• Title/Summary/Keyword: thirty years old

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Surgical Repair of Isolated Secundum Atrial Septal Defect - Clinical features, hemodynamic function, early and late results according to age at operation - (이차공형 심방중격결손증의 외과적 치료;연령에 따른 혈류학적 상관관계에 관한 고찰)

  • Lee, S.;Choi, B.C.;Ahn, W.S.;Hur, Y.;Kim, B.Y.;Lee, J.H.;Yu, H.S.
    • Journal of Chest Surgery
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    • v.25 no.11
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    • pp.1318-1326
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    • 1992
  • Backgroud. To determine the influence of age at operation upon surgical outcome in patients with isolated secundum atrial septal defect, retrospective clinical analysis was done. Material and method. From June, 1976 to December, 1991, 146 patients, 63 male and 83 female patients ranging in age from 13 months to 56 years, were operated on for isolated secundum atrial septal defect. The patients were divided into 3 groups according to their age at operation: Group I [<20 years old], 91 patients[62.3%]; Group II [21 to 40 years old], 44 patients[30.1%]; GroupIII[>41 years old], 11 patients[7.6%]. Significant differences in clinical features, hemodynamic function, early and late results between age groups were speculated. Results. One hundred thirty-one patients[89.6%] were symptomatic at the time of operation, the most common symptoms being dyspnea on exertion, recurrent respiratory infection, palpitation and chest pain. Patients in NYHA class III or IV were 3.3% in group I, 25% in groupIII, and 54.5% in group Ill. Hemodynamic data was available for 138 patients [94.5%]. Significant pulmonary hypertension [MPA systolic pressure $^3$ 40mmHg] was noted in 22 patients [15.9%]. Patients with pulmonary vascular disease [Rp/Rs>1.25] were 2% in group I, 7.3% in group Il, and 9.1% in groupIII. But there were no significant differences between the age groups in the size of the shunt or the ratio of pulmonary to systemic flow. Atrial septal defects were closed with direct suture in 144 patients and patch repair was performed in 2 patients with high defect. Atrial arrhythmia [8.2%] was the most common postoperative complication. The mean [LSD] duration of follow-up in all patients was 16$\pm$22 months [range, 1~96 months]. Functional result was excellent regardless of the age groups. During follow-up period, late cardiovascular events were arrhythmia [7 cases], reoperation for recurrent ASD [2 cases], and premature late death due to bacterial endocarditis [1 case]. Incidence of preoperative and late atrial fibrillation was significantly higher in older age group. Conclusion. Age at operation is one of the most important predictor of early and late surgical outcome with its impact on the following factors : 1] hemodynamic alterations and ventricular dysfunction due to longstanding volume and pressure overload, 2] pulmonary vascular disease, and 3] atrial arrhythmia including atrial fibrillation as a result of atrial dilatation. Therefore, among patients with surgically repaired atrial septal defects, those operated on over the age of 20 require careful supervision on the long-term basis.

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Ecological Characteristics of Daphniphyllum macropodum Miq. Community in Naejangsan National Park (내장산국립공원 굴거리나무군락의 생태적 특성)

  • Choi, Song-Hyun;Oh, Koo-Kyoon;Cho, Hyun-Seo;Kang, Hyun-Mi
    • Korean Journal of Environment and Ecology
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    • v.25 no.2
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    • pp.175-188
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    • 2011
  • The purpose of this study was to investigate the vegetation structure of Daphniphyllum macropodum community in the Geumseon Valley area of Naejangsan National Park. To do so, thirty-seven plots($100m^2$) were set up and surveyed. The surveyed plots were divided into four groups according to the analysis of classification by TWINSPAN; (I)Carpinus laxiflora community (II)Carpinus laxiflora community (III)Deciduous Broad-leaved community and (IV)Zelkova serrata community. The results of vegetation structure analysis were; Daphniphyllum macropodum did not appeared in the canopy later but in understory and shrub layer. Even though Daphniphyllum macropodum will not be dominant species in the canopy later, but it was expected that Daphniphyllum macropodum will be major species in understory and shrub layer. The expected age of forest of the Geumseon Valley where Carpinus laxiflora and Zelkova serrata were dominant trees in canopy layer, was about 50 years old while that of Daphniphyllum macropodum in understory layer was 20 years old.

