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Post-Infarction Ventricular Septal Rupture : 10 Years of Experience (급성 심근경색증 후 심실중격 결손: 10년 경험)

  • Jung, Yo-Chun;Cho, Kwang-Ree;Kim, Ki-Bong
    • Journal of Chest Surgery
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    • v.40 no.5 s.274
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    • pp.351-355
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    • 2007
  • Background: Postinfarction ventricular septal rupture is associated with mortality as high as $85\sim90%$, if it is treated medically. This report documents our experience with postinfarction ventricular septal rupture that was treated surgically, Material and Method: We retrospectively reviewed the medical records of 11 patients who were operated on due to postinfarction ventricular septal rupture between August 1996 and August 2006. There were 4 men and 7 women, with a mean age of $70{\pm}11$ years (age range: $50\sim84$ years). The location of the rupture was anterior in 7 cases and posterior in 4 cases. The interval between the onset of acute myocardial infarction and the occurrence of the ventricular septal rupture was $2.0{\pm}1.3$ days (range: $1\sim5$ days). Operation was performed at an average of $2.4{\pm}2.7$ days (range: $0\sim8$ days) after the diagnosis of septal rupture. Preoperative intraaortic balloon pump therapy was performed in 10 patients. Result: The infarct exclusion technique was used in all cases. Coronary artery bypass grafting was done in 8 cases, with the mean number of distal anastomosis being $1.0{\pm}0.8$. There was one operative death. In 2 patients, reoperation was performed due to a residual septal defect. The postoperative morbidities were transient atrial fibrillation (n=7), paroxysmal supraventricular tachycardia (n=1), low cardiac output syndrome (n=3), bleeding reoperation (n=2), delayed sternal closure (n=2), acute renal failure (n=2), pneumonia (n=1), intraaortic balloon pump-related thromboembolism (n=1), and transient delirium (n=2). Nine patients have been followed up for a mean of $38{\pm}40$ months except for one follow-up loss. There have been 3 late deaths. At the latest follow-up, all 6 survivors were in a good functional class. Conclusion: We demonstrated satisfactory operative and midterm results with our strategy of preoperative intraaortic balloon pump therapy, early repair of septal rupture by infarct exclusion and combined coronary revascularization.

A Study on the Health Insurance Management System; With Emphasis on the Management Operating Cost (의료보험 관리체계에 대한 연구 - 관리비용을 중심으로 -)

  • 남광성
    • Korean Journal of Health Education and Promotion
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    • v.6 no.2
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    • pp.23-39
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    • 1989
  • There have been a lot of considerable. discussion and debate surrounding the management model in the health insurance management system and opinions regarding the management operating cost. It is a well known fact that there have always been dissenting opinions and debates surrounding the issue. The management operating cost varies according to the scale of the management organization and component members characteristics of the insurance carrier. Therefore, it is necessary to examine and compare the management operating cost to the simulated management models developed to cover those eligible for the health insurance scheme in this country. Since the management operating cost can vary according to the different models of management, four alternative management models have been established based on the critical evaluation of existing theories concerned, as well as on the basis of the survey results and simulation attempts. The first alternative model is the Unique Insurance Carrier Model(Ⅰ) ; desigened to cover all of the people with no classification of insurance qualifications and finances from the source of contribution of the insured, nationwide. The second is the Management Model of Large-scale District Insurance Carrier(Ⅱ) ; this means the Korean society would be divided into 21 large districts; each having its own insurance carrier that would cover the people in that particular district with no classification of insurance qualifications arid finances as in Model I. The third is the Management Model of Insurance Carrier Divided by Area and Classified with Occupation if Largescale (Ⅲ) ; to serve the self-employed in the 21 districts divided as in Model Ⅱ. It would serve the employees and their dependents by separate insurance carriers in large-scale similar to the area of the district-scale for the self-employed, so that the insurance qualifications and finances would be classified with each of the insurance carriers: The last is the Management Model of the Multi - insurance Carrier (Ⅳ) based on the Si. Gun. Gu area which will cover their own self- employed people in the area with more than 150 additional insurance carriers covering the employees and their dependents. The manpower necessary to provide services to all of the people according to the four models is calculated through simulation trials. It indicates that the Management Model of Large-scale District Insurance Carrier requires the most manpower among the four alternative models. The unit management operating costs per the insured individuals and covered persons are leveled with several intervals based on the insurance recipients. in their characteristics. The interval levels derived from the regression analysis reveal that the larger the scale of the insurance carriers is in the number of those insured and covered. the more the unit management operating cost decreases. significantly. Moreover. the result of the quadratic functional formula also shows the U-shape significantly. The management operating costs derived from the simulated calculation. on the basis of the average salary and related cost per staff- member of the Health Insurance Societies for Occupational Labours and Korean Medical Insurance Corporation for the Official Servants and Private School Teachers in 1987 fiscal year. show that the Model of Multi-insurance Carrier warrants the highest management operating cost. Meanwhile the least expensive management operating cost is the Management Model of Unique Insurance Carrier. Insurance Carrier Divided by Area and Classified with Occupation in Large-scale. and Large-scale District Insurance Carrier. in order. Therefore. it is feasible to select the Unique Insurance Carrier Model among the four alternatives from the viewpoint of the management operating cost and in the sense of the flexibility in promoting the productivity of manpower in the human services field. However. the choice of the management model for health insurance systems and its application should be examined further utilizing the operation research analysis for such areas as the administrative efficiency and factors related to computer cost etc.

