• Title/Summary/Keyword: 사망의 주요 원인

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Result of Surgical Treatment for Infective Endocarditis (심내막염 환자의 수술적 치료성적)

  • Choe, Sun-Ho;Yang, Hyeon-Ung;Lee, Sam-Yun
    • Journal of Chest Surgery
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    • v.29 no.2
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    • pp.157-163
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    • 1996
  • Between January 1986 and June 1994, 23 patients underwent surgical intervention for infective endocarditis at Wonkwang University Hospital. There were 13 male and 5 female, ran ing in age from 13 to 67(mean 43.7 $\pm$ 5.8) years. 21 had native valve endocarditis and 2 had prosthetic valve endocardits. The most common causative organism was streptococci in 9 patients, and the others were staphylococci in 7 patients and unknown in 7 patients. The infection was in the mitral valve in 10 patients, the aortic valve in 6 patients, the aortic and mitral In 5 patients, 2 in tricuspid. Surgical indications for surgery were intractable congestive heart failure, giant growing vegetation and severe valvular insufficiency. There were 3 perioperative death (13%) and no late death. The main causes of death were cerebral embolism in 2 due to recurrent endocarditis and low cardiac output in 1. By NYHA functional classification, all patients were in class III or IV preoperatively, and all patients were improved postoperatively with HYHA functional classification in class I or II. In conclussion, early operative intervention is life-salving in patients with persistent or progres ive congestive heart failure, irrespective of the activity of the infectious process or the duration of antibiotic therapy.

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Management of Patients with Rib Fractures: Analysis of the Risk Factors Affecting the Outcome (늑골골절 환자 치료: 결과에 영향을 주는 위험인자 분석)

  • Kim, Han-Yong;Kim, Myoung-Young
    • Journal of Chest Surgery
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    • v.43 no.3
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    • pp.285-291
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    • 2010
  • Background: Thoracic trauma is one of the leading causes of morbidity and mortality in developing countries. A rib fracture that is secondary to blunt thoracic trauma is an important indicator of the severity of the trauma. The purpose of study was to determine the morbidity and mortality rates and the management of rib fractures. Material and Method: We performed a retrospective study that involved all the blunt trauma patients with rib fractures, excluding those that were transferred to other hospital within 3 days, that were seen at our hospital between May 2002 and December 2008. Of the 474 admitted patients, 454 met the inclusion criteria. There were 356 male and 98 females, and their overall mean age was 53 years (range: 5~90 years). The outcome parameters included the mechanism of injury, the number of fractured ribs, the length of stay in the ICU, the Injury Severity Score (ISS), the length of the hospital stay, the pulmonary complications and the mortality. Result: The mechanism of trauma included traffic accidents in 189 (41.7%) cases, slipping down in 103 (22.7%) cases, falls in 85 (18.7%) cases, cultivator accidents in 30 (6.6%) cases, industrial accidents in 32 (7.0%) cases and assault in 15 (3.3%) cases. Intrathoracic injury was noted such as hemothorax in 269 (59.3%) cases, pneumothorax in 144 (31.7%) cases, pulmonary contusion in 95 (20.9%) cases, subcutaneous emphysema in 29 (6.4%) cases and great vessel injury in 5 (0.1%) cases. Conservative treatment was administered to most of the patients. Tube thoracostomy was administered in 234 (51.5%) cases, whereas thoracotomy was performed in 18 (4.0%) cases. The mean duration of thoracostomy was $5.2{\pm}6.2$ days. Most of the cases with rib fracture were treated in wards and their mean duration of hospital stay was $22.5{\pm}20$ days. The mean Injury Severity Score (ISS) was $14.8{\pm}10.9$ (range: 3~75). The mortality rate was calculated to be 4.8% (n=22). The main factors correlated with an adverse outcome were the number of ribs fractured, the duration of thoracostomy and pulmonary disease. Industrial insurance affected the length of hospitalization. Pulmonary contusion and the Injury Severity Score (ISS) affected the mortality. Conclusion: Rib fractures are a indicator of severe injury. Because of the complication and associated injuries, we believe these patients should be admitted for evaluation and treatment. Recent studies on the impact of rib fractures after blunt trauma have shown that patients as young as 40 years of age demonstrate increased morbidity and mortality with similar injuries as compared to that of older patients. The ISS and pulmonary contusion influenced the mortality rate. Patients with isolated rib fractures should be hospitalized if the number of fractured ribs is one or more.

