• Title/Summary/Keyword: Outcome Assessment

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The Influence of Gender on the Long-term Outcome of Coronary Artery Bypass Surgery (성별에 따른 관상동맥 우회술의 장기 결과)

  • Choi Jong-Bum;Lee Mi-Kyung;Cha Byoung-Ki;Lee Sam-Youn
    • Journal of Chest Surgery
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    • v.39 no.6 s.263
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    • pp.449-455
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    • 2006
  • Background: Female sex was known to be a risk factor for mortality after coronary bypass grafting (CABG), and women showed higher in-hospital mortality than men. Material and Method: Between 1992 and 1996, 147 consecutive patients (98 men and 49 women) undergoing CABG were included in the study. Most patients had undergone CABG with left internal thoracic artery and saphenous vein under cardiopulmonary bypass. We examined the influence of gender on survival after CABG and looked for risk factors for survival. Result: There was no in-hospital mortality in women, but 3 death (3.0%) in men. During the mean follow-up period of $138.5{\pm}23.0$ months, mortality was lower in women than in men (20.4% vs 44.9%, p=0.004), and the most common cause of death in women was chronic renal failure (40%). Survival in women at 1, 5, 10, and f4 years was 100%, $98.0{\pm}2.0%,\;81.2{\pm}5.6%,\;and\;78.4{\pm}6.1%$, respectively, which was better than in men (p=0.004). Although preoperative left ventricular ejection fraction was higher in women than in men, this did not affect early and long-term survival difference between two sexes (p=0.15). Risk factor for long-term survival in women was diabetes (p=0.033) and in men number of diseased coronary artery (p=0.006). Conclusion: Long-term survival after CABG was better in women than men. Risk factor for long-term survival in women was morbid disease rather than cardiac disease.

Estimation of Fresh Weight, Dry Weight, and Leaf Area Index of Soybean Plant using Multispectral Camera Mounted on Rotor-wing UAV (회전익 무인기에 탑재된 다중분광 센서를 이용한 콩의 생체중, 건물중, 엽면적 지수 추정)

  • Jang, Si-Hyeong;Ryu, Chan-Seok;Kang, Ye-Seong;Jun, Sae-Rom;Park, Jun-Woo;Song, Hye-Young;Kang, Kyeong-Suk;Kang, Dong-Woo;Zou, Kunyan;Jun, Tae-Hwan
    • Korean Journal of Agricultural and Forest Meteorology
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    • v.21 no.4
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    • pp.327-336
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    • 2019
  • Soybean is one of the most important crops of which the grains contain high protein content and has been consumed in various forms of food. Soybean plants are generally cultivated on the field and their yield and quality are strongly affected by climate change. Recently, the abnormal climate conditions, including heat wave and heavy rainfall, frequently occurs which would increase the risk of the farm management. The real-time assessment techniques for quality and growth of soybean would reduce the losses of the crop in terms of quantity and quality. The objective of this work was to develop a simple model to estimate the growth of soybean plant using a multispectral sensor mounted on a rotor-wing unmanned aerial vehicle(UAV). The soybean growth model was developed by using simple linear regression analysis with three phenotypic data (fresh weight, dry weight, leaf area index) and two types of vegetation indices (VIs). It was found that the accuracy and precision of LAI model using GNDVI (R2= 0.789, RMSE=0.73 ㎡/㎡, RE=34.91%) was greater than those of the model using NDVI (R2= 0.587, RMSE=1.01 ㎡/㎡, RE=48.98%). The accuracy and precision based on the simple ratio indices were better than those based on the normalized vegetation indices, such as RRVI (R2= 0.760, RMSE=0.78 ㎡/㎡, RE=37.26%) and GRVI (R2= 0.828, RMSE=0.66 ㎡/㎡, RE=31.59%). The outcome of this study could aid the production of soybeans with high and uniform quality when a variable rate fertilization system is introduced to cope with the adverse climate conditions.

