• Journal of Chest Surgery
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• 제46권2호
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• pp.111-116
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• 2013

Background: Heart transplantation in elderly patients has raised concerns because of co-morbidities and limited life expectancy in the era of donor shortage. We examined the outcomes after heart transplantation in elderly patients. Materials and Methods: From March 1994 to December 2011, 81 patients (male:female=64:17, $49.1{\pm}14.0$ years) underwent heart transplantation. The outcomes after heart transplantation in the younger patients (<60 years; group Y, n=60) were compared with those in the elderly patients (${\geq}60$ years; group O, n=21). The follow-up duration was $51.8{\pm}62.7$ months. Results: Early mortality (${\leq}30$ days) occurred in 5.0% (3/60) and 4.8% (1/21) of groups Y and O, respectively (p>0.999). There were no differences in overall survival between the two groups (p=0.201). Freedom from rejection was higher in group O than in group Y (p=0.026). Multivariable analysis revealed that age ${\geq}60$ years was not a significant risk factor for long-term survival; postoperative renal failure was the only significant risk factor for long-term survival (p=0.011). Conclusion: Early and mid-term results of heart transplantation in elderly patients were similar to those in younger patients.

• 한국초등과학교육학회지:초등과학교육
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• 제30권4호
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• pp.459-467
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• 2011

The purpose of this study is to find out the level of science teaching efficacy belief in the elementary school teachers and to find out the students' science process skills and scientific attitudes according to the level of the teacher's science teaching efficacy belief. After measuring science teaching efficacy belief of 109 teachers from nine elementary schools, three teachers who received the high score and three teachers who received the low score were selected from each 5th and 6th grade. Science process skills and scientific attitudes of 331 students who were in the selected 12 teachers' classes were measured. The results of this study were as follows; First, there were significant differences on the elementary school teachers' science teaching efficacy belief according to teacher's gender and career. The men's average score was clearly higher than women's average score on personal science teaching efficacy in science teaching efficacy belief according to teacher's gender. There was a obvious difference between the group of more than six-year less than ten-year and the group of more than fifteen-year less than twenty-year, the group of more than twenty-year on science teaching outcome expectancy in science teaching efficacy belief according to teacher's career. Second, there was not a evident difference on the elementary school students' science process skill according to the level of the elementary school teachers' science teaching efficacy. Third, there was a distinct difference on the elementary school students' scientific attitude according to the elementary school teachers' science teaching efficacy. There was a significant difference on the openness and the endurance in each scientific attitude. The level of science teaching efficacy belief in the elementary school teachers had few effects on the elementary school students' science process skill, on the other hand the level of science teaching efficacy belief in the elementary school teachers had an positive effect on the elementary school students' scientific attitude.

• Journal of Korean Neurosurgical Society
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• 제60권2호
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• pp.189-194
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• 2017

Objective : We evaluated the validity of bone cement-augmented percutaneous screw fixation for treating malignant spinal metastases. Methods : Between 2011 and 2015, 14 patients (eight men and six women) who underwent bone cement-augmented percutaneous screw fixation for malignant spinal metastases were enrolled in this study. Their life expectancy was considered to be more than one month and less than one year, based on the revised Tokuhashi scoring system. Clinical findings including the back pain scale score, functional outcome, procedure related complications, and survival were assessed preoperatively, postoperatively, and then six months after the procedure. Results : Twelve of the patients (86%) survived up to six months after the procedure. Three required mini-open decompressive laminectomy for severe epidural compression. Bone cement-augmented percutaneous screw fixation was performed one level above, one level below, and at the pathologic level itself. The mean operation time was 60 minutes (45-180) and blood loss was less than 100 mL. Prior to surgery, the mean pain score on the visual analogue scale was 8.8, while one month after the procedure, it had reduced to 3.0; this improvement was maintained until the six-month assessment in the surviving patients. All patients were able to sit within the first two days after surgery, and no patient experienced neurological deterioration at the one-month follow up after the surgery. No patient experienced screw loosening during the six months of follow-up. Asymptomatic cement leakage into the epidural space was observed in two patients, but no major complications were observed. Conclusion : For selected patients with malignant spinal metastases, bone cement-augmented percutaneous screw fixation can provide significant pain relief and improve quality of life.

