• Journal of Chest Surgery
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• v.30 no.9
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• pp.885-890
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• 1997

Patients with coronary artery disease and depressed ventricular function have better longterm benefits after coronary artery bypass grafting compared with medical therapy. But operative mortality remains high. This study was designed to identify the risk factors for coronary artery bypass grafting according to ventricular function. The records of 103 patients who underwent coronary artery bypass grafting from truly 1994 to June 1996 were analysed. The patients were divided into two groups based on preoperative ejection fraction: Low EF group(Ejection fraction < 40%, n=24) and Normal EF group(Ejection fraction $\geq$ 40%, n=79). The indication of operation was significantly different between the two groups (p=0.00003). Postinfarction angina was frequent in Low EF group but unstable angina was frequent in Normal EF group. The frequency of cardiomegaly(p=0.0012), serum creatinine abnormality(p=0.0473) and preoperative use of IABP(Intra Aortic Balloon Pump, p=0.0095) were higher in Low EP group. The left internal thoracic artery was used less frequently in Low EP group(p=0.00416). The operative mortality was 8.3% in Low EF group and 5.1% in Normal EF group, but without statistical difference(p=0.5492). In Normal EF group, age (p=0.041) was identified as a significant risk factor for operative mortality. In Low EF group, age(p=0.018), preopertive use of IABP(p=0.0036), hypercholesterolemia(p=0.0007), and emergency of operation(p=0.0037) were identified as significant risk factors. Postoperative morbidity was 50% in Low EF group and 33olo in Normal EP group, but without s atistical significance(p=0.1007). These results suggest that in patients with coronary artery disease and depressed ventricular function, more aggresive coronary artery bypass grafting is needed to improve the symptom and long-term benefit.

• Korean Journal of Clinical Laboratory Science
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• v.53 no.4
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• pp.309-316
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• 2021

Sepsis is a physiological response to a source of infection that triggers mechanisms that compromise organ function, leading to death if not treated early. Biomarkers with high sensitivity, specificity, speed, and accuracy that could differentiate sepsis from non-infectious systemic inflammatory response syndrome (SIRS) could bring about a revolution in sepsis treatment. Given the limitations and time required for microbial verification of pathogens, the accurate diagnosis of infection before employing antibiotic therapy is important and clinically necessary. Procalcitonin (PCT), lactate, C-reactive protein (CRP), cytokines, and proadrenomedullin (ProADM) are the common biomarkers used for diagnosis. The procalcitonin (PCT)-guided antibiotic treatment in patients with acute respiratory infections effectively reduces antibiotic exposure and side effects while improving survival rates. The evidence regarding sepsis screening in hospitalized patients is limited. Clinicians, researchers, and healthcare decision-makers should consider these findings and limitations when implementing screening tools, future research, or policy on sepsis recognition in hospitalized patients. The use of biomarkers in pediatric sepsis is promising, although such use should always be correlated with clinical evaluation. Biomarkers may also improve the prediction of mortality, especially in the early phase of sepsis, when the levels of certain pro-inflammatory cytokines and proteins are elevated.

• Journal of the Society of Disaster Information
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• v.19 no.3
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• pp.719-728
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• 2023

Purpose: Mobile cranes are machines that contribute to high mortality, and the High Risk Factor (SIF) information, which analyzed 2,574 accidental deaths in the construction industry in the past 6 years (2016~2021), resulted in a total of 61 mobile crane accidents. Despite safety measures in the field, it is not used properly. In this study, we present standard risk assessment indicators that contribute to accident prevention. Method: Through expert interviews, fatal accident case analysis, field analysis, and literature research, we present the standard risk assessment index method of the 4M risk assessment method. Result: As a result of analyzing the risk assessment of eight sites, it was concluded that it cannot make a significant contribution to disaster prevention and should be applied as an improvement measure of the Standard Risk Assessment Index Law. Conclusion: Switching to the standard risk assessment index method at construction sites has been proposed to make it easier for health and safety personnel and workers to use, contributing to the reduction of accidents.