The Study of the Driving Characteristics in Persons With Spinal Cord Injury (척수손상 장애인의 자가운전 특성에 관한 연구)

  • Kim, Su-Il;Rah, Ueon-Woo;Kim, Deog-Young;Bae, Ha-Suk
    • Physical Therapy Korea
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    • v.10 no.2
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    • pp.71-84
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    • 2003
  • The purpose of this study was to provide information on driving characteristics in persons with spinal cord injury through basic statistic analysis of the survey results. The survey was administered to 44 drivers with spinal cord injury. The subjects' general, neurologic and driving characteristics were analyzed, as well as the degree of difficulty in using their vehicles between tetraplegia and paraplegia. The results were as follows: thirty-five (79.6%) of forty-four respondents was men. The average age was 35.0 years old and the age at the time of injury was 29.0 years old. Their neurologic characteristics were tetraplegics 12 (27.3%) and paraplegics 32 (72.2%). Among complete lesions, the highest level those who could drive independently was C7. All the vehicles were equipped with special devices, including "power steering", "automatic transmission" and "hand controls". The vehicles for cervical cord injury were equipped with "grip bars" as well as for the degree of difficulty in using their vehicles, all the subjects felt that "moving the wheelchair in and out of their vehicles" was too difficult for them to do. We suggest that the driver training should be an essential part of the rehabilitation program for patients with spinal cord injuries to maximize their mobility in the community. This training seems to be essential in order to modify the standards of the Handicapped Drivers Ability Test and to aid the driver rehabilitation program in the health insurance payment system. Also, the driver rehabilitation training program should include instruction in that moving wheelchairs in and out of vehicles.

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Three-dimensional Kinematics of Knee Joint in a Complete Gait Cycle: A Comparative Study between Handball Players and Non-athletes

  • Dinesh, Paudel;Back, Jin-Ho
    • Korean Journal of Applied Biomechanics
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    • v.31 no.3
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    • pp.176-182
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    • 2021
  • Objective: The purpose of this study is to investigate whether the athletic knee show greater rotation and translation movement than non-athletic knee during the treadmill walking with their preferred speed in a complete gait cycle. Method: Thirty young and healthy male subjects participated in the study, fifteen handball players (mean age: 19.6 ± 1.4 years old, mean weight: 85 ± 11.9 Kg, mean height: 179.8 ± 4.7) and fifteen non-athletes (mean age: 22.8 ± 1.2 years old, mean weight: 74.5 ± 8.6 Kg, mean height: 175 ± 5.9). Three-dimensional positional coordinate of lower limb during treadmill walking were analyzed. Results: There were significant differences (t (22.014)=1.585, p=0.127 in the range of internal and external rotation with mean value for handball player (M=14.4513, SD=2.3839) was higher than non-athletes (M=13.3327, SD=1.337). The magnitude of the difference in the means (mean difference=1.11867, 95% CI: -0.34489 to 2.5822) was significant. There were also significant differences (t (17.956)=1.654, p=0.116 in the max abduction and adduction with mean value for handball player (M=5.7160, SD=2.49281) was higher than non-athletes (M=4.5773, SD=0.94667). The magnitude of the difference in the means (mean difference=1.138, 95% CI: -0.30805 to 2.58539) was significant. At significance level 0.05. Conclusion: Finding of this study suggest that to understand the actual characteristic of knee motion studies have to be done in different walking and running trial at variable speed.

The Effects of Music Therapy on Vital Sign Changes of operational Patients (음악요법이 수술환자의 활력징후 변화에 미치는 영향)