• Advances in pediatric surgery
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• 제3권1호
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• pp.47-53
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• 1997

Accidental ingestion of caustic substance is one of the common problems among children around the world. Acid intake accounts for a mere 5% of all reported cases of corrosive ingestion in the West. Because of the esophageal sparing effect of acid, clinically significant esophageal involvement after acid ingestion occurs in only 6 to 20 percent of the instances. Despite effort of prevention, 7% to 15% of children sustaining caustic esophageal burns develop esophageal strictures. If balloon dilatation or bougie dilatation fails to resolve the esophageal strictures, successful outcome following replacement by colon or stomach has been reported in children. But the complications and morbidity following these operations are still relatively high. Seven patients with corrosive-acid induced esophageal strictures who were operated upon at the Department of Pediatric Surgery, Seoul National University Children's Hospital from 1991 to 1995 were reviewed. Primary resection and anastomosis was performed in all of 7 patients. The stricture involved short segments of the esophagus at the level of the lower cervical and the upper thoracic vertebra. The operations were approached through a left cervical incision or a left thoracotomy. In one patient, operative repair of anastomotic leakage was done, and three patients required re-resection of anastomotic strictures postoperatively, and one patient required a third operation(reversed gastric tube) due to an anastomotic stricture. The other anastomotic leaks, strictures or pulmonary complications were resolved with conservative treatment. In conclusion, primary resection and anastomosis of the esophagus was performed successfully on the 6 of 7 children with acid induced corrosive esophageal strictures. This approach is physiologic, especially in children who should have a long life expectancy, and recommended for the treatment of short-segment acid induced corrosive esophageal strictures.

• 한국과학교육학회지
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• 제32권7호
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• pp.1157-1168
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• 2012

본 연구는 구성주의에 기반한 모의수업 활동 후 예비 생물교사들의 인식론적 신념, 과학 교수 효능감, 그리고 교수동기에 미치는 영향을 조사하였다. 예비 생물교사들은 과학교수 개혁안의 목표를 반영하고 있는지 보기 위한 평가척도인 RTOP을 토대로 수업을 구상하고 시연하도록 하였으며, 동료평가의 기회를 가졌다. 수업처치 후 예비 생물교사들은 지식의 단순성 영역에서 인식론적 신념이 향상되었으며(p<.05), 과학 교수 효능감 또한 향상되었다(p<.01). 교수동기에 있어서 예비 생물교사들은 외재적 교수 동기는 감소하였으나(p<.05) 내재적 교수 동기는 증가하지 않았다(p>.05). 또한 피어슨 상관관계 결과, 과학 교수 자기 효능감과 외재적 동기는 부적 상관 관계를 나타냈다(p<.05). 구성주의를 강조한 모의수업 활동 후 학생들은 이상적인 과학수업과 과학교사의 자질로 탐구, 토론 및 참여라는 단어를 선택하여, 본 연구에서의 수업처치를 통해 예비 교사들은 구성주의가 지향하는 교수학습 방법을 인식하는데 도움이 되었다고 판단된다.

• Asian Pacific Journal of Cancer Prevention
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• 제16권15호
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• pp.6353-6358
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• 2015

Background: To explore the safety, efficacy, and oncological outcome of 3-port laparoscopic radical cystectomy (LRC) compared to open radical cystectomy (ORC) in patients older than 75 years. Materials and Methods: From June 2010 to July 2014, we analyzed 16 radical cystectomies in patients older than 75 years (LRC group=8; ORC group=8). Demographic parameters, operative variables, and perioperative outcome in the 2 groups were retrospectively collected, analyzed, and compared. Results: Patients in both groups had comparable preoperative characteristics. A significantly longer operating time (476 vs. 303 min, P=0.0002) and less estimated blood loss (627 vs. 2,106 mL, P=0.021) were observed in the LRC group compared to the ORC group. Infection and ileus were the most common early complications after surgery. Patients who underwent ORC suffered from more postoperative infection (22.2% vs. 0.0%, P=0.054) and ileus (25.0% vs. 12.5%, P=0.521) than the LRC group, but the difference was not significant. Conclusions: Judging from this initial trial, 3-port LRC can be safely carried out in elderly patients. We suggest 3-port LRC as the primary intervention to treat muscle-invasive or high-risk nonmuscle-invasive bladder cancer in elderly patients with an otherwise relatively long life expectancy.

