• Title/Summary/Keyword: classification technique

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Role of Radiation Therapy for Locally Advanced Gastric Carcinoma Management (재발성 또는 국소진행된 위암의 방사선치료 -35예의 치료성적 분석)

  • Yoon Sei Chul;Oho Yoon Kyeoung;Shinn Kyeong Sub;Bahk Yong Whee;Kim In Chul;Lee Kyung Sik
    • Radiation Oncology Journal
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    • v.6 no.1
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    • pp.41-47
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    • 1988
  • Thirty-five patients with locally advanced gastric carcinoma were treated with combined modalities of external radiation therapy (RT) and 5-FU based chemotherapy at the Division of Radiation Therapy, Department of Radiology, Kangnam 51. Mary's Hospital, Catholic University Medical College from May 1983 to May 1987. The purpose of this retrospective study is for the evaluation of the palliative response to RT. There were 25 men and 10 women. The age ranged from 38 to 80 years (median: 56 years). The pathologic classification showed $14(40\%)$ poorly differentiated, $12 (34\%)$ moderately differentiated, $3(9\%)$ well differentiated adenocarcinomas, 2 mucinous cystadenocarcinomas, 1 signet ring cell and 3 not specified ones. The time intervals from the initial surgicopathologic diagnosis to the starting day of RT was within 1 year for $18 (51\%)$, 1 to 2 years for $8 (23\%)$ and 2 to 3 years for $5 (14\%)$, respectively. The major symptoms to be treated were pain in $30 (80\%)$, mass for $29 (83\%)$, obstruction for $11 (31\%)$ and jaundice for $9 (20\%)$ patients. The response rate (patient number of positive response/total patient number) according to treated radiation doses were observed as follows; $14/16(88\%)$ for $40\~50Gy,\;8/10(80\%)$ for over $50Gy,6/8 (75\%)\;for\;30\~40Gy\;and\;8/10(53\%)\;for\;20\~30 Gy$ in decreasing order. The over ail survival was 3.0 months and that of 5FU+RT, FAM+RT and RT alone groups were 4.6 months, 3.7 months and 2.5 months respectively. Complications induced by RT were nausea and vomiting in $16(46\%)$, diarrhea in $7(20\%)$, leukopenia in $6(17\%)$ and anemia and intercurrent pneumonia in each $3(9\%)$ patients in decreasing order.

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Results of Arthroscopic-assisted Minimally Invasive Removal of a Lateral Periarticular Plate used for the Treatment of AO Type-C Distal Femoral Fractures (AO C-형 원위 대퇴골 골절의 치료로 삽입된 관외측 금속판의 절경 보조하 최소 침습적 제거의 결과)

  • Kim, Young-Mo;Lee, June-Kyu;Yang, Jae-Hoon;Kim, Bo-Kun;Lee, Won-Gu
    • Journal of the Korean Arthroscopy Society
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    • v.13 no.1
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    • pp.46-52
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    • 2009
  • Purpose: To evaluate the usefulness of minimally invasive arthroscopy-assisted plate removal of a laterally inserted periarticular distal femur plate used for the treatment of AO type-C distal femur fractures. Materials and Methods: From October 2002 to November 2005, we evaluated 17 patients whose plates were removed through minimally invasive arthroscopy-assisted plate-removal technique and 15 patients who got their plates removed through conventional method without using arthroscopy, 32 patients in total. All these patients included in this study initially underwent open reduction and internal fixation of the distal femoral fractures with a lateral plate, and complained of continued pain over the lateral femoral condyle after the fracture fixation. The average age was 42.6 (ranges: 20~66) and initial fracture types included 16 cases of C1, 11 cases of C2, and 5 cases of C3 following AO/ASIF classification guidelines. Measured outcomes included: associated intra-articular pathologies, time needed to return to activities of daily living, patients' overall satisfaction, complications following the removal of hardware, and pain before and 6 months after the operation. Results: The distal-most end of the plate was placed in the knee joint in all cases and damage of the lateral articular capsule was found in 23 cases. Continuous wound discharge after surgery was found in one case who underwent arthroscopy-assisted plate removal, and it was treated by irrigation and re-suture. Average time needed to return to activities of daily living was 7 days in arthroscopy assisted group and 7.6 days in conventionally removed group. Fourteen patients (82.4%) who underwent arthroscopyassisted plate-removal reported above 'fair' satisfaction and the Visual analog scale pain score decreased from 4.9 to 1.9, six months after the plate removal. Thirteen patients(86.7%) who underwent conventional plate removal reported above 'fair' satisfaction and the Visual analog scale pain score decreased from 5.2 to 2.5, six months after the operation. Conclusion: Through minimally invasive arthroscopic-assisted plate removal, intrarticular pathology of the knee joint was able to be simultaneously identified and treated at the time of hardware removal. Damage of lateral capsule of the knee joint caused by the inserted plate for the treatment of type C distal femoral fracture was very frequently found and following the plate removal, patients experienced an improvement in pain score. We therefore recommend routine lateral distal femoral plate removal if the bony union is attained in such cases as type C distal femoral fractures whose distal most end of the plates are located in the joint.

