• Title/Summary/Keyword: Classification method

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Arthroscopically-Assisted Reduction and Internal Fixation of Intra-Articular Fractures of the Lateral Tibial Plateau (관절면을 침범한 경골 외측 고평부 골절에 대한 관절경을 이용한 정복 및 내고정술)

  • Kim, Juhan;Kim, Dong Hwi;Lim, Jae-Hwan;Jang, Hyunwoong;Kim, Young Wook
    • Journal of the Korean Orthopaedic Association
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    • v.54 no.3
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    • pp.227-236
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    • 2019
  • Purpose: To evaluate the results of tibial lateral plateau fractures using arthroscopic-assisted reduction and internal fixation without cortical window or bone grafts. Materials and Methods: From March 2009 to March 2017, 27 patients with Schatzker type II tibial plateau fractures with articular depression and displacement over 5 mm on a computed tomography (CT) scan, who were treated with arthroscopic reduction and internal fixation and followed-up for at least 18 months, were enrolled in this study. Under arthroscopic guidance, the depressed fracture fragment was reduced using a freer and fixed with 5.0 or 6.5 mm cannulated screws through the inframeniscal portal without a cortical window or bone graft. The clinical and radiological results were evaluated using a Rasmussen system. Second look arthroscopy was performed in thirteen patients during the implant removal operation. Results: All fractures healed completely with a mean union time of 8.7 weeks (range from 8 to 12 weeks). Twenty four patients had good to excellent clinical results and 25 patients had good to excellent radiological results according to the Rasmussen classification. A well-healed articular surface with fibrocartilage was also found in 13 cases with second look arthroscopy. The 8 cases on CT scan at outpatient department follow-up showed bone union without bone grafting. Conclusion: Arthroscopic-assisted fixation of tibial lateral plateau fractures is a useful method without a cortical window or bone graft that produces good clinical results.

A Study on the Linkage and Development of the BRM Based National Tasks and the Policy Information Contents (BRM기반 국정과제와 정책정보콘텐츠 연계 및 구축방안에 관한 연구)

  • Younghee, Noh;Inho, Chang;Hyojung, Sim;Woojung, Kwak
    • Journal of the Korean Society for information Management
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    • v.39 no.4
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    • pp.191-213
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    • 2022
  • With a view to providing a high-quality policy information service beyond the existing national task service of the national policy information portal (POINT) of the National Library of Korea Sejong, it would be necessary to effectively provide the policy data needed for the implementation of the new national tasks. Accordingly, in this study, an attempt has been made to find a way to connect and develop the BRM-based national tasks and the policy information contents. Towards this end, first, the types of national tasks and the contents of each field and area of the government function's classification system were analyzed, with a focus placed on the 120 national tasks of the new administration. Furthermore, by comparing and analyzing the national tasks of the previous administration and the current information, the contents ought to be reflected for the development of contents related to the national tasks identified. Second, the method for linking and collecting the policy information was sought based on the analysis of the current status of policy information and the national information portal. As a result of the study, first, examining the 1st stage BRM of the national tasks, it turned out that there were 21 tasks for social welfare, 14 for unification and diplomacy, 17 for small and medium-sized businesses in industry and trade, 12 for general public administration, 8 for the economy, taxation and finance, 6 for culture, sports and tourism, science and technology, and education each, 5 for communication, public order and safety each, 4 for health, transportation and logistics, and environment each, 3 for agriculture and forestry, 2 for national defense and regional development each, and 1 for maritime and fisheries each, among others. As for the new administration, it is apparent that science technology and IT are important, and hence, it is necessary to consider such when developing the information services for the core national tasks. Second, to link the database with external organizations, it would be necessary to form a linked operation council, link and collect the information on the national tasks, and link and provide the national task-related information for the POINTs.

