• Journal of Chest Surgery
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• v.29 no.1
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• pp.24-31
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• 1996

Between January 1992 and February 1995, 36 patients with mitral regurgitation were treated by a mitral repair There wert nineteen men and seventeen women whose mean age was 41.8 years, ranged from 10 to 71. Seventeenth patients had dystrophic change of mitral valve, twelve patients had rheumatic change of mitral valve, second patients had infective change of mitral valve and another fifth patients had functional change of mitral valve. Operation proced res were suture annuloplasty (35 cases), resection of leaflet (25 cases), chordal shortening(9 cases) and commisurotomy(1 cases). These procedures were combined in most patients. Two third of the patients were in New York Heart Association class III or IV and four fifth of the patients were in mitral regurgitation grade III or IV by doppler echocardiogram. After mitral valve repair, the patients were improved hemodynamic, echocardiographic data and functional class. Intraoperative TEE had been used in all most patients after weaning of bypass. If there remained MR more than grade 2, the valve was re-repaired or replacement. There were no operative death. The late mortality was 5.5% and cause of death was congestive heart failure. Patients have been followed up from 3 to 40 months, mean 15. Second patients underwant reoperation due to recurred mitral regurgitation, 4 and 19 days after the operation. During reoperation, we found that the repair suture was disrupted in both patients. Th s expierence demonstrated that intraoperative TEE is accurate and predictable and excellent immediate and mid-term results have been achieved by mitral valve repair.

• Journal of Chest Surgery
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• v.42 no.1
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• pp.46-52
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• 2009

Background: Vascular injuries to the extremities are potentially devastating and they can lead to limb loss and mortality if they are not appropriately managed. The vascular trauma caused by traffic and industrial accidents has recently increased according to the developing industry and transport system in Korea. Early recognition and treatment of these injuries are mandatory to achieve satisfactory outcomes. Material and Method: We retrospective reviewed 43 patients with vascular injuries that were due to blunt and penetrating trauma and they underwent emergency operations from January of 1998 to December of 2006. Result: There were 38 men and 5 women patients with a mean age of $42.0{\pm}16.8$ years (range: 17~77). The cause of vascular injuries were 28 traffic accidents (65%), 6 industrial accidents (14%), 6 glass injuries (14%) and 3 knife injuries (7%). The average time from admission to the operating room was $319.0{\pm}482.2$ minutes (range: 27~2,400 minutes). The average time from admission to discharge was $53.1{\pm}56.0$ days (range: 2~265 days). The anatomic injuries included the femoral artery in 16 cases (37%), the popliteal artery in 8 cases (19%), the brachial artery in 8 cases (19%), and the subclavian and axillary arteries in 7 cases (16%). The associated injuries were 23 bone fractures (53%), 18 muscle injuries (42%) 5 nerve injuries (12%) and 11 vein injuries (26%). The operation methods were 20 end to end anastomoses (46%), 16 interposition grafts (36%), 2 repairs with using patches (5%) and 5 others (12%). The number of amputations and cases of mortality were 3 cases (7%) and 4 cases (9%), respectively. Conclusion: Minimizing ischemia is an important factor for maximizing salvage of extremities. Prompt diagnosis and treatment can reduce the amputation and mortality rates.

• Journal of Nutrition and Health
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• v.46 no.3
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• pp.261-275
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• 2013

This study was designed to investigate the relationships of depressed mood with obesity, blood and urinary compositions, and dietary habits in Koreans at the age of 40, a critical transition to the middle adulthood stage. A total of 27,684 people who have taken the Life Transition Period Health Examination at the Korea Association of Health Promotion in 2011 were divided into two groups; the depressed mood group (DG) and the non-depressed group (NG) according to results of the primary questionnaire for mental health. The results were analyzed using the health examination criteria of the National Health Insurance Corporation. Women and medicaid recipients showed higher incidence of depressed mood than men and health insurance subscribers. People with underweight in BMI or abdominal obesity showed correlation with depressed mood, while there was no significant relationship with metabolic syndrome. Regarding blood and urinary compositions, DG was related to a higher level of hemoglobin and lower levels of HDL-cholesterol and triglyceride, although the relationships diminished after adjustment for other confounder effects. According to dietary habits, more people in DG were categorized as a group for "Needs Much Improvement", and the odds ratio of the depressed mood showed a significant increase. Significant difference regarding the frequency of food items such as milk products, animal proteins, Kimchi, and fruits was observed between DG and NG. In addition, a higher portion of subjects in DG did not consume regular meals and various kinds of food. In conclusion, the depressed mood of 40 year-old adults was significantly related to underweight, higher waist measurement, and undesirable dietary habits. Results of our study can be applicable as a basic resource for development of effective nutrition counseling and education programs for improvement of mental health promotion during the critical transition to the middle adulthood stage.