  • 홍순탁
    • Journal of Korean Academy of Nursing
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    • v.24 no.3
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    • pp.377-388
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    • 1994
  • The purpose of this study was to determine the effects of music therapy on changes in the vital signs of patients about to undergo an operation. The patients listened to the music at a time when they were feeling preoperative anxiety up until the preanesthesia was given in the operating room. The subjects for this study were selected from sixty patients to undergo operations, who were hospitalized at Dong Eui hospital in Pusan city. They were assigned to two groups, thirty to the experimental group and thirty to the control group. The subjects were from 20 years old to 69 years old, and had no other problem except the one requiring the operation, and no premedication. The data were collected during the period from July 1 to September 30, 1993. The method used in this study was to measure state-anxiety on the ward in the morning of the operation, and vital signs immediately before leaving for the operating room. Vital signs were measured immediately before the anesthesia was given and after the experimental group had listened to the music during the ten minutes needed to prepare the operation setting. The control group just waited during ten mimutes. Vital signs were check again before the anesthesia was given. The data were analyzed by descriptive statistics, mean±SD, p-value, and t-test using the SPSS progrom. The results of this study are : 1. Systolic blood pressure taken in the operating room was elevated, over the level measured on the ward, by 5.00 ± 15.26㎜Hg in experimental group and 18.67±14.56㎜Hg in control group. (t=-3.5496, p=.0008) 2. Diastolic blood pressure was elevated by 6.67±12.95㎜Hg in experimental group and 18.67±12. 79㎜Hg in control group. (t=-3.6100, p=.0006) 3. Pulse was elevated by 2.931±9.44 / min in experimental group and 8.03±8.37 /min in control group. (t=-2.2144, p=.0307) 4. Respiration was elevated by 0.60±1.35 /min in experimental group and 1.57±1.48 /min in control group. (t=-2.6409, p=.0106) 5. Body temperature was down by 0.13±1.91'c in experimental group and elevated by 1.13±1.11'c in control group. (t=-3.1471, p=.0026) Thus, in this study there was a statistically significant difference in the change in the vital signs between the experimental group treated with music therapy and the control group which received no treatment. Because music therapy is valuable to decrease the anxiety of patients facing operations, the result of this study support its effect in relieving anxiety as a valuable nursing intervention. From this study, the following recommendations can be made : First, it is necessary to further study music therapy to develope a better system and determine optimal time. Second, it is necessary that more detailed re-search on measurement of changes in vital signs be done to determine changes over time intervals.

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Diameters of the Thoracic Aorta Measured with Multidetector Computed Tomography (다중검출 전산화 단층촬영을 이용하여 측정한 흉부대동맥의 직경)

  • Lee, Gun;Lim, Chang-Young;Lee, Hyeon-Jae
    • Journal of Chest Surgery
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    • v.42 no.1
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    • pp.79-86
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    • 2009
  • Background: Background: Computed tomography (CT) is the main tool for detecting abnormalities of the thoracic aorta, but conventional CT only shows the cross-sectional images. These CT images have some limitations fo accuratly measuring the thoracic aortic diameters at various levels. Multidetector computed tomography (MDCT) overcomes these limitations. We measured the thoracic aortic diameter perpendicular to the loop-shaped thoracic aortic course and this was studied in relation to age, gender, height, weight, the body surface area, the body mass index and the presence of hypertension. Material and Method: Thirty hundred thirty one patients (males: 141 patients and females: 190 patients) who had no abnormalities of the thoracic aorta were investigated using MDCT aortography. They were divided into three age categories: 20~39 years old, 40~59 years old and over age 60. The image was reformed with multiplanar reconstruction and the diameter of the aorta was measured perpendicular to the aortic course at 5 anatomic segments. Level A was the mid-ascending aorta, level B was the distal ascending aorta, level C was the aortic arch, level D was the aortic isthmus and level E was the mid-descending aorta. Result: The mean age was 49.5 years old for males and 54.9 years old for females (p<0.05). The mean diameter of the thoracic aorta at level A was 31.1 mm, that at level B was 30.2 mm, that at level C was 26.5 mm, that at level D was 24.0 mm and that at level E was 22.6 mm. The diameters at all the levels were gradually increased with age. Hypertensive patients had larger diameters than did the non-hypertensive population. There was a positive correlation between the ascending aortic diameter (levels A&B) and height and the body surface area, but there were no statistical differences at the aortic arch (level C) and the descending aorta (levels D&E). There were no statistical differences of the weight and body mass index at all levels. Conclusion: The diameters of the thoracic aortas were directly correlated with gender, age and hypertension. Height and the body surface area were only correlated with the ascending aorta. Weight and the body mass index have no statistical difference at all levels. We measured the age related thoracic aortic diameters and the upper normal limits and we provide this data as reference values for the thoracic aortic diameter in the Korean population.

A Clinical Study of Management In Myasthenia Gravis (중증 근무력증 환자의 임상적 고찰)