Text Mining-Based Emerging Trend Analysis for e-Learning Contents Targeting for CEO (텍스트마이닝을 통한 최고경영자 대상 이러닝 콘텐츠 트렌드 분석)

  • Kyung-Hoon Kim;Myungsin Chae;Byungtae Lee
    • Information Systems Review
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    • v.19 no.2
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    • pp.1-19
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    • 2017
  • Original scripts of e-learning lectures for the CEOs of corporation S were analyzed using topic analysis, which is a text mining method. Twenty-two topics were extracted based on the keywords chosen from five-year records that ranged from 2011 to 2015. Research analysis was then conducted on various issues. Promising topics were selected through evaluation and element analysis of the members of each topic. In management and economics, members demonstrated high satisfaction and interest toward topics in marketing strategy, human resource management, and communication. Philosophy, history of war, and history demonstrated high interest and satisfaction in the field of humanities, whereas mind health showed high interest and satisfaction in the field of in lifestyle. Studies were also conducted to identify topics on the proportion of content, but these studies failed to increase member satisfaction. In the field of IT, educational content responds sensitively to change of the times, but it may not increase the interest and satisfaction of members. The present study found that content production for CEOs should draw out deep implications for value innovation through technology application instead of simply ending the technical aspect of information delivery. Previous studies classified contents superficially based on the name of content program when analyzing the status of content operation. However, text mining can derive deep content and subject classification based on the contents of unstructured data script. This approach can examine current shortages and necessary fields if the service contents of the themes are displayed by year. This study was based on data obtained from influential e-learning companies in Korea. Obtaining practical results was difficult because data were not acquired from portal sites or social networking service. The content of e-learning trends of CEOs were analyzed. Data analysis was also conducted on the intellectual interests of CEOs in each field.

Spatial Distribution of Aging District in Taejeon Metropolitan City (대전광역시 노령화 지구의 공간적 분포 패턴)

  • Jeong, Hwan-Yeong;Ko, Sang-Im
    • Journal of the Korean association of regional geographers
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    • v.6 no.2
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    • pp.1-19
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    • 2000
  • This study is to investigate and analyze regional patterns of aging in Taejeon Metropolitan city-the overpopulated area of Choong-Cheong Province-by cohort analysis method. According to the population structure transition caused by rapid social and economic changes, Korea has made a rapid progress in population aging since 1970. This trend is so rapid that we should prepare for and cope with aging society. It is not only slow to cope with it in our society, but also there are few studies on population aging of the geographical field in Korea. The data of this study are the reports of Population and Housing Censuses in 1975 and 1985 and General Population and Housing Censuses with 10% sample survey in 1995 taken by National Statistical Office. The research method is to sample as the aging district the area with high aged population rate where the populations over 60 reside among total population during the years of 1975, 1985, 1995 and to sample the special districts of decreasing population where the population decreases very much and the special districts of increasing population in which the population increases greatly, presuming that the reason why aged population rate increases is that non-elderly population high in mobility moves out. It is then verified and ascertained whether it is true or not with cohort analysis method by age. Finally regional patterns in the city are found through the classification and modeling by type based on the aging district, the special districts of decreasing population, and the special districts of increasing population. The characteristics of the regional patterns show that there is social population transition and that non-elderly population moves out. The aging district with the high aged population rate is divided into high-level keeping-up type, relative falling type below the average of Taejeon city in aging progress, and relative rising type above the average of the city. This district can be found at both the central area of the city and the suburbs because Taejeon city has the characteristic of over-bounded city. But it cannot be found at the new built-up area with the in-migration of large population. The special districts of decreasing population where the population continues to decrease can be said to be the population doughnuts found at the CBD and its neighboring inner area. On the other hand, the special districts of increasing population where the population continues to increase are located at the new built-up area of the northern part in Taejeon city. The special districts of decreasing population are overlapping with the aging district and higher in aged population rate by the out-migration of non-elderly population. The special districts of increasing population are not overlapping with the aging district and lower in aged population rate by the in-migration of non-elderly population. To clarify the distribution map of the aging district, the special districts of decreasing and increasing population and the aging district are divided into four groups such as the special districts of decreasing population group-the same one as the aging district, the special districts of decreasing population group, the special districts of increasing population group, and the other district. With the cohort analysis method by age used to investigate the definite increase and decrease of aging population through population transition of each group, it is found that the progress of population aging is closely related to the social population fluctuation, especially that aged population rate is higher with the out-migration of non-elderly population. This is to explain each model of CBD, inner area, and the suburbs after modeling the aging district, the special districts of decreasing population, and the special districts of increasing population in Taejeon city. On the assumption that the city area is a concentric circle, it is possible to divide it into three areas such as CBD(A), the inner area(B), and the suburbs(C). The special districts of increasing and decreasing population in the city are divided into three districts-the special districts of decreasing population(a), the special districts of increasing population(b), and the others(c). The aging district of this city is divided into the aging district($\alpha$) and the others($\beta$). And then modeling these districts, it is probable to find regional patterns in the city. $Aa{\alpha}$ and $Ac{\beta}$ patterns are found in the CBD, in which $Aa{\alpha}$ is the special district of decreasing population and is higher in aged population rate because of aged population low in mobility staying behind and out-migration of non-elderly population. $Ba{\alpha}$, $Ba{\beta}$, $Bb{\beta}$, and $Bc{\beta}$ patterns are found in the inner area, in which neighboring area $Ba{\alpha}$ pattern is located. $Bb{\beta}$ pattern is located at the new developing area of newly built apartment complex. $Cb{\beta}$, $Cc{\alpha}$, and $Cc{\beta}$ patterns are found in the suburbs, among which $Cc{\alpha}$ pattern is highest in population aging. It is likely that the $Cc{\beta}$ under housing land readjustment on a large scale will be the $Cb{\beta}$ pattern. As analyzed above, marriage and out-migration of new family, non-elderly population, with house purchase are main factors in accelerating population aging in the central area of the city. Population aging is responsible for the great increase of aged population with longer life expectancy by the low death rate, the out-migration of non-elderly population, and the age group of new aged population in the suburbs. It is necessary to investigate and analyze the regional patterns of population aging at the time when population problems caused by aging as well as longer life expectancy are now on the increase. I hope that this will help the future study on population aging of the geographical field in Korea. As in the future population aging will be a major problem in our society, local autonomy should make a plan for the problem to the extent that population aging progresses by regional groups and inevitably prepare for it.

