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Midterm Results of Aortic Valve Replacement Using Tissue Valve (조직판막을 이용한 대동맥판막치환술의 중기성적)

  • Moon, Duk-Hwan;Lee, Jae-Won;Kim, Yun-Seok;Cho, Won-Chul;Jung, Sung-Ho;Choo, Suk-Jung;Chung, Cheol-Hyun
    • Journal of Chest Surgery
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    • v.43 no.6
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    • pp.627-634
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    • 2010
  • Background: The durability of the tissue valve is important in choice between a mechanical valve and a tissue valve in cardiac surgery. We studied the mid-term results of tissue valve in the aortic position. Material and Method: The subjects were 380 patients who had undergone aortic prosthesis replacement between May 1990 and March 2009. We retrospectively analyzed hospital and outpatient records: the mean age was $69{\pm}9$ years; the male to female ratio was 227 : 162; and the mean follow-up duration was $46.7{\pm}40.8$ months (range 0~196 months). Result: 389 surgical cases in total had been taken with 380 patients. Early death occurred in 15 patients (3.9%). Overall survival rate at 1, 5 and 10 years were 92.3%, 78.1% and 54.2% respectively. Freedom from reoperation at 1, 5 and 10 years were 98.4%, 97.1% and 91.7% respectively. Freedom from structural valvular deterioration at 1, 5 and 10 years were 96.1%, 92.3% and 88.0% respectively. In the multivariate analysis of preoperative risk factors, young age (p<0.001) was significant risk factor for reoperation. High peak velocity in the postoperative period (p=0.034) and young age (p=0.029) were significant risk factors for structural valvular deterioration. Old age (p=0.001), long bypass time (p=0.035), concomitant coronary artery bypass graft surgery (p=0.003) and preoperative low left ventricular ejection fraction (p=0.003) were significant factors for early mortality. Preoperative estimated glomerular filtration rate (< 60 mL/min) (p=0.025) and persistent left ventricular hypertrophy (p=0.032) were the risk factors for late mortality. Conclusion: This study showed that the freedom from reoperation and the freedom from structural valvular deterioration in aortic tissue valve replacement were acceptable. It will be necessary to conduct further studies with long-term follow-up and more patients.

Clinical Analysis of Infective Endocarditis (감염성 심내막염의 임상적 고찰)

  • Kim, Hyuck;Kim, Young-Hak;Chung, Won-Sang;Shin, Kyung-Wook;Kim, Ji-Hoon
    • Journal of Chest Surgery
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    • v.43 no.6
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    • pp.619-626
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    • 2010
  • Background: The indications and the optimal time of surgery of infective endocarditis are controversial. We report the surgical results of our hospital during the last 10 years with literature review. Material and Method: Between January 2000 and December 2009, we enrolled 23 infective endocarditis patients who underwent surgery, and analyzed retrospectively. In the preoperative blood culture, 8 cases (34.8%) were positive. The average preoperative antibiotics treatment period was $20.78{\pm}16.00$ days. There were 12 (52.2%) urgent operations. The average follow up period was $49.26{\pm}33.21$ months. Result: 20 mechanical valve replacements were performed, 9 in aortic position, 8 in mitral position and 3 in the both positions. The other procedures were one mitral valvuloplasty, one infected myxoma extirpation, and one infected pacemaker lead removal with debridement. The average period of postoperative intravenous antibiotic treatment was $24.39{\pm}15.98$ days. There were 5 complications, including 2 cases of postoperative bleeding, one postcardiotomy syndrome, one cerebral ischemia, and a low cardiac output syndrome. There were statistically significant postoperative improvement in NYHA class, left ventricle end diastolic/end systolic volume, and left atrium size (p-value < 0.05). Conclusion: We could obtain the satisfactory results without any moftalities by using sufficient preoperative antibiotics in hemodynamically stable patients, and by prompt surgery in unstable patients.