  • Kim, Hun;Lee, Du-Yeon;Jo, Beom-Gu;Hong, Seung-Rok
    • Journal of Chest Surgery
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    • v.20 no.1
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    • pp.112-127
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    • 1987
  • Myasthenia gravis is a neuromuscular transmission function disorder characterized by fatigue and weakness of voluntary muscles. This muscular weakness is intensified by activity and stress, and improved by the use of anticholinesterase compounds. It was initially described by Erb in 1879 and later named myasthenia gravis by Jolly in 1895. Although the pathogenesis is Known to be an autoimmune related reduction in the number of available acetylcholine receptors at neuromuscular junctions, the role of thymus in myasthenia gravis is still unclear and under investigation. Thymectomy in the management of myasthenia gravis has become increasingly important since Dr. Blalock observed in 1939 that some patients with thymic tumors and myasthenia gravis improved following thymectomy. A clinical study of 102 cases of myasthenia gravis was performed at Yonsei University College of Medicine. Seoul, Korea from Jan. 1976 to Jun. 1986. In order to determine which factors are of prognostic significance, attention is focused upon pre-operative patient evaluation, problems in operative and post-operative care, and long-term follow-up observations. The results were as follows: 1. The sex distribution was 67 females and 35 males, the mean age of onset was 28.95*1.69 years, and the maximal incidence occurred between 21 and 40 years of age [56 cases: 54.9%]. 2. Clinical manifestations of ocular symptoms were seen to 70 patients [68.6%] extremities weakness in 33 [32.3%], bulbar weakness in 29 [28.4%], and dyspnea in 13 [12.7%]. 3. Study cases more than two thirds were classified as mild types [MG 1 and MG 11A] and 6 cases as grave [MG 1V] based on the modified Osserman`s classification system, 4. Thymectomy was performed in 19 cases which presented in severe myasthenia symptoms and showed no improvement with cholinergic drugs. Histologic examination of the excised thymus glands revealed no abnormalities in 4 cases, thymic hyperplasia in 5, benign thymoma in 5, and malignant thymoma in 5. 5. Immediate post-operative complications included 2 cases of pneumothorax which were treated by tube thoracostomies, there was no operative mortality. 6. The response to cholinergic drugs in 36 cases younger than 20 years old and in 27 cases older than 40 years was relatively poor, while that in 35 cases between the ages of 21 and 40 years old was good. 7. Thirty of 39 cases in groups IIB, III & IV improved markedly with medical or surgical management while only 16 of 59 cases in the mild groups [I and IIA] improved, almost all surgical cases improved in all categories. 8. There were 5 deaths. occurring between 7 months and 3 years 3 months of treatment of myasthenia gravis. The causes of death were myasthenic crisis in 2 cases, respiratory failure due to candidiasis & radiation pneumonitis in one case, cerebral hemorrhage due to high blood pressure in two case.

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Effects of Biological and Environmental Factors on the Occurrence of Chestnut Blight in Chestnut Tree Plantations (밤나무 재배지에서의 생물적, 환경적 요인이 밤나무 줄기마름병 발생에 미치는 영향)

  • Lee, Sang-Hyun;Kim, Kyung-Hee;Byun, Jae-Kyung;Lee, Jong Kyu;Moon, Byung-Ju
    • Journal of Korean Society of Forest Science
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    • v.95 no.1
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    • pp.139-144
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    • 2006
  • Chestnut trees have been severely damaged by the various cankers in Korea. Field surveys for elucidating the relationships between disease occurrence and environmental factors, i.e., tree age, temperature, rainfall precipitation, direction, degree of slope, chemical properties of soils, and so on, were carried out in the chestnut tree plantations located at Gyeongnam, Jeonnam, Chungnam, and Gyeonggi-Do Province. Totally, one thousand and one hundred thirty seven trees from 36 experiment plots were investigated. Trees infected by at least one of the canker fungi were estimated up to 66%. The most severely infested area was Sunchon in Jeonnam Province with the rate of 80%, while the most lightly infested area was Kongju in Chungnam Province with 39%. Disease occurrence was found to be highly correlated with tree age. The disease occurred most frequently on trees ranged from 7 to 12 years old, while it was relatively low on trees below 5 years old or above 25 years old. Canker positions on the tree formed by the pathogenic fungi were most often at 1.6-2.0m above the ground. Over five hundreds bark samples from the canker area on the tree were collected and the pathogenic fungi were isolated. The most commonly isolated fungus was identified as Cryphonectria parasitica, the chestnut blight fungus.

The Effect of Safety Education on Accident Proneness Prospect in Preschooler (안전교육이 학령전기 아동의 사고경향 예측에 미치는 효과)

