• Title/Summary/Keyword: 사망의 종류

검색결과 201건 처리시간 1.827초

Foreign bodies in air passage in Children (소아의 기도이물에 관한 통계적 관찰)

  • 유장열;오경균;백만기
    • Proceedings of the KOR-BRONCHOESO Conference
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    • 대한기관식도과학회 1977년도 제11차 학술대회연제 순서 및 초록
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    • pp.8.5-9
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    • 1977
  • Foreign bodies in food and air passage, especially the latter in infants and children requires emergency treatment. The frequent symptoms are coughing, wheezing, and dyspnea, So may be confused as asthma, pneumonia and acute Laryngitis. The species and incidence of the foregin bodies are variable according to the age, method of life, environment and economic condition. The authors experienced 35 cases of foreign body in air passage during the period of last 3yrs which were treated by ventilating Bronchoscopy, and thoractomy in this hospital. One of them was lead to death. The authors analysed above cases and report with it's literature consideration. Results: 1. The prevalent foreign bodies were peanut, metal, food particles in order of frequency. 2. In frequent symptoms were dyspnea, coughing and wheezing in the order. 3. In the age incidence, 48% of the foreign bodies were 1∼5yrs. 4. In sex distribution, male to female ratio was 2.1: 1 5. In duration of lodgment, 65% of the foreign body were removed within 24hrs. 6. Most prevalent site of the foreign body was Rt. main bronchus Rt. to Lt. ratis was 2 : 1 was 7. Treatment was done; 25 cases were by ventilating bronchoscopy.

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The value and sharing of medical research data (의학연구데이터의 가치와 공유의 의미)

  • Kim, Na Won
    • Proceedings of the Korean Society for Information Management Conference
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    • 한국정보관리학회 2017년도 제24회 학술대회 논문집
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    • pp.104-104
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    • 2017
  • 연구 데이터란 과학적 연구에서 사용된 일차 자료와 연구자에 의해 직접 작성된 연구의 결과로서 수치, 문자, 이미지, 음성 등의 사실적 기록을 의미한다. 이 연구의 주제 분야인 의학은 잠재적 가치와 활용 가능성이 높고 공익적 성격을 가지고 있는 학문 분야로 의학 연구 데이터의 종류와 관리의 필요성을 통해서 그 가치와 공유 의미를 찾아보고자 한다. 또한 연구 데이터의 대표적인 임상 시험 기록과 연구 논문의 발표와 공유 현황에 대해서도 살펴보고 그 안에서 도서관의 역할이 어떤 것인가를 짚어보고자 한다. 의학 연구 데이터는 환자 진료기록, 건강 검진 기록, 임상 기록, 사망 기록, 임상 시험 기록, 유전체 정보, 연구 논문 등 그 종류와 형태가 다양하며 대용량인 경우가 많다. 의학 연구는 개인 정보보호와 윤리적인 문제 등 연구 수행 과정에서 어려운 점이 많은 성격을 가지고 있으나 질병 치료나 예방 나아가 인류의 건강과 직접적으로 관련된 학문 분야로 의학 연구 데이터의 보존과 공개, 공유를 위한 관리는 큰 의미가 있다. 의학 연구 데이터관리는 새로운 연구의 밑받침이 될 뿐만 아니라 중 저개발 국가의 연구자들에게도 큰 기회를 부여하여 세계적인 의학 발전에 기여할 수 있다. 또한 임상 시험 결과에 대한 은폐와 거짓 연구 방지에도 의미가 있어 미국뿐만 아니라 전세계적으로 학술 연구 논문 발표에 사용된 데이터는 등록하도록 규정하고 있다. 임상 시험 등록으로 공인된 사이트는 NIH의 ClinicalTrials.gov, ICTRP의 Primary Registry 등이 있으며, 우리나라에도 질병관리본부 국립보건연구원에서 관리하는 CRIS 등이 있다. 의학 연구자들은 연구의 시작부터 연구 데이터를 수집, 사용, 보존, 공유의 문제를 고려해야 하나 시간적 물리적인 문제 등으로 어려움을 겪고 있으며, 이를 지원하는 서비스는 도서관에서도 관심이 높아지고 있는 분야로 Virginia Commonwealth 대학 도서관과 Emory 대학 도서관 등에서 시도되고 있다. 이 서비스는 연구 과정에서 사서의 지원이 가능한 새로운 기회로 연구자의 데이터관리를 위한 단계별 스토리를 조직하고 DMP 작성 지원 및 교육 등을 통해서 학술 커뮤니케이션에서 새로운 역할자로 자리잡을 수 있을 것이다.

