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Saphenous Vein Graft as a Composite Graft in Patients Who Are Undergoing Off-pump Coronary Artery Bypass: The Early Results (복재정맥 복합도관을 이용하여 시행한 심폐바이패스를 사용하지 않는 관상동맥우회술의 조기 결과)

  • Hwang, Ho-Young;Kim, Jun-Sung;Choi, Eun-Seok;Lee, Jae-Hang;Kim, Ki-Bong
    • Journal of Chest Surgery
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    • v.42 no.3
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    • pp.324-330
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    • 2009
  • Background: The long term patency of the free saphenous vein graft, which is the most commonly used conduit, anastomosed to the ascending aorta has been reported to be lower than that of arterial grafts. We evaluated early clinical outcome and the angiographic patency of the saphenous vein composite graft based on the left internal thoracic artery, and compared these results with those of using arterial composite grafts. Material and Method: From September 2006 to October 2008, 419 patients underwent off-pump coronary revascularization. Among those, 295 patients (70.4%) were revascularized using composite grafts (group I: saphenous vein composite graft, n=71, group II: arterial composite graft, n=224). The clinical results were compared between the 2 groups. Early postoperative coronary angiograms were performed in all the patients. ($1.6{\pm}1.6$ days) Result: The number of the distal anastomosis per patient was $3.5{\pm}1.0$ and $3.1{\pm}0.8$ in group I and II, respectively (p=.002). The operative mortality (n=2, 0.7%) and postoperative complications such as atrial fibrillation (n=73, 24.7%), perioperative myocardial infarct (n=6, 2.0%), acute renal failure (n=6, 2.0%), reoperation for bleeding (n=5, 1.7%), cerebrovascular accident (n=3, 1.0%), and mediastinitis (n=1, 0.3%) were not related with the use of saphenous vein graft. Early coronary angiograms revealed a 96.9% (126/130) for the saphenous vein grafts and a 98.8% (479/485) for the composite graft in group II (p=.231). Conclusion: Our data suggested that a saphenous vein graft might be used as analtemative conduit to the arterial graft for constructing a composite graft, as based on our early clinical and angiographic results. Further study is required to establish the long-term efficacy of using a saphenous vein as a composite graft.

Stressful Life Events, Physical Symptoms, and Anxiety in Adolescents (청소년의 스트레스 생활사건, 신체적증상과 불안에 관한 연구)

  • Yun, Kyu-Wol
    • Korean Journal of Psychosomatic Medicine
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    • v.8 no.1
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    • pp.20-30
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    • 2000
  • Objective : This study was designed to investigate the frequencies and the relation of stressful life events and health problems and evaluate the influence of stressful life events on the physical symptoms and anxiety in adolescents. Method : Newcomb's 39-item life-event questionnaire and Newcomb's 19-item health problems questionnaire were administered to 475 adolescents. The frequencies of stressful life events and health problems which had actually occurred to them during the previous 12 months were investigated. Items of stressful life events were classified in 8 dimensional scaling factors(Family/parents, Accident/Illness, Sexuality, Autonomy, Deviance, Relocation, Distress, Items not in scales) and items of health problems were classified in 5 health problems(General, Heart and Lung, Nervous system, Anxiety, Psychosomatic symptoms) and the correlation between them was analyzed. Result : 1) The average number of events occurring during the past year for the 475 adolescents is 3(7.7%). The most frequent item of stressful life events was 'Thought about suicide' and dimensional factors of "Distress" and "Autonomy" were the most frequent life events in multidimensional sacling analysis. There were more factors of "Family/Illness" and " Autonomy" in male, while there was more factor of "Distress" in female. There were more factors of "School violence" and "Deviance" in younger students, while there were more factors of "Sexuality" and "Autonomy" in older students. 2) The most frequent item of health problem was 'excessive fatigue' and "anxiety" was most frequent health problem in multidimensional scaling analysis. There were more health problems in female than those in male. The higher grades the students became, the more health problems they have reported. 3) There was significant relationship between 7 factors of stressful life events except one factor of "Relocation" and 5 health problems. Conclusions : These findings suggest that as adolescents grow older, they are engaging in more controllable behaviors related to autonomy and sexuality and at the same time are experiencing increased difficulty with distressful or discomforting events, and their stressful life events are significantly related to decreased health and psychological functiong.

