Background: The number of elderly patients undergoing coronary artery bypass grafting (CABG) is increasing. Elderly patients are at increased risk for a variety of perioperative complications and mortality. We identified determinants of operative complications and mortality in elderly patients undergoing CABG. Material and Method: Between January 1995 and July 2003, 91 patients older than 75 years underwent isolated CABG at Asan Medical Center. There were 67 men and 24 women with mean age of $77.0\pm2.4$ years. Thirty clinical or hemodynamic variables hypothesized as predictors of operative mortality were evaluated. Result: CABG was performed under emergency conditions in 5 patients. The internal thoracic artery was used in 85 patients and 10 patients received both internal thoracic arteries. The mean number of distal anastomosis was 3.7 per patient. Operative mortality was $3.3\%$. Twenty-two patients had at least one major postoperative complication. Low cardiac output syndrome was the most common complication, followed by reoperation for bleeding, pulmonary dysfunction, perioperative myocardial infarction, stroke, acute renal failure, ventricular arrhythmia, upper gastrointestinal bleeding, infection, and delayed sternal closure. None were the predictors of mortality. Renal failure, peripheral vascular disease, emergency operation, recent myocardial infarction, congestive heart failure, New York Heart Association (HYHA) class III or IV, Canadian Cardiovascular Society (CCS) angina scale III or IV, and low left ventricle ejection fraction below $40\%$ were univariate predictors of overall complications. Actuarial probability of survival was $94.9\%,\;89.8\%,\;and\;83.5\%$ at postoperative 1, 3 and 5 years respectively. During the follow-up period $93.3\%$ of patients were in NYHA class I, or II and $91.1\%$ were free from angina. Conclusion: Although operative complication is increased, CABG can be performed with an acceptable operative mortality and excellent late results in patients older than 75 years.
Preferential flow has recently been the subject of increasing interest because these phenomena contribute to solute transport in soils. Commonly, preferential flow paths are associated with macropores or highly structured soils. We presented an analysis of the measured breakthrough curves (BTCs) of $Cl^-$ and $Cu^{2+}$ ions to test the occurrence of preferential flow in soils using miscible displacement technique under steady flow conditions. We also analyzed soil water retention curves and from this curves induced cumulative pore size distribution of undisturbed soils, which sampled from Ap1, B1, and C horizons of Songjeong series soils (the fine loamy, mesic family of Typic Hapludults). In this study, miscible displacement experiment on C horizon was excluded, because it is structureless sandy loam with saturated hydraulic conductivity of $5.2cmhr^{-1}$. The saturated hydraulic conductivity of Ap1 horizon was $2.0cmhr^{-1}$, which was about 7 times higher than that of B1 horizon ($0.27cm hr^{-1}$). Cumulative pore size distribution predicted that Ap1 horizon had more macropores (pore diameter larger than $49{\mu}m$, equivalent to -6 kpa of soil matric potential) than B1 horizon. The hydrodynamic dispersion coefficient from chloride BTCs was estimated as $1.3cm^2hr^{-1}$ for B1 and $34cm^2hr^{-1}$ for Ap1 horizon. However the retardation factors of B1 and Ap1 horizon were significantly different, i.e. 1 and 0.6, respectively, which means that there was distinct partition between mobile water and immobile phase in Ap1 horizon. The copper retardation effect of Ap1 horizon was less than that of B1 horizon, even though cation exchange capacity of Ap1 horizon was higher than that of B1 horizon. Thus, breakthrough curves of $Cl^-$ and $Cu^{2+}$ obviously showed the probability that preferential flow would occur in Ap1 horizon.