• Journal of Chest Surgery
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• v.37 no.4
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• pp.356-363
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• 2004

Esophageal cancer is an aggressive disease with a poor prognosis. Recently, every effort has been made to improve the long term survival, but the general prognosis for patients with this disease remains poor. In this study, we reviewed 8 years of experiences with esophageal cancer patients managed in our department at Dong-A University Hospital and evaluated the effectiveness of cervical lymph node dissection performed selectively. Material and Method: From January 1995 to August 2003, 70 patients underwent esophagectomy for esophageal cancer in our department. Among them, 51 patients who underwent curative resection, had no double primary tumors and no neoadjuvant therapy were analyzed retrospectively. In most patients, intrathoracic esophagectomy and cervical esophago-gastrostomy was performed. Since 1997, 3-field lymph node dissection was performed selectively. Result: There were 46 men and 15 women. The median age was 60 years. The tumor was located in the upper third part in 10 patients (19%), middle third in 21 (41%), and lower third in 20 (40%). Majority of the patients (90%) had squamous cell carcinoma. Cervical anastomosis was made in 41 patients, and intrathoracic anastomosis in 10. 2-field lymph node dissection was done in 40 patients, and 3-field lymph node dissection in 11. The pathologic staging were as follows: stage I in 9 patients (17.6%), IIA in 20 (39.2%), IIIB in 7 (13.7%), III in 11 (21.6%), IVA in 2 (3.9%), and IVB in 2 (3.9%). The in-hospital mortality was 3.9% (2 patients) and complications occurred in 24 patients (47%). Overall actuarial 1, 3, and 5-year survival rates were 74.4%, 48.4%, and 48.4% including operative mortality. The 4-year survival rate did not differ significantly between 3-field lymph node dissection group (50.5%) and 2-field lymph node dissection group (48.9%). In 3-field lymph node dissection group, the respiratory complications were more frequent and operative time was significantly longer. Conclusion: We think that curative resection for esophageal cancer can be performed with acceptable mortality, and aggressive surgical approach may improve the long term survival. even for advanced stages. Effectiveness of 3-field lymph node dissection needs further investigations.

• Journal of Chest Surgery
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• v.41 no.6
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• pp.736-741
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• 2008

Background: Pneumonia continues to be the most common major infection in trauma patients. Despite the advances in prevention, diagnosis, and treatment for pneumonia, it remains a major cause of morbidity and mortality. The aim of this retrospective study is to identify the risk factors and clinical features of ventilator-associated pneumonia among chest trauma patients. Material and Method: The study population consisted of 78 mechanically ventilated patients admitted to the ICU of Chonnam National University Hospital between January, 2001, and December, 2006. The patients were divided into two groups: those with pneumonia (Group I) and without pneumonia (Group II). Clinical predictors of the occurrence and mortality for ventilator associated pneumonia were analyzed. Result: There were 57 men and 21 women, with a mean age of $48.3{\pm}19.9$ years. Almost half of the patients, 48.7% (38 of 78), had pneumonia. The mortality rate was 21.0% (8 of 38) in Group I and 2.5% (1 of 40) in Group II. The predictors of ventilator-associated pneumonia were the duration of mechanical ventilation (17.4 days vs 6.5 days, p<0.001), the mean stay in the ICU (21.7 days vs 9.7 days, p<0.001), the use of inotropics due to hemodynamic instability (63.1% vs 25.0%, p=0.001), and the serum level of CRP ($11.3{\pm}7.8$ vs $6.4{\pm}7.3$, p=0.006). Conclusion: Posttraumatic ventilator-associated pneumonia was significantly related with the duration of mechanical ventilation, the mean stay in ICU, and the use of inotropics due to hemodynamic instability. The serum level of CRP at admission was higher in the pneumonia group. Morbidity and mortality can be reduced by early identification of predictive factors for developing pneumonia in chest trauma patients.

• Sleep Medicine and Psychophysiology
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• v.10 no.2
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• pp.100-107
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• 2003