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Treatment and Prognosis for an Esthesioneuroblastoma over a 20-Year Period: Impact of Treatment Era (감각신경모세포종의 20년에 걸친 치료와 예후 분석: 치료 시기에 따른 차이)

  • Song, Chang-Hoon;Kim, Il-Han;Wu, Hong-Gyun;Kim, Dong-Wan;Rhee, Chae-Seo
    • Radiation Oncology Journal
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    • v.27 no.4
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    • pp.189-193
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    • 2009
  • Purpose: To report on the changes in the patterns of care and survival over time for esthesioneuroblastoma. Materials and Methods: We retrospectively analyzed 42 previously untreated and histologically confirmed esthesioneuroblastoma patients seen between March 1989 and June 2007. According to Kadish's classification, 3 patients (7%) were stage A, 6 (14%) at stage B, and 33 (79%) at stage C. Of the 33 Kadish C patients, 19 and 14 patients were treated from 1989 through 2000 and from 2001 through 2007, respectively. Treatment included surgical resection, radiotherapy, chemotherapy, or a combination of these methods. Chemotherapy was administered to 8 of 19 patients (42%) seen from 1989 through 2000, whereas all of the 14 patients seen from 2001 through 2007 received chemotherapy (p<0.001). No patient was treated by three-dimensional conformal radiotherapy (3D-CRT) from 1989 through 2000, however 8 of 14 patients (67%) seen from 2001 through 2007 underwent 3D-CRT (p<0.001). The median follow-up time for surviving patients was 6.5 years (range, 2.2~15.8 years). Results: The 5-year overall survival (OS) and progression-free survival (PFS) rates for the entire cohort were 53% and 39%, respectively. The 5-year OS was 100% for Kadish stages A or B and 39% for stage C (p=0.007). For patients with stage C disease who were treated from 1989 to 2000 and from 2001 to 2007, the 5-year OS rate was 26% and 59% (p=0.029), respectively and the corresponding 5-year PFS rate was 16% and 46% (p=0.001), respectively. Intraorbital extension and treatment era (1989~2000 vs. 2001~2007) were found as independent factors for OS and PFS in a multivariate analyses. Conclusion: The results of this study suggest that treatment era, which features a distinction in treatment modality and technique with the introduction of 3D-CRT, may be the cause of improved OS and PFS in Kadish stage C patients. To achieve better outcomes for patients with Kadish stage C, combined chemoradiotherapy, especially 3D-CRT, is recommended in addition to surgery.

