• The Journal of Korean Society for School & Community Health Education
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• v.25 no.2
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• pp.59-70
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• 2024

Objectives: The purpose of this study is to analyze each country's infectious disease response capacities and, based on this, find areas for improvement in Korea's infectious disease management response. Methods: First, the capacity to respond to the COVID-19 infectious disease was analyzed by country using the SPAR scores of 96 countries around the world released by WHO in 2022. Second, we analyzed each country's specific COVID-19 quarantine performance using Our World in Data and the Global Health Security Index (GHSI). Results: First, the quarantine intensity index on January 24, 2021 was the highest in the Southeast Asia branch at 67.6, which had strong quarantine measures, and the lowest at 44.5 in the Africa branch. As of December 31, 2022, the quarantine intensity index in Europe was significantly lowered to 11.6. Second, the factor that influenced the SPAR indicator on the total number of patients per million population was national laboratory (C4), p=.027, and the factor that influenced the total number of deaths per million population was infection prevention and control (C9), p=.005., Risk Communication and Community Participation (C10) p=.040. The influential factor on GDP per capita was infection prevention and control (C9) p=.009, and the influential factor on GHSI was infection prevention and control (C9) p=.002. Conclusion: The research findings indicate that it was difficult to find a correlation between the SPAR, which is each country's self-assessment of their infectious disease capacities, and the number of COVID-19 cases or the intensity of pandemic responses. However, mortality rates, as well as factors such as the Global Health Security Index (GHSI) and national income, appear to be somewhat influenced. For future improvements in infectious disease management and response in our country, it is necessary to develop pandemic strategies that can reduce socio-economic costs based on more scientific and reliable data like JEE or GHSI, especially in preparation for potential unknown emerging infectious diseases. Based on this, proactive decision-making led by a control tower of experts and effective health communication are also required to respond to public health crises at a national level.

• 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.

• Journal of Chest Surgery
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• v.37 no.1
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• pp.19-26
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• 2004

Background: The aims of this study are to verify the result of the surgical treatment of ALCAPA and to identify the postoperative changes of left ventricular dimensions and mitral regurgitation (MR), Material and Method: Fifteen patients operated on since 1985 were included in the study. The patients operated on before 1998 (n=9) showed heterogeneous properties with various surgical strategies and cardiopulmonary bypass techniques. However, six patients were operated on with the established surgical strategy since 1998; 1) Dual perfusion and dual cardioplegic solution delivery through ascending aorta and main pulmonary artery, 2) Coronary transfer by rolled-conduit made of pulmonary artery wall flap, and 3) Additional mitral valvular procedure was not peformed. Result: Median age of the study group was 6 months (1 month to 34 years). The operative methods were left subclavian artery to left coronary artery anastomosis in 1, simple ligation in 2, Takeuchi operation in 2, and coronary reimplantation in 10 patients. The mean follow up period was 5.5<5.8 years (2 months 14 years), There were one early death (6.7%) and one late death. Overall 5-year survival rate was 85.6$\pm$9.6%. The Z-value of left ventricular end-diastolic and end-systolic dimensions were 6.4$\pm$3.0 and 5.1 $\pm$3.6 preoperatively, and decreased to 1.7$\pm$ 1.9 and 0.8$\pm$ 1.6 in 3 months (p<0.05). Significant preoperative MR was identified in 6 patients (40%) and all the patients showed immediate improvement of MR within f month postoperatively. There were 3 cases of reoperation due to coronary anastomosis site stenosis and recurrence of MR. However, there was no mortality nor late reoperation in the patients operated on after 1998. Conclusion: The surgical treatment of ALCAPA showed favorable survival and early recovery of ventricular dimensions and mitral valvular function. Although long-term reintervention was required in some cases of earlier period, all the cases after 1998 showed excellent surgical outcome without long-term problem.

