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The Long-term Clinical Outcomes after Coronary Artery Bypass Graft Surgery (관상동맥 우회술의 장기 임상성적)

  • Park, Chan Beom;Jo, Min-Seop;Kim, Young-Du;Jin, Ung;Moon, Seok-Whan;Kim, Chi-Kyung;Jo, Keon Hyon
    • Journal of Chest Surgery
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    • v.42 no.1
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    • pp.22-27
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    • 2009
  • Background: Coronary artery bypass grafting (CABG) is the standard surgical treatment for coronary artery disease. Although there are many clinical reviews of the long term results after CABG in the Western countries, not many such studies have been done for Korea. Therefore, we reviewed the long term clinical results for the patients who underwent CABG at our hospital. Material and Method: We retrospectively reviewed the medical records of 342 patients who underwent CABG at our hospital from February 1984 to December 2006, which is when CABG was first performed in our institution. A total of 286 patients (83.6%) were able to be followed-up, and the mean follow-up period was $75.7{\pm}46.1$ months. Result: The early mortality rate was 5.6%, and late mortality rate was 23.1%. The one-year survival rate, the five-year survival rate, the ten-year survival rate and the fifteen-year survival rate were 91.5%, 82.1%, 60.7% and 50.0%, respectively. The survival rate was significantly lower for the patients over the age of 60 (p=0.002) and for those with diabetes mellitus (p=0.000), hypertension (p=0.002), multivessel disease (p=0.006) and left ventricular dysfunction (p=0.015). No significant difference was observed between the genders. Multivariate analysis showed that the statistically significant risk factors were diabetes mellitus (p=0.001), age (p=0.005) and those cases for which the left internal thoracic artery was not used (p=0.037). Conclusion: CABG is the effective method of treatment for coronary artery disease. Therefore, active usage of the internal thoracic artery and appropriate medical treatment after surgery, and especially for diabetes mellitus patients, are mandatory for achieving good long-term survival.

A Comparative Study on Injury Severity, Self esteem, Health Locus of control and Health Promotion Lifestyles between Helmeted and Nonhelmeted Motorcycle Accident Victims (오토바이 사고환자의 안전모 착용여부에 따른 뇌 손상비교와 자아존중감, 건강통제위 성격, 건강증진행위의 비교연구)