A Comparative Study of the Function of Nursing Management According to the Position of Nursing Department in Hospital Organization (병원조직내 간호부서의 위치에 따른 간호관리 기능 비교 연구)

  • Lee, Kum-Ja
    • Journal of Korean Academy of Nursing Administration
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    • v.4 no.2
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    • pp.387-403
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    • 1998
  • These days our nation is standing on tiptoe of welfare nation. so hospital in authority have done reformation to provide quality medical services. This effective nursing work to provide quality nursing by keeping pace with the reformation of management of hospital for quality medical function might be well said to be depending on the degree of function of nursing management of nursing department. This essay has been aimed to prepare the data to build the position of nursing organization which can elevate the quality of nursing by clarifying the difference of the degree of the function of nursing management according to the position of nursing department in hospital organization. 135 nurses of 1 general hospital in Seoul which has independent nursing organization of the hospitals of over 600 beds and 155 nurses of 1 general hospital in Seoul which has the nursing organization under the management of medical department have been the objects of this study. The tool of Yoon. Young Ae(1988) has been used by having it amended and complemented and the degree of reliability of the tool was resulted in Cronbach's Alpha .9155. The collected data have been analysed by SPSS program as mean. frequency, chi-square. t-test. F-test(ANOVA) and the results are as the follows; 1. Compared result of general characteristics of the two groups by $x^2$-test showed statistically significant difference between religion ($x^2$=10.375, p=.015) and educational background($x^2$=51.222. p=.000) 2. The t-test aimed to compare the degree of function of nursing management according to the position of nursing department is as the below: Compared result of the degree of the function of nursing management according to the areas has shown higher point in independent type(M=3.22) than in the type under the management of medical department(M=2.85) in the personnel and administrative activities of nursing department. the standard and regulation of nursing duty also showed higher point in independent than in the type under the management of medical department (M=3.37) and the education of nursing showed higher point in independent type(M=3.53) than in the type under the management of medical department(M=3.19) and the evaluation of nursing quality has shown higher point in independent type(M=3.33) than in the type under the management of medical department(M=3.05), The area which showed the highest difference of the degree of the function of nursing management between the two organizations was in the activities of personnel and administration management of nursing department (independent type M=3.22. the type under the management of medical department(M=2.85). The degree of function of general nursing management showed higher in independent type nursing organization than in the type under the management of medical department by 3.41 in independent type and 3.11 in the type under the management of medical department. The items which showed the lowest degree of function of nursing management of both organizations have been suitable nursing man power and distribution and the reflection of the opinion of nursing department. In conclusion. the degree of function of nursing management to be able to provide quality nursing for the hospital goal of quality medical works showed visibly higher in independent nursing organization than in the nursing organization under the management of medical department. Therefore it is desirable for the hospital to operate the nursing department in hospital organization by independent type rather than the type under the management of medical department and the chief of nursing department of the nursing organization of the type under the management of medical department should make effort to reform its structure to be able to establish the position of performing independent nursing management. And also the chief of the nursing organization of independent type should endeavor to build substantial independent type organization more than ever under the viewpoint of securing suitable nursing man power and the low degree of management in the reflection of the opinion of nursing department.

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Effect of Nitrogen Fertigation on The Growth and Nutrition Uptake of 'Brightwell' Rabbiteye Blueberry (질소관비 수준이 래빗아이 블루베리 '브라이트웰'의 생장과 양분흡수에 미치는 영향)

  • Kwack, Yong-Bum;Chae, Won-Byoung;Lee, Mock-hee;Jeong, Hae-Won;Rhee, Han-Cheol;Kim, Jin-Gook;Kim, Hong-Lim
    • Korean Journal of Environmental Agriculture
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    • v.36 no.3
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    • pp.161-168
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    • 2017
  • BACKGROUND: Rabbiteye blueberry(Vaccinium ashei Reade) has low nutrient uptake efficiency due to its shallow and fibrous root system without root hairs. This study was carried out to establish an efficient nutrient application standard by investigating the effect of nitrogen fertigation on the growth and fruit characteristics of rabbiteye blueberry. METHODS AND RESULTS: 'Brightwell' rabbiteye blueberry was treated with 0, 50, 100 and 200% nitrogen fertigation of recommended fertilizer application (6, 9 and 14 g/bush in the first, second and third years, respectively). The results showed that leaf nitrogen content significantly correlated with the fruit weight and fruit yield. However, canopy area, dry weight, sugar and anthocyanin contents did not correlate significantly with the leaf nitrogen content. The leaf and stem dry weights of 'Brightwell' rabbiteye blueberry during the third year of planting were the highest with 50% nitrogen fertigation (leaf dry weight=723.7 g/bush; stem dry weight=890.7 g/bush). Maximum fruit yield of 'Brightwell' rabbiteye blueberry (12.9 kg/bush) was observed during the third year of planting with 50% nitrogen fertigation and this was about 70% greater than the treatment that received no nitrogen fertigation. The fruit yields of 'Brightwell' rabbiteye blueberry during the third year of planting treated with 100 and 200% nitrogen fertigation were 11.0 and 11.5 kg/bush, and these were 17 and 12%lower than the 50% nitrogen fertigation treatment, respectively. Further, the efficiency of nitrogen utilization was the highest (90%) with 50% nitrogen fertigation and lowest (18%) with 200% nitrogen fertigation. CONCLUSION: The results of this study suggests that fertigation with 50% of the recommended fertilizer could be most effective for enhancing the growth and nitrogen use efficiency of rabbiteye blueberry.

