• Title/Summary/Keyword: 사망률 지수

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Surgical Treatment of Primary Lung Cancer (원발성 폐암의 외과적 치료)

  • 김성완;구본원;이응배;전상훈;장봉현;이종태;김규태;강덕식
    • Journal of Chest Surgery
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    • v.31 no.2
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    • pp.134-141
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    • 1998
  • Primary lung cancer has recently increased progressively in its incidence in Korea. It is clearly evident that surgical resection offers the best offortunity for cure of non-small cell carcinoma. This study was designed to analyse the clinical data of 100 primary non-small cell carcinoma patients who underwent lung resection surgery from January 1992 to July 1995 at the department of Thoracic and Cardiovascular Sugery, Kyungpook National University Hospital. There were 86 males and 14 females(6:1). In the age distribution, the peak incidence was recorded in the seventh decade(43%). The methods of tissue diagnosis were bronchoscopic biopsy in 53 patients(50.5%), percutaneous needle aspiration in 17 patients(16.2%), transbronchial lung biopsy in 11 patients(10.5%), mediastinoscopic biopsy in 2 patients (1.9%), sputum cytology in 2 patients(1.9%), and thoracotomy in 20 patients(19.0%). Fifty-five lobectomies, 22 pneumonectomies, 15 bilobectomies, 2 segmentectomies, 4 sleeve lobectomies, a sleeve pneumonectomy, and a wedge pneumonectomy were performed. Operative mortality occured in 4 cases(sepsis in 2 cases, respiratory failure in 1 case, and acute myocardiac infarction in 1 case). The histologic types of tumor were 67 squamous cell carcinomas, 26 adenocarcinomas, 6 large cell carcinomas, and an adenosquamous cell carcinoma. Eighteen patients with N2 mediastinal lymph node metastases had 8 squamous cell carcinomas(11.9%), 9 adenocarcinomas(34.6%), and a large cell carcinoma(16.7%). The primary tumors in these patients were in the right upper lobe in 4 patients, the right middle and lower lobe in 9 patients, the left upper lobe in 3 patients, and the left lower lobe in 2 patients. With regard to pathologic stages, 45 patients had stage I disease; 13 patients, stage II; 36 patients, stage IIIa; 5 patients, stage IIIb; and 1 patient, stage IV. The overall actuarial survival rate was 77.5% at 12 months, 56.1% at 24 months and 43.7% at 43 months. The actuarial survival rates at 43 months were 81.3% in Stage I, 20.8% in Stage II, 27.9% in Stage IIIa, 25.0% in Stage IIIb and 33.3% in Stage IV. These facts suggest that early detection and surgical resection are recommended for favorable postoperative survival in non-small cell lung cancer.

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Depression and Anxiety in Outpatients with Chronic Obstructive Pulmonary Disease (만성폐쇄성폐질환 환자에서 우울과 불안심리 평가)

  • Ryu, Yon Ju;Chun, Eun Mi;Sim, Yun Su;Lee, Jin Hwa
    • Tuberculosis and Respiratory Diseases
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    • v.62 no.1
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    • pp.11-18
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    • 2007
  • Background: Patients with chronic obstructive pulmonary disease (COPD) have often been reported to suffer from depression and anxiety possibly due to the exacerbation, hospitalization and mortality of COPD. However,scarce data are available in Korea. This study assessed degree of depression and anxiety, and evaluated the factors associated with depressive symptoms in COPD. Methods: The cross-sectional data on the lung function measurements, smoking behavior, body mass index (BMI), age, gender, depressive symptoms using Beck Depression Inventory (BDI) and anxiety using the State-Trait Anxiety Inventory (STAI) were evaluated in 72 outpatients with COPD and 50 controls without underling lung diseases from September, 2005 to October, 2006 in the Ewha medical center. Results: 1) The age, body mass index (BMI) and serum albumin levels were similar in the patients and controls. The BDI scores (16(0-37) vs. 12(1-30), p=0.001) and the prevalence of depression (36% vs. 6%, p<0.0001) were higher in the COPD patients than in the controls. In the COPD group, the prevalence of depression increased with increasing GOLD stage (p=0.008). The prevalence was 18%(4/22), in mild cases, 30%(6/20) in moderate cases, 52%(13/25) in severe cases and 60%(3/5) in very severe cases. 2) The SAI and TAI scores were higher in the COPD patients (44(20-67) and 47(20-66)) than in the healthy controls (39(26-65) and 44(33-90)). There were a significant correlation between the depression and anxiety scores (p<0.001). 3) A lower BMI, lower postbronchodilator $FEV_1$, current smoking behavior and severity of COPD were univariately associated with the depressive group in COPD, 4) while multivariate logistic analysis revealed only the severe-to-very severe group (OR 3.9, 95% CI 1.2 to 12.9) to be independently associated with depressive symptoms. Conclusion: COPD is strongly associated with depression and anxiety. Therfore, screening for psychological problems in COPD patients is essential, particularly in patients with severe-to-very severe COPD.

A Study of Serum Lipid, Blood Sugar, Blood Pressure of Buddhist Nuns in Vegetarians and Non-Vegetarians (III) - Based on Age - (채식인과 비채식 일반인의 혈중 지질, 혈당, 혈압에 관한 연구(III) -연령을 중심으로-)

  • Cha, Bok-Kyeong
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.33 no.8
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    • pp.1311-1319
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    • 2004
  • The purpose of this study was to compare the serum lipid level, blood sugar and blood pressure in vegetarians and non-vegetarians. The subjects of the study were 127 Buddhist nuns (age: 23∼79 y) from Oonmoon Temple in Choungdo district Gyeongsang Bookdo province and 118 Buddhist nuns practicing Zen meditation at Soodeok Temple in Yeosan district Chongcheong Namdo province. For control subjects, 235 healthy female adults (age: 23∼79 y) were selected. They were the nurses in the Gyeongsang National University Hospital, teachers and housekeepers living in Jinju, Gyeongsang Namdo province. The period of this study was from October 1996 to February 1997. The contents were consisted of food consumption survey, anthropometric measurement, estimated amount of energy expenditure, physical activity and clinical examination. The mean ages of the subjects were 44.2 y for vegetarians and 40.5 y for non-vegetarians, respectively. Average body mass index (BMI) of vegetarians and non-vegetarians were 22.47 and 21.08, WHR 0.85 and 0.84, percentage of body fat 28.79 and 26.55 respectively. The average duration of vegetarian diet of the vegetarians was 13.16 y. Levels of total cholesterol, LDL-cholesterol, atherogenic index (AI), diastolic blood pressure, blood sugar and HDL-cholesterol were significantly higher (p<0.01) in non-vegetarians than those of vegetarians. In both of subjects, levels of TG, total cholesterol, LDL-cholesterol, atherogenic index (AI) and systolic blood pressure were significantly higher (p<0.01) with an increment of age and the vegetarians showed a lower ratio of rise than the non-vegetarians. Levels of serum TG, LDL-cholesterol and AI were utmost in the 60 s and declined in the 70 s. Consequently, vegetarian diet can be considerably effective in reducing the level of the risk factors causing cardiovascular disease.

Longevity and Life Table of the Foxglove Aphid (Aulacorthum solani K.) Adults on Lettuce (Lactuca sativa L.) (상추를 먹이로 공급할 때 싸리수염진딧물 성충의 수명과 생명표)

  • Lee, Sang-Guei;Kim, Hyeong-Hwan;Kim, Tae-Heung;Park, Gil-Jun;Kim, Kwang-Ho;Kim, Ji-Soo
    • Korean journal of applied entomology
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    • v.47 no.4
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    • pp.365-368
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    • 2008
  • Adult longevity and fecundity of the foxglove aphid, Aulacorthum solani Kaltenbach, were studied at $12.5{\sim}25^{\circ}C$ with $60{\sim}70%$ RH under 16L:8D and the results were put together to build a life table. The longevity of foxglove gradually increased with decreasing temperature below $25^{\circ}C$. Also total fecundity increased with decreasing temperature and highest fecundity was 74.1 nymphs per female at $15^{\circ}C$. However, daily fecundity increased with increasing temperatures up to $20^{\circ}C$ showing 2.9 nymphs per day and thereafter decreased. Net reproduction rate ($R_0$) was highest of 58.7 at $15^{\circ}C$. The intrinsic rate of increase per day ($r_m$) and the finite rate of increase per day (${\lambda}$) were highest of 0.27 and 1.32, respectively and the doubling time (Dt) was shortest of 2.52. the mean generation time (T) was 10.99 at $22.5^{\circ}C$.

Acute Oral Toxicity and Skin Irritation Studies on Natural Dyes Extracted from Chrysanthemum (국화로부터 추출한 천연염료에 대한 급성경구독성 및 피부자극성 시험에 대한 연구)

  • Kwon, Jung-Ki;An, In-Jung;Lee, Jin-Seok;Kim, Hae-Ri;Park, Ha-Seung;Kim, Dong-Chan;Choi, Byung-Jun;Lee, Kyu-Min;Park, Yong-Jin;Jung, Ji-Youn
    • Journal of Food Hygiene and Safety
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    • v.27 no.2
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    • pp.188-193
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    • 2012
  • This study was designed to evaluate to acute oral toxicity and skin irritation of Chrysanthemum dye in Sprague-Dawley (SD) rats. SD rats were orally treated with Chrysanthemum dye at a dose of 0, 1 and 2 ml/kg body weight. After oral administration, the rats were observed for 14days. In primary skin irritation test, SD rats were dermally treated with Chrysanthemum dye and observed for 3 days. To ensure the safety of Chrysanthemum dye such as the following were observed and tested. We examined the body weight, the feed intake, the clinical signs, the ophthalmological test, the histopathological test, the mortality and skin irritation. As a result, no significant differences were found in body weight, feed intake and histopathological test between control and Chrysanthemum dye treated group. In the result of skin irritation test, Chrysanthemum dye did not induce erythema and edema after topical application. Primary irritation index was "0" in the test. Therefore, it is suggested that Chrysanthemum dye has no effect on acute toxicity and side effect in SD rats and is non-irritant material based on the score "0" of primary irritation index.

Difference of Area-based deprivation and Education on Cerebrovascular Mortality in Korea (교육수준과 지역결핍지수에 따른 뇌혈관질환 사망률 차이)

  • Sim, Jeoung-Ha;Ahn, Dong-Choon;Son, Mi-A
    • Health Policy and Management
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    • v.22 no.2
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    • pp.163-182
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    • 2012
  • This study was performed to identify the difference of the area-based deprivation and the educational level on the cerebrovascular mortality in Korea. Data used in this study was obtained from the Death Certificate Data 2000 and the 2000 Census produced by Korean National Statistics(NSO). We classified the whole country into 246 areas based on the administrative districts. Then, the Standardized Mortality Ratio (SMR) in cerebrovascular disease was calculated according to the sex, education level and 246 areas. Its Predicted SMR was calculated by the Empirical Bayes Methods to reduce the variation of the SMR values. The area-based deprivation of 246 areas were measured using the modified Carstairs index in which the 5 indicators consisted of overcrowding, the unemployment ratio of men, the percentage of households classified low social class, the percentage of non home owners, and finally those houses lacking basic amenities. The correlation between the area-based deprivation and the SMR of the whole country and the correlation between the area-based deprivation and the SMR of each metropolitan cities or provinces was analyzed by the Pearson correlation analysis method. After classifying the deprivation of 246 areas into 5 levels, we performed the random intercept Poisson regression analysis after adjusting education level and age using Empirical Bayes Method to investigate the relationship between the 5 deprivation levels and the cerebrovascular mortality. The SMR was increased in lower education level. Each 246 areas had different values in SMR, Predicted SMR and area-based deprivation. The area-based deprivation and the SMR of the whole country was not correlated in both sexes. The education level of an individual was associated the risk of cerebrovascular mortality in men. The risk of cerebrovascular mortality increased with age compared to the reference(<30). The area-based deprivation was not associated with the risk of cerebrovascular in both sexes. The findings of this study suggest that the SMR had positive and negative correlations with area-based deprivation depending on the metropolitan cities or province. It also suggests that the individual education level and age were related with mortality and finally that the area-based deprivation was not associated to the cerebrovascular mortality in Korea.

Bionomics of the Green Peach Aphid(Myzus persicae $S\H{u}lzer$) Adults on Chinese cabbage(Brassica campestris) (복숭아혹진딧물(Myzus persicae $S\H{u}lzer$) 성충의 수명과 생명표)

  • Kim, Ji-Soo;Kim, Tae-Heung;Lee, Sang-Guei
    • Korean journal of applied entomology
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    • v.44 no.3 s.140
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    • pp.213-217
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    • 2005
  • Adult development and fecundity of the green peach aphid, Myzus persicae $S\H{u}lzer$, were studied at $15{\sim}32.5^{\circ}C$ with $60{\sim}70%$ RH under 16L:8D and the results were put together to build a life table. The longevity shortened as temperatures rose at and below $25^{\circ}C$ whereas it remained relatively constant at $27.5^{\circ}C$. Total fecundity was not significantly different at all temperatures except at $30^{\circ}C$. Daily fecundity gradually increased from $15\;to\;22.5^{\circ}C$. It was 5.1 at $25^{\circ}C$ and as temperatures either went down or up, it decreased to 2.8 at both $15^{\circ}C\;and\;30^{\circ}C$. Fecundity model built from total fecundity at various temperatures suggests that $18.3^{\circ}C$ was the optimum temperature for the maximum progeny of 51. Net reproduction rate RO was highest of 36.5 at $27.5^{\circ}C$. The intrinsic rate of increase per day $r_m$ and the finite rate of increase per day $\lambda$ were highest of 0.4 and 1.6, respectively and the doubling time Dt was shortest of 1.6. Constructed life table suggests that the optimum temperature for adult development for the green peach aphid was $27.5^{\circ}C$ at which the mean generation time was 8.1.

Simulation of Pension Finance and Its Economic Effects (연금재정(年金財政) 시뮬레이션과 경제적(經濟的) 파급효과(波及效果))

  • Min, Jae-sung;Kim, Yong-ha
    • KDI Journal of Economic Policy
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    • v.13 no.1
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    • pp.115-134
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    • 1991
  • The role of pension plans in the macroeconomy has been a subject of much interest for some years. It has come to be recognized that pension plans may alter basic macroeconomic behavior patterns. The net effects on both savings and labor supply are thus matters for speculation. The aim of the present paper is to provide quantitative results which may be helpful in attaching orders of magnitude to some of the possible effects. We are not concerned with the providing empirical evidence relating to actual behavior, but rather with deriving the macroeconomic implications for a alternative possibilities. The pension plan interacts with the economy and the population in a number of ways. Demographic variables may thus affect both the economic burden of a national pension plan and the ability of the economy to sustain the burden. The tax transfer process associated with the pension plan may have implications for national patterns of saving and consumption. The existence of a pension plan may have implications also for the size of the labor force, inasmuch as labor force participation rates may be affected. Changes in technology and the associated changes in average productivity levels bear directly on the size of the national income, and hence on the pension contribution base. The vehicle for the analysis is a hypothetical but broadly realistic simulation model of an economic- demographic system into which is inserted a national pension plan. All income, expenditure, and related aggregates are in real terms. The economy is basically neoclassical; full employment is assumed, output is generated by a Cobb-Douglas production process, and factors receive their marginal products. The model was designed for use in computer simulation experiments. The simulation results suggest a number of general conclusions. These may be summarized as follows; - The introduction of a national pension plan (funded system) tends to increase the rate of economic growth until cost exceeds revenue. - A scheme with full wage indexing is more expensive than one in which pensions are merely price indexed. - The rate of technical progress is not a critical element in determining the economic burden of the pension scheme. - Raising the rate of benefits affects its economic burden, and raising the age of eligibility may decrease the burden substantially. - The level of fertility is an element in determining the long-run burden. A sustained low fertility rate increases the proportion of the aged in total population and increases the burden of the pension plan. High fertility has inverse effects.

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Early Result of Surgical Management of the Anomalous Origin of the Left Coronary Artery from the Pulmonary Artery (관상동맥-폐동맥 이상 기시증에 대한 수술의 조기 결과)

  • Yoon Yoo Sang;Park Jeong Jun;Yun Tae Jin;Kim Young Hwue;Ko Jae Kon;Park In Sook;Seo Dong Man
    • Journal of Chest Surgery
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    • v.39 no.1 s.258
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    • pp.18-27
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    • 2006
  • Background: Anomalous origin of the left coronary artery from the pulmonary artery (ALCAPA) is a rare congenital anomaly, but is one of the most common causes of myocardial ischemia which would result in high mortality within the first year of life. This is our early result of the surgical management for these patients. Material and Method: From June 1989 to July 2003, 6 patients with ALCAPA and one patient with ARCAPA (Anomalous origin of the Right coronary artery from the pulmonary artery) underwent surgical repair. We have reviewed the all medical records, electrocardiogram, chest X-ray and echocardiography retrospectively. Result: Three of the patients were boys and four were girls. The median age at the operation was 5.4 months (Range: 3$\∼$33 months). The average body weight of at the operation was 6.7 kg (Range: 3.7$\∼$11.3 kg). A mean follow up period was 18 months. Only 3 patients were initially diagnosed as ALCAPA. And 3 patients had moderate mitral regurgitation. Immediate coronary artery reimplantation on diagnosis with the aim of restoring a two-coronary system circulation was done. The average bypass time was 114$\pm$37 minutes, and the average aortic cross clamping time was 55$\pm$22 minutes. The average stay of intensive care unit was 5$\pm$3 days, the mean mechanical ventilator time was 38$\pm$45 hours and the hospital stay after operation was 12$\pm$5 days. There were significant improvements in electrocardiogram and chest X-ray of the all patients except one late death patient. The ventricular function showed almost normal recovery after operation; the EF (Ejection Fraction) increased from 41.2$\pm$ 10.3$\%$ to 60.5$\pm$ 15.8$\%$ within 1 month and to 59.8$\pm$13.9$\%$ within 1 year after operation, the SF (Shortening Fraction) increased from 23.6$\pm$4.7$\%$ to 38.6$\pm$8.4$\%$ within 1 month and to 37.4$\pm$7.9$\%$ within 1 year after operation, LVEDDI (Left Ventricular End-diastolic Dimension Index) decreased from 100.8$\pm$25.6 mm/$m^{2}$ to 90.3$\pm$ 19.2 mm/$m^{2}$ within f month and to 79.3$\pm$ 15.8 mm/$m^{2}$ within 1 year after operation. Concomitant mitral repair was done in two patients with anterior mitral leaflet prolapse. In every patient, mitral valve showed less than mild regurgitation during follow up. One late death occurred in which patient Dor procedure was applied 10 months after initial operation due to the dilated cardiomyopathy Conclusion: In the management of this rare and could be fatal Anomalous origin of the left coronary artery from the pulmonary artery (ALCAPA), early suspicion and correct diagnosis is of most important. But, after diagnosis, immediate restoration of 2 coronary systems could result in good outcome.

Effects of Methylprednisolone on TGF-${\beta}1$, Apoptosis and Renal Scarring in Experimental Acute Pyelonephritic Weaning Rats (실험적 급성 신우신염이 유발된 이유기 백서에서 methylprednisolone이 TGF-${\beta}1$, 세포고사 및 신반흔에 미치는 영향)

  • Whang, Soo-Ja;Sung, Soon-Hee;Lee, Seung-Joo
    • Childhood Kidney Diseases
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    • v.6 no.1
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    • pp.75-84
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    • 2002
  • Purpose Acute pyelonephritis of growing kidneys may result in renal scarring. TGF-${\beta}1$, inflammatory cytokine, has been suggested to play an important role in promoting renal scarring through apoptosis, suppression of cellular proliferation and fibrosis. We observed the effects of a potent anti-inflammatory agent, methylprednisolone on apoptosis and renal scarring in experimentally induced acute pyelonephritic weaning rats. Materials and Methods: To induce ascending pyelonephritis a saline solution containing Escherichia coli type ATCC No. 25922, pili- form (107 bacteria/mL) was infused into the bladder through the 16-guage silicone cannula for 48 hours to 102 three-week-old Sprague-Dawley rats (50-60g). Experimental groups were divided into three groups according to the treatment protocols, group I (ceftriaxone only, n=3l), group II (methylprednisolone+ceftriaxone n=28), control group (n=43) was not treated. Histopathologic scores of inflammatory changes, fibrosis and tubular atrophy, the apoptosis index and TGF-${\beta}1$ expression score were observed at post-infection 1 and 3 week. Datas were analysed using ANOVA test and P value below 0.05 was interpreted as significant. Results: The mortality rate ($21.4\%$) of group II was not different to the control group ($41.9\%$) and group I ($32.3\%$). The inflammatory score of group II ($0.8{\pm}0.87$) at week 1 was significantly lower than those of the control group ($2.3{\pm}0.87$) and Group I ($1.7{\pm}0.79$) (P<0.05). Apoptosis index of group II ($2.9{\pm}2.15$) at week 1 was significantly lower than those of the control group ($10.0{\pm}1.95$) and group 1 ($8.3{\pm}2.53$) (P<0.05). TCF-${\beta}1$ expression score of group II ($0.8{\pm}0.72$) at week 1 was significantly lower than those of the control group ($1.9{\pm}0.68$) and group I ($1.8{\pm}0.60$) (P<0.05). The fibrosis score of group II ($1.1{\pm}1.10$) at week 3 was significantly lower than that of the group I ($1.8{\pm}0.83$) (P<0.05) Conclusion: Conclusion Combined treatment with methylprednisolone and ceftriaxone reduced inflammation, fibrosis, apoptosis and TGF-${\beta}1$ expression in acute pyelonephritic weaning rats, compared to ceftriaxone alone. Anti-inflammatory agent supplemented to antibiotics could prevent renal scarring more effectively. (J Korean Soc Pediatr Nephrol 2002 ; 6 : 75-84)

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