System Error during Information Transmission (정보전달에 있어서 System error)

  • 신승헌
    • Journal of the Ergonomics Society of Korea
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    • v.1 no.2
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    • pp.39-42
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    • 1982
  • 과거의 많은 사고를 분석해 보면 정보전달에 어떤 결함이나 불비가 원인이 되어 사고가 발생한 예가 많다. 그 예로서 정비작업이 끝나기도 전에 전원을 넣어서 기계가 작동하여 정비원이 기계에 휘말려 사망했다던가, 공항에서 이륙태세를 취하고 있던 항공기가 소음때문에 관리관의 목 소리를 전부 듣지 못하고 이륙 OK 라고 생각하여 이륙동작을 하다가 다른 항공기와 충돌한 사고 등이 있다. 인적원인으로 되는 사고에서는 system error와 human error로 구분할 수 있다. system error는 인원의 부족, 순서의 불비, 통신의 불비와 같은 system의 구성요소가 적절하지 못하거나 충분하지 못한 때에 발생하는 error이다. 이에 반하여 human error는 system의 순서나 설계에서 미리 정해진 권동에 반대가 되는 인간의 행동 때문에 발생한다. 지금까지 human error에 의한 사고로서 결말을 지웠던 것도 그 원인을 깊이 추구해가면 생각 밖의 system error였던 예가 적지 않다. 그러므로 여기에서는 주로 정보전달과정에서 system의 불비로 인하여 발생하는 error에 대하여 고찰한다.

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A Critical Review of Political Conspiracy in Korea (한국정치에서 음모론과 선거의 연관성: '장준하 사망', '광주민주화운동', '천안함 침몰'을 중심으로)

  • Chung, Tae-Il
    • Korea and Global Affairs
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    • v.1 no.1
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    • pp.7-30
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    • 2017
  • The conspiracy theories of political events are occurring in every country and society. In Korean society, conspiracy theories about political events are constantly happening. Conspiracy refers to the phenomenon of a particular individual or group who oppose the official causes of social phenomena. Conspiracy is a resistance to the credibility of the state and the government. In Korean society, conspiracy occurs mainly in political events. The conspiracy theories of political events appear in the form of conservatism and progressivism, which seeks to replace political power and political power to stabilize political power. The conspiracy theory about Jang Jun-Ha's death occurred in the process of seeking justification for a person who is resisting the ruling forces. Also, the conspiracy theory of the Gwangju Democratization Movement and the Cheonan Warship Sinking may be a drag on the justification for the justification for the takeover of the new military government and the justification for the Disconnection of inter-Korean relations. In Korean politics, Conspiracy theory is a factor that confuses Korean society regardless of whether it is true or not.

Type A Aortic Dissection with Aortocaval Fistula -Report of 1 case- (대동맥-상대정맥루를 동반한 A형 대동맥 해리증 수술 치험 -1례보고-)

  • 김흥수;양승인;정성운;김종원;이형렬
    • Journal of Chest Surgery
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    • v.35 no.8
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    • pp.599-604
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    • 2002
  • Acute or chronic aortic dissection may lead to the rupture, which is the major cause of death. A dissecting aneurysm of ascending aorta(Stanford type A dissection) can rupture into the superior vena cava producing a aortocaval fistula, which is rare, but has been reported mostly in the cases of abdominal aortic aneurysm. We report a case of 67-year-old man with type A chronic dissection and aortocaval fistula, presenting symptoms of superior vena syndrome. The preoperative diagnosis was composed of radiologic examinations, including computed tomography, magnetic resonance imaging angiography and aortography. The dissecting aneurysm was resected and replaced, and the aortocaval fistula was repaired under deep hypothermic circulatory arrest. The details are described here.

노인의 항산화 영양상태와 만성질환 및 면역기능과의 관련성 연구

  • 김미정;김정희
    • Proceedings of the KSCN Conference
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    • 2004.05a
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    • pp.392.2-394
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    • 2004
  • 최근 우리나라는 노인인구가 급격히 증가되고 있고, 주요사망원인이 만성퇴행성 질환으로 이동하고 있다. 노화는 산화-환원의 균형이 깨져 산화 촉진쪽으로 반응이 진행되어 일어나며, 이러한 산화적 스트레스의 증가는 당뇨병이나 고혈압과 같은 만성질환의 유병율을 높이고, 또한 면역기능에도 영향을 미친다. 그러므로, 노화 억제 및 만성질환의 예방을 위한 항산화 영양소의 건강증진 효과에 대한 연구가 매우 중요하다. 따라서 본 연구는 우리나라 노인들의 항산화 영양상태를 평가하고, 만성질환 중 유병율이 높은 당뇨병, 고혈압에 따른 항산화 영양상태와의 관련성 및 노인들에게서 감소하는 것으로 알려진 면역기능과의 관련성을 조사하기 위해 3차에 걸친 연구를 수행하였다.(중략)

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노인용 심혈관계질환 관리 영양교육 자료 및 프로그램 개발

