Patients with an atrial septal defect (ASD) and severe pulmonary arterial hypertension (PAH) are considered ineligible for defect closure surgery because of the risk of right ventricular decompensation and death after the operation. We report the case of a patient with large ASD and severe PAH who was able to undergo defect closure surgery successfully following long-term use of combined oral sildenafil and beraprost.
The seroprevalence of human toxoplasmosis has been increasing in Korea, and it is controversial whether cats are an important infection source or not. This study was performed to evaluate the seroprevalence of Toxoplasma gondii infection in a high risk group (cat sitters) and to determine the possible importance of cats as an infection source in Korea. Risk factors, including the age, sex, and diet of cat sitters, their contact experience and contact frequency with stray cats, and origin, number, and outdoor activity of their pet cats, were analyzed using structured questionnaires. A total of 673 serum samples from people who have frequent contact with cats (high risk group) and 1,114 samples from general people (low risk group) were examined for specific IgG antibodies against T. gondii by ELISA. The results revealed that the overall seroprevalence of T. gondii infection was 7.4% (n=1,787). The seroprevalence among low risk group was 8.0% (89/1,114), whereas that among high risk group was rather lower 6.4% (43/673), though this difference was statistically not significant (P=0.211). Among the risk factors, only the outdoor activity of pet cats was important; people having cats with outdoor activities revealed 2 times higher seroprevalence than people having cats with only indoor activities (P=0.027). In conclusion, the seroprevalence of T. gondii was not significantly different between the high risk group and low risk group, and the importance of cats as a source of infection in Korea is questionable.
The main problem of consumer behavior is choice since the outcome of me of a choice can only be known in the future, consumers are forced to deal with the risks of und\certainty. So, perception of risk is pivotal aspect of consumer behavior. This study was designed to investigate the relationships between purchasing behavior of textile and perceived risk. Data were obtained from 276 housewives. ANOVA, x2-test were employed to analyse the data. The result were : 1. general features of textile purchase behavior are as follows. Blend wools and pure wool products are prefered. Fall is the major season in purchasing textile. Wholesalers, department stores and agent stores are prefered. Purchasing decision making process independent upon not only textile itself but the practice value of the textile. Purchasing textile, married young women depend on outward shape of the textile, middle and old aged groups depend on the economic value of the textile and the credibility of the stores. 2. Perception of risk is relatively high in the preference of store, color/design, and psycological uncertainty. But the perceived risks is relatively low in brand, price and social credibility. 3. There is significant relationship between the recognition rate of risk and the sensitiveness of the consumer. In addition, there are strong relationship between the risk rate and the preference of shop, brand, and price. On the other hand, there are no significant relationship between the color, design, and sociopsyco-logical risk and demographic variables. 4. The perceived risk of consumer would be a key stone to grasp the consumer behavior. The product company needs to provide full information which could reduce the perceived risk of consumer. there attitude would help for the mutual interests. In the future research, we need to develop the precise methods for finding variables on the perceived risk during the process of making purchase intention.
Objectives: The promotion of health and safety (H&S) awareness among hospital staff can be applied through various methods. The aim of this study was to assess the risk level of physical hazards in the hospital sector by combining workers' perception, experts' evaluation and objective measurements. Methods: A cross-sectional study was designed using multiple triangulation. Hospital staff (n = 447) filled in an H&S questionnaire in a general hospital in Athens and an oncology one in Thessaloniki. Experts observed and filled in a checklist on H&S in the various departments of the two hospitals. Lighting, noise and microclimate measurements were performed. Results: The staff's perception of risk was higher than that of the experts in many cases. The measured risk levels were low to medium. In cases of high-risk noise and lighting, staff and experts agreed. Staff's perception of risk was influenced by hospital's department, hospital's service, years of working experience and level of education. Therefore, these factors should be taken into account in future studies aimed at increasing the participation of hospital workers. Conclusion: This study confirmed the usefulness of staff participation in the risk assessment process, despite the tendency for staff to overestimate the risk level of physical hazards. The combination of combining staff perception, experts' evaluation and objective measures in the risk assessment process increases the efficiency of risk management in the hospital environment and the enforcement of relevant legislation.