  • 최스미
    • Journal of Korean Academy of Nursing
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    • v.23 no.4
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    • pp.585-601
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    • 1993
  • Data on 63 patients who had had motorcycle accidents and who were admitted to four general hospitals in the Chung Chung Nam Do area from July / 1993 to August 1993 were analyzed. The tool used for this study was a structured questionnaire which consisted of ten items on self- esteem, 18 items on health locus of control and 37 items profiling health prometion lifestyle. Injury severity scores were calculated bated based on data from the patients’ medical records. The collected data were analyzed using the SPSS, yielding descriptive statistics, t-test, ANOVA, Pearson’s Product Moment Correlation. The findings of this study are as follows. 1) Of the 63 injured motorcyclists, 35(55.6%) were helmeted and 28(44.4%) were nonhelmeted, and the nonhelmeted motorcyclists were predominantly young and male. The demographic variables for the helmeted and nonhelmeted groups were heterogeneous for age and occupation. 2) The results of the comparison between the two groups showed a statistically significant difference in the injury severity score(t=-4.70, p=0.000). The helmeted group had lower scores on injury severity score (9.00±3.93) than the nonhelmeted group(14.32土5.05). More than 60% of the nonhelmeted motorcyclists had brain injuries compared to only a third of the helmeted cyclists. 3) There .was a statistically significant difference between the two groups on self esteem(t=4.5, 000). The helmeted group had a higher mean score (31.27±2.72) than the nonhelmeted group(27.46±3.80). 4) The means for Internal health locus of control (IHLC), Powerful others health locus of control (PHLC), and Chance health locus of control (CHLC) in the two groups were similar to instrument norms reported in other literature. The mean scores on the IHLC in the two groups were higher than scores on the PHLC or the CHLC. However, there was a significant difference between the mean scores for the two groups on the PHLC (t=2.85, P=0.006). 5) The mean score for the helmeted group on the health promotion lifestyle profile was higher than the mean score for the nonhelmeted group(107.30±11.10, 96.57土 15.54 respectively), and there was a significant difference between the mean scores (t=3.64, p=0.001) . The highest score for helmeted group on the health promotion lifestyle profile was in the health care domain. However, for the nonhelmeted group the highest score was in the exercise domain and the lowest score was in the health care domain. 6) With regard to the relationship between health promotion lifestyle, health locus of control and self esteem in the two groups, the correlation coefficient between health promotion lifestyle and internal health locus of control for the helmeted group was 50(p〈0.01). For the nonhelmeted group, there was no correlation between health promotion lifestyle and internal health locus of control. However, there were significant correlation between health pro-motion lifestyle and external locus of control(r=0. 46, p〈0.01), and self esteem(r=0.495, p〈0.01). 7) Among the demographic variables, age and education had an impact on individual’s self-esteem The modifying factors of age made a contribution to explaining health - promoting lifestyle. In the present study, more than 40% rf the motorcyclists were riding without a helmet. The incidence of brain injury for patients riding without a helmet was nearly twice as high in the nonhelmeted rider as compared to the helmeted rider. The nonhelmeted motorcyclists in this study had lower self-esteem, obtained a higher score on the IHLC, and were not strongly engaged in performing health promotion activities as compared to the helmeted riders. However, some of the nonhelmeted riders who had a strong belief in PHLC were positively associated with engaging in health promotion activities. Based on the results obtained from this study, strategies to promote helmet usage for motorcyclists have to be developed.

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Analysis of Prenatal and Postnatal Factors Associated with Complications and Prognosis in Premature Infants with Leukemoid Reaction (백혈병양반응을 보인 미숙아의 합병증과 예후에 관한 산전과 산후 인자에 대한 분석)

  • Kwon, Se-Ho;Lee, Byoung-Kook;Lee, Heun-Ji;Na, So-Young;Lee, Jung-Ha;Park, Su-Yeon;Kang, Eun-Kyeung;Kim, Do-Hyeon;Lee, Kwan;Kim, Hee-Sup
    • Neonatal Medicine
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    • v.15 no.2
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    • pp.151-159
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    • 2008
  • Purpose : This study determined the prenatal and postnatal factors associated with complications and prognosis in premature infants with leukemoid reaction. Methods : We retrospectively reviewed the medical records of premature infants with gestational ages <37 weeks and low birth weights (<2,500 g) who were admitted immediately after birth to the neonatal intensive care unit at the Dongguk University Ilsan Hospital between June 2005 and July 2006. A leukemoid reaction was defined as an absolute neutrophil count (ANC) >30,000/$mm^3$. The infants who had leukemoid reaction comprised the study group, while the remainder of infants made up the control group. The relationships between maternal and neonatal variables and ANC were studied. Results : Leukemoid reaction was detected in 3.1% of the study infants (8 of 252). Factors more frequently associated with infants with leukemoid reaction were as follows: maternal chorioamnionitis, high levels of maternal and infant C-reactive protein, gestational age <37 weeks, birth weight <2,500 g, low Apgar score, prolonged ventilator support, and a high incidence of bronchopulmonary dysplasia (BPD). However, there were no significant differences with respect to the antenatal usage of steroids, the incidences of patent ductus arteriosus, necrotizing enterocolitis, intraventricular hemorrhage, retinopathy of prematurity, and mortality between the two groups. Conclusion : Leukemoid reaction in premature infants was associated with chorioamnionitis and high levels of serum C-reactive protein in mothers and infants, and BPD in infants. These findings suggest that leukemoid reaction is secondary to inflammation caused by infection.

