• Title/Summary/Keyword: Significant factors

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20-Year Experience of Surgical Treatment for Postpneumonectomy Empyema (전폐절제술 후 사강에 발생한 농흉의 치료)

  • 김형렬;김영태;성숙환;김주현
    • Journal of Chest Surgery
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    • v.35 no.7
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    • pp.542-547
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    • 2002
  • Background: Postpneumonectomy empyema(PPE) is an infrequent but potentially life-threatening complication. To date, various surgical efforts have been made to manage this complication. We reviewed our 20-year surgical experience of PPE and long-term follow-up data. Material and Method: Total of 37 patients who were treated for PPE between fan, 1980 and Jun, 2000 were included. Various clinical factors such as micro-organism, operative method and timing, presence of bronchopleural fistula(BPF), underlying disease and fate of empyema cavity were retrospectively reviewed and analyzed. Result: Majority of patients(34) underwent Eloesser operation for effective drainage. There was only one operative mortality. The causative organisms were Staphylococcus species and Pseudomonas species in 46% BPF was found in 20 cases, among which spontaneous closures took place in 4 cases. The chest wall was closed in 40%(8/20) of patients with BPF, compared to 59%(10/17) without BPF. The closure rate was statistically better in patients without BPF(p=0.006). Even though the patients with benign disease showed higher closure rate(50%) than those with lung cancer (31%), the difference was not significant(p=0.25). Conclusion: Eloesser procedure was an effective method for initial drainage of PPE cavity with low operative mortality. Given the findings of low spontaneous closure rate of BPF, aggressive approach to close the BPF is mandatory to achieve the final goal of chest wall closure. It was found that majority of patients still left their chest cavity opened, even after controlling the active inflammation of the empyema cavity. More aggnessive approach for chest wall closure is recommended in all patents with benign disease and in selective patients with lung cancer if there is no evidence of recurrence at several years after the initial operation.

The Clinical Value of Intima-media Thickness in Patients with Stable Coronary Artery Disease and C-reactive Protein within Normal Limits (경동맥 내중막 두께가 정상 C-반응성 단백질 농도를 가진 안정형 협심증 환자에서 가지는 임상적 의의)

  • Kwon, Jong-Bum;Park, Kuhn;Choi, Si-Young;Park, Chan-Beom;Kim, Yong-Hwan;Her, Sung-Ho;Park, Mahn-Won;Lee, Jong-Ho
    • Journal of Chest Surgery
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    • v.43 no.5
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    • pp.482-489
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    • 2010
  • Background: The purpose of this study was to determine whether hand-measured carotid intima-media thickness (IMT) was a reliable and simple tool that could be used to evaluate the severity of stable coronary artery disease (CAD) with normal high-sensitivity C-reactive protein (CRP). Material and Method: We examined left carotid IMTs in 688 patients with stable CAD and excluded 121 patients with abnormally elevated hs-CRP (0.5 mg/dL). We sought to determine the association between risk factors and the severity of stable CAD and carotid IMT in 567 patients who were divided into lower and higher groups based on the median value. Patients underwent a coronary artery angiogram and had at least significant stenosis (>50% of the original luminal diameter involving one or more major coronary artery). Result: Of the 567 patients, 300 (52.9%) were in the lower IMT group and 267 (47.1%) were in the higher IMT group; the median value was 0.76 mm. By multivariable logistic regression analysis, the following groups were different: older age (~49 vs. 70~ years, respectively; OR=6.552), high FBS (~99 vs. 120~ mg/dL; OR=1.713) and severity of CAD (1 vessel vs. 2 vessel disease; OR=1.711, 1 vessel vs. 3 vessel disease; OR=1.714). Conclusion: We conclude that there are correlations between increased carotid IMT and severity of CAD in stable angina patients with normal CRP levels.