• Tuberculosis and Respiratory Diseases
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• v.52 no.4
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• pp.376-384
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• 2002

Background : The mortality from acute respiratory distress syndrome(ARDS) in the late stage, which is characterized by progressive pulmonary fibroproliferation, is ${\geq}80%$. Although previous prospective trials failed to show a survival benefit of steroid therapy in early ARDS, recently, a few of reports have described the survival benefit of the long-term use of steroid in patients with late ARDS. In this study, we analyzed the effect of steroid therapy on patients with late ARDS retrospectively in a single. Medral intensive care unit (MICU). Methods : Over a 3-year period, the medical records of 48 ARDS patients who had been on mechanical ventilation more than 8 days were reviewed. 14 patients were treated by the long-term use of methylprednisolone and another 34 patients served as a control. Both groups were comparable regarding clinical and physiologic data lung injury score(LIS), multiple organ failure score, APACHE III and SAPS II score. Because steroid was instituted after 8 days of advanced mechanical ventilatory support in average, we arbitrarily defined the $8^{th}$ day of ARDS as first day of the study. Results : Initially, the groups had similar PF($PaO_2/FiO_2$) ratio, LIS, APACHE III and SAPS II score. By 7th day after the start of steroid therapy, there were significant improvements in PF ratio, LIS, APACHE III and SAPS II score. The mortality in the steroid treated group was significantly lower(42.9% vs 73.5%, p<0.05). Conclusion : Although the data of this study was retrospective and was not randomized, in order to improve the patient's outcomes, steroid therapy should be considered in late ARDS patients. However, prospective trials are needed to define the indication and the effect of steroid therapy in late ARDS.

• Tuberculosis and Respiratory Diseases
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• v.61 no.3
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• pp.233-238
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• 2006

Study objectives: To determine the factors associated with mortality after an in-hospital diagnosis of tuberculosis in a region with low levels of HIV coinfection. Methods: From January 2003 to December 2004, all subjects who were > 15 years of age and had received a diagnosis of tuberculosis were registered. The clinical, radiological and laboratory aspects of the patients who died (n=27) were compared with those of an age and gender matched control population(n=54). Logistic regression analyses were carried out, which included age, gender, hospital admission source, initial site of admission, dyspnea, general weakness and initial laboratory data. Results: The mean age of the patients was $60{\pm}16$ years and male patients outnumbered female patients. Univariate analysis identified hemoglobin, blood urea nitrogen, albumin, cholesterol, aspartate aminotransferase (AST), C-reactive protein and the risk factors for tuberculosis to be significantly associated with mortality. Among the characteristics of disease presentation and treatment, emergency department admission, intensive care unit, disease severity, general weakness and dyspnea at the time of admission were associated with mortality. Multiple regression analysis revealed the initial management in the intensive care unit and lower serum albumin to be independently associated with mortality. Conclusion: The markers of disease chronicity and severity appear to be associated with in-hospital mortality. Identifying potentially reversible factors such as malnutrition and respiratory failure suggests specific intervention that might lead to an improvement in the patients' outcomes.

• Clinical and Experimental Pediatrics
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• v.45 no.6
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• pp.719-726
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• 2002

Purpose : Neonates in neonatal intensive care units(NICU) have a high risk of acquiring nosocomial infection because of their impaired host defence mechanism and invasive procedures. Nosocomial infection result in considerable morbidity and mortality among neonates. This study was carried out to survey both the epidemiology of nosocomial infection in our NICU and the annual trends of pathogens. Methods : We retrospectively reviewed culture proven nosocomial infection which occurred in our NICU from January 1995 to December 1999. The data included clinical characteristics, site of infection, pathogens, and mortality. Results : Nosocomial infection rates was 9.0 per 100 NICU admissions during the five-year period. Major sites of infection were bloodstream(32.3%), skin(18.4%), endotracheal tube(17.2%), and catheter(10.6%). The most common pathogen was S. aureus(29.9%). and the others were coagulase- negative staphylococci(CONS)(14.8%), Enterobacter(12.4%), and Candida(9.0%). During the five-year period, nosocomial infection rates increased from 9.5 to 11.6 per 100 admissions with the increase of CONS, Candida, Klebsiella, and Acinetobacter baumannii. The infection rate of S. aureus decreased. Multiple episodes of nosocomial infection occurred in 26.1% of all nosocomial infections. Overall bloodstream infection rates were 3.6 per 100 NICU admissions during five years. CONS(29.1%) and S. aureus(27.1%) were the two most common pathogens. Increasing rates of bloodstream infection by CONS, Candida, Klebsiella, and Acinetobacter baumannii were observed. Bloodstream infection related mortality was 11.9%. Conclusion : The predominant pathogens of nosocomial infection in NICU were S. aureus and CONS. Bloodstream infection, the most frequent nosocomial infection, should be a major focus of surveillance and prevention efforts in NICU.