• Journal of Animal Science and Technology
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• v.45 no.5
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• pp.777-786
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• 2003

An experiment was conducted to investigate the effects of supplementary Blended essential oil(CRINA$^{\circledR}$) on the performance, nutrient availability, fatty acid composition of leg muscle, small intestinal microflora and blood parameters in broiler chickens. One thousand unsexed day-old broiler chickens were assigned to five treatments : control(T1), 5ppm avilamycin(starter diet) & 5ppm flavomycin(grower diet) T2, 5ppm avilamycin(starter diet) & 50ppm CRINA$^{\circledR}$(grower diet) T3, 50ppm CRINA$^{\circledR}$(starter & grower diet) T4, 50ppm CRINA$^{\circledR}$+ 500ppm lactic acid$^{\circledR}$ (starter & grower diet) T5. Each treatment had four replications of 50 birds each. Growth performance was significantly improved by dietary supplements(T2-T5). There were no significant differences among treatment T2, T3, T4 and T5. Feed intake was not significantly different among treatments. Dietary supplementation of CRINA$^{\circledR}$(T3, T4, T5) resulted in significant(p〈0.05) improvement in feed/gain(F/G) during finishing period (4-5weeks). The birds fed CRINA$^{\circledR}$ supplemented diet(T4) showed significantly(p〈0.05) higher availability of crude fat, methionine and methionine + cystine than those fed antibiotics supplemented diet(T2). Mortality was not significantly affected by treatments. The colony forming unit(CFU) of E.coli in small intestinal content was significantly lower in antibiotics & CRINA$^{\circledR}$(T3) compared to CRINA$^{\circledR}$ treatment(T4)(P〈0.05). CFU of Cl. perfringens was low in CRINA$^{\circledR}$(T4) but not different significantly with other treatments. Serum triglyceride level of birds fed CRINA$^{\circledR}$ + lactic acid diet(T5) was significantly lower(p〈0.05) than those fed antibiotics supplemented diet(T2). Cholesterol level of the birds fed antibiotics(T2) or CRINA$^{\circledR}$ + lactic acid supplemented diet(T5) was significantly higher(p〈0.05) than other treatments. HDL level of birds fed control diet was significantly lower(p〈0.05) than that of others. The levels of serum IgG were not significantly different among treatments. Major fatty acids composition of leg muscle fat was significantly influenced by treatments. Control group showed significantly higher palmitic acid(C$_{16:0}$) and steraric acid(C$_{18:0}$) content than other treatments(p〈0.05). Content of oleic acid(C$_{18:1}$), however, was significantly lower in the control than others treatments. Content of linolenic acid(C$_{18:3}$) was significantly higher in CRINA$^{\circledR}$+ lactic acid(T5) than antibiotics & CRINA$^{\circledR}$(T3) treatments. Total saturated fatty acids content was higher and total unsaturated fatty acids were lower in the leg muscle fat of the control than that of other treatments. It is concluded that CRINA$^{\circledR}$ supplementation improved growth rate and F/G ratio in broilers. The combination of CRINA$^{\circledR}$ with either antibiotics or lactic acid did not show any additive or synergistic effects in broiler chickens .

• Advances in pediatric surgery
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• v.8 no.2
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• pp.143-155
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• 2002

A survey on biliary atresia was made among 26 members of the Korean Association of Pediatric Surgeons. The members were required to complete a questionnaire and a case registration form for each patient during the twentyone-year period of 1980-2000. Three hundred and eighty patients were registered from 18 institutions. The average number of patients per surgeon was one to two every year. The male to female ratio was 1:1.3. The age of patients on diagnosis with biliary atresia was on average $65.4{\pm} 36.2$ days old. The national distribution was 32.8% in Seoul, 25.3% in Gyoungki-Do, 21.6% in Gyoungsang-Do, 9.27% in Choongchung-Do, etc. in order. The most common clinical presentation was jaundice (98.4%) and change of stool color (86.2%) was second. Two hundred eighty (74.7%) of 375 patients were operated by 80 days of age. Three hundred thirty six (9 1.9%) of 366 patients were operated on by the original Kasai procedure, and 305 (84.3%) of 362 patients were observed by bile-drainage postoperatively. The overall postoperative complication rate was 18.5% and the overall postoperative mortality rate was 6.8%. The associated anomalies were observed in 72 cases (22.5%). One hundred ninty five (64.7%) of 302 patients have been alive in follow-up and 49 (25.1%) have survived over 5 years without problem after operation. Ascending cholangitis, varices and ascites affected survival significantly, and the important long-term prognostic factor was the occurrence of complications.