Characteristics and Policy Implications of Materials and Parts Industry in Japan (일본 소재부품산업의 특성과 시사점)

  • Kim, Young-woo;Lee, Myun-hun
    • Journal of Venture Innovation
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    • v.2 no.2
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    • pp.31-46
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    • 2019
  • Materials and Parts acts as the bridge in the manufacturing industry. In 2018, the materials and parts industry became the leading industry in Korea as its export reached $316.2 billion, accounting for 52.3 percent of the country's total exports. As such, it is the main industry of Korea leading the trade surplus, but when it comes to Japan, it is not. The trade deficit with Japan shrinks to $24 billion last year but the materials and parts industry still accounts for 60 percent of total deficit, which is about $15.1 billion. Today Japan has the top competitiveness in the high-tech materials and parts industry and the factors can be found in cooperation and symbiosis among companies, monotsukuri spirit, and long-term government policy. In order for Korean economy to pursue the Japan's high-tech materials and parts industry, the following change of perception is necessary. First, the material and parts industry requires win-win cooperation. In general, materials and parts are intermediate products. Therefore, it is important to understand the characterist that the transactions are all made up between companies not the with consumers. Second, expansion of joint technology development is absolutely necessary. South Korea is a leading country in the field of general-purpose materials and parts. However, the research shows that South Korea has structure which small and medium-sized companies could have difficulties in developing high-tech products as finding demand and developing market are hard due to low participation of large corporations at R&D stage. It is necessary for large corporations to participate in joint R&D and share opinions of customers from the beginning stage of R&D. Third, a long-term approach is needed. Structural vulnerabilities in the Korea's materials and parts industry, including the lack of advanced technologies is the main reason of solidification of Korea's trade deficit with Japan but there are also cultural differences about technology in the background. Even if it takes time, a long-term approach is absolutely necessary to build up technology and know-how in order to secure competitiveness in the high-tech materials and parts industry. This approach applies to act of corporation and government policy.

Comparison of Clinical Features between Idiopathic Pulmonary Arterial Hypertension and Chronic Thromboembolic Pulmonary Hypertension (특발성 폐동맥고혈압과 만성혈전색전성 폐고혈압의 임상상 비교)

  • Kim, Hyun Kuk;Na, Joo Ock;Ahn, Jong Joon;Park, Yong Bum;Lim, Jae Min;Hong, Sang-Bum;Oh, Yeon-Mok;Shim, Tae Sun;Lim, Chae-Man;Koh, Younsuck;Kim, Woo Sung;Kim, Dong Soon;Kim, Won Dong;Lee, Sang-Do
    • Tuberculosis and Respiratory Diseases
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    • v.59 no.2
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    • pp.170-178
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    • 2005
  • Background : Idiopathic pulmonary arterial hypertension (IPAH) and chronic thromboembolic pulmonary hypertension (CTEPH) are rare but significantly imperative in inducing chronic pulmonary hypertension. Clinically, it is difficult to distinguish between IPAH and CTEPH. However, the treatment of pulmonary hypertension is different depending on the disease. The present study was performed to analyze the similarities and differences in clinical features between IPAH and CTEPH. Methods : During a nine-year period, thirty-three patients with IPAH and twenty-two patients with CTEPH were enrolled. Symptoms, physical findings, chest radiograph, electrocardiograph, pulmonary function test, echocardiograph, perfusion lung scan, right heart catheterization results were analyzed between both the groups. Results : The median age of IPAH group was 33 (6~70) years that was lower than that (52(27~80) years) of CTEPH group. Amongst the IPAH patients, there was female predominance (76 %) and there was no sex difference between the patients with CTEPH. Both the groups exhibited similarity in the results of chest radiograph, electrocardiograph, pulmonary function test, and echocardiograph. In the perfusion lung scan, all IPAH patients exhibited findings with normal (28%) or low probability (72%) of pulmonary embolism and all CTEPH patients exhibited findings with high probability of pulmonary embolism. Conclusion : Although IPAH and CTEPH bear similarities in terms of symptoms, physical signs and general investigation results, there were differences in age distribution, sex predominance and results of perfusion lung scan.