Ten patients with deep muscle-invading bladder carcinoma (clinical stages T3a to T4b) who were not candidates for cystectomy were treated with combined modality treatment with transurethral resection, cisplatin chemotherapy and pelvic irradiation from 1989 through 1990, and were analyzed retrospectively. All patients were not candidates for cystectomy because the tumors were judged unresectable or they were not fit for a radical cystectomy. Of the patients 5 had clinical stage T3a, 3 stage T3b and 2 stage T4b disease. The minimum follow-up was 16 months. The complete response rate is 60$\%$ for all patients. The complete responses were achieved in 4 of 5(80$\%$) with stage cT3a, in 2 of 3(67$\%$)with stage cT3b and in none of 2(0$\%$) with stage cT4b. The partial responses were achieved in 2, so an overall response rate was 80$\%$. All six patients with grade I or II transitional cell carcinoma showed complete responses. Four patients with higher grade tumors showed partial responses in 2 and no response in 2, and all died of their bladder cancer. Six patients who showed complete responses after treatment are alive and only one of them showed a local recurrence 10 months after treatment. Distant metastases developed in 3 patients: lungs in 2(cT4b) of those who were never locally free of disease and spine in 1 patient (cT3b) among those with a partial response. Two patients died of metastases to lungs. During the follow-up diarrhea occurred in one which was improved after conservative treatment. On the basis of this analysis it is suggested that combined modality treatment seems to be a tolerable regimen and can be offered with a relatively high probability of success and conservation of bladder function in those with less advanced tumors by clinical stage and low grade.
Puroose: This study evaluated the late rectal complications in cervix cancer patients following treatment with external beam radiotherapy (EBRT) and high dose rate intracavitary radiation (HDR ICR). The factors affecting the risk of developing late rectal complications and its incidence were analyzed and discussed. Materials and Methods: The records of 105 patients with cervix cancer who were treated with radical radiotherapy using HDR ICR between July, 1995 and December, 2001 were retrospectively reviewed. The median dose of EBRT was 50.4Gy $(41.4{\sim}56.4 Gy)$ with a daily fraction size of 1.8Gy. A total of $5{\sim}7$ (median: 6) fractions of HDR ICR were given twice weekly with a fraction size of $4{\sim}5 Gy$ (median: 4Gy) to A point using an Ir (Iridium)-192 source. The median dose of ICR was 24 Gy $(20{\sim}35 Gy)$. During HDR ICR, the rectal dose was measured in vivo by a semiconductor dosimeter. The median follow-up period was 32 months, ranging from 5 to 84 months. Results: Of the 105 patients, 12 patients (11%) developed late rectal complications: 7 patients with grade 1 or 2, 4 patients with grade 3 and 1 patient with grade 4. Rectal bleeding was the most frequent chief complaint. The complications usually began to occur $5{\sim}32$ (median: 12) months after the completion of radiotherapy. Multivariate analysis revealed that the measured cumulative rectal BED over 115 Gy3 (Deq over 69 Gy) and the depth (D) of a 5 Gy isodose volume more than 50 mm were the independent predictors for late rectal complications. Conclusion: With evaluating the cumulative rectal BED and the depth of a 5 Gy isodose volume as predictors, we can individualize treatment planning to reduce the probability of late rectal complications.
This study investigates the effect of organic certification of apples on consumer preference in China as a way to support the expanded export of Korean apples to China. A choice experiment was designed to analyze the apple consumption in China. A total of 298 Chinese consumers answered the survey, and multinomial logit models were used to analyze the results. Organic certification was identified as an important determinant of consumer preference for apples in China, affecting both the evaluation and choice of country of origin. The results also indicated that Korean organic certification significantly increased the probability of Chinese consumers choosing Korean apples. Thus, organic certification by the Korean government should be strengthened to promote apple exports to China, plus the results of this study may provide useful information to promote agricultural product exports and improve the organic certification system.
