• Journal of Chest Surgery
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• v.31 no.4
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• pp.346-352
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• 1998

Rheumatic valvulitis produces at least three distinct pathologic changes, the degree varying widely among the patients: fusion of the valve leaflets at the commissures; fusion and shortening of chordae tendinae: and fibrosis of the leaflets with subsequent stiffening, contraction and calcification. The most extensive changes usually are seen in patients with recurrent attacks of rheumatic fever. We studied on outcome of the surgical treatments of rheumatic valvular diseases that have been experienced for 12 years since 1982 at Pusan National University Hospital. The diagnoses were made by rheumatic fever history, echocardiographic findings, gross operative findings and microscopic findings. Total 502 patients were performed surgery for valvular heart diseases and 440 patients of rheumatic origin have bene analysed. There were more female than male patients as 1.3:1, and the mean age was 37.8 years old. 96.3% of them affected to the mitral valve, 19.8% to aortic valve, 16.3% affected to the tricuspid valve. Most of them underwent valve replacement, and valve repair was done in 3.9% of patients. There were 36 hospital deaths(8.2%) mainly from low cardiac output syndrome, and 15 late deaths equally due to embolism and hemorrhage. Follow up was 90.1% completed(2890 patient- year). Linealized rates of late complication events are follows : thromboembolism 1.3% per patient year; anticoagulant related hemorrhage 0.8% per patient year. Overall actuarial survival including hospital mortality was 92.7＋/-2.9% in 1 year, 88.0＋/-4.5% in 5 year, 82.3＋/-7.7% in 10 year. We conclude that the rheumatic disease is still the most frequent and the most important cause of heart valve disease. So more intensive study is needed in spite of the abrupt decreasing rate of rheumatic fever in U.S.A. and other industrial country.

• Journal of Chest Surgery
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• v.40 no.1 s.270
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• pp.8-16
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• 2007

Background: We performed a prospective clinical study to evaluate the ultrastructural integrity of the myocardium after using Histidine-Tryptophan-Ketoglutarate (HTK) solution in comparison with blood cardioplegic solution during congenital heart surgery. Material and Method: Twenty two patients with acyanotic heart disease, who were scheduled for elective open heart surgery, were randomized into two groups. The HTK Group (n=11) received HTK cardioplegic solution; the blood group (n=11) received conventional blood cardioplegic solution during surgery. The preoperative diagnoses included ventricular septal defect (n=9) and atrial septal defect (n=2) in each group. A small biopsy specimen was taken from the right ventricle's myocardium, and this was processed for ultrastructural examination at the end of 30 minutes of reperfusion. Semiquantitative electron microscopy was carried out 'blindly' in 4 areas per specimen and in 5 test fields per area by 'random systematic sampling' and 'point and intersection counting'. The morphology of the mitochondrial membrane and cristae were then scored. The interstitial edema of the myocardium was also graded. Result: The semiquantitative score of the mitochondrial morphology was $19.65{\pm}4.75$ in the blood group and $25.25{\pm}5.85$ in the HTK group (p=0.03). 6 patients (54.5%) in the blood group and 3 patients (27.3%) in the HTK group were grade 3 or more for the interstitial edema of the myocardium. Conclusion: The ultrastructural integrity was preserved even better with HTK solution than with conventional blood cardioplegic solution.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.5 no.1
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• pp.19-25
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• 2002