Journal of Korean Academy of Fundamentals of Nursing
/
v.8
no.1
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pp.7-23
/
2001
This study was done to provide basic data on prevention of breast cancer by identifying and analyzing risk factors for breast cancer in Korean women. The data were collected from three hospitals. The data from Jan. 1995 to Dec. 1997 was based on the patient recordings and personal contacts if possible. Data from 1998 to 1999 was collected from 280 inpatients and outpatients diagnosed as breast cancer. From this data, information about the risk factors of breast cancer could be acquired. The factors are scaled according to the degree of risk. Menstrual history, obstetrical history, family history. lactation period, life style were given 5 point, and body mass index was given 4 point. Using one-way ANOVA. the most important risk factors were identified and analyzed by multiple regression. The conclusion of this study are as follows : General factors which would show an effect on the results of the multiple regression included risk factors such as menstrual history, obstetrical history, lactation period, family history, and life style factors including mortal state, monthly income, educational level, job and age. Family history(R=0.481) was found to be the highest risk factor(23.1%) affecting breast cancer risk. The next factors were dying hair(R=0.603), drinking(R=0.846), body mass index(R=0.885), smoking(R=0.916), age of menopause(R=0.937), pregnancy age of first full-term(R=0.957), eating vegetable(R=0.980) and the number of full term pregnancies in that order. The sum total(R=0.986) of all the above factors accounted for 97.3% of the risk of breast cancer for Korean women. In conclusion, it was found that family history and dyeing hair were the highest risk factors for breast cancer. It is recommended that those with a family history of breast cancer should have regular breast examinations, and those who often dye their hair should reconsider this practice.
Background The septal cartilage is the most useful donor site for autologous cartilage graft material in rhinoplasty. For successful nasal surgery, it is necessary to understand the developmental process of the nasal septum and to predict the amount of harvestable septal cartilage before surgery. Methods One hundred twenty-three Korean patients who underwent three-dimensional (3D) facial bone computed tomography (CT) were selected for evaluation of the midsagittal view of the nasal septum. Multiple parameters such as the area of each component of the nasal septum and the amount of harvestable septal cartilage were measured using Digimizer software. Results The area of the total nasal septum showed rapid growth until the teenage years, but thereafter no significant change throughout the lifetime. However, the development of the septal cartilage showed a gradual decline due to ossification changes with aging after puberty in spite of a lack of change in the total septal area. The area of harvestable septal cartilage in young adults was $549.84{\pm}151.26mm^2$ and decreased thereafter with age. Conclusions A 3D facial bone CT scan can provide valuable information on the septal cartilage graft before rhinoplasty. Considering the developmental process of the septal cartilage identified in this study, septal surgery should not be performed until puberty due to the risk of nasal growth impairment. Furthermore, in elderly patients who show a decreased cartilage area due to ossification changes, septal cartilage harvesting should be performed carefully due to the risk of saddle nose deformity.
Kim, Jeong-Won;Sim, Hyung Tae;Yoo, Jae Suk;Kim, Dong Jin;Cho, Kwang Ree
Journal of Chest Surgery
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v.49
no.6
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pp.427-434
/
2016
Background: Recent studies have demonstrated the benefits of off-pump coronary bypass grafting over the on-pump technique in patients with chronic kidney disease (CKD). To further reduce the risk of acute kidney injury and the need for renal replacement therapy, even in patients undergoing off-pump coronary artery bypass grafting, we adopted protocol-based perioperative management for patients with CKD. Methods: From December 2012 to March 2015, 265 patients underwent isolated off-pump coronary artery bypass grafting. To analyze renal function in a stable condition, we excluded 12 dialysis-dependent end stage renal failure and 10 emergency or urgent cases. Among the remaining 243 patients, 208 patients had normal kidney function (normal group), and 35 patients had CKD (CKD group). Minimizing contrast exposure, ensuring adequate hydration, using strict drug dosage adjustment, and optimizing hemodynamic status were key elements of the protocol for the CKD group. Results: The risk of acute kidney injury was about ${\times}3$ higher in the CKD group than in the normal group (p=0.01). Estimated glomerular filtration rates and serum creatinine levels deteriorated until the third postoperative day in the CKD group. However, by adopting protocol-based perioperative management, this transient renal dysfunction recovered to preoperative levels by the fifth postoperative day without requiring renal replacement therapy in all cases. Conclusion: Off-pump coronary bypass surgery combined with this protocol-based perioperative management strategy in patients with non-dialysis-dependent CKD could mostly be performed without renal replacement therapy.