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A standardized procedure on building spectral library for hazardous chemicals mixed in river flow using hyperspectral image (초분광 영상을 활용한 하천수 혼합 유해화학물질 표준 분광라이브러리 구축 방안)

  • Gwon, Yeonghwa;Kim, Dongsu;You, Hojun
    • Journal of Korea Water Resources Association
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    • v.53 no.10
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    • pp.845-859
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    • 2020
  • Climate change and recent heat waves have drawn public attention toward other environmental issues, such as water pollution in the form of algal blooms, chemical leaks, and oil spills. Water pollution by the leakage of chemicals may severely affect human health as well as contaminate the air, water, and soil and cause discoloration or death of crops that come in contact with these chemicals. Chemicals that may spill into water streams are often colorless and water-soluble, which makes it difficult to determine whether the water is polluted using the naked eye. When a chemical spill occurs, it is usually detected through a simple contact detection device by installing sensors at locations where leakage is likely to occur. The drawback with the approach using contact detection sensors is that it relies heavily on the skill of field workers. Moreover, these sensors are installed at a limited number of locations, so spill detection is not possible in areas where they are not installed. Recently hyperspectral images have been used to identify land cover and vegetation and to determine water quality by analyzing the inherent spectral characteristics of these materials. While hyperspectral sensors can potentially be used to detect chemical substances, there is currently a lack of research on the detection of chemicals in water streams using hyperspectral sensors. Therefore, this study utilized remote sensing techniques and the latest sensor technology to overcome the limitations of contact detection technology in detecting the leakage of hazardous chemical into aquatic systems. In this study, we aimed to determine whether 18 types of hazardous chemicals could be individually classified using hyperspectral image. To this end, we obtained hyperspectral images of each chemical to establish a spectral library. We expect that future studies will expand the spectral library database for hazardous chemicals and that verification of its application in water streams will be conducted so that it can be applied to real-time monitoring to facilitate rapid detection and response when a chemical spill has occurred.

A Look at the Need for a Crafts program of Developmental Disabilities (발달장애의 수예공작 프로그램 필요성에 관한 고찰)

  • Kim, Nam-Soon;Kim, Dong-Hyun;Kim, Hee-Jung
    • The Journal of Korean society of community based occupational therapy
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    • v.1 no.1
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    • pp.79-89
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    • 2011
  • The number of the disabled person had been increased for the industrial accident and the environmental pollution. Especially, developmental disability has the high prevalence rate between 5% and 10% of the whole children. The children with a developmental disability can be treated by the physical therapy, the occupational therapy, the psychology therapy, speech therapy, and art therapy. Visual preception which is function to recognize the external environment through the optic organ could be related to most behaviors on the everyday life. But because the children with disability could not develop the visual-preception enough, they came to have difficulties in executing daily life project. For this reason, it is most important to understand the estimation and the cure on the visual-preception in the pediatric occupational therapy. To improve the visual-preception power, we have many kind of methods including sensory integration, training program for the visual-perception and art-craft program. Particularly, the art-craft which is the representative activity for making something by hands, can be applied to anyone. As the study on the brain has been activated, it was proved that handicraft actives could have an good effect on the brain function and using brain. When the fine motor exercise and more delicate and accurate motion were carried, these motions need the essential help of the visual-perception. So it could be expected that using the repetitive hand function by art-craft makes the brain function improve, when a activity that needs a fine motor exercise and more delicate, accurate motion was carried, It also indicates that the art-craft program has a clear treatment value. Though the intervention between visual-perception development and visual-perception disability have a majority in the field of occupational therapy, there is a few study yet. Therefore, this study tried to look back on the necessity of applying the art-craft program to the children with disability as the prestudy for preliminary validity of the master's thesis.