Purpose: The triple therapy with proton pump inhibitor (PPI) has been recognized as the treatment of choice in Helicobacter pylori (H. pylori) infection in adults. However, the effect of triple therapy with omeprazole, amoxicillin and clarithromycin (OAC) on eradication of H. pylori infection in children has not been established yet. This study was performed to evaluate the efficacy of OAC triple therapy and to compare the effect of one-week with two-week therapy on H. pylori eradication. Methods: From July 1998 to July 2000, 34 children with upper gastrointestinal symptoms, who underwent upper gastrointestinal endoscopy with biopsy at entry and 4 or more weeks after therapy, were enrolled in this study. H. pylori infection was assessed by CLO test and histologic examination (Hematoxylin-Eosin stain or Alcian yellow stain) with biopsy specimens. The regimen consisted of omeprazole (0.7 mg/kg/day), amoxicillin (50 mg/kg/day), and clarithromycin (25 mg/kg/day) for 1 week (n=21) or 2 weeks (n=13). Eradication of H. pylori was determined after the termination of treatment by the CLO test and histologic examination. Results: One-week treatment group consisted of 21 children (11 male, 10 female) with a mean age of $9.5{\pm}3.0$ years. Two-week group consisted of 13 children (4 male, 9 female) with a mean age of $9.9{\pm}4.0$ years. The endoscopic diagnoses included nodular gastritis in 19 cases, superficial gastritis in 7 cases, gastric ulcer in 4 cases, purpuric duodenitis in 2 cases, and normal in 2 cases. H. pylori was eradicated in 28 of total 34 children (82.4%). In 1-week group, H. pylori was eradicated in 17 of 21 children (81%). In 2-week group, H. pylori was eradicated in 11 of 13 children (84.6%). In remaining 6 cases in whom H. pylori had not been eradicated with OAC regimen, H. pylori infection persisted despite of the treatment with additional drugs such as colloidal bismuth subcitrate ($Denol^{(R)}$) and metronidazole. Conclusion: In this study, eradication rate of H. pylori with OAC regimen was 82.4%, and the triple therapy would be highly effective as primary treatment. However, there was no significant difference in the eradication rate between the 1-week and 2-week treatment group (P=0.785).

• Pediatric Infection and Vaccine
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• v.4 no.2
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• pp.210-217
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• 1997

Purpose: To prevent residual physical disability and chronic infection, prompt diagnosis and adequate treatment are important in the skeletal infections in children. Although radioisotope scanning is knwon as the method of choice for early diagnosis of bone infection, we conducted a study on twenty nine children who had skeletal infections to reevaluate the most appropriate way in diagnosis and management. Methods: A retrospective study was conducted on twenty nine children, who were admitted to the departments of Pediatrics and Orthopedic Surgery and who had acute osteomyelitis or septic arthritis, through review of medical records, radiologic & radioisotope study results. Their diagnoses were confirmed by bacteriologic cultures on the aspirated specimens from suspected bony lesions. Results: 1) Among twenty nine patients, there were 6 infants including 5 newborn infants, and 23 children were aged between 1 and 15 years. Male to female ratio was 1.4 to 1. 2) Point tenderness was noted in all cases, and the common physical signs were swelling, limitation of motion, fever and local heat in the order of frequency. 3) Fifty two percents of the patients were diagnosed within a week after onset of symptoms and all cases were within 15 days. 4) Leukocytosis was noted in only 58.6% of cases but erythrocyte sedimentation rate was increased in all cases except only one case. Staphylococcus aureus was revealed as the most common etiologic agent. 5) Radioisotope scans showed hot uptake in five of six cases(83.3%) who had no abnormal finding on plain skeletal radiolograms. Conclusions: Although radioisotope scan and MRI are helpful in early diagnosis before radiologic finding was detected on plain X-ray film, the antimicrobial therapy can be started after bacteriologic study of the aspirated specimens from the suspected skeletal lesions if skeletal infection is highly suspected clinically.

• Health Policy and Management
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• v.11 no.2
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• pp.141-168
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• 2001