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Analysis of Cancer Incidence in Zhejiang Cancer Registry in China during 2000 to 2009

  • Du, Ling-Bin;Li, Hui-Zhang;Wang, Xiang-Hui;Zhu, Chen;Liu, Qing-Min;Li, Qi-Long;Li, Xue-Qin;Shen, Yong-Zhou;Zhang, Xin-Pei;Ying, Jiang-Wei;Yu, Chuan-Ding;Mao, Wei-Min
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.14
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    • pp.5839-5843
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    • 2014
  • Objective: The Zhejiang Provincial Cancer Prevention and Control Office collected cancer registration data during 2000 to 2009 from 6 cancer registries in Zhejiang province of China in order to analyze the cancer incidence. Methods: Descriptive analysis included cancer incidence stratified by sex, age and cancer site group. The proportions and cumulative rates of 10 common cancers in different groups were also calculated. Chinese population census in 1982 and Segi's population were used for calculating age-standardized incidence rates. The log-linear model was used for fitting to calculate the incidence trends. Results: The 6 cancer registries in Zhejiang province in China covered a total of 60,087,888 person-years during 2000 to 2009 (males 30,445,904, females 29,641,984). The total number of new cancer cases were 163,104 (males 92,982, females 70,122). The morphology verified cases accounted for 69.7%, and the new cases verified only by information from death certification accounted for 1.23%. The crude incidence rate in Zhejiang cancer registration areas was $271.5/10^5$ during 2000 to 2009 (male $305.41/10^5$, female $236.58/10^5$), age-standardized incidence rates by Chinese standard population (ASIRC) and by world standard population (ASIRW) were $147.1/10^5$ and $188.2/10^5$, the cumulative incidence rate (aged from 0 to 74) being 21.7%. The crude incidence rate was $209.6/10^5$ in 2000, and it increased to $320.20/10^5$ in 2009 (52.8%), with an annual percent change (APC) of 4.51% (95% confidence interval, 3.25%-5.79%). Age-specific incidence rate of 80-84 age group was achieved at the highest point of the incidence curve. Overall with different age groups, the cancer incidences differed, the incidence of liver cancer being highest in 15-44 age group in males; the incidence of breast cancer was the highest in 15-64 age group in females; the incidences of lung cancer were the highest in both males and females over the age of 65 years. Conclusions: Lung cancer, digestive system malignancies and breast cancer are the most common cancers in Zhejiang province in China requiring an especial focus. The incidences of thyroid cancer, prostate cancer, cervical cancer and lymphoma have increased rapidly. Prevention and control measures should be implemented for these cancers.

Clinical Analysis of Recurrent Intussusception and the Pathologic Lead Point in a Single Center (단일 병원에서의 재발성 장중첩증과 병적 선두에 대한 임상적 고찰)