  • 신은미;강현주;김경원
    • Proceedings of the KSCN Conference
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    • 2004.05a
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    • pp.396.2-397
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    • 2004
  • 심혈관계질환은 노인층에서 유병율이 높고 주요한 사망 원인으로, 균형된 식생활 등 생활습관의 변화를 통해 미리 예방하고 관리함이 중요하다. 본 연구에서는 심혈관계 질환 관리를 주제로, 노인과 50세 이상 중년층을 위한 영양교육 프로그램과 교육 자료를 개발하고 영양교육을 실시하였다. 우선 lesson plan을 작성하고 이에 따라 영양교육 자료(소책자, 리플렛)의 내용을 구성하였으며, 수차례의 수정, 보완을 거쳐 교육 자료의 초안을 마련하였다.(중략)

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건강검사에서 가장 받고 싶은 것은 간기능 검사

  • KOREA ASSOCIATION OF HEALTH PROMOTION
    • 건강소식
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    • v.14 no.9 s.142
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    • pp.34-37
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    • 1990
  • 생활이 복잡다단해지면서, 사람들의 건강문제 특히 성인병의 문제는 한층 심각하게 다가오고 있으며 그만큼 사람들의 건강에 대한 관심도 증대되었다. 그럼에도 불구하고, 건강관리를 위한 검사를 정기적으로 해보겠다는 생각을 가진 사람은 의외로 적다. 건강관리협회가 ‘89년에 이어, 본회 내원자 500명을 대상으로 실시한 설문조사를 통해 이러한 결과를 알 수 있었는데, 이번 설문조사에서는 특히, 사람들이 매스콤을 통해 여러 차례 알려진 주요사망원인과 관련된 질환에 대해 많은 관심을 가져 매스콤의 국민건강에 대한 역할을 실감케 해 주었다.

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A Study on the Management of Non-Communicable Disease in Fiji (피지에서의 만성병 관리)

  • Kim, Daeseon;Romakin, Pablo;Rafai, Eric;Lee, Chulwoo
    • Journal of Appropriate Technology
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    • v.6 no.2
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    • pp.163-173
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    • 2020
  • For the successful execution of an ODA project, it is necessary to know what areas are weak and necessary to the country of demand exactly. The health sector is also a top priority in most of developing countries. This study was carried out to introduce non-communicable disease (NCD) in Fiji for ODA projects planning. The major causes of death in Fiji in 2016 are diabetes, ischemic heart disease, cerebrovascular disease, chronic kidney disease, lower respiratory infect, asthma in ranking. The major causes of death in Korea in same year are cancer, ischemic heart diseases, cerebrovascular diseases, pneumonia, suicide, diabetes in the order of ranking. The chronic disease as non-communicable disease (NCD) has been increasing continuously due to changes in lifestyle and consumption patterns and population aging in prevalence rate. This global trend is also apparent in Fiji and Korea, reflected in increasing mortality and personal costs for the treatment and management of NCD. The need for a sustained comprehensive treatment tailored for individual patients has suggested from many studies and the development of a systematic program to manage NCD patients to provide such care have been recommended. The Fiji government developed Non-communicable Diseases Strategic Plan 2015-2019 and has tried to reduce the prevalence rate of non-communicable diseases by factors. The WHO global action plan guiding national-level NCD policies requires an NCD prevention and control model at the community level, presenting strategic goals and detailed options for the introduction and application of the approach to communities. It is necessary to develop an NCD prevention and control model, consisting of a strategy of community intervention, education for students and NCD patients, and the legal enactment of NCD that adequately meets the needs of community members.

The Clinical Experience of The Descending Thoracic and Thoracoabdominal Aortic Surgery (하행대동맥 및 흉복부 대동맥 수술의 임상적 경험)

  • 조광조;우종수;성시찬;최필조
    • Journal of Chest Surgery
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    • v.35 no.8
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    • pp.584-589
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    • 2002
  • Background : The thoracic and thoracoabdominal aortic surgery is a complicated procedure that has various method of approach and protection. The authors have performed several methods to treat these diseases. Therefore, we attempt to analyze their results and risks. Material and Method: From June of 1992 to August of 2001, we performed 26 cases of thoracic aortic surgery and 10 cases of thoracoabdominal aortic surgery. There were 17 aortic dissections, 17 aortic aneurysms, one coarctation of aorta and one traumatic aortic aneurysm. The thoracic aortic replacement was performed under a femorofemoral bypass, an LA to femoral bypass, or a deep hypothermic circulatory arrest. The thoracoabdominal aortic replacement was performed under a femorofemoral bypass or a pump assisted rapid infusion. Result: There were 7 renal failures, 11 hepatopathies, 7 cerebral vascular accidents, 2 heart failures, 5 respiratory insufficiencies, and 2 sepsis in postoperative period. There were 9 hospital mortalities which were from 2 bleedings, 2 heart failures, 2 renal failures, a sepsis, a respiratory failure, and a cerebral infarction. There were 3 late deaths which were from ruptured distal anastomosis, cerebral infarction, and pneumonia. Conclusion: Deep hypothermic circulatory arrest was not good supportive methods for thoracic aortic replacement. Total thoracoabdominal aortic replacement was a high risk operation.