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Early and Mid-term Results of Operation for Infective Endocarditis on Mitral Valve (감염성 승모판 심내막염의 중단기 수술 성적)

  • Ahn, Byong-Hee;Chun, Joon-Kyung;Yu, Ung;Ryu, Sang-Wan;Choi, Yong-Sun;Kim, Byong-Pyo;Hong, Sung-Bum;Bum, Min-Sun;Na, Kook-Ju;Park, Jong-Chun;Kim, Sang-Hyung
    • Journal of Chest Surgery
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    • v.37 no.1
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    • pp.27-34
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    • 2004
  • Background: Infective endocarditis shows higher operative morbidity and mortality rates than other cardiac diseases. The vast majority of studies on infective endocarditis have been made on aortic endocarditis, with little attention having been paid to infective endocarditis on the mitral valve. This study attempts to investigate the clinical aspects and operative results of infective endocarditis on the mitral valve. Meterial and Method: The subjects of this study consist of 23 patients who underwent operations for infective endocariditis on the mitral valve from June 1995 to May 2003. Among them, 2 patients suffered from prosthetic valvular endocarditis and the other 21 from native valvular endocarditis. The subjects were evenly distributed age-wise with an average age of 44.8$\pm$15.7 (11∼66) years. Emergency operations were performed on seventeen patients (73.9%) due to large vegetation or instable hemodynamic status. In preoperative examinations, twelve patients exhibited congestive heart failure, four patients renal failure, two patients spleen and renal infarction, and two patients temporary neurological defects, while one patient had a brain abscess. Based on the NYHA functional classification, seven patients were determined to be at Grade II, 9 patients at Grade III, and 6 patients at Grade IV. Vegetations were detected in 20 patients while mitral regurgitation was dominant in 19 patients with 4 patients showing up as mitral stenosis dominant on the preoperative echocardiogram. Blood cultures for causative organisms were performed on all patients, and positive results were obtained from ten patients, with five cases of Streptococcus viridance, two cases of methicillin-sensitive Staphylococcus aureus, and one case each of Corynebacteriurn, Haemophillis, and Gernella. Operations were decided according to the AA/AHA guidelines (1988). The mean follow-up period was 27.6 $\pm$23.3 (1 ∼ 97) months. Result: Mitral valve replacements were performed on 43 patients, with mechanical valves being used on 9 patients and tissue valves on the other 4. Several kinds of mitral valve repair or mitral valvuloplasty were carried out on the remaining 10 patients. Associated procedures included six aortic valve replacements, two tricuspid annuloplasty, one modified Maze operation, and one direct closure of a ventricular septal defect. Postoperative complications included two cases of bleeding and one case each of mediastinitis, low cardiac output syndrome, and pneumonia. There were no cases of early deaths, or death within 30 days following the operation. No patient died in the hospital or experienced valve related complications. One patient, however, underwent mitral valvuloplasty 3 months after the operation. Another patient died from intra-cranial hemorrhage in the 31st month after the operation. Therefore, the valve-related death rate was 4.3%, and the valve-related complication rate 8.6% on mid-term follow-up. 1, 3-, and 5-year valve- related event free rates were 90.8%, 79.5%, and 79.5%, respectively, while 1, follow-up. 1, 3-, and 5-year valve- related event free rates were 90.8%, 79.5%, and 79.5%, respectively, while 1, 3-, and 5-year survival rates were 100%, 88.8%, and 88.8%, respectively. Conclusion: The findings suggest that a complete removal of infected tissues is essential in the operative treatment of infectious endocarditis of the mitral valve. It is also suggested that when infected tissues are completely removed, neither type of material nor method of operation has a significant effect on the operation result. The postoperative results also suggest the need for a close follow-up observation of the patients suspected of having brain damage, which is caused by preoperative blood contamination or emboli from vegetation, for a possible cerebral vascular injury such as mycotic aneurysm.