  • Lee, Kun-Song;Park, Yun-Joon
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.12 no.2
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    • pp.163-170
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    • 2009
  • Purpose: Intussusception is the most common cause of intestinal obstruction in young children. Although intussusceptions are easily treated, some intussusceptions with or without a pathologic lead point (PLP) often recur. In this study, we analyzed the clinical characteristics and prognosis of recurrent intussusceptions (RI), the frequency of the PLP, and correlation between RI with PLP. Methods: The medical records of 144 patients, among 590 patients with intussusceptions who had been admitted to the Department of Pediatrics and Pediatric Surgery of Dankook University Hospital between May 1994 and June 2009 were reviewed retrospectively. Results: The overall recurrence rate of intussusceptions in this study was 9.2%. The mean interval between the initial occurrence and the first recurrent attack was 130${\pm}$175 days (range, 12 hours to 3 years). There was no statistically significant difference in the recurrence rate among patients who underwent air, barium, and manual reduction (p=0.131). Eighty-seven cases (92.6%) of RI had a successful reduction by the use of non-operative techniques. A PLP was present in 18 patients (3.0%). The most common PLP was intestinal lymphoid hyperplasia, followed by Meckel's diverticulum, duplication cyst, intestinal polyp, and adenomyoma. The mean number of intussusceptions was 4.7${\pm}$1.9 in 7 patients with PLP, which was significantly higher than (2.4${\pm}$0.9) patients without a PLP (p=0.023). The mean duration of recurrences was 17.4${\pm}$19.8 months (range, 2 days to 72 months). Conclusion: A careful search for a PLP should be performed to prevent recurrence of intussusception, especially when intussusception has recurred more than three times.

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Detection of Spinal Metastases: Comparison of Bone Scan and MR Imaging (전이성 척추 악성 종양의 진단 : 골스캔과 자기공명영상의 비교)

  • Kim, Ki-Jun;Sohn, Hyung-Sun;Park, Jeong-Mi;Chung, Soo-Kyo;Lee, Jae-Moon;Kim, Choon-Yul;Bahk, Yong-Whee;Shinn, Kyung-Sub
    • The Korean Journal of Nuclear Medicine
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    • v.28 no.3
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    • pp.384-390
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    • 1994
  • Authors retrospectively compared the 99mTc MDP bone scans and corresponding MR imagings in 20 patients with histologically proven malignancy, Mean interval of the two studies was 16.6 days, Cancer diagnosis Included 8 lung, 2 each of colon, breast, stomach, 1 each of prostate, thyroid, malignant lymphoma and 3 adenocarcinoma of unknown primary site. Of the 105 regions compared, :t6 regions were positive for metastases in bone scans or MR imagings. 30 regions(65.2%) were positive by bone scan and 44 regions(95.7%) by MR imaging. 87 regions(82.9%) were concordantly positive or negative by bone scan and MR imaging, but 18 regions(17.1%) were discordant. In the discordant regions, 16 regions positive in MR imaging were negative in bone scan. The greatest number of discordant findings occured in the cervical region and in the patient with stomach cancer. Our results suggest that the sensitivity of MR Imaging is greater than that of bone scan in detecting spinal metastases. And bone scan is useful screening test of metastasis for evaluating entire skeleton including spine.

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Damage and biological control of dark winged fungus gnats, Lycoriella ingenua (Diptera: Sciaridae) in a shiitake cultivation (표고 톱밥재배에서 검정날개버섯파리 Lycoriella ingenua (Diptera: Sciaridae)의 피해와 생물적 방제)

  • Kim, Hyeong-Hwan;Cho, Myoung-Rae;Kang, Taek-Jun;Ahn, Seung-Joon;Jeon, Sung-Wook;Lee, Chan-Jung;Cheong, Jong-Chun
    • Journal of Mushroom
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    • v.10 no.4
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    • pp.184-190
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    • 2012
  • Monitorings and management experiment of adult Lycoriella ingenua (Diptera: Sciaridae) in artificial sawdust grown shiitake mushroom cultivation were carried out by using yellow sticky traps and Hypoaspis aculeifer (Acari: Laelapidae) at Hwaseong, Buyeo and Cheongwon in 2012. The larvae of L. ingenua reduced commercial value of the mushroom by direct eating or retarding the growth of mushroom by spongifying the sawdust medium. The number of L. ingenua caught by traps showed the highest peak in late september resulting in 127.5~1,025.7, 87.4~743.6 and 133.7~650.4 individuals per trap in Hwaseong, Buyeo and Cheongwon, respectively. Damage rate of fruiting bodies in shiitake mushroom by L. ingenua were 7.7~30.3% in Hwaseong, 6.7~25.3% in Buyeo and 5.3~26.0% in Cheongwon and showed the highest peak in late september. L. ingenua were effectively controlled when 30.3 individuals of H. aculeifer per $m^2$ inoculated for three time with 7 to 14 days of interval. In Hwaseong, Buyeo and Cheongwon, density of L. ingenua which were caught on the yellow sticky traps were 168.2, 126.1, 132.5 individuals, respectively. And, damage rate of fruiting bodies by L. ingenua were 5.9%, 5.5% and 5.4% respectively. Both of the L. ingenua density and damage rate of mushroom reduced more than 60% in all experimental site in contrast to the control treatment.