A Basie Health Survey of the Yonsei Community Health Service Area, Seoul (연세지역(延世地域)에 대(對)한 보건기초조사(保健基礎調査))

  • Yang, Jae-Mo;Kim, Myung-Ho
    • Journal of Preventive Medicine and Public Health
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    • v.1 no.1
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    • pp.25-36
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    • 1968
  • Introduction In order to improve medical education through the introduction of a concept of comprehensive health care of a community, an area surrounding the University Campus was chosen for the Community Health Service Project. It has been on operation for last 4 years with its major emphasis on family planning services, and maternal and child health care. The major objectives of this survey at the area are to obtain: 1) The demographic data, 2) The health need and trend of medical care, 3) The attitude and practice in maternity care to be used for further improvement of the planning and the services of the project. Population and Survey Method Out of three Dongs of the Community Health Service Area, only two Dongs namely Changchun and Yonhee were selected for the survey. Total number of households and population in the area studied was 3,683 and 21,857 respectively. An interview was performed with questionnaire schedule which was recorded by interviewers. This includes the degree of utilization of health services provided by the Community Health Service Program such as family planning, prenatal care during their last pregnancy, delivery history and complications of the delivery as well as the incidence of illnesses in general. Prior to the interview, all interviewers were trained for interviewing technique for two days. The survey was carried out during the period from October December 1967. Results 1) Demographic Data : 41.3% of the population studied were children under age 15 and only 3.5% were over 60 years of age. Crude birth rate and crude death rate of this area studied during the period of November 1966-October 1967 were 20.5 and 7.7 respectively. Infant mortality rate during the same period was 35.9. 50.4% of the 2,832 households fell into the category of middle class, 39.8% to the lower class and 9.5% to the upper class in economic condition. 19.8% of 2,832 householders had no formal education, 22.7% primary school, and 57.5% middle or higher school education. 2) Health Status and Utilization of the Community Health Service: Those who suffered from many illnesses during the month of October, 1967 were 690(4.6% of 14,891 persons). Classification of these patients into the type of disease shown respiratory diseases 27.4%, gastrointestinal diseases 18.1%, tuberculosis 10.9%, skin and genitourethral diseases 4.5% and gynecologic patients 4.5%. Only 55.9% of the patients received medical care at hospital or doctor's clinic. But among TB and gynecologic patients, 70.7% and 72.4% were treated at medical facilities. 10.6% of 2,832 householders interviewed has ever utilized the Community Health Service Program provided by the Yonsei Medical School, Classifying these clients into the type of service, 35.9% utilized the wellbaby clinic, 31.0% the family planning clinic, 14.7% the home delivery care, and the rest utilized other services such as the premarital guidance cinlic and the sanitary inspection service. 3) Maternity Care: 23.6% of 2,151 deliveries were done at medical facilities such as hospital, private clinic, while 76.4% were done at home. Acceptance rate of prenatal care was 32.6% as whole, but 49.6 of 774 women who had the prenatal care service had their deliveries at medical facility. 45.1% of total deliveries were attended by medical and or paramedical personnel. 75.8% of the deliveries of those received prenatal care were attended by medical and or paramedical personnel while only 27.8% of the deliveries of those who did not have prenatal care attended by medical and or paramedical personnel. 49.8% of deliveries of the upper class, 29.8% of the middle class and 9.9% of the lower class were attended by medical and or paramedical personnel. 6.2, 3.3% and 24.8% of mothers reported about their xeperience of edema, coma and fever during the period of trimester of pregnancy and puerperium. 4) Family Planning: The rate of practice of family planning was 27.9%. 31.7% of them were by IUD, 2.9% by oral pill, 15.2% by sterilization and the rest by traditional methods. Those women who had 3 to 4 children had highest(30.2%). Practice rate among the various methods of family planning, oral pill was the most popular method to whom had 2 or less children. In relation between the practicing rate of family planning and living standard, the upper, middle and lower class practiced 37.5, 29.4 and 19.9% respectively.