A Study on the Development of an Instrument for Knowledge Contribution Assessment (조직 구성원의 지식기여도 평가 도구 개발에 관한 연구)

  • Na, Mi-Ja;Kym, Hyo-Gun
    • Information Systems Review
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    • v.6 no.2
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    • pp.113-135
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    • 2004
  • This paper defines appraisal items and weights of the items for the purpose of developing an appraisal instrument that objectively measures employee's effectiveness of knowledge contribution. Deductive research is used for the development of appraisal items and delphi method for the development of weights of the items. In the deductive research the term, "effectiveness of knowledge contribution" is first defined. Then knowledge contribution activities are classified as "dimension of explicit contribution" and " dimension of tacit contribution" due to the characteristics of knowledge. Each dimension is divided again by components. The dimension of explicit contribution is divided according to the content of knowledge, and the dimension of tacit contribution is divided according to the extent of tacitness of knowledge contribution. The total components of dimensions are 7. The dimension of explicit contribution is composed of factual knowledge and procedural knowledge. The factual knowledge is made up of "procedural knowledge outcome" and "other factual knowledge". The procedural knowledge is made up of "procedural knowledge manual" and "lessons-learned procedural knowledge". The dimension of tacit contribution is composed of "agency", "model" and "Q&A". The basic framework for measuring 7 components of knowledge contribution is quantitative and qualitative approach. This paper is premised on the assumption that the outcomes of employee's knowledge contribution activities are recorded in the knowledge management systems in order to evaluate them objectively. The appraisal items are defined as follows: at the dimension of explicit contribution, in quantitative approach, "the upload number" or "performance number", and in qualitative approach, other employee's "referred number" and other employee's "content and format satisfaction evaluation"; at the dimension of tacit contribution, "demanded number of performance" After the development of appraisal items by the deductive method, delphi method was used for the analysis of the weights of the items with the total degree of knowledge contribution, 100. This research does not include the standard marks of the appraisal items. It is because when companies apply this appraisal instrument, they could use their own standard appraisal marks of the appraisal items considering their present situations and companies' goals. Through this almost desert-like research about the appraisal instrument of employee's knowledge contribution effectiveness, it proposes a cornerstone in the research field of appraisal instrument, which provides a standard for employee's knowledge contribution appraisal, and appraisal items that make organizational knowledge to be managed more systemically in business sites.

Assessment of Nutrition Status and Quality of Life after Curative Resection in Patients with Upper Gastric Cancer: Comparison of Total Gastrectomy and Proximal Gastrectomy (상부 위암에 대한 근위부 위절제술 뜻 위전절제술을 시행한 환자의 영양상태와 삶의 질 비교)

  • Lee, Hyun-Soo;Park, Jong-Hyun;Choi, Hun;Kim, Jae-Hee;Min, Lac-Kee;Lee, Sang-Il;Noh, Seung-Moo
    • Journal of Gastric Cancer
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    • v.5 no.3 s.19
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    • pp.152-157
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    • 2005
  • Purpose: A total gastrectomy is generally peformed for the treatment of upper third gastric cancer. However, the optimal extent of resection for early-stage upper third gastric cancer is still controversial. In this research, we compared the nutritional status and the quality of life in patients who underwent a total gastrectomy with uncut Roux en Y esophagojejunostomy with those in patients who underwent a proximal gastrectomy with esophagogastrostomy for treatment of upper third gastric cancer. Materials and Methods: We reviewed 50 patients with no evidence of recurrent disease following curative surgery for upper third gastric cancer. Among this group, 25 patients underwent a total gastrectomy (TG) and 25 patients a proximal gastrectomy (PG). 8 TG and 4 PG patients were excluded from this study because of death, refusal to interview etc. The nutritional status was assessed by measuring body weight, serum albumin, serum hemoglobin, and serum total protein. The gastrointestinal function and the quality of life were assessed by Cuschieri grading and modified Visick qrading. Results: In analysis of covariance of age and preoperative serum albumin, PG patients demonstrated lower weight loss (P=0.038), elevated serum albumin (P=0.049), and better outcome based on modified Visick grading (P=0.016) than TG, but there were no significant differences in the serum hemoglobin change (P=0.165), serum total protein change (P=0.435), and Cuschieri grading (P=0.064) between the preoperative and the postoperative data. Conclusion: In this study, a proximal gastrectomy led to a better nutritional status and quality of life than a total gastrectomy, as judged from the low weight loss, elevated serum albumin and better modified Visick grade.