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The Legal Response and Future Tasks regarding Oil-Spill Damage to Korea - Focusing on the Hebei Spirit oil-spill (한국의 해양유류오염피해에 대한 법적 대응과 과제 - HEBEI SPIRIT호 유류유출사고를 중심으로 -)

  • Han, Sang-Woon
    • Journal of Environmental Policy
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    • v.7 no.3
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    • pp.89-120
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    • 2008
  • With petroleum being a major source of energy in Korea, the quantity of petroleum transported via ocean routes is on its way up due to increased consumption. Due to the increase, more than 300 cases of pollution caused by petroleum occur annually. Moreover, the number of oil-spill accidents is also on the rise. Causes of such accidents, not including the disposal of waste oil on purpose, turn out to be human error during navigation or defects in the vessels, showing that most accidents are caused by humans. Therefore, to prevent future oil spills, it is imperative that navigation efficiency be enhanced by improving the quality of navigators and replacing old vessels with newer ones. Nevertheless, such improvements cannot occur overnight, so long- and mid-term efforts should be made to achieve it institutionally. As large-scale oil-spill accidents can happen at anytime along the coastal waters of Korea, it is necessary to set-up institutional devices which go beyond the compensation limit of 92FC. The current special law regarding this issue has its limits in that it prescribes compensation be supplemented solely by national taxes. Therefore, the setting-up of a new 'national fund' is recommended for consideration rather than to subscribe to the '2003 Convention for the Supplementary Fund'. It is strongly suggested that a National fund be created from fees collected from oil companies based on the risks involved in oil transportation and according to the profiteers pay principle. In addition, a public fund should be created to handle general environmental damage, such as the large-scale destruction of the ecosystem, which is distinct from the economic damage that harms the local people. The posterior responses to the large-scale oil spill have always been unsatisfactory because of the symbolic nature of the disasters included in such accidents. Oil-spills can be prevented in advance, because they are caused by human beings. But once they occur, they inflict long-term damage to both human life and the natural ecosystem. Therefore, the best response to future oil-spills is to work to prevent them.

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A Study on Cognition about 119 Rescue·First Aid Team - Gwangju Area College Student as the Central Figure - (119구조·구급대에 대한 인식도 조사 연구 - 광주지역 보건계열과 비보건계열 대학생을 중심으로 -)