Compliance of Nasal Continuous Positive Airway Pressure in Patients with Obstructive Sleep Apnea Syndrome (폐쇄성 수면무호흡증 환자의 지속적 상기도 양압술 순응도)

  • Choi, Jong-Bae;Lee, Seung-Hee;Jeong, Do-Un
    • Sleep Medicine and Psychophysiology
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    • v.13 no.1
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    • pp.27-32
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    • 2006
  • Objectives: Nasal continuous positive airway pressure (nCPAP) is the treatment of choice and has been shown to reduce the frequency of nocturnal respiratory events, improve sleep architecture, and decrease daytime sleepiness in patients with obstructive sleep apnea syndrome (OSAS). However, little is known about the compliance of nCPAP treatment in Korea. Our objective was to look into the nCPAP compliance and examine the factors influencing it. Methods: We reviewed the records of one hundred and twenty consecutive patients with OSAS referred for nocturnal polysomnography with nCPAP pressure titration during the period of January 1995 through April 1999 to the Seoul National University Hospital. We performed a telephone interview and obtained data from eighty-three patients. Results: In sixty patients who had accepted nCPAP treatment, twenty-six patients (43.3%) were still using nCPAP device, while thirty-four patients (56.7%) stopped using it. Fifteen patients (25%) were using nCPAP device everyday. In thirty-four patients who discontinued nCPAP use, twenty-five patients (73.5%) did within the first three months, and thirty-one (91.2%) within the first year. Significant predictor of long-term nCPAP use was the presence of subjective daytime sleepiness before nCPAP application. Conclusions: Long-term compliance with nCPAP treatment appears to be associated with the presence of subjective daytime sleepiness before nCPAP application. Long-term compliance with nCPAP may be mostly predicted from the usage pattern within the first three months of use.

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Changing Aspects of the Wall Types of Hahoe Village (하회마을 담장 형태의 변화양상)

  • Kim, Dong-Hyun;Lee, Won-Ho
    • Journal of the Korean Institute of Landscape Architecture
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    • v.45 no.5
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    • pp.87-96
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    • 2017
  • This study focuses on the Andong Hahoe Village and seeks to identify the shape of the walls since the 1970s. The change of walls can be divided into four periods based on characteristics of materials, shape and distribution. The following is a summary of the results: First, In the 1970s, when Andong Hahoe Village was not designated as a cultural heritage, roof tiles hung on the earthen walls in the middle of the village were major forms. On the outside of the village, rice straw and pine needles were put on the earthen walls or bush clover walls were put in place around if walls were not built. Second, after being designated as a cultural heritage in the 1980s, readjustments for cultural heritages were carried out at the primary stage. However, the distribution of cultural heritages and major changes were not determined at this time since readjustments were mainly focused on the renovation of derelict houses or maintenance of infrastructures. Third, in the past the use of stone bricks for the Hahoe Village site had been difficult, but in the 1990s, replacements with soil-stone walls were identified and the usage of roof tiles increased. The portion of earthen walls, which used to be the major form in the prior era, decreased and this seems to have continued until the 2000s. Fourth, via a field survey, it was found that most of Hahoe village walls consisted of soil cement bricks mixed with cement, steel, lime, gravel. etc. Also, the scope of straw-stricken walls and bush clover walls were reduced to a section of area outside of the village. Fifth, from the 1970s to the present, there were changes to the walls in Hahoe Village including an increase in usages of new materials and an expansion of houses with tiled roofs on top in accordance with the replacement of walls of existing houses. Relevant reasons for this have been identified, such as the fading value of Fungsui(風水) and lack of original records, insufficient awareness and expertise in non-building areas, and the relationship between residents on repairing the wall.