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Relationship Between MC1R and ASIP Genotypes and Basic Coat Colors in Jeju Horses (제주마의 기본모색과 MC1R과 ASIP 유전자형 조합의 상관관계)

  • Kim, Nam-Young;Han, Sang-Hyun;Lee, Sung-Soo;Lee, Chong-Eon;Park, Nam-Geon;Ko, Moon-Suck;Yang, Young-Hoon
    • Journal of Animal Science and Technology
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    • v.53 no.2
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    • pp.107-111
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    • 2011
  • This study was undertaken to reveal the relationship between genetic variations and the basic coat color classification system in Jeju horses. Genetic variations of the melanocortinreceptor 1 (MC1R) and agouti signaling protein (ASIP) genes were investigated using pyrosequencing technique. A nucleotide substitution mutation for MC1R g.901C>T and an ASIP 11-bp deletion mutation were screened. Black horses had MC1R $E^+$/- ($E^+/E^+$ or $E^+/E^e$) and ASIP $A^a/A^a$ genotypes. In contrast, chestnut horse genotypes were MC1R $E^e/E^e$ and ASIP -/-. Thus, black and bay horses have at least one dominant MC1R allele, $E^+$, whereas chestnut horses have homozygous recessive alleles $E^e/E^e$. This suggests that the MC1R genotypes determine chestnut or black/bay coat color, regardless of the genotype distribution of ASIP. In addition, the horses with MC1R $E^+$/- and a dominant ASIP $A^A$/- allele showed bay coat color, but not black, suggesting that the ASIP $A^A$ allele represses black coat color development in the hairs of the body, but not in the mane and all four legs. Pedigree analysis showed a consistent relationship between the genotype distribution of the MC1R and ASIP genes and basic coat color patterns, even in the $F_1$ progeny. The results of this study revealed the relationship between the coat color phenotype and genetic background and suggested that useful information may be provided for molecular breeding of Jeju horses.

Development and Validation of Real-time PCR to Determine Branchiostegus japonicus and B. albus Species Based on Mitochondrial DNA (Real-time PCR 분석법을 이용한 옥돔과 옥두어의 종 판별법 개발)

  • Chung, In Young;Seo, Yong Bae;Yang, Ji-Young;Kim, Gun-Do
    • Journal of Life Science
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    • v.27 no.11
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    • pp.1331-1339
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    • 2017
  • DNA barcoding is the identification of a species based on the DNA sequence of a fragment of the cytochrome C oxidase subunit I (COI) gene in the mitochondrial genome. It is widely applied to assist with the sustainable development of fishery-product resources and the protection of fish biodiversity. This study attempted to verify horse-head fish (Branchiostegus japonicus) and fake horse-head fish (Branchiostegus albus) species, which are commonly consumed in Korea. For the validation of the two species, a real-time PCR method was developed based on the species' mitochondrial DNA genome. Inter-species variations in mitochondrial DNA were observed in a bioinformatics analysis of the mitochondrial genomic DNA sequences of the two species. Some highly conserved regions and a few other regions were identified in the mitochondrial COI of the species. In order to test whether variations in the sequences were definitive, primers that targeted the varied regions of COI were designed and applied to amplify the DNA using the real-time PCR system. Threshold-cycle (Ct) range results confirmed that the Ct ranges of the real-time PCR were identical to the expected species of origin. Efficiency, specificity and cross-reactivity assays showed statistically significant differences between the average Ct of B. japonicus DNA ($21.85{\pm}3.599$) and the average Ct of B. albus DNA ($33.49{\pm}1.183$) for confirming B. japonicus. The assays also showed statistically significant differences between the average Ct of B. albus DNA ($22.49{\pm}0.908$) and the average Ct of B. japonicus DNA ($33.93{\pm}0.479$) for confirming B. albus. The methodology was validated by using ten commercial samples. The genomic DNA-based molecular technique that used the real-time PCR was a reliable method for the taxonomic classification of animal tissues.