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A Clinical Analysis of Neonatal Surgical Gastrointestinal Diseases in Daegu·Busan Area (대구·부산 지역에서 수술을 요하는 신생아 소화기 질환의 임상적 고찰)

  • Son, Seung Kook;Park, Jae Hong;Choi, Byung Ho;Choi, Kwang Hae;Lee, Kyoung Hoon
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • 제7권2호
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    • pp.179-185
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    • 2004
  • Purpose: Perinatal mortality rates have been used as a summary statistic for evaluating child health and medical status. Neonatal mortality rates have decreased over the past 30 years in Korea. To understand the current status of neonatal surgical gastrointestinal diseases in Daegu Busan area, we have studied about neonatal gastrointestinal diseases with their clinical features, postoperative outcome, and mortality rates. Methods: A clinical analysis on 202 neonates who underwent neonatal surgery from January 1996 to July 2003 at Pusan National University, Kyungpook National University, Youngnam University, and Daegu Catholic University was carried out. Results: The main diseases of surgical conditions were anorectal malformation (23.8%), atresia/stenosis of midgut (13.4%) and pyloric stenosis (13.4%). The male to female ratio was 2.8 : 1. Thirty-five cases (17.0%) had one or more associated anomalies including congenital heart disease, cryptoorchidism, hydronephrosis, and chromosomal anomaly. Twenty cases (10.0%) were diagnosed by antenatal ultrasound. Patients with esophageal atresia had the longest hospitalization for 54.6 days. Postoperative complications occurred in 18 cases (8.9%). The main postoperative complications were wound infection (3.5%) and anastomotic leakage (2.5%). Overall mortality was 5.9%. Diaphragmatic hernia showed the highest mortality rate (37.5%), and esophageal atresia (28.6%) and omphalocele (20.0%) were followed. Conclusion: The current status of neonatal surgical gastrointestinal diseases in Daegu Busan area has improved because the disease categories are various, postoperative complications and mortality rates are decreased.

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Clinical Characteristics and Prognostic Factors of Severe Community-Acquired Pneumonia (중증 지역사회획득 폐렴의 임상상 및 예후 예측인자에 관한 연구)

  • Oh, Heung-Kook;Seo, Ji-Young;Kim, Dong-Kyu;Choi, Jeong-Eun;Mo, Eun-Kyung;Park, Myung-Jae;Lee, Myung-Goo;Hyun, In-Gyu;Jung, Ki-Suck
    • Tuberculosis and Respiratory Diseases
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    • 제44권5호
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    • pp.1072-1082
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    • 1997
  • Background : To characterize the clinical features and determine the prognostic factors of severe community-acquired pneumonia. This study is the first of its kind in Korea. Methods : Recruited were 40 patients diagnosed as severe community-acquired pneumonia in Hallym University Hospital from January 1, 1989 through July 31, 1996. Patients were analysed retrospectively for age, sex, underlying disease, respiration rate, hypoxemia, requirement of mechanical ventilation, involvement on chest radiograph, shock, and the serum concentration of BUN and albumin. All parameters were compared between survived and dead group. Results : Male to female ratio was 2.07 : 1. The mean age was $63.1{\pm}17.5$years(range 25~90years) with 65% of patients aged equal to or more than 60. The major underlying diseases were old pulmonary tuberculosis(12.5%), chronic obstructive pulmonary disease(7.5%), bronchial asthma(5%), bronchiectasis(2.5%), and diabetes mellitus(22.5%). Microbiologic diagnosis was made in 26 out of 40 patients(65%). The most common causative organism was S. pneumoniae(17.5%, 7/40) followed by S. aureus(15.0%, 6/40), K. Pneumoniae(12.5%, 5/40), M. tuberculosis(7.5%, 3/40), H. influenzae(2.5%, 1/40), coagulase negative staphylococcus(2.5%, 1/40), P. aeruginosa(2.5%. 1/40), E. cloaceae(2.5%, 1/40), and E. coli(2.5%, 1/40). M. pneumoniae was detected in no patient. The most frequent drugs administered in single or combination therapy were aminoglycosides(75%, 30/40), second- and third-generation cephalosporin(40%, 16/40 and 27.5%, 11/40), macrolides(27.5%, 11/40), and amoxicillin/clavulanic acid(22.5%, 9/40). Of the 40 patients, 14 died of severe community-acquired pneumonia(37.5%). Among them, seven patients (50%) expired within 72h of hospital arrival. According to multivariate analysis, mortality was significantly associated with requirement of mechanical ventilation, bilateral pulmonary involvement, and serum albumins$\leq$3.0g/dl. Conclusion : An understanding of the clinical characteristics and prognostic factors in severe community-acquired pneumonia identified in this study will optimize therapeutic approach in this disease and help decreasing its notorious mortality rate.