Objectives: Periodic leg movements in sleep (PLMS) might be subdivided based upon whether or not they are associated with visible EEG microarousals (MA). MA is considered to be responsible for nonrestorative sleep and daytime fatigue. The American Sleep Disorders Association's (ASDA) scoring rules for MA based on visual analysis of the EEG changes suggest that MA should last more than 3 seconds. However, it has been suggested that visual analysis may not detect some changes in EEG activity. This study is aimed at measuring changes in EEG spectra during PLMS without MA in order to better understand the arousing response of PLMS. Methods: Ten drug-free patients (three men and seven women) diagnosed with PLMS by polysomnography were studied. Spectral analysis of the EEG was performed in each patient on 30 episodes of PLMS without MA, chosen randomly across the night in stage 2 non-REM sleep. We applied stricter criteria for MA compared to ASDA, by defining it as a return to alpha and theta frequency lasting at least 1 second. Results: The mean PLMS index was $16.7{\pm}10.0$. The mean PLMS duration was $1.3{\pm}0.7$ seconds. Comparison of 4-second EEG activity both before and after the onset of PLMS without MA using independent t-test showed that the movements were associated with significant increase of relative activity in the delta band (p=0.000) and significant decrease of activity in the alpha (p=0.01) and sigma (p=0.000) bands. No significant decrease in the theta (p=0.05), beta (p=0.129), or gamma (p=0.062) bands was found. Conclusion: PLMS without MA was found to be associated with EEG change characterized by increase in the delta frequency band. This finding seems to be compatible with the hypothesis of an integrative hierarchy of arousal responses of Sforza's. Considering that the subjects had lower PLMS index and shorter PLMS duration than those of the previous study, it is suggested that an even less severe form of PLMS without MA could induce neurophysiologic change, which may potentially be of clinical significance.

• Investigative Magnetic Resonance Imaging
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• v.10 no.1
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• pp.1-7
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• 2006

Purpose : Recent development of diffusion tensor imaging enables the evaluation of the microstructural characteristics of the brain white matter. However, optimal imaging parameters for diffusion tensor imaging, particularly concerning the number of diffusion gradient direction, have not been studied thoroughly yet. The purpose of this study was to evaluate the influence of the number of diffusion gradient direction on the fiber tracking of the white matter. Materials and methods : 13 healthy volunteers (ten men and three women, mean age 30 years, age range 23-37 years) were included in this study. Diffusion tensor imaging was performed with different numbers of diffusion gradient direction as 6, 15, and 32, keeping the other imaging parameters constant. The imaging field ranged from 1 cm below the pons to 2-3 cm above the lateral ventricle, parallel to the anterior commissure-posterior commissure line. FA (fractional anisotropy) maps were created via image postprocessing, and then FA and its standard deviation were calculated in the genu and the splenium of the corpus callosum on each of FA maps. Fiber tracking of the corticospinal tract in the brain was performed and the number of the reconstructed fibers of the tract was measured. FA, standard deviation of FA and the number of the reconstructed fibers were compared statistically between the different diffusion gradient directions. Results : FA is not statistically significantly different between the different diffusion gradient directions. By increasing the number of diffusion gradient direction, standard deviation of FA decreased significantly, and the number of the reconstructed fibers increased significantly. Conclusion : The higher number of diffusion gradient direction provided better quality of fiber tracking.

• Tuberculosis and Respiratory Diseases
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• v.40 no.5
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• pp.565-574
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• 1993

Background: Pulmonary hamartomas are benign tumors that occur in the parenchyma or in the bronchi. They present as a solitary pulmonary nodule(SPN) or as a cause of bronchial obstruction. The incidence, once minimal, is increasing in Korea. To get clinical spectrum about the tumor, we analyzed all the reported cases in Korea since 1964. Methods: We reviewed the clinical, radiological and pathological findings of 13 patients of intrapulmonary or endobronchial hamartomas in Severance Hospital and of 38 reported cases in Korea published in literatures from 1964 to 1992 retrospectively. Results: Including 17 endobronchial hamartomas, 54 cases were studied. There were 25 men and 29 women, with a mean age of 47.2 years; 45.3 years in endobronchial type and 51.3 years in parenchymal type. Pulmonary symptoms were present in 8 patients (22%) of intrapulmonary type and in all patients of endobronchial type: cough (65%), dyspnea (53%), sputum (35%), fever (29%) in order. On chest X-rays, atelectasis was seen in 10 patients (59%) in endobronchial type; but SPN was noted in 36 patients (97%) of intrapulmonary type. Calcification was present in 7 intapulmonary hamartomas (23%); but is in 2 endobronchial hamartomas (12%). The diagnostic yield was 6 out of 14(43%) in endobronchial ones; 4 out of 7(57%) in intrapulmonary ones. Fifty patients underwent operations as follows: lobectomy (28), enucleation (8), resection (8), bilobectomy (4), pneumonectomy (2). The hamartomas were 1.2 times more common in the right lung; mean transverse diameter at the time of operation was 2.3 cm in endobronchial type, 3.8 cm in intrapulmonary ones. Chondroid components were present in 11(65%) of 17 endobronehial ones but in 30(91%) of 33 intrapulmonary hamartomas. No malignant changes were seen perioperative period and up to early 1993. Conclusion: The younger age in endobronchial hamartomas, the preponderance of the female sex and the more incidence in the right lung, and the diagnostic choice of lobectomies were different from the studies of the Western countries.