Use of Intermittent Antegrade Warm Blood Cardioplegia in CABG (관상동맥 우회로조성술에서 간헐적 전방 온혈 심정지액의 이용)

  • 김정택;백완기;김영삼;윤용한;김혜숙;이춘수;임현경;김현태;김광호
    • Journal of Chest Surgery
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    • v.36 no.11
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    • pp.828-833
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    • 2003
  • Background: It has been reported that the recently developed intermittent antegrade warm blood cardioplegia (IAWBC) has better myocardial protective effects during coronary artery bypass surgery than cold blood cardioplegia or continuos retrograde cold blood cardioplegia. The aim of this study is to evaluate the safety and usefulness of IAWBC by comparing it retrospectively with intermittent retrograde cold blood cardioplegia (lRCBC). Material and Method: From April 2001 to Feb. 2003, fifty seven patients who underwent isolated coronary surgery were divided into two groups (IAWBC vs. IRCBC). The two group had similar demographic and angiographic characteristics. There were no statistical differences in age, sex, Canadian Cardiovascular Society Functional Classification for angina, ejection fraction, and number of grafts. Result: Aortic cross clamping time and total pump time in IAWBC (99$\pm$23 and vs. 126$\pm$32 min) were shorter than those of IRCBC (118$\pm$32 min. and 185$\pm$48 min.)(p<0.05). The reperfusion time (13$\pm$7 min) in IAWBC was shorter than that of IRCBC (62$\pm$109 min.)(p<0.05). CKMB at 12 hours and 24 hours (16$\pm$15 and 9$\pm$13) in IAWBC was lower than that of IRCBC (33$\pm$47 and 17$\pm$26)(p<0.05). The awakening time in IAWBC (2$\pm$1 hour) was shorter than that of IRCBC (4$\pm$3)(p<0.05). The number of spontaneous heart beat recovery in IAWBC (85%) was more than that of IRCBC (35%)(p<0.05). The cardiac index after discontinuing cardio-pulmonary bypass was significantly elevated in the IAWBC group. The prevalence of perioperative myocardial infarction in IAWBC (4%) was lower than that of IRCBC group (20%)(p<0.05). Conclusion: Intermittent antegrade warm blood cardioplegia is a safe, reliable, and effective technique for myocardial protection. It can also provide simpler and economic way than the retrograde cold cardioplegia by shortening of cardiopulmonary bypass time and avoiding retrograde cannulation for coronary sinus.

Optimal Selection of Classifier Ensemble Using Genetic Algorithms (유전자 알고리즘을 이용한 분류자 앙상블의 최적 선택)

