성형술의 임상적 고찰)

  • 이석기;김정중;오삼세;백만종;나찬영;김욱성
    • Journal of Chest Surgery
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    • v.37 no.9
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    • pp.768-773
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    • 2004
  • Failure of mitral valve repair sometimes may be ascribed to severe or progressive alteration of the subvalvar apparatus. The aim of this study was to evaluate the effects of new chordae formation on mitral repair. Material and Method: From March 1997 to february 1999, 26 patients underwent mitral valve repairs with new chordae formation, we compared the symptoms and echocardiographic findings checked at preoperative state, and intraoperative period, discharge, and their last OPD visit. There were 45 male, and 11 female patients, and their mean age was 51.2$\pm$43.4 years. Etiology of the lesions was degenerative (18), rheumatic (6), infective (1) and ischemic (1). Chordal lesions were caused by rupture (18), elongation (6), and a combination of two causes (2). Associated lesions included atrial septal defect (2), tricuspid insufficiency (7), aortic insufficiency(4), and a combination of previous two factors (2). The number of mean artificial chordae was 3.6$\pm$1.6. Annuloplasty was per-formed in all cases. The CPB time was 182,1$\pm$63.7 minutes and the ACC time was 133.1$\pm$45.6 minutes. Aver-age follow up period was 49.2$\pm$7.1 months. Result: There was no early death. Early reoperation was performed in bud patients, one patient received mitral valve replacement because of an abnormality of annuloplasty and ano-ther received pericardiostomy due to postoperative pericardial effusion. During the follow up of 49.2$\pm$7.1 moths, there was no late mortality. Postoperative NYHA functional class checked at last OPD visit was class I in 22 patients (88%), class II in 2 (8%), and class III in 1 (4%). Regarding the late echocardiogram MR was absent in 20 patients (78%), 1 in 4 (15%), and II in 1 (4%). The postrepair mitral valve area was 2.2$\pm$0.35 $\textrm{cm}^2$ Conclusion: This study suggests that mitral valve repair using new chordae formation provides good early and mid term survivals and functional improvement. We think that the artificial chorda formation with polytetrafluoroethylene suture might be safe and effective technique for mitral valve repair.

Influence of Lifestyle-Related Diseases on the Oral Health of the Rural Elderly in Korea (일부 농촌지역 60세 이상 노인의 생활습관병이 구강건강에 미치는 영향)

  • Park, Jung-Hye;Lee, Hee-Kyung;Lee, Kyeong-Soo;Jang, Eun-Jin
    • Journal of agricultural medicine and community health
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    • v.35 no.3
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    • pp.249-259
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    • 2010
  • Objectives: The purpose of this study was to analyze the influence of four lifestyle-related diseases, diabetes, hypertension, obesity and hypercholesterolemia, on oral health in the rural elderly in Korea. Methods: We enrolled 399 subjects over 60 years of age over a six year period, year 2000-2006/ year 2001-2007. All subjects received a routine health examination as part of a program conducted by the National Health Insurance Corporation at Seongju-gun Public Health Center in Gyeongsangbuk-do Province, South Korea. All subjects were surveyed and examined to determine their general and oral health statuses. Results: Our results suggest that the duration of lifestyle-related diseases has a significant influence on oral health. The following factors were all significant in the results of analyses: duration of diabetes, tooth decay, which teeth had decayed, missing and filled teeth(DMFT), duration of hypertension, and duration of obesity and hypercholesterolemia(p<0.05). Our results also suggest that the number of lifestyle related diseases has a significant influence on oral health. Subjects with more than two diseases had significantly greater numbers of missing teeth and greater numbers of DMFT(p<0.01). The results of simple regression analysis indicate that patients exhibiting longer durations of diabetes also exhibit more tooth decay, and that patients exhibiting longer durations of hypertension and obesity are characterized by greater numbers of missing teeth. The longer the duration of any of the four lifestyle-related diseases we considered, the more DMFT we observed. Multiple regression analyses also demonstrated that longer duration of lifestyle-related disease was associated with greater numbers of missing teeth. As the number of lifestyle-related diseases increased, DMFT also increased. Conclusions: In summary, lifestyle-related diseases such as diabetes, hypertension, obesity and hypercholesterolemia have significant influences on oral health in the elderly. In this context, the prevention and management of lifestyle-related disease is critical for the maintenance and promotion of oral health.