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The Value of ICAM-1 Expression and the Soluble ICAM-1(sICAM-1) Level as a Marker of Activity in Sarcoidosis: The Relationship Between the ICAM-1 Level and the Clinical Course of the Disease (유육종증의 활동성 지표로서의 ICAM-1)

  • Kim, Dong-Soon;Paik, Sang-Hoon;Shim, Tae-Sun;Lim, Chae-Man;Lee, Sang-Do;Koh, Youn-Suck;Kim, Woo-Sung;Kim, Won-Dong
    • Tuberculosis and Respiratory Diseases
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    • v.45 no.1
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    • pp.116-127
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    • 1998
  • Background: The natural course of sarcoidosis is variable from spontaneous remission to significant morbidity or death. So the assessment of disease activity is important but no single parameter was generally accepted as a good marker. Recently several studies suggested that adhesion molecules, especially ICAM-1 can be a marker, but there are some controversies. And only few data are available about the relationship of ICAM-1 with clinical follow-up course. Methods: We measured the expression of adhesion molecules on BAL cells by flow cytometry and the level of soluble ICAM-1(sICAM-1) in serum and BALF at the time of diagnosis in 12 patients with active disease and 7 inactive sarcoidosis(5 male, 14 female, mean age: $39.4{\pm}10.7$ years, mean follow-up : $20{\pm}15$ months). Follow-up clinical course were compared with the changes in serum sICAMA-1 level and the adhesion molecule on BAL cells. Results: In the patients with active disease, the ICAM-1 on AM(RMFI: $3.68{\pm}1.71$) and sICAM-1 level in serum($582{\pm}193$ng/ml) and BAL fluid($47.8{\pm}16.5$ng/ml) were all higher than those of 7 inactive disease(RMFI: $1.89{\pm}0.75$, p=0.0298, serum: $294{\pm}117$ ng/ml, p=0.0049, BALF: $20.9{\pm}8.3$ ng/ml). In the active sarcoidosis, ICAM-1 on AM(RMFI : $1.51{\pm}0.84$) and serum sICAM-1 were decreased after the therapy($250{\pm}147$ ng/ml) but no significant change was noted in inactive disease. Also we found the initial ICAM-1 on AM and serum sICAM-1 had a significant correlation with the degree of improvement in PFT after the therapy. During the follow-up, the disease relapsed in 4 patients after the discontinuation of steroid and the serum sICAM-1 level went-up again at the time of relapse. Conclusion: Our data suggest that the serum sICAM-1 level and the ICAM-1 expression on AM can be a good marker of disease activity and also a predictor of outcome in sarcoidosis.

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A Study on Location Selection for Rainwater Circulation System Elements at a City Level - Focusing on the Application of the Environmental and Ecological Plan of a Development - (도시차원의 빗물순환체계 요소별 입지선정에 관한 연구 - 개발예정지역의 환경생태계획 적용방안을 중심으로 -)

  • Kim, Hyo-Min;Kim, Kwi-Gon
    • Journal of the Korean Institute of Landscape Architecture
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    • v.40 no.3
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    • pp.1-11
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    • 2012
  • This study focused on establishing a natural rainwater circulation system using rainwater meant for relatively large urban development projects such as a new town development. In particular, when the location selection techniques for individual elements of a natural rainwater circulation system are developed for the integrated rainwater management, changes in hydrological environment will be minimized and the natural water circulation would be restored to realize the low impact development (LID). In that case, not only the excess will be reduced but water space and green areas in a city would also increase to improve the urban sustainability. First of all, there were five elements selected for the location selection of a rainwater circulation system intended for the integrated rainwater management: rainwater collection, infiltration, filtration, retention and movement spaces. After generating these items, the location selection items and criteria were defined for each of the five elements. For a technique to apply the generated evaluation items and criteria, a grid cell analysis was conducted based m the suitability index theory, and thematic maps were overlapped through suitability assessment of each element and graded based on the suitability index. The priority areas were identified for each element. The developed technique was applied to a site where Gim-cheon Innovation City development is planned to review its feasibility and limitations. The combined score of the overlapped map for each element was separated into five levels: very low, low, moderate, high and very high. Finally, it was concluded that creating a rainwater circulation system conceptual map m the current land use plan based on the outcome of the application would be useful in building a water circulation system at the de1ailed space planning stage after environmental and ecological planning. Furthermore, we use the results of this study as a means for environment-friendly urban planning for sustainable urban development.