Evaluation of Social Nicotine Dependence Using the Kano Test for Social Nicotine Dependence (KTSND-K) Questionnaire in Korea (Kano Test for Social Nicotine Dependence(KTSND-K) 설문지를 통한 한국인의 사회적 니코틴의존성의 평가)

  • Jeong, Jae Hee;Choi, Sang Bong;Jung, Wou Young;Byun, Min Gwang;Park, Moo Suk;Kim, Young Sam;Kim, Se Kyu;Chang, Joon;Yoshii, Chiharu;Kim, Sung Kyu
    • Tuberculosis and Respiratory Diseases
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    • v.62 no.5
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    • pp.365-373
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    • 2007
  • Background: Smoking is one of the most important leading causes of morbidity and mortality. Smoking habit is recognized as nicotine dependence, which consists of physical and psychosocial dependence. To evaluate social nicotine dependence, the Kano Test for Social Nicotine Dependence (KTSND) working group developed a new questionnaire, which consists of 10 questions with a total score of 30 in Japan. We examined the social nicotine dependence among healthy adults using the new KTSND questionnaire and evaluated validity of the KTSND questionnaire in Korea. Method: We applied Korean KTSND questionnaire version 2 to employees of hospital, university students and people for medical examination and promotion test. Complete data obtained from the 741 responders were analyzed. Result: The mean age of responders was 31.8 years. Among them, males were 57.8%. Current smokers, ex-smokers, and non-smokers were 13.8%, 12.8%, and 73.4% respectively. According to smoking status, the total KTSND scores of current smokers were significantly higher than those of ex-smokers, and of non-smokers ($17.1{\pm}5.4$ versus $14.3{\pm}5.5$, and $12.3{\pm}5.5$, $p{\leq}0.001$). The total KTSND scores of males were higher than those of females, suggesting that males have a propensity for depending nicotine socially much more than females ($14.3{\pm}5.7$ and $11.7{\pm}5.4$ respectively, p<0.001). Eight of ten questions produced significantly different scores among three different smoking groups. When current smokers were sub-classified by heavy smoking index (HSI) that represented physical nicotine dependence, we did not find a significant difference of KTSND score between low HSI group (<4) and high HSI group (${\geq}4$), This finding suggested that the psychosocial dependence might play a different role from physical nicotine dependence in smoking. Most of the non-smokers (62.5%) had an experience of harmful passive smoking especially in public place. Conclusion: Our study suggested that the KTSND questionnaire could be a useful method to evaluate psychosocial aspects of smoking.

Comparison of PCR-RFLP and Real-Time PCR for Allelotyping of Single Nucleotide Polymorphisms of RRM1, a Lung Cancer Suppressor Gene (폐암 억제유전자 RRM1의 단일염기다형성 검사를 위한 PCR-RFLP법과 Real-Time PCR법의 유용성 비교)

  • Jeong, Ju-Yeon;Kim, Mi-Ran;Son, Jun-Gwang;Jung, Jong-Pil;Oh, In-Jae;Kim, Kyu-Sik;Kim, Young-Chul
    • Tuberculosis and Respiratory Diseases
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    • v.62 no.5
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    • pp.406-416
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    • 2007
  • Background: Single nucleotide polymorphisms (SNPs), which consist of a substitution of a single nucleotide pair, are the most abundant form of genetic variations occurring with a frequency of approximately 1 per 1000 base pairs. SNPs by themselves do not cause disease but can predispose humans to disease, modify the extent or severity of the disease or influence the drug response and treatment efficacy. Single nucleotide polymorphisms (SNPs), particularly those within the regulatory regions of the genes often influence the expression levels and can modify the disease. Studies examining the associations between SNP and the disease outcome have provided valuable insight into the disease etiology and potential therapeutic intervention. Traditionally, the genotyping of SNPs has been carried out using polymerase chain reaction-restriction fragment length polymorphism(PCR-RFLP), which is a low throughput technique not amenable for use in large-scale SNP studies. Recently, TaqMan real-time PCR chemistry was adapted for use in allelic discrimination assays. This study validated the accuracy and utility of real-time PCR technology for SNPs genotyping Methods: The SNPs in promoter sequence (-37 and -524) of lung cancer suppressor gene, RRM1 (ribonucleotide reductase M1 subunit) with the genomic DNA samples of 89 subjects were genotyped using both real-time PCR and PCR-RFLP. Results: The discordance rates were 2.2% (2 mismatches) in -37 and 16.3% (15 mismatches) in -524. Auto-direct sequencing of all the mismatched samples(17 cases) were in accord with the genotypes read by real-time PCR. In addition, 138 genomic DNAs were genotyped using real-time PCR in a duplicate manner (two separated assays). Ninety-eight percent of the samples showed concordance between the two assays. Conclusion: Real-time PCR allelic discrimination assays are amenable to high-throughput genotyping and overcome many of the problematic features associated with PCR-RFLP.