Purpose: This study was designed to determine the relationship between health behaviors and high levels of low-density lipoprotein-cholesterol (LDL-cholesterol) according to cardiovascular risk factors among Korean adults. Methods: This cross-sectional study was based on the sixth Korea national health and nutrition examination survey (KNHANES VI). Participants were 13,841 adults aged 19 years and older. Cardiovascular risk factors were stroke, myocardial infarction or angina, diabetes mellitus, smoking, hypertension, aging, high density lipoprotein-cholesterol (HDL-cholesterol) under 40 mg/dL and HDL-cholesterol over 60 mg/dL. Cardiovascular risk groups were classified as very high risk (stroke, myocardial infarction or angina), high risk (diabetes mellitus), moderate risk (over 2 risk factors), and low risk (below 1 risk factor). The prevalence of high LDL-cholesterol was calculated using the LDL-cholesterol target level according to cardiovascular risk group. Results: The prevalence of high LDL-cholesterol was 25.5% in males and 21.7% in females. Complex sample cross tabulation demonstrated that the high LDL-cholesterol and normal groups differed significantly according to age, education, body mass index, percentage of energy from carbohydrate, fat, saturated fat and n-6 in males and females. These two groups were also significantly different according to smoking in males and the percentage of energy from n-3 in females. Complex sample multiple logistic regression analysis adjusted for multiple confounding factors demonstrated that the probability of high LDL-cholesterol was significantly associated with current smoking (OR: 1.66, 95% CI: 1.40-1.99), obesity (OR: 1.95, 95% CI: 1.64-2.31) in males, and current smoking (OR: 1.73, 95% CI: 1.19-2.52), obesity (OR: 1.63, 95% CI: 1.39-1.90), percentage of energy from n-3 (quartile 1 vs. quartile 2; OR: 0.77, 95% CI: 0.62-0.96; quartile 1 vs. quartile 3; OR: 0.73, 95% CI: 0.56-0.94; quartile 1 vs. quartile 4: OR: 0.67, 95% CI: 0.51-0.87) in females. Conclusion: This study reveals the impact of smoking, obesity, energy percentage of nutrient intake on LDL-cholesterol.
Kim, Chul-Gyum;Lee, Jeongwoo;Lee, Jeong Eun;Kim, Nam Won;Kim, Hyeonjun
Journal of Korea Water Resources Association
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v.54
no.9
/
pp.731-745
/
2021
In this study, the monthly temperature of the Han River basin was predicted by statistical multiple regression models that use global climate indices and weather data of the target region as predictors. The optimal predictors were selected through teleconnection analysis between the monthly temperature and the preceding patterns of each climate index, and forecast models capable of predicting up to 12 months in advance were constructed by combining the selected predictors and cross-validating the past period. Fore each target month, 1000 optimized models were derived and forecast ranges were presented. As a result of analyzing the predictability of monthly temperature from January 1992 to December 2020, PBIAS was -1.4 to -0.7%, RSR was 0.15 to 0.16, NSE was 0.98, and r was 0.99, indicating a high goodness-of-fit. The probability of each monthly observation being included in the forecast range was about 64.4% on average, and by month, the predictability was relatively high in September, December, February, and January, and low in April, August, and March. The predicted range and median were in good agreement with the observations, except for some periods when temperature was dramatically lower or higher than in normal years. The quantitative temperature forecast information derived from this study will be useful not only for forecasting changes in temperature in the future period (1 to 12 months in advance), but also in predicting changes in the hydro-ecological environment, including evapotranspiration highly correlated with temperature.
The purpose of this study is to present empirical evidence for discussion of financing social welfare via estimating optimal tax burden in the main member countries of the OECD by using Hausman-Taylor method considering endogeneity of explanatory variables. Also, the author produced an international tax comparison index reflecting theoretical hypotheses on revenue-expenditure nexus within a model to compare real tax burden by countries and to examine feasibility of tax increase in Korea. As a result of the analysis, the higher the level of tax burden was, the higher the level of welfare expenditure was, indicating the connection between high burden and high welfare from the aspect of scale. The results also indicated that the subject countries recently entered into the state of low tax burden. Meanwhile, Korea had maintained low burden until the late 1990s but the tax burden soared up since the financial crisis related to the IMF. However, due to the impact of foreign economy and the tax reduction policy, it reentered into the low-burden state after 2009. On the other hand, the degree of social welfare expenditure's reducing tax burden has been gradually enhanced since the crisis. In this context, the current optimal tax burden ratio of Korea as of 2010 may be 25.8%~26.5% of GDP based on input of welfare expenditure variables, a percent that Korea was investigated to be a 'high tax burden-low ITC' country whose tax increase of 0.7~1.4%p may be feasible and that the success of tax system reform for tax increase might be higher probability when compare to others. However, measures of increasing social security contributions and consumption tax were analyzed to be improper from the aspect of managing finance when compared to increase in other tax items, considering the relatively higher ITC. Tax increase is not necessarily required though there may be room for tax increase; the optimal tax burden ratio can be understood as the level that may be achieved on average when compared to other nations, not as the "proper" level. Thus, discussion of tax increase should be accompanied with comprehensive understanding of models of economic developmental difference from nations and institutional & historical attributes included in specific tax mix.