Health Status and Associated Health Risks among Female Marriage Immigrants in Korea (한국 여성결혼이민자의 건강상태와 건강위험요인)

  • Kim, Hye-Kyeong;Yoo, Seung-Hyun;Cho, Seon;Kwon, Eun-Joo;Kim, Su-Young;Park, Ji-Youn
    • Korean Journal of Health Education and Promotion
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    • v.27 no.5
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    • pp.79-89
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    • 2010
  • Objectives: This study aims to identify health status and health risks among female marriage immigrants to Korea and to provide a basis for public health strategies to address their health issues. Methods: The participants of the study were 3,069 immigrant wives. The health examination was conducted by the Korea Association of Health Promotion (KAHP) in 2008. The participants also completed self-administered questionnaires on demographic characteristics, health-related behaviors and mental health. Results: Patterns of immigrant women's health problems differed by age and country of origin. Behavior patterns also differed by their heritage, age, and years of residence in Korea. Generally Vietnamese women fell in lower ranges of disease prevalence and health risk factors in the participant group and Japanese women presented most healthy eating habits. Filipina women showed relatively high disease prevalence than any other group. Conclusion: Immigration to Korea by marriage is relatively a new phenomenon, thus continuing surveillance and research are needed to identify health risks, behavior patterns, and their relationships. Interventions and policies for the health of migrant wives, their children and families are required.

Effects on Surgical Repair of VSD by TATV (막성주위형 심실중격결손중의 봉합시 경삼첨판륜 절개방법의 외과적 치료효과)

  • Gwak, Mong-Ju;Kim, Bo-Yeong
    • Journal of Chest Surgery
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    • v.30 no.9
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    • pp.869-875
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    • 1997
  • Perimembranous ventri ular septal defects(PMVSDS) are the most common type of ventricular septal defects(VSDs) and consist morphologically of deficiency of the membranous septum and variable portions of the adjacent muscular septum. Repair of VSD has begun via a right ventriculotomy. Even with this exposure, however, it mght lead to ventricular dysfunction. Transatrial exposure of VSDs is luiown to a versatile approach to PMVSDS and even malaligunent defects can be repaired by this method. Although transatrial exposure can be improved by taking down'the atrioventricular valve at the annulus, surgeons have been hesitant to do so because of concern for valvular competence. Therefore, this study was undertaken to clarity the effects of transamlular approach of tricuspid valve (TATV) at operation of PMVSD. During last 5 years, twenty eight cases from 96 patients of PMVSD were closed by TATV and follow up study was done from 3 months to 33 months and results were obtained as follows. 1. Age at operation was fr m 4 months to 38 years and most patients(17, 62%) were above 5 years. 2. Preoperative pulmonary-systemic flow ratio(QPIQS) was ranged from 1 to 2.8 and 22 patients(79%) were less than 2. 3. Peak systolic pulmonary artery pressure was below 30mmHg in 8, 30-50mmHg in 17, above 50mmHg in 3 patients and 25 patients(89%) were less than 50mmHg. 4. Preoperative tricuspid regurgitation(TR) is none in 12, trivial in 6, mild in 3, moderate in 5, severe in 2 patients but postoperative TR was none in 18, trivial in 6, mild in 4 patients, so TR in most patients had decreased or not. 5. Indications for operation were based on the presence of a significant shunt. However, in patients with small shunts, indications for operation were included additional factors, tricuspid valve pouch, RVOT obstruction(right ventricular outflow tract obstruction), subacute bacterial endocarditis and associated anomalies. 6. There were no hospital deaths and residual shunts in postoperative echocardiography. Therefore TATV is especially a good method in PMVSn where patients have trcuspid valve pouch. And it is a safe and effective technique that improves exposure for PMVSD repair and does not adversely affect tricuspid valvular competence.

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Effects of Health Education with Printed Media for Smoking Cessation, Pap Smear and Breast Self-examination (금연, 자궁암 검진 및 유방암 자가검진에 대한 인쇄매체를 이용한 보건교육의 효과)

