Early and Mid-Term Impacts of Cardiopulmonary Bypass on Coronary Artery Bypass Grafting in Patients With Poor Left Ventricular Dysfunction

Youn, Young-Nam,Chang, Byung-Chul,Hong, You-Sun,Kwak, Young-Lan,Yoo, Kyung-Jong Japanese Circulation Society. 2007 CIRCULATION JOURNAL Vol.71 No.9

<P><B>Background</B> Cardiopulmonary bypass may exacerbate myocardial damage in compromised left ventricles. Early and mid-term outcomes of off-pump coronary artery bypass grafting (OPCAB) vs on-pump coronary artery bypass grafting (On-pump CABG) were compared in patients with poor left ventricular dysfunction, using an analysis of a propensity score matching. <B>Methods and Results</B> Between December 2000 and November 2005, 1,473 patients underwent isolated coronary artery bypass grafting in our institute and 153 patients who had a left ventricular ejection fraction (LVEF) lower than 35% were enrolled. The OPCAB group contained 100 patients and the On-pump CABG group contained 53 patients. Preoperative risk factors were compared and 50 patients in each group were matched. The mean follow-up time was 35.5±17.3 months. Three deaths (3.0%) occurred in the matched cohort, with no significant difference between 2 groups. The operation time, ventilation time, intensive care unit admission time and occurrence of respiratory failure were significantly lower in the OPCAB group. The mean LVEF of the 2 groups improved significantly. The overall 6-year actuarial survival rates of the OPCAB and On-pump CABG group were 88.2% and 72.4% (p=0.2), respectively, and there were no significant differences in 6-year rates of freedom from major adverse cardiac and cerebrovascular events (p=0.97). <B>Conclusions</B> Coronary artery bypass grafting in patients with poor left ventricular dysfunction improved myocardial function. Postoperative respiratory failure was significantly related to the cardiopulmonary bypass for surgical myocardial revascularization. Off-pump and On-pump surgical revascularization resulted in equivalent mid-term outcomes. (<I>Circ J</I> 2007; <B>71:</B> 1387 - 1394)</P>

초등학생의 스트레스요인, 대처방식, 어머니와의 의사소통 및 학교적응

홍연란,Hong Youn Lan 한국아동간호학회 2000 Child Health Nursing Research Vol.6 No.3

The purpose of this study was to examine the stressors, coping styles, communication with mother, school adaptation and predictors for school adaptation. The subjects of this study consisted of 354 children. They were 6th grade of elementary school in Taegu city. The periods of study was from march 10, to march 18, 2000. Data were analyzed by SAS computer programme. The results of this study were as follows: 1. The mean score for stressor was 39.91 in children(range 24-72). The higher stressor among three subgroups of stressor was mass media stressor. The degree of stressor revealed to be influenced significantly economic status. 2. The most frequently used coping style was problem-oriented coping style(M=18.94) in children. The degree of emotion-oriented coping style revealed to be influenced significantly family's atmosphere 3. The mean score for communication with mother was 72,44 in children(range 20- 100). The degree of communication with mother revealed to be influenced significantly sex, economic status, family' atmosphere. 4. The mean score for school adaptation was 62.48 in children(range 25-100). The higher school adaptation among five subgroup was rule dimension. The degree of school adaptation revealed to be influenced significantly sex, birth, mother's job, economic status, family's atmosphere. 5. School adaptation were positively correlated with communication with mother, problem- oriented coping style(r=0.40 p<0.001) (r=0.30 p<0.001). 6. School adaptation were negatively correlated with emotion-oriented coping style, stressor (r=-0.16 p<0.01)(r=-0.13 p<0.01). 7. Forward multiple regression analysis revealed that the most powerful predictor was the variable communication with mother accounted for 15.25% in school adaptation. All variables accounted for 25.55% in school adaptation. From the above results, it can be concluded that teaching mother about importance of communication, encouraging to use problem-oriented coping style is necessary to improve school adaptation in 6th grade elementary school children

암 사망자의 의료이용 변이

홍월란 ( Worl Lan Hong ),이원재 ( Won Jae Lee ),윤경일 ( Kyung Il Youn ) 한국병원경영학회 2007 병원경영학회지 Vol.12 No.3

This study focused on finding the variation of medical service utilization and medical payments of the patients died by three cancers, stomach, breast, and colon cancer. For this study, data of the one-year episodes of the health insurance subscribers died in 2004 were selected. The frequency of medical visits, the lengths of stays, the days of outpatient visits, the total period of medical services and the total medical payments were compared by the characteristics of the suppliers and utilizers. The data of the patients died by cerebrovascular diseases and cancer in 2004 were selected. To select the dead by cerebrovascular diseases and cancer in 2004, we matched the 2004 reimbursement data of all medical institutions to the data of funeral fee payment by the National Health Insurance Corporation from January 2004 to May 2005 for the death in 2004. The results of the analysis were as follows. The current study found that the variation of medical care utilization was influenced by the factors of suppliers, such as types and locations of medical institutions and the factors of users, such as sex and age. It was suspected that the reimbursement by fee-for-service contributed to the variation quite a lot, but we could not compare the variation between the different reimbursement systems in Korea. The results of the study suggested that the factors of suppliers and utilizers should be reviewed to reduce the under use and over use expressed by variations of medical service utilization. The processes of care, effective communication and management system should be investigated for the equity of medical service utilization. Additionally, prospective payment could be recommended to reduce the high variation of medical service use. To find the variation caused by under use and over use, further study need to control the severity of diseases, socio-economic status of the users and the system factors.