Bivalvation Valvuloplasty for Common Atrioventricular Valve Regurgitation in Functional Single Ventricle; Early and Mid-term Results (기능적 단심설에서 공통방실판 역류의 판막성형술; 판막 이분성형술(bivalvation)의 조기 및 중기 결과)

  • Chang, Yun-Hee;Sung, Si-Chan;Kim, Seon-Hee;Lee, Hyoung-Doo;Ban, Ji-Eun
    • Journal of Chest Surgery
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    • v.42 no.5
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    • pp.597-603
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    • 2009
  • Background: Atrioventricular valve regurgitation in pediatric patients with a functional single ventricles (FSV) - has been known as one of the important risk factors for death and unfavorable long-term results after a Fontan operation. We evaluated early and mid-term results of bivalvation valvuloplasty in FSV patients. Material and Method: We retrospectively evaluated 11 patients with a functional single ventricle who underwent bivalvationvalvuloplasty between 1999 and 2007. The degree of common atrioventricular valve regurgitation (CAVVR) was determined by color Doppler echocardiography (regurgitation grade scoring, trivial; 1, mild; 2, moderate; 3, severe; 4). Mean age at valve surgery was 6.9±7.0 months (median 4 months, 24 days21 months)and mean body weight was 6.2±2.8kg (3.111.3kg). Nine patients had isomerism heart and two of them had TAPVC. The concomitant procedures were performed in all but one patient. Additional commissural closure was performed in 3 patients and commissural annuloplasty in another 3 patients. Result: There was one hospital death after. surgery. A 32-day old patient who had been preoperatively dependent on a ventilator died of air way and lung problems 4.3 months after pulmonary artery banding and bivalvation valvuloplasty. Mean follow-up duration was 40 months (4.3114 months). Mean preoperative CAVVR score was 3.3±0.6, which decreased to 1.9±0.7 postoperatively (p<0.0001). This residual regurgitation slightly increased to 2.2±0.4 (no statistical significance) after a mean follow-up of 1.4.3 months. Six patients (60%) required re-operations for residual regurgitation at a subsequent bidirectionalcavopulmonary shunt or Fontan operation. One patient with Ebsteinoid malformation of the right sided atrioventricular valve required valve replacement due to stenoinsufficiency. Another patient required edge-to-edge repair at the right sided AV valve (between the right mural leaflet and the bridging leaflets). The remaining 4 patients required additional suture placements between bridging leaflets with or without commissural annuloplasty. All survivor had trivial or mild CAVVR at the latest follow-up. Conclusion: Bivalvation valvuloplasty for CAVVR in FSV patients is. an effective and safe procedure. However, significant numbers of the patients have small residual regurgitation and require additional valve procedures at subsequent operations. Long-term observations to monitor progression of the CAVVR is mandatory.

Effects of Antibrowning agents on browning of apple slices during cold storage (냉장저장 중 사과 슬라이스의 갈변에 미치는 갈변저해제의 효과)

  • Ahn Sun-Choung;Lee Gui-Chu
    • Korean journal of food and cookery science
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    • v.21 no.1 s.85
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    • pp.24-32
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    • 2005
  • Changes in apple slices during cold storage were investigated by evaluating the physical properties such as degree of browning and compression force. Chemical properties such as PPO activity and total phenol contents were also determined and sensory evaluation was carried out. The correlation analysis between browning parameters was conducted. Degree of browning was increased in the order of fresh apple slice, water-dipped apple slice, 0.5% ascorbic acid solution-dipped apple slice and CP(caramelization product) from sucrose-dipped apple slice. PPO activity was increased in the order of fresh apple slice, water-dipped apple slice, 0.5% ascorbic acid solution-dipped apple slice and CP(caramelization product) from sucrose-dipped apple slice. Amongst several treatments, CP from sucrose-dipped apple slice showed the lowest degree of browning and PPO activity. Total phenol contents were decreased from 60 to 56.2 mg and from 59.6 to 56.0 mg in fresh apple slice and water-dipped apple slice, respectively, but CP from sucrose-dipped apple slice and 0.5% ascorbic acid solution-dipped apple slice were increased from 51.9 to 52.8 mg and from 54.1 to 54.4 mg, respectively, showing the smallest changes when compared with fresh apple slice and water-dipped apple slice. Compression forces of apple slices during cold storage were decreased in the order of fresh apple slice, water-dipped apple slice, 0.5% ascorbic acid solution-dipped apple slice and CP from sucrose-dipped apple slice. In sensory evaluation of apple slices during cold storage, CP from sucrose-dipped apple slice had higher score than the other treatments. In addition, a significant correlation was observed among degree of browning, PPO activity and phenol content. Therefore, CP from sucrose-dipped apple slice seems to be effective in controlling of enzymatic browning during cold storage. In addition, CP from sucrose-dipped apple slice seems to be effective on other several factors. These results suggest that CP from sucrose should be a potential source for controlling enzymatic browning during storage of vegetables and fruits.