• Journal of Technologic Dentistry
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• v.28 no.1
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• pp.121-142
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• 2006

Collecting materials for study on teaching efficiency and satisfaction of clinical training, it changes. Dental technology's educational procedure to many ways of a prospect. In a circumstance that needed higher level of education, this study is aimed on realizing an importance of clinical training through the various materials that previously carried out and offering basic knowledge to take better clinical training for the students. Study results below 1. This Investigation conducted on 123 of sophomores(70.3%) and 52 of juniors(29.7%) who have been taken clinical training, and men's proportion(51.45%)is a bit higher than girls(48.6%). The 64% of respondents taken largest proportion were 20 to 24 years old. As 67.9% of respondents attended daytime school and 30.3% of them attended nighttime one, their school time shows a little difference. In a question about relation ship, one answered "Harmonious" took largest proportion by 72.6% during training, and about the degree of satisfaction of campus life who answered "normal" were the most with 59.4%. 2. About the reason choosing dental technology as a major, 41.1% taken the most answered "due to the specialized job", "Getting job easily" was second with 26.9%, and third was "recommended from around" with 18.3%. 50.3% of the respondents answered "normal" about the Satisfaction of their major, student marked in grade "B" most with 51.4% 3. In a investigation result about clinical training statues and preference, most(72.6%) choose place less than 10 for clinical training, and 60.6% of them resided own home. About their commuting time from home to training place, 44% was under 30min, 40% took time 30-60min. It shows students prefer shotter distance in terms of choosing training place. 4. Each part manager took large proportion as a clinical trainer with 33.7%, Training curriculum reform and developing method were most answer as a improvement measure after completing training with 30%. 5. The average of total score about clinical training was 3.15 of 5. In the detailed question, 'satisfaction of clinical training' got 3.38 as a highest score, the lowest score was 2.86 that is about satisfaction of clinical training period. The average score about efficiency of study was 2.86 and in detailed question, 'a Role model' got 3.26 as a highest score and participation of student got 3.05 as a lowest score. 6. The result of T-test to see the difference of the satisfaction according to the general character and clinic training condition between teaching efficiency is that the degree of satisfaction of clinical training showed statistical significance only in the degree of satisfaction of campus life(p<0.05), and teaching efficiency has a statistical significance with their age, grade, and satisfaction of campus life (p<0.05). 7. The relation between of teaching efficiency of clinical training and satisfaction of clinical training of dental technologic student has a statistical meaning in significance leveler 0.01. Now, therefore we suggest following based on these result. 1. To elevate satisfaction of clinical training, it agentry needs development of consistent clinical training curriculum. 2. To grasp the satisfaction and requirement, in needs to measure anxiousness and satisfactory degree after completing training 3. To train efficiently and evaluate efficiency over the teaching activities, it needs to develop measuring tools for teaching efficiency in terms of teacher's important rules in a clinical training. 4. Strengthen the relations with the study developing and managing curriculum gathering theoretical knowledge and practice. And make an effort to apply to their students. 5. Let the trainee take a class setting a belief, sense of value, function and obtain behavior by making the students comfort over clinical training as increasing teaching efficiency.

• Journal of Nutrition and Health
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• v.35 no.4
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• pp.480-488
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• 2002

This study was performed to document the association between obesity, a major risk factor for chronic diseases, and dietary pattern in Korean elderly. The subjects were 595 men and women aged 60-89 years. The subjects were classified into 4 groups based on BMI: under weight, BMI < 18.5, normal weight, 18.5 $\leq$ BMI 22.9; overweight, 23.0 BMI 24.9; and obese BMI $\geq$ 25.0. Dietary intakes by 24-hr recall, blood pressure, anthropometric parameters and health eating index (HEI) were measured. Underweight group was excluded for data analysis doe to small number of subjects, and age-adjusted measurements were compared among normal, overweight and obese groups. The mean anthropometric values for males and females were 23.7 and 24.8 kg/$m^2$ for BMI, 0.90 and 0.86 for WHR and 140.7 and 138.8 mmHg for SBP, respectively. The mean intakes of energy, Ca, vitamin A, vitamin B$_2$, and vitamin E did not meet Korean RDA for elderly. Intakes of fat and cholesterol were low: the percent energy from fat for male and female subjects were 19.1% and 18.1% and mean cholesterol intakes were 208 mg and 152 mg, respectively. Judging by HEI score, dietary quality was better in females than in male subjects. The mean BMI of normal, over and obese groups were 21.4, 23.9, 26.7 kg/$m^2$ in male subjects and 21.6, 23.9, 27.1 kg/$m^2$ in female subjects. WHR, SBP and TSF were increased with increasing BMI No association was found between BMI and nutrient intakes and/or food consumption pattern. However, a tendency was shown that the overweight group reported higher intakes in most nutrients compared to normal and obese groups. This study implies that with increasing BMI, anthropometric risk factors, such as WHR, TSF, and blood pressure were Increased, however, no significant differences were found in nutrient intakes and food patterns. Energy and fat intakes do not seem to be a cause for obesity in Korean elderly.