Healthcare service organizations can apply the cost of quality(COQ) model as a method to evaluate a service quality improvement project such as Total Quality Management (TQM). COQ model has been used to quantify and evaluate the efficiency and effectiveness of TQM project through estimation between cost and benefit in intervention for a quality Improvement to provide satisfied services for a customer, and to identify a non value added process. For estimating cost of quality, We used activities and activity costs based on Activity Based Costing(ABC) system. These procedures let the researchers know whether the process is value-added by each activity, and identify a process to require improvement in TQM project. Through the series of procedures, health care organizations are service organizations can identify a problem in their quality improvement programs, solve the problem, and improve their quality of care for their costumers with optimized cost. The study subject was a quality improvement program of the department of radiology department in a hospital with n bed sizes in Metropolitan Statistical Area (MSA). The principal source of data for developing the COQ model was total cases of retaking shots for diagnoses during five months period from December of the 1998 to April of the 1999 in the department. First of the procedures, for estimating activity based cost of the department of diagnostic radiology, the researchers analyzed total department health insurance claims to identify activities and activity costs using one year period health insurance claims from September of the 1998 to August of the 1999. COQ model in this study applied Simpson & Multher's COQ(SM's COQ) model, and SM's COQ model divided cost of quality into failure cost with external and internal failure cost, and evaluation/prevention cost. The researchers identified contents for cost of quality, defined activities and activity costs for each content with the SM's COQ model, and finally made the formula for estimating activity costs relating to implementing service quality improvement program. The results from the formula for estimating cost of quality were following: 1. The reasons for retaking shots were largely classified into technique, appliances, patients, quality management, non-appliances, doctors, and unclassified. These classifications by reasons were allocated into each office doing re-taking shots. Therefore, total retaking shots categorized by reasons and offices, the researchers identified internal and external failure costs based on these categories. 2. The researchers have developed cost of quality (COQ) model, identified activities by content for cost of quality, assessed activity driving factors and activity contribution rate, and calculated total cost by each content for cost for quality, except for activity cost. 3. According to estimation of cost of quality for retaking shots in department of diagnostic radiology, the failure cost was ￦35,880, evaluation/preventive cost was ￦72,521, two times as much as failure cost. The proportion between internal failure cost and external failure cost in failure cost is similar. The study cannot identify trends on input cost and quality improving in cost of qualify over the time, because the study employs cross-sectional design. Even with this limitation, results of this study are much meaningful. This study shows possibility to evaluate value on the process of TQM subjects using activities and activity costs by ABC system, and this study can objectively evaluate quality improvement program through quantitative comparing input costs with marginal benefits in quality improvement.

• The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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• v.16 no.1
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• pp.1-32
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• 2003

Objectives: This study was carried out to analyze and understand the trends of research papers published In the Journal of Oriental Medical Surgery？phthalmology & Otolaryngology Society(JOMSOOS). Methods: We studied the 308 research papers that had been published in JOMSOOS from 1988 Vol. 1. No. 1. to 2002 Vol. 15. No. 2. Our study was developed through the four stages in order to analyze the papers; 1) we analyzed all the papers overall to classify them into three categories; original article. review article and case report. 2) we classified the original articles in terms of methodology. 3) we also analyzed the case reports according to the sort of disease each paper dealt with. 4) we had another statistical approach to each paper to figure out the distribution of diagnoses in detail. Results: We have got the following outcomes from our analysis of the papers in terms of the four stages. 1. Overall Analysis. 1) Classification of 308 research papers between 1988 and 2002: 137 original articles(44.48$\%$), 111 review articles(36.04$\%$), 56 case reports(18.18$\%$). 2) Used language: Korean(99.03$\%$). English(0.97$\%$). 3) The Number of Authors: 2 persons(42.86$\%$). 3 persons(29.87$\%$), 1 person(14.61$\%$). 2. Original Article Analysis 1) Classification of 137 original articles in terms of methodology: 90 experimental studies(65.69$\%$)46 descriptive studies(33.58$\%$), 1 analytic study(0.73$\%$). 2) Classification of the original articles according to the use of statistical methods: No statistical methods(36.42$\%$), Descriptive methods only(1.99$\%$), Not defined(23.18$\%$), t-test(24.50$\%$), ANOVA(3.97$\%$), Multiple comparison(2.65$\%$), Non-parametric test(2.65$\%$), Other methods(1.32$\%$). 3) Classification of 46 descriptive articles in terms of diseases: otorhinolaryngology(43.48$\%$), dermatology(23.91$\%$), ophthalmology(13.04$\%$), facial palsy(13.04$\%$). 4) Classification of descriptive articles in terms of the number of patients: the highest was 'more than 26 but less than 50 persons'(19 articles - 41.30$\%$). 5) Classification of descriptive articles in terms of the period for patients observation: the highest was the time 'more than 9 but less than 12 months(34.78$\%$)' Out of the 34.78$\%$, the number of articles with the patients observed for more than 12 months was 13(28.26$\%$). 3. Case Report Analysis 1) Classification of 56 case reports in terms of the sort of disease: dermatology(44.64$\%$), ophthalmology(19.64$\%$), otorhinolaryngology(14.29$\%$), facial palsy(8.93$\%$). 2) Classification in terms of the number of patients: 1 person(50$\%$), 3 persons(16.07$\%$), 2 persons(14.29$\%$). 4. Diagnosis Distribution of Each Disease. 1) Studies regarding ophthalmology : the percentage of 'strabismus' cases was the highest(33.33$\%$). 2) Studies regarding otorhinolaryngology : nasal inflammation(34.48$\%$), tinnitus(20.69$\%$). 3) Studies regarding dermatology: the percentage of 'allergic skin disease' was the highest(33.33$\%$). Conclusions: We analyzed the trends of research papers that have been published in JOMSOOS in detail. We came to understand the trends of the research through this study. However, we acknowledge that we only adopted the quantitative method out of various possible analysis methods. For further studies, we strongly urge to adopt the qualitative methods as well.