A Validation Study for the Practical Use of Screening Scale for Potential Drug-use Adolescents(SPDA) (청소년 약물사용 잠재군 선별척도(SPDA) 활용을 위한 타당화 연구)

  • Lee, Ki-Young;Kim, Young-Mi;Im, Hyuk;Park, Mi-Jin;Park, Sun-Hee
    • Korean Journal of Social Welfare
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    • v.57 no.3
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    • pp.305-335
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    • 2005
  • This paper is a result from validation study for SPDA(A Screening Scale For Potential Drug-use Adolescents) created in 2003 and newly developed during 2004. SPDA aims to screen adolescents in their early stage of drug-use and to help practitioners make a preventive approach for the adolescents. 4307 junior and senior high school students were selected as primary research subjects by stratified and quota sampling methods. 305 adolescents on probation were also selected as a comparison group and asked to answer the same questionnaire. Reliability for SPDA recorded 0.914, which proved to be better than previous year's (0.898). Exploratory and confirmatory factor analyses to test construct validity proved that SPDA could be divided into 7 factors and that each factor structure of SPDA could be a proper measurement model with high level of fitness and factor loadings. Discriminant analysis to test predictive validity confirmed that SPDA could classify the adolescents excellently by the frequency of drug-use, with hit ratio of 86.6 percent(78.8% and 87.4% for junior and senior high school students respectively). For concurrent validity test, Hare Home Self-Esteem Scale, Hare School Self-Esteem, Zuckerman-Kuhlman Sensation-seeking Scale were employed to find correlation with SPDA and all the three scales had significant Pearson correlation coefficients with SPDA. Known-groups validity test indicated that SPDA had an adequate power to classify out adolescents on probation from those in schooling, with a hit ratio of 71.8 percent. Cut-off point to detect adolescents with high risk of substance use was 77, which indicated approximately T score, 55 (0.5 SD), satisfying sensitivity, specificity, and efficiency criteria.

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Relations between Polymorphism of NRAMP1 Gene and Susceptibility to Pulmonary Tuberculosis (NRAMP1 유전자 다형성과 폐결핵의 감수성과의 관계)

  • Lee, Ji Seok;Cho, Jin Hoon;Kim, Ki Uk;Park, Hye-Kyung;Kim, Yun Seong;Lee, Ho Seok;Kim, Yeong Dae;Jeon, Doo Soo;Park, Seung Kyu;Lee, Min Ki;Park, Soon Kew
    • Tuberculosis and Respiratory Diseases
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    • v.62 no.6
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    • pp.492-498
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    • 2007
  • Background: Several lines of evidence suggest that a host's genetic factors influence the outcome of exposure to Mycobacterium tuberculosis. The aim of this study was to determine whether polymorphism in NRAMP1 (natural resistance associated macrophage protein 1) gene is associated with the susceptibility or resistance to tuberculosis infection for patients with drug-sensitive pulmonary tuberculosis (DS-TB) and multi-drug resistant pulmonary tuberculosis (MDR-TB). Methods: Eight genetic polymorphisms of the NRAMP1 gene were investigated in patients suffering with DS-TB (n=100) or MDR-TB (n=102), and in healthy normal controls (NC, n=96). The genetic polymorphisms of NRAMP1 were determined by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP). Results: The frequency of D543N A/G heterogygotes was significantly higher in the DS-TB subjects than the NCs (OR=2.10, 95% CI: 1.00 to 4.41, p=0.049). The frequency of 823C/T T/C heterozygotes was significantly higher in the DS-TB subjects (OR=2.79, 95% CI: 1.11 to 7.04, p=0.029) and the MDR-TB subject (OR=3.30, 95% CI 1.33 to 8.18, p=0.010) than in the NCs. However, the frequency of these genotypes was not different between the DS-TB and MDR-TB subjects. Conclusion: A significant association was found between NRAMP1 823 C/T polymorphism and pulmonary tuberculosis. This result suggests that NRAMP1 polymorphism may be involved in the development of pulmonary tuberculosis in Koreans.