Kim, Seongcheol;Gwon, Da Yeong;Jeon, Yeoryeong;Han, Jiyoung;Kim, Yongmin
The Korean Journal of Nuclear Medicine Technology
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v.25
no.2
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pp.41-47
/
2021
Purpose There are many cyclotrons compared to the land area of the Republic of Korea. Because GMP certification is required and the nuclear medicine test does not apply for insurance, the number of examinations for nuclear medicine is decreasing. Therefore, there is a high probability of early decommissioning of the cyclotron. However, we do not unusually perform the radioactivation evaluation on concrete that can be classified as radioactive waste during the decommissioning of the cyclotron. In this study, we aim to confirm the radioactivation in the concrete surface using Handheld Radionuclide Identification Devices (RIDs). Materials and Methods Because there is no cyclotron being decommissioning in the Republic of Korea, it was impossible to perform the coring of concrete for radioactivation analysis. In this study, we used the KIRAMS-13 and analyzed the concrete surface in the target direction in the cyclotron room. After setting the target direction as the center, radionuclides were measured for about five months at thirty points with vertical and horizontal intervals of 30 cm. We used the RIIDEye(Detector: NaI(Tl) detector, manufacturer: Thermo) in this study and set the measurement time per point to one day (24 hours). Results Co-60 and Cs-137 were detected in some measurement points, and we confirmed the radioactivity of Co-60 detected at the most points. As a result, we found that the radioactivity of Co-60 was high in the diagonal direction (from the lower-left direction to the upper right direction) based on the center of the target. However, we think it is impossible to apply the corresponding results to all cyclotrons because we performed the study using only one cyclotron. Conclusion In thirty measurement points, we could confirm the radioactive nuclides and the relative radioactivity using the results of portable nuclides analyzer. Therefore, we expect that we can use the portable nuclides analyzer to select the coring position of concrete during the decommissioning of the cyclotron. Also, if we secure the radioactivation data for several years, we expect to make a more accurate estimate of radioactive waste during the preparation period of decommissioning of the cyclotron.
Space is becoming more commercialized. Despite of its delayed start-up, space activities in Korea are attracting more nation-wide supports from both investors and government. May 25, 2023, KSLV II, also called Nuri, successfully transported, and inserted seven satellites to a sun-synchronous orbit of 550 km altitude. However, Starlink has over 4,000 satellites around this altitude for its commercial activities. Hence, it is necessary for us to constantly monitor the collision risks of these satellites against resident space objects including Starlink. Here we report a quantitative research output regarding the conjunctions, particularly between the Nuri satellites and Starlink. Our calculation shows that, on average, three times everyday, the Nuri satellites encounter Starlink within 1 km distance with the probability of collision higher than 1.0E-5. A comparative study with KOMPSAT-5, also called Arirang-5, shows that its distance of closest approach distribution significantly differs from those of Nuri satellites. We also report a quantitative analysis of collision-avoiding maneuver cost of Starlink satellites and a strategy for Korea, being a delayed starter, to speed up to position itself in the space leading countries. We used the AstroOne program for analyses and compared its output with that of Socrates Plus of Celestrak. The two line element data was used for computation.
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