  • Kim, Kab-Sun
    • The Korean Journal of Emergency Medical Services
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    • v.6 no.1
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    • pp.141-152
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    • 2002
  • The purpose of this study is to provide the basic materials for searching the way of improvement to heighten the emergency medical welfare level by one step further. To achieve this purpose, the subjects of this study were selected 452 college students in Gwangju, using a random sampling method. The statistical analysis methods utilized for analyzing the collected data are frequency analysis, $x^2$ test. The conclusions obtained from these analyses are as following ; 1. In question about necessary optimum number of persons for rescue first aid activity, health and non-health major college students responded by 39.2%, 45.3% respectively that rescue team 15 people, first aid team 3 people is most suitable. But there was no significant difference in major department(p<0.05). 2. In question about security of the public health doctor and the emergency medical technician, all health and non-health major college students are recognizing necessity urgently, but there was no significant difference in major department(p<0.05). 3. In question about 119 rescue first aid team member applying for an examination qualification grant to the department of EMT's graduate, all health and non-health major college students were highest by 52.9%, 52.4% respectively in "necessity" item. But there was no significant difference in major department(p<0.05). 4. Because rescue first aid equipment level appears higher than 41.7% in non-health major college student's case by 54.2% in health major college student's case, health major college students are recognizing that equipment level should be supplemented more but there was no significant difference in major department(p<0.05). 5. In question about equipment supplement, all health and non-health major college students appeared highest by 64.8%, 69.3% in accident type different special equipment. But there was no significant difference in major department(p<0.05). 6. In question about rescue ambulance car size, we could know being thinking that health and non-health major college student each 61.2%, 56.5% is small and narrow that large size of the rescue ambulance amount need. But there was no significant difference in major department(p<0.05). 7. In question about patient's state is worsened, because rescue first aid equipment is inferior, health major college student responded sometimes 55.1%, many 29.5%. very many by 11.5%, while non-health major college student responded 65.8%, 23.1%, 4.0% respectively. There was significant difference in major department(p<0.05). 8. In question about emergency patient must utilize for 119 rescue ambulance car, all health and non-health major college students appeared highest by 38.8%, 41.3% in "not so" item. In question about rescue first aid team's first-aid treatment ability improves more, all health and non-health major college students appeared highest by 58.1% and 58.7% respectively in "improve" item. In question about "119 rescue ambulance car must go more rapidly than now", all health and non-health major college students are recognizing that should be quicker by 58.1%, 60.9% respectively. When called to 119 all health and non-health major college students responded highest by 55.5%, 53.3% respectively that we must receive first-aid treatment direction from a doctor. In question about "119 rescue ambulance car must be made the pay system", all health and non-health major college students responded 74%, 80% respectively in "not so" item. There was significant difference in major department(p<0.05). In conclusions, In oder to provide superior rescue first aid service to people, a public health doctor should be placed in the situation room inside the fire station so that the doctor could instruct the proper emergency treatment suitable for each situation to the rescue first aid team. Also, national education about a first-aid treatment that do to all people is necessarily necessary in emergency delivery system and this should be spread extensively through school education and broadcasting medium and education should be gone side by side, and see that will can save emergency patients' life which is more when these education consists continuously fixed period for public institution of policeman, fire officer etc. specially. And for reinforcement of patient transfer system, public organization must procure special ambulance car so that emergency patient receive first aid treatment while transfer.

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Analysis of Risk Factors in Coronary Artery Bypass Surgery (관동맥우회술의 위험인자 분석)

  • 정태은;한승세
    • Journal of Chest Surgery
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    • v.31 no.11
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    • pp.1049-1055
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    • 1998
  • Background: Coronary artery bypass surgery is an important treatment for ischemic heart disease. Recently operative mortality and morbidity has decreased, however further improvement is necessary. Materials and methods: This study was designed to evaluate the risk of operative mortality and morbidity by retrospective method. From 1992 to 1997, eighty six patients underwent coronary artery bypass surgery. There were 61 males and 25 females aged 36~74 years(mean, 58.6). Fourteen patients(16%) had previous PTCA or stent insertion, 41 patients(48%) had unstable angina, and 45 patients(52%) had three vessel disease. Patients with low LV ejection fraction(<35%) were 7 cases and urgent or emergent operation were 10 cases. There were 6 cases of combined surgery which were mitral valve replacement(2 cases), aortic valve replacement(2 cases), ASD repair(1 case), and VSD repair(1 case). Average number of distal anastomosis was 3.5 per patient and average aortic cross clamp time was 115±38.3min. Preoperative risk factors were defined as follows: female, old age(>70 years), low body surface area(<1.5M2), PTCA or stent insertion history, hypercholesterolemia, smoking, hypertension, DM, COPD, urgent or emergent operation, left main disease, low LV ejection fraction(<35%), and combined surgery. Results: Operative mortality was 7cases(8%). As a postoperative morbidity, perioperative myocardial infarction was 6 cases, cerebrovascular accident 6 cases, reoperation for bleeding 5 cases, acute renal failure 4 cases, gastrointestinal complication 3 cases, and mediastinitis 3 cases. In the evaluation of operative risk factors, low body surface area, DM and low LV ejection fraction were found to be predictive risk factors of postoperative morbidity(p<0.05), and low ejection fraction was especially a risk factor of hospital mortality(p<0.05). Conclusions: In this study, low body surface area, DM and low LV ejection fraction were risk factors of postoperative morbidity and low ejection fraction was a risk factor of hospital mortality.