• Tuberculosis and Respiratory Diseases
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• v.84 no.4
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• pp.263-273
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• 2021

Cough is the most common respiratory symptom that can have various causes. It is a major clinical problem that can reduce a patient's quality of life. Thus, clinical guidelines for the treatment of cough were established in 2014 by the cough guideline committee under the Korean Academy of Tuberculosis and Respiratory Diseases. From October 2018 to July 2020, cough guidelines were revised by members of the committee based on the first guidelines. The purpose of these guidelines is to help clinicians efficiently diagnose and treat patients with cough. This article highlights the recommendations and summary of the revised Korean cough guidelines. It includes a revised algorithm for the evaluation of acute, subacute, and chronic cough. For a chronic cough, upper airway cough syndrome (UACS), cough variant asthma (CVA), and gastroesophageal reflux disease (GERD) should be considered in differential diagnoses. If UACS is suspected, first-generation antihistamines and nasal decongestants can be used empirically. In cases with CVA, inhaled corticosteroids are recommended to improve cough. In patients with suspected chronic cough due to symptomatic GERD, proton pump inhibitors are recommended. Chronic bronchitis, bronchiectasis, bronchiolitis, lung cancer, aspiration, intake of angiotensin-converting enzyme inhibitor, intake of dipeptidyl peptidase-4 inhibitor, habitual cough, psychogenic cough, interstitial lung disease, environmental and occupational factors, tuberculosis, obstructive sleep apnea, peritoneal dialysis, and unexplained cough can also be considered as causes of a chronic cough. Chronic cough due to laryngeal dysfunction syndrome has been newly added to the guidelines.

• Pediatric Infection and Vaccine
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• v.25 no.3
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• pp.156-164
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• 2018

Purpose: We aimed to identify the epidemiology and the clinical characteristics of human parainfluenza virus type 4 (HPIV-4) infection compared to HPIVs 1-3 infections in Korean children. Methods: We reviewed medical records of children with HPIV infection who visited Seoul National University Children's Hospital from 2015 to 2017. Detection of respiratory viruses was performed using real time-polymerase chain reaction (rt-PCR), which could differentiate HPIVs 1-4. Diagnosis was classified as a febrile illness, upper respiratory tract infection (URI), croup, bronchiolitis, or pneumonia. The epidemiology, demographic features, and clinical characteristics among HPIV types were compared. The clinical data were analyzed only for the previously healthy children. Results: Of the 472 children diagnosed with HPIV infection, 108 (22.9%) were previously healthy: 24 (22.2%), 19 (17.6%), 39 (36.1%), and 26 (24.1%) in HPIV types 1, 2, 3, and 4, respectively. The median age of children with HPIV-4 infection was 11 (0-195) months: the proportion of children aged < 2 years and 2 to < 5 years were 65.4% and 19.2%, respectively. Clinical diagnoses of HPIV-4 infection were bronchiolitis (38.5%), pneumonia (30.8%), and URI (30.8%). Croup was the most prevalent in HPIV-2 (21.1%) and none in HPIV-4 infection (P=0.026). Hospital admission rates among HPIV types were not significantly different (P>0.05). Conclusions: We observed seasonal peak of HPIV-4 infection in 2015 and 2017. HPIV-4 was a common respiratory pathogen causing lower respiratory tract infection in hospitalized children.