Utility of B-type Natriuretic Peptide in Patients with Acute Respiratory Distress Syndrome (급성호흡곤란증후군 환자에 있어서 B-type Natriuretic Peptide의 유용성)

  • Rhee, Chin Kook;Joo, Young Bin;Kim, Seok Chan;Park, Sung Hak;Lee, Sook Young;Koh, Yoon Seok;Kim, Young Kyoon
    • Tuberculosis and Respiratory Diseases
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    • v.62 no.5
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    • pp.389-397
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    • 2007
  • Background B-type natriuretic peptide (BNP) has been shown to be strong mortality predictors in a wide variety of cardiovascular syndromes. Little is known about BNP in patients with acute respiratory distress syndrome (ARDS). We studied whether BNP can predict mortality in patients with ARDS. Method Echocardiographic study was done to all patients with ARDS, and we excluded patient with low ejection fraction (less than 50%) or showing any features of diastolic dysfunction. 47 patients were enrolled between December, 2003 and February, 2006. Parameters including BNP were obtained within 24h hours at the time of enrollment. Result Mean BNP concentrations and APACHE II scores differed between the survivors and nonsurvivors (BNP, $219.5{\pm}57.7pg/mL$ vs $492.3{\pm}88.8pg/mL$; p=0.013, APACHE II score, $17.4{\pm}1.6$ vs $23.1{\pm}1.3$, p=0.009, respectively). With the use of the threshold value for BNP of 585 pg/mL, the specificity for the prediction of mortality was 94%. The threshold value for APACHE II of 15.5 showed sensitivity of 87%. 'APACHE II + $11{\times}logBNP$' showed sensitivity 63%, and specificity 82%, using threshold value for 46.14. Conclusion BNP concentrations and APCHE II scores were more elevated in nonsurvivors than survivors in patients with ARDS who have normal ejection fraction. BNP can predict mortality. Further study should be done.

A Study on Fast Iris Detection for Iris Recognition in Mobile Phone (휴대폰에서의 홍채인식을 위한 고속 홍채검출에 관한 연구)

  • Park Hyun-Ae;Park Kang-Ryoung
    • Journal of the Institute of Electronics Engineers of Korea SP
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    • v.43 no.2 s.308
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    • pp.19-29
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    • 2006
  • As the security of personal information is becoming more important in mobile phones, we are starting to apply iris recognition technology to these devices. In conventional iris recognition, magnified iris images are required. For that, it has been necessary to use large magnified zoom & focus lens camera to capture images, but due to the requirement about low size and cost of mobile phones, the zoom & focus lens are difficult to be used. However, with rapid developments and multimedia convergence trends in mobile phones, more and more companies have built mega-pixel cameras into their mobile phones. These devices make it possible to capture a magnified iris image without zoom & focus lens. Although facial images are captured far away from the user using a mega-pixel camera, the captured iris region possesses sufficient pixel information for iris recognition. However, in this case, the eye region should be detected for accurate iris recognition in facial images. So, we propose a new fast iris detection method, which is appropriate for mobile phones based on corneal specular reflection. To detect specular reflection robustly, we propose the theoretical background of estimating the size and brightness of specular reflection based on eye, camera and illuminator models. In addition, we use the successive On/Off scheme of the illuminator to detect the optical/motion blurring and sunlight effect on input image. Experimental results show that total processing time(detecting iris region) is on average 65ms on a Samsung SCH-S2300 (with 150MHz ARM 9 CPU) mobile phone. The rate of correct iris detection is 99% (about indoor images) and 98.5% (about outdoor images).