Results of Extracardiac Pericardial-flap Lateral Tunnel Fontan Operation (자가심낭막절편을 이용한 심외외측통로 Fontan 수술의 결과)

  • Park Han-Ki;Youn Young-Nam;Yang Hong-Seok;Yoo Byoung-Won;Choi Jae-Young;Park Young-Hwan
    • Journal of Chest Surgery
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    • v.39 no.4 s.261
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    • pp.281-288
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    • 2006
  • Background: Extracardiac pericardial-flap lateral tunnel Fontan operation has theoretical advantage of growth potentiality of the extracardiac tunnels. The mid-term results of this technique and morphologic change of the lateral tunnel were studied. Material and Method: Clinical data was reviewed in 42 patients who underwent extracardiac pericardial-flap lateral tunnel Fontan operation between November 1993 and December 2004. The age was $2.8{\pm}1.5$ years and the body weight was $12.3{\pm}3.2$ kg. Extracardiac tunnel was constructed using the pedicled pericardium with the base undetached. By reviewing the follow-up cardiac angiograms, the diameter and the cross-sectional area of the lateral tunnel was compared to those of inferior vena cava. Result: There were four operative mortality cases (9.8%) and the causes of death were low cardiac output for all four cases. Postoperatively, five patients had prolonged pleural effusion longer than two weeks and one patient required a permanent pacemaker due to complete heart block. Follow-up was possible in 37 patients and the follow up duration was $3.8{\pm}2.2$ years. During that period, one patient died, of upper gastrointestional bleeding combined with heart failure and one patient died a sudden death of unknown cause. Two patients required reoperation due to subaortic stenosis and anastomosis site stenosis between inferior vena cava and lateral tunnel. In one patient, bradyarrhythmia was anew but there was no thromboembolic complication. The lateral tunnel showed growth in proportion to the size of the inferior vena cava. Conclusion: Extracardiac pericardial-flap lateral tunnel Fontan operation is relatively simple and safe. The mid-term result was favorable and the extracardiac tunnel showed potential for growth.

Result of Cox Maze Procedure with Bipolar Radiofrequency Electrode and Cryoablator for Persistent Atrial Fibrillation - Compared with Cut-sew Technique - (양극고주파전극과 냉동프로브를 이용한 지속성 심방세동의 수술 결과 - 절개/봉합술식과 비교 -)

  • Lee, Mi-Kyung;Choi, Jong-Bum;Lee, Jung-Moon;Kim, Kyung-Hwa;Kim, Min-Ho
    • Journal of Chest Surgery
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    • v.42 no.6
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    • pp.710-718
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    • 2009
  • Background: The Cox maze procedure has been used as a standard surgical treatment for atrial fibrillation for about 20 years. Recently, the creators have used a bipolar radiofrequency electrode (Cox maze IV procedure) instead of the incision and suture (cut-sew) technique to make atrial ablation lesions for persistent atrial fibrillation. We investigated clinical outcomes for the Cox maze procedure with a bipolar radiofrequency electrode and cryoablator in patients with persistent atrial fibrillation, and compared results with clinical outcomes of the cut-sew procedure. Material and Method: Between April 2005 and July 2007, 40 patients with persistent atrial fibrillation underwent Cox maze IV procedure with a bipolar radiofrequency electrode and cryoablator (bipolar radiofrequency group). Surgical outcomes were compared with those of 35 patients who had the cut-sew technique for the Cox maze III procedure. All patients had concomitant cardiac surgery. Postoperatively, the patients were followed up every 1 to 2 months. Result: At 6 months postoperatively, the conversion rate to regular sinus rhythm was not significantly different between the two groups: 95.0% for the bipolar radiofrequency ablation group; 97.1% for the cut-sew technique (p=1.0). At the end of the follow-up period, the conversion rate to regular sinus rhythm was also not significantly different (92.5% vs. 91.6%, p=1.0). In multivariate analysis using a Cox-regression model, the postoperative atrial dimension was an independent determinant of sinus conversion in the bipolar radiofrequency ablation group (hazard ratio 31, p=0.005). In the Cox-regression model for both groups, atrial fibrillation at 6 months postoperatively (hazard ratio 92.24, p=0.003) and the postoperative left atrial dimension (hazard ratio 16.05, p=0.019) were independent risk factors of continuance or recurrence of atrial fibrillation after Cox maze procedures. Aortic cross-clamp time and cardiopulmonary bypass time were significantly shorter in the radiofrequency group than in the cut-sew group. Conclusion: In the Cox maze procedure for patients with persistent atrial fibrillation, the use of bipolar radiofrequency ablation and a cryoablator is as good as the cut-sew technique for conversion to sinus rhythm. The postoperative left atrial dimension is an independent determinant of postoperative continuance and recurrence of atrial fibrillation.