Prognostic Value of p53 Overexpression in Patients with Pathologic Stage I Non-small Cell Lung Cancer (제 1기 비소세포폐암 환자에서 p53 과발현과 예후의 관계)

  • Um, Sang-Won;Kim, Hojoong;Kwon, O Jung;Han, Joungho;Shim, Young Mog
    • Tuberculosis and Respiratory Diseases
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    • v.65 no.6
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    • pp.487-494
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    • 2008
  • Background: Chromosome 17p allele losses and mutations of p53 gene are the most common genetic abnormalities in lung cancer. The purposes of this study were to evaluate the factors associated with p53 protein overexpression and to evaluate its prognostic value in patients with pathologic stage I non-small cell lung cancer (NSCLC). Methods: This is a retrospective review for the patients who underwent surgical resection at Samsung Medical Center between Jan 2003 and Jun 2004. Immunohistochemical staining for p53 protein was performed on tumor tissues from patients with lung cancer. The p53 overexpression was evaluated in relation to age, sex, smoking history, histology and pathologic stage by univariate and multivariate analyses. The disease-free survival (DFS), disease-specific survival (DSS) and overall survival (OS) were analyzed using the Kaplan-Meier methods and the differences in DFS, DSS and OS were assessed by using the log-rank tests. Results: A total of 125 patients were included in the analysis and a median frequency of p53 expression in tumor tissue was 10%. The p53 overexpression (10) was more common in squamous cell carcinoma (66%) than in adenocarcinoma (38%, p=0.002). The p53 overexpression was more common in pathologic stage IB (59%) than in IA (38%, p=0.002). Patients with p53-overexpressing tumor (27 years) smoked more years compared with those without it (20 years, p=0.032). Smoking history 25 pack-years was more common in patients with p53 overexpression (58%) than in those without it (38%, p=0.024). In the multivariate analysis, only histology was significantly associated with p53 overexpression. However, there were no significant differences of DFS, DSS and OS in relation to p53 status. Conclusion: The p53 overexpression was associated with histology, pathologic stage and smoking history in patients with pathologic stage I NSCLC. However, the p53 overexpression was not associated with patient's survival.

Oncologic Outcome of Chondrosarcomas (연골육종의 종양학적 결과)

  • Kim, Chol Jin;Chung, Jun Young;Chung, Yang Guk;Rhee, Seung Koo;Kang, Yong Koo;Bahk, Won Jong;Shim, Jung In
    • The Journal of the Korean bone and joint tumor society
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    • v.19 no.1
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    • pp.9-13
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    • 2013
  • Purpose: We evaluated oncologic outcomes of chondrosarcomas and analyzed the disease-free survival rate of chondrosarcomas according to the various factors. Materials and Methods: We performed a retrospective study for the disease-free survival rate of 48 chondrosarcomas, 44 of which underwent surgical treatment and followed up more than 18 months since 1993, and in the remaining 4 cases, the patients died before 18 months after surgery. The vsariables were location, tumor volume, histologic grade, stage, age at presentation and treatment performed. The mean follow up period was 43.8 months (1-196 months). Results: The overall disease-free survival rate was 77.1% at mean 43.8 month follow up. The 5 year- and 10 year disease-free survival rates were 64% and 58% respectively. The histologic grade, stage, age at presentation revealed statistical significance on disease-free survival. All 9 patients treated with extended curettage for grade 1 central chondrosarcomas revealed disease-free survival with excellent functional outcome. Conclusion: The disease-free survival rate of chondrosarcomas mainly depended on histologic grade, stage and age at presentation. Local recurrence and distant metastasis also revealed statistically significant differences of disease-free survival rate. Comparing to wide resection, extended curettage for low-grade central chondrosarcomas in extremities were efficient methods with similar survival rate and less functional losses and complications.