• 한국과학교육학회지
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• 제20권4호
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• pp.542-561
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• 2000

교사들의 전문적인 자질 향상과 교사 양성과정과 재교육 과정의 변화를 위한 기본 방향을 제시하고자하여 본 연구에서는 초등학교 교사들의 과학에 대한 학문적 배경, 과학 교수 태도, 과학 교수 효능에 대한 신념, 과학 교수법의 관계를 양적, 질적인 방법으로 조사하였다. 양적 연구 방법은 초등학교 교사들의 과학에 대한 학문적 배경(고등학교 때 이수한 과학과목의 수와 성취도, 교사양성 기간 중 이수한 과학과목과 과학교육과목의 수와 성취도), 과학 교수 태도, 과학 교수 효능에 대한 신념(과학 교수 자기 효능감과 과학 교수 결과의 기대감), 과학 교수법(비지시적, 지시적, 혼합형 교수법)의 활용을 각각 측정도구로 조사하였고 각각의 변인들간의 상관 관계를 Pearson 상관 계수로 분석하였다. 그 결과는 다음과 같다.: 첫째, 초등학교 교사들이 고등학교 때 이수한 과학과목의 성취도, 교사양성 기간 중 이수한 과학과목과 과학교육과목의 수는 과학교수 태도와 각각 통계적으로 유의한 양의 상관관계를 나타내었다. 둘째, 교사들이 고등학교 때 이수한 과학과목의 성취도, 교사양성 기간 중 이수한 과학과목의 수와 과학교육과목의 성취도는 과학교수 자기 효능감과 각각 통계적으로 유의한 양의 상관관계를 나타내었다. 셋째, 교사들이 고등학교와 교사양성 기간의 과학과목 성취도는 비지시적인 교수법과 각각 통계적으로 유의한 양의 상관관계를 나타내었다. 넷째, 교사들이 고등학교 때 이수한 과학과목의 수와 성취도, 교사양성 기간 중 이수한 과학 과목과 과학 교육 과목 성취도는 혼합형 교수법과 각각 통계적으로 유의한 양의 상관관계를 나타내었다. 다섯째, 교사들의 과학교수 태도와 과학교수 자기 효능감과 과학교수 결과의 기대감과는 각각 통계적으로 유의한 양의 상관관계를 나타내었다. 여섯째, 교사들의 과학교수 자기 효능감과 비지시적 교수법과 혼합형 교수법과는 각각 통계적으로 유의한 양의 상관 관계를 나타내었다. 일곱째, 초등학교 교사들의 과학교수 태도와 비지시적 교수법과 혼합형 교수법은 각각 통계적으로 유의한 양의 상관관계를 나타내었다. 효과 있는 교수법의 개발 연구, 과학교수 효능의 신념과 과학교수 태도의 개발 연구와 이에 영향을 미치는 요인 및 상관 연구가 계속되기를 기대한다.

• 가족자원경영과 정책
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• 제16권2호
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• pp.123-143
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• 2012

This study, based on a health belief model, examines how baby boomers perceive health and how they are financially preparing for future medical expenses. In addition, the study analyzes which factors influence baby boomers' preparation behaviors for future medical expenses and their perceived sufficiency of the preparation for medical expenses. Through such activities, this study examines baby boomers' current preparation status for future medical expenses, and based on this outcome, will turn the attention of individuals and society toward becoming more concerned with health and increasing health expectancy. For this study, an online survey was conducted targeted at men and women who were born between 1955 and 1963 and live nationwide, and its resultant data were collected. After conducting a 15-day survey in November 2011, a total of 418 questionnaire responses were used for the final analysis. The major findings of this study and their implications are as follows: First, baby boomers' health beliefs and their perceptions of health identified by subjective health conditions were very positive. Second, while there were some partial differences in the influencing factors, health beliefs and perceived health influenced the sufficiency of future medical expenses in the three groups, which were segmented according to how they prepare for future medical expenses-insurance-based, pension-based, and insufficiently prepared groups. Third, the baby boomers selected the national health insurance as the primary means of preparing for post-retirement medical expenses, and backed it up with private health insurance or the national pension. In addition, when baby boomers' perceived sufficiency of future medical expenses were examined, 57.6% of the respondents expressed that their old-age medical expenses were not sufficient. Fourth, in terms of baby boomers' preparation behaviors for future medical expenses, it was revealed that as one recognizes old-age health more seriously, he/she has a higher chance of using insurance and lower chance of using a pension to prepare for medical expenses. Fifth, regarding baby boomers' sufficiency of preparations for future medical expenses, economic factors such as total assets, the sufficiency of retirement assets, and the number of insurance policies, as well as health perceptions, including health beliefs and subjective health conditions, were important influencing factors.