Research on The Utility of Acquisition of Oblique Views of Bilateral Orbit During the Dacryoscintigraphy (눈물길 조영검사 시 양측 안 와 사위 상 획득의 유용성에 대한 연구)

  • Park, Jwa-Woo;Lee, Bum-Hee;Park, Seung-Hwan;Park, Su-Young;Jung, Chan-Wook;Ryu, Hyung-Gi;Kim, Ho-Shin
    • The Korean Journal of Nuclear Medicine Technology
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    • v.18 no.1
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    • pp.76-81
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    • 2014
  • Purpose: Diversity and the lachrymal duct deformities and the passage inside the nasal cavity except for anterior image such as epiphora happens during the test were able to express more precisely during the dacryoscintigraphy. Also, we thought about the necessity of a method to classify the passage into the naso-lachrymal duct from epiphora. Therefore, we are to find the validity of the method to obtain both oblique views except for anterior views. Materials and Methods: The targets of this research are 78 patients with epiphora due to the blockage at the lachrymal duct from January 2013 to August 2013. Average age was $56.96{\pm}13.36$. By using a micropipette, we dropped 1-2 drops of $^{99m}TcO4^-$ of 3.7 MBq (0.1 mCi) with $10{\mu}L$ of each drop into the inferior conjunctival fold, then we performed dynamic check for 20 minutes with 20 frames of each minute. In case of we checked the passage from both eyes to nasal cavity immediately after the dynamic check, we obtained oblique view immediately. If we didn't see the passage in either side of the orbit, we obtained oblique views of the orbit after checking the frontal film in 40 minutes. The instrument we used was Pin-hole Collimator with Gamma Camera(Siemens Orbiter, Hoffman Estates, IL, USA). Results: Among the 78 patients with dacryoscintigraphy, 35 patients were confirmed with passage into the nasal cavity from the anterior view. Among those 35 patients, 15 patients were confirmed with passage into the nasal cavity on both eyes, and it was able to observe better passage patterns through oblique view with a result of 8 on both eyes, 2 on left eye, and 1 on right eye. 20 patients had passage in left eye or right eye, among those patients 10 patients showed clear passage compared to the anterior view. 13 patients had possible passage, and 30 patients had no proof of motion of the tracer. To sum up, 21 patients (60%) among 35 patients showed clear pattern of passage with additional oblique views compared to anterior view. People responded obtaining oblique views though 5 points scale about the utility of passage identification helps make diagnoses the passage, passage delayed, and blockage of naso-lachrymal duct by showing the well-seen portions from anterior view. Also, when classifying passage to naso-lachrymal duct and flow to the skin, oblique views has higher chance of classification in case of epiphora (anterior:$4.14{\pm}0.3$, oblique:$4.55{\pm}0.4$). Conclusion: It is considered that if you obtain oblique views of the bilateral orbits in addition to anterior view during the dacryoscintigraphy, the ability of diagnose for reading will become higher because you will be able to see the areas that you could not observe from the anterior view so that you can see if it emitted after the naso-lachrymal duct and the flow of epiphora on the skin.