  • 김인숙;김석범;강복수
    • Korean Journal of Health Education and Promotion
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    • v.15 no.2
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    • pp.163-183
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    • 1998
  • To evaluate the impacts of the health education programs including smoking cessation, pap smear and breast self-examination(BSE), a community trial was conducted during one year from December 1996 to December 1997 in Kyongju City. Before health education, a base-line survey was implemented and the target population was allocated randomly to case and control groups. The case and control groups were divided into three categories which were smoking cessation, pap smear and BSE. The series of health education leaflets about anti-smoking, pap smear and BSE were mailed to case group and the evaluation survey was conducted at the end of this trial to compare the change of health related behaviours of case and control groups. Smoking prevalence of case group did not decline significantly after anti-smoking education but the cessation rates of the elderly and low educated were higher than others. The knowledge level of case group on the health risk associated with smoking was higher than that of control group and the willingness of case group to quit smoking was higher than the control group. The case group's compliance with pap smear for cervical cancer was more increased compared to control group after health education. Of the case group, the younger and lower educated women were screened at a higher rate than others. The knowledge level of case group on the risk factors of cervical cancer and how to prevent it was higher than that of control group. Nearly 60 percent of case group reported that the health education leaflet influenced them to have the pap smear. The unscreened cases were highly motivated to get the pap smear test in the future.

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Short-term Variability of Carbon Dioxide within and across the Korean Peninsula: Case Study during 1995-1997 (이산화탄소의 단주기적 농도변화 특성)

  • Song, Ki-Bum;Youn, Yong-Hoon;Kim, Ki-Hyun
    • Journal of the Korean earth science society
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    • v.21 no.5
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    • pp.623-634
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    • 2000
  • This study was conducted to analyze the patterns associated with the short-term variability of CO$_2$ concentrations over 24-h scale within and across the Korean Peninsula. In the course of our study, we compared the data sets obtained from Moo-Ahn (MAN) station located in the far western coastal area of Korea with those determined from major background observatory stations around the world from the periods of Aug. 1995 to Dec. 1997. The mean CO$_2$ concentration of the MAN area for the whole study periods, when computed using the daily mean values, was found out to be 374.5${\pm}$6.6 ppm (N=884); seasonal mean values were found out to be 378${\pm}$5.2 (spring: N=181), 372${\pm}$10.2 (summer: N =210), 372${\pm}$7.2 (fall: N=243), and 376${\pm}$5.4 ppm (winter: N=206). When the data from MAN was compared with those of major background stations, the effects of both daily and seasonal components appear to vary distinctively across different stations. Those effects are expected to reflect the mixed effects of various factors which include: seasonal pollution patterns, weather conditions, vegetation, and so forth. Based upon this comparative analysis, we suspect that the MAN area is under the strong influence of anthropogenic source processes relative to all the other stations under consideration. If that is not the case, the existence of enhanced CO$_2$ level may be rather ubiquitous phenomena in Korea. More detailed inspection of CO$_2$ behavior from various respects is strongly desired in the future.

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Analysis of health habit and hair mineral nutrition status of media addicted adolescent (미디어중독 청소년의 스마트폰 사용의존도에 따른 건강습관 및 모발 무기질 영양상태 분석)

  • Lim, Hee-Sook;Kim, Soon-Kyung
    • Journal of Nutrition and Health
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    • v.51 no.4
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    • pp.295-306
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    • 2018
  • Purpose: Koreans' internet and smartphone usage hours are steadily increasing and the dependence of young people on smartphones is causing social problems. Therefore, this study was conducted to examine health and dietary habits, as well as hair mineral contents according to the level of dependence of smartphone use among adolescents to clarify the interrelation of smartphone dependence, lifestyle, dietary behavior, and mineral nutrition status. Methods: A total of 80 smartphone-addicted adolescents participated in this study and were divided into three groups (general, potential and danger group) according to smartphone dependence. The subjects' lifestyles and dietary behaviors were then surveyed, and hair mineral contents were analyzed. Results: Higher smartphone dependence was associated with lower average weekly sleeping time and later first smoking age. In the danger group, the rate of eating fast and the rate of snacking twice a day was also relatively high. Parents (45.0%) and mobile (30.0%) were the factors having the greatest influence on an individual's dietary behavior. In the hair mineral analysis, all subjects had lower selenium concentrations and higher lead concentrations than normal. In addition, the levels of aluminum in the danger group were higher than in the normal range and the highest among the three groups. Conclusions: It is necessary to guide adolescents to use smartphones correctly and manage dietary habits. In addition, careful attention is needed the mineral nutritional status of smartphone-addicted adolescents.