• The Southeast Asian review
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• v.28 no.1
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• pp.21-51
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• 2018

This article takes several approaches in explaining recent developments in Vietnam. First, it draws upon an array of sources that idealize Vietnam's embrace of capitalism and integration into the global market in order to sketch out its economy's progress in 2017. Second, it observes, evaluates, and diagnoses recent changes in the Vietnamese economy in the medium to long term by incorporating conflicting perspectives on Vietnam's performance as a capitalist country. Third, this article traces the power shifts that have risen from internal struggles in the Communist Party over political and social issues. Fourth, it elaborates on the aforementioned impact that foreign relations have had on socio-political developments in Vietnam, as well as the government's response. In so doing, it also attempts to evaluate, however briefly, the significance of the 25th anniversary of South Korea-Vietnam relations. Finally, it examines the public's reaction to the post-reform transitions in light of recent sociocultural changes. 2017 was a memorable year for Vietnam: a continuous march toward capitalism; the resulting expansion of the Vietnamese people's demands; political controversies and government control; the looming instability of United States-China relations and various attempts to address the situation. These events will inevitably replicate themselves in the future as the ostensibly socialist Vietnam adopts a capitalist model. The problem is that it is unclear whether these experiences will continue with the consent of the people of socialist Vietnam or engender resistance. It is difficult to achieve meaningful consent in the status quo of worsening inequalities, widespread corruption, monopoly on power, and sustained use of unskilled low-wage workers. In other words, when concerns such as welfare, public health, and the environment are set aside in favor of economic development and commercialization as they have been, discontent, rather than consent, will prevail. It is thus important to keep a watchful eye on the viability of the nominal economic growth, surface-level political stability, and strategic responses to foreign relations that took place in 2017.

• Korean Journal of Agricultural and Forest Meteorology
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• v.25 no.1
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• pp.1-16
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• 2023

As the Intergovernmental Panel on Climate Change (IPCC) emphasized the transition to a carbon-neutral society globally by 205 0, major countries such as Korea, Japan, and Europe declared carbon-neutral goals. The agricultural sector is a carbon-absorbing sector, and its importance has increased as the General Assembly of the Parties to the Climate Change Convention (COP 26) held in the UK in November 2021 emphasized the role of agriculture to discuss climate change. However, GHG reduction projects in the agricultural sector are not properly monitored considering the domestic situation, and a system for quantitative evaluation of the effectiveness or basis of implementing the project program is not in place. Therefore, a priori study is needed to understand the current status of existing policies and to review matters that need to be improved in order to facilitate policy design, implementation, and monitoring for GHG reduction in the agricultural sector. The purpose of this study is to examine the opinions of stakeholders by applying a semi-structured interview method to diagnose the current status of Korea's GHG reduction policy in the agricultural sector and identify factors that hinder policy implementation. As a result of the semi-structured interview, this study presented factors that hinder the promotion of GHG reduction policies in the agricultural sector according to four types of data and technology, finance, institutions, and perceptions. Some stakeholders also stressed that the pilot project could be helpful as a way to comprehensively consider the implications of this study, such as securing technology data, establishing a system for verifying effectiveness, and providing incentives and promoting them. Rather than drawing specific conclusions, this study is an exploratory study that diagnoses and reviews the progress of GHG reduction policies, and it can be used as useful basic data if it secures enough interview respondents and balances the number of samples by group.