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A Study on the Distribution, Contents and Types of Stone Inscription of Wuyi-Gugok in China (중국 무이구곡 바위글씨(石刻)의 분포와 내용 및 유형에 관한 연구)

  • Rho, Jae-Hyun;Cheng, Zhao-Xia;Kim, Hong-Gyun
    • Journal of the Korean Institute of Traditional Landscape Architecture
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    • v.38 no.1
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    • pp.115-131
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    • 2020
  • Through literature research and field investigation, this paper attempts to study the distribution, morphology and the typification of the visual and perceptual stone inscription in Wuyi-Gugok of China. The results are as follows: First, there are 350 stone inscriptions in total from the 1st Gok to 9th Gok in Wuyi-Gugok. Second, according to the analysis of the stone inscription distribution, 74(21.2%) stone inscriptions in the 5th Gok, 67(19.2%) in the 6th Gok, 65(18.6%) in the 1st Gok, 60(17.2%) in the 2nd Gok and 53(15.2%) in the 4th Gok are confirmed. The above five Goks contain 319(91.1%) stone inscriptions, so they have rich cultural landscape. Third, according to the survey, the number of the stone inscriptions existed in the Sugwangseok of the 1st Gok are 41(22.6%), in the Homagan of Cheonyubong of the 6th Gok are 29(8.3%), in the Jesiam of the 4th Gok are 23(6.6%), in the Nyeongam of the 2nd Gok are 22(6.3%), in the Hyangseongam of the 6th Gok are 21(6%), in the Unwa of the 5th Gok are 19(5.4%), in the Bokhoam of the 5th Gok are 18(5.1%), in the Eunbyeongbong of the 5th Gok are 17(4.9%), in the Daejangbong of the 4th Gok are 14(4%), in the Daewangbong of the 1st Gok and the Geumgokam of the 4th Gok are 12(3.4%). Thus, a total of 228 (65.1%) stone inscriptions are concentrated in these 11 sites, which represent the popularity and cultural value of these rocks. Fourth, the stone inscription of Wuyi-Gugok, praising the landform and topographical geological landscape of Mount Wuyi, mainly describe the scenic name of each Gok related to Zhu Xi's Gugok culture, appreciate Zhu Xi's tracks and the stone inscription in the sacred land of Neo-Confucianism culture, and also record the Confucian edification of mencius thoughts, Muigun(武夷君) and the myths and legends related to the site names of Wuyi mountain, which can remind people of the worldview of the celestial paradise where the gods live and the fairyland of the land of peach blossoms. In addition, it indicates that the historical and cultural landscape, which is full of colorful history and myths and legends, including allusions related to Confucian, buddhist and Taoist celebrities and the ancestor ancient things related to traditional culture of China is very diverse. Fifth, the results of the classification, based on the content of the stone inscription in Wuyi-Gugok, are classified as the scenery name inscription, the praise scene inscription, the recording travel inscription, the recording event inscription, the philosophy inscription, the expressing emotion inscription, the religion inscription, the inscription for auspiciousness, the slogan and expressing ambition inscription and the official document notice inscription, among which there are 102(29.1%) praise scene inscriptions, 93(26.6%) scenery name inscriptions and 61(17.4%) recording travel inscriptions. The stone inscriptions of Wuyi-Gugok have the characteristics of the special emphasis on scenery names, landscape praise and commemorative tours. Sixth, the analysis of the intertext between the 「Figure of Wuyi-Gugok」 and Wuyi-Gugok rock letters, in the study found that the method of propagation between media was mostly the method of propagation of quotations and maintained intermedia through extension, repetition, extension, and compression.