The prevalence rate of low back pain in nurses is higher than that of other jobs, because there are many more risk factors(for example, standing postures, lifting and carrying heavy loads, transfering patients, changing a patient's position etc.). This investigation is to provide basic data for prevention of low back pain by analyzing the prevalence rate and related factors of low back pain in nurses(esp. operating room staff) in general hospitals. A self-reported questionaire survey was carried out on three hundred and five nurses of three general hospitals in Seoul from June, 1996 to August, 1996. Subjects of the survey were divided into a low back pain group(LBP) and a cotrol group to investigate the association between low back pain and the general characteristics and work related factors of each group. The results were as follows: 1. In the subjects of the survey, the prevalence rate of low back pain was 60.0% for the last year. 2. 73.6% of operating room(OR) staff complained of low back pain. 3. Standing for a long time and working in twisting postures were associated with low back pain, and so were the shift, the type of work, and the frequency of transfering patients. 4. The weight loads which nurses frequently carried were, under 5kg, 5-10kg, 15-20kg, 15-20kg, over 20kg, and all, except for 10-15kg, were associated with LBP. 5. 76.9% of the LBP experienced low back pain within 3 years after starting nursing jobs. 6. Concerning the degrees of low back pain: 75.8% was limited to waist; 18.8% reached the knees; 4.2% reached ankles. In conclusion, the prevalence rate of low back pain in general hospital nurses was associated with the works in operating room and other work related factors, therefore it is necessary to develop on educational program for the prevention of low back pain as well as and to improve working environments.
Aytekin, Turkan;Aytekin, Alper;Maralcan, Gokturk;Gokalp, M. Avni;Ozen, Dogukan;Borazan, Ersin;Yilmaz, Latif
Asian Pacific Journal of Cancer Prevention
/
v.15
no.17
/
pp.7181-7185
/
2014
Cyclin D1 is an important positive regulator of the G1/S phase of the cell cycle. We investigated the association between the CCND1 G870A polymorphism and susceptibility to papillary thyroid cancer in Turkish people. This study covered 102 patients with papillary thyroid cancer and 174 healthy controls. CCND1 genotyping was determined by the PCR-RFLP method. We found that the A allele frequency was higher in the cases than in the controls (p=0.042). On stratification analysis, papillary thyroid cancer risk was significantly elevated in individuals older than 45 years with the A allele (OR=1.91, 95% CI, 1.09-3.35, p=0.024) and in females with the A allele (OR=1.73, 95% CI, 1.06-2.84, p=0.029), compared to the G allele. According to the subject age, there was an increased papillary thyroid cancer risk for the individuals older than 45 years with the AA genotype (OR=2.28, 95% CI, 1.02-5.13, p=0.046) compared to the AG+GG combined genotypes. In conclusion, it is suggested that the CCND1 G870A polymorphism may contribute to the susceptibility to papillary thyroid cancer, especially in those who were older subjects ($45{\leq}$ years old) and female, in the Turkish population.
Background: Digital panoramic dental X-ray equipment (PDX) is frequently used by patients and dental workers for diagnosis and examination in dental institutions; however, infection control has not been properly implemented. Therefore, in this study, we aimed to systematically review the potential risk of cross-infection in the dental environment by investigating the contamination level of general aerobic bacteria and Staphylococcus aureus, which are important in hospital infections, in PDX areas that people mainly contact. Methods: This survey was conducted from March to May 2023 and covered one general hospital, three dental hospitals, and nine dental clinics equipped with PDX. Bacteria samples were collected from the left-handle, right-handle, forehead support, and head side support as the patient's contact areas, as well as the X-ray exposure switch and left-click mouse button as the dental hygienist's contact areas of the PDX. The collected bacteria were spread on Petrifilm, and colonies formed after 48 hours of culture were counted. Results: General aerobic bacteria and S. aureus were detected in all areas investigated. Significant differences in bacterial counts between different regions of the PDX were observed in both groups (p<0.001). The detection rates of general aerobic bacteria (p<0.001) and S. aureus (p<0.001) were significantly higher in the contact areas of patients than those of dental hygienists. A positive correlation was observed between the forehead and the temple region in terms of general aerobic bacteria and S. aureus detection (r=1) (p<0.01). Conclusion: Taken together, the presence of many bacteria, including S. aureus, detected in PDX indicates that PDX has a potential cross-infection risk. Our results therefore highlight the need for the development of appropriate disinfection protocols for reusable medical devices such as PDX and periodic infection prevention training for hospital-related workers, including dental hygienists.
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