Quantification of Temperature Effects on Flowering Date Determination in Niitaka Pear (신고 배의 개화기 결정에 미치는 온도영향의 정량화)

  • Kim, Soo-Ock;Kim, Jin-Hee;Chung, U-Ran;Kim, Seung-Heui;Park, Gun-Hwan;Yun, Jin-I.
    • Korean Journal of Agricultural and Forest Meteorology
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    • v.11 no.2
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    • pp.61-71
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    • 2009
  • Most deciduous trees in temperate zone are dormant during the winter to overcome cold and dry environment. Dormancy of deciduous fruit trees is usually separated into a period of rest by physiological conditions and a period of quiescence by unfavorable environmental conditions. Inconsistent and fewer budburst in pear orchards has been reported recently in South Korea and Japan and the insufficient chilling due to warmer winters is suspected to play a role. An accurate prediction of the flowering time under the climate change scenarios may be critical to the planning of adaptation strategy for the pear industry in the future. However, existing methods for the prediction of budburst depend on the spring temperature, neglecting potential effects of warmer winters on the rest release and subsequent budburst. We adapted a dormancy clock model which uses daily temperature data to calculate the thermal time for simulating winter phenology of deciduous trees and tested the feasibility of this model in predicting budburst and flowering of Niitaka pear, one of the favorite cultivars in Korea. In order to derive the model parameter values suitable for Niitaka, the mean time for the rest release was estimated by observing budburst of field collected twigs in a controlled environment. The thermal time (in chill-days) was calculated and accumulated by a predefined temperature range from fall harvest until the chilling requirement (maximum accumulated chill-days in a negative number) is met. The chilling requirement is then offset by anti-chill days (in positive numbers) until the accumulated chill-days become null, which is assumed to be the budburst date. Calculations were repeated with arbitrary threshold temperatures from $4^{\circ}C$ to $10^{\circ}C$ (at an interval of 0.1), and a set of threshold temperature and chilling requirement was selected when the estimated budburst date coincides with the field observation. A heating requirement (in accumulation of anti-chill days since budburst) for flowering was also determined from an experiment based on historical observations. The dormancy clock model optimized with the selected parameter values was used to predict flowering of Niitaka pear grown in Suwon for the recent 9 years. The predicted dates for full bloom were within the range of the observed dates with 1.9 days of root mean square error.

Effect of Night-break Timing on Growth, Bolting and Anthesis of Orostachys japonicus (암기중단 처리시기에 따른 바위솔의 생장, 추대 및 개화)

  • 강진호;류영섭;강신윤;심영도;김동일
    • KOREAN JOURNAL OF CROP SCIENCE
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    • v.42 no.5
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    • pp.597-603
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    • 1997
  • Orostachys japonicus, Wasong as herb medicine, has been artificially cultivated as an anti-tumor medicinal. The experiment was carried out to examine the effect of natural daylength as control or night-break treatment (NB) imposed at June 20, July 18 or Aug. 15 on its growth, dry weights of leaf and bract, stem, floret and root, and morphological characters including bolting and floret flowering. After a plant was grown in a 15cm plastic pot containing a 2 : 1 soil : peat moss mixture on May 23, three treatments with above differing night-break had been imposed around midnight up to Nov. 7. The plants were sampled 3 times at the same day forced to night-break and then done 6 times by 2-week interval after the final NB. Plant height and inflorescence length of all the NB increased with delayed NB but declined in comparison with the natural daylength. No. of leaves including bracts showed similar response to plant height although NB given before July 18 showed less leaves and bracts. Stem diameters of NB were continuously increased to middle Sept. to middle Oct. while that of natural daylength decreased after middle Oct. Natural daylength or NB given on Aug. 15 had greater fraction, shoot and total dry weights resulting from increment of leaf and bract up to Aug. or of floret, stem and root after Sept. The earlier NB, the later formation of florets and the less number of flowering florets whereas in natural daylength florets on inflorescence begun to be formed from middle Sept. were sharply increased up to middle Oct. when all the plants were flowered. Bolting was not formed in the plant of the earliest NB of June 20, and thereby no anthesis of florets up to early Nov. It was concluded that year-round cultivation of Orostachys japonicus plants was possible through controlling the NB timing because its bolting and flowering of florets separately occurred.