A Methodology of Customer Churn Prediction based on Two-Dimensional Loyalty Segmentation (이차원 고객충성도 세그먼트 기반의 고객이탈예측 방법론)

  • Kim, Hyung Su;Hong, Seung Woo
    • Journal of Intelligence and Information Systems
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    • v.26 no.4
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    • pp.111-126
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    • 2020
  • Most industries have recently become aware of the importance of customer lifetime value as they are exposed to a competitive environment. As a result, preventing customers from churn is becoming a more important business issue than securing new customers. This is because maintaining churn customers is far more economical than securing new customers, and in fact, the acquisition cost of new customers is known to be five to six times higher than the maintenance cost of churn customers. Also, Companies that effectively prevent customer churn and improve customer retention rates are known to have a positive effect on not only increasing the company's profitability but also improving its brand image by improving customer satisfaction. Predicting customer churn, which had been conducted as a sub-research area for CRM, has recently become more important as a big data-based performance marketing theme due to the development of business machine learning technology. Until now, research on customer churn prediction has been carried out actively in such sectors as the mobile telecommunication industry, the financial industry, the distribution industry, and the game industry, which are highly competitive and urgent to manage churn. In addition, These churn prediction studies were focused on improving the performance of the churn prediction model itself, such as simply comparing the performance of various models, exploring features that are effective in forecasting departures, or developing new ensemble techniques, and were limited in terms of practical utilization because most studies considered the entire customer group as a group and developed a predictive model. As such, the main purpose of the existing related research was to improve the performance of the predictive model itself, and there was a relatively lack of research to improve the overall customer churn prediction process. In fact, customers in the business have different behavior characteristics due to heterogeneous transaction patterns, and the resulting churn rate is different, so it is unreasonable to assume the entire customer as a single customer group. Therefore, it is desirable to segment customers according to customer classification criteria, such as loyalty, and to operate an appropriate churn prediction model individually, in order to carry out effective customer churn predictions in heterogeneous industries. Of course, in some studies, there are studies in which customers are subdivided using clustering techniques and applied a churn prediction model for individual customer groups. Although this process of predicting churn can produce better predictions than a single predict model for the entire customer population, there is still room for improvement in that clustering is a mechanical, exploratory grouping technique that calculates distances based on inputs and does not reflect the strategic intent of an entity such as loyalties. This study proposes a segment-based customer departure prediction process (CCP/2DL: Customer Churn Prediction based on Two-Dimensional Loyalty segmentation) based on two-dimensional customer loyalty, assuming that successful customer churn management can be better done through improvements in the overall process than through the performance of the model itself. CCP/2DL is a series of churn prediction processes that segment two-way, quantitative and qualitative loyalty-based customer, conduct secondary grouping of customer segments according to churn patterns, and then independently apply heterogeneous churn prediction models for each churn pattern group. Performance comparisons were performed with the most commonly applied the General churn prediction process and the Clustering-based churn prediction process to assess the relative excellence of the proposed churn prediction process. The General churn prediction process used in this study refers to the process of predicting a single group of customers simply intended to be predicted as a machine learning model, using the most commonly used churn predicting method. And the Clustering-based churn prediction process is a method of first using clustering techniques to segment customers and implement a churn prediction model for each individual group. In cooperation with a global NGO, the proposed CCP/2DL performance showed better performance than other methodologies for predicting churn. This churn prediction process is not only effective in predicting churn, but can also be a strategic basis for obtaining a variety of customer observations and carrying out other related performance marketing activities.

CLINICAL CHARACTERISTICS OF CHILD AND ADOLESCENT PSYCHIATRIC INPATIENTS WITH MOOD DISORDER (입원한 기분장애 소아청소년의 임상특성 - 주요 우울증과 양극성장애의 우울삽화 비교를 중심으로 -)