Smoking Investigation of the Sixth Year Grade-Students of Elementary School in the Rural and Small Sized Urban Area (농어촌과 중소도시 초등 학교 6년생의 흡연 실태)

  • Kim, Sang-Young;Jung, Moon-Sook
    • Journal of agricultural medicine and community health
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    • v.20 no.1
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    • pp.61-72
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    • 1995
  • To investigate the rate of smoking of 6th year grade students of elementary School by general characteristics in rural and small sized urban area, the survey was conducted during the period of Feb. 1, 1994 to Fed. 28, 1994 to 778 respondents of sixth year students of elementary school in rural area and 649 students in the small sized urban area, and also it was based on the questionnaire method. The sample consisted of 22 questions for general features of the respondents and 19 questions of smoking-ideas, totally 41 questions, which were related to the general features and the smoking oriented-factors, the real smoking fact of students, their ideas on smoking influences, and these questionnaires were statistically analysed by percentage and χ2-test. The results are as follows : The total respondents were 1427 students. 54.5% of respondents was of the farming, fishing area-students and 45.5% was of small, medium-sized city. Talking about the statistics of smoking, the present smoking boy-students in the farming, fishing area was marked to 14.6% ; the present smoking-boy students was marked 5.7% in the small, medium sized-city. From the viewpoint of smoking experience, 13.8% of students in farming, fishing area was shown to be experienced ; 9.7% of students in the small, medium sized-city was shown to be experienced. This indicated that there were significant difference of p<0.01 between two compared areas. From the viewpoint of family scale, in the family with many brothers, the younger brothers have a higher rate of p<0.001 of smoking-oriented than elder brother, and the students with a single parent or without parents have a higher rate of smoking on. In addition, the motivation of their smoking indicated that they had the most curiosity in smoking. From the viewpoint of academic grade, the low-level group has a higher smoking rate. Talking about the smoking knowledge of students, the present smoking students has less ideas about the smoking influences the than non-smoking students. More than 70% of the smoking-student group agreed that the education on the smoking influences was required to the elementary school students.

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Study on perception and eating attitude towards vegetables among elementary school children and their parents in Gangwon area (강원지역 초등학생과 학부모의 채소류 섭취에 대한 인식 및 섭취태도 연구)

  • Kim, Mi Kyeong;Oh, Hae Sook;Lee, Myung Hee
    • Journal of Korean Home Economics Education Association
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    • v.27 no.3
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    • pp.19-34
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    • 2015
  • Current study aimed to evaluate elementary school children's perception and eating attitude towards vegetables and analyze environmental factors influencing it. Survey was conducted among elementary school students and their parents in Gangwon district, 410 subjects each(Total 742, 391 students, 351 parents). The results are as follows. Both the children(64.3%) and the parents(84.9%) showed high concern over health. 46.6% of children and 52.4% of parents admitted unbalanced eating behavior, and commonly avoided foods were mostly vegetables such as mushroom, carrot, garlic, sweet pepper-green, welsh onion, kimchi, pumpkin, or beans. Unbalanced eating habit was significantly related to health consideration in choosing what to eat(p<0.01) and interest in health(p<0.05). 70.9% of children with unbalanced eating habit showed intention for correction, and those with high interest in health had stronger intention (p<0.01). Regarding children's perception of 20 kinds of vegetables frequently used in school lunch, swiss chard leaf beet, amaranthus magistratus, and curled mallow were rarely heard of or hardly eaten before. Korean chinese cabbage, radish(62.7%), cucumber(62.1%), perilla leaves(60.4%), lettuce(58.1%), and spinach(54.5%) were among the most frequently eaten. Survey result on children's preference for the vegetables shows lettuce, cucumber, Korean chinese cabbage, perilla leaves, spinach, and radish were highly preferred and stem of garlic, crown daisy, sweet pepper-green, pepper, and curled mallow were the least preferred. There was a significant positive correlation(p<0.01, p<0.001) between children's and their parent's preference for each vegetables, implying that children's preference towards vegetables is greatly influenced by their parent's choice. Children showed negative attitude towards vegetables with strong flavor and tended to avoid vegetables that they remember as not tasty. This suggest that strong flavor and negative prior experience is what determines children's attitude in vegetable consumption. Many children said they try to eat vegetables even if they haven't had it before, and this tendency was significantly correlated with the degree of interest in health(p<0.05) and the degree of consideration of health in choosing what to eat(p<0.001).

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