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Biliary Atresia -A Survey by the Korean Association of Pediatric Surgeons in 2011- (담도폐쇄증 -대한소아외과학회 회원 대상 전국 조사-)

  • Oh, J.T.;Kim, D.Y.;Kim, S.C.;Kim, I.K.;Kim, H.Y.;Kim, H.Y.;Nam, S.H.;Park, K.W.;Park, W.H.;Park, J.Y.;Seo, J.M.;Lee, N.H.;Lee, M.D.;Lee, S.K.;Lee, S.C.;Chung, S.Y.;Jung, S.E.;Chung, J.H.;Choi, K.J.;Choi, S.O.;Choi, S.H.;Choi, Y.M.;Han, S.J.;Hong, J.
    • Advances in pediatric surgery
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    • v.19 no.1
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    • pp.1-13
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    • 2013
  • The Korean Association of Pediatric Surgeons (KAPS) performed the second nationwide survey on biliary atresia in 2011. It was a follow-up study to the first survey, which was performed in 2001 for the retrospective analysis of biliary atresia between 1980 and 2000. In the second survey, the authors reviewed and analyzed the clinical data of patients who were treated for biliary atresia by the members of KAPS from 2001 to 2010. A total of 459 patients were registered. Among them, 435 patients primarily underwent the Kasai operation. The mean age of patients who underwent the Kasai operation was $66.2{\pm}28.7$ days, and 89.7% of those patients had type III biliary atresia. Only five patients (1.4%) had complications related to the Kasai operation. After the Kasai operation, 269 (61.8%) of the patients were re-admitted because of cholangitis (79.9%) and varices (20.4%). One hundred and fifty-nine (36.6%) of the patients who underwent the Kasai operation subsequently underwent liver transplantation. The most common cause of subsequent liver transplantation was persistent hyperbilirubinemia. The mean interval between the Kasai operation and liver transplantation was $1.1{\pm}1.3$ years. Overall the 10-year survival rate after the Kasai operation was 92.9% and the 10-year native liver survival rate was 59.8%. We had 23 patients for primary liver transplantation without the Kasai operation. The mean age patients who underwent primary liver transplantation was $8.6{\pm}2.9$ months. In summary, among the 458 Kasai-operation and liver-transplantation patients, 373 lived, 31 died, and 54 were unavailable for follow up. One-third of the patient who survived have had complications correlated with biliary atresia. In comparison with the first survey, this study showed a higher survival rate and a greater number of liver transplantation.

Combination Culture of Rotifer Brachionus rotundiformis and Copepod Apocylops sp. (로티퍼 Brachionus rotundiformis와 코페포다 Apocyclops sp.의 혼합 배양)

  • Jung, Min-Min;Rho, Sum
    • Journal of Aquaculture
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    • v.11 no.4
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    • pp.449-455
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    • 1998
  • The small size food organism(under the size 150${\mu}m$) is needed as food for early stage of marine fish larvae of small mouse (e.g the group of grouper). This study was investigated to develop a method for copepod Apocyclops sp. culture in combination with the rotifer B. rachionus for stable culture of copepod species and harvest of various size food organisms. The culture conditions as temperature, salinity, culture volume, photo period, culture preiod and observation interval were 25${\circ}C$, 22ppt, 40ml, all dark except to observation time, 16 days and every two day during the experimental period, respectively. The Tetraselmis suecica was used as the food for the two testing orgtanisms. After every two day counting, theses two organisms were transferred to fresh culture tanks with Tetraselmis suecica of $7{\times}10^5$cells/ml. In the mixed culture of B. rotundiformis and A. sp., growth of rotifer was suppressed by mixed culture with A. sp. whereas the growth of copepod Apocyclops was promoted in the mixed culture with rotifer B. rotundiformis (the maximum density was 22 individuals/ml through the 16 culture days). Moreover, the number of copepod nauplius were promoted about 2 times in the mixed culture compared to the numbers in single species culture. With this combination culture, the havested two food organisms of variable sizes. This size variation of food organisms was useful tools for larval rearing of small mouse marine fish larvae and next step food organism size of post hatched larvae.

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