  • Cho, Su-Chul;Paik, Ki-Chung;Lee, Kyung-Kyu;Kim, Hyun-Woo;Hong, Kang-E;Lim, Myung-Ho
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.11 no.2
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    • pp.209-220
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    • 2000
  • The purpose of this study is to find out the characteristics of depressive episode about major depression and bipolar disorder in child and adolescent. The subjects of this study were 34 major depression patients and 17 bipolar disorder patients hospitalized at child and adolescent psychiatry in OO university children's hospital from 1st March 1993 to 31st October 1999. The method of this study is to review socio-demographic characteristics, diagnostic classification, chief problems and symptoms at admission, frequency of symptoms, maternal pregnancy problem history, childhood developmental history, coexisting psychiatric disorders, family psychopathology and family history and therapeutic response through their chart. 1) The ratio of male was higher than that of female in major depressive disorder while they are similar in manic episode, bipolar disorder. 2) Average onset age of bipolar disorder was 14 years 1 month and it was 12 years 8 months in the case of major depression As a result, average onset age of major depression is lower than that of bipolar disorder. 3) The patients complained of vegetative symptoms than somatic symptoms in both bipolar disorder and depressive disorder. Also, the cases of major depression developed more suicide idea symptom while the case of bipolar disorder developed more aggressive symptoms. In the respect of psychotic symptoms, delusion was more frequently shown in major depression, but halucination was more often shown in bipolar disorder. 4) Anxiety disorder coexisted most frequently in two groups. And there coexisted symptoms such as somartoform disorder, mental retardation and personality disorder in both cases. 5) The influence of family loading was remarkable in both cases. Above all, the development of major depression had to do with child abuse history and inappropriate care of family. It is apparent that there are distinctive differences between major depression and bipolar disorder in child and adolescent through the study, just as in adult cases. Therefore the differences of clinical characteristics between two disorders is founded in coexisting disorders and clinical symptoms including onset age, somatic symptoms and vegetative symptoms.

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Early Clinical Experience in Aortic Valve Replacement Using On-X$^{circledR}$Prosthetic Heart Valve (On-X$^{circledR}$ 기계판막을 이용한 대동맥판 치환술의 조기 임상 경험)

  • 안병희;전준경;류상완;최용선;김병표;홍성범;박종춘;김상형
    • Journal of Chest Surgery
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    • v.36 no.9
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    • pp.651-658
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    • 2003
  • Since the first implanted in September 1997, the use of On-X prosthetic heart valve has been increasing around in the world. This study was designed to assess the feasibility, safety, and the postoperative hemodynamics with this new valve in clinical setting. Material and Method: The current study was carried out on 52 patients undergoing aortic valve replacement with this prosthesis between April 1999 to August 2002 at Chonnam National University Hospital to evaluate the surgical results. 52% of the patients were male and the average age at implant was 50$\pm$13 years. The study followed the guidelines of the AATS/STS. Preoperatively, 32(61.5%) patients were in NYHA functional class III or IV and 2 patients had previous aortic valve surgery. Concomitant cardiac surgery was performed in 71.1%. The implanted valve sizes were 19 mm in 13 patients, 21 mm in 26, 23 mm in 10 and 25 mm in 3, respectively. Mean follow-up was 16.6$\pm$10.5 months (1∼39 months). Echocardiographic assessment was performed pre- and immediate postoperatively, as well as 3, 6, 12 months after surgery, evaluating pressure loss and regression of left ventricular hypertrophy. Result: Mean cardiopulmonary bypass time was 191$\pm$94.7 minutes with an aortic cross-clamp time of 142$\pm$51.7 minutes. There was no early and late mortality, Freedom from adverse events at 1 year in the study were as follows: thromboembolism, 95.6$\pm$6%; bleeding events, 90.2$\pm$4%; paravalvular leakage 92.3$\pm$4%; and overall valve-related morbidity at 1 year was 76.6$\pm$3%. There were no cases of valve thrombosis, prosthetic valve endocarditis and structural or non-structural failure. Left ventricular function at 12 months after surgery (EF=62.7$\pm$9.8%) revealed a statistically significant improvement compared to preoperative investigation (EF=55.8$\pm$15.9%, p=0.006). Left ventricular mass index was 247.3$\pm$122.3 g/$m^2$ on preoperative echocardiographic study, but regressed to 155.5$\pm$58.2 g/$m^2$ at postoperative 1 year (p=0.002). Over the follow-up period a further decrease of peak transvalvular gradients was observed in all patients: 62.5$\pm$38.0 mmHg on preoperative assessment, 18.2$\pm$6.8 mmHg at immediate postoperative period (p < 0.0001), 7.6$\pm$5.09 mmHg (p<0.0001) at 6 month, 18.0$\pm$10.8 mmHg (p<0.0001) at 1 year. Conclusion: The On-X prosthetic heart valve performs satisfactorily in the first 1 year period. Clinical outcome by examining NYHA functional classification revealed especially good results. Effective regression of left ventricular hypertrophy and statistically significant decrease of transvalvular gradient were observed over the first year, but longer-term follow-up of this patient group is needed to establish the expected rates for late valve-related events as well as the long-term clinical efficacy of this valve.