  • Kim, Myung-Jong
    • Journal of Intelligence and Information Systems
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    • v.16 no.4
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    • pp.99-112
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    • 2010
  • Ensemble learning is a method for improving the performance of classification and prediction algorithms. It is a method for finding a highly accurateclassifier on the training set by constructing and combining an ensemble of weak classifiers, each of which needs only to be moderately accurate on the training set. Ensemble learning has received considerable attention from machine learning and artificial intelligence fields because of its remarkable performance improvement and flexible integration with the traditional learning algorithms such as decision tree (DT), neural networks (NN), and SVM, etc. In those researches, all of DT ensemble studies have demonstrated impressive improvements in the generalization behavior of DT, while NN and SVM ensemble studies have not shown remarkable performance as shown in DT ensembles. Recently, several works have reported that the performance of ensemble can be degraded where multiple classifiers of an ensemble are highly correlated with, and thereby result in multicollinearity problem, which leads to performance degradation of the ensemble. They have also proposed the differentiated learning strategies to cope with performance degradation problem. Hansen and Salamon (1990) insisted that it is necessary and sufficient for the performance enhancement of an ensemble that the ensemble should contain diverse classifiers. Breiman (1996) explored that ensemble learning can increase the performance of unstable learning algorithms, but does not show remarkable performance improvement on stable learning algorithms. Unstable learning algorithms such as decision tree learners are sensitive to the change of the training data, and thus small changes in the training data can yield large changes in the generated classifiers. Therefore, ensemble with unstable learning algorithms can guarantee some diversity among the classifiers. To the contrary, stable learning algorithms such as NN and SVM generate similar classifiers in spite of small changes of the training data, and thus the correlation among the resulting classifiers is very high. This high correlation results in multicollinearity problem, which leads to performance degradation of the ensemble. Kim,s work (2009) showedthe performance comparison in bankruptcy prediction on Korea firms using tradition prediction algorithms such as NN, DT, and SVM. It reports that stable learning algorithms such as NN and SVM have higher predictability than the unstable DT. Meanwhile, with respect to their ensemble learning, DT ensemble shows the more improved performance than NN and SVM ensemble. Further analysis with variance inflation factor (VIF) analysis empirically proves that performance degradation of ensemble is due to multicollinearity problem. It also proposes that optimization of ensemble is needed to cope with such a problem. This paper proposes a hybrid system for coverage optimization of NN ensemble (CO-NN) in order to improve the performance of NN ensemble. Coverage optimization is a technique of choosing a sub-ensemble from an original ensemble to guarantee the diversity of classifiers in coverage optimization process. CO-NN uses GA which has been widely used for various optimization problems to deal with the coverage optimization problem. The GA chromosomes for the coverage optimization are encoded into binary strings, each bit of which indicates individual classifier. The fitness function is defined as maximization of error reduction and a constraint of variance inflation factor (VIF), which is one of the generally used methods to measure multicollinearity, is added to insure the diversity of classifiers by removing high correlation among the classifiers. We use Microsoft Excel and the GAs software package called Evolver. Experiments on company failure prediction have shown that CO-NN is effectively applied in the stable performance enhancement of NNensembles through the choice of classifiers by considering the correlations of the ensemble. The classifiers which have the potential multicollinearity problem are removed by the coverage optimization process of CO-NN and thereby CO-NN has shown higher performance than a single NN classifier and NN ensemble at 1% significance level, and DT ensemble at 5% significance level. However, there remain further research issues. First, decision optimization process to find optimal combination function should be considered in further research. Secondly, various learning strategies to deal with data noise should be introduced in more advanced further researches in the future.

Response Modeling for the Marketing Promotion with Weighted Case Based Reasoning Under Imbalanced Data Distribution (불균형 데이터 환경에서 변수가중치를 적용한 사례기반추론 기반의 고객반응 예측)

  • Kim, Eunmi;Hong, Taeho
    • Journal of Intelligence and Information Systems
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    • v.21 no.1
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    • pp.29-45
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    • 2015
  • Response modeling is a well-known research issue for those who have tried to get more superior performance in the capability of predicting the customers' response for the marketing promotion. The response model for customers would reduce the marketing cost by identifying prospective customers from very large customer database and predicting the purchasing intention of the selected customers while the promotion which is derived from an undifferentiated marketing strategy results in unnecessary cost. In addition, the big data environment has accelerated developing the response model with data mining techniques such as CBR, neural networks and support vector machines. And CBR is one of the most major tools in business because it is known as simple and robust to apply to the response model. However, CBR is an attractive data mining technique for data mining applications in business even though it hasn't shown high performance compared to other machine learning techniques. Thus many studies have tried to improve CBR and utilized in business data mining with the enhanced algorithms or the support of other techniques such as genetic algorithm, decision tree and AHP (Analytic Process Hierarchy). Ahn and Kim(2008) utilized logit, neural networks, CBR to predict that which customers would purchase the items promoted by marketing department and tried to optimized the number of k for k-nearest neighbor with genetic algorithm for the purpose of improving the performance of the integrated model. Hong and Park(2009) noted that the integrated approach with CBR for logit, neural networks, and Support Vector Machine (SVM) showed more improved prediction ability for response of customers to marketing promotion than each data mining models such as logit, neural networks, and SVM. This paper presented an approach to predict customers' response of marketing promotion with Case Based Reasoning. The proposed model was developed by applying different weights to each feature. We deployed logit model with a database including the promotion and the purchasing data of bath soap. After that, the coefficients were used to give different weights of CBR. We analyzed the performance of proposed weighted CBR based model compared to neural networks and pure CBR based model empirically and found that the proposed weighted CBR based model showed more superior performance than pure CBR model. Imbalanced data is a common problem to build data mining model to classify a class with real data such as bankruptcy prediction, intrusion detection, fraud detection, churn management, and response modeling. Imbalanced data means that the number of instance in one class is remarkably small or large compared to the number of instance in other classes. The classification model such as response modeling has a lot of trouble to recognize the pattern from data through learning because the model tends to ignore a small number of classes while classifying a large number of classes correctly. To resolve the problem caused from imbalanced data distribution, sampling method is one of the most representative approach. The sampling method could be categorized to under sampling and over sampling. However, CBR is not sensitive to data distribution because it doesn't learn from data unlike machine learning algorithm. In this study, we investigated the robustness of our proposed model while changing the ratio of response customers and nonresponse customers to the promotion program because the response customers for the suggested promotion is always a small part of nonresponse customers in the real world. We simulated the proposed model 100 times to validate the robustness with different ratio of response customers to response customers under the imbalanced data distribution. Finally, we found that our proposed CBR based model showed superior performance than compared models under the imbalanced data sets. Our study is expected to improve the performance of response model for the promotion program with CBR under imbalanced data distribution in the real world.