Association between picky eating behaviors and growth in preschool children (유아기 까다로운 식습관과 성장상태 간의 연관성)

  • Shim, Jae Eun;Yoon, Ji Hyun;Kim, Kijoon;Paik, Hee Young
    • Journal of Nutrition and Health
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    • v.46 no.5
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    • pp.418-426
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    • 2013
  • This study was conducted in order to investigate the association between picky eating behaviors of preschool children and growth outcomes. In this study, picky eating behaviors were defined as containing four constructs of 'eating a small amount (ES),' 'neophoic behavior (NB),' 'refusal of specific food groups (RF),' and 'preference for specific food-preparation methods (PP).' A 7-point scale was used for the multi-item questionnaire, which consisted of 21 items (three items for ES, two items for NB, nine items for RF, and seven items for PP), in order to evaluate picky eating behaviors of children. Subjects were recruited among visitors at a medical clinic in Seoul. A total of 150 self-administered survey responses from parents of preschool children were analyzed in order to investigate the association between picky eating behaviors of preschool children and growth outcomes. Height for age (HFA) and weight for height (WFH) z-scores were used for assessment of preschool children's growth. The prevalence of ES, NB, RF, and PP was 44%, 57%, 73%, and 53%, respectively. Children with ES had lower HFA (p < 0.05) and WFH (p < 0.0001) than those without ES, while children with NB, RF, or PP had HFA and WFH were similar to their counterparts. The mean HFA z-score of children with ES was less than 0 (p < 0.05) and the mean WFH z-scores of children with ES, NB, RF, or PP were less than 0 (p < 0.05). According to the study results, related growth outcome differed depending on constructs of picky eating behaviors. In particular, picky eating of ES showed a risk of faltering height growth in preschool children. Further comprehensive studies on the reason for ES and intervention approach is warranted.

Treat-to-Target Strategy for Asian Patients with Early Rheumatoid Arthritis: Result of a Multicenter Trial in Korea

  • Song, Jason Jungsik;Song, Yeong Wook;Bae, Sang Cheol;Cha, Hoon-Suk;Choe, Jung-Yoon;Choi, Sung Jae;Kim, Hyun Ah;Kim, Jinseok;Kim, Sung-Soo;Lee, Choong-Ki;Lee, Jisoo;Lee, Sang-Heon;Lee, Shin-Seok;Lee, Soo-Kon;Lee, Sung Won;Park, Sung-Hwan;Park, Won;Shim, Seung Cheol;Suh, Chang-Hee;Yoo, Bin;Yoo, Dae-Hyun;Yoo, Wan-Hee
    • Journal of Korean Medical Science
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    • v.33 no.52
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    • pp.346.1-346.11
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    • 2018
  • Background: To evaluate the therapeutic benefits of the treat-to-target (T2T) strategy for Asian patients with early rheumatoid arthritis (RA) in Korea. Methods: In a 1-year, multicenter, open-label strategy trial, 346 patients with early RA were recruited from 20 institutions across Korea and stratified into 2 groups, depending on whether they were recruited by rheumatologists who have adopted the T2T strategy (T2T group) or by rheumatologists who provided usual care (non-T2T group). Data regarding demographics, rheumatoid factor titer, anti-cyclic citrullinated peptide antibody titer, disease activity score of 28 joints (DAS28), and Korean Health Assessment Questionnaire (KHAQ) score were obtained at baseline and after 1 year of treatment. In the T2T group, the prescription for disease-modifying antirheumatic drugs was tailored to the predefined treatment target in each patient, namely remission (DAS28 < 2.6) or low disease activity (LDA) ($2.6{\leq}DAS28$ < 3.2). Results: Data were available for 163 T2T patients and 162 non-T2T patients. At the end of the study period, clinical outcomes were better in the T2T group than in the non-T2T group (LDA or remission, 59.5% vs. 35.8%; P < 0.001; remission, 43.6% vs. 19.8%; P < 0.001). Compared with non-T2T, T2T was also associated with higher rate of good European League Against Rheumatism response (63.0% vs. 39.8%; P < 0.001), improved KHAQ scores (-0.38 vs. -0.13; P = 0.008), and higher frequency of follow-up visits (5.0 vs. 2.0 visits/year; P < 0.001). Conclusion: In Asian patients with early RA, T2T improves disease activity and physical function. Setting a pre-defined treatment target in terms of DAS28 is recommended.