Urinary Tract Infection Following Voiding Cystourethrography (배뇨 방광 요도 조영술 시행 후 발생하는 요로 감염에 대한 고찰)

  • Ryu, Jung-Min;Ahn, Yo-Han;Lee, So-Hee;Choi, Hyun-Jin;Lee, Beom-Hee;Kang, Hee-Gyung;Ha, Il-Soo;Cheong, Hae-Il;Choi, Yong
    • Childhood Kidney Diseases
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    • v.12 no.2
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    • pp.194-201
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    • 2008
  • Purpose : Voiding cystourethrography(VCUG) is required to detect vesicoureteral reflux(VUR), which may manifest as urinary tract infection(UTI) in children. It is well known that VCUG can cause UTI(post-VCUG UTI). In this study, risk factors for post-VCUG UTI and the preventive effect of antibiotics against this complication of VCUG were explored. Methods : Medical records of 284 patients who underwent VCUG at our hospital in 2007 were reviewed retrospectively. The incidence of post-VCUG UTI and risk factors for post-VCUG UTI, and the impact of antibiotic use on prevention of post-VCUG UTI were evaluated. According to antibiotics usage, we divided the enrolled patients into 4 groups of noantibiotics group, prophylactic antibiotics group(prophylactic antibiotics having been used before), antibiotics-for-VCUG group(antibiotics added for VCUG) and antibiotics-for-treatment group(treatment dose of antibiotics). Results : Seven of 284 children(2.5%) developed UTI after they underwent VCUG. Highgrade(grade$\geq$III) VUR was the only statistically significant risk factor(odds ratio[OR] 6.266, P=0.026) for post-VCUG UTI, while sex, age, and other anomalies of urinary system were not significant. Five post-VCUG UTI cases belonged to prophylactic antibiotics group. Antibiotics use (three groups using antibiotics vs. no-antibiotics group) or addition of antibiotics for VCUG (antibiotics-for-VCUG vs. other groups) did not have any effect on prevention of post-VCUG UTI. Conclusion : The risk factor for post-VCUG UTI was high-grade VUR. Antibiotics use did not prevent post-VCUG UTI in this study.

Surgical Treatment for Carotid Artery Stenosis (경동맥 협착증의 수술적 치료)

  • Kim, Dae-Hyun;Yi, In-Ho;Youn, Hyo-Chul;Kim, Bum-Shik;Cho, Kyu-Seok;Kim, Soo-Cheol;Hwang, Eun-Gu;Park, Joo-Chul
    • Journal of Chest Surgery
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    • v.39 no.11 s.268
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    • pp.815-821
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    • 2006
  • Background: Carotid endarterectomy is an effective treatment modality in patients with severe carotid artery stenosis, but it may result in serious postoperative complications, We analyzed the results of the carotid endarterectomy performed in our institution to reduce the complications related to the card endarterectomy. Material and Method: We analyzed retrospectively the medical records of 74 patients(76 cases) who underwent carotid endarterectomy for carotid artery stenosis by a single surgeon from February 1996 to July 2004. Result: There were 64 men and 10 women. The mean age of the patients was 63.6 years old. Carotid endarterectomy only was performed in 63 cases, carotid endarterectomy with patch angioplasty in 8 cases, and carotid endarterectomy with segmental resection of internal carotid artery and end to end anastomosis in 5 cases. Intra-arterial shunt was used in 29 cases. The mean back pressures of internal carotid arteries checked after clamping common carotid arteries and external carotid arteries were $23.48{\pm}10.04$ mmHg in 25 cases with changes in electroencephalography(group A) and $47.16{\pm}16.04$ mmHg in 51 cases without changes in electroencephalography(group B). There was no statistical difference in the mean back pressure of internal carotid arteries between two groups(p=0.095), but the back pressures of internal carotid arteries of all patients with changes in electroencephalography were under 40 mmHg. When there was no ischemic change of electroencephalography after clamping common carotid artery and external carotid artery, we did not make use of intra-arterial shunt regardless of the back pressure of internal carotid artery. Operative complications were transient hypoglossal nerve palsy in four cases, cerebral hemorrhage occurred at previous cerebral infarction site in two cases, mild cerebral infarction in one case, hematoma due to anastomosis site bleeding in one case, and upper airway obstruction due to laryngeal edema probably caused by excessive retraction during operation in two cases. One patient expired due to cerebral hemorrhage occurring at previous cerebral infarction site. Conclusion: Carotid endarterectomy is a safe operative procedure showing low operative mortality. We suggest that intra-arterial shunt usage should be decided according to the ischemic change of electroercephalography regardless of the back pressure of internal carotid artery. Excessive retraction during operation should be avoided to prevent upper alway obstruction due to laryngeal edema and if upper airway obstruction is suspected, prompt management is essential.