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Isolation and Activity of Insect Pathogenic Bacillus thuringiensis Strain from Soil (국내 토양으로부터 곤충병원성 세균인 Bacillus thuringiensis 균주의 분리 및 생물검정)

  • Kim, Da-A;Kim, Jin-Su;Kil, Mi-Ra;Youn, Young-Nam;Park, Dong-Sik;Yu, Yong-Man
    • Korean journal of applied entomology
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    • 제45권3호
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    • pp.357-362
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    • 2006
  • Bacillus thuringiensis strains were isolated from the domestic soil and a strain was selected that had a new host range and high toxicity against agriculture insect pest. The 142 samples of soil were sampled from the mountains, paddy fields and patches, in Daejon, Chungnam, Chungbuk and Jeonbuk and used for the investigation. Sixteen B. t strains were isolated from 12 samples among collected samples. There were 11 strains that showed toxical activity on Plutella xylostella (Lepidoptera: Yponomeutidae), 7 steins on Spodoptera litura (Lepidoptera: Noctuidae), 5 strains on Arete coerulea (Lepidoptera: Noctuidae), 5 strains on Culex pipiens pallens (Diptera: Culicidae) among the 16 isolated B. t strains. But there were not any strains that showed activity against Hyphanria cunea (Lepidoptera: Arctiidae) and Sitophilus oryzae (Coleoptera: Rhynchophoridae). And also some of B. thuringiensis strains showed insecticidal activity with 2, 3 or 4 kinds of insects. But there were also 3 strains that did not show any activities to the 6 insects which were used in the experiment. When examined with a phase-contrast microscope, the insecticidal crystal protein produced from 16 selected strains had 13 bipyramidal and 3 spherical shapes. The insecticidal bioactivity of the S. litura showed 100% mortality when there were $1.3{\times}10^{7}\;(cfu/ml)$ of CAB109 isolates.

Bloodstream Infections in Children with Cancer between 2005 and 2008 in a Single Center (2005-2008년 단일 기관의 소아 혈액 종양 환자에서의 균혈증 양상: 소아 혈액 종양 환자에서의 균혈증)

  • Kim, Ji Hye;Kim, Hyung Jin;Lim, Yeon Jung;Lee, Young Ho;Oh, Sung Hee
    • Pediatric Infection and Vaccine
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    • 제17권1호
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    • pp.36-48
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    • 2010
  • Purpose : In children on anticancer chemotherapy, bloodstream infections (BSIs) are a major cause of morbidity and mortality. We investigated febrile episodes and bloodstream infections in pediatric cancer patients to guide proper selection of empiric antibiotics for febrile pediatric hemato-oncologic patients. Methods : All febrile episodes treated in the division of hematology-oncology, the department of pediatrics, Hanyang University Hospital, between July 2005 and June 2008 were reviewed. Episodes with and without bloodstream infections were compared. Results : Forty cases (18.9%, 25 patients) of BSI occurred in 212 febrile episodes (63 patients). Thirty-seven cases (23.6%, 22 patients) of BSI occurred in 157 febrile episodes with neutropenia (54 patients). Microorganisms identified in BSI corresponded to 23 gram-positive bacteria (51.2%), 20 gram-negative bacteria (44.5%), and 2 fungi (4.4%). Rates of BSI between those who had received umbilical cord blood transplantation and those who had received transplantation from other source were significantly different (55.0% vs. 7.7%, P =0.001). No differences in mortality rate were observed among organisms in BSI patients. For febrile episodes the rate of BSI was higher among those with Chemoport than those with Hickman catheter (P =0.029) and gram-positive pathogens were more likely to be associated with Chemoport (P =0.001). Conclusion : The study showed the rate of BSI, distribution of pathogens with regard to neutropenia, transplantation, central venous catheters, and antimicrobial susceptibility of pathogens in order to help guide in the choice of optimal empiric antibiotics in pediatric febrile neutropenic hemato-oncologic patients.