• Journal of Korean Neurosurgical Society
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• 제50권2호
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• pp.99-102
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• 2011

Objective : The purpose of this retrospective study was to evaluate the outcome of gamma knife radiosurgery (GKRS) and/or whole brain radiation therapy (WBRT) for the treatment of small cell lung carcinoma (SCLC) metastasis to the brain. Methods : From 2000 to 2010, 50 patients underwent GKRS for metastatic brain lesions originating from SCLC. Among these patients, 11 received prophylactic cranial irradiation (PCI) before the development of metastatic lesions (PCI group), and GKRS was performed as an initial treatment for newly diagnosed lesions in 12 patients who had not received PCI (primary GKRS group). In addition, GKRS was performed as a salvage treatment for progressive lesions after WBRT in 27 patients (salvage GKRS group). The medical records and imaging data of all patients were retrospectively analyzed. Results : The overall survival of the 50 patients was 20.8 months (range 1-53) after the diagnosis of primary tumor and 12.0 months (range 1-47) after the development of cerebral metastasis. Median survival after GKRS was 4.8 months (range 1-15) in the PCI group, 4.6 months (range 0-18) in the primary GKRS group, and 7.6 months (range 0-33) in the salvage GKRS group. Further treatment for progressive lesions after GKRS was necessary in 15 patients, after a mean interval of 3.8 months. Causes of death were systemic organ failure in 15 patients, deterioration of neurological state in 13 patients, and unknown or combined causes in 16 patients. The local control rate of the lesions treated with GKRS was 76.4% (decreased in 13 patients and stable in 16 patients at the final imaging follow-up (mean 5.60 months). Conclusion : GKRS is an effective local treatment for brain metastasis from SCLC both as an initial treatment for newly diagnosed lesions after PCI and as a salvage treatment for recurrent or progressive lesions. However, the survival benefit is not significant because most patients die of systemic multi-organ failure with a short life expectancy.

• Asian Pacific Journal of Cancer Prevention
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• 제16권14호
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• pp.6033-6038
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• 2015

Background: Experience of lung cancer includes negative impacts on both physical and psychological health. Pain is one of the negative experiences of lung cancer. Cognitive behavioral therapy techniques are often recommended as treatments for lung cancer pain. The objective of this review was to synthesize the evidence on the effectiveness of cognitive behavioral therapy techniques in treating lung cancer pain. This review considered studies that included lung cancer patients who were required to 1) be at least 18 years old; 2) speak and read English or Thai; 3) have a life expectancy of at least two months; 4) experience daily cancer pain requiring an opioid medication; 5) have a positive response to opioid medication; 6) have "average or usual" pain between 4 and 7 on a scale of 0-10 for the day before the clinic visit or for a typical day; and 7) able to participate in a pain evaluation and treatment program. This review considered studies to examine interventions for use in treatment of pain in lung cancer patients, including: biofeedback, cognitive/attentional distraction, imagery, hypnosis, and meditation. Any randomized controlled trials (RCTs) that examined cognitive behavioral therapy techniques for pain specifically in lung cancer patients were included. In the absence of RCTs, quasi-experimental designs were reviewed for possible conclusion in a narrative summary. Outcome measures were pain intensity before and after cognitive behavioural therapy techniques. The search strategy aimed to find both published and unpublished literature. A three-step search was utilised by using identified keywords and text term. An initial limited search of MEDLINE and CINAHL was undertaken followed by analysis of the text words contained in the title and abstract, and of the index terms used to describe the article. A second search using all the identified keywords and index terms was then undertaken across all included databases. Thirdly, the reference list of all identified reports and articles were searched for additional studies. Searches were conducted during January 1991- March 2014 limited to English and Thai languages with no date restriction. Materials and Methods: All studies that met the inclusion criteria were assessed for methodological quality by three reviewers using a standardized critical appraisal tool from the Joanna Briggs Institute (JBI). Three reviewers extracted data independently, using a standardized data extraction tool from the Joanna Briggs Institute (JBI). Ideally for quantitative data meta-analysis was to be conducted where all results were subject to double data entry. Odds ratios (for categorical data) and weighted mean differences (for continuous data) and their 95% confidence intervals were to be calculated for analysis and heterogeneity was to be assessed using the standard Chi-square. Where statistical pooling was not possible the finding were be presented in narrative form. Results: There were no studies located that met the inclusion requirements of this review. There were also no text and opinion pieces that were specific to cognitive behavioral therapy techniques pain and lung cancer patients.Conclusions: There is currently no evidence available to determine the effectiveness of cognitive behavioural therapy techniques for pain in lung cancer patients.