• Korean Journal of Construction Engineering and Management
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• v.20 no.6
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• pp.66-73
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• 2019

Thanks to various efforts to reduce disasters by the government and the Health and Safety Authority, disasters across industries and the construction industry show their reduction trend. However, the falling disasters in the construction industry have not decreased and increased on the contrary. Especially falling disaster caused by Hanging Scaffolding is the most critical disaster which shows low occurrence frequency but is directly connected to death of worker. The working environment for Hanging Scaffolding is poor in domestic construction site. In particular, the Hanging Scaffolding workers in small construction sites are not on the safety control and management by anyone for their works. They are driven to unsafe working condition with mostly uncertified facilities which are made by themselves. Therefore, this study is focused on searching falling disaster factors from the 242 disaster cases caused by Hanging Scaffolding Work in 15 years presented by KOSHA, and trying to provide suggestions for improvement. The improvement of the method of work requires facility improvement and work due to high accident rate caused by unsafe behavior. Analysis of the case of a disaster occurring over the past 15 years shows that no disaster occurred due to problems in the order of operations presented by KOSHA. However, it was found that many accidents resulted from death caused by safety belts not being installed or attached to ropes using safety belts without following the order of work. The most important aspect of improving the work method was the installation and wearing of lifeboats and safety belts.

• Journal of Chest Surgery
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• v.35 no.12
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• pp.854-861
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• 2002

In this study, we reviewed our early and long-term surgical results of complete atrioventricular septal defect during the last 16 years at our hospital. Materials and Methods: Between April 1986 and March 2002, 73 patients with complete atrioventricular septal defect underwent total correction without preceding palliation. Age at repair ranged from 2 to 85 (median age, 7) months, and weight ranged from 3 to 22 (median weight, 5.9)kg. Follow-up was complete with a mean duration of 69$\pm$51 months. Results: Overall operative mortality was 16.4%(12) with 3 late deaths. One, 5, and 10 year actuarial survival rates were 96.3 %, 94.2 % and 94.2 % respectively Sixteen of 61 (22.2%) operative survivors have undergone reoperation for postoperative mitral regurgitation or left ventricular outflow tract obstruction (LVOTO). Freedom from mitral reoperation at 1, 5, and 10 years were 87.8 %, 72.4 %, and 57.8 % and freedom from LVOTO at 1, 5, and 10 years were 98.2 %, 86.3 %, and 83.2 % respectively. Summary: In this study, we found that our early surgical results improved with quite an acceptable long-term outcome. Close observation of remaining mitral regurgitation was necessary, A precise evaluation of the atrioventricular valve morphology, a meticulous surgical technique, and the adequate postoperative management are mandatory for the excellent results.

• Journal of Hospice and Palliative Care
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• v.7 no.1
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• pp.37-48
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• 2004

Purpose: Population using complementary and alternative medicine (CAM) and the cost or it are increasing all over the world. In this study, we investigated the utilization state of CAM in the elderly people during the last 6 months of life. Methods: We found 4,210 persons in Seoul, older than 65 years who received a funeral subsidy from health insurance after death during the latter half of the year, 2001. We stratified them by age and gender and selected 301 persons and surveyed them by questionnaire. Results: 247 persons (83.1%) used at least one of CAM during their last 6 months of life. Diet and Nutrition remedy showed the highest utilatization rate (65.5%), and drug therapies also were much used (29.9%). Utilization rate was higher in female (60%) and according to the cause of death, the highest in a geriatric disease groups, and the lowest in the cancer group. Whole satisfaction to CAM was high with average 4.25 points out of total 6, and adverse effects were almost free with average 5.55 points out of total 6. Satisfaction was the highest in Diet and Nutrition remedy but the lowest in Manipulative and Body-Based methods. Adverse-effect score was best in Manipulative and Body-Based methods. According to age and the causative disease of death, there were significant differences in satisfaction and adverse effect levels. Conclusion: Majority of old people used at least one of CAM during their last 6months of life. Whole satisfaction and adverse-effect level were very excellent.

• Journal of the Korean Society of Food Science and Nutrition
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• v.34 no.9
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• pp.1362-1366
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• 2005

To evaluate red ginseng-chungkukjang extracts (RC) on levels of blood sugar and serum lipids in diabetes rats fed with ethanol, SD rats were supplemented 2 mL of $20\%$ ethanol solution with or without RC by gastric intubation for 2 weeks after streptozotocin (STZ) injection and then body weight gains, food efficiency ratio (FER), water intake, urine volume, organ weight, levels of blood sugar and serum lipids were determined. Water intake and urine volume were not restored in STZ-treated rats by RC supplementation. On the other hand, decreased body weight gam and FER were restored in diabetes rats by RC supplementation. Furthermore, levels of blood sugar, serum triglyceride, total cholesterol and LDL-cholesterol were significantly decreased by RC supplementation. The rate of mortality in diabetes rats was significantly inhibited by RC supplementation. These results suggest that inhibited rate of mortality in diabetes rats by supplementation of ethanol with RC was considered to be due to improvement of blood sugar and serum lipids levels by components of RC.