  • Kim Shin Jeong;Lee Jung Eun
    • Child Health Nursing Research
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    • v.6 no.3
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    • pp.372-386
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    • 2000
  • The purpose of this study was to provide basic data on preschool children for accident prevention and improve their health through sound, safe living environment with safety education established through more systematic method. Data were collected from 300 preschoolers(150 preschooler are assigned to experimental group and 150 preschoolers are assigned to control group) from 4 to 6 years old using APP paper test which consists of questions and drawings. To experimental group, safety education were done 4 times within the time of 30 minutes per 1 time using education books, video, OHP, slide. The findings of this study are as follows: 1. There were significant difference in behavioral character between experimental group and control group(χ2=11.690, p= 0.003). So, safety education have effect on the behavioral character of preschooler. 2. In the accident proneness on preschooler between experimental group and control group according to general characteristics, it proved significant difference in the case of accident prevention education were done, movement stability(χ2=8.844, p=0.012) and behavioral character(χ2=6.699, p=0.035), in the case of housing pattern is mixed-type, behavioral character(χ2=10.37, p=0.006), in the case of subjects' age is 4 years old, watchfulness(χ2=9.525, p=0.009), in the case of subjects' age is 5 years old, behavioral character(χ2=7.324, p=0.026), in the case of children's order is second, behavioral character(χ2=14.31, p=0.001), in the case of children's sex is boy, living safety(χ2=7.981, p=0.018), movement speed (χ2=6.661, p=0.036), bihavioral character(χ2=8.837, p=0.012), in the case of children's sex is girl, reasoning power(χ2 =9.78, p=0.008), in the case of childrens have no past accidental experience, behavioral character(χ2=9.862, p=0.007), in the case of nuclear family, movement speed(χ2=6.341, p=0.042) and behavioral character(χ2=9.326, p=0.009), in the case of mothers' age is under thirty behavioral character(χ2=16.40, p=0.000), in the case of mothers' school career is under high school graduate, behavioral character(χ2 =8.375, p=0.015), in the case of mothers' school career is beyond college graduate, reasoning power(χ2=9.803, p=0.007) and behavioral character(χ2=6.205, p=0.045), in the case of mothers' job is part time, movement speed(χ2=10.99, p=0.004), in the case of mothers have no job, movement stability(χ2=8.490, p=0.014) and behavioral character(χ2=10.11, p=0.006). The difference of accident proneness between experimental group and control group according to general characteristics, it also showed that there were significant difference in behavioral character compared to other area.. From this findings, we can guess that safety education change and guide preschoolers' behavioral character to desirable direction.

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Prediction Equations of Pulmonary Function Parameters Derived from the Forced Expiratory Spirogram for Healthy Adults over 50 years old in rural area (농촌지역 50세 이상 인구의 노력성호기곡선을 이용한 폐활량측정법 검사지표의 추정정상치)

  • Kim, Won-Young;Kim, Kwang-Hyun;Youn, Boung-Han;Lee, Seung-Uk;Cho, Chul-Hyun;Choi, Jin-Su;Kim, Hun-Nam
    • Tuberculosis and Respiratory Diseases
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    • v.45 no.3
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    • pp.536-545
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    • 1998
  • Background: The studies on prediction equations of pulmonary function parameters for adults in Korea have been performed in a reference population mainly consisted of young and middle ages. So they included a relatively few elderly who conducted pulmonary function test frequently in clinic. We established prediction equations of pulmonary function parameters for healthy adults over 50 years old in rural area and compared this results with those of other studies. Therefore we attempted to consider normative values of pulmonary function tests for elderly in Korea. Method: Five hundred thirty-three women and men over 50 years old in rural area were participated. A "healthy" subgroup of 110 women and 32 men were identified by excluding those who had conditions that negatively influenced pulmonary function. We derived prediction equations for FVC, $FEV_1$ and $FEV_1%$ by multiple linear regression method from their age, heights and weights in each sex. Results: Prediction equations for FVC and $FEV_1$ in each sex were derived as follows Male; FVC (L)=0.02488Height(cm)-0.0269Age(years)+0.493 $FEV_1(L)$=0.01874Weight(kg)-0.0282Age(years)+2.906 Female; FVC(L)=0.02160Height(cm)-0.0192Age(years)-0.0125 $FEV_1(L)$=0.01720Height(cm)-0.0194Age(years)+0.3890 Prediction equations for $FEV_1%$ were not derived because $FEV_1%$ didn't have statistically significant terms. Comparing Predicted values that were calculated by substitution into the equations of various studies of mean values of age, heights and weights from this study, FVC and $FEV_1$ values in men of this study were lower than those of other studies. In women, FVC and $FEV_1$ values of this study were as similar as or lower than those of the study conducted for healthy elderly blacks in U.S.A respectively. Conclusion: We have got prediction equations of pulmonary function parameters which were driven from forced expiratory spirogram in adults over 50 years old in rural area. Predicted values of this study were lower than those of other studies which were conducted in Korea. So we consider that the study for spirometry reference values for elderly Korean using the method compatible with ATS recommendation need to be conducted more frequently forward.

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