A Study on Environmental Traits and Significance of Eouidongji Pond(於義洞池) Area in Dongchon(東村), Hanseong-bu(漢城府) (한성부 동촌(東村) 어의동지(於義洞池) 일대의 환경 특성과 장소적 의미)

  • Gil, Ji-Hye;Son, Yong-Hoon;Hwang, Kee-Won
    • Journal of the Korean Institute of Traditional Landscape Architecture
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    • v.35 no.2
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    • pp.1-14
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    • 2017
  • The purpose of this study is to understand the environmental traits and significance of the pond place that appears in historic maps in 'Dongchon(東村)', which is the eastern section within the fortress wall of Hanyang. We reviewed various documents and maps to identify the name of the pond, and of those materials we followed the name provided by official national records and geographical titles to designate it 'Eouidongji Pond(於義洞池).' The results of the research showed, first, that from the standpoint of location and environmental characteristics, that the area of the Eouidongji Pond was an area that contained a pastoral atmosphere within the city. It was located in an area where the waters flowing from the mountains gathered, and the boundaries of the pond would change based on water levels within a plot of land about 2,000pyeong(app. $6,600m^2$) in size. Second, when seen from the perspective of its creation background, the Eouidongji Pond seems to have been a naturally occurring pond which was modified when the water system was managed in the city at the beginning of the dynasty. In addition to its role as a reservoir, it was operated as a lotus pond(蓮池) to offer lotus(蓮) related by-products. With the nearby detached palace being actively used, it seems the pond was managed at the same time. The pond had already been filled in by the early 20th century, and although there were efforts to reconstruct the pond, it was eventually destroyed as the area was included in the site of a school during the colonial period. Third, the Eouidongji Pond was appreciated in many cases by individuals or admired as part of the natural landscape by viewing it from afar. In addition, it provided entry landscape near the road entering Dongchon, and was a location that was easily visited in connection with other nearby pleasure grounds. Through studying the location and environmental characteristics, the background of its creation and destruction, operation and management by time period, usage at the time, and characteristics of scenery appreciation of Eouidongji Pond, the Eouidongji Pond was a pond of high practical value to the nation, as it supplemented the water system in the city and was able to provide lotus harvests for the nation. In addition, from a urban environment perspective, it was a lateral landmark with a large area, as well as an effective boundary. It was an open area that the people of the Hanseong-bu could freely use, and it had a high public value due to its ease of accessibility.

Improving Performance of Recommendation Systems Using Topic Modeling (사용자 관심 이슈 분석을 통한 추천시스템 성능 향상 방안)