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Significance of Early Esophagoscopy in Corrosive Esophagitis (부식성 식도염에서의 조기 식도경술의 의의)

  • 임병석;봉정표;박순일;문태용;윤강묵
    • Proceedings of the KOR-BRONCHOESO Conference
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    • 1983.05a
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    • pp.12.2-13
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    • 1983
  • Corrosive injuries of the esophagus by accident or suicidal attempt, though decreasing in number, still represent an important problem of our national pathology. One of the most difficult problems facing any physician is the diagnosis and management of caustic ingestion. In order to determine the extent of esophageal bums, to prevent the potential complication, to increase the therapeutic effect, the use of esophagoscopy is an essential step, and it has lessened an unnecessary admission and treatment. The authors have found the value of early esophagoscopy in selected 41 corrosive esophagitis patient who were admitted to Dept. of ENT, Wonju medical college, Yonsei university between 1980. 1-1982. 12

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The Jurisdictional Precedent Analysis of Medical Dispute in Dental Field (치과임상영역에서 발생된 의료분쟁의 판례분석)

  • Kwon, Byung-Ki;Ahn, Hyoung-Joon;Kang, Jin-Kyu;Kim, Chong-Youl;Choi, Jong-Hoon
    • Journal of Oral Medicine and Pain
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    • v.31 no.4
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    • pp.283-296
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    • 2006
  • Along with the development of scientific technologies, health care has been growing remarkably, and as the social life quality improves with increasing interest in health, the demand for medical service is rapidly increasing. However, medical accident and medical dispute also are rapidly increasing due to various factors such as, increasing sense of people's right, lack of understanding in the nature of medical practice, over expectation on medical technique, commercialize medical supply system, moral degeneracy and unawareness of medical jurisprudence by doctors, widespread trend of mutual distrust, and lack of systematized device for solution of medical dispute. This study analysed 30 cases of civil suit in the year between 1994 to 2004, which were selected among the medical dispute cases in dental field with the judgement collected from organizations related to dentistry and department of oral medicine, Yonsei university dental hospital. The following results were drawn from the analyses: 1. The distribution of year showed rapid increase of medical dispute after the year 2000. 2. In the types of medical dispute, suit associated with tooth extraction took 36.7% of all. 3. As for the cause of medical dispute, uncomfortable feeling and dissatisfaction with the treatment showed 36.7%, death and permanent damage showed 16.7% each. 4. Winning the suit, compulsory mediation and recommendation for settlement took 60.0% of judgement result for the plaintiff. 5. For the type of medical organization in relation to medical dispute, 60.0% was found to be the private dental clinics, and 30.0% was university dental hospitals. 6. For the level of trial, dispute that progressed above 2 or 3 trials was of 30.0%. 7. For the amount of claim for damage, the claim amounting between 50 million to 100 million won was of 36.7%, and that of more than 100 million won was 13.3%, and in case of the judgement amount, the amount ranging from 10 million to 30 million won was of 40.0%, and that of more than 100 million won was of 6.7%. 8. For the number of dentist involved in the suit, 26.7% was of 2 or more dentists. 9. For the amount of time spent until the judgement, 46.7% took 11 to 20 months, and 36.7% took 21 to 30 months. 10. For medical malpractice, 46.7% was judged to be guilty, and 70% of the cases had undergone medical judgement or verification of the case by specialists during the process of the suit. 11. In the lost cases of doctors(18 cases), 72.2% was due to violence of carefulness in practice and 16.7% was due to missing of explanation to patient. Medical disputes occurring in the field of dentistry are usually of relatively less risky cases. Hence, the importance of explanation to patient is emphasized, and since the levels of patient satisfaction are subjective, improvement of the relationship between the patient and the dentist and recovery of autonomy within the group dentist are essential in addition to the reduction of technical malpractice. Moreover, management measure against the medical dispute should be set up through complement of the current doctors and hospitals medical malpractice insurance which is being conducted irrationally, and establishment of system in which education as well as consultation for medical disputes lead by the group of dental clinicians and academic scholars are accessible.