Coronary Artery Bypass Graft in Patient with Advanced Left Ventricular Dysfunction (중등도 이상의 좌심실 기능 부전 환자에서의 관상동 우회술의 임상 분석)

  • 정종필;김승우;신제균
    • Journal of Chest Surgery
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    • v.34 no.12
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    • pp.901-908
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    • 2001
  • Background : Coronary artery bypass graft(CABG) in patients with advanced left ventricular dysfunction has often been regarded as having high mortality rate, despite the great improvement in operative result of CABG. With recent advances in surgical technique and myocardial protection, surgical revascularization improved the symptom and long-term survival of these high risk patients more than the medical conservative treatment. Material and Methold : Clinical data of 31(4.1%) patients with preoperative ejection fraction less than 30% among 864 CABGs performed between January 1995 and March 1999 were retrospectively analyzed and pre- and postoperative changes of the ejection fraction on echocardiography were analyzed. There were 26 men and 5 women. The mean age was 60.7 years(range 41 to 72 years). History of myocardial infarction(30 cases, 98%) was the most common preoperative risk factor. There were seven irreversible myocardial infarction on thallium scan. Most patients had triple vessel diseases(26 cases, 84%) and first degree of Rentrop classification(16 cases, 52%) on coronary angiography. The mean number of distal anastomosis during CABG was per patient was 4.9${\pm}$0.8 sites in each patient. In addition to long saphenous veins, the internal mammary artery was used in 20 patients. Total bypass time was 244.7${\pm}$3.7 minutes(range, 117 to 567 minutes), and mean aortic cross-clamp time was 77.9 ${\pm}$ 1.6 minutes(range, 30 to 178 minutes). There were five other reparative procedures such as two left ventricular aneurysrmectomy, two mitral repair, and one aortic valve replacement. There were twelve postoperative complications such as three cardiac arrhythmia, two bleeding(re-operation), one delayed sternal closure, eleven usage of intra-aortic balloon counterpulsation for low cardiac output. Two patients died, postoperative mortality was 6.5% . Twenty-nine patients were relieved of chest pain and left ventricular ejection fraction after operation was significantly higher(38.5${\pm}$11.6%, p 0.001) as compared with preoperative left ventricular ejection fraction(25.3${\pm}$2.3%). The follow up period of out patient was 25. 3 months. Conclusion: In patients with coronary artery disease and advanced left ventricular dysfunction, coronary artery bypass grafting can be performed relatively safely with improvement in left ventricular function, but it will be necessary to study long term results.

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