히구마 양파의 열풍 예건 처리에 따른 저장 중 품질 변화

엄향란(Hyang Lan Eum),이인권(In Kwon Lee),홍세진(Sae Jin Hong),박세원(Se Won Park),박윤문(Youn-Moon Park) 한국원예학회 2001 Horticulture, Environment, and Biotechnology Vol.42 No.6

Association between chronic hepatitis B virus infection and interleukin-10, tumor necrosis factor-α gene promoter polymorphisms

Cheong, Jae Youn,Cho, Sung Won,Hwang, Il Lan,Yoon, Seung Kew,Lee, June Hyuk,Park, Choon Sik,Lee, Jong Eun,Hahm, Ki Baik,Kim, Jin Hong Blackwell Publishing Asia 2006 Journal of gastroenterology and hepatology Vol.21 No.7

<P>Abstract</P><P>Background: </P><P>The reasons for the viral persistence of hepatitis B virus infection (HBV) are unknown, but are probably related to host immune factors. Cytokines play a significant role in immune defense. The present study was undertaken to investigate the association between HBV infection and polymorphisms of tumor necrosis factor (TNF)-α and interleukin(IL)-10 gene promoter.</P><P>Methods: </P><P>A total of 412 Korean patients with HBV infection (72 inactive carriers, 261 witih chronic hepatitis, 79 with liver cirrhosis) and 204 healthy individuals who recovered from HBV infection, were studied. The polymorphisms in IL-10 gene promoter (−1082, −819, −592), and TNF-α gene promoter (−308, −238) were assessed by single base primer extension assay.</P><P>Results: </P><P>The frequency of C/C genotype at position −592 of IL-10 gene promoter was higher in the HBV clearance group than that in the persistence group in univariate analysis (12.7% vs 7.5%, <I>P</I> = 0.036). The IL-10 gene promoter −592 C/C genotype was related to clearance of HBV infection in logistic regression analysis after adjusting for age and sex (<I>P</I> = 0.003). Genotype frequencies of TNF-α gene promoter at position −308 and −238 were not different between the clearance and the persistence group in univariate analysis, but in multivariate analysis after adjusting for age and sex, −308G/−238G homozygotes were associated with HBV persistence (<I>P</I> = 0.005). Genotype distributions of both gene promoters in inactive carriers were similar to those in patients with chronic progressive liver disease.</P><P>Conclusions: </P><P>The carriers of the −592A allele in the IL-10 promoter and −308G/−238G haplotype homozygotes in the TNF-α promoter region have higher risk of persistent HBV infection.</P>

대학생들의 건강증진행위와 삶의 만족도에 대한 구조모형

홍연란,이가언,박현숙,Hong, Youn-Lan,Yi, Ga-Eon,Park, Hyun-Sook 한국지역사회간호학회 2000 지역사회간호학회지 Vol.11 No.2

The purpose of this study was designed to test and develope the structural model that explains health promoting behaviors among college students in Korea. The hypothetical model was constructed on the Pender's Health promotion Model(l996) and the inclusion of some influential factors for life satisfaction. The conceptual framework was built around eight constructs. Exogenous variables included in the model were self-esteem, perceived health status, self-efficacy, internal locus of control, chance locus of control. powerful other locus of control. Endogenous variables were health promotion behaviors and life satisfaction. The results are as follows; 1. The overall fit of the hypothetical model to the data was moderate <$x^2$=4.18(df=11. p=0.041), GFI= 0.99, AGFI= 0.76, RMR= 0.019, CFI= 0.99, CN= 248.50> 2. Path and variable of the model were modified by considering both its theoretical implication and statistical significance of parameter estimates. Compared to the hypothetical model. the revised model has become parsimonious and had a better fit to the data expected in a chi-square value <$x^2$=8.43( df= 16, p=0.21), GFI= 0.99, AGFI= 0.92., RMR= 0.024, CFI= 0.99, CN= 312.01> 3. Some of the predictive factors. especially self efficacy. self esteem. powerful others locus of control. perceived health status revealed the direct effects on health promoting behaviors. Of these variables. self-efficacy was the most signigicant factor. These predictive variables of health promoting behaviors explained 59% of total variances in the model. 4. Health promoting behaviors, self-esteem. and perceived health status revealed direct effect on the life satisfaction. Self-efficacy was identified as an important variable that contributed indirectly to improve life satisfaction by enhancing health promoting behaviors. These predictive variables of life satisfaction explained 42% of total variances in the model. In conclusion. the derived model in this study is considered appropriate in explaining and predicting health promoting models and life satisfaction among college students in Korea and could effectively be used as a reference model for further studies by suggesting a direction in health promoting nursing practices.