Discussion on the Necessity of the Study on the Principle of 'How to Mark an Era in Almanac Method of Tiāntǐlì(天體曆)' Formed until Han dynasty (한대(漢代) 이전에 형성된 천체력(天體曆) 기년(紀年) 원리 고찰의 필요성에 대한 소론(小論))

  • Seo, Jeong-Hwa
    • (The)Study of the Eastern Classic
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    • no.72
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    • pp.365-400
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    • 2018
  • The signs of $G{\bar{a}}nzh{\bar{i}}$(干支: the sexagesimal calendar system) almanac, which marked each year, month, day and time with 60 ordinal number marks made by combining 10 $Ti{\bar{a}}ng{\bar{a}}ns$(天干: the decimal notation to mark date) and 12 $D{\grave{i}}zh{\bar{i}}s$(地支 : the duodecimal notation to mark date), were used not only as the sign of the factors affecting the occurrence of a disease and treatment in the area of traditional oriental medicine, but also as the indicator of prejudging fortunes in different areas of future prediction techniques.(for instance, astrology, the theory of divination based on topography, four pillars of destiny and etc.) While theories of many future predictive technologies with this $G{\bar{a}}nzh{\bar{i}}$(干支) almanac signs as the standard had been established in many ways by Han dynasty, it is difficult to find almanac discussion later on the fundamental theory of 'how it works like that'. As for the method to mark the era of $Ti{\bar{a}}nt{\check{i}}l{\grave{i}}$(天體曆: a calendar made with the sidereal period of Jupiter and the Sun), which determines the name of a year depending on where $Su{\grave{i}}x{\bar{i}}ng$(歲星: Jupiter) is among the '12 positions of zodiac', there are three main ways of $$Su{\grave{i}}x{\bar{i}}ng-J{\grave{i}}ni{\acute{a}}nf{\check{a}}$$(歲星紀年法: the way to mark an era by the location of Jupiter on the celestial sphere), $$T{\grave{a}}isu{\grave{i}}-J{\grave{i}}ni{\acute{a}}nf{\check{a}}$$ (太歲紀年法: the way to mark an era by the location facing the location of Jupiter on the celestial sphere) and $$G{\bar{a}}nzh{\bar{i}}-J{\grave{i}}ni{\acute{a}}nf{\check{a}}$$(干支紀年法: the way to mark an era with Ganzhi marks). Regarding $$G{\bar{a}}nzh{\bar{i}}-J{\grave{i}}ni{\acute{a}}nf{\check{a}}$$(干支紀年法), which is actually the same way to mark an era as $$T{\grave{a}}isu{\grave{i}}-J{\grave{i}}ni{\acute{a}}nf{\check{a}}$$(太歲紀年法) with the only difference in the name, there are more than three ways, and one of them has continued to be used in China, Korea and so on since Han dynasty. The name of year of $G{\bar{a}}nzh{\bar{i}}$(干支) this year, 2018, has become $W{\grave{u}}-X{\bar{u}}$(戊戌) just by 'accident'. Therefore, in this discussion, the need to realize this situation was emphasized in different areas of traditional techniques of future prediction in which distinct theories have been established with the $G{\bar{a}}nzh{\bar{i}}$(干支) mark of year, month, day and time. Because of the 1 sidereal period of Jupiter, which is a little bit shorter than 12 years, once about one thousand years, 'the location of Jupiter on the zodiac' and 'the name of a year of 12 $D{\grave{i}}zh{\bar{i}}s$(地支) marks' accord with each other just for about 85 years, and it has been verified that recent dozens of years are the very period. In addition, appropriate methods of observing the the twenty-eight lunar mansions were elucidated. As $G{\bar{a}}nzh{\bar{i}}$(干支) almanac is related to the theoretical foundation of traditional medical practice as well as various techniques of future prediction, in-depth study on the fundamental theory of ancient $Ti{\bar{a}}nt{\check{i}}l{\grave{i}}$(天體曆) cannot be neglected for the succession and development of traditional oriental study and culture, too.