  • Choi, Seongi;Hyun, Yoonjin;Kim, Namgyu
    • Journal of Intelligence and Information Systems
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    • v.21 no.3
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    • pp.101-116
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    • 2015
  • Recently, due to the development of smart devices and social media, vast amounts of information with the various forms were accumulated. Particularly, considerable research efforts are being directed towards analyzing unstructured big data to resolve various social problems. Accordingly, focus of data-driven decision-making is being moved from structured data analysis to unstructured one. Also, in the field of recommendation system, which is the typical area of data-driven decision-making, the need of using unstructured data has been steadily increased to improve system performance. Approaches to improve the performance of recommendation systems can be found in two aspects- improving algorithms and acquiring useful data with high quality. Traditionally, most efforts to improve the performance of recommendation system were made by the former approach, while the latter approach has not attracted much attention relatively. In this sense, efforts to utilize unstructured data from variable sources are very timely and necessary. Particularly, as the interests of users are directly connected with their needs, identifying the interests of the user through unstructured big data analysis can be a crew for improving performance of recommendation systems. In this sense, this study proposes the methodology of improving recommendation system by measuring interests of the user. Specially, this study proposes the method to quantify interests of the user by analyzing user's internet usage patterns, and to predict user's repurchase based upon the discovered preferences. There are two important modules in this study. The first module predicts repurchase probability of each category through analyzing users' purchase history. We include the first module to our research scope for comparing the accuracy of traditional purchase-based prediction model to our new model presented in the second module. This procedure extracts purchase history of users. The core part of our methodology is in the second module. This module extracts users' interests by analyzing news articles the users have read. The second module constructs a correspondence matrix between topics and news articles by performing topic modeling on real world news articles. And then, the module analyzes users' news access patterns and then constructs a correspondence matrix between articles and users. After that, by merging the results of the previous processes in the second module, we can obtain a correspondence matrix between users and topics. This matrix describes users' interests in a structured manner. Finally, by using the matrix, the second module builds a model for predicting repurchase probability of each category. In this paper, we also provide experimental results of our performance evaluation. The outline of data used our experiments is as follows. We acquired web transaction data of 5,000 panels from a company that is specialized to analyzing ranks of internet sites. At first we extracted 15,000 URLs of news articles published from July 2012 to June 2013 from the original data and we crawled main contents of the news articles. After that we selected 2,615 users who have read at least one of the extracted news articles. Among the 2,615 users, we discovered that the number of target users who purchase at least one items from our target shopping mall 'G' is 359. In the experiments, we analyzed purchase history and news access records of the 359 internet users. From the performance evaluation, we found that our prediction model using both users' interests and purchase history outperforms a prediction model using only users' purchase history from a view point of misclassification ratio. In detail, our model outperformed the traditional one in appliance, beauty, computer, culture, digital, fashion, and sports categories when artificial neural network based models were used. Similarly, our model outperformed the traditional one in beauty, computer, digital, fashion, food, and furniture categories when decision tree based models were used although the improvement is very small.

Material composition and change of baekdong alloy in the late Joseon period (조선후기 백동의 재료 구성과 변화)

  • Kong, Sanghui
    • Korean Journal of Heritage: History & Science
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    • v.52 no.3
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    • pp.38-55
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    • 2019
  • The purpose of this study is to clarify the historical flow of baekdong alloy's usage according to the alloying materials mentioned in document records. For this purpose, we first overviewed the use of copper as a base material for white copper alloys and other types of copper alloys. Baekdong is an alloy of copper and other metals and is currently defined as an alloy of copper and nickel. However, depending on the research subjects and time of the scholars, baekdong may be defined as a metal with over a certain percentage of tin added to copper, or as an alloy of tin, zinc, and lead with copper. There is disagreement regarding the interpretation of this term. Baekdong, which started to appear in the literature of the Three Kingdoms Period, has been steadily seen through the Goryeo and Chosun Dynasties to the modern period. It has been used in various ways, according to each age and culture, from the symbol of the office to trading goods, daily life goods, and money. In the literature, baekdong's alloying material is not only copper and nickel, which are currently defined as alloys, but it is the same in that copper is used as the base metal of the alloy, although it varies slightly from generation to generation. In addition to copper, tin, zeolite, and emerald, zinc and lead also appeared. It was found that baekdong, which means alloy, and baekdong, which means white metal, were mixed. Nickel, which is the alloy material of baekdong as it is currently defined, is a metal with a relatively high discovery time and is widely used as a material for modern industrial fields. Nickel was introduced into Korea at the end of the Joseon Dynasty, but its use is not known in detail. In this study, we examined the acceptance and use of nickel-based baekdong in articles of modern newspapers and in statistical data. Based on the experience of craftsmen, we estimated the period when nickel-based alloys were used in crafts. Material is a direct factor in the development and deterioration of technology, and the development of technology is the basis for the changing of civilizations and cultures. In this context, this study was to investigate baekdong with the material of alloys as a starting point.