아동의 어머니와의 의사소통과 우울이 두통에 미치는 영향

정복례,홍연란 여성건강간호학회 2000 여성건강간호학회지 Vol.6 No.3

The purpose of this study was to examine the variables such as communication with mother and depression with regard to headache in headache-suffering children. The study subjects consisted of 315 in 5th&6th grade elementary school children in T city, headache-suffering children mean children experiencing twice or more march, 2. 2000-July. 20, 2000. The data were analyzed by SAS computer program. The results of this study were as follows: 1. The mean score for communication with mother was 73.74 in headache-free group and 70.42 in headache-suffering group and difference had statistical significance. 2. The mean score for depression was 39.43 in headache-free group and 43.03 in headache-suffering group and difference had statistical significance. This study in relation to nursing implies that there is a need to teach mothers to encourage positive communication with children and that to develop depression-reducing program to prevent headache attack in children.

개심술시 술전 및 술중 자가수혈이 동종수혈에 미치는 영향

한정선,홍용우,곽영란,방서욱,홍정숙,최윤영,박정현,서영선 대한마취과학회 1995 Korean Journal of Anesthesiology Vol.28 No.4

This study was designed to investigate the effect of preoperative collection of blaod and acute normovolemic hemodilution(ANH) on the requirement of homologous transfusion, perioperative blood loss and hematological parameters in patients undergoing open heart surgery. Ninety two adult patients for elective open heart surgery were randomly assigned to one of three groups. Group I, ANH group, had blood withdrawn to a hematocrit of 33%o after induction of anesthesia(n =54). In Group II preoperative collection of blood in accordance with hospital protocol and ANH were performed(n=16). Ciroup III was control group(n=22). Autologous blood was replaced post bypass. The patients whose hematocrit fell below 25% were transfused with homologous blood. The use of homologous transfusion was 2.2±0.4 units in group I, 0.1±0.1 units in group II and 4.1±0.8 units in group III. Requirement of homologous transfusion in group II was reduced compared with group II and III with statistical significance(P$lt;0.05). There was statical significance between group I and group III(P$lt;0.05) in homologous transfusion. Postoperative blood loss was 760.7±74.6 ml in group I, 675.6+101.5 ml in group II and 819.3±91.3 rnl in group III. There was no statistical significance among 3 groups. There was no difference in hematocrit or platelet count, and total blood loss on immediately post surgery or on day 1. Our data show that preoperative collection of blood and ANH can reduce the amount of homologous transfusion.

외기조건에 따른 단독주택의 에너지소비특성 분석

김유란(Kim, Yu-Lan),서운규(Seo, Youn-Kyu),여명길(Yeo, Myung-Kil),전규엽(Jeon, Gyu-Yeob),홍원화(Hong, Won-Hwa) 대한건축학회 2010 대한건축학회 학술발표대회 논문집 - 계획계/구조계 Vol.30 No.1(계획계)

Predictive Value of C-Reactive Protein for Major Postoperative Complications Following Off-Pump Coronary Artery Bypass Surgery

Kim, Dae Hee,Shim, Jae Kwang,Hong, Seong Wook,Cho, Kwang Rae,Kang, Seung Youn,Kwak, Young Lan Japanese Circulation Society. 2009 CIRCULATION JOURNAL Vol.73 No.5

<P><B><I>Background:</I></B> To prospectively investigate the predictive value of the preoperative C-reactive protein (CRP) concentration for major postoperative complications following off-pump coronary artery bypass (OPCAB) surgery. <B><I>Methods and Results:</I></B> From January 2007 to December 2007, 185 consecutive patients scheduled for elective OPCAB surgery were allocated to a low-CRP group (n=137, CRP <0.3 mg/dl) and a high-CRP group (n=48, CRP ≥0.3 mg/dl). The incidence of major postoperative complications, defined as postoperative myocardial infarction, and 5 major morbidity endpoints including permanent stroke, renal dysfunction, any cardiac surgery reoperation, ventilation for more than 48 h, and deep sternal wound infection were assessed and compared. Multivariate logistic regression was used to determine the predictors of major postoperative complications. Patients in the high-CRP group had a significantly higher overall incidence of major postoperative complications, particularly renal dysfunction. In the multivariate logistic regression model, adjusting all the significant univariate predictors, baseline CRP >0.3 mg/dl and preoperative chronic renal failure (CRF) remained as significant independent predictors of major postoperative complications. <B><I>Conclusions:</I></B> Elevated preoperative CRP level and/or preoperative CRF indicate increased risk of developing major postoperative complications, particularly acute postoperative renal dysfunction in patients undergoing OPCAB surgery. (<I>Circ J</I> 2009; <B>73:</B> 872 - 877)</P>