The Use of Analgesics in the Last 24 hours of Life of Patients with Advanced Cancer : A Comparison of Medical Physicians and Surgeons (말기 암 환자의 마지막 24시간 동안 진통제 사용의 분석 : 내과의사와 외과의사의 비교)

  • Choi, Youn-Seon;Kim, Jong-Min;Lee, Young-Mee;Lim, Jong-Kuk;Lee, Tai-Ho;Hong, Myung-Ho
    • Journal of Hospice and Palliative Care
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    • 제1권1호
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    • pp.47-55
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    • 1998
  • Background : It is almost important therapy modality to control pain for the terminal cancer patients for the last 24 hours because those terminally illed patient deserved to have pain free and peaceful time before death. Physician who is deal with terminal cancer patients for their last 24 hours does not need to worry about drug addiction or other untoward side reactions of pain medications. The purpose of this study was to evaluate if terminally illed cancer patient was given pain medication properly and sufficiently and if there was any different behavior to control pain of terminal cancer patients between medical physicians and surgeons in terms of type, amount and administration route and frequency. Methods : A retrospective chart audit of analgesic type, amount and administration route was performed on the medical recorders of 160 hospitalized terminal cancer patients who had died in the Korea University Medical Center Anam Hospital during the period of July 1, 1994 to June 30, 1995. Patients were classified into 103 patients were cared for by medical physicians and 57 patients were cared for by surgeons. After then, we analysed the difference of pain control pattern between them. Different types and amount of analgesics were converted to a common standard, an oral morphine equivalents(OME) relative to 1mg of oral morphine. Results : 1) The total number of patients was 160, male 102 cases(63.8%), and the female was 58 cases(36.2%) respectively. 2) The mean age was 56.4(${\pm}14.62$) years old and mean admission period was 27.8 days(${\pm}34.85$). 3) The frequent cancer site was stomach 42 cases(26.315), lung and liver 29 cases(18.1%) each, pancreas 10 cases(6.2%) in order 4) 125 out of 160 subjects (78.13%) complained pain, and 66 out of 103(64.08%) and 31 out of 57(54.39%) were treated with analgesics to relieve pain. 50 out of 97(51.55%) were able to continue on oral medication. 5) 86 cases(53.75%) were well oriented 24 hours prior to death. 6) The frequent analgesics for regular basis were long acting form of oral morphine 34 cases(Medical phsicians 24, Surgeons 10), intravenous morphine 26 cases(Medical physicians 20, Surgeons 6) in order, and the most common p.r.n.(pro re nata) analgesics used was intravenous morphine. 7) The mean amount of analgesics on regular basis was 115.41 OME by medical physicians and 52.7 OME by surseons(P<0.05). The mean amount of p.r.n. analgesics was significantly larger in patients are for by surgeons(66.64 OME) than medical physicians 23.49 OME(P<0.01). 8) The mean frequency of administrated number of p.r.n. analgesics was 0.62 times/day on medical part and 1.88 times/day on surgical part (P<0.001). Conclusion : Of the 97 patients with advanced cancer, 51.55% were able to take oral medications in the last day of life. The parenteral analgesics were more frequently used in the patients cared for by surgeons than medical physicians. Over the half of terminal cancer patients were well oriented in the last day of life. Doctor's knowledge and attitude towards pain is very important to mange the pain, effectively.