Early assessment of atherosclerosis in children with type 1 diabetes (제1형 당뇨병 소아 환자에서 동맥경화증의 조기 평가)

  • Park, So-Yoon;Kang, Seok Jeong;Choi, Kwang Hae;Park, Yong Hoon;Lee, Young Hwan
    • Clinical and Experimental Pediatrics
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    • v.51 no.7
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    • pp.747-753
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    • 2008
  • Purpose : Diabetes mellitus is a major risk factor for the development of cardiovascular disease. Early atherosclerotic changes in the arterial walls begin in adolescence and the risk factors are associated with its development. To assess the usefulness of carotid artery intima-media thickness (IMT), as a marker of early atherosclerosis, we evaluated the structural and functional characteristics of the carotid artery and investigated their relationshop with the metabolic and anthropometric parameters in children and adolescents with type 1 diabetes. Methods : For this study, we enrolled 23 children with type 1 diabet and 19 age and sex-equivalent healthy children as the control group. Metabolic and anthropometric parameters such as serum lipid levels, plasma glycated hemoglobin (HbA1c), and body mass index were measured after a 12-h fasting period. The carotid artery IMT was measured by a high-quality ultrasound system, and compliance, and distensibility were calculated by an equation. Results : There were no significant differences between the 2 groups with regard to the sex ratio, age, blood pressure and serum cholesterol levels' however, HbA1c levels were significantly higher in the diabetic children ($8.5{\pm}1.8$ vs. $5.0{\pm}0.2$, P=0.001). Ultrasonographic findings showed that compared with the control group, the diabetic group had higher IMT ($0.45{\pm}0.06mm$ vs. $0.41{\pm}0.04mm$, P=0.04), but there were no significant differences in compliance and distensibility. The HbA1c (P=0.002) and high-density lipoprotein cholesterol (P=0.026) levels were independent IMT predictors in the diabetic group. Conclusion : Here, the carotid artery IMT was higher in the diabetic group, and it is correlated with atherosclerotic risk factor. Thus, carotid IMT could be evaluated as a marker of early atherosclerosis in diabetic children.

A Study on the Relationship between Adiponectin, BDNF and Leptin with Abdominal Fat Thickness in Male Workers (남성 근로자의 복부지방두께와 adiponectin, BDNF 및 leptin의 관련성)

  • Ko, Kyung-Sun;Choi, Yoon-Jung
    • Journal of radiological science and technology
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    • v.36 no.3
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    • pp.209-217
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    • 2013
  • Adiponectin (AdipoN), brain-derived nerotrophic factor (BDNF) and leptin (LeP) are mainly secreted from adipose tissue and are known to be involved in regulation of the development of obese. However, there are not many studies on the association between abdominal fat and neuropeptides such as AdipoN, BDNF and LeP. The aim of this study was undertaken to investigate the association between abdominal fat thickness, neuropeptides and cardiovascular disease (CVD) risk factors. The participants in the study were 138 male employees without CVD. This study was approved by the Institutional Review Board of Occupational Safety and Health Research Institute. Written informed consent for the participants in this study was obtained from all individuals. We obtained subcutaneous fat thickness (SFT) and visceral fat thickness (VFT) by using ultrasonography and neuropeptides levels were measured with ELISA kit according to the method suggested by kit manufacturer. The mean SFT and VFT were $1.58{\pm}0.51$ and $4.52{\pm}1.44$ cm. The mean concentrations of AdipoN, BDNF and LeP were $3.14{\pm}3.52$ ng/ml, $24.11{\pm}8.52$ pg/ml and $4.27{\pm}2.38$ ng/ml, respectively. VFT were positively correlated with total cholesterol (r=0.217, p<0.05), LDL-cholesterol (r=0.271, p<0.01), triglyceride (r=0.233, p<0.05) and insulin (r=0.338, p<0.01), but was inversely correlated with HDL-cholesterol (r=-420, p<0.01). AdipoN levels were positively correlated with HDL-cholesterol (r=0.220, p<0.05) and were inversely correlated with total cholesterol (r=-0.196, p<0.05), LDL-cholesterol (r=-0.190, p<0.05), triglyceride (r=-0.199, p<0.05), SFT (r=-0.195, p<0.05) and VFT (r=-0.412, p<0.01). However, LeP levels showed a reverse trend to AdipoN. AdipoN level was significantly higher in non-obese participants (BMI<25 kg/m), but LeP concentration was significantly higher in obese participants (BMI>25 kg/m) than in non-obese. On multiple logistic regression analysis, obese were significantly associated with AdipoN (odds ratio=0.784) and LeP (odds ratio=1.494). These results suggested that AdipoN and LeP concentrations are affected abdominal fat and that dysfunction and/or declination in the production and secretion of neuropeptides might induced ultimately obese and CVD.

Understanding the Mismatch between ERP and Organizational Information Needs and Its Responses: A Study based on Organizational Memory Theory (조직의 정보 니즈와 ERP 기능과의 불일치 및 그 대응책에 대한 이해: 조직 메모리 이론을 바탕으로)

  • Jeong, Seung-Ryul;Bae, Uk-Ho
    • Asia pacific journal of information systems
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    • v.22 no.2
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    • pp.21-38
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    • 2012
  • Until recently, successful implementation of ERP systems has been a popular topic among ERP researchers, who have attempted to identify its various contributing factors. None of these efforts, however, explicitly recognize the need to identify disparities that can exist between organizational information requirements and ERP systems. Since ERP systems are in fact "packages" -that is, software programs developed by independent software vendors for sale to organizations that use them-they are designed to meet the general needs of numerous organizations, rather than the unique needs of a particular organization, as is the case with custom-developed software. By adopting standard packages, organizations can substantially reduce many of the potential implementation risks commonly associated with custom-developed software. However, it is also true that the nature of the package itself could be a risk factor as the features and functions of the ERP systems may not completely comply with a particular organization's informational requirements. In this study, based on the organizational memory mismatch perspective that was derived from organizational memory theory and cognitive dissonance theory, we define the nature of disparities, which we call "mismatches," and propose that the mismatch between organizational information requirements and ERP systems is one of the primary determinants in the successful implementation of ERP systems. Furthermore, we suggest that customization efforts as a coping strategy for mismatches can play a significant role in increasing the possibilities of success. In order to examine the contention we propose in this study, we employed a survey-based field study of ERP project team members, resulting in a total of 77 responses. The results of this study show that, as anticipated from the organizational memory mismatch perspective, the mismatch between organizational information requirements and ERP systems makes a significantly negative impact on the implementation success of ERP systems. This finding confirms our hypothesis that the more mismatch there is, the more difficult successful ERP implementation is, and thus requires more attention to be drawn to mismatch as a major failure source in ERP implementation. This study also found that as a coping strategy on mismatch, the effects of customization are significant. In other words, utilizing the appropriate customization method could lead to the implementation success of ERP systems. This is somewhat interesting because it runs counter to the argument of some literature and ERP vendors that minimized customization (or even the lack thereof) is required for successful ERP implementation. In many ERP projects, there is a tendency among ERP developers to adopt default ERP functions without any customization, adhering to the slogan of "the introduction of best practices." However, this study asserts that we cannot expect successful implementation if we don't attempt to customize ERP systems when mismatches exist. For a more detailed analysis, we identified three types of mismatches-Non-ERP, Non-Procedure, and Hybrid. Among these, only Non-ERP mismatches (a situation in which ERP systems cannot support the existing information needs that are currently fulfilled) were found to have a direct influence on the implementation of ERP systems. Neither Non-Procedure nor Hybrid mismatches were found to have significant impact in the ERP context. These findings provide meaningful insights since they could serve as the basis for discussing how the ERP implementation process should be defined and what activities should be included in the implementation process. They show that ERP developers may not want to include organizational (or business processes) changes in the implementation process, suggesting that doing so could lead to failed implementation. And in fact, this suggestion eventually turned out to be true when we found that the application of process customization led to higher possibilities of failure. From these discussions, we are convinced that Non-ERP is the only type of mismatch we need to focus on during the implementation process, implying that organizational changes must be made before, rather than during, the implementation process. Finally, this study found that among the various customization approaches, bolt-on development methods in particular seemed to have significantly positive effects. Interestingly again, this finding is not in the same line of thought as that of the vendors in the ERP industry. The vendors' recommendations are to apply as many best practices as possible, thereby resulting in the minimization of customization and utilization of bolt-on development methods. They particularly advise against changing the source code and rather recommend employing, when necessary, the method of programming additional software code using the computer language of the vendor. As previously stated, however, our study found active customization, especially bolt-on development methods, to have positive effects on ERP, and found source code changes in particular to have the most significant effects. Moreover, our study found programming additional software to be ineffective, suggesting there is much difference between ERP developers and vendors in viewpoints and strategies toward ERP customization. In summary, mismatches are inherent in the ERP implementation context and play an important role in determining its success. Considering the significance of mismatches, this study proposes a new model for successful ERP implementation, developed from the organizational memory mismatch perspective, and provides many insights by empirically confirming the model's usefulness.

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