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Analysis of Intraoral Squamous Cell Carcinoma Reconstructed with Radial Forearm Flap (전완부 유리 피판으로 재건한 구강내 편평상피암환자의 예후분석)

  • Park Myong-Chul;Soutar David S.
    • Korean Journal of Head & Neck Oncology
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    • 제10권1호
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    • pp.53-62
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    • 1994
  • 미세외과 수술에 의한 유리 피판술의 도입은 두경부 종양제거후 재건에 괄목할 만한 진보를 가져왔다. 특히 광범위한 종양의 제거가 필요하며 인근의 조직으로 수복이 어렵고 기능 및 외모상의 재건이 문제가 되는 경우 유리 피판은 절대적인 적응이 된다. 구강은 언어구사 와 연하(deglutition)기능을 담당하므로 재건을 위해서는 얇고 부드러운 조직으로 수복하여 주어야 한다. 전완부 유리피판은 혈관경의 위치가 대부분 일정하고 종양 제거후 결손의 모양에 따라 피판을 계획할 수 있기 때문에 구강암 제거후 가장 많이 이용되는 유리피판이다. 저자는 1982년 부터 1988년까지 영국 글라스고우 소재 서부 스코틀랜드 성형 및 구강외과 병원에서 구강의 편평상피암환자로 암종제거 후, 전완부 피판에 의한 재건 및 방사선 치료를 받은 151명의 치료결과(재발율 및 생존율)를 분석하였다. 절제연의 종양조직의 양성(P<0.05), 경부 임파절의 extracapsular node spread여부(P<0.001), 경부 임파절 곽청술의 종류(P<0.05) 등은 재발율과 관련하여 통계적으로 유의하였다. 반면에 종양의 구강내 위치, 하악골의 침범여부등은 통계적의의가 없었다. 생존율에 관하여는 종양의 구강내 위치 (P<0.05), 종양절제연 종양여부(P<0.005), 하악골의 침범여부(P<0.05), 경부 임파절의 extracapsular node spread여부(P<0.001) 등이 통계적으로 유의할 만한 요소로 밝혀졌다. 젊은 나이의 환자들에서(50세이하) 특징적으로 높은 사망률을 보였다. 하악골절제방법의 차이는 환자의 생존예후에 통계적으로 유의할 만한 영향을 주지 못했다.

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A Study on the Life Risk Assessment of Ship's Engine Room Fire (기관실화재 인명위험성평가에 관한 연구)

  • Han, Sang-Kook;Cho, Dae-Hwan;Park, Chan-Soo
    • Proceedings of KOSOMES biannual meeting
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    • 해양환경안전학회 2006년도 추계학술발표회
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    • pp.283-289
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    • 2006
  • This study is a preparation for the application of FSA (Formal Safety Assessment) to the fire safety of ships. FSA is the new-fashioned methodology proposed to prevent ships from the accidents. To make a base of the fire safety assessment about ship's fire protection design and Classification Society rule, statistical informations for the fire safety engineering are investigated. From results, the necessity of new criterion for ship's fire safety design, the need to study the human behavior in the evacuation from fire, and the development of new fire progress model considering special situations in ships are acknowledged.

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A Cytotoxic Comparison of Contact Lens Care Solutions on Cultured Mouse fibroblasts (콘택트렌즈 관리용액이 배양 생쥐 섬유모세포에 미치는 세포독성에 관한 연구)

  • Kim, Jae-Min
    • Journal of Korean Ophthalmic Optics Society
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    • 제1권2호
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    • pp.13-18
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    • 1996
  • In this study, contact lens care solutions were compared to each other for cytotoxic effect on cultured mouse fibroblasts by the use of neutral red(NR) assay. This study tested the cytotoxicity of 12 cleaning solutions, 2 lubricants and 5 multipurpose solutions(MPS) at 1%, 2%, 3% and 5% concentrations. These solutions are manufactured in Korea and foreign countries. The relative cytotoxic comparison of these solutions showed that some of them are toxic, three of the cleaning solutions were especially highly toxic 10 cells, so most fibroblasts were dead at 1% concentration. The toxic cleaning solutions have more components than other solutions. But both lubricants and MPSs are non-cytotoxic 10 cells. Some of these solutions did not have any descriptions or indications. They are very dangerous to eyes. From this study, contact lens